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New Guidance Allows for More Personal Visits at Long-term Care Facilities in New Jersey

Guidelines allowing for visitations at long-term care facilities in New Jersey during the coronavirus pandemic were revised that will result in increased interactions between residents and their loved ones. 

The New Jersey Department of Health (NJDOH) is adopting federal guidance for visitation in long-term care facilities which allows for indoor visitation at all times regardless of the vaccination status of the resident or visitor—except for a few circumstances where visitation should be limited due to high risk of coronavirus transmission.

“We know that some residents are suffering from the impact of social isolation (due to) being apart from their families for so long,” said Gov. Phil Murphy at a press briefing March 22. “It’s (been) tough on everybody, certainly on the residents but also on their families.”

New Visitation Rules

Fully vaccinated residents can choose to have close contact—including touch and hugs—with a visitor if both the visitor and resident are wearing a well-fitting face mask. Compassionate care, essential caregiver, end-of-life visitation, and outdoor visitation can be permitted even when indoor visitation is otherwise restricted because of COVID-19 transmission.

“As the Spring holidays approach, we know it is essential for the health and well-being of long-term care residents that they visit with their loved ones,” said NJDOH Commissioner Judith Persichilli. “The significant drop in outbreaks and the increasing vaccination rates are hopeful signs for residents, families and staff that allow us to adopt the federal guidance from the Centers for Medicare and Medicaid.”

According to the guidance, if the COVID-19 Activity Level Index (CALI score) is high or very high and less than 70% of the residents of the facility are fully vaccinated, indoor visitation should be limited for unvaccinated or partially vaccinated residents.

Indoor Visits

Indoor visitation of unvaccinated residents can take place regardless of CALI score if 70% of the residents in the facility are vaccinated—currently, 367 facilities in New Jersey meet that criteria. Additionally, indoor visitations are limited for residents under quarantine or have a confirmed coronavirus infection until they have met criteria for release from quarantine.

“The overriding principle that we are working under is that we recognize that families need to be able to be together, especially when so many have been kept apart for so long,” said Murphy. “With both Passover and Easter coming up, we know especially that this is a time of year when families gather. We expect all of our long-term care facilities to work with us; not just with us but with their residents and the families of those residents to allow for visitations under these new guidelines.” 

New Cases Modifications

The guideline mandates when a new coronavirus case among residents or staff is identified, a facility should immediately begin testing and suspend visitation until at least one round of facility-wide testing is completed. 

If the first round of outbreak testing reveals no additional coronavirus cases in other areas, then visitation can resume for residents in areas with no coronavirus cases; visitations are to be suspended in the affected areas until the facility meets the criteria to discontinue outbreak testing. 

But if the first round of outbreak testing reveals two or more coronavirus cases in the same area as the original case, but not in other areas, visitation can resume for residents in areas with no coronavirus cases.

Visitations for all residents is suspended if testing reveals one or more additional coronavirus cases among resident and/or staff in other areas until the facility meets the criteria to discontinue outbreak testing—no new cases in residents or staff identified for 14 days since last positive case.

Long-term Care Overview

Health officials noted 237 long-term care facilities are currently reporting at least one case of COVID-19, accounting for a total of 8,940 of the cases, broken down between 4,196 residents and 4,744 staff. 

Cumulatively, 1,300 long-term care facilities reported a case since last March infecting 32,461 residents and 21,381 staff, for a total of 53,842 cases. 

The state’s official death total sits at 7,978 on March 23. The facilities are reporting to the state 7,845 residents deaths and 143 staff deaths.

New Vaccination Push

Additionally, state officials announced a new initiative to vaccinate long-term care staff and residents and to offer education/outreach and vaccination to staff who have been hesitant to get vaccinated.

“Vaccination among residents is high, however only about half of long-term care staff have chosen to get vaccinated,” said Persichilli. “A new outreach effort is underway to offer education and vaccination.”

This initiative will provide direct access to the COVID-19 vaccine for staff and residents who were not vaccinated during the three on-site clinics as well as newly admitted residents and new staff. In addition, long-term care staff and residents are eligible statewide and can access vaccines on their own anywhere with appointments in the state.

Vaccine Distribution

The number of COVID-19 vaccines administered in New Jersey totaled 3,560,502 as of March 23. Of those who have received the vaccine, 2,367,495 residents have received their first dose with 1,259,736 receiving their second dose or the one jab Johnson & Johnson dose; 49% have been administered the Moderna vaccine, 49% the Pfizer vaccine and 2% the Johnson & Johnson vaccine. 

