Amid Regional COVID-19 Surge, Doctors Say Now Is the Time to Protect Hospitals
By Christina Stella , Reporter/Producer Nebraska Public Media
Nov. 11, 2020, 4:48 p.m. ·
On Monday, the state of Nebraska reported over 2,000 new COVID-19 cases. Infectious disease experts statewide say those kinds of numbers — coupled with rising hospitalizations — will max out Nebraska’s health system in coming weeks.
With just under a third of hospital and ICU beds available, healthcare systems across the state are reporting strained resources. As of yesterday, 860 Nebraskans are hospitalized with COVID-19.
Dr. Andrew Pavia, an infectious disease expert at the University of Utah and fellow at the Infectious Diseases Society of America says similar situations are also playing out in nearby states like Utah, North Dakota, Iowa, and Wisconsin.
He and counterparts in Nebraska agree that stricter policies must be put in place regionally to reverse the tide, preserve capacity, and allow providers to maintain quality of care.
"Under normal circumstances, if you're admitted to an ICU, you have either a nurse devoted just to you or another nurse taking care of two patients," he explained. "Right now in many ICUs around the region, it's one nurse to four patients or five patients ... you may have care coming for 8 to 12 patients from an ICU trained doctor."
A higher caseload inevitably leads to burnout among staff, which is its own burgeoning epidemic. But it can also impact patient outcomes when hospitals are forced into an all-hands-on-deck scenario. In some hospitals, doctors and nurses who don't typically work in the ICU are finding themselves treating severe COVID cases.
"This doesn't have to do with running out of respirators, you know ventilators yet," he said. "It just has to do with the fact that to help somebody survive an illness like this, it requires a great deal of care from very skilled paid people. And as we have to spread those resources, then the care gets less good."
As an extreme surge is unfolding in North Dakota, officials recently announced care providers who are COVID-19 positive will be allowed to come to work and care for patients with the virus due to a lack of backup staffing. Pavia says states must prevent these scenarios by ramping up the “amount of control” they use to fight the outbreaks with stricter policies.
“The kinds of things that are effective includes having some teeth to your mask mandate, making sure that businesses are allowed to exclude customers who don't wear a mask," Pavia said.
"It means that some places like bars and gyms and probably restaurants need much stricter restrictions. And you can't have a lot of loopholes for large public gatherings that allow you to have crowds inside a gym or a sports arena.”
While Nebraska still does not have a statewide mask mandate, slightly tighter measures went into effect across the state this week. They include a mask requirement for Nebraskans getting a haircut, tattoo, massage, or other close-contact service, a rule to keep a distance of six feet at indoor gatherings, which are now limited to 25% occupancy, and a six-foot distance requirement in restaurants.
Some medical professionals have criticized the measures, saying they don’t go far enough.
"Unfortunately, those DHMs that were announced today are grossly insufficient to slow down transmission rates in the community and those are not going to dramatically deflect the curve," Dr. James Lawler told KMTV on Monday. Lawler is an infectious disease physician and co-director of the Global Center for Health Security at the University of Nebraska Medical Center.
In an op-ed published by The Washington Post on Wednesday, he wrote that indoor restaurants, clubs, and bars should be closed, masks must be mandated, and gatherings of no more than 10 people should be allowed nationwide.
NET News is tracking the spread of COVID-19 in Nebraska. You can find more information on cases, hospitalizations, deaths, and more here.