Hospital CEOs from across Nebraska sounded the alarm Monday over rising COVID-19 cases that are putting a crunch on hospitals already strained by staff shortages.
The Nebraska Department of Health and Human Services reported 602 hospitalized COVID-19 patients as of Monday morning, a nearly 35% increase since Christmas Eve.
That number remains below the 2021 peak of 637 patients set Dec. 13, and is well below the pandemic high of 987 set Nov. 20, 2020.
But Jeremy Nordquist, president of the Nebraska Hospital Association, said hospital numbers are likely to climb rapidly in the next few weeks thanks to a surge in COVID-19 cases because of the omicron variant.
"We could see a doubling of hospitalizations in Nebraska due to COVID in the next two to three weeks," Nordquist said during a news conference held via Zoom.
In Lancaster County, 130 patients with the virus were hospitalized Monday, but COVID-19 cases last week reached an all-time high during the pandemic of nearly 2,900, topping the previous record of 2,100.
The Lincoln-Lancaster County Health Department reported its 366th death, a man in his 60s who was hospitalized and vaccinated.
Rising hospitalizations resulting from the rapid surge in cases would be bad news for hospitals that are already struggling to care for current patient loads.
Ivan Mitchell, CEO of Great Plains Health in North Platte, said about 25% of the hospital's patients are COVID-positive.
That makes it hard to care for all the patients the hospital has but also affects the region, because Great Plains is often forced to turned down transfer requests from smaller hospitals.
Mitchell said that in a typical year before COVID-19, Great Plains would turn down about 10% of transfer requests, but that number currently is 30%-35%.
It's not only the sheer numbers of COVID-19 patients but also a shortage of health workers.
Mitchell said that he's worked in health care for 20 years, "and in my time, I've never seen a staffing shortage like it is right now."
Usually, he said, the hospital can fill open positions with traveling nurses, but even that option is getting more difficult.
A shortage of health care workers, especially nurses, was an issue before the pandemic, but COVID-19 has made things markedly worse.
"I think it all just came to a head during the pandemic," Mitchell said.
Josie Abboud, president and CEO of Methodist Hospital in Omaha, said workers are leaving for a variety of reasons, including burnout. She also said there are not nearly enough new workers coming out of college to replace the ones who are leaving.
Abboud said Methodist currently has more than 900 open positions.
Todd Consbruck, president and CEO of Avera St. Anthony's hospital in O'Neill, said he's seeing a lot of older workers, who stayed during the early part of the pandemic out of a sense of duty, now deciding to retire.
Consbruck applauded the workers who continue to gut it out, noting they face a lot of challenges, including a lack of respect and kindness from frustrated patients and their families.
"Thank God they keep coming to work every day and caring for people," he said.
The long-term staffing issues are also being exacerbated by a short-term problem: As the omicron variant rages through communities, health care workers and their families are getting sick, which is taking vital people out of the workforce.
Abboud said Methodist currently has 178 employees out because of COVID-19, including about 50 nurses.
Nebraska has seen more than 16,000 new COVID-19 cases over the past seven days, an average of more than 2,350 cases a day. Less than a month ago, it was averaging less than 1,000 cases a day.
Hospitals have taken a number of measures to free up space in preparing for more patients, such as canceling some elective surgeries and using operating and recovery areas as patient rooms.
But the hospital executives said they need the public's help to slow the surge of people heading to the hospital because of COVID-19.
"We need people to vaccinate," said Consbruck, who added that people should also get a booster shot if eligible.
And, he said, people need to "take it seriously" when they are ill, stay home and not attend family and social gatherings.
"I think there's just a numbness to COVID," Consbruck said. "People think in some sense it's went away."
Virus Q&A: Answers to common questions about COVID-19 vaccines, travel and more
Do at-home COVID-19 tests detect the omicron variant?
Yes, but U.S. health officials say early data suggests they may be less sensitive at picking it up.
Government recommendations for using at-home tests haven't changed. People should continue to use them when a quick result is important.
"The bottom line is the tests still detect COVID-19 whether it is delta or alpha or omicron," says Dr. Emily Volk, president of the College of American Pathologists.
Government scientists have been checking to make sure the rapid tests still work as each new variant comes along. And this week, the Food and Drug Administration said preliminary research indicates they detect omicron, but may have reduced sensitivity. The agency noted it's still studying how the tests perform with the variant, which was first detected in late November.
