S S >> COVID-19 CASES STATEWIDE LOOK LIKE THEY ARE HEADING IN THE RIGHT DIRECTION BUT HOSPITALS STILL REMAIN STRAINED.

ARE THE NUMBERS DOWN FOR GOOD?

WHAT DO YOU NEED TO KNOW ABOUT BOOSTER SHOTS?

AND WHAT'S NEXT FOR THE PANDEMIC?

MEDICAL EXPERTS GIVE US THEIR ANSWERS TONIGHT ON "SPEAKING OF NEBRASKA."

S S S S THANKS FOR JOINING US ON "SPEAKING OF NEBRASKA."

I'M NEBRASKA PUBLIC MEDIA NEWS DIRECTOR DENNIS KELLOGG.

THE DELTA VARIANT DROVE A SWIFT WAVE OF CASES THIS SUMMER.

IT FILLED HOSPITALS AFTER OTHER PANDEMIC FIGURES HAD REACHED ALL-TIME LOWS.

IN THE LAST FEW WEEKS CASES HERE HAVE STARTED TIPPING THE OTHER WAY.

THE DROP IN CASES IN NEBRASKA REFLECTS A BROADER NATIONWIDE DROP THIS FALL.

BEFORE WE SPEAK WITH NEBRASKA DOCTORS AND PUBLIC HEALTH EXPERTS NEBRASKA PUBLIC MEDIA NEWS REPORTER WILL BAUER HAS MORE ON WHERE THE STATE STANDS RIGHT NOW.

>> AS OF WEDNESDAY CDC STATS SHOW CASES IN NEBRASKA ARE DOWN NEARLY 22% OVER THE LAST TWO WEEKS.

THAT MEANS THE 7-DAY AVERAGE FOR CASES DROPPED FROM 620 TO ABOUT 485 PER DAY.

FOR THE MOST PART COVID HOSPITALIZATIONS ARE ALSO DROPPING.

THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES TALLIED 370 HOSPITALIZATIONS ON WEDNESDAY.

THAT NUMBER HAS BEEN STEADILY DROPPING SINCE IT PEAKED DURING THE HEIGHT OF THE DELTA SURGE AT NEARLY 450 IN MID-SEPTEMBER.

IN OMAHA DOUGLAS COUNTY HEALTH DIRECTOR LINDSEY HUGHES SAYS HOSPITALS ARE QUITE FULL.

>> SO, OVERALL WE'VE CONTINUED TO SEE AN INCREASE IN OUR HOSPITALIZATIONS, WHICH, I KNOW HAS BEEN SOMETHING THAT WE HAVE CONTINUED TO BE CONCERNED ABOUT WE'VE CONTINUED TO TALK ABOUT.

I DON'T THINK WE ARE OUT OF THE WOODS THERE, YET.

WE DO CERTAINLY CONTINUE TO HAVE SOME HOSPITALS THAT DON'T HAVE BEDS AT ALL.

>> THE SOLUTION ACCORDING TO PUBLIC HEALTH OFFICIALS LIKE HUGHES HAS ALWAYS BEEN COVID VACCINES.

LINCOLN-LANCASTER COUNTY HEALTH DIRECTOR PAT LOPEZ WOULD AGREE.

AND AS WE APPROACH COLDER WEATHER, WHEN MORE PEOPLE WILL SPEND TIME INDOORS SHE SAYS VACCINES WILL BE IMPORTANT.

>> YOU KNOW, IT'S HARD TO PREDICT WHAT'LL HAPPEN AND THAT'S WHY WE WANT TO YOU KNOW, EXPRESS CONCERN AND THAT PEOPLE USE CAUTION AND USE THE AVAILABLE TOOLS THAT THEY HAVE.

THAT'S AGAIN WHERE VACCINE PLAYS AN IMPORTANT ROLE.

BUT GOING BACK INSIDE IS SOMETHING WE ARE CONCERNED ABOUT.

>> IN ALL, 68% OF NEBRASKANS 12 AND OLDER ARE FULLY VACCINATED.

EACH DAY, ABOUT 1800 NEBRASKANS GET A SHOT.

THOSE NUMBERS ARE EXPECTED TO CLIMB AS MORE BOOSTER SHOTS ARE ROLLED OUT.

FOR "SPEAKING OF NEBRASKA," I'M WILL BAUER.

S S >> JOINING US NOW IS DR. MATT DONAHUE THE ACTING NEBRASKA STATE EPIDEMIOLOGIST ALSO, DR. RENUGA VIVEKANANDAN.

SHE IS WITH C.H.I.

HEALTH AND ALSO WITH CREIGHTON.

THANK YOU FOR JOINING US.

AND DR. DAVID CANTRAL A PULMONOLOGIST WITH KEARNEY REGIONAL MEDICAL CENTER.

THANK YOU, ALL, VERY MUCH FOR TAKING THE TIME OUT TO BE WITH US ON "SPEAKING OF NEBRASKA."

DR. DONAHUE, I WANT TO START WITH YOU.

YOU DID AN INTERVIEW WITH US BACK IN JUNE WHEN YOU FIRST STARTED YOUR POSITION.

AT THAT TIME, WHEN IT CAME TO COVID, YOU SAID "FALL IS AN UNKNOWN."

WELL, WE NOW KNOW A LITTLE BIT MORE NOW ABOUT FALL.

