Adding Up the Hidden Figures of COVID

Governor Murphy, First Lady Tammy Murphy, Lieutenant Governor Sheila Oliver, Whoopi Goldberg, Essex County Executive Joe DiVincenzo, Reverend Melvin Wilson, and the Office of East Orange Mayor Ted Green participate in a “Grateful for the Shot” Vaccination Event in East Orange on Friday, May 14th,

New Jersey recently lost the dubious distinction of having the highest per capita COVID death rate in the nation to the state of Mississippi whose extraordinarily low vaccination rate and lack of a mask mandate helped feed the devastating Delta variant.

Mississippi, now closing in on 10,000 virus deaths, is registering 315 COVID deaths per 100,000, as opposed to New Jersey, approaching 28,000 fatalities, or 306 per 100,000, largely a consequence of the first several months of the pandemic before we had a vaccine.

To get a sense of just how abysmal these numbers are, consider that ranks our two states, a blue union state that fancies itself progressive, and a red state that was the cradle of the confederacy, we are both global standouts. And in both states, the legacy of generations of systemic racism and lack of access to regular healthcare meant that people of color were the most vulnerable to COVID.

According to Johns Hopkins that puts both states well above Brazil, the world’s hardest hit, at 281.29 per 100,000 followed by Argentina that reports 255.52 per 100,000. The United States, as a whole, ranks fourth on the planet at 209.32 per 100,000, only slightly less deadly than Mexico at 215.33.

In contrasting the latest stats from Mississippi and New Jersey you see the arc of the tragic American COVID experience that was so avoidable. Our blind partisanship has short circuited the ability of the states to learn from each other as our COVID death toll blows past the 675,000 lost during the 1918-21 Spanish Flu pandemic.

Mississippi, a year and half plus into the pandemic is seeing an exponentially higher death count and hospitalization rate than New Jersey.

While Mississippi has one of the lowest vaccination rates in the nation, under Murphy’s leadership, over two thirds of our state is fully vaccinated.  Mississippi’s vaccination rate is hovering just over 43 percent.  Gov. Murphy, unlike his Republican counterpart in Mississippi, has also been a universal mask mandate advocate when it comes to our state’s schools.

Incredibly, former Assemblyman Jack Ciattarelli, Murphy’s Republican opponent, wants to eliminate the K-12 mask mandate, which aligns him with Mississippi Gov. Tate Reeves, as well as Florida Gov. Ron DeSantis, and Texas Gov. Gregg Abbott, all Republicans.

Several months into President Biden’s presidency, we remain a badly fractured nation where the COVID seven-day average for daily death count is over 2,000 a day, something we haven’t seen since March. That’s two thirds of the number of Americans that died on 9/11 in the terrorist attacks each and every day.

Even as we close in on 45 million infections, and the reality that as many as 25 percent of those infected will have long term healthcare consequences of varying severity, we are being hobbled by the threat of a federal government shutdown over whether or not to extend the debt ceiling.

Despite the tangible progress we have made in New Jersey battling COVID, we still have yet to come to terms with just how vulnerable communities of color were and remain. Accelerating wealth inequality and longstanding healthcare disparities impacts hundreds of thousands of New Jersey residents of color. Add in that cohort there are the undocumented who served as frontline essential workers throughout the pandemic.

Back in April of 2020 Gov. Murphy signed legislation mandating that all of the state’s hospitals report the age, ethnicity, gender and race of everyone infected.  .

“Understanding the impact of COVID-19 by demographic groups is critical to ensure equity in our response to the virus,” said Murphy in a press statement back at the time.  “We must do everything we can to protect the most vulnerable in our state during this unprecedented crisis. This data will inform our effort and allow us to make sure that no one is left behind.”

“Decades of systemic poverty, lack of sufficient healthcare and chronic unemployment in our communities, especially black communities, lends to the increased risk of coronavirus hitting residents living below the poverty line harder than others,” said one of the bill’s leading sponsors, Assemblywoman Verlina Reynolds-Jackson, in a press statement after the bill was signed.

Yet, more than a year after that bill was signed, COVID subject matter experts following closely New Jersey’s efforts to document the racial disparities revealed during the pandemic, say the state’s COVID data collection and dissemination efforts have gaps and need improvement.

According to Dr. Laura A. Sullivan, the director of Economic Justice for the New Jersey Institute for Social Justice, the New Jersey Department of Health’s dashboard that provides the cumulative COVID-19 deaths  and hospital discharge data for the state’s municipalities is “not accurate” and hasn’t been updated since April.

