A1 A1
State
AP
Trump back at White House

BETHESDA, Md. — President Donald Trump staged a dramatic return to the White House Monday night after leaving the military hospital where he was receiving an unprecedented level of care for COVID-19. He immediately ignited a new controversy by declaring that despite his illness the nation should not fear the virus that has killed more than 210,000 Americans — and then he entered the White House without a protective mask.

Trump’s message alarmed infectious disease experts and suggested the president’s own illness had not caused him to rethink his often-cavalier attitude toward the disease, which has also infected the first lady and several White House aides, including new cases revealed Monday.

Landing at the White House on Marine One, Trump gingerly climbed the South Portico steps, removed his mask and declared, “I feel good.” He gave a double thumbs-up to the departing helicopter from the portico terrace, where aides had arranged American flags for the sunset occasion. He entered the White House, where aides were visible milling about the Blue Room, without wearing a face covering.

The president left Walter Reed National Military Medical Center, where his doctor, Navy Cmdr. Sean Conley, said earlier Monday that the president remains contagious and would not be fully “out of the woods” for another week but that Trump had met or exceeded standards for discharge from the hospital. Trump is expected to continue his recovery at the White House, where the reach of the outbreak that has infected the highest levels of the U.S. government is still being uncovered.

Still, just a month before the election and anxious to project strength, Trump tweeted before leaving the hospital, “Will be back on the Campaign Trail soon!!!” And in case anyone missed his don’t-worry message earlier, he rushed out a new video from the White House.

“Don’t be afraid of it,” Trump said of the virus. “You’re going to beat it. We have the best medical equipment, we have the best medicines.” His remarks were strong, but he was taking deeper breaths than usual as he delivered them.

Trump’s nonchalant message about not fearing the virus comes as his own administration has encouraged Americans to be very careful and take precautions to avoid contracting and spreading the disease as cases continue to spike across the country. For more than eight months, Trump’s efforts to play down the threat of the virus in hopes of propping up the economy ahead of the election have drawn bipartisan criticism.

“We have to be realistic in this: COVID is a complete threat to the American population,” Dr. David Nace of the University of Pittsburgh Medical Center, said of Trump’s comment.

“Most of the people aren’t so lucky as the president,” with an in-house medical unit and access to experimental treatments, added Nace, an expert on infections in older adults.

“It’s an unconscionable message,” agreed Dr. Sadiya Khan of Northwestern University Feinberg School of Medicine. “I would go so far as to say that it may precipitate or worsen spread.”

Likewise, Democratic presidential nominee Joe Biden, who spent more than 90 minutes on the debate stage with Trump last week, said during an NBC town hall Monday night that he was glad Trump seemed to be recovering well, “but there’s a lot to be concerned about — 210,000 people have died. I hope no one walks away with the message that it’s not a problem.” Biden tested negative for the virus on Sunday.

There was pushback from a prominent Trump political supporter as well.

Republican Sen. John Cornyn of Texas told the Houston Chronicle editorial board that Trump had “let his guard down” in his effort to show that the country was moving beyond the virus and had created “confusion” about how to stay safe.

Conley said that because of Trump’s unusual level of treatment so early after discovery of his illness he was in “uncharted territory.” But the doctor also was upbeat at an afternoon briefing and said the president could resume his normal schedule once “there is no evidence of live virus still present.”

According to the Centers for Disease Control and Prevention, those with mild to moderate symptoms of COVID-19 can be contagious for as many as — and should isolate for at least — 10 days.

Trump’s arrival back at the White House raised new questions about how the administration was going to protect other officials from a disease that remains rampant in the president’s body. Press secretary Kayleigh McEnany announced she had tested positive for the virus Monday morning and was entering quarantine.

There were also lingering questions about potential long-term effects to the president — and even when he first came down with the virus.

Conley repeatedly declined to share results of medical scans of Trump’s lungs, saying he was not at liberty to discuss the information because Trump did not waive doctor-patient confidentiality on the subject. COVID-19 has been known to cause significant damage to the lungs of some patients. Conley also declined to share the date of Trump’s most recent negative test for the virus — a critical point for contact tracing and understanding where Trump was in the course of the disease.

Only a day earlier, Trump suggested he had finally grasped the true nature of the virus, saying in a video, “I get it.” But on Sunday afternoon, he ventured out of the hospital while contagious to salute cheering supporters by motorcade — an outing that disregarded precautions meant to contain the virus.

