With the holidays now passed, the worst of the season’s viral ‘tripledemic’ may be behind us, experts say, but still expect a continued rise in hospital admissions and deaths from COVID-19 – although not near the levels seen in past years. 

Influenza arrived early last fall so that its impact overlapped with respiratory syncytial virus, or RSV, more than usual, driving up demand for over-the-counter remedies and health care services in New Jersey and nationwide.  

COVID-19 also remains a constant presence here and elsewhere, with new diagnoses and hospitalizations rising more quickly since Thanksgiving.   

State health officials said predictive modeling suggests that COVID-19 will continue to actively spread through mid-January, a trajectory now considered an annual pattern. But while hospitalizations – considered the most accurate measure of the virus’ impact – shot up from around 1,000 at the start of December 2021 to over 6,000 on Jan. 11, 2022, experts don’t think that will happen again. 

“I am feeling comfortable that we will not likely be as bad as we were last year,” said state medical director Dr. Edward Lifshitz, who heads the health department’s communicable disease service.  

Lifshitz said none of the COVID-19 variants now circulating appear to be as transmissive as the omicron strain that devastated the nation last winter. “But unfortunately, there is a lot of virus out there,” he said. “And people are still going to get sick and some will be hospitalized, and unfortunately some of them are going to die.”  

When it comes to COVID-19 hospitalization numbers, “last year we went up on an elevator; this year we’re kind of going up a staircase,” Lifshitz continued, “and we’re not seeing suggestions that the number of cases are likely to overwhelm hospitals now.”  

COVID-19 hospitalizations were trending upward most of last year and the state’s 71 acute care facilities have been treating more than 1,000 patients daily since early October, state data show. By the first week of January 2023, there were 1,600 hospitalizations statewide. During the first winter of the pandemic – before treatments or vaccines were widespread – hospmaskitals were treating more than 2,500 COVID-19 patients in mid-November, but the census never topped 4,000. 

“Yes, the hospitals are still under significant stress,” Lifshitz said. “They’ve been under a lot of pressure for the last couple of years.”  

Since March 2020, some 2.5 million infections have been reported in New Jersey – an undercount given the popularity of home testing, the results of which are not required to be reported – and more than 145,000 people have been hospitalized with the virus. At least 25,600 New Jerseyans are likely to have died from COVID-19, the state reports.  

The state medical examiner’s office has certified at least a dozen deaths daily since early December, a rate Lifshitz notes would normally seem shocking. “If this was day 1 of COVID and we were talking about ten or 20 deaths a day,” he said, “it would be a major cause of concern in the state. But people have become so used to it.”  

Dr. Eddy Bresnitz, a former state epidemiologist who served as a special advisor to the health department for the first year of the pandemic, agreed hospitalizations will continue to rise this winter, while not at the dramatic rate seen last year.  

“I would predict we are going to continue to see this [increase in cases] for a number of weeks,” he said, “particularly with the fact that so many of the factors that potentially prevent COVID-19 are no longer in play.”  

State officials have continued to encourage vaccination, especially the reformulated booster shot released last fall, which Lifshitz called “the best possible protection you can have.” But uptick remains limited, with less than 18% of New Jerseyans having had the new shot by the end of 2022, state officials said. Most people here have some natural immunity from the original vaccine series – which nearly 8 in 10 residents received – or from disease, Lifshitz said. “Immunity is not absolute,” he added, but comes in degrees and wanes over time. 

Rising COVID-19 hospitalizations are also being driven by the fact that people are out mixing more, Bresnitz said, and not just for the holidays. Use of masks and other public health precautions has dwindled, increasing the threat for viral spread – including flu, RSV and common colds. “On top of all that you’ve got constantly changing strains,” he said, like the highly transmissible variant now sweeping the northeast.  

Bresnitz said there are some positive trends in the data, including indications that the worst of RSV is behind us, especially for children. Flu cases also appear to be trending downward now, although viral activity remains high throughout the state and nearly 76,000 New Jerseyans have been diagnosed, according to the most recent report from late December, and at least three children have died.  

“If there’s any potentially good news it is that it looks like the flu has basically peaked and is now coming down a little bit from that peak,” Bresnitz said, something that’s good news for struggling hospitals.  “Even though we’re in this novel confluence of three viral respiratory diseases, they’re not exactly peaking at the same time, which is why the hospitals are handling things as well as they are.”  

Gov. Phil Murphy has said he does not see a current need for more statewide public health restrictions, some school districts are stepping up precautions after the holiday break. Camden and Paterson have reinstituted mask mandates. “I don’t want kids to be out. I don’t want teachers to be out. I want everybody to be in for in-person instruction,” Paterson superintendent Eileen Shafer said early last week. The requirement is “not forever,” she said, but will remain until viral levels recede some.  

Lifshitz urged residents to continue their own COVID-19 precautions, including tracking local spread. His team releases weekly reports showing viral activity, based on federal data, with the most recent from late December showing 15 of the state’s 21 counties experiencing “high” levels of disease and the other six listed as “moderate” COVID-19 spread. People should also use masks indoors when in groups, be mindful of more vulnerable individuals, stay home when sick and wash their hands regularly, he said.   

“We need to learn to live between compliance and panic. People should be able to live their lives on the one hand,” Lifshitz said, “and on the other hand not be at the point where they’re just, ‘Oh, I’m over this,’ and they basically ignore it.”  

Living a normal life and staying safe “are not completely incompatible,” he added. “You can be quite safe by taking reasonable precautions.”