N.J. Had a Plan to Fight a Pandemic, but State Leaders Didn’t Know It Existed When COVID Hit

They had a strategy.

Years before people in New Jersey started dying from COVID-19, the state Department of Health had a plan in place on how to respond to the next big pandemic.

But according to a new report on how the state handled the outbreak, released on Monday, it did not appear that anyone was aware that the 2015 plan even existed when they needed it most.

Paul Zoubek, a former assistant state attorney general who led the years-long $9 million report of the state’s COVID response through his law firm of Montgomery McCracken Walker & Rhoads, working with Boston Consulting Group, said it would have been helpful for more senior leadership to be familiar with it.

“It projected and anticipated some of the things that happened,” Zoubek remarked, although downplaying its impact somewhat, blaming the lack of information about the pandemic and how it spread as the bigger problem.

Having a viable plan of action on a shelf gathering dust, though, was just one of the issues highlighted in the 910-page report that had been commissioned by Gov. Phil Murphy.

The report said there were “meaningful gaps in New Jersey’s level of planning and preparation” that could have been avoided. The state also had to start from scratch in creating the needed authorizations for the emergency response — which included more than 200 Executive Orders and more than 100 waivers to suspend regulations during the emergency period. That cost precious time and effort and caused agencies and health facilities to “scramble” to give services, the report said.

In addition, the report called for the state to create plans for a wide set of emergencies that match the level of detail recommended in the 2015 Pandemic/Flu plan, and then practice them.

“New Jersey should start by updating plans for cyber emergencies and bioterrorism incidents,” the report said.

New Jersey also needs to ensure all levels of government have agency-specific plans that are all integrated — something that was lacking at the start of the pandemic, the report said. The state should make sure all agencies know such plans exist.

That was not the case with the 2015 pandemic response plan, which was sparked by a series of serious worldwide outbreaks that potentially threatened the public’s health.

In 2003, another novel coronavirus, Severe Acute Respiratory Syndrome, or SARS, was identified, becoming the first pandemic of the 21st Century, the report noted. Originating in the Guangdong province of China, SARS spread to 29 countries, infected 8,098 people, and killed 774 of them. Despite the fear it would spread, it was not seen much in this country, although outbreaks of West Nile Virus, Ebola, Zika, and Mpox would follow.

According to the report, the Ebola scare in particular prompted the state Department of Health to take additional steps to prepare for a public health emergency, and in September 2015 the Division of Public Health Infrastructure, Laboratories & Emergency Preparedness published the Pandemic Influenza Plan referenced by Zoubek.

While the plan focused on a generic influenza pandemic, many of its warnings and assumptions proved prophetic for the coming COVID-19 pandemic.

“Indeed, the plan warned that, in an influenza pandemic, outbreaks would most likely occur simultaneously throughout much of the U.S., preventing shifts in human and material resources that usually occur in response to other disasters,” the report noted, adding that the effect on individual communities would be prolonged.

“Healthcare systems could be rapidly overburdened, economics strained, and social order disrupted,” that plan said, adding that “New Jersey’s geographic and demographic characteristics make it particularly vulnerable to importation and spread of infectious diseases, including influenza.”

And that’s exactly what happened when COVID struck.

The 2015 pandemic plan relied on several assumptions based on previous flu pandemics, including that no vaccines would be available for at least 6 months and then there would be limited quantities available periodically; that there would be a large number of hospitalizations and deaths; and medical supplies would be limited.

Those assumptions were confirmed during the COVID-19 pandemic, the report said.

Even before COVID, the health department did not sufficiently exercise or review the plan. And neither the department nor leadership in the governor’s office turned to the plan for guidance as COVID-19 infections soared.

State Assemblyman Brian Bergen, R-Morris, said that should never have happened

“If there was a playbook out there and they didn’t use it, then shame on them. Shame on them. That makes it even more awful,” Bergen said.

He added that the state has not done anything to make itself more prepared, other than commissioning the review of its response.

“I was in the military and after every mission. you look at lessons learned and apply them to next time. We should do that so we can be better in every way possible if God forbid this ever happens again,” Bergen said. “The worst thing about all this is that we haven’t done anything to be more prepared. That’s the biggest takeaway.”

Democratic state Sens. Joe Vitale, Joe Cryan, and Gordon Johnson in a joint statement said the report offered many lessons and recommendations that make for an early blueprint to ensure the state is not “caught off-guard and ill-equipped in future health emergencies, and to make sure our response is better coordinated to save more lives.”

But more alarmingly, they said the authors found that four years after the onset of COVID, “our state is not moving swiftly enough to prepare our defenses for a future pandemic or other health crisis.”

The state still has not updated its pandemic/flu plan to reflect the lessons learned from the COVID-19 pandemic, according to the report.

Neither the governor’s office nor the health department immediately responded to requests for comment. But in a statement on Monday, Murphy said the report highlighted both “numerous examples of New Jersey’s strong leadership during the crisis, and identifies gaps in preparedness and structural deficiencies that must be addressed.”

Who’s in charge?

In its recommendations, the COVID response report released Monday called upon the state to update its pandemic plan, which needs to be clear about who is responsible for what roles. While the governor designated the Office of Emergency Management and the Health Department as co-leads to the pandemic response, the distinct responsibilities of each were confusing at first, the report said.

While state Health Commissioner Judith Persichilli and New Jersey State Police Superintendent Col. Patrick Callahan were able to work together to build a collaborative and dynamic response effort, the report said the effectiveness of emergency response should not be left up to specific individuals.

“Had the leaders of any of these agencies become ill, collaborated poorly, or been `territorial’ about response effort and responsibilities, New Jersey would have lost more lives and suffered more economic damage,” the report stated.

It called upon the state to regularly train and exercise emergency plans.

“Plans are of limited benefit if they are not the subject of regular training and exercises,” the report said. “Not only are these critical to ensure that staff are aware of the contents of emergency plans, but they are also the most effective ways to determine if the plans are sufficiently comprehensive and effective.”

It recommended mandated emergency training during leadership transitions while calling for a permanent Office of Preparedness within the state Attorney General’s Office that would have oversight and auditing responsibilities, including verifying that emergency preparedness plans “exist and are actionable.”

Finally, the report said the state Legislature should pass a new law that requires New Jersey to have sufficiently comprehensive and updated emergency preparedness plans.

Zoubek, in a press briefing on Monday, said all the officials his team met with were acting in good faith on information that was available at the time.

“It’s our fervent hope we can all come together like we did after 9/11 to better prepare for the next crisis — because there is going to be another one at some point,” he said. “We don’t want to answer the question from our grandchildren as to why we were not better prepared.”

NJ Advance Media writer Brent Johnson contributed to this report.

Our journalism needs your support. Please subscribe today to NJ.com.

Karin Price Mueller may be reached at KPriceMueller@NJAdvanceMedia.com. Follow her on X at @KPMueller.

Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio.

Ted Sherman may be reached at tsherman@njadvancemedia.com. Follow him on Twitter @TedShermanSL.

©2024 Advance Local Media LLC. Visit nj.com. Distributed by Tribune Content Agency, LLC.