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First Ebola, Now Coronavirus. Why an Omaha Hospital Gets the Toughest Cases. First Ebola, Now Coronavirus. Why an Omaha Hospital Gets the Toughest Cases.
(3 days later)
In the years after the Sept. 11 attacks, officials at Nebraska Medical Center envisioned a time when the nation would need a large, secure treatment center to guard against the threats of bioterrorism and infectious diseases. They spent $1 million to transform an empty wing of the hospital into a 10-bed biocontainment unit, complete with concrete walls, filtered air and video links to the nursing station.In the years after the Sept. 11 attacks, officials at Nebraska Medical Center envisioned a time when the nation would need a large, secure treatment center to guard against the threats of bioterrorism and infectious diseases. They spent $1 million to transform an empty wing of the hospital into a 10-bed biocontainment unit, complete with concrete walls, filtered air and video links to the nursing station.
Then they waited.Then they waited.
The beds sat empty for years, until an Ebola outbreak in 2014. The unit became a central player in treating Americans returning from West Africa with the lethal disease. Nurses wearing face shields, water-resistant gowns and three pairs of surgical gloves treated three Ebola patients. When that threat subsided, the unit returned to being a quiet ward used only for training and planning.The beds sat empty for years, until an Ebola outbreak in 2014. The unit became a central player in treating Americans returning from West Africa with the lethal disease. Nurses wearing face shields, water-resistant gowns and three pairs of surgical gloves treated three Ebola patients. When that threat subsided, the unit returned to being a quiet ward used only for training and planning.
Now, the hospital in Omaha is once again playing a key role in an international health emergency, after 13 Americans who tested positive or were exposed to the new coronavirus on a contaminated cruise ship in Japan were hustled off an international flight and transported there for evaluation on Monday.Now, the hospital in Omaha is once again playing a key role in an international health emergency, after 13 Americans who tested positive or were exposed to the new coronavirus on a contaminated cruise ship in Japan were hustled off an international flight and transported there for evaluation on Monday.
In addition to the biocontainment unit, the hospital’s campus has the only federal quarantine unit in the country.In addition to the biocontainment unit, the hospital’s campus has the only federal quarantine unit in the country.
“We do a huge amount of research in these areas,” said Dr. Jeffrey P. Gold, chancellor of the University of Nebraska Medical Center, citing work on infectious diseases and research on countermeasures to weapons of mass destruction.“We do a huge amount of research in these areas,” said Dr. Jeffrey P. Gold, chancellor of the University of Nebraska Medical Center, citing work on infectious diseases and research on countermeasures to weapons of mass destruction.
“What — heaven forbid — happens if an employee or staff member gets exposed to one of these agents, or even worse than that, gets infected, where are you going to put them? You can’t just call up a local hospital and say, ‘I’ve got somebody who has anthrax, make up a bed,’” he said. “You need facilities that can do everything from air and water handling to the complexities of waste disposal.”“What — heaven forbid — happens if an employee or staff member gets exposed to one of these agents, or even worse than that, gets infected, where are you going to put them? You can’t just call up a local hospital and say, ‘I’ve got somebody who has anthrax, make up a bed,’” he said. “You need facilities that can do everything from air and water handling to the complexities of waste disposal.”
By Tuesday, hospital officials said they were awaiting additional test results but anticipated that most of the people in the group of 13 would be confirmed as having the coronavirus, the latest development in a sprawling international outbreak which originated in Wuhan, China. The virus has sickened tens of thousands of people in at least two dozen countries.By Tuesday, hospital officials said they were awaiting additional test results but anticipated that most of the people in the group of 13 would be confirmed as having the coronavirus, the latest development in a sprawling international outbreak which originated in Wuhan, China. The virus has sickened tens of thousands of people in at least two dozen countries.
Still, the risk of infection outside of China remains low, and the virus is considered a less immediate threat than the seasonal flu.Still, the risk of infection outside of China remains low, and the virus is considered a less immediate threat than the seasonal flu.
Before arriving in Omaha, the 13 patients — all adults — had been stuck for days aboard a cruise ship in Yokohama, Japan, where Japanese officials have confirmed more than 400 cases of the virus. As officials prepared to evacuate Americans on board, the U.S. Embassy in Tokyo told passengers that no one infected with the coronavirus would be allowed to board flights to the United States. But during a chaotic evacuation on Monday, the decision was apparently reversed at the last minute.Before arriving in Omaha, the 13 patients — all adults — had been stuck for days aboard a cruise ship in Yokohama, Japan, where Japanese officials have confirmed more than 400 cases of the virus. As officials prepared to evacuate Americans on board, the U.S. Embassy in Tokyo told passengers that no one infected with the coronavirus would be allowed to board flights to the United States. But during a chaotic evacuation on Monday, the decision was apparently reversed at the last minute.
Officials have said that 14 infected evacuees were allowed to board the planes, which flew to military bases in California and Texas. Many of the infected evacuees then continued on for evaluation in Omaha, along with some of their spouses.Officials have said that 14 infected evacuees were allowed to board the planes, which flew to military bases in California and Texas. Many of the infected evacuees then continued on for evaluation in Omaha, along with some of their spouses.
The groups landed in Omaha on Monday morning and traveled in passenger buses to the hospital, along with a police escort.The groups landed in Omaha on Monday morning and traveled in passenger buses to the hospital, along with a police escort.
The evacuees who arrived were upbeat — if a bit cold, because of the weather in Nebraska — and glad to have a few moments of fresh air as they stepped off the plane, said Mike Wadman, a medical director for the National Quarantine Unit. He said some of them had been in interior rooms of the cruise ship and had not been outside for many days.The evacuees who arrived were upbeat — if a bit cold, because of the weather in Nebraska — and glad to have a few moments of fresh air as they stepped off the plane, said Mike Wadman, a medical director for the National Quarantine Unit. He said some of them had been in interior rooms of the cruise ship and had not been outside for many days.
At least two of the more seriously ill evacuees were being monitored in the hospital’s biocontainment unit, a special ward on the seventh floor where the three Ebola patients were treated in 2014. It looks like a typical hospital ward, but is equipped with special technology, including doors that act like an airlock and a separate area for doctors and nurses to change and shower.At least two of the more seriously ill evacuees were being monitored in the hospital’s biocontainment unit, a special ward on the seventh floor where the three Ebola patients were treated in 2014. It looks like a typical hospital ward, but is equipped with special technology, including doors that act like an airlock and a separate area for doctors and nurses to change and shower.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The other evacuees are being housed across the street in a 20-bed quarantine unit, which opened last year and is a joint venture with the University of Nebraska Medical Center. The rooms resemble something out of a college dorm: beige walls, a single bed, wooden furniture. But each room also comes with exercise equipment, like a stationary bike or a treadmill, to help patients stay active if they are feeling well enough. Patients will stay in quarantine for 14 days if they continue to test negative, and as long as necessary if they have the virus.The other evacuees are being housed across the street in a 20-bed quarantine unit, which opened last year and is a joint venture with the University of Nebraska Medical Center. The rooms resemble something out of a college dorm: beige walls, a single bed, wooden furniture. But each room also comes with exercise equipment, like a stationary bike or a treadmill, to help patients stay active if they are feeling well enough. Patients will stay in quarantine for 14 days if they continue to test negative, and as long as necessary if they have the virus.
Officials plan to provide books and games to those who want them, similar to what they have done with a group of 57 people who are separately being quarantined at a national guard facility outside Omaha after flying back from Wuhan. Taylor Wilson, a spokesman for Nebraska Medicine, said patients there have sent in requests for entertainment, including a guitar, which was granted, and a game of Twister, which he said was turned down because “it’s probably not the best quarantine activity.”Officials plan to provide books and games to those who want them, similar to what they have done with a group of 57 people who are separately being quarantined at a national guard facility outside Omaha after flying back from Wuhan. Taylor Wilson, a spokesman for Nebraska Medicine, said patients there have sent in requests for entertainment, including a guitar, which was granted, and a game of Twister, which he said was turned down because “it’s probably not the best quarantine activity.”
To fight against isolation, patients in the biocontainment rooms also have access to video technology that attaches to a separate room, so they can virtually visit with loved ones without risk of infection, Dr. Gold said.To fight against isolation, patients in the biocontainment rooms also have access to video technology that attaches to a separate room, so they can virtually visit with loved ones without risk of infection, Dr. Gold said.
“I remember when we had Ebola patients, their families used to come and they used to read stories to their children, they would pray with their wife,” he said. “It was quite emotional.”“I remember when we had Ebola patients, their families used to come and they used to read stories to their children, they would pray with their wife,” he said. “It was quite emotional.”
Nicholas Bogel-Burroughs contributed reportingNicholas Bogel-Burroughs contributed reporting