Directed by ROIC, FEMA hospital in NJ takes shape

BY Brenda Flanagan, Senior Correspondent |

New Jersey’s emergency command center, a complex outside Trenton referred to as “the rock”, is playing a key role in the state’s battle with COVID-19, coordinating the distribution of critical supplies and preparing for the opening of a new, 250-bed, pop-up field hospital in Secaucus that will start hosting patients next week.

Col. Patrick Callahan, the superintendent of the State Police, is in charge of the nerve center, which sits in Ewing Township, five miles to the northwest of the State House.

First opened in 2006, the complex formally known as the Regional Operational and Intelligence Center, or ROIC, has played key roles in the wake of tropical cyclones like Superstorm Sandy, as well as domestic security threats. It’s never had to handle a pandemic before.

“To say it’s a little surreal, I think, would be appropriate,” said Callahan, who’s been a constant presence at the daily COVID-19 press briefings conducted by Gov. Phil Murphy, alongside Health Commissioner Judith Persichilli and others.

Callahan expects the Meadowlands pop-up to come on line Friday, and Persichilli said it will see its first patients by the middle of next week. Its 250 beds won’t be for COVID-19 patients.

“These are going to be for your lower-acuity patients so we can move patients out of hospitals and then use those rooms as critical care,” he said.

It’s called “cascading” — a tactic that will free up beds at North Jersey hospitals where COVID-19 patients now crowd the ICUs. At the ROIC, they’re working on how to identify and transport those 250 patients.

“Where are they?” he said. “What ambulance services are we going to contract with? How will we get them to the Meadowlands medical station? I was here at 5 o’clock this morning and that was the first thing on my action item list.”

The popup hospitals are a component of one part of a two-pronged strategy in the fight against COVID-19, all designed to prevent the state’s health system from being overwhelmed by an uncontrolled surge of patients.

Social distancing is designed to limit the number of cases that develop, and to “flatten the curve” of infected people who need hospital care, especially critical care.

At the same time that state officials are ordering people to shelter in place, they are looking to add to the total number of beds available to those who contract COVID-19.

The field hospital at the Meadowlands Convention Center in Secaucus is the first of four such facilities sponsored by the Federal Emergency Management Agency that officials are planning to open across the state. Officials are also overseeing the reopening of unused wings at existing hospitals and reopening at least one that had been shut down.

Hospitals are also working on their own to increase their critical care capability, repurposing rooms that had been devoted to now-canceled elective surgeries for COVID-19 patients, a move that Persichilli said will double the number of critical care beds.

During the daily press briefing in Trenton on Monday, Murphy stressed the necessity of pursuing both elements of the strategy. He reported that 198 New Jerseyans have now died, and that the number of those who’ve tested positive for the novel coronavirus now stands at over 16,000.

He sat in front of charts showing various scenarios for the number of COVID-19 patients that can be expected to need care at New Jersey hospitals over time, including a projection that the state will reach hospital ICU bed capacity by April 11, assuming a 31% social distancing compliance rate.

He pushed for residents to strive to do better.

“Our mission must be to flatten the curve,” Murphy said. “We need you to do your part and take necessary steps so you don’t end up on any graph.”

Multiple agencies occupy about 100 desks at the ROIC on a 24/7 basis — including FEMA, the Army Corps of Engineers and the state Department of Health. Each feeds data into a coordinated response.

Callahan’s current focus is also devoted to allocating scarce medical equipment properly — in particular personal protective equipment, or PPE, for health care workers, and ventilators for critically ill COVID-19 patients — among hospitals desperate for supplies. Health care centers must now report their inventories daily, per the governor’s executive order.

“This is a crisis, that we need to know what you have, we need to know your bed capacity, we need to know your staffing,” he said. “All geared towards making those decisions, critical decisions. We think in the next few weeks we may have to make some decisions like, where do ventilators go? Where does equipment go?”

Those who work at the ROIC have a history of dealing with natural disasters and other crises. But this is different, they say.

“We do training and we do exercising for situations like this,” said Chris Grady, critical infrastructure coordinator at the Health Department. “This one has never happened before. So the most challenging part is stick to what we know, and stick to what we can do.”

This pandemic raises the bar.

“It’s different than a Sandy,” Callahan said. “A Sandy comes and goes, and you know the next day, I’ve got to move those trees, I’ve got to fix that bridge, I’ve got to raise that house. This is not like that. We’re still in kind of a storm mode right now.”

So far during the crisis, the complex has helped coordinate school closings and the release of non-violent, low-level prisoners from county jails. Officials say its work helping to coordinate hospital staff, supplies and patients throughout this epidemic is a mission that could continue for months.