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UNMC experts warn Nebraskans of 'potential perfect storm' as coronavirus cases rise

UNMC experts warn Nebraskans of 'potential perfect storm' as coronavirus cases rise

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Dr. Mark Rupp, center, an infectious diseases expert, gives an update on coronavirus cases and hospitalizations in Nebraska on Monday.

Six scientists and physicians from the University of Nebraska Medical Center and clinical partner Nebraska Medicine warned Monday that the state is entering a “dangerous period” in the COVID-19 pandemic, marked by a record number of new cases and hospitalizations due to the virus.

Tallies of new COVID-19 cases and of hospitalizations now have surpassed May’s highs in Nebraska. On Friday, the state recorded its highest seven-day average of daily cases for the pandemic with 545 cases. That topped the May 8 average of 427 new daily cases.

UNMC coronavirus

A chart displayed Monday at a press conference shows a spike in COVID-19 cases in Nebraska.

The number of patients hospitalized with COVID-19 on Saturday and Sunday stood at 249, well above the previous peak of 232 patients hospitalized statewide on May 27.

On Monday, the state’s cases landed it at No. 7 among the 50 states for new cases per capita on a tally maintained by COVID Act Now. Iowa’s case counts, which also have been increasing, put it at No. 6 on COVID Act Now.

Nebraska also has logged 501 COVID-19 deaths.

The record spike in COVID-19 cases comes as numbers are increasing across the country. Nebraska is among 21 states reporting increases, according to CNN. The state also is among nine that set records last week for new cases, Reuters reported.

U.S. Health and Human Services Secretary Alex Azar told lawmakers Friday that the country is facing increasing cases in the Upper Midwest and farther west that are canceling out some of the decreases in the Southwest and Southeast.

The UNMC researchers, who released a statement Monday during a press conference on the UNMC/Nebraska Medicine campus, noted that the increase comes as the state continues to relax social distancing measures and fully open schools. At the same time, cooler weather is beginning to drive activities indoors, and influenza season looms.

To absorb an increasing load of patients, they said, Nebraska is relying on hospitals that currently are more than 85% full. That’s a different situation from April and May, when hospitals were 50% full.

“It is a potential perfect storm,” they wrote.

Nebraskans, they said, know how to beat the virus but have gotten complacent.

The researchers also emphasized that the pandemic is not a political or ideological issue and that their advice is the same regardless of political leadership at any level.

That advice includes wearing masks in public, avoiding large gatherings and close contact indoors, keeping at least 6 feet from others in public, practicing good hand hygiene, staying home if ill, quarantining at home after close contact with someone with COVID-19 and cooperating with public health officials in tracking exposures and illness.

John Lowe, assistant vice chancellor for health security at UNMC, said scientists and citizens now know how to control transmission in their communities.

But researchers are concerned by the number of people who don’t follow the basic guidelines. They’re hearing too many stories from patients who have attended parties, visited extended family, dined with a dozen friends in a small indoor space or attended weddings involving several hundred people.

And they emphasized that it’s not the time to relax restrictions.

“We have not yet reached levels of community transmission where we can open businesses up fully, open schools up fully and return to what people would consider normal community activities,” said Dr. James Lawler, a director of the Global Center for Health Security at UNMC.

James Lawler

James Lawler

“We’re at record numbers and going up, so we know we need to do more in terms of restricting those opportunities that allow the virus to spread,” he said.

The City of Omaha has mandated masks in indoor public spaces since mid-August, which health officials have credited with helping slow the virus’s spread. The Omaha City Council is expected to vote Tuesday to extend the mandate until Nov. 24.

Dr. Mark Rupp, chief of UNMC’s infectious diseases division, said the mask requirement should be expanded throughout the state.

Nebraska Gov. Pete Ricketts has encouraged the use of masks by the state’s residents. But he has said repeatedly that he would not mandate masks.

Dr. Daniel Johnson, division chief of critical care at the Nebraska Medical Center, said ICU beds in the metro area are 85% full. The thought of having a flu season and COVID-19 at the same time makes clinicians “extremely uneasy.”

The medical center was far beyond ICU capacity in May, he said, and opened three additional COVID-19 units at that time.

“We all have the power to slow this down,” Johnson said. “But if people do not change the way (they) are currently behaving, we are not going to have capacity.”

Ricketts said last week that the state is in a much better position than it was in May. Health care providers have learned more about caring for COVID-19 patients, and the state has more protective gear, testing and contact tracing available.

Ricketts also noted that fewer than 5% of hospital beds and a little more than 10% of ICU beds in Omaha are filled by COVID-19 patients. In Lincoln, about 16% of hospital beds and 11.7% of ICU beds are being used by coronavirus patients. The state, he said, is working with hospitals on planning, including staffing.

The researchers said they are not advocating lockdowns.

Rupp said the public health measures that have been recommended can prevent transmission “without going into a strict lockdown and throwing our economy back into the ditch.”

Following those measures, he said, “doesn’t necessarily mean we all have to stay at home and shelter. We just need to be careful and we need to be cognizant of these things and do the right thing for each other, and we’ll get through this.”

Rupp said the weekend addition of test results that had been delayed by a cyberattack at Nebraska Medicine would not affect the seven-day averages for new cases.

Indeed, the 14-day average for new cases on Friday stood at 480, also a record.

Among what’s now known about the virus:

  • Close and prolonged contact carries the highest risk of transmission, but the SARS-CoV-2 virus can spread through the air and infected people at distances, especially in enclosed spaces with poor ventilation.
  • Transmission is sporadic — a small proportion of infected people infect large numbers of people. Talking, singing and yelling appear to increase the risk of transmission.
  • Infected people without symptoms can be highly infectious and may cause the largest number of clusters.
  • The disease is much more severe in the elderly. In Nebraska, 20% of people over age 65 diagnosed with COVID-19 have required hospitalization, and over 7% have died.
  • Health officials are testing school-age children at a far lower rate than adults. If most children have minimal to no symptoms, then the majority may go untested and unrecognized.

World-Herald staff writer Jeffrey Robb contributed to this report.

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