Paul Hammel
LINCOLN — With terms such as “directed health measure,” “personal protective equipment” and “quarantine” being spoken at the State Capitol on Wednesday, you’d think the COVID-19 pandemic was still underway.
Instead, a panel of state lawmakers called on nine health care associated officials to look back and explain what went right, and wrong, with Nebraska’s response to the pandemic, which killed 5,068 people in the state, according to a New York Times count in March.
During a hearing that lasted more than four hours, representatives of the state’s nurses, doctors, hospitals, nursing homes and health and disaster response departments recounted the state’s scramble to avoid the spread of the highly contagious disease, obtain masks and other protective gear amid fierce competition and avoid a stampede of infected people overwhelming hospitals across the state.
“The pandemic was new to all of us,” said Dr. John Trapp, the president of the Nebraska Medical Association. “Every day was a challenge.”
“We were building a plane while we were flying it,” said Charity Menefee, the director of the public health division of the Nebraska Department of Health and Human Services.
The interim study was sought by State Sen. Ben Hansen of Blair, the chairman of the Legislature’s Health and Human Services Committee, who has introduced bills to block the state and businesses from mandating COVID-19 vaccinations.
Hansen said he called the hearing so that if “COVID 2.0” comes, the state is better prepared and has learned from the pandemic, which began in early 2020 and was declared over in March by the Centers for Disease Control and Prevention.
‘Did a lot right’
“I think we did a lot right, but I hope there’s room for improvement,”Hansen said.
“I know a lot of people are tired of even saying the word ‘COVID-19,’ and we hope that it’s in our rear-view mirror,” he added. “But I also don’t want to lose all the things we’ve learned if it happens again.”
Generally, those testifying said Nebraska fared well in blunting the spread of COVID-19, did a good job in communicating why people needed to avoid crowds and wear masks and avoided some of the stricter shutdowns and mandates adopted in other states.
Some lauded then-Gov. Pete Ricketts for prioritizing hospital capacity, and many said that allowing local officials to make decisions about controlling COVID worked best.
The pandemic opened the way for increased use of “telemedicine” and Zoom meetings, testifiers added.
‘Vulnerable’ populations needed more
On the down side, they said the pandemic exacerbated nursing shortages and exposed a wider lac kof places, due to staff shortages, to transfer patients who no longer needed hospitalization. They said officials may have moved too slowly to help the most vulnerable populations — the aged and those working in essential industries such as meatpacking.
“There were a lot of vulnerable people who were not given the access they needed,” said Omaha Sen. Machaela Cavanaugh.
Linda Hardy, a registered nurse and president of the Nebraska Nurses Association, said the number of nurses working in the state decreased by 9.5% from 2018-19 to 2020-21.
The “crisis,” she said, was caused in large part by the “baby boomer” generation nurses retiring and by burnout caused by staff shortages and mandatory overtime.
“It is the responsibility of the nursing profession with our Nebraska legislators to find solutions to address this problem,” Hardy told the committee.
Test Nebraska was expensive, but worked
Angela Ling, who became “incident commander” for DHHS’s response to COVID, said it was expensive to hire Nomi Health to set up the “Test Nebraska” program — nearly $69 million in five no-bid contracts, according to the Omaha World-Herald) .
But Ling said it allowed all Nebraskans to get free COVID tests and set up “strike teams” that went into state facilities and nursing homes to do testing there.
“Without this platform, Nebraskans wouldn’t have had the opportunity to test and make the best decisions for their families regarding work and engaging with others,” she said.
But Ling added that it was “terrifying” when she was unable to find an available bed at a more advanced hospital — even after calling all facilities in Nebraska and adjoining states — for a critically ill patient who needed to transfer out of a rural hospital.
The logjam was relieved, she said, when the state set up “alternative care sites” at the end of 2021 for patients discharging from hospitals and awaiting placement at long-term care facilities. That freed up beds for critically ill patients from rural areas.
‘Think outside the box’
Ling urged future leaders to “think outside the box” to solve problems, adding that Nebraska was possibly the only state that tried alternative care sites.
Hansen asked nearly every testifier if there were steps lawmakers could take to make the jobs faced by doctors and nurses less burdensome. One consistent response was less paperwork.
A survey by the Nebraska Nurses Association in 2020 also found that 19% of respondents felt that higher pay was needed.
Jeremy Nordquist, of the Nebraska Hospital Association, said the association’s polling indicated that three out of 10 health care workers are considering leaving the profession.
In addition, 41% of the state’s hospitals are operating in the red, Nordquist said, due to necessary increases in pay, increased supply costs and the need to hire more “traveling” nurses — nurses who cost up to $200 an hour during the peak of the pandemic — to fill vacant posts.
Scottsbluff Sen. Brian Hardin said the recent pandemic “flipped the paradigm” of how to handle contagious disease. Instead of quarantining the sick, he said, “the healthy” were quarantined.
“Will patients become prisoners in hospitals, in nursing homes?” the senator asked, using the example of patients dying from COVID who were isolated from their families.
“The evidence is there. We took risks that were unnecessary,” Hardin said.
Dr. Trapp said that those were difficult decisions but that the first duty of physicians is to “keep our patients safe.”
While such separation was “not desirable,” there was not an abundance of protective gear for families to wear, he said, adding that keeping people away from an infected patient “absolutely” kept other people safe.
A representative of the state’s nursing homes and assisted living facilities said that such facilities tried many creative ways to keep residents in touch with families, including computer tablets, window visits and even cloaking family members in plastic gear so they could hug a loved one.
Were vaccines effective?
Hardin also asked, whether the vaccines were effective.
“No question in my mind vaccines were effective,” the doctor answered. “It saved lives, probably millions of lives.”
Earlier, Hardin asked whether some drugs were still on the “naughty list,” such as ivermectin, a medicine used most frequently to treat roundworm and other parasites in horses.
Trapp said that he does not prescribe that medicine for “off label” uses and that there’s no proof it works for COVID, though he acknowledged that some doctors will prescribe it.
The doctor added that the mask mandate adopted in Lincoln allowed the state’s second-largest city to have one of the lowest death rates from COVID.
Hansen cited a January report by the Cochrane research institute, saying it concluded, after looking at 78 different studies, that wearing masks was ineffective. The report stated that there was “uncertainty” about whether masks worked.
Cochrane has since posted a clarification, however, saying it was “inaccurate and misleading” to conclude that masks don’t work.
“It would be accurate to say that the review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses, and that the results were inconclusive,” the institute stated.