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Nebraska pandemic expert urges people to get COVID boosters amid rise in cases

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Both COVID cases and hospitalizations continued their months-long climb in Nebraska last week.

Both COVID-19 cases and hospitalizations continued their months-long climb in Nebraska last week, prompting one pandemic expert to say Nebraskans should get booster shots, resume masking and avoid crowds in an effort to slow the spread of the virus.

The state reported 4,030 new cases last week, up from 3,535 the previous week and 3,474 the week before that, according to data from the federal Centers for Disease Control and Prevention.

In Lancaster County, the increase prompted Lincoln officials on Thursday to require city employees to mask when interacting with co-workers, members of the public or in meetings with more than two people, the Lincoln Journal Star reported. The move marked the first time since February that Lincoln city employees have had to wear masks.

Douglas County recently moved into the “medium” category for transmission under CDC community levels, which are based on hospital capacity and case counts. The county recorded 747 cases from Thursday to Sunday, an average of nearly 187 a day.

Hospitalizations in Nebraska due to COVID-19 also continued a steady climb that began in early May.

An average of 176 people a day were in Nebraska hospitals with COVID as of Friday, up 5% from 168 the previous week. Hospitalizations, though, still are less than a third of levels seen when the omicron variant peaked earlier this year.

Nebraska’s 14% case growth for the week was nearly double the U.S. increase, though the state’s per-capita rate remained about 10% below the U.S. figure. The highest rates are mostly found in southern states, including Oklahoma, Mississippi, Alabama, Arkansas, Louisiana and Florida.

Even with fewer test results being publicly reported due to the increased use of at-home tests, the current case counts are higher than at the same time during each of the past two summers.

Dr. James Lawler, a co-executive director of UNMC’s Global Center for Health Security, said the majority of hospitalizations are occurring in those over age 65. But increases in hospitalization are occurring in other age groups as well.

In some regions, children now are hospitalized at the third-highest rate of the pandemic, behind only the delta and omicron waves. In Health and Human Services Region 7, which is made up of Nebraska, Iowa, Kansas and Missouri, hospitalizations among children are at delta levels, Lawler said. And that’s coming at a time when school, a known driver of viral spread, is not in session.

“Where our elderly have benefited from relatively higher rates of vaccination and boosting, our younger populations don’t, and so have seen higher rates of severe disease and infection,” he said.

Lawler said the tools to fight the pandemic are the same ones that have been working all along. “We just need to actually use them,” he said.

The first, he said, is staying up to date on vaccines.

Those over 50 and some immunocompromised people 12 and older currently are eligible for two boosters in addition to their original shots. Healthy people between 5 and 50 are eligible for one booster in addition to their original series. A CDC tool helps people determine when they can get boosters.

The United States a year ago had great success vaccinating its vulnerable older population, with 91.7% of Americans 65 and over receiving their original vaccination shots. But only 65% of those 65 and over got a booster shot, and only 23% have gotten both booster shots.

Nebraska has been somewhat better than most states at boosting and vaccinating older residents, but the rates are still less than optimal.

While 93% of Nebraskans 65 and older received their original shots, only 73% that age received a booster, and only 26% have received two boosters. Nebraska’s 65-and-over rate with two booster shots ranks 18th among the states. Iowa is 13th at 29%. Minnesota at 38% has the nation’s highest two-booster rate.

Lawler said people also need to go back to using tools that have helped slow transmission in the past, including avoiding large, crowded gatherings, particularly indoors; masking in large, public indoor gatherings; and testing routinely, especially when having symptoms. People should stay home when having symptoms and when positive.

All of those measures have worked when people have done them together. “The issue with pandemics ... it’s a team sport,” Lawler said. “It doesn’t work if only a couple people do these things. Everybody really has to do them together.”

Taking such steps together, he said, will significantly reduce transmission in the community, avoid more hospitalizations and deaths and head off long COVID and other lingering effects. Researchers are learning that long COVID can accompany mild and moderate infections, not just serious ones.

Without many people taking such measures, he said, waves will continue until researchers can devise a vaccine that provides longer and more broadly effective immunity.

The currently available vaccines, he said, work well when people stay up to date on the shots. They also continue to prevent serious illness.

Indeed, immunity from vaccination, particularly recent vaccination, seems to provide better protection against new variants than an infection with an old variant.

“This idea that once everyone had been infected at least once, we would ... achieve this status of herd immunity and everything would be fine ... hasn’t proven to be true,” he said.

While that immunity has slowed pandemic trends, leaving the nation in a better place than before vaccinations were widely available and many had been infected, Lawler said, “we know that immunity and protection wanes as time goes by and also that protection goes down when a new variant pops up.”

New variants, for that matter, appear to be spinning out more quickly as time goes by, he said. Earlier in the pandemic, new variants were emerging roughly every six months. But by March, BA.2 had replaced the original omicron that rose in December and January. BA.4 and BA.5, a highly transmissible subvariant now dominant in the U.S., began rising in May. Now scientists are watching two new omicron subvariants, BA.2.75, which has been detected in the U.S., and BA.5.2.1.

People can, and are, getting infected multiple times, Lawler said. And those infections don’t necessarily carry a lower risk of long COVID or hospitalization.

“Just ignoring the problem and pretending it’s gone away doesn’t solve anything,” he said. “Because it hasn’t gone away.”

Nebraska reported 18 more COVID deaths last week, bringing the total number of confirmed or probable deaths to 4,363 for the two-year pandemic. Nearly 510,000 positive tests have been reported in Nebraska.

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