Scientists and physicians at UNMC/Nebraska Medicine released a press statement on Monday in response to the sudden increase of COVID-19 in Nebraska:
“We are entering a dangerous period for our state in the course of the COVID-19 pandemic. The largest surge of cases and hospitalizations we have seen is currently upon us. We know how to beat this virus, but we’ve gotten complacent. COVID-19 has now killed nearly 500 Nebraskans, and many more are likely to die if we don’t take more action immediately. Nebraskans have a long history of helping our neighbors to work through the most difficult tragedies – floods, ice storms, tornadoes and droughts. We need to find that spirit of community now more than ever to overcome COVID-19.
We can’t emphasize this enough: COVID-19 ISN’T a political or ideological issue. Our advice is the same regardless of political leadership at any level:
- Wear a face covering in public
- Avoid large gatherings and close contact indoors
- Maintain at least six feet distance from others in public
- Practice good hand hygiene
- Stay home and call your doctor if you are ill
- Quarantine at home if you have close contact with someone with COVID-19
Cooperate with public health in tracking exposures and illness
Our daily counts of COVID-19 cases and hospitalizations are now equal to our May peak and rising rapidly. However, we continue to relax social distancing measures and fully open schools, all while cooler weather begins to drive activities indoors and the annual flu season looms. To absorb the increasing load of patients, Nebraska is relying on hospitals that are currently more than 85% full, which is a very different scenario than in April and May, when hospitals were 50% full. It is a potential perfect storm.
Early in the pandemic, Nebraska took sensible and strong actions to mitigate COVID-19 spread, and we reaped the results of those actions by having one of the lowest fatality rates of any state. We built a solid structure of community protection, but like the game of Jenga, we steadily have removed block after block of that tower: lifting limitations of occupancy inside restaurants, opening bars, allowing large gatherings and opening schools at full student density. As the structure weakens, our case counts accelerate. Now, some communities are considering rolling back the use of face masks. Remove that block, and the entire structure may collapse.
We understand everyone has pandemic fatigue – we do, also. But we are hearing too many COVID patient stories that start with, “I went to a party” or “I visited extended family, but everyone seemed well.” You’ve seen it on your Facebook feeds – a dozen friends eating dinner in a small indoor space with no masks in sight. This is the perfect environment for COVID-19 to continue to spread, which threatens the lives of our most vulnerable neighbors and family members. We can’t let down our guard.
Finally, the COVID-19 response isn’t an all or nothing proposition. Many states and countries have shown it is possible to suppress spread without going into complete lock-down. We can strike an effective balance. Now is clearly not the time to relax restrictions, but by following the precautions mentioned above, we can weather the storm this fall and winter and still while supporting our economy and overall community well-being. Together, we can emerge in the spring to a vaccine and a clearer road back to normal.”
Alongside the statement, official released information on what they currently know, and don’t know, about COVID-19.
According to officials, Nebraska is currently tied for 6th among U.S. states for daily cases per capita. Many states and countries have reduced their community case rates to near zero by adhering to basic precautionary behaviors.
COVID-19 is easily spread from person-to-person. Close and prolonged contact carry the highest risk of transmission, but the SARS-CoV-2 virus can spread through the air and infect people at distances, especially in enclosed spaces with poor ventilation.
Transmission is sporadic – a small proportion of infected individuals 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.
Children and young adults usually do not develop severe disease; however, hospitalizations and deaths do occur in these age groups. This past week Douglas County mourned the death of a six-year-old stricken with COVID-19. The disease is much more severe in the elderly. In Nebraska, 20% of our seniors over the age of 65 diagnosed with COVID-19 have required hospitalization, and over seven percent have died.
According to officials, Nebraska has fared better than most states in that regard, as the state avoided a substantial number of large outbreaks in nursing homes and prevented our hospitals from becoming overwhelmed.
Young people, while suffering fewer ill effects of disease, are a primary driver of transmission in community outbreaks. In August and September, colleges were at the center of community outbreaks across the country.
Finally, face coverings have proven capable of limiting virus shedding and reducing transmission risk, particularly when worn by all members of the community.
Early limited data suggested that school-aged children were not easily infected and were not important spreaders, but more recent information points to the fact that children get infected at similar rates as adults. Larger recent studies point to children as important sources of transmission to other children and adults in the community. In fact, adolescents and younger children may pose the highest risk for community transmission, as infection likely is not symptomatic and often missed.
Officials said that judging cause and effect from community actions is difficult with COVID-19, because it appears that long lag times occur between initiation of community epidemics, rise in confirmed case counts, and increases in hospitalizations and deaths.
UNMC/Nebraska Medicine warned that on our current trajectory, Nebraska’s health system is likely to be overwhelmed by late fall or early winter.
Officials said numbers of confirmed COVID-19 cases linked to school transmission have been relatively low since the school year began, but they may be missing a large proportion of COVID-19 cases in schools due to a lack of testing. UNMC/Nebraska Medicine are testing school-aged children at a far lower rate than adults. If most children have minimal to no symptoms, then the majority may go untested and unrecognized.