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Covid-19
Board of health recommends mask policy to deal with COVID-19 crisis

Calling the rising number of novel coronavirus, COVID-19, cases a crisis, members of the Hastings Board of Health recommended approval of an ordinance requiring masks indoors when maintaining 6 feet of separation isn’t possible.

The Board of Health voted 5-0 during an emergency meeting Friday to make that recommendation to the Hastings City Council, which meets 5:30 p.m. Monday in the Hastings City Building.

Friday’s meeting marked the first meeting of the Board of Health in decades. The board includes the mayor, council president, police chief, a physician and member at large.

Dr. Mackenzie Hemje, a family physician with Family Medical Center of Hastings who also serves as the city physician, and City Administrator Dave Ptak were appointed at the council’s April 13 meeting to fill the physician and member-at-large positions.

The meeting’s only agenda item was to review Ordinance No. 4650 dealing with COVID-19 and a face mask policy for the city of Hastings.

Michele Bever, executive director of the South Heartland District Health Department, began the meeting summarizing a letter she wrote Thursday to Mayor Corey Stutte recommending a masking policy for the city of Hastings that coincides with the passage of similar policies in Kearney and Grand Island. The Kearney City Council approved its policy Tuesday, and the Grand Island City Council is scheduled to act during its meeting Nov. 24.

“Our regional hospitals are very close to capacity,” Bever said. “Patients, who under normal circumstance would be cared for in ICUs, are now being managed in medical surgical units because there are either no beds, or not enough staff in ICUs, or nowhere to transfer them.”

For the week ending Oct. 3, Adams County averaged 12 new cases daily.

Just one month later, for the week ending Nov. 7, the average increased to 38 new cases daily. Now, just two weeks later, Adams County is averaging 56 new cases daily.

Today, 68% of hospitalizations in the South Heartland District are related to COVID-19.

“We are at a critical juncture,” Bever said. “If we don’t act as a community and act locally now, we are going to have additional uncontrolled spread, and that will increase numbers on our health care system and can result in many more deaths.”

Masking has a lot of science behind it, and it’s an effective procedure.

Bever cited a study conducted by the University of Kansas Institute for Policy and Social Research that evaluated the effectiveness of mask policies in Kansas counties, finding counties with mask policies began seeing a decrease in cases about 14 days after the policy went into effect.

An oscillation of increases and decreases followed, but overall those communities maintained about 20 average new daily cases per 100,000 population.

By comparison, counties that didn’t have universal mask policies continued with a steady increase in cases and had nearly twice as many average new daily cases per 100,000 than counties with mask policies.

“This is an important tool to use,” Bever said. “It’s a non-pharmaceutical intervention that can be used, along with social distancing.”

The ordinance draft states everyone 5 years of age and older will be required to wear a face mask covering their mouth and nose while indoors in premises open to the general public.

Among exemptions is anyone: seated at a bar or restaurant while eating or drinking; engaged in an occupation preventing the wearing of a face covering; obtaining a service or purchasing goods or services that requires the temporary removal of a face covering; removing a face covering to verify an identity; providing a speech to an audience as long as the audience is at least 6 feet away; or having medical conditions preventing the wearing of masks.

Individuals who are alone in an office, officiating at a religious service, exercising in an indoor facility where the level of exertion makes it difficult to wear a mask, or communicating with other individuals who have a disability making communication difficult also are among those exempted.

Ptak pointed out the policy doesn’t close any businesses.

“It protects our hospitals and our care workers that work there, as well as our first responders,” he said. “That’s what we need to do to make sure that we don’t overload either one of those.”

Hemje said in his role as a private-practice primary care family physician he cares for COVID-19 patients on a daily basis.

He said in his discussion with other physicians, he said their experience with masks echoes the research Bever cited.

Less transmission was found upon contact tracing.

He also collaborates with the health department and Mary Lanning Healthcare.

He said the hospital’s biggest concern is medical beds and staffing.

Hemje said according to the most recent data, 130% of staff beds are occupied.

