It’s too soon to consider COVID-19 an endemic disease in New Jersey, and misinformation about the coronavirus and our options for protection continue to put people’s lives at risk.
That was the consensus among the four health care professionals who joined NJ Spotlight News on Wednesday for a virtual roundtable, “Living with COVID: from Pandemic to Endemic.” The panelists included Dr. Eddy Bresnitz, a former state epidemiologist; Dr. John Bonamo, executive vice president with RWJBarnabas Health; Dr. Denise Rodgers, a vice chancellor at Rutgers University, and Camden City School District nurse Robin Cogan.
The conversation — preceded by a short keynote address by Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute — also touched on the COVID-19 response in public schools, where masks are no longer required, and the state’s ability to monitor the viral spread. Panelists discussed how COVID-19 treatment has vastly improved over two years, while accessing the latest options remains a challenge, and how it is too soon to know if we will need another booster dose of vaccine this year.
Here are edited excerpts from the event:
Dr. John Bonamo on the shift from pandemic to endemic:
“I don’t believe we’re in an endemic phase yet. I think perhaps we have declared that too soon because we are hopeful to be there … I worry about (the impact of) celebrating too soon on people not doing the things that we know are helpful because even in an endemic phase of the disease, people still get sick or people still die … But now we have to live with managing that (risk), and declaring (the pandemic) over too soon is a great way to have it become unmanageable again.”
On keeping each other safe: “We think that people should not forget about hand hygiene, not forget about social distancing, not forget about source protection (like avoiding infected individuals) and masking — all those things that worked before will continue to work. And as far as families, they have to make some personal decisions … If there’s going to be a large family gathering (and) if people have the capability, they ought to be tested before, or perhaps they should be tested before and after. If they have the capability of doing that, that’s just that extra level of protection.
“And there are people who, of course, would never do that because they refuse to believe this is as serious as it is… But there are a lot of people who are doing things like that. And thank God for those people, because they’re keeping a lot of other people safe by having that high index of suspicion.”
Dr. Denise Rodgers on communication challenges:
“We have the perception that we’ve turned the corner (from pandemic to endemic). So it’s going to be even more difficult to do contact tracing because people are like ‘Oh, we’re over this’ and ‘We really don’t need to be as vigilant.’
“I’m listening to our conversation and realizing that there are a number of people who are in our audience who think we are exaggerating, who think that we’re just sort of, more of the ‘Chicken Little, the sky is falling.’ That’s one of the biggest difficulties for us doing this work, from a public health and a preventive health standpoint. We don’t have a common set of facts anymore. And the data is very clear about how serious this disease is. Yet I certainly hold myself somewhat responsible — as a person who’s spent my career working in communities — at what seems to be my relative inadequacy at being able to help people understand what this data means and what the facts are. And that COVID is something that we must continue to take very, very, very seriously.”
On COVID-19 in children and misinformation: “I think this is one of those areas where people have difficulty with ambiguity and uncertainty, because it is true that children, by and large, don’t do as badly as adults (who have higher COVID-19 death rates and especially) seniors with underlying chronic illness. On the other hand, there are a number of children who sadly die, but also children who get complications from COVID. And there’s some evidence that maybe as much as 10% of (infected) children get long COVID.
“We don’t have a good way of talking to families about that, because you certainly don’t want to overestimate the deaths so that people are just terrified for their children. But you also want to put into perspective that this is not a completely benign disease for all children. …There’s a tremendous amount of disinformation and misinformation about (COVID) vaccinations, and it’s compounded by the fact that we’ve had decades of misinformation about childhood immunizations … We just had a tremendously difficult time getting that nonsense out of the public view. We do need to continue to put (the risk) into perspective, but also educate families about the importance of vaccinating their children.”
Nurse Robin Cogan on child and school safety:
“Children are facing increasing risk, especially as we’re now abandoning mask mandates and the vaccination rates have stalled. I think it’s really concerning. I think it’s important to have the conversation of ‘Are we ending these mask mandates way too soon?’ or ‘We don’t know what’s happening with this new variant.’…Children under five are not even eligible for the vaccine. All of these reasons actually are part of the rationale of why Camden City School District and other urban school districts have decided to continue universal masking, because we need to protect everyone. We need to make public spaces safer for everyone.
“New Jersey residents and our children deserve to participate in school life and public life. But we also have immunocompromised children in school. We have children under five that are not yet eligible for the vaccine. We have, you know, adults in our buildings that are immunocompromised. We looked at all of the reasons in our particular community to keep universal masking in place until we have more specific metrics about when it is really safe to drop the only protective measures that we have.
“School really should be considered a congregate setting. We spend so much time there to gather in large groups. While we don’t sleep there, we certainly spend the bigger chunk of our day at school. And so, to be able to attend school safely and safely receive the most important services that we know kids need (including) learning, certainly nutrition, health care, all the things that we provide at school, we are looking at continuing the universal masking as a protective measure.”
Dr. Eddy Bresnitz on a fourth COVID-19 vaccination:
“There’s a lot of interest in (a fourth dose). And right now, there has not been a (federal regulatory) recommendation for another booster dose. We don’t really know when that should be given. We don’t know what the durability of that dose might be. Pfizer filed yesterday with the FDA for emergency use authorization to administer a fourth dose in an older population and they’re basing their data on a couple of studies in Israel …I think both studies are suggesting for the benefit of a fourth dose, but I wouldn’t base policy in the U.S. on these studies from Israel, frankly, and I think, particularly in the current environment where we have so little disease, because you can’t keep on boosting everybody every three or four months, that’s not a good public health approach.
“And then there’s the question of whether the vaccines that we’re using (will) continue to be effective against subsequent variants. And we don’t have any idea about that. So there are a lot of unknowns about when the booster dose, the fourth dose or a second booster, might be appropriate. We’re just not there yet, but it will be discussed by the FDA and their advisory committee, I believe, next month.
“Vaccines are the foundation for our preventive measures… But the bottom line is that there is a significant proportion of the population, not just in New Jersey, but around the country, maybe more so now in some other states, that refuse to get vaccinated and no one will ever convince them they should get vaccinated unless maybe they get sick and survive.”
Additional resources:
- “Emerging from COVID-19: An Action Plan for a Healthier State,” white paper referenced by Linda Schwimmer.
- Centers for Disease Control and Prevention
- American Academy of Pediatrics’ Healthy Children website
- New Jersey Department of Health’s COVID-19 dashboard
- Believe in a Healthy Newark, a nonprofit organization
- PBS Kids COVID-19 Resources for Parents
- Child Mind Institute: COVID & Kids’ Mental Health
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