[music]

Brian: Brian Lehrer, WNYC. After COVID cases across the country appeared to be hitting a plateau, new infections are slowly starting to creep up again nationwide. The state with the most cases per capita right now, New Jersey. Though things aren't anywhere near where they were last spring or this past January, to be clear. These recent setbacks in the battle against the Coronavirus have raised the all too familiar questions about the pace of the states reopening and vaccination disparities. As governor Phil Murphy put it last Wednesday, we are not where we want to be in terms of equity.

With me now to make sense of where New Jersey is at this stage of the pandemic, are Karen Yi WNYC and Gothamist reporter covering New Jersey and Dr. Stephanie Silvera, epidemiologist at Montclair State. Karen, hi, and Dr. Silvera, welcome to WNYC.

Karen: Hi, thanks for having me.

Brian: Karen, your story in Gothamist last week is, headline, "Why COVID-19 is surging in New Jersey, but flat in New York." Is there a simple answer to that question?

Karen: There is not, of course. There are some things that we know to be true. We know that the variant is circulating. There's at least 500 cases confirmed with the variant in New Jersey, mostly the UK and now the New York variant. We know there's this feeling that we've crossed the finish line with good news as more and more people getting vaccinated. It's warmer, at least the last few days have been, people want to go out. They're tired of the lockdown, but all those things also apply in New York. I think one of the differences that we saw is that when you look at vaccine disparities, they're very, very pronounced in New Jersey.

7% of the doses have gone to the Latinx, Hispanic community, 5% to the Black community. When you have infections rising over all across the state, these are the groups that have not only been most hard hit throughout the pandemic. They're also the least likely to be protected. I think it's a complicated answer and we still don't have all the answers, but I think it says something that New Jersey is leading the country and New York is fourth right now in terms of cases per 100,000 residents.

Brian: Dr. Silvera, help us understand the numbers and what they actually mean or don't mean. I'm looking at the New York Times' New Jersey COVID tracker. They update it every day and for cases they have a 21% increase in cases over the last two weeks. For hospitalizations, they have a 10% increase in hospitalizations over the last two weeks, but for deaths they have a 35% decrease in deaths over the last two weeks. How do those three things fit together?

Dr. Silvera: I think there's a few things that are happening here. One, we know that hospitalization and deaths are both lagging indicators, so it's not that you get tested today and then you're automatically hospitalized or die within a week. If cases are starting to go up now, deaths usually lag by about a month or possibly more, so even though those numbers are going down now, as cases start to increase, we may in a month from now start to see those numbers of deaths increase. That said, we also know that we've got much better at treating COVID cases and so there are fewer deaths.

We have monoclonal antibodies, for example, that are doing a significant and important job and keeping people from dying. The other thing that I think is really important to note is that consistently the age group that has been most likely to transmit the disease, ages 20 to 49, are the group that for the most part are not eligible to be vaccinated yet. It's possible that we're seeing some of those cases being driven by transmission from young adults.

Brian: Karen, from your reporting, where are cases surging most rapidly? How precisely can you pinpoint them geographically?

Karen: I think we can see they're really surging in Monmouth and Ocean counties, but also in some of the denser counties in New Jersey, Hudson and Essex. I know Hudson and Essex have recently put in a request for more vaccines, particularly Hudson, which for the last few weeks has administered the least number of vaccines per population. I think part of it is supply, how many vaccines are going to these counties, which they say isn't enough, but also access. I was talking to the Hudson County Deputy Administrator and he was saying that the mass drive through vaccine site in Hudson is drive-through and requires a QR code.

That's already a barrier to some people who may not have cars and who may not have a smartphone to put up their QR code, but he says that's the quickest way to do these vaccinations in mass. You see Hudson with high infection rates and also lowest vaccination rates. I think there's something interesting there.

Brian: New Jersey listeners, we can take your calls on the state of the pandemic in the garden state with Karen Yi, WNYC reporter covering New Jersey and Dr. Stephanie Silvera, epidemiologist at Montclair state University. Help us report this story about the surgeon cases and the persistent disparities or ask a question. 646-435-7280. Dr. Silvera, in addition to more mobile sites and ones that don't need things like QR codes, what other tools, in your opinion, should New Jersey be deploying right now to make sure people in the most affected communities can get vaccinated?

Dr. Silvera: I think one thing that we tend not to do as well is really engage with local community leaders to better understand what exactly all of the barriers are. I think we tend to think we know what the challenges are and then react to those assumptions, but we can always do a better job of listening to the communities. There's been a lot of talk, for example, about vaccine hesitancy, but I haven't heard a lot of discussion about the impact of the past four years of anti-immigration rhetoric, for example, and how that has an impact on immigrant communities feeling safe, going online, if they have access to wifi or smartphones, and then inputting their demographic information.

I think we need to acknowledge that there are likely far more reasons for those numbers being low than we're even currently aware of. I think the only way to do that is really to deeply engage with a lot of those communities.

Brian: I'm looking at the New York Times case count map by county, and it's one of these color coded maps where the deeper red it is the higher the new case concentration in the last week. It looks like the two hotspots are Monmouth County, just south of the city, and Sussex County, all the way in the northwest. Does that make sense to you, Dr. Silvera? How would you start to explain that perhaps?

Dr. Silvera: I think when we're looking at the maps what we need to think about is also where people are traveling, whether it's for work or whether they're gathering. In Monmouth County, for example, people may be traveling into New York city, taking public transportation. How they're behaving in those counties. I think when we're thinking about also the more rural counties, it's not surprising that they're maybe getting hit later on. We saw this as well with the 1918 pandemic, where communities that thought that they were relatively safe because they weren't as population dense were hit later on in the pandemic.

Brian: Karen, new groups become eligible for the vaccine today, right, in New Jersey?

Karen: Today is a big day. People who work in grocery stores, restaurants, food, production, warehouse, hospitality. This is something that we've been waiting for. It's a big group of people, a lot of essential workers. Then next week, April 5th, a lot more essential workers and everyone 55 plus is eligible. Press is also eligible starting April 5th, but you also have laundry people who are working in laundromats, dry cleaning, librarians, higher education, sanitation. Slowly widening that pool. The governor has said that he fully expects to be able to open vaccine eligibility to all adults by May, which is the deadline that the president has set.

Brian: I can't believe the laundromats and dry cleaners didn't become eligible until now. They stay open all this time. They're these close, tight spaces for the most part, they're taking in people's clothing to clean. Many, many immigrant run dry cleaners and laundromats from exactly the communities that have been hardest hit. Just my shout-out for the laundry and dry cleaning places and those folks. Penny in Tom's River, you're on WNYC. Hi Penny.

Penny: Hi there Brian, first-time caller.

Brian: Glad you're on.

Penny: Thank you. What I'm curious about in what the doctor's take is on this. I live in Ocean County, New Jersey, which also borders Monmouth, which you just mentioned there being high rates of infection. When I go on like the local patch where there's neighbor conversations, I'm just so appalled at the mindset of the people who live in my area against vaccinations, about their rights being infringed upon. Then they just had this maskless protest at the freehold mall on Saturday. I haven't heard anything about what happened but the Patriot Party put up this thing on Facebook encouraging people to go to the Freehold Mall last Saturday en mass. I'm just curious how do we fight that? Obviously they don't listen.

Brian: Who wants it first? Karen, how about you?

Karen: I had heard about this protest. I haven't followed up to see what happened or how many people showed up but that is concerning. There was actually a poll, a Stockton University poll, either last week or two weeks ago that looked at vaccine hesitancy and vaccine access. It found these racial and ethnic disparities we were talking about that Blacks and Hispanics want a vaccine but don't can't find a way to get it. Also, interestingly, it found that about 50%, 52%, I'm forgetting the number of Republicans said they were not likely to get the vaccine.

Brian: Especially Republican men, particularly likely to say no.

Karen: Right. This was in New Jersey. Specifically, I don't know how much that is playing into it. Maybe Dr. Silvera can speak to it. That's a concern moving forward, especially as more things open up.

Brian: Dr. Silvera, you want to add to that?

Dr. Silvera: I would just add that it's unfortunate but not surprising. When we talk about who is most likely to seek those opt out for vaccines for themselves or their children, they actually tend to be people with higher socioeconomic status. People who are able to work through the system to avoid getting vaccines. I think this is the very unfortunate result of what is now decades of this growing anti-vaccination rhetoric that is largely based on, I hate to even call it science, but junk science at best. Science that has been refuted and discounted and retracted, quite frankly. I think we tend to rely on education to try to help people understand.

I'm a data person. We tend to use data, but I think very often people don't change their behavior unless it impacts them directly, unfortunately, or through storytelling. I think we need to do a better job of telling the stories of people who've been really significantly impacted. Karen's been doing a great job of that and really sharing the stories and making it real for people.

Brian: Listeners, some of you will remember the Karen was just on the program last week talking about her amazing reporting about how Latino men under 50 make up such a high proportion of the under 50 cases in New Jersey and the under 50 deaths. Dr. Silvera, there is another group. We've been talking about the white Republican men as now the leading hesitancy group according to these polls and statistics. There is another thread that I keep seeing in the press, which is about healthcare workers, of all people, refusing the vaccines at a high rate. They of course were being offered the vaccines in so many of these instances right in their workplace and were offered them first.

There was another one today, I forget which news organization, but about people who work in nursing homes where 100% or so of the nursing home residents are accepting the vaccines but maybe 50% of the healthcare workers. They themselves tend to be from at risk communities. How do you explain that and how do you fight that?

Dr. Silvera: Again, I think that actually goes back to the long-term issue of vaccine hesitancy in terms of government mistrust. If you're in populations of color who've been historically discriminated against, I think it's really difficult to then suddenly ask people to trust the government in distributing vaccines. I think, for example in New Jersey, there was this idea to target the J&J vaccine to Black and Latinx communities, which on the surface seems like a great way to increase vaccination rate and decrease disparities but it also sends the message that there's one vaccine for one group and different options for different people.

It plays into some of that mistrust and hesitancy issues. I think that as we move forward and we make sure that visible people, leaders in the community are getting vaccinated, and that the same people from those communities are offered the vaccine, we'll start to see a shift. I think it's going to take quite a bit of time. I also think that we generally need to do better in health literacy in this country and teaching it at younger and younger ages because most people don't understand the research process and how clinical trials work and how drugs go through the process of getting approval.

Brian: Karen, on the anti-vax Patriot Party demonstration in the Tom's River area, my producer tells me there's also a gym in New Jersey that's offering free memberships to anti-vaxxers and anti maskers. Apparently, specifically to people who are refusing the vaccine as a response to Krispy Kreme, which some of you have heard, the doughnut place, offering free donuts to vaccinated people. Unbelievable that there would be that ideological war of free services. Let's go to another call Twila in Union City. You're on WNYC. Hi Twila.

Twila: Hi, this question is really for the medical profession. I have an eight year old and our family's trying to make the decision on whether or not to put him in school. My fear is that although they will be six feet apart, there's A, not enough information. We don't know if the teachers are being vaccinated or not. More so, the numbers are climbing and so these children may be completely asymptomatic coming into the schools and then my son comes home with this virus. That's a real concern for me. I just feel like sometimes we're rushing to open things up for economics but at a very, very real risk not just to the adults but also to the children.

I just don't know how to make that decision because it doesn't seem like there's enough information being told on the protocol, first of all. Beyond just not enough information for the protocol, I just don't know how to make that decision if the numbers keep climbing.

Brian: So many parents are struggling with this decision. Dr. Silvera, we have about a minute and a half left in the show. Can you help Twila with some advice? I'm sure a lot of other parents will be hanging on it too. Do you have an opinion about the pace of opening up in general, opening up businesses, which is sometimes a different decision than opening up schools?

Dr. Silvera: Absolutely. What I will say that to help ease your mind a little bit is that children 11 and under seem to be less likely to transmit the virus. The likelihood of an eight year old contracting the virus and bringing it home and transmitting it to you is much less than if you had a child who was 12 years old or older. The older the child, the more likely they are to transmit. I think that what you need to ask your school when making this decision is what is the compliance with mask wearing. Are students and teachers wearing them consistently and correctly? What is the ventilation like in the school? Are they able to keep windows open? Can they ensure six feet?

I know some schools are now moving to less than six feet. Then I think at the end of the day you need to look at what your own risk factors are within your home. How likely are you to contract the virus or be susceptible to it? Then I think you make the best decision you can as a parent from that point. I will share that I have one child who is fully virtual and one that is hybrid because of the risk factors at different schools and within my own family. In terms of are we opening up too soon? I think with the increase in variants and particularly the South African and Brazilian variant which are circulating now in some of our hardest hit communities Hudson, Essex, Union and Camden, I think that those communities need to be particularly careful about how quickly we reopen.

We know that particularly for those two variants, you're more susceptible even if you've been exposed to a different variant because of the slower immune response. I think we do need to really step back and think about how quickly we want to reopen.

Brian: Obviously we'll keep covering this daily, folks. Dr. Stephanie Silvera, epidemiologist at Montclair State. Thank you so much and WNYC's Karen Yi. Brian Lehrer on WNYC.

Copyright © 2021 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.