AFTER THE DELTA SURGE THIS SUMMER, CASES ARE TRENDING DOWN HERE AND IN THE REST OF THE NATION, AS WELL.

IN NEBRASKA ACCORDING TO THE CDC THE 7-DAY AVERAGE IS DOWN 22% THE PAST TWO WEEKS.

DO YOU THINK WE'VE SEEN THE PEAK OF THE DELTA SURGE?

>> WELL, THROUGHOUT THE U.S. CASES ARE NOW BEGINNING TO DOWN TREND.

BOTH CASES AND ACTIVE HOSPITALIZATIONS LOOK TO HAVE PEAKED AND ARE NOW BEGINNING TO IMPROVE.

OVER THE LAST SEVERAL WEEKS WE'VE SEEN IMPROVEMENT BY ABOUT 50% IN BOTH CASE NUMBERS AND ACTIVE HOSPITALIZATION NUMBERS AND I THINK SINCE THAT LAST TIME IN JUNE, DELTA HIT THE U.S. AND IT'S KIND OF MOVED FROM PLACE TO PLACE THROUGHOUT THE U.S. AND CAUSED HOT SPOTS TO CROP UP ALL OVER.

AS IT MOVED FROM SOME OF OUR MORE POPULATED CENTERS OUT INTO -- THROUGHOUT THE SOUTH AND INTO THE NORTHWEST, AND NOW INTO THE UPPER MOUNTAIN WEST AS IT MOVED OUT OF THOSE POPULATION CENTERS AND INTO OTHER AREAS WE'VE STARTED SEEING CASES AND HOSPITALIZATIONS REALLY DECLINE OVERALL.

NEBRASKA IS BEGINNING TO FOLLOW THAT TREND, TOO.

SO WHILE THE U.S. HAS BEEN IMPROVING FOR SEVERAL WEEKS NEBRASKA HAS BEEN A BIT STUBBORN AND WE'VE BEEN HOLDING OUT BUT WE'RE BEGINNING TO TURN THE CORNER OURSELVES, I THINK.

IN THE PAST WEEK, WE'VE SEEN ACTIVE HOSPITALIZATIONS FALL ALONGSIDE OUR CASES.

>> YOU WILLING TO SAY WE'VE SEEN THE PEAK AND WE'RE ON THE DOWNHILL?

>> I THINK WE'RE BEGINNING THE DOWNHILL SLOPE HERE IN NEBRASKA.

>> DR. VIVEKANANDAN, IN THE RESEARCH YOU'RE DOING THE TRENDS YOU'RE EXAMINING WHAT ARE YOU SEEING?

WHAT'S THE CURRENT STATE OF THE PANDEMIC FROM YOUR VIEWPOINT?

>> I AGREE WITH DR. DONAHUE.

I THINK WE'RE SEEING A LITTLE BIT OF A DOWNWARD TREND OVERALL IN NEBRASKA AND DEFINITELY ACROSS THE U.S., AS WELL.

PERSONALLY, I'M ROUNDING IN THE HOSPITALS RIGHT NOW AND TAKING CARE OF PATIENTS WITH COVID-19.

AND I COULD DEFINITELY SEE NUMBERS SLOWLY TRENDING DOWN.

SO THAT'S A LITTLE BIT OF A POSITIVE NOTE, REASSURING BUT, OF COURSE, I THINK OUR IMPORTANT THING IS GETTING VACCINATED.

BUT WE'RE SLOWLY SEEING A DOWNWARD TREND.

>> AND DR. CANTRAL WHAT'S HOSPITAL CAPACITY LIKE IN KEARNEY AND DO YOU SEE ANY DIFFERENCES IN YOUR REGION IN CENTRAL NEBRASKA AS COMPARED WITH OTHER REGIONS OF THE STATE?

>> JUST IN TERMS OF THE NUMBERS THE NUMBERS REPORTED BY TWO RIVERS PUBLIC HEALTH OVER THE LAST SEVERAL WEEKS INDICATE BASICALLY KIND OF A FLATTENING OF THE TREND IN TERMS OF TOTAL NUMBERS.

NUMBERS WITHIN THE HOSPITALS AND I -- I PRACTICE AT BOTH HOSPITALS IN KEARNEY TOTAL NUMBERS ARE DOWN.

ICU BEDS WITH COVID PATIENTS ARE ABOUT STEADY.

WE'RE STILL GETTING SEVERAL INTENSIVE CARE VENTILATED PATIENTS A WEEK AT EACH HOSPITAL.

AND, THAT TENDS TO TAKE A LITTLE BIT LONGER TO DOWNTREND BECAUSE THE LENGTH OF TIME THE CRITICALLY ILL PATIENTS STAY IN THE ICU.

>> DR. VIVEKANANDAN THIS IS ABOUT THE SAME TIME LAST YEAR WHEN CASES REALLY STARTED TO SURGE A LITTLE BIT IN THE STATE AND THE REST OF THE COUNTRY.

MANY PEOPLE SUSPECTED BECAUSE IT WAS OF THE COLD WEATHER MORE PEOPLE ARE INDOORS.

DO YOU EXPECT THAT TO HAPPEN AGAIN THIS YEAR WITH WINTER COMING AND -- OR WOULD YOU SAY WE'RE IN A DIFFERENT PLACE NOW?

