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LINCOLN – New COVID-19 cases, hospitalizations and emergency room visits continue to increase this week in the U.S according to the Centers for Disease Control and Prevention (CDC).
Cumulative hospitalizations in Nebraska due to COVID-19 number are at 6,447, with 163 patients currently hospitalized. Nebraska hospitals cared for an average of 161 COVID-19 patients a day over the last seven days. Daily averages in prior weeks were 167, 140, and 106 COVID-19 patients. Nebraska's main goal remains protecting hospital capacity.
Nebraska reported more cases in the last few weeks, but at the end of last week, cases were down 13% from the previous week. The daily average of new positive cases in the last week was 360, compared to 327 daily cases two weeks ago. Averages for positive cases are now based on specimen collection instead of lab report dates, which provides a more precise view of COVID-19 cases. Data from previous days is updated as lab results are received.
Nationwide, more Americans age 18 to 64 have gone to emergency departments for COVID-19 complications. This increase of mainly younger adults is because most of them have not yet been vaccinated and may be more susceptible to new variants. The number of elderly Americans getting hospitalized or dying from COVID-19 is on the decline, as they are more likely to be vaccinated.
As of Tuesday, the latest statewide total of positive COVID-19 cases is 217,596, with a total of 167,516 of those Nebraskans recovered. The total number of COVID-19-related deaths reported in Nebraska to date is 2,229.
The DHHS data quality team discovered a duplication error during a recent review. This was a result of a vendor coding error. The correction resulted in a decrease in death counts and cumulative hospitalizations. However, the error and subsequent correction did not impact any of the testing or hospital capacity metrics
The state has confirmed the presence of five COVID-19 variant strains. The Department of Health and Human Services (DHHS) and Nebraska Public Health Lab (NPHL) have confirmed that the South African variant of COVID-19, known as B.1.351 has newly arrived in the state. This variant has been spreading throughout the United States, but has been identified less frequently than other variants.
A total of 423 of these variants of concern have been identified in the state. To date, 354 cases of the B.1.1.7 COVID-19 variant (U.K.), which is more contagious than the original strain of coronavirus and is the most dominant strain in the U.S. Other variants present in Nebraska are 58 cases of the B.1.427/B.1.429 variant (CA), 2 of the B1.526 variant (NY), 2 cases of the B.1.351 variant (South Africa) and 7 cases of the P.1 variant (Brazil).
Testing platforms like Test Nebraska and others will still produce a “positive" result for the identified variants. DHHS and NPHL have been working to increase sequencing capabilities within the state. Higher volumes of in-state sequencing began in January and NPHL currently has capacity to sequence more than 100 specimens per week. Creighton University is also sequencing roughly 100 specimens per week.
Although caution is required because of many of the unknowns surrounding the new variant strains, vaccines remain the greatest hope for returning to normal. Widespread vaccinations can help prevent the spread of COVID-19. All approved vaccines were shown to prevent hospitalization and deaths related to COVID-19.
Nebraskans are reminded that precaution is the best defense against COVID-19 until you are vaccinated. You can be #BigRedResponsible by wearing a mask. Additionally, watching your distance, washing hands often, staying home when you're sick, and avoiding the 3Cs – crowded places, close contact with others, and confined spaces – remain critical to preventing infection and controlling spread. Officials continue to urge Nebraskans to be tested if they are exposed or develop COVID symptoms. Anyone who is not fully vaccinated and may have been exposed to COVID-19 should quarantine.
Nebraskans are encouraged to Finish Strong and do their part to end the pandemic by registering for the vaccine. As the State is now in Phase 2B, which means anyone 16 and older can get vaccinated, there are several options available. Register at Vaccinate.Ne.Gov, or with your local health district, or check with area pharmacies that may be scheduling appointments. Those registered will be alerted when a vaccine is available in their priority group and health district. There is a Spanish translation site for the vaccine portal on the State's website; users can access this by selecting Español from the language drop-down menu at the top-right side of the page.
Testing continues to be available to help limit the spread of COVID-19. Anyone who may have been exposed to COVID-19, anyone experiencing any symptoms, those planning to travel, or those returning from travel are encouraged to schedule a COVID-19 test. Free testing is available at more than 60 Test Nebraska sites across the state, and has remained steady; rapid tests may be available for a fee at some medical walk-in centers.
As of today, over 2,775,213 tests have been administered throughout Nebraska.
COVID-19 symptoms can include fever or chills, cough, shortness of breath or difficulty breathing, tiredness, muscle aches, headache, loss of taste or smell, sore throat, runny nose, nausea or vomiting, and diarrhea. Those infected with any variant will show these same symptoms. The severity of a B117 variant infection appears to be elevated compared to normal strains, based on international hospitalization and mortality data.
Visit Testnebraska.com, or TestNebraska.com/es for Spanish, to schedule an appointment. Those with questions about testing, or who need help completing the online assessment, can call the Test Nebraska hotline at (402) 207-9377.