Demographically, 57% of those vaccinated are women and 43% men. As for ethnicity, 59% are White, 11% unknown, 11% other, 7% Asian, 7% Hispanic and 5% Black. In regards to age of those having received the vaccine, 40% are 65 years old or olders, 28% are between the ages of 50-64, 23% are between the ages of 40-49, and 8% are between the ages of 18-29.  

In North Jersey, Bergen County has delivered 409,031 doses, Essex 273,512 doses, Morris 265,573 doses, Hudson 178,681 doses, Passaic 158,649 doses, Sussex 55,622 doses, and Warren 36,086 doses. 

Daily Data

As of March 23, the cumulative number of confirmed coronavirus cases in New Jersey was 770,980 with 3,429 total new PCR cases reported. There were 971 probable cases, bringing the cumulative total of antigen tests to 102,860. The total number of individual cases for the state is 873,840. Gov. Murphy previously noted there is some unknown overlap due to health officials urging those taking a rapid test to get a PCR test.

As for those that have passed, the state reported 61 new deaths, bringing that total to 21,727. The state listed probable deaths at 2,515, bringing the overall total to 24,242. State officials noted 28 deaths occurred in the last 24 hours of reporting that have not yet been lab confirmed.  

For North Jersey counties on March 23, Bergen had a total of 362 new confirmed cases and 108 probable cases, Essex 311 new cases and 80 probable cases, Hudson 344 new cases and 98 probable cases, Morris 187 new cases and 40 probable cases, Passaic 174 new cases and 62 probable cases, Sussex 57 new cases and 28 probable cases, and Warren 61 cases and six new probable cases.

State officials documented 389 cases of the UK variant, seven cases of two California variants, three of the Brazil variant and one South African variant. Additionally, there are 65 cases of the New York variant, considered “of interest” by the Centers for Disease Control.

Of the total confirmed deaths in North Jersey, Essex County has the most with 2,478, followed by Bergen at 2,412, Hudson with 1,889, Passaic at 1,579, Morris at 928, Sussex at 214 and Warren County at 199.

In regards to probable deaths reported March 17, Bergen has 288, Essex has 282, Morris has 238, Hudson has 197, Passaic has 189, Sussex has 65 and Warren has 25.

State Testing 

As for the rate of transmission, it remained unchanged from the day before at 1.09. The daily rate of infections from those tested as of March 18, was 8.5%; by region, the rate was 8.3% in the North, 8.5% in the Central region and 9.0% in the South. 

Officials reported 2,066 patients were hospitalized; by region, there were 1,012 in the North, 647 in the Central and 407 in the South. Of those hospitalized, 433 are in intensive care units and 234 on ventilators. A total of 185 patients were discharged, while 330 were admitted.

Officials have continually cited transmission rate, hospilizations, intensive care units, ventilators and positivity rate as health data they rely on to track how the coronavirus is being contained in New Jersey, guiding them in determining when restrictions have to be tightened or lifted.

Bergen Tops County Count

Bergen has the most confirmed cumulative cases in the state with 76,870, followed by Middlesex at 74,235, Essex at 73,978, Hudson at 69,777, Monmouth at 58,347, Ocean at 57,461, Passaic at 56,318, Union at 53,085, Camden at 42,066, Morris at 36,489, Burlington at 33,311, Mercer at 28,085, Gloucester at 22,678, Atlantic at 21,516, Somerset at 20,769, Cumberland at 12,884, Sussex at 9,096, Warren at 7,272, Hunterdon at 7,153, Salem at 4,568, and Cape May at 3,998.  

In regards to probable cases, Bergen had the most at 10,478, followed by Union at 8,959, Ocean at 8,158, Essex at 7,454, Hudson at 6,992, Monmouth at 6,619, Morris at 6,543, Middlesex at 5,979, Passaic at 5,746, Atlantic at 5,689, Camden at 5,254, Burlington at 5,130, Somerset at 4,791, Cape May at 3,940, Gloucester at 3,363, Cumberland at 2,166, Mercer at 1,861, Sussex at 1,548, Warren at 789, Hunterdon at 687 and Salem 474.

Another 1,027 cases are still under investigation to determine where the person resides.

In regards to cases related to in-school transmissions, a total of 188 outbreaks involving 890 cases have been reported, with 28 new outbreaks accounting for 125 cases in the weekly update on March 17. 

For North Jersey, Bergen County has 42 confirmed outbreaks with 172 cases, Passaic County has 11 confirmed outbreaks with 40 cases, Sussex has eight confirmed outbreaks with 21 cases, Warren has eight confirmed outbreaks with 20 cases, Morris County has five confirmed outbreaks with 34 cases, Hudson County has four confirmed outbreaks with 21 cases, and Essex County with one confirmed outbreak with 92 cases.

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