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Livewellnebraska
Ricketts says Nebraska Med Center shouldn't perform non-emergency surgeries
  • Updated

Nebraska Gov. Pete Ricketts on Friday said the state has issued a new health measure suspending some inpatient and outpatient surgeries at the Nebraska Medical Center in Omaha, a day after Nebraska Medicine began operating under its crisis plan.

The directed health measure suspends pre-scheduled, nonemergency surgeries — what are known as Class C, D and E inpatient and outpatient surgeries — at the medical center, effective at 5 p.m. Friday. The measure is expected to remain in place through Feb. 13.

Nebraska Medicine officials said Thursday that they were activating the crisis plan, known as crisis standards of care, for the first time in the health system’s history in the face of a growing demand for health care and a shortage of staff to provide it. The health system is in the first stage of that plan. They said the governor’s order would not disrupt needed care.

“Hospitals that decide to operate under a crisis standard of care should not be performing non-emergency surgeries,” Ricketts said in a statement. “Today’s DHM makes sure the Nebraska Medical Center remains focused on prioritizing care for patients with the most urgent medical needs.”

Nebraska Medicine officials said in a statement Friday that the operational changes they announced Thursday are consistent with the directed health measure.

“The actions we are taking ensure we are prioritizing care for patients with the most urgent medical needs,” officials said. “As outlined in the directed health measure, our medical providers will continue to make case-by-case determinations on surgeries and procedures that must be done to preserve the patient’s life or physical health.”

Health system officials said that because current operations are consistent with the health measure, any necessary care will not be delayed. “Patients should continue to access care as they’ve planned unless they hear from their physician,” they said in the statement.

Nebraska Medicine officials said patients still can receive care at the health system’s facilities. The goal behind activating the crisis plan, they said, was to provide flexibility in operations and staffing and to ensure the safety of patients and staff. The health system, they said, also enacted the plan to prepare for an anticipated further surge in COVID-19 cases caused by the omicron variant and the need for additional health care expected to come with it.

Nebraska Medicine, a private, nonprofit business that operates the Nebraska Medical Center, is the clinical partner of the University of Nebraska Medical Center.

The new health measure comes as Douglas County on Friday reported 1,866 new cases of COVID-19, the highest one-day total since the beginning of the pandemic. In addition, 403 COVID patients were hospitalized in the Omaha metro area, a figure approaching the pandemic peak of 445, recorded in November 2020. Some 671 COVID patients were hospitalized across Nebraska.

The health measure cites state law and administrative code as giving the Nebraska Department of Health and Human Services the authority to order health measures to prevent the spread of communicable disease and illness.

The measure says that the state health department finds that the “current hospital capacity and healthcare resources at the Nebraska Medical Center are reaching near capacity as noted in the activation of the NMC Crisis Standards of Care plan, and that the immediate implementation of the following Directed Health Measure is necessary to preserve sufficient hospital capacity and health care resources to ensure public health needs can be met.”

The health measure further states that “surgeries or procedures that must be done to preserve the patient’s life or physical health, but do not need to be performed immediately, are allowed on a case-by-case determination of the medical provider.”

A number of health systems across the country are enacting crisis plans as they face the dual challenges of rising case counts fueled by the omicron COVID variant and a growing number of health care workers sidelined by their own or their relatives’ infections.

No other hospital was named in the health measure. Many of the large hospitals in the state have been limiting surgeries and procedures that can wait for months as they have responded to increased demand for care of all types, including a high number of patients with COVID-19.

Nebraska Medicine, Methodist and Lincoln’s Bryan Health have been limiting elective procedures and surgeries requiring overnight stays since August. CHI Health also has been delaying cases that can safely wait. Bryan Health officials said Thursday that many of the elements in its crisis plan are in place and have been for some time, including redeploying staff and repurposing some clinical areas.

Class D and E surgeries typically can wait for some weeks. But Class C procedures can include cancer surgeries.



Livewellnebraska
Your mask probably needs an upgrade. Here's what Omaha experts recommend
  • Updated

Think again before you dig out those cloth face masks from early on in the coronavirus pandemic.

With the surge of cases caused by the omicron COVID variant — and in light of Omaha’s new mask mandate — local infectious disease experts are urging people to upgrade their face coverings.

CHRIS MACHIAN, THE WORLD-HERALD 

Omaha City Councilwoman Juanita Johnson walks outside the Union Pacific downtown headquarters, where she works. Omaha's new mask mandate went into effect this week.