That means over the medical industry standard, nurses and doctors in the hospital are overburdened by 30% above what is considered a safe staffing capacity.

He said 23 out of 26 designated Mary Lanning COVID-19 beds are occupied.

“Some of those were set up within the last weeks by the help of engineering from the hospital,” he said. “Those take a lot of work from engineering at the hospital to make sure air flow in the hospital in those rooms are safe for both patients and those providers taking care of them.”

The hospital also needs beds to care for patients dealing with conditions like pneumonia, kidney failure, car accidents, heart attacks and strokes.

“That’s our biggest concern right now,” Hemje said. “It’s not just numbers on hospitalization rates, death rates for COVID. It’s also affecting outcomes in otherwise curable, treatable conditions.”

Police Chief Adam Story said the police department wants to do anything and everything possible to help the community.

“The shutdowns in the past were extremely tough for our community,” he said. “Seeing the success in schools is something that is very positive. We will do anything to help encourage doing the best practices for our community.”

Council President Paul Hamelink asked Hemje whether he would consider the current COVID-19 situation a crisis, and Hemje agreed.

“I personally believe in wearing masks,” Hamelink said. “There’s a lot of community discussion about that. A lot of disputed science. With all due respect to our medical folks here who cited that, there are a lot of people who wouldn’t agree.”

He said people are searching the internet and sending him information from all sorts of sources.

The University of Nebraska Medical Center is arguably one of the best facilities for viral issues in the world, Hamelink said. He has received health care from there.

“On the advice from UNMC, they believe in wearing masks,” he said. “That kind of settles the issue for me. If that’s their recommendation, that’s how I’m basing my decision.”

Hastings needs to do everything possible as a community to solve this crisis, he said.

“We need to respond. Our community needs to respond,” Hamelink said. “We have to do something to address the issues of our hospital beds, in particular, because this stretches far beyond COVID. If our hospital is affected and we have a non-COVID, life-threatening issue it puts you at higher risk.”

Ptak said the city needs to protect its first responders.

As of Friday, the city has 48 employees either in quarantine or who tested positive for COVID-19, compared to just eight from the start of the pandemic through the beginning of November.

“As a result, our first responders, police and fire, have been hit with the largest percentage of the 48 as far as how it affects their abilities to deal with and provide essential services as far as the citizens of Hastings,” he said.


Adams Central greenhouse takes shape
  • Updated

Construction continued this week as a new greenhouse at Adams Central High School took shape with hopes of having students using the building by January 2021.

The new structure is located to the west of the school and south of the track. Contractors on Friday started adding the distinctive panels that will help distinguish the metal frame as a greenhouse.

Brandon Jacobitz, agriculture instructor and FFA adviser at Adams Central, said that once the structure is enclosed, the process will be protected from inclement weather. He expects construction to finish within the next four weeks.

The greenhouse features an underground heat transfer system that will help reduce energy costs.

Contractors dug down 3.5 feet into the ground to install 1,800 feet of black tubing and four pipes to serve as an air movement system. The circulation will act like a heat pump, only using air instead of water.

“It’s using the natural heat of the ground,” Jacobitz said. “It will also reduce the humidity and moisture content.”

aroh / Amy Roh/Tribune  

A crew from Integrity Construction of Axtell works on the building of a greenhouse Thursday at Adams Central.

The greenhouse will have an automatic shade system, automated control system and automated irrigation system. In addition to making it easier to maintain the structure, he said, it also gives students a firsthand look at automated systems that can be used in agriculture.

Adding a greenhouse at the school had been discussed since about two years after the agriculture and FFA programs were brought to Adams Central. Jacobitz said students had learned about other schools being able to work in a greenhouse and asked school officials about it.

Planning for the greenhouse started alongside talks about renovations to the parking lot and school entrance. At that point, Jacobitz said, the goal was simply to keep a greenhouse in mind as plans for the parking lot were made so that any needed underground lines could be installed while other work was being done.