“Looking at the data of cases by municipality there does seem to be some information that is not accurate and hasn’t been updated since April 8,” Sullivan said. “One of the reasons that we think the localized information by race and ethnicity in communities is so important is so that tailored approaches to the pandemic can be developed and implemented. Using the best data possible is the way to make sure that people in the most vulnerable communities of color get their needs met which is really important because of the disproportionate impact we have already seen on them.”

According to the NJDOH municipal data on the website, while there were 8,752 Black residents who had a case of COVID, 24.6 percent of all the cases in the city, the site reports only three died, or 4.3 percent.

All totaled, the site indicates just 69 people died of COVID in Newark, with the Asian cohort accounting for 37 of that number, or 53.6 percent of that total on the NJDOH Newark “cumulative” chart.

The NJDOH chart for Montclair lists 10 Asian COVID deaths which the site purports to be 100 percent of the community’s COVID cumulative deaths.

In Irvington, the NJDOH lists 280 deaths, 234 Hispanic, 16 Asian, four Black and no white virus deaths.

A closer examination of all of 20 Essex County municipalities on the NJDOH website, last updated back in April, indicates Essex County had close to 2,200 COVID deaths including 1,150 Hispanic, 479 Asian, 447 “other”, 83 “unknown”, 59 Black and 15 white.

According to USAFacts.org, as of Sept.24, Essex County had 3,041 COVID deaths, the highest county total in the state.

In the NJDOH municipal data there are  eight municipalities (Caldwell, Cedar Grove, Essex Field, Fairfield, Glen Ridge, Roseland, South Orange and Verona) the website says had ten or fewer COVID cases and they were “redacted to protect the privacy of New Jersey residents.” Combined, these communities have just over 73,000 residents in a county with a population of 863,000.

Dr. Brittany Holom-Trundy, a senior analyst for New Jersey Policy Perspectives, says that after a “slow start” documenting the demographics of the pandemic, New Jersey has “generally done very well” in ramping up its data collection and is tracking this kind of data “more than some other states.”

“It is always going to be challenging when it’s the case that we rely on hospitals, rely on facilities, to report that racial and ethnic data,” Holom-Trundy said. “If you look at the percent of cases and deaths that we actually accounted for with racial and ethnic data they are not actually covering all of the data.”

The NJ Policy Perspective senior analyst points to years of public health program cuts at both the federal and state level as handicapping agencies to respond effectively as the virus spread.

“Health disparities in the COVID-19 pandemic spotlight the long-standing inequities that permeate the health care system,” wrote Holom-Trundy, in October of 2020. “Though the pandemic has been undeniably devastating throughout the country, the impact on Black and Latinx communities outpaces that on other populations.  Nationally, Black and Latinx residents have been three times more likely than white residents to contract COVID-19 and nearly twice as likely to die from it. These patterns are also reflected at the state level.”

Holom-Trundy continued. “The Garden State’s population, while increasingly diverse, still sees the impact of structural racism in its housing and occupational divides. Past redlining practices have resulted in the segregation of neighborhoods and schools, with many Black and Latinx families living in densely populated metro areas with segregated school districts.”

And, as the New Jersey Policy Perspective analyst rightly observed, it was our state’s residents of color that made “up over half of employees in essential, or ‘frontline’ industries, including grocery stores and pharmacies; trucking, warehouse, and postal services; cleaning services; public transportation; health care; and childcare and social services.”

In that essential worker mix in New Jersey are hundreds of thousands of undocumented workers and their families that Holom-Trundy maintains are vulnerable to COVID, and the most apprehensive about getting the vital medical care that most New Jersey residents take for granted.

“Overall, we really do need to build toward universal healthcare because, as we saw during the pandemic, the first people hit by the pandemic, particularly one involving a virus as contagious as this, will be the essential workers, many of whom are undocumented,” Holom-Trundy said. “They are on the frontlines, yet they don’t have access to insurance and aren’t going to go to the doctor if they start feeling unwell because of the potential medical bills that come with them being uninsured.”

Sadly, though we are in the midst of a gubernatorial campaign, these are not likely to be the kind of issues that Murphy and Ciattarelli will debate Tuesday. As the issues we face, like the pandemic and global warming, loom ever larger, our politics continues to shrink, increasingly captive to the small minded.

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