This week, Douglas County Health Director Lindsay Huse issued a mask mandate for schools and many other public indoor spaces in the city of Omaha.

While Omaha doctors back the plan, they’re encouraging people to upgrade from the sometimes gaping cloth masks to masks that fit more snugly around the face. The recommendations come on the heels of some hospital systems revamping mask rules for staff and visitors.

Any mask is better than no mask, said Dr. Renuga Vivekanandan, chief of infectious disease with CHI Health and Creighton University. But options like KN95s or doubling up a cloth mask over a surgical mask are even better.

“When you’re infectious, you are expelling particles,” Vivekanandan said. A mask “catches that so you don’t infect others, and masks also protect you.”

Good fit is key.

Data from the ACGIH Pandemic Task Force shows that an N95 mask has between 1 and 10% of leakage, depending on if it’s been fit-tested. Surgical masks allow for 50% leakage and cloth masks allow for 75% leakage.

According to the task force, if a person wears an N95 mask that has not been fit-tested around someone infected with the virus, they’re protected from between 2½ hours to 25 hours, depending on what type of face covering the infected person is sporting.

N95s and KN95 offer the best protection, leaving very few gaps on the sides, top or bottom of the mask. Additional cloth face coverings should not be placed over these masks.

N95 masks can be purchased from most home improvement stores. They tend to be pricier than a surgical mask, and buyers should be cautious of counterfeits, said Dr. Maureen Tierney, associate dean for clinical research and public health at Creighton University School of Medicine.

Surgical masks are better at filtering virus droplets than cloth masks. Adding a cloth face mask over it provides a tighter seal, Tierney said.

“It’s pretty doable and not too expensive,” she said. “If you’re going to wear masks, wearing the best-fitting mask you can makes the most sense.”

According to lab test data from the federal Centers for Disease Control and Prevention, exposure to potentially infectious aerosols decreased about 95% when both parties wore tightly fitted masks.

People should get a fresh surgical mask each day and use a clean cloth mask. When masks get wet, that’s generally a sign that they should be tossed, Tierney said. Wetness, she said, causes the filter to lose some of its effectiveness.

President Joe Biden announced Thursday that the government will double to 1 billion the number of rapid, at-home COVID tests to be distributed free to Americans, along with “high-quality masks.”

Masks protect the user and the wearer, Tierney said. And it’s possible, she added, to make it through this surge without getting infected. Tierney shared a story of a woman she knows who had a teenage son contract the virus. The woman wore KN95s around the house and had her son temporarily move into the basement. The woman never got sick.

“It’s possible if you take all the precautions,” Tierney said.

This report includes material from the Associated Press.



Local
Some Omaha employers drop vaccine requirements after Supreme Court ruling
  • Updated

In the wake of the U.S. Supreme Court’s ruling Thursday blocking the Biden administration’s requirements that employees at large companies either get vaccinated against COVID-19 or be tested regularly, some Omaha companies said they will no longer require employees to receive the vaccine.

Spokespeople for First National Bank of Omaha and Conagra said they are no longer proceeding with the steps specified in the now-blocked emergency temporary standard (ETS) issued by the Occupational Safety and Health Administration in November.

A Mutual of Omaha spokesperson said Monday that the company was collecting the vaccination status of its employees and requiring unvaccinated employees to wear a face covering in the workplace, but was not requiring its employees to either be vaccinated or tested. The spokesperson said Mutual has not changed any of its protocols in the wake of the 6-3 Supreme Court decision.

Several other large employers contacted by The World-Herald did not specify whether they would require their employees to receive a vaccine or be tested for COVID-19.

Nationally, some large employers, including Target and Ford Motor Co., said they were reviewing the court’s decision.

The companies that would have been affected by the federal mandate, which would have also required unvaccinated people to wear a mask while at work, employ at least 100 people.

With the court’s conservative majority striking down the mandate, Baird Holm attorney R.J. Stevenson and Creighton University law professor Kelly Dineen said it’s up to companies whether they want to require their employees to be vaccinated or tested.

They said companies can implement those requirements as long as they don’t violate collective bargaining agreements or approved religious and medical exemptions.

“This (ruling) is simply the court saying that the government cannot mandate” employees be vaccinated or tested weekly, Stevenson said. “There may be some employers who like certain aspects of the ETS and decide to keep it in place. … Employers can still implement those things if they want to. They’re just not mandated by OSHA to do so.”

Stevenson said employers may be hesitant to implement such requirements and risk losing employees in a tight labor market.

