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'One of the darkest times of the pandemic': Nebraska hospital leaders share fears as COVID-19 positivity rate soars

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The number of patients hospitalized because of the coronavirus rose from 440 on Dec. 26 to about 650 this week, the Nebraska Hospital Association said Monday.

At the same time, the percentage of Nebraskans testing positive for COVID-19 has skyrocketed from 11% to 27% — a potential harbinger of more hospitalizations to come over the next month.

The latest spike, driven by the highly transmissible omicron variant, has continued to strain hospitals, said Jeremy Nordquist, president of the Nebraska Hospital Association.

It's led Nebraska Medicine to enact its crisis standards of care plan, which includes postponing surgeries and limiting outpatient appointments in order to preserve capacity of the most critically ill patients.

The spread of omicron has also pushed Lincoln to reimpose the mask mandate officials let expire just before Christmas and led Omaha to impose its own last week over the objections of Gov. Pete Ricketts.

"There is no doubt we are still in one of the darkest times of the pandemic," Nordquist said Monday during a conference call with reporters. "This is going to be with us for a little while longer."

Bryan Health in Lincoln, which reported a hospital census of 543 patients Monday, well above its surge capacity, has not yet enacted its crisis plan, according to John Trapp, a pulmonologist and vice president of medical affairs.

Still, at noon Monday, there were 20 patients in Bryan's emergency department waiting for an inpatient bed, and 19 others — including those needing ICU-level care for COVID-19 — on a waiting list to transfer into the hospital.

Nearly 40% of intensive care unit beds at Bryan Health campuses in Lincoln are occupied by COVID-19 patients as of Monday.

Also, 38% of its 42 ICU beds are in use by patients who are actively receiving treatment for COVID-19 or who are no longer infected with the virus but are still grappling with its effects.

Bryan has done what it can to move health care staff to areas that need additional support or holes filled because of staff being out sick, Trapp said.

It has also restricted surgeries requiring an overnight stay in an effort to keep beds available.

"We're using every contingency available to us to manage patient flow," he said. "It's a very fluid time; this could change very quickly."

The strain on hospitals and health care workers in Lincoln is also being felt in places such as Box Butte General Hospital in Alliance, where the number of total COVID-19 patients has doubled since Jan. 3.

At the start of the year, there were eight people hospitalized at Box Butte General with the virus, according to CEO Lori Mazanec.

The number for the hospital in the Panhandle stood at 16 on Monday.

Mazanec said she expects those numbers could climb higher in the coming weeks, and persist 1-2 weeks after the latest wave begins to subside in the more populous areas of eastern Nebraska.

That's a troubling trend, she said. Between an overworked staff, unfilled openings and some health care workers out sick themselves, Mazanec said Box Butte General is "stretched thin" before the peak has arrived.

Further complicating matters is the inability to transfer patients, both those with and without COVID-19 needing more specialized care, to other hospitals in Nebraska or across the Midwest.

Mazanec said the staff at Box Butte General have called 40-60 hospitals looking for openings for some patients.

"Because the big hospitals are full, it has a rippling effect on the smaller hospitals," she said. "Our local resources are being exhausted."

CHI Health St. Francis has typically been able to accept transfers from whomever asked before the pandemic, said Ed Hannon, president of the Grand Island hospital.

Spiking hospitalizations — Hannon said between 70%-75% of patients hospitalized with COVID-19 are unvaccinated, including 90%-95% of those in the ICU — combined with staff out sick have created added stress.

More than 40 of the hospital's 750 employees have tested positive for COVID-19 recently, according to Hannon.

"The staff are tired, they've been dealing with this for almost two years and they would love to see an end to this," he said.

Monday's news conference was meant to convey the severity of the current situation in the pandemic, Nordquist said, and allow hospital leaders to once again ask Nebraskans "to do the right things."

That includes getting fully vaccinated and boosted, observing social distancing, wearing a mask, and staying home if you feel sick.

"Because of the contagiousness of this, staying home is key to preventing transmission," Mazanec said.

Data from the Nebraska Department of Health and Human Services shows 67% of Nebraskans "have chosen to do the right thing" in getting vaccinated, Nordquist said, with the number continuing to tick up slowly.

The Nebraska Hospital Association is also anticipating an order from Ricketts in the coming days to open up beds at skilled nursing facilities for patients who are ready to leave the hospital but not yet ready to go home.

Nordquist said those facilities are also working through their own staffing challenges, but he said hospitals welcomed any relief available.

Hannon reiterated the call from hospital leaders for Nebraskans to do what's necessary to help bring the end of the pandemic and to support health care workers across the state.

"COVID is still here; the omicron variant is relentless," he said. "The best thing any of us can do is to keep social distanced and get the vaccine. Let's not require it; let's just do the right thing."

Chris Dunker's memorable stories from 2021

A months-long investigation into issues at the AltEn ethanol plant near Mead dominated Chris Dunker's top stories list, but the Josh Fight was among the highlights.

Reach the writer at 402-473-7120 or cdunker@journalstar.com.

On Twitter @ChrisDunkerLJS

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