>> I AM WORRIED ABOUT THE WINTER.

I LIKE THE DOWNWARD TREND CURRENTLY, BUT UNTIL WE GET OUR POPULATION VACCINATED OVER 85-90% HAVE BETTER IMMUNITY THE VIRUS IS STILL GOING TO BE IN THE COMMUNITY ESPECIALLY IN THE WINTERTIME WE'RE GOING TO BE INDOORS BECAUSE OF THE COLD WEATHER LOTS MORE FAMILY GATHERING THANKSGIVING, CHRISTMAS.

SO I AM A LITTLE BIT WORRIED SO I THINK THAT'S WHY ONE OF THE BIGGEST, IMPORTANT THINGS IS TO CONTINUE TO WEAR A MASK AND GET VACCINATED AND PLUS YOU ALSO HAVE TO REMEMBER INFLUENZA IS ALSO A CONCERN.

AND RSV IS ALREADY IN OUR COMMUNITY, SO OTHER VIRUSES MIGHT BE IN PLAY, AS WELL.

>> DR. DONAHUE DOES THE RESEARCH SHOW THAT WHEN WE HAVE MORE PEOPLE INDOORS DOES IT REALLY IMPACT THE TOTAL NUMBER OF COVID CASES?

>> YES, I THINK IT REALLY DOES.

THIS IS THE PATTERN THAT ALL RESPIRATORY ILLNESSES FOLLOW.

WHEN IT GETS COLDER AND PEOPLE GO INSIDE THOSE RESPIRATORY ILLNESSES SPREAD MORE EASILY.

COVID-19 IS NO EXCEPTION.

IT FOLLOWS THAT SAME PATTERN.

>> DR. CANTRAL AS A PULMONOLOGIST IN KEARNEY YOU DEAL WITH THE LUNGS.

SO TELL US WHAT YOU'VE SEEN OVER THE LAST YEAR AND A HALF FROM YOUR PATIENTS AND HOW THIS VIRUS ATTACKS THE LUNGS.

>> YEAH, I'LL START BY SAYING IN 30 SOME YEARS OF DOING WHAT I DO, I'VE NEVER SEEN ANYTHING SO OVERTLY DESTRUCTIVE OF THE INTEGRITY OF THE LUNGS ON SUCH A BROAD BASIS.

IN THE PAST WITH SEVERE PNEUMONIAS, WHETHER THEY WERE VIRAL OR BACTERIAL, WE WOULD OCCASIONALLY SEE PATIENTS WHO HAD A.R.D.S.

WHICH IS A SEVERE RESPIRATORY FAILURE COMPLICATION OF RESPIRATORY INFECTIONS BUT THIS IS A MUCH WORSE AND MUCH MORE WIDESPREAD INJURY TO THE LUNGS.

IT OFTEN AFFECTS WELL OVER 50% OF THE LUNG TISSUE, WITH A COMBINATION OF BOTH JUST MASSIVE AMOUNTS OF VIRUS WITHIN THE STRUCTURE OF THE LUNG AND THEN INJURY TO THE LUNG FROM THE IMMUNE SYSTEM TRYING TO PROTECT THE BODY.

SO IN ADDITION TO THAT ONE OF THE MAIN DIFFERENCES THAT I'M SEEING COMPARED TO OTHER RESPIRATORY INFECTIONS IS THE AFTER EFFECTS ARE MORE SEVERE AND MORE LONG-LASTING.

WE'RE SEEING A FAIR NUMBER OF PEOPLE NOW WHO ARE WEEKS TO MONTHS OUT FROM THEIR ORIGINAL INFECTION AND THEY STILL HAVE EVIDENCE OF INJURY TO THEIR LUNG.

SOME OF THAT INJURY MAY BE PERMANENT SOME OF IT MAY BE RECOVERABLE.

THERE IS A NUMBER OF DIFFERENT WAYS IT SEEMS TO PLAY OUT.

BUT THERE IS NO QUESTION THAT THIS IS BROADLY THE MOST SEVERE RESPIRATORY INFECTION THAT I'VE EVER COME ACROSS.

>> AND YOU TALKED EARLIER ABOUT HOSPITAL CAPACITY.

EVEN THOUGH CASES AND COVID HOSPITALIZATIONS ARE DROPPING HOSPITALS ARE STILL FULL BECAUSE SOME OF THOSE OTHER NORMAL PROCEDURES AND CARE ARE STILL TAKING PLACE.

HAVE YOU SEEN PEAKS AND VALLEYS WITH THE NUMBER OF PATIENTS YOU'VE BEEN TREATING IN THIS PANDEMIC OR HAS IT JUST BEEN EXTREMELY BUSY ALL THE TIME?

>> WELL, THE HOSPITAL NUMBERS WHERE WE'RE AT WHICH I THINK REFLECTS THE REST OF THE STATE HAS PARALLELED THE SURGE IN CASES IN GENERAL.

THE DIFFERENCE WITH THIS MOST RECENT SURGE PRIMARILY IS THE FACT THAT THE VAST MAJORITY ARE UNVACCINATED PATIENTS, BOTH HOSPITALIZED AND INTENSIVE CARE.

BUT THE -- THE EFFECT ON HOSPITAL CAPACITY HAS BEEN JUST AS SIGNIFICANT AS THE ORIGINAL SURGE AND SUBSEQUENT SURGES.