At the hospital, doctors revealed that his blood oxygen level had dropped suddenly twice in recent days and that they gave him a steroid typically only recommended for the very sick.

Trump’s experience with the disease has been dramatically different from most Americans, who do not have access to the same kind of monitoring and care. While most must cope with their symptoms — and fear of whether they’ll take a turn for the worse — at home and alone, Trump has been staying in the presidential suite of one of the nation’s best hospitals and has been given experimental drugs not readily available to the public. He returns to the White House, where there is a team of doctors on call with 24-hour monitoring.

Trump was leaving the hospital after receiving a fourth dose of the antiviral drug remdesivir Monday evening, Conley said. He will receive the fifth and final dose Tuesday at the White House.

Vice President Mike Pence returned to the campaign trail moments after Trump announced he would soon leave the hospital. The vice president boarded Air Force Two to fly to Salt Lake City, where he is to face off against Democratic vice presidential nominee Sen. Kamala Harris on Wednesday.

Trump, in his new video, defended his decision to repeatedly flout his own administration’s guidelines to slow the spread of the virus, including by holding rallies with thousands of mostly maskless supporters.

Apparently referring to any potential danger to himself rather than others, he said: “I stood out front. I led. Nobody that’s a leader would not do what I did.” He added: “And I know there’s a risk, there’s a danger. But that’s OK. And now I’m better. And maybe I’m immune, I don’t know.”

Even before Trump’s motorcade outing Sunday, some Secret Service agents had expressed concern about the lackadaisical attitude toward masks and social distancing inside the White House, but there isn’t much they can do, according to agents and officials who spoke to The Associated Press.

Trump’s aggressive course of treatment included the steroid dexamethasone and the single dose he was given Friday of an experimental drug from Regeneron Pharmaceuticals Inc. that supplies antibodies to help the immune system fight the virus. Trump on Friday also began a five-day course of remdesivir, a Gilead Sciences drug currently used for moderately and severely ill patients. The drugs work in different ways — the antibodies help the immune system rid the body of virus, and remdesivir curbs the virus’s ability to multiply.

———

Miller and Colvin reported from Washington. Associated Press writers Lauran Neergaard and Jonathan Lemire in Washington, and Bill Barrow in Wilmington, Delaware, contributed to this report.


County planners OK subdivision in Juniata zoning jurisdiction

Members of the Adams County Planning and Zoning Commission recommended approval during their regular meeting Monday of a subdivision application that would allow an existing house to be moved and placed on property near Juniata.

Applicants John and Leslie Hoffman would like to subdivide 2.996 acres along DLD Road within the 1-mile zoning jurisdiction of the village of Juniata.

Commissioners voted 6-0 to recommend approval. Commissioners Brad Henrie, Mike Allen and Ken Lukasiewicz was absent.

The proposed subdivision doesn’t have any improvements on it. The tract is to the south of Rosewood Villa and west of Hoffman Heights Subdivision, both subdivisions in Juniata.

Logan Kershner, who is purchasing a house to place on the property, told the commissioners a crew will be on site to dig a basement on Wednesday.

Also during the meeting, commissioners unanimously recommended approval of the Reprisal Corner Subdivision. Applicants Michael and Lauren Henry of Juniata would like to subdivide 2.80 acres at the intersection of DLD Road and Reprisal Avenue.

The proposed subdivision contains a house, garage, storage building, well and septic system. Michael Henry told commissioners he recently discovered that his garage and storage building were not on the property as believed and is platting property to include them.

“To me this is just the logical layout of the tract,” he said.

Commissioners also recommended approval of rezoning several lots in Kenesaw, west of downtown, to commercial district.

Applicant Spare Lot LLC, which is Jon Denkert, and Michael Quackenbush of Kenesaw are requesting to rezone Lot 47, except the north 6 feet, as well as lots 48, 49, 50, 51, 52, and 53 and adjoining alley, Original Town Kenesaw from R-2 Urban Residential District to C-2 Commercial District.

The lots are near Kenesaw Motors, which Denkert operates, and are used to showcase vehicles.

The zoning districts adjoining said lots and alley are as follows: To the North and west, R-2; to the South, I-2 and to the east C-2.

The Future Land Use Plan lists these lots as C-2; this rezone would be consistent with the comprehensive plan.

The land use plan states “additional commercial development is proposed along Kenesaw Boulevard west of the downtown area.”

A list of the landowners notified is included within the case file.

Commissioner Henry Wilson requested the applicants keep vehicles on those lots at least 20 feet away from adjacent residential property.