Dr. Anthony Fauci, the top U.S. infectious disease expert, said the FDA wanted to be "totally transparent" by noting the sensitivity might come down a bit, but that the tests remain important.
There are many good uses for at-home tests, Volk says. Combined with vaccination, they can make you more comfortable about gathering with family and friends.
If you've been exposed to a person who tested positive but you don't have symptoms, a rapid test five days later can give a good indication of whether you caught the virus. It can also help if you're not sure whether your runny nose or sore throat is COVID-19.
But consider the context when looking at results. If you feel sick after going out to a nightclub in an area with high infection rates, for example, you should look at a negative result from an at-home test with a little more skepticism, Volk says.
Following up with a PCR test is a good idea, she says. Those tests are more accurate and are done at testing sites and hospitals.
Can my pet get COVID-19?
Yes, pets and other animals can get the coronavirus that causes COVID-19, but health officials say the risk of them spreading it to people is low.
Dogs, cats, ferrets, rabbits, otters, hyenas and white-tailed deer are among the animals that have tested positive, in most cases after contracting it from infected people.
While you don't have to worry much about getting COVID-19 from your pets, they should worry about getting it from you. People with confirmed or suspected COVID-19 should avoid contact with pets, farm animals and wildlife, as well as with other people, according to the U.S. Centers for Disease Control and Prevention.
"If you wouldn't go near another person because you're sick or you might be exposed, don't go near another animal," says Dr. Scott Weese at Ontario Veterinary College.
Not all infected pets get sick and serious illness is extremely rare. Pets that show symptoms typically get mildly ill, the CDC says.
Some zoos in the U.S. and elsewhere have vaccinated big cats, primates and other animals that are thought to be at risk of getting the virus through contact with people.
This particular coronavirus most likely jumped from animals to humans in the first place, sparking a pandemic because the virus spreads so easily between people. But it does not easily spread from animals to people. Minks are the only known animals to have caught the virus from people and spread it back, according to Weese.
Three countries in northern Europe recorded cases of the virus spreading from people to mink on mink farms. The virus circulated among the animals before being passed back to farmworkers.
How easily animals can get and spread the virus might change with different variants, and the best way to prevent the virus from spreading among animals is to control it among people, Weese says.
Is travel safe during the pandemic this holiday season?
It depends. It can be safe if you're fully vaccinated against COVID-19, but officials say people who haven't gotten the shots should delay travel.
Regardless of vaccination status, all travelers should keep taking precautions like avoiding indoor, unmasked crowds, says Dr. Keith Armitage, an infectious disease expert at Case Western Reserve University.
"The delta variant has really brought us back to an earlier time in the pandemic," he says.
The U.S. Centers for Disease Control and Prevention says not to travel if you're sick, or if you tested positive for COVID-19 and your isolation period isn't over yet — even if you're fully vaccinated. Unvaccinated people who decide to travel should get a COVID-19 test one to three days before travel and three to five days after returning.
All travelers must still wear masks on trains, planes and other indoor public transportation areas, the agency says.
Airlines say plane cabins are low risk since they have good air circulation and filtration. However, there is no requirement for vaccination or testing before domestic flights, and passengers can remove their face masks while eating or drinking.
Hotels aren't risky for the vaccinated as long as they wear masks around strangers, Armitage says. More fraught are family gatherings with unvaccinated individuals, particularly for those who are older or have health problems.
Health experts suggest looking at the case levels and masking rules in the place you are visiting before you travel.
Why can't some COVID-19 vaccinated people travel to the US?
Because they might not be vaccinated with shots recognized by the U.S. Food and Drug Administration or the World Health Organization.
When lifting overseas travel restrictions in November, the U.S. required adults coming to the country to be fully vaccinated with shots approved or authorized by the FDA or allowed by WHO.
Among the most widely used vaccines that don't meet that criteria are Russia's Sputnik V vaccine and China's CanSino vaccine. Sputnik V is authorized for use in more than 70 countries while CanSino is allowed in at least nine countries. WHO still is awaiting more data about both vaccines before making a decision.
Vaccines recognized by the FDA and WHO undergo rigorous testing and review to determine they're safe and effective. And among the vaccines used internationally, experts say some likely won't be recognized by the agencies.
"They will not all be evaluated in clinical trials with the necessary rigor," said Dr. William Moss, executive director of the Johns Hopkins International Vaccine Access Center.