Nebraska will update its guidance in relation to travel, both domestic and internationally. The CDC recommends the following:
Visit https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html for more information
The entire state has moved to Phase 2B, which includes all Nebraskans age 16-49. DHHS is allocating doses via an existing vaccine network that includes local health departments, federally-qualified health centers (FQHCs), community-based clinics, and tribal health care centers across the state. For the week ending April 25, Nebraska is scheduled to receive 54,990 total doses of Pfizer and 39,900 total doses of Moderna. The Johnson & Johnson/Janssen Pharmaceutical vaccine is still temporarily paused by DHHS following CDC and FDA recommendations.
U.S. health regulators recommended last week that use of the J&J vaccine be paused after six cases of rare blood clots, accompanied by low platelet levels, were reported in younger adult women following vaccination, out of some 7 million people who have received the shot in the United States.
Resuming the use of the Johnson & Johnson/Janssen Pharmaceuticals in the United States will require clear guidelines for the medical community on how to best treat patients that develop a rare type of blood clot, as well as alerting vaccine recipients to be aware severe headaches, abdominal pain, vomiting, leg pain (and/or swelling), or shortness of breath within three weeks after vaccination. If any of these symptoms occur, patients should contact their health care provider.
A panel of expert advisors to U.S. health agencies will meet later this week to determine whether the pause should continue, with a decision expected as early as Friday. Scientists have yet to establish a direct link between the Johnson & Johnson/Janssen Pharmaceutical vaccine and the unusual blood clots.
Any potential adverse reactions to vaccines should be reported into the CDC's vaccine adverse events reporting system (VAERS, https://vaers.hhs.gov/). The Health Insurance Portability and Accountability Act (HIPAA) permits reporting of protected health information to public health authorities including the CDC and Federal Drug Administration (FDA). The CDC's Advisory Committee on Immunization Practices (ACIP) continues to meet to discuss the safety of the Johnson & Johnson/Janssen Pharmaceuticals vaccine and to continue to provide oversight and updates on safety in all available vaccines.
The pause on the Johnson & Johnson/Janssen Pharmaceuticals vaccine has not caused significant interruption to vaccine administration efforts in the State. Registrants should check email and/or text alerts for potential scheduling changes. Most local health districts are continuing with already scheduled clinics and will use either Pfizer or Moderna.
Please note that at this time there are no recommendations to pause the use of the other two vaccines (Pfizer and Moderna). These two vaccines will be provided in place of the Johnson & Johnson /Janssen Pharmaceutical vaccine until further notice.
Mild side effects like a sore arm and fatigue are some of the most common symptoms with COVID-19 vaccines. While many people will have no symptoms, others may experience headaches, chills or a fever. These side effects are normal and a sign your body is building protection, and you should be feeling better within a few days. Those receiving their first dose of the Pfizer or Moderna are reminded to keep their vaccination record card in a safe place and take it to their second dose appointment. The Johnson and Johnson/Janssen Pharmaceuticals vaccine requires just one dose.
The Pfizer vaccine was 95% effective and the Moderna vaccine 94% effective in phase three clinical trials. Comparatively, the flu vaccine is generally 40 to 60% effective. Two doses are needed to reach full effectiveness against COVID-19, and the same brand of vaccine must be administered for both doses. The Pfizer COVID-19 vaccine has been approved for those 16 and older, and the Moderna and Johnson and Johnson/Janssen Pharmaceuticals vaccines are approved for those 18 and older.
A phase three clinical trial showed the Johnson & Johnson/Janssen Pharmaceutical vaccine had 66% efficacy in the U.S. at preventing any moderate to severe disease 28 days after vaccination (while being studied in regions with new variant strains of COVID-19). Comparatively, the flu vaccine is generally 40 to 60% effective. Each of these three authorized COVID-19 vaccines had 100% efficacy against COVID-19-related hospitalizations and deaths. Since each of these COVID-19 vaccines works extremely well against the virus, individuals should feel confident they are reducing their risk when they choose to vaccinate. Moreover, every person who gets vaccinated is doing their part to help reduce spread and put an end to this global pandemic.
Per CDC definition, as of today, DHHS has identified 215 possible vaccine breakthroughs among Nebraska residents, which include individuals with positive tests 14 days or more after completing a vaccination series. Out of the 539,061 Nebraskans fully vaccinated, this represents just 0.0004 (0.04%), indicating the vaccine is working for more than 99% of people who receive it. We have the most confidence in 74 of these individuals, for whom genomic sequencing was successful thereby suggesting a high level of virus was present in the specimen they provided. Variants of concern represent 60 (81%) of the 74 that have been successfully sequenced; four of these 74 have been hospitalized, and none have died. Answers to these and other questions are available on the COVID-19 Vaccine Information page and are available in several languages.
The CDC considers a person to be fully vaccinated two weeks after receiving their final second dose, or in the case of the Johnson & Johnson/Janssen Pharmaceuticals vaccine, two weeks after their single dose. Officials also said people who are fully vaccinated do not need to quarantine if exposed to a COVID-19 case and may opt out of COVID-19 testing if they do not experience any symptoms.
DHHS continues to share new information via the Coronavirus website, as well as Facebook and Twitter and at virtual town halls. Each week, members of the DHHS team hold a mid-day Facebook Live session to discuss vaccine-related and pandemic-related topics. On Thursday, April 22, at 1 pm, DHHS Chief Medical Officer Dr. Gary Anthone and Incident Commander Angela Ling will discuss variants and vaccines. For those unable to watch live, all sessions are archived and available on the video tab of the DHHS Facebook page and the DHHS website.
There are many people who want to get vaccinated and who are attending mass vaccination clinics, particularly in larger counties. This includes many younger people 16 and older who recently became eligible for the shots.
Walk-in shots at some clinics have been offered in some areas, as well as expanded walk-in opportunities. State and local health officials are holding virtual town halls and other events to provide information and opportunities to ask questions. More clinics in the future may be attached to schools.
Other options include reaching out to chambers of commerce and other business organizations to host virtual meetings to help businesses inform reluctant workers on vaccine safety and benefits. Some health departments still are offering vaccination clinics at manufacturing facilities.
As of Tuesday, more than 1,297,017 doses of COVID-19 vaccine have been given to Nebraskans throughout the state, according to the Nebraska Department of Health and Human Services (DHHS). Additionally, over 552,282 Nebraskans are fully vaccinated. That number translates to 37.2% of those over 16 years of age. To follow Nebraska's COVID-19 vaccination progress, please visit the COVID-19 Vaccination dashboard.
These numbers include all vaccinations that took place in Nebraska last week, including through federal entities, such as the Indian Health Service, the Department of Veterans Affairs, the Department of Defense, and the Federal Pharmacy Program. The Federal Retail Pharmacy Program is coordinated and managed by the Centers for Disease Control and Prevention (CDC) and participating pharmacies in the state have signed up and been approved by the federal government. For more on the Federal Retail Pharmacy Program, visit the CDC website https://www.cdc.gov/vaccines/covid-19/retail-pharmacy-program/participating-pharmacies.html.
Nebraskans can register online to be notified when COVID-19 vaccination is available in their area, and a Spanish translation of the site is now available. Available at Vaccinate.Ne.Gov, users should select Español from the language drop-down menu at the top-right side of the page.
As of today, more than 372,746 Nebraskans with an average age of 51.6, have registered for the vaccine. Those interested in registering will need to provide name and contact information, date of birth and answer health questions used to help determine priority group eligibility. Any information entered is strictly confidential and used solely for this purpose. Friends, family and caregivers are encouraged to assist others with vaccine sign-up if needed, and the DHHS Information line can assist those with limited technology, language or Internet access, and is available by calling (531) 249-1873 or (833) 998-2275.
Those who entered a friend's email will have their emails sent to that friend's email address where they can again be assisted, this time to make their appointment. If the state's email address was used in your registration, either the state or your local public health department will contact you to help you make your appointment.
Directed Health Measures
As vaccination continues, Directed Health Measures (DHMs) continue to be updated to provide clarity as more Nebraskans complete vaccination and recover from COVID-19.
Those who have received both COVID-19 vaccine doses are not required to quarantine if they are exposed to someone with COVID-19. Individuals should self-monitor for symptoms for 14 days, and are required to wear a mask when in public. Anyone who later develops symptoms must then quarantine at home.
Those who have recovered from coronavirus within the last three months are not required to quarantine if they are exposed to someone with COVID-19. Wearing a mask is encouraged but not required. Those who have recovered from coronavirus longer than three months ago are required to quarantine if they are exposed to someone with COVID-19.
A DHM is in effect regarding those who have completed antibody tests. Unvaccinated individuals who test positive for antibodies are not required to quarantine if it's within 3 months of the completed antibody test. However, those who experience symptoms of COVID-19 are still required to quarantine.
In addition, a five-phase series of DHMs aimed at preserving hospital capacity for urgent medical care remains in effect for the entire state. Currently, less than 10% of hospital beds are needed for COVID-19 patients. The state is in the green phase, which removes capacity restrictions for indoor gatherings but it's recommended that Nebraskans continue following guidance to reduce virus transmission. Organizers of events for 500 or more people, or 1,000 people in Douglas County, are required to receive approval from their local health department. Capacity restrictions remain in place for Lancaster County.
In addition, the DHHS COVID-19 information line is available to answer questions at (531) 249-1873 or (833) 998-2275. The line is staffed seven days a week from 8 a.m. to 8 p.m. CT.