Zoning Commissioner Judy Mignery also introduced to the commissioners an administrative replat for the West Fork North 6th Subdivision, which includes 5.25 acres across two lots, north of 88th Street and west of U.S. Highway 281.

Mignery said the applicant plans to open a motorcycle restoration business.

The commission doesn’t need to take action on an administrative replat.


Covid-19
South Heartland breaks daily record for new COVID-19 cases

Fifty-four residents of the South Heartland Health District were confirmed positive for the novel coronavirus disease, COVID-19, Friday through Monday, the district health department reported Monday night.

The four-day total included 29 new cases recorded on Monday alone — a new single-day record. The four days’ new cases included 30 in Adams County, 14 in Clay County and 10 in Nuckolls County.

The previous single-day record for new cases was 25 on May 1.

In a news release, the health department also reported that 81 South Heartland residents were confirmed positive for the viral infection for the week of Sept. 27-Oct. 3.

Although that was a big jump in the cases from the previous week, the four-county health district’s case positivity rate for last week was roughly half of what it was the week before — 7.4%, compared to 14.5%.

The test positivity rate is the total number of new positive cases recorded in a week’s time divided by the total number of test results received, to arrive at a percentage. So the number of test results received obviously is a key value.

By county, the test positivity rates for last week were 8.0% in Adams County, 7.2% in Clay County, 3.5% in Webster County and 2.5% in Nuckolls County — all down significantly.

In Monday’s news release, Michele Bever, the health department executive director, said the department received a whopping 870 test results last week — 193% more than the average number reported to the department per week over the previous three weeks.

Bever said the health department is working on converting the weekly positivity calculation to account for specimen collection date — when tests were administered — rather than when the results were received, and that future positivity calculations will reflect that change.

Both new case tallies and test positivity rates had been increasing week over week in the South Heartland district for several weeks running. In terms of new cases, the string of week-over-week increases now has reached eight.

The district’s four-day total of new cases includes 38 new cases recorded Sunday and Monday to start the tally for the new week.

As of Monday night, a running total of 782 positive cases had been recorded in the health district since March 18. That total included 631 cases in Adams County, 104 in Clay County, 26 in Nuckolls County and 21 in Webster County.

A total of 40 district residents had spent time in a hospital in connection with a COVID-19 diagnosis. Twelve people had died.

According to statistics posted online by the Nebraska Department of Health and Human Services, as of Monday, 249 Nebraska residents were hospitalized for COVID-19 — exceeding the peak number of 232 who were in the hospital May 27, much earlier in the pandemic.

Across the state, 35% of all hospital beds, 33% of intensive care beds and 78% of ventilators were available for use by new patients.

Overall, the pace of new case confirmations is undesirably rapid at this time.

According to a news release Monday from scientists and physicians at the University of Nebraska Medical Center and its affiliated health network, Nebraska Medicine, Nebraska currently is tied for sixth among the 50 U.S. states for daily cases of COVID-19 per capita.

By contrast, the group said, many states and other countries have reduced community rates to near zero through basic precautions.

While the greatest risk of spreading the virus comes from close and prolonged contact with others, and thus social distancing and wearing face coverings are key precautions, the group said, the virus also can spread through the air and infect others at greater distances — especially in indoor environments with poor ventilation.

Moreover, transmission is sporadic, meaning a small number of infected individuals infect large numbers of people. Talking, singing and yelling appear to increase the risk of transmission.

As a demographic group, Nebraskans over age 65 collectively suffer the most from the viral infection. Twenty percent of senior citizens who are diagnosed with COVID-19 have ended up in the hospital, and more than 7% have died.

Meanwhile, however, it’s young people, who in general suffer fewer ill effects from the disease, who are the primary drivers of community outbreaks. Colleges were at the center of community outbreaks across the United States in August and September, the UNMC and Nebraska Medicine group said.

Recent information indicates children get infected with the coronavirus at rates similar to adults. Furthermore, large recent studies indicate children are important sources of transmission to other children and adults.

“In fact, adolescents and younger children may pose the highest risk for community transmission, as infection likely is not symptomatic and often missed,” the UNMC/Nebraska Medicine group said.

The group issued a statement on Monday urging Nebraskans to take the pandemic and the threat posed by COVID-19 seriously.

“We can’t emphasize this enough: COVID-19 ISN’T a political or ideological issue,” they said. “Our advice is the same regardless of political leadership at any level.”

