Inside Nebraska’s Surprisingly Effective Covid Strategy


“Our hospital, which is by far the largest in the state, has obviously focused quite intensely on preparing for infections and pandemics with serious consequences,” he said. UNMC already had an aggressive stockpiling program for N95 masks and other PPE in early 2020. But “even before the pandemic really started to affect Nebraska, we kind of looked at what was going on and said , you know, we’re all going to be running without PPE unless we do something about it. A team found a way to reuse N95s by tying them to clotheslines in a room with UV bulbs and UV-reflecting walls and irradiating them for a few hours. They shared the technique with other hospitals in the state, helping them preserve their own supplies. At least at UNMC, “we never ran out of N95”.

Elsewhere, the state was aggregating data from local health departments to identify shortages and using the National Guard as logistical support to source supplies in Nebraska — not a transparent process at all but one that, according to Department of Health Department chief Jason Jackson. administrative services, benefited from not being dependent on the federal government. “I think other states have fallen into this trap. … I don’t know what informed that confidence that the federal government was going to be able to step in and meet that need,” Jackson said. “But that never governed our response.” There’s no good data on this, but such efforts likely saved the lives of healthcare workers at a time when thousands of people were dying across the country, in part due to lack of equipment. adequate protection.

UNMC has also been instrumental in infection prevention and control in vulnerable corners of the state – and again, Nebraska had a head start. The university and its associated health network, Nebraska Medicine, already had a team working to help nursing homes improve infection control in the state before Covid hit, work that took on new meaning. emergency in the early months of the pandemic, when around 40 percent of Covid deaths were among nursing home residents and staff. They also worked with other vulnerable facilities, including meat processing plants (Nebraska is one of the nation’s top meat-packing states, with nearly 27,000 workers) and prisons (it also has some of the most overcrowded prisons in the country, with over 5,000 inmates). In June 2020, Muhammad Salman Ashraf, manager of Nebraska’s Infection Control Assessment and Promotion Program, estimated that less than 1% of Nebraska’s nursing home population had died of Covid, compared to 10% in some other states (Andrew Cuomo’s government was famously accused of covering up the staggering death toll in New York nursing homes of more than 15,000 people). Lawler says this has been a major contributor to reducing the total death toll in Nebraska.

However, it does not give high marks to the state’s Covid response overall.

“We did the first few months of the pandemic very well,” he says, when many other states were taken by surprise. Ricketts moved quickly to limit the size of gatherings and some in-person businesses — gentlemen’s clubs, tattoo parlors and others — without forcing the entire state to shut down, though he asked people to voluntarily stay home for a while. 21 days to help the state protect and increase hospital capacity. Lawler thinks avoiding reflexive lockdowns and instead using tailored health measures was the right way to go, but the state has too many laissez-faire too quickly and was too eager to move on once the vaccine was available. He referenced the March 2020 article “The Hammer and the Dance”, which argued for a limited period of strict confinement measures (the “hammer” of severe limits on social activity), followed by a strategy longer-term and more flexible of adjustable measures to control the virus (the “dance” of continued testing and tracing, infection isolation, social distancing and masking, with the possibility of applying more strict in the event of worsening epidemics).

“That was kind of the approach we were pushing,” Lawler said. “The problem is that I think we never followed through on that, in terms of continuing to modulate our response based on disease activity. … We didn’t do the dance part. We just kind of took our dance card and went home.

When I asked Ricketts if he saw a trade-off between growth and health, he said he had taken a “holistic” approach to the pandemic, that public health officials were only looking at part of the picture and that even if he valued their contribution, he had to weigh more factors than them. “We have been focused on slowing the spread of the virus and allowing people to live as normal lives as possible,” he said, which for him meant, among other things, no mandate to statewide.

“I think other states have tried to be very high-handed and order people to do things, and I think that breeds resistance” — especially when governors didn’t even follow their own rules ( see: California Governor Gavin Newsom’s “French Laundry moment”). While some national media swooned over Andrew Cuomo’s daily press conferences, which Variety Called “daytime TV’s hottest property,” Ricketts’ low-key, wacky daily updates rarely even made C-SPAN.

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