“It started as a way to plan ahead, and it blossomed into saying we would see this thing through,” he said.

But when schools were forced to close in March due to the pandemic, Jacobitz said it helped spur efforts to get the greenhouse under way.

“It allowed me extra time to do the legwork with the greenhouse companies,” he said.

Jacobitz reached out to a close-knit group of ag teachers across Nebraska, and many recommended Stuppy Greenhouse in Kansas City, Missouri, which is where the school got the structure.

W Design Associates in Hastings created the design plans, and Ceres Greenhouse Solutions in Boulder, Colorado, designed the underground heat transfer system used in the building.

Heartland Concrete in Hastings made the foundation, and A-1 Fiberglass provided the piping underground.

“It really was a group effort,” Jacobitz said.

Once complete, the greenhouse will be used for both agricultural production and scientific research.

Jacobitz said this is the first time Ceres has had one of its systems installed for an educational facility. The school has agreed to provide its data to the company as a case study.

For the students, it’s a chance for real-world application of scientific skills. He said the school has a core group of students who are interested in research.

“As soon as we’re up and running, we’re going to be doing tests to measure energy consumption,” Jacobitz said. “It’s going to be great to see them sink their teeth into something that is real.”

Through FFA, students have been working on ag-related research, which has been taken to state and national stages.

Jacobitz said the project wouldn’t have been possible without help from the ag community, school district and others in the area.

“We’ve been fortunate since the start of the ag education and FFA programs to have received a lot of support from the ag community,” he said.


Bruning-Davenport/Shickley players hold up their Class D2 state championship trophy Friday in Shickley.


Covid-19
Watson School closed all next week due to COVID-19
  • Updated

Watson Elementary School will be closed Monday and Tuesday due to multiple staff members recently testing positive for the novel coronavirus disease, COVID-19.

The announcement was made Friday afternoon by Jeff Schneider, superintendent of Hastings Public Schools.

All other HPS buildings will be in session those two days, Schneider said. All schools will be closed Wednesday through Friday for Thanksgiving break.

According to the COVID-19 data dashboard posted to the HPS website, a total of nine Watson staff members and three Watson students have tested positive for the virus since Nov. 9.

Five of the staff members and all three students have received their positive test results since Nov. 14.


Health
AP
Pfizer, BioNTech seek emergency use of COVID-19 shots in US
  • Updated

Pfizer formally asked U.S. regulators Friday to allow emergency use of its COVID-19 vaccine, starting the clock on a process that could bring limited first shots as early as next month and eventually an end to the pandemic — but not until after a long, hard winter.

The action comes days after Pfizer Inc. and its German partner BioNTech announced that its vaccine appears 95% effective at preventing mild to severe COVID-19 disease in a large, ongoing study.

The companies said that protection plus a good safety record means the vaccine should qualify for emergency use authorization, something the Food and Drug Administration can grant before the final testing is fully complete. In addition to the FDA submission, they have already started “rolling” applications in Europe and the U.K. and intend to submit similar information soon.

With the coronavirus surging around the U.S. and the world, the pressure is on for regulators to make a speedy decision.

“Help is on the way,” Dr. Anthony Fauci, the top U.S. infectious disease expert said on the eve of Pfizer’s announcement, adding that it’s too early to abandon masks and other protective measures. “We need to actually double down on the public health measures as we’re waiting for that help to come.”

Friday’s filing sets off a chain of events as the FDA and its independent advisers debate if the shots are ready. If so, still another government group will have to decide how the initial limited supplies are rationed out to anxiously awaiting Americans.

How much vaccine is available and when is a moving target, but initial supplies will be scarce and rationed. Globally, Pfizer has estimated it could have 50 million doses available by year’s end.

About 25 million may become available for U.S. use in December, 30 million in January and 35 million more in February and March, according to information presented to the National Academy of Medicine this week. Recipients will need two doses, three weeks apart. The U.S. government has a contract to buy millions of Pfizer-BioNTech doses, as well as other candidates than pan out, and has promised shots will be free.