WHEN THIS SURGE REALLY GOT GOING, JUST LIKE LAST YEAR WE WERE CLOSED BOTH HOSPITALS HAD TO CLOSE OUR INTENSIVE CARE UNITS AT DIFFERENT TIMES AND THERE WAS -- WHEN WE WERE OPEN, WE WERE GETTING PATIENTS FROM AS FAR AWAY AS RAPID CITY SOUTH DAKOTA, AND PARTS OF CENTRAL OKLAHOMA BECAUSE ANYWHERE THAT THERE WAS AN OPEN INTENSIVE CARE BED THERE WAS THE LIKELIHOOD YOU WERE GOING TO GET A PATIENT TRANSFERRED IN AS SOON AS YOU HAD AN OPEN BED AND THAT'S ACTUALLY STILL BEEN THE CASE.

THE PROBLEM IS NOT JUST THE NUMBER OF BEDS THE PROBLEM IS THE PERSONNEL TO STAFF THOSE BEDS.

AND THE LONGER THE PANDEMIC HAS GONE ON, THE MORE DIFFICULT IT'S BEEN TO FIND QUALIFIED PEOPLE TO STAFF THE PHYSICAL BEDS THAT YOU HAVE.

THAT'S REALLY BECOME THE BIGGER ISSUE MORE RECENTLY.

>> THE STAFFING.

>> OH, ABSOLUTELY, YEAH.

>> DR. VIVEKANANDAN THE GOVERNOR HAS USED EXECUTIVE ORDERS TO TRY TO HELP WITH HOSPITAL CAPACITY.

IN LATE AUGUST, HE STARTED BY EXPANDING THE AMOUNT OF STAFF TO DEAL WITH THE INFLUX OF PATIENTS.

THAT ORDER ALLOWED RETIRED OR INACTIVE NURSES TO COME BACK TO WORK.

LAST WEEK, HE ISSUED AN ORDER THAT ALLOWS OTHER HEALTHCARE STAFF WHO DON'T TRADITIONALLY CARE FOR PATIENTS TO DO SO.

THE GOVERNOR ALSO JUST RESCINDED A DIRECTED HEALTH MEASURE THAT WILL NOW ALLOW ELECTIVE SURGERIES TO RESUME FOR INPATIENTS.

ARE THESE EFFORTS HAVING AN IMPACT WITH THE HOSPITALS?

>> TIME WILL TELL, BUT DEFINITELY I THINK IT WILL HELP.

OUR BIGGEST CONCERN RIGHT NOW IN A HOSPITAL SETTING IS NURSING SHORTAGE IN ALL AREAS AND ALSO BURN OUT FROM HEALTHCARE PROFESSIONALS IN ALL DIFFERENT AREAS, PHYSICIANS NURSING STAFF RESPIRATORY THERAPISTS.

I THINK ANY EXTRA HELP WE CAN GET IN HOSPITALS IS GOING TO BE REALLY IMPORTANT.

AND IF WE DO HAVE QUALIFIED PERSONNEL IN THE COMMUNITY I THINK EVERYBODY WILL WELCOME THEIR SUPPORT.

SO I THINK YES, I THINK IT WILL HELP WITH THE HOSPITAL CAPACITY.

CURRENTLY A LOT OF THE HOSPITALS THEY HAVE BEDS WE JUST DON'T HAVE STAFF TO STAFF THE BEDS.

SO LOT OF PATIENTS WANT TO GET TRANSFERRED INTO BIG HOSPITALS.

UNFORTUNATELY, THE BIGGER HOSPITALS ARE FULL SO THERE IS A LARGE WAIT TIME AS WELL, FROM OUR CRITICAL ACCESS HOSPITAL.

SO MORE STAFF WE HAVE WE COULD OPEN UP MORE BEDS TO TAKE CARE OF OUR PATIENTS.

>> AND DR. DONAHUE AS THE STATE EPIDEMIOLOGIST YOU'RE CONSTANTLY GATHERING INFORMATION AND STUDYING HOW DISEASES SPREAD AND WHY THEY SPREAD.

HOW CLOSELY ARE YOU WORKING WITH THE GOVERNOR AND HIS STAFF REGARDING THESE PUBLIC POLICIES?

ARE YOU IN CONSULTATION WITH HIM?

>> YEAH.

WE MEET VERY REGULARLY TO GO OVER ALL THE DATA.

AND WITH VACCINATION AND BOOSTERS AND DIFFERENT TYPES OF VACCINE THERE IS A LOT OF DATA TO GO OVER.

AND I THINK THE -- HE'S BEEN VERY CLEAR IN HIS ADVOCACY FOR VACCINATION.

WE -- MY ROLE AS A STATE EPIDEMIOLOGIST IS GATHERING THAT DATA AND SHARING IT IN A WAY THAT'S UNDERSTANDABLE.

WITHOUT MANIPULATING IT AND WITHOUT TRYING TO CHANGE EXACTLY WHAT IT SAYS I THINK IT'S BEEN VERY CLEAR AND HE'S HELPED GET IN A ACROSS THAT VACCINATION WORKS AND VACCINATIONS ARE THE BEST WAY TO PROTECT OUR HOSPITAL CAPACITY.

