Here's when COVID may peak in New Jersey. It could be earlier than initially expected

Ashley Balcerzak

If most New Jerseyans wear masks, avoid gatherings and keep 6 feet away from others, the Garden State could see the second wave of COVID-19 cases peak as soon as Dec. 14, and the highest hospitalization count for COVID patients on Jan. 1, according to the state's moderate modeling predictions. 

Daily infection counts could peak at 5,466 in two weeks, and about 4,984 people could be in the hospital on New Year's Day, according to four-month predictions from the Office of Innovation provided to The Record and

That's an earlier peak than was predicted by modeling in October, which anticipated that a second wave would not peak until March 2021 in both a moderate and a worst-case scenario. 

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If the current modeling is accurate, New Jersey's second wave would have more known cases than the first wave, last March and April, when testing was scarce and the peak hit 4,391 on April 16. But more than 6,200 were hospitalized with the virus at the end of April — 1,200 more than the predicted peak during the second wave. 

On Wednesday, New Jersey reported 3,287 people hospitalized with the virus, and 4,350 new cases. New Jersey's new cases per capita is the 30th-highest rate in the country, according to the latest White House Coronavirus Task Force report. As of Tuesday, the state's hospitals still had capacity: 68% of ventilators were available and 33% of ICU beds were open, according to the New Jersey Hospital Association. 

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The governor's office predicts that cases and hospitalizations will climb in the wake of Thanksgiving and remain high around Christmas. The numbers could begin to fall as COVID-19 vaccines are rolled out to high-priority groups at the beginning of the year. The virus cases would then drop more sharply around the beginning of March, as vaccines become more widely available to the public. 

“I am really hopeful ... we're hoping we hit the plateau pretty soon,” said Dr. Daniel Varga, chief physician executive for the Hackensack Meridian Health system. “The rate of rise this time has not been as rapid. We’ve done a real good job at the state level and facility level of protecting our nursing homes. Doctors are doing a great job of taking care of patients. We’re getting people in and out of the hospital. When you’re discharging 10 to 15 percent of your COVID patients in a day, that’s great.”

New Jersey health officials and statisticians run multiple models a day to predict when hospitals will see the biggest surge in cases, so administrators can understand if their hospitals have enough medical staff, equipment and beds to accommodate all the patients who need them. The numbers can easily shift as the data or assumptions change — such as how well New Jerseyans follow social distancing guidelines. 

The moderate modeling scenario assumes a rate of transmission of between 1 and 1.2 in December, which means that an infected person could spread the virus to at least one other person. An ideal rate of transmission is below 1, meaning cases would decline. The model then assumes a transmission rate between 0.95 and 1.05 in January, and between 0.9 and 1.02 in February. After March, the model assumes a consistent rate of transmission below 1.

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But Health Commissioner Judy Persichilli warned in mid-November, "If people are not vigilant, it could be worse."

"That means we would exceed 8,300 hospitalizations, 2,300 critical care; we would be worse than April," Persichilli said, referring to worst-case predictions. "I cannot encourage people enough to understand how their behaviors — each one of us  — our behaviors can manage that."

Persichilli said the factors that go into these models include new cases, hospitalizations, average length of stay, admission, discharges and — "most important" — behavior by the public. 

"We make assumptions about social distancing, masking," Persichilli said.

At the start of the year, the state assumed in its modeling that about 30% of residents would adhere to wearing a mask in public. It turned out about 50% followed that guidance in the spring.

"If we go back to 50%, we expect a peak at the end of the year and a very busy January and February, but not as high as it was in April," she said.

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Also in the mix will be New Jersey's vaccine rollout. The state predicts it will have enough Pfizer doses to vaccinate 130,000 people by the end of December, and enough Moderna vaccine doses to inoculate 100,000 more residents shortly after. 

While the country will have a shortage of supplies through January, New Jersey estimates the state will start getting around 1.1 million doses a month and should have enough supplies to "meet the overall general population demand" by April or early May, Persichilli said. 

The first to receive vaccines will likely be health care workers, long-term care staff and residents, and other essential workers. 

But residents should not relax their mask-wearing or social distancing just because vaccines may soon be available, Persichilli warned. 

"I don't think it's going to work right away," Persichilli said of the vaccines, saying it is still unknown how long the antibody buildup in people who receive the vaccine will last. "I’m concerned for the next six months."

Models can shift based on the latest data and how well New Jerseyans follow public health guidelines and state restrictions.

In early October, the governor's office models showed two scenarios for the second wave: a worst-case future with more than 12,000 people hospitalized at once, and a "moderate but realistic prediction" having fewer than 1,200 people in the hospital at once during the most crowded time. The latest projection falls in the middle. 

Staff Writer Lindy Washburn contributed to this article.

Ashley Balcerzak is a reporter in the New Jersey Statehouse. For unlimited access to her work covering New Jersey’s Legislature and political power structure, please subscribe or activate your digital account today.


Twitter: @abalcerzak