“Right now, employers are trying to do everything they can to get and keep employees,” he said. “They’re not really motivated to separate (with) those employees over such things as employees not being willing to provide proof of vaccination or not willing to be tested.”

In contrast, Dineen believes that it may be advantageous for employers to implement some of the requirements.

“I think we overestimate the number of people who object and underestimate the number of people who might want to go work at some place with a vaccine mandate,” she said.

Although President Joe Biden announced the mandate in September, OSHA didn’t formalize the mandate until it issued the ETS. At the time of Biden’s announcement, Stevenson and Dineen said the administration appeared to be within its rights.

But after oral arguments before the court, neither of them were surprised by the ruling.

The majority wrote that the mandate was unprecedented in its scope.

While saying the decision shows that the court recognizes OSHA’s general authority to implement safety and health standards even in an emergency basis, Stevenson said the court determined that this ETS was too broad.

Paraphrasing the court’s thoughts, Stevenson said “Here, the court said (they) believe that the agency exceeded its authority because this ETS really goes beyond just the workplace. This is dealing with the matter that’s of concern to the general public.”

The court’s liberal justices wrote a dissenting opinion that, among other things, said the decision “seriously misapplies the applicable legal standards” and thus the court acted “outside of its competence and without legal basis.”

Dineen said that she found the dissenting opinion “fairly persuasive” and that arguments presented by the majority are inconsistent with what OSHA said in the ETS, which was targeted toward workplace exposure. She said some of the hazards that OSHA regulates inside the workplace are also hazards outside of the workplace.

That has not mattered before, Dineen said.

In a separate 5-4 ruling, the court upheld a vaccine mandate for health care workers.

A vaccine mandate for federal contractors has not been considered by the Supreme Court. That mandate is on hold after a lower court blocked it.

Many of Nebraska’s top elected officials, all Republicans, publicly praised the Supreme Court’s ruling blocking the OSHA mandate.

“The Supreme Court has rightly struck down this stunning overreach of federal power. Letting the mandate stand would have created a dangerous precedent. Any future administration could then declare an emergency, publish OSHA rules, and force private businesses to enact federal policies,” Gov. Pete Ricketts said in a statement.

On Twitter, Sen. Deb Fischer, Rep. Don Bacon and Rep. Adrian Smith also praised the decision.

This report includes material from the Associated Press.



Crime-and-courts
Drinking and driving 106 mph: Omahan sentenced for crash that killed 'uncommonly good' man​
  • Updated

Sometimes, numbers are cold, cruel, impersonal. Other times, they are a measuring stick, telling a story of character, longing, a life’s work.

Both cases were true Friday in a Douglas County courtroom.

First, the cold and cruel facts: A 28-year-old Omaha man was driving 106 mph in a 45 mph zone on West Dodge Road when he crashed into a Toyota Camry driven by Jim Yungbluth — a 63-year-old husband, father, longtime Omaha musician and Nebraska Furniture Mart employee.

Yungbluth — described as “one of the nicest men to walk the Earth” in his obituary — died at the scene.

Caillau

Driver John Caillau’s blood alcohol content measured .41% about 45 minutes after the crash. That is five times the legal limit of .08% for driving.

Those numbers were so staggering that Judge Horacio Wheelock raised his voice as he repeated them.

“The court cannot ignore the fact that Mr. John Caillau was driving at ONE HUNDRED SIX MILES PER HOUR on Dodge Street at 4:03 a.m. July 9,” Wheelock said loudly.

Wheelock said he also could not ignore the staggering blood alcohol content. The first blood draw taken at the hospital was .41%. The second, hours later, measured .26%. Either one blew away Nebraska’s legal limit, Wheelock noted.

Wheelock then delivered the cold, hard terms of Caillau’s sentence: 16 to 20 years in prison, a term that is cut in half under state law. Twenty was the maximum the judge could give Caillau for motor vehicle homicide.

At that, Caillau’s mom burst into tears.

“Oh my God, oh my God, oh my God,” she said as her son was led away in handcuffs. “I can’t believe this.”

One could have heard the same reaction from Yungbluth’s relatives the morning of July 9.

And that is where the numbers begin to tell a story of longing. July 9 was the 25th birthday of Yungbluth’s youngest daughter, Cassidy. It was two days shy of Jim and Becky Yungbluth’s 29th wedding anniversary. Nine months shy of when Jim Yungbluth would have walked his oldest daughter, Carey, down the aisle for her wedding. Of when father and daughter would have shared a dance to the song Jim Yungbluth sang his daughters before bedtime.

“’You are my sunshine,’” Carey said. “It was his song for us.”

Jim Yungbluth, 63, a longtime Omaha musician and Nebraska Furniture Mart employee, was killed by a drunken driver going 106 mph near 90th Street and West Dodge Road about 4 a.m. July 9.

Yungbluth had so much brightness left to give Omaha. The bandmate and music lover had a fitting nickname. Childhood buddies dubbed him Chunga because, they said, he looked exactly like the cover photo on Frank Zappa’s third album, “Chunga’s Revenge.”

Speaking of numbers, Chunga, a drummer and harmonica player, played in more bands than his wife could count. The bands spanned an assortment of classic names: The Eggmen, The Hornets, Jared and the Blues Teachers, The Good Guys, Front Porch Blues and OLUS (Old Like Us).

Like any good dad, he had nicknames for his daughters, eventually calling his oldest daughter by the name of a famous blues harmonica player.

“She was Cass,” Carey said of her little sister, “and I was his Carey Bell.”

Yungbluth also had a motto, passed down from his dad, Loyson “Joe” Yungbluth.

“Be good, kind and careful. Sweet and lovable.”

Joe Yungbluth lived that motto while a caretaker and property manager at Boys Town — where the Yungbluth children grew up.

Later, Jim Yungbluth had his childhood home moved, via stilts, down West Dodge Road to a lot he bought in Waterloo. He and Becky raised their two daughters there, and the Yungbluth home was the gathering place for family celebrations.

From Waterloo, Jim Yungbluth traveled Dodge daily, showing up for his 4 a.m. to noon shift to make sure delivery vans were loaded with Omaha’s furniture. He worked for 38 years at Nebraska Furniture Mart, the past several as a warehouse supervisor.

Becky said her husband had the countdown going. That Friday, July 9, he had 255 days until retirement. A long post-work life was a real possibility, too. Dad Joe died five years ago at age 96.

Then an aunt showed up at both Yungbluth daughters’ workplaces that morning. Cassidy said she had a horrible feeling but “hoped against hope” that she was just there to cart her away for a surprise 25th birthday party.

“It was the wrong kind of surprise,” she said.

That morning, Yungbluth was going east on Dodge at 90th Street, less than 2 miles from the Mart.

Caillau, meanwhile, had been out of work from his job at Oriental Trading Co. because of a foot injury. His attorney, Michael Fitzpatrick, said he had been reeling from a breakup with a fiancée of a couple of years.

Fitzpatrick repeatedly emphasized that Caillau had no adult criminal record. In November 2020, he was the subject of a police report that described him as being ejected from a vehicle that nearly hit a pedestrian and crashed into bushes in Sanibel Island, Florida. No arrests were made in that case.

In this case, Caillau drank at least a half-pint of vodka and blacked out, Fitzpatrick said.

Others questioned whether Caillau really blacked out. The car’s internal diagnostics noted that it was going over 100 mph for a couple of miles before the crash.

Fitzpatrick said Caillau had no memory of the crash. He has been overwhelmed with grief, Fitzpatrick said.

For his part, Caillau turned to Yungbluth’s family in court and apologized: “There’s nothing I can say to any of you to make any of this right. I completely understand if you guys hate me ... I just ask if you can find it in your hearts to forgive me ... I understand it’s not likely … If I were in your situation, I probably wouldn’t either.”

His voice trailed.

Ryan Lindberg, the prosecutor, said he wished he hadn’t had to watch surveillance video that captured the devastating crash. At 106 mph — “operating essentially as a missile,” according to Lindberg — Caillau’s 2018 Chevy Equinox vaulted Yungbluth’s 1998 Camry into the concrete barrier of a bus stop, flipping it on his roof.

By the time medics arrived, Yungbluth had died.

“It’s hard to understand how this loss has affected and will continue to affect this family,” Lindberg said. “As one of his sisters put it, it was the loss of a common man who was uncommonly good.”

Brother-in-law Bud Sachs — one of more than 30 family members and friends who showed up for Friday’s sentencing hearing — vouched for that. He called Chunga a “true free spirit,” a musician with a heart to match it.

“Not a mean bone in his body,” Sachs said.

He thumbed through his phone for a photo of Chunga, eventually settling on one. Standing next to Becky, Yungbluth had a slight grin between his salt-and-pepper mustache and beard. Crow’s feet framed his soft brown eyes.

“Such a good man,” Sachs said. “God always takes the good ones too soon.”



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