The group encourages: wearing a face covering in public; avoiding large gatherings and close contact indoors; maintaining at least 6 feet of distance from others in public; practicing good hand hygiene; staying home and calling your doctor if you are ill; quarantining at home if you have close contact with someone with COVID-19; and cooperating with public health officials in tracking exposures and illness.

“Our daily counts of COVID-19 cases and hospitalizations are now equal to our May peak and rising rapidly. However, we continue to relax social distancing measures and fully open schools, all while cooler weather begins to drive activities indoors and the annual flu season looms. To absorb the increasing load of patients, Nebraska is relying on hospitals that are currently more than 85% full, which is a very different scenario than in April and May, when hospitals were 50% full. It is a potential perfect storm.”

The doctors and scientists compared Nebraska’s current policy approach to thwarting COVID-19 to the game of Jenga, with more and more blocks being removed from the tower, increasing the odds the entire structure may collapse.

In a fact sheet accompanying their statement, they say that if the current trajectory continues, Nebraska’s health system is likely to be “overwhelmed” by late fall or early winter.

“We understand everyone has pandemic fatigue,” they said in their statement. “We do, also. But we are hearing too many COVID patient stories that start with, ‘I went to a party’ or ‘I visited extended family, but everyone seemed well.’ You’ve seen it on your Facebook feeds — a dozen friends eating dinner in a small indoor space with no masks in sight. This is the perfect environment for COVID-19 to continue to spread, which threatens the lives of our most vulnerable neighbors and family members. We can’t let down our guard.”


Business
AP
Big-name conservatives rally against Nebraska casino measure

LINCOLN — Some of the biggest conservative names in Nebraska politics lined up Monday against ballot measures to legalize casinos, which they argue would fuel an increase in gambling addictions and related social problems.

Voters will decide next month whether to allow casinos at state-licensed race tracks in Omaha, Lincoln, Grand Island, Columbus and South Sioux City. In-person, early voting for the general election started Monday.

Opponents of the legalization measure drew vocal support from Republican Gov. Pete Ricketts, former Gov. Kay Orr, former Nebraska football coach U.S. Rep. Tom Osborne, and a handful of state lawmakers.

“We feel that these initiatives are certain to damage that quality of living,” Osborne said. He said the people affected most “will be the family, spouses and children of those have a gambling problem.”

Backers argue that the three measures, which would legalize, tax and regulate the industry, would create jobs and a new source of state tax revenue.

Opponents tried to keep the issue off the ballot with a lawsuit in September, but the Nebraska Supreme Court ruled that the question can go to voters.

Ricketts said Nebraskans are generally prudent, fiscally responsible and take care of their families, and “casino gambling is opposed to all of those values.”

He pointed to the high-profile cases of former state Sen. Brenda Council, a lawyer who pleaded guilty in 2012 to misdemeanor charges, lost her reelection bid and was disbarred after she admitted to using campaign money to gamble at casinos. Ricketts also cited a Lincoln pharmacist who was sentenced to prison in 2016 for defrauding the Medicaid system out of $14.4 million so he could gamble.

“We already fight gambling addition here in our state,” Ricketts said. “This will make it so much worse.”

Backers counter that Nebraska already has gambling-related problems because of the legal casinos in neighboring Iowa, just a short drive from Omaha across the Missouri River. The Ponca Tribe of Nebraska recently opened a casino in Carter Lake, a town that’s technically a part of Iowa but is located on the western side of the Missouri River and surrounded by Omaha.

A call to the pro-casino group Keep the Money in Nebraska wasn’t immediately returned Monday.

Supporters also say casinos will create jobs and help the state’s struggling horse-racing industry. The main group behind the ballot campaign is Ho-Chunk Inc., the economic development arm of the Winnebago Tribe of Nebraska, which has worked on other job-creation projects in Nebraska and Iowa.

Pat Loontjer, executive director of the anti-casino group Gambling with the Good Life, said she expects to be outspent by gambling supporters but still plan to campaign against it. The group successfully derailed similar ballot measures in the early 2000s.

Nate Grasz, policy director of the Nebraska Family Alliance, said he’s concerned that casinos will exploit low-income residents, who make up a large portion of the industry’s customer base.

“We cannot protect the poor and vulnerable in our state while simultaneously inviting in an industry that relies on blatantly exploiting the poor and the vulnerable,” he said.

Former Republican Govs. Dave Heineman and Mike Johanns and Democratic Gov. Bob Kerrey have also voiced opposition to casino gambling.