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Nebraska has far to go in virus fight, faces huge hospital bed shortfall

Nebraska has far to go in virus fight, faces huge hospital bed shortfall


A woman exits the St. Thomas Aquinas Church at the University of Nebraska-Lincoln. Nebraskans are trying to adapt to social distancing guidelines amid the coronavirus pandemic. 

LINCOLN — Gov. Pete Ricketts says Nebraska is “well ahead of the curve” in preventing the spread of the coronavirus.

President Donald Trump says Nebraska is one of the states that’s been “very lightly affected” by the outbreak that’s crippling the economy.

But others who have tried to plot out the future course of the virus are urging patience and are waiting for more tests and more data.

Nebraska, they say, may have taken some preventive steps earlier than other states and may eventually escape the full wrath of the virus, but it’s just too soon to predict how bad it will be.

There’s plenty of reason for concern — the Legislative Research Office, as well as a Lincoln doctor, have produced projections that, among other things, raise questions about the state’s capacity to handle a surge of cases.

If half or more of Nebraskans contract COVID-19, the disease caused by the coronavirus, and if 5% to 10% of the sick require hospitalization — as some health organizations have projected — perhaps 100,000 hospital beds will be needed in Nebraska, a state with about 7,000 such beds.

“I think we’ve been more lightly affected, but the real answer is we don’t know yet because we haven’t done enough testing,” said Dr. Bob Rauner of Lincoln, the chief medical director for a network of 58 independent medical clinics in Nebraska.

Rauner said that he’s “cautiously optimistic” that Nebraska took quick enough action to prevent the spread — such as shutting down K-12 schools and universities. But, he said, more widespread testing is needed to know whether infections have been slowed. Such mass testing, as has been done in South Korea, may take one or two more weeks to develop, Rauner said.

“I can see it peaking in the next couple of weeks, but we won’t know until we get the testing,” the doctor said.

Dr. Gary Anthone, Nebraska’s chief medical officer, said Tuesday that while Nebraska has “received encouragement and strong approval” for being an “early adopter” of precautions, residents must continue to practice safety measures.

Rauner, who is also a member of the Lincoln school board and head of a nonprofit group that promotes wellness of schoolchildren, is among the medical professionals and government agencies trying to project what’s ahead for the virus, so they can prepare.

Over the past few weeks, Rauner has produced a series of five videos on YouTube that attempt to estimate the spread of the coronavirus in Lincoln and Nebraska.

The University of Nebraska Medical Center, home to a center specializing in contagious diseases, has also done some projections, as has the research office of the Nebraska Legislature, which recently produced a briefing paper for state senators entitled, “COVID-19 Pandemic: Where is Nebraska headed?”

Their conclusions? Some rough times ahead.

Rauner’s latest video projects that between 30% and 70% of Nebraskans will contract COVID-19, and between 28,939 and 148,554 will need hospital beds. Projections released on Friday by the Legislative Research Office were somewhat similar, estimating a need for 95,000 hospital beds.

Those are sobering numbers, considering that Nebraska has only 6,958 hospital beds, according to the Legislative Research Office.

The projections help explain why officials from hospitals and the state have said they are already looking at ways to expand their capacity if a “surge” of patients hits. Among the ideas: Convert existing hospital space into intensive care rooms, or turn nonhospital buildings into temporary hospitals.

The projections also explain why Ricketts and other government officials have repeatedly emphasized the need to adopt precautionary measures such as hand-washing and social distancing. Those steps can help flatten the curve of cases, so there’s a slow, steady rise of coronavirus patients that would not overwhelm the state’s hospitals. The goal is to prevent a steep incline in numbers, like that seen in Italy, where the health care system is swamped.

Rauner said he has produced his YouTube projections to help his patients and clinics prepare.

Nebraska and other Midwestern states are showing lower rates of infection, he said, in part because of their geographic location, which is far from the coasts, where the coronavirus entered the country. That’s given Nebraska more time and better clues on how to respond.

The Midwest also sees less impact from travelers who might be bringing the virus from other countries and states than major transportation hubs such as New York City, Rauner said.

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Nebraskans, he said, might also just be naturally better at social distancing. Italy and Spain are countries where a greeting is accompanied by hugs and kisses on the cheeks; Nebraskans, meanwhile, are more reserved, Rauner said.

Maintaining social distance and avoiding large public gatherings are most important in urban areas, where population density is greater, he said. The impact of preventing one infected student from attending a school of 2,000 students day after day cannot be underestimated in blunting the spread of the highly contagious coronavirus, Rauner said.

Most sobering are the projections on the number of deaths the virus could cause in Nebraska.

The fatality rate is hard to pin down, Rauner said, because there are so many undiagnosed cases. The Legislative Research Office’s memo assumed a fatality rate of 1% to 3% of all cases, but Rauner said it’s probably 1% or lower, based on the experience in Germany and South Korea.

He estimates, based on a best-case fatality rate of 0.5% and a “severe” case fatality rate of 2.7% as in Italy, that between 2,894 and 36,463 Nebraskans could die from the virus.

Rauner said he’s “reasonably confident” that the state’s impact might be on the low end. Schools in Lincoln and Omaha were shut down quickly, and it appears — as Ricketts has said — that Nebraskans are adhering to social distancing recommendations.

“In Lincoln, O Street was dead, downtown was dead,” Rauner said on his most recent video. “That’s bad for local restaurants, but may have stopped the arc of the epidemic in its tracks.”

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Reporter - Regional/state issues

Paul covers state government and affiliated issues. He specializes in tax and transportation issues, following the governor and the state prison system. Follow him on Twitter @PaulHammelOWH. Phone: 402-473-9584.

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