Not far behind is competitor Moderna Inc.’s COVID-19 vaccine. Its early data suggests the shots are as strong as Pfizer’s, and that company expects to also seek emergency authorization within weeks.

Here’s what happens next:

MAKING THE DATA PUBLIC

The public’s first chance to see how strong the evidence really is will come Dec. 10 at a public meeting of the FDA’s scientific advisers.

So far, what’s known is based only on statements from Pfizer and BioNTech. Of 170 infections detected to date, only eight were among people who’d received the actual vaccine and the rest had gotten a dummy shot. On the safety side, the companies cite results from 38,000 study participants who’ve been tracked for two months after their second dose. That’s a milestone FDA set because historically, vaccine side effects don’t crop up later than that.

“We’ll drill down on these data,” said FDA adviser Dr. Paul Offit of the Children’s Hospital of Philadelphia.

Think of it like science on trial. A few days before the meeting, the FDA will release its own internal analysis. That sets the stage for the advisers’ daylong debate about any signs of safety concerns and how the new vaccine technology works before rendering a verdict.

They’ll recommend not just whether FDA should allow broader use of the vaccine generally but if so, for whom. For example, is there enough proof the vaccine works as well for older, sicker adults as for younger, healthier people?

There’s still no guarantee. “We don’t know what that vote’s going to be,” said former FDA vaccine chief Norman Baylor.

EMERGENCY USE ISN’T THE SAME AS FULL APPROVAL

If there’s an emergency green light, “that vaccine is still deemed investigational. It’s not approved yet,” Dr. Marion Gruber, chief of FDA’s vaccine office, told the National Academy of Medicine this week.

That means anyone offered an emergency vaccination must get a “fact sheet” describing potential benefits and risks before going through with the shot, she said.

There will be a lot of unknowns. For example, the 95% protection rate is based on people who developed symptoms and then were tested for the virus. Can the vaccinated get infected but have no symptoms, able to spread the virus? How long does protection last?

That’s why the 44,000-person study needs to keep running — something difficult considering ethically, participants given dummy shots at some point must be offered real vaccine, complicating the search for answers.

“I’m curious,” said Barry Colvin, 52, of White Plains, New York, who is taking part in that study at NYU Langone Health.

But he’s not in a great hurry to find out which group he’s in. “You need to hang in there for a while to understand and answer a lot of the other questions that remain unknown.”

Additionally at least for now, pregnant women won’t qualify because they weren’t studied. Pfizer only recently began testing the vaccine in children as young as 12.

A decision on Pfizer-BioNTech’s vaccine won’t affect other COVID-19 vaccine candidates in the pipeline, which will be judged separately.

MANUFACTURING

Brewing vaccine is more complex than typical drug manufacturing, yet the millionth dose to roll out of Pfizer’s Kalamazoo, Michigan, factory must be the same purity and potency as every dose before and after.

That means the FDA decision isn’t just based on study data, but on its determination that the vaccine is being made correctly.

The Pfizer-BioNTech vaccine — and Moderna’s shots — are made with brand-new technology. They don’t contain the actual coronavirus. Instead, they’re made with a piece of genetic code for the “spike” protein that studs the virus.

That messenger RNA, or mRNA, instructs the body to make some harmless spike protein, training immune cells to recognize it if the real virus eventually comes along.

GETTING INTO PEOPLE’S ARMS

Another government group — advisers to the Centers for Disease Control and Prevention — decides who is first in line for scarce doses. Health and Human Services Secretary Alex Azar said he hopes that decision can be made at the same time as FDA’s.

The Trump administration’s Operation Warp Speed has worked with states to line up how many doses they’d need to cover the populations offered vaccine first.

Pfizer will ship those supplies as ordered by the states — only after FDA gives the OK.

Company projections of how much it will ship each month are just predictions, Baylor warned.

“It’s not like a pizza,” he said. Manufacturing is so complex that “you don’t necessarily end up with what you thought.”