An exception to the U.S. rule is people who received a full series of the Novavax vaccine in a late-stage study. The U.S. is accepting the participants who received the vaccine, not a placebo, because it was a rigorous study with oversight from an independent monitoring board.
The U.S. also allows entry to people who got two doses of any "mix-and-match" combination of vaccines on the FDA and WHO lists.
Are COVID-19 boosters the same as the original vaccines?
Yes, COVID-19 boosters use the same recipe as the original shots, despite the emergence of the more contagious delta variant. The vaccines weren't tweaked to better match delta because they're still working well.
The vaccines work by training your body to recognize and fight the spike protein that coats the coronavirus and helps it invade the body's cells. Delta's mutations fortunately weren't different enough to escape detection.
The increased protection you might get from a booster adjusted to better match the delta or other variants would be marginal, says Dr. Paul Goepfert, director of the Alabama Vaccine Research Clinic at the University of Alabama at Birmingham.
Manufacturing doses with a new formula would have also delayed the rollout of boosters.
Moderna and Pfizer are studying boosters tweaked for the delta and other variants to be ready if one's ever needed. Health authorities would have to decide if and when a vaccine formula swap would be worthwhile.
"What we don't know," Goepfert noted, "is if you have a delta vaccine compared to the regular vaccine, does it actually work better in preventing transmission or asymptomatic infection?"
The U.S. has authorized booster doses of the Pfizer, Moderna and Johnson & Johnson vaccines for certain people, and a few other countries also are using boosters of those shots or other COVID-19 vaccines.
Can at-home COVID-19 tests make holiday gatherings safer?
Yes, combined with vaccination, home test kits for COVID-19 can add a layer of safety and reassurance by providing on-the-spot results during this second year of pandemic holidays.
"We will be using rapid tests to doublecheck everybody before we gather together," says Dr. Emily Volk, president of the College of American Pathologists, who is planning a holiday meal with six vaccinated family members. "We'll be doing it as they come in the door."
Home kits are not as accurate as the PCR tests done in hospitals and at testing sites, Volk says. But they have the advantage of giving results within minutes instead of days.
Testing kits are available at drugstores without a prescription, and a box with two tests typically costs about $25. Swabs, testing solution and instructions are included.
Adults and teens can test themselves. An adult can test a child as young as 2. How-to videos on product websites can be helpful.
Most tests require swabbing about a half inch inside both nostrils, so it may tickle but doesn't hurt. You will get a positive result if the test detects a viral protein in your sample.
Home tests will miss some infections and in rare cases mistakenly indicate an infection. One popular test misses around 15 out of 100 infections — these are called "false negatives" — and gives a false positive result in about 1 in 100 people who aren't infected.
Test shortages were widely reported during the last COVID-19 surge, but new options have recently hit the market and major manufacturers such as Abbott Laboratories have ramped up production.
The Centers for Disease Control and Prevention offers other tips on ways to enjoy the holidays safely. Vaccination remains the best way to protect against the coronavirus.
How will the world decide when the pandemic is over?
There's no clear-cut definition for when a pandemic starts and ends, and how much of a threat a global outbreak is posing can vary by country.
"It's somewhat a subjective judgment because it's not just about the number of cases. It's about severity and it's about impact," says Dr. Michael Ryan, the World Health Organization's emergencies chief.
In January 2020, WHO designated the virus a global health crisis "of international concern." A couple months later in March, the United Nations health agency described the outbreak as a "pandemic," reflecting the fact that the virus had spread to nearly every continent and numerous other health officials were saying it could be described as such.
The pandemic may be widely considered over when WHO decides the virus is no longer an emergency of international concern, a designation its expert committee has been reassessing every three months. But when the most acute phases of the crisis ease within countries could vary.
"There is not going to be one day when someone says, 'OK, the pandemic is over,'" says Dr. Chris Woods, an infectious disease expert at Duke University. Although there's no universally agreed-upon criteria, he said countries will likely look for sustained reduction in cases over time.
Scientists expect COVID-19 will eventually settle into becoming a more predictable virus like the flu, meaning it will cause seasonal outbreaks but not the huge surges we're seeing right now. But even then, Woods says some habits, such as wearing masks in public places, might continue.
"Even after the pandemic ends, COVID will still be with us," he says.
The AP is answering your questions about the coronavirus in this series. Submit them at: FactCheck@AP.org.
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