>> FORMER FDA COMMISSIONER SCOTT GOTTLIEB RECENTLY SAID THAT A QUOTE, "NOBODY SHOULD BE DYING FROM COVID NOW BECAUSE OF THE THERAPEUTICS THAT WE HAVE AVAILABLE FOR IT."

WOULD YOU AGREE WITH THAT?

>> I COMPLETELY AGREE.

SO WE PUT TOGETHER A VACCINE AND THAT WORKS SO, SO WELL THAT WE'VE TURNED COVID-19 INTO A VACCINE-PREVENTABLE DISEASE.

MORE THAN TREATMENT WE HAVE PREVENTION.

AND AN OUNCE OF PREVENTION IS WORTH OF A POUND OF TREATMENT.

SO THE TOOLS ARE OUT THERE.

PEOPLE JUST NEED TO DECIDE TO USE THEM NOW.

THEY WORK REALLY WELL.

AND WE HAVE THERAPIES THAT EXIST FOR PEOPLE WHO DO GET COVID-19.

MONOCLONAL ANTIBODY THERAPIES ARE WIDELY AVAILABLE THROUGHOUT THE STATE AND THAT EXISTS AS AN OPTION FOR PEOPLE WHO GET COVID EVEN DESPITE VACCINATION.

>> DR. CANTRAL IS THERE ANYTHING ELSE YOU WANT TO SEE THE STATE DO THAT CAN HELP THE HOSPITALS TO CONTINUE TO GET OVER THIS CRISIS?

>> WELL, YEAH, PUSHING VACCINATIONS CLEARLY THE MOST IMPORTANT THING.

BUT THERE IS ALSO OTHER MEASURES THAT WE HAD IMPLEMENTED THROUGHOUT THE WINTER LAST YEAR.

SOCIAL DISTANCING WEARING MASKS INDOORS ARE COMMON SENSE THINGS THAT CLEARLY WORK.

UNFORTUNATELY THERE'S BEEN A LOT OF RESISTANCE TO THAT PARTICULARLY IN THE MORE RURAL AREAS.

I PROBABLY RUN INTO IT MORE THAN YOU DO IN DOUGLAS, SARPY, AND LANCASTER COUNTIES WHERE THERE IS, AT LEAST IN TERMS OF THE NUMBERS, VACCINATION HAS BEEN MORE READILY ACCEPTED.

THE MORE RURAL YOU GO IN NEBRASKA, THE LOWER THE VACCINATION RATES AND BUFFALO COUNTY IT'S ABOUT 53%.

THAT IS 12 AND OVER.

SO NUMBERS ARE MAYBE LITTLE BIT SKEWED NOW THAT WE INCLUDE THE POTENTIAL FOR KIDS TO GET VACCINATED BUT THAT IS STILL AN UNACCEPTABLY LOW NUMBER.

IF YOU GO TO CHERRY COUNTY AT THIS POINT IT'S LIKE 28% VACCINATION RATE.

THAT'S JUST NOT GOING TO CUT IT.

YOU'RE GOING TO CONTINUE TO HOTSPOTS IN PLACES LIKE THAT BECAUSE WE KNOW THAT PEOPLE WHO HAVE THE VIRUS CAN GET RE-INFECTED, AND WE KNOW THAT THERE ARE OTHER VARIANTS OUT THERE THAT POTENTIALLY COULD BE PROBLEMS FURTHER DOWN THE LINE.

>> SO IF WE LOOK AT THOSE NUMBERS ABOUT 1800 PEOPLE GET A VACCINE EACH DAY IN THE STATE AND IN ALL MORE THAN 68% OF NEBRASKANS ARE VACCINATED -- FULLY VACCINATED.

ANOTHER 5% PARTIALLY VACCINATED.

DR. DONAHUE, 70% WAS OUR GOAL.

IS THAT STILL OUR GOAL?

WHAT RATE DO WE NEED TO SHOOT FOR TO SUPPRESS THE VIRUS?

>> I THINK WE GOT TO SHOOT FOR MORE.

CLEARLY, COMMUNITY TRANSMISSION IS STILL ONGOING.

OUR HOSPITALS STILL HAVE COVID-19 PATIENTS AND ALL OF THESE ARE PREVENTABLE.

THAT 70% NUMBER IS STILL JUST A STATEMENT OF OUR POPULATION WHO ARE ELIGIBLE FOR VACCINATION.

SO THE GOAL WE SHOOT FOR FOR HERD IMMUNITY IS 80-90% OF EVERYBODY.

AND THAT INCLUDES THE CHILDREN THAT AREN'T YET ELIGIBLE TO RECEIVE VACCINE.

>> SO DR. VIVEKANANDAN THOSE 65 AND OLDER SHOULD BE ABLE TO GET A BOOSTER SHOT NOW WITH THE VACCINES THANKS TO A VOTE BY THE FDA THIS WEEK.

HOW IMPORTANT IS GETTING THAT BOOSTER SHOT IF YOU'RE ALREADY FULLY VACCINATED AND IF YOU FOR SOME REASON CHOOSE NOT TO GET THE BOOSTER SHOT AND YOU HAVE BEEN VACCINATED, WILL YOU STILL HAVE SOME LEVEL OF IMMUNITY?

>> IT'S A REALLY GOOD QUESTION.

I THINK BOOSTER SHOTS ARE IMPORTANT BECAUSE AS WE'RE SEEING OVER THE AGE OF 65 THEY'RE HAVING BREAKTHROUGH INFECTIONS BUT STILL EVEN IF YOU HAVE BREAKTHROUGH INFECTION IF YOU HAVE OTHER VACCINES BEFORE THE OTHER TWO IT'S MILDER INFECTION.

EVEN IF YOU GET HOSPITALIZED YOU'RE NOT DYING FROM THE INFECTION.

SO IT'S REALLY IMPORTANT TO -- BUT WE STILL WANT TO PREVENT YOU FROM COMING INTO THE HOSPITAL OR HAVING ANOTHER INFECTION.

SO 65 AND OLDER DEFINITELY SHOULD BE GETTING BOOSTER VACCINE.

BUT ALSO REMEMBER NOW IT'S APPROVED FOR ANYBODY OVER THE AGE OF 18 IF THEY HAVE ANY CHRONIC MEDICAL CONDITION IF YOUR IMMUNE SYSTEM IS NOT VERY STRONG IT'S IMPORTANT TO GET A BOOSTER SHOT TO JUST BRING THE ANTIBODY LEVEL UP SO YOU'RE PROTECTED.

SO I'M ACTUALLY IN A BOOSTER STUDY, AND I'M PARTICIPATING SO I TRULY BELIEVE IN THE BOOSTER AND I ALSO THINK BOOSTER SHOTS SHOULD BE GIVEN TO HIGH RISK OCCUPATION SOMEBODY LIKE MYSELF WHO IS IN THE HEALTHCARE FACILITY SO I DON'T GET BREAKTHROUGH INFECTION AND GIVE IT TO MY PATIENTS BY ACCIDENT.

SO I THINK I'M REALLY HAPPY THAT WE HAVE THE BOOSTER SHOTS AND IT'S APPROVED FOR PFIZER AND CURRENTLY IT'S IN THE PROCESS FOR GETTING APPROVED FOR MODERNA AND JOHNSON & JOHNSON, AS WELL.

>> AND DR. DONAHUE WHERE DOES NATURAL IMMUNITY ENTER INTO THE SCIENCE OF ALL OF THIS?

IF SOMEONE HAS COVID, RECOVERS HAS THE ANTIBODIES, WHAT DO WE KNOW ABOUT WHETHER THEY NEED VACCINATION OR THEIR CHANCES OF GETTING THE VIRUS AGAIN?

>> NATURAL IMMUNITY FOR COVID-19 EXISTS LIKE IT DOES FOR OTHER RESPIRATORY ILLNESSES.

JUST LIKE OTHER COLD VIRUSES NATURAL IMMUNITY WEARS OFF OVER TIME.

OTHER COLD VIRUSES YOU CAN KEEP GETTING AGAIN AND AGAIN.

YOU CAN GET A COLD EACH RESPIRATORY SEASON.

SARS-COV-2 MIGHT BE THE SAME WAY.

NATURAL IMMUNITY IS GOING TO EXPIRE AT SOME POINT.

IT EXISTS AND IT LIKELY HELPS AND PROVIDES SOME BENEFIT BUT IT'S GOING TO EXPIRE.

GETTING INFECTION AGAIN ISN'T THE RIGHT ANSWER.

THAT'S WHERE THE VACCINE PLAYS A ROLE.

SO YOU GET RE-INFECTED AGAIN YOU CAN STILL WIND UP IN THE HOSPITAL AND IF YOU GET A VACCINE YOU DECREASE YOUR CHANCES OF THAT HAPPENING.

>> DR. CANTRAL WE OCCASIONALLY HEAR ABOUT POSSIBLE SIDE EFFECTS TO THE VACCINE THE RARE INSTANCES OF MYOCARDITIS INFLAMMATORY HEART CONDITION IN YOUNG MEN FOLLOWING TAKING THE VACCINE.

SO HOW DO RARE SIDE EFFECTS LIKE THAT PLAY INTO YOUR THINKING WHEN YOU'RE ADVISING YOUR PATIENT ON WHETHER TO GET THE VACCINE OR THE BOOSTER SHOT?

>> I THINK YOU HAVE TO INFORM THE PATIENT.

BUT YOU HAVE TO ALSO MAKE SURE YOU PUT IT IN THE CONTEXT OF WHAT IT REALLY MEANS.

WHEN YOU CONSIDER THE TOTAL NUMBER OF PEOPLE WHO HAVE BEEN VACCINATED AND THE EXTREMELY SMALL NUMBER OF SERIOUS SIDE EFFECTS, THE RISK BENEFIT RATIO CLEARLY FALLS IN FAVOR OF VACCINATION.

YOU HAVE TO TAKE YOUR -- AS A PRACTITIONER YOU HAVE TO SIT WITH YOUR PATIENTS AND YOU HAVE TO EXPLAIN THIS TO THEM IN A WAY THAT THEY UNDERSTAND BECAUSE WHAT THEY'RE HEARING IS IF I GET THIS VACCINE, I MAY DIE FROM A HEART CONDITION.

AND YOU SIMPLY HAVE TO PUT THAT IN CONTEXT.

AND MAYBE COMPARE IT TO THE RATE OF COMPLICATIONS FROM OTHER VACCINES, WHICH AGAIN IS VERY SMALL, BUT NOT ZERO.

SO IT JUST TAKES TIME AND IT TAKES EDUCATION AND YOU HAVE TO JUST DO IT ONE PATIENT AT A TIME.

UNFORTUNATELY PEOPLE ARE GETTING A LOT OF THEIR INFORMATION OFF THE SOCIAL MEDIA AND PLACES WHERE THE INFORMATION IS SIMPLY NOT RELIABLE SO EVERY OPPORTUNITY I GET TO TALK WITH PATIENTS, FAMILIES ET CETERA, I DO.

AND TRY GIVE THEM THE REAL FACTS.

>> DR. VIVEKANANDAN THE FDA ALSO WEIGHED IN THIS WEEK AND SAID THAT MIXING AND MATCHING JOHNSON & JOHNSON AND PFIZER AND MODERNA SEEM TO BE OKAY.

IS THAT SIMILAR TO WHAT WE SEE WITH THE FLU SHOT?

WE DON'T REALLY KNOW THE BRAND OF THE FLU SHOT WE GET.

THEY MIX AND MATCH UNTIL IT WORKS.

IS IT SIMILAR TO THAT?

>> YEAH, DR. DONAHUE ACTUALLY PRESENTED SOME DATA THIS WEEK.

THERE IS A SMALL STUDY WITH ABOUT 150 PATIENTS THEY LOOKED AT, AND THERE WAS BENEFIT IN MIXING AND MATCHING OF VACCINES.

I THINK THE REAL BENEFIT IS THAT LET'S SAY WHEN YOU GO TO A PHARMACY OR CLINIC AND YOU WANT A BOOSTER SHOT, AND IF THEY DON'T HAVE PFIZER YOU DON'T HAVE TO BE TURNED AWAY.

THEY COULD GIVE YOU A DIFFERENT VACCINE AND THAT BOOSTS YOUR IMMUNE SYSTEM.

I THINK THAT IS THE RIGHT THING TO DO, MIX AND MATCH.

WE'LL SEE WITH THE ACIP CURRENTLY MEETING WHAT THEY DECIDE.

BUT I THINK THEY WILL SAY THAT'S A GOAL, AS WELL.

>> DR. DONAHUE WE'RE STARTING TO HEAR ABOUT DIFFERENT VARIANTS IN THE UNITED KINGDOM, THE DELTA SUB VARIANT AY 4.2.

IT'S PRESENT IN THE UNITED STATES, AS WELL BUT NOT IN GREAT NUMBERS.

ARE YOU WATCHING THAT PARTICULAR STRAIN AND ARE THERE OTHER STRAINS OUT THERE THAT YOU THINK ARE GOING TO BE A THREAT?

>> SO WE'RE WATCHING EACH PARTICULAR STRAIN HERE IN NEBRASKA.

SO WE HAVE REALLY BUILT UP A GENOMIC EPIDEMIOLOGY PARTNERSHIP TO BE ABLE TO DETECT, TRACE, AND IDENTIFY EACH OF THESE STRAINS AS THEY ARRIVE IN NEBRASKA.

BUT WE EXPECT SARS-COV-2 TO KEEP MUTATING.

THAT'S WHAT IT'S GOING TO CONTINUE DOING, AND RIGHT NOW DELTA IS STILL EVERYWHERE.

DELTA IS STILL THE MAIN VARIANT WE'RE DEALING WITH.

THERE IS A LOT OF SUBLINEAGES AND LITTLE DIFFERENT SECTS OF DELTA.

WHAT THOSE MEAN YET IS UNCLEAR AND THERE ISN'T REAL SOLID EVIDENCE ANYWHERE THAT A SUB LINEAGE OF DELTA IS CAUSING ANY REAL CHANGE IN WHAT SARS-COV-2 CAN DO SO I'M NOT OVERLY CONCERNED ABOUT NEW VARIANTS AT THE MOMENT.

RIGHT NOW DELTA IS STILL EVERYWHERE.

I'M MORE CONCERNED WITH VACCINE HESITANCY.

WE KNOW THAT EACH ONE OF THESE VACCINES WE HAVE WORKS REALLY WELL AGAINST EACH VARIANT.

WE HAVEN'T SEEN A VARIANT THAT CAN BREAK THROUGH ALL VACCINE-INDUCED IMMUNITY.

SO, MORE THAN ANY NEW VARIANT VACCINE HESITANCY I THINK IS OUR MAIN TARGET NOW.

>> DR. CANTRAL WE'RE STARTING TO HEAR ABOUT VACCINES FOR CHILDREN AGE FIVE TO 11.

WE KNOW THAT THE CHILDREN GET COVID AS OFTEN AS ADULTS BUT OFTEN 50% OF THEM ARE ASYMPTOMATIC BUT THEY'RE STILL OUT THERE SPREADING COVID AS WELL.

WHAT DO YOU TELL A PARENT ABOUT WHETHER OR NOT THEY SHOULD HAVE THEIR CHILD VACCINATED?

>> WELL, THAT'S A LITTLE OUTSIDE MY AREA BECAUSE I DON'T SEE CHILDREN.

BUT I KNOW CHILDREN, AND CHILDREN CAN CERTAINLY SERVE AS A RESERVOIR FOR FURTHER SPREAD.

NOT ONLY THAT YOU HAVE TO UNDERSTAND THAT THESE VARIANTS DON'T COME FROM NOWHERE.

THEY COME FROM PREVIOUS STRAINS THAT MUTATE WITHIN THE HUMAN BODY, AND SO EVERY PERSON ASYMPTOMATIC OR NOT, WHO GETS INFECTED BECOMES A POTENTIAL SITE OF A NEW VARIANT EMERGING WHICH MAY BE MORE VIRULENT THAN THE PREVIOUS ONE.

EVERY INFECTION THAT WE CAN PREVENT, WHETHER THAT'S THROUGH VACCINATION OR THROUGH SOCIAL DISTANCING, MASKING, ET CETERA REDUCES THE LIKELIHOOD THAT WE'LL HAVE ANOTHER VARIANT EMERGE.

SO I THINK IT'S EXTREMELY IMPORTANT THAT EVERYONE WHO IS ELIGIBLE, INCLUDING CHILDREN BE VACCINATED.

AND THAT'S THE ADVICE THAT I WOULD GIVE TO ANY PARENT.

>> DR. VIVEKANANDAN YOU'RE SHAKING YOUR HEAD YES.

YOU WOULD AGREE.

>> YEAH, I HAVE A FIVE-YEAR-OLD AND 7-YEAR-OLD AND ACTUALLY ENROLLED MY 7-YEAR-OLD IN THE CLINICAL TRIAL FOR MODERNA.

SHE RECEIVED THE VACCINE ABOUT TWO MONTHS AGO AND SHE IS DOING REALLY WELL.

SO I THINK IT'S REALLY IMPORTANT WHEN IT'S AVAILABLE FOR KIDS WE GET OUR KIDS VACCINATED.

>> DR. DONAHUE PART OF YOUR WORK IS TO ANALYZE DATA AND ESTIMATE KEY OUTCOMES THE NUMBER OF INFECTIONS WE CAN EXPECT, THE NUMBER OF ILLNESSES THE NUMBER OF HOSPITALIZATIONS THE NUMBER OF DEATHS.

I KNOW YOU DON'T HAVE A CRYSTAL BALL, BUT BASED ON WHAT YOU'RE SEEING AND BASED ON THE RESEARCH THAT YOU'RE LOOKING AT WHAT DO YOU PROJECT IS GOING TO BE HAPPENING IN THE NEXT FEW MONTHS OVER THE WINTER WITH THE PANDEMIC?

>> SO, YOU'RE SPOT ON WITH NO CRYSTAL BALL.

I THINK WE'VE ALL TRIED TO MAKE PREDICTIONS AT EACH POINT IN THIS AND SOME OF THEM HAVE BEEN RIGHT SOME OF THEM HAVE BEEN WRONG.

I REALLY WANT TO BE HOPEFUL WITH HOPEFUL ABOUT MY PROJECTIONS FOR NEXT FEW MONTHS.

WE'RE JUST COMING OFF A BIG SURGE.

WE KNOW THERE IS A LOT OF NATURAL IMMUNITY OUT THERE.

VACCINE IS MORE AND MORE AVAILABLE.

MORE NEBRASKANS NOW ARE FULLY VACCINATED THAN THERE HAVE BEEN AT ANY POINT IN TIME.

I'M HOPEFUL THAT AS VACCINES BECOME AVAILABLE FOR CHILDREN AND FOR YOUTH AS BOOSTERS BECOME MORE WIDELY AVAILABLE A COMBINATION OF NATURAL IMMUNITY AND VACCINE-INDUCED IMMUNITY WILL HELP REALLY PROTECT US MOVING FORWARD AND KEEP US FROM BEING IN AS BAD OF A PLACE AS WE'VE SEEN IN THE PAST SEVERAL MONTHS.

>> DR. VIVEKANANDAN GOVERNOR RICKETTS JUST ANNOUNCED THAT THE NEBRASKA HOSPITAL CAPACITY DASHBOARD IS GOING TO GO DOWN TO ONCE AGAIN WEEKLY AS OPPOSED TO MORE OFTEN NO LONGER DEMOGRAPHIC DATA OR NO LONGER COUNTY-SPECIFIC NUMBERS.

SO NEBRASKA HAS BEEN CRITICIZED AT TIMES FOR NOT BEING AS OPEN WITH THE DATA AS THEY SHOULD BE.

HOW HAS THAT IMPACTED THE HOSPITALS?

ARE YOU HAVING TROUBLE MAKING THE DECISIONS YOU NEED TO MAKE?

>> AS AN INFECTIOUS DISEASE PHYSICIAN, THE MORE NUMBER I HAVE, THE MORE DATA I HAVE IT'S REALLY HELPFUL TO KNOW WHERE IS THE INFECTION RATE WHERE IS IT HIGHER.

IT'S DEFINITELY HELPFUL FOR THE HOSPITAL BUT ALSO FOR THE COMMUNITY.

SO IF YOU KNOW IN A COMMUNITY IF THE RATES ARE HIGH THEY KNOW TO WEAR A MASK TAKE EXTRA PRECAUTION.

FOR ME, MORE DATA IS BETTER.

BUT IF YOU ONLY HAVE DATA ONCE A WEEK I THINK THAT'S STILL VERY GOOD.

BUT IDEALLY I WOULD LIKE DATA ON A DAILY BASIS BUT YOