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Warren County, New Jersey COVID-19 Report 6/24/20

Warren County COVID-19 Cases at a Glance

The first case of COVID-19, caused by novel coronavirus (SARS COV-2) in Warren County was identified on March 17,

2020. Since then, cases have been identified in all 22 municipalities.

As cases are reported to the Warren County Health Department, they are investigated as quickly as possible. Cases are

interviewed about their symptoms, risk factors, and close contacts, including their place of employment and coworkers

when applicable. Beginning April 24, the case definition for novel coronavirus expanded to include “probable” cases;

these cases must fit certain epidemiologic and clinical criteria and most often, they are untested, symptomatic house-

hold contacts of lab-confirmed COVID-19 cases. In most cases, these probable case will not be confirmed by laboratory

results. Advice is given to all confirmed cases regarding their own self-isolation and investigators notify close contacts

of their risk and advise them on 14-day quarantine measures.

Information on recoveries is self-reported or reported by a case’s doctor or residential facility.

419 (35%) of COVID-19 cases are residents of

Long-Term Care Facilities (LTCFs); 8 facilities total

Heat Map: Known Covid-19 Case Counts

by Municipality as of 6/17/20

Known COVID-19 Cases by Municipality Warren County, NJ as of 6/24/20

Municipality Confirmed

Cases Confirmed LTCF Cases

Probable Cases

Known Recoveries

Allamuchy 33 7 5 18

Alpha 23 0 2 10

Belvidere 28 0 3 22

Blairstown 19 0 1 13

Franklin 17 0 0 13

Frelinghuysen 85 79 2 19

Greenwich 59 0 6 50

Hackettstown 126 44 9 76

Hardwick 13 0 3 11

Harmony 14 0 0 8

Hope 16 0 4 15

Independence 30 0 7 23

Knowlton 11 0 2 10

Liberty 17 0 3 14

Lopatcong 281 199 7 126

Mansfield 126 56 1 80

Oxford 7 0 1 6

Phillipsburg 133 2 12 97

Pohatcong 24 0 3 15

Washington Borough 55 0 12 38

Washington Township 45 0 10 31

White 59 32 4 36

Total: 1,221 419 97 731

Click the map to view online

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Warren County, New Jersey COVID-19 Report 6/24/20

Epidemic Curves

There are now 1,221 confirmed COVID-19 cases in Warren County. An average of 2.5 new cases per day have been re-

ported in the past 7 days. On June 19, a new outbreak was identified in a congregate living setting which has contribut-

ed to the recent rate of increase.

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Warren County, New Jersey COVID-19 Report 6/24/20

Probable Cases

Beginning April 24, the case definition for COVID-19 adopted by the New Jersey Department of Health was expanded to

include “probable” cases; these cases must meet certain clinical and epidemiologic criteria in order to be classified as

such. Most commonly, an untested, symptomatic household member of a lab-confirmed case is now classified as a

“probable” COVID-19 case. WCHD is conducting retrospective case-finding to identify older “probable” cases. Expand-

ing this definition will allow us to have a fuller understanding of the overall number of illnesses during this pandemic. A

summary of the new case definition is listed below.

Confirmed

• Meets confirmatory laboratory evidence (Detection of SARS-CoV-2 RNA in a clinical specimen using a

molecular amplification detection test)

Probable

• Meets clinical criteria* AND epidemiologic evidence** with no confirmatory laboratory testing per-

formed for COVID-19.

*Clinical criteria include: at least two of the following symptoms [fever (measured or subjective), chills, rigors, myal-

gia, headache, sore throat, new olfactory and taste disorder] or at least one of the following symptoms [cough,

shortness of breath, or difficulty breathing

**One or more of the following exposures in the 14 days before onset of symptoms [Close contact with a confirmed

or probable case of COVID-19 disease]

Please refer to the Council for State and Territorial Epidemiologists (CSTE) Position Statement for the full case definition

adopted by New Jersey Department of Health.

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Warren County, New Jersey COVID-19 Report 6/24/20

COVID-19 Cases—Non-LTCF Residents vs. LTCF Residents

Currently, 34% of Warren County’s COVID-19 cases are residents of Long Term Care Facilities (LTCFs).

The chart below plots newly reported non-LTCF resident COVID-19 cases and LTCF resident COVID-19 cases. The re-

porting of new non-LTCF resident COVID-19 cases appears to have peaked in early to mid April; our local LTCFs have

conducted facility-wide testing in different intervals, which introduces challenges in interpreting the data. It does ap-

pear, however, that the LTCF peak period spans the last two weeks of April. Beginning May 26, 2020, all LTCFs were

mandated to conduct facility-wide testing, including staff. Therefore, we anticipate that our facilities will add addition-

al cases in the following weeks; some of these cases may be out-of-county/out-of-state staff members who are not

counted in the Warren County case totals.

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Warren County, New Jersey COVID-19 Report 6/24/20

COVID-19-Related Deaths

There are now 145 deaths among confirmed COVID-19 cases reported to WCHD; 118 of those individuals were resi-dents of long term care facilities. It is important to note that while LTCF residents represent 34% of Warren County COVID-19 cases, these residents also make up 81% of COVID-19-related deaths.

Self-Reported COVID-19 Case Recoveries

WCHD follows up with all investigated cases to assess their recovery. Recoveries are generally self-reported, but infor-mation on recoveries is also provided by care providers and long-term care facilities.

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Warren County, New Jersey COVID-19 Report 6/24/20

Descriptive Statistics

The table below shows a summary of descriptive statistics for Warren County COVID-19 cases and COVID-19-Related

deaths. The chart below, right shows that 22% of all Warren County COVID-19 cases have required hospitalization,

including 5% ICU care.

Descriptive Statistics for Confirmed COVID-19 Cases Warren County, NJ

All Cases Total COVID-19-Related Deaths

Mean Age 610 83

Median Age 60 85

Min Age 4mo 41

Max Age 102 102

Case Count 1221 145 (81% LTCF residents)

Male 39% 39%

Female 61% 61% *WCHD has collected complete hospitalization data for 81% of cases so far

Testing Rates

As of June 23, WCHD has received 7155 SARS COV-2 test results; 17% (1,204) positive and 83% (5951) negative. The

figure titled “Percent Positive SARS COV-2 Test Results” (below, right), shows that daily percent positivity among War-

ren County residents’ tests is beginning to decrease, likely indicating a reduction in overall infections and spread. In the

past seven days, an average of 101 tests per day have been collected from Warren County residents.

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Warren County, New Jersey COVID-19 Report 6/24/20

COVID-19 Age-Stratified Incidence & Case-Fatality Rates - Warren County, NJ 6/24/20

Age Group Total Popula-

tion Incidence Rate per 100,000 Overall CFR Non-LTCF CFR LTCF CFR

<5 years 4,871 102.65 0% 0% 0%

5-19 years 19,436 66.89 0% 0% 0%

20-44 years 30,143 968.72 0% 0% 100%

45-64 years 33,607 1190.23 3% 1% 14%

65+ years 18,236 2802.15 26% 17% 29%

Total 106,293 1148.71 12% 3% 28%

The table above also shows that the population of Warren County has not been affected equally among all age groups

or by LTCF residents. The incidence rate for all residents over age 65 is 2.4 times higher than for all ages groups com-

bined; for LTCF residents of all age groups, the incidence rate is 55 times higher than those who are not LTCF residents.

Similarly, the CFR among LTCF residents over age 65 is 27% versus 16% for those in that age group who are not LTCF

residents. For LTCF residents overall, over 1 in 4 of those diagnosed with COVID-19 has died.

For comparison, according to the CDC the U.S. 2017-18 influenza season, which was characterized as a severe season,

resulted in approximately 45,000,000 infections and an estimated 61,000 deaths; that equates to a crude incidence

rate of 13,709 cases per 100,000 people and a CFR of 0.13%. Furthermore, approximately 1.3% of influenza cases re-

quired hospitalization during that season.

Incidence and Case Fatality Rates: How does Warren County compare?

While the total number of COVID-19 cases and associated deaths may seem low overall, the population of the county is

also smaller than many of the counties in the northern part of the state. Warren County is generally less densely popu-

lated than the counties to the east, but the burden of illness and disease has still been high.

As of June 24, Warren County’s crude case fatality rate (CFR; the proportion of COVID-19 cases who have died in com-

parison to the total number of cases, not adjusted for age or other confounding factors) is 11.8%; the second highest in

the state. The CFR for New Jersey overall is 7.6%.

The current burden of disease can be assessed by understanding the cumulative incidence rate, or number of cases per

100,000 people in the population during the pandemic; this gives us an idea of the proportion of people who are being

affected. As of June 24, Warren County’s crude incidence rate was 1,148 cases per 100,000, ranking 15 out of 21 coun-

ties despite ranking 19 out of 21 in population size. For reference, as of June 24 the crude incidence across the state

was 1,910 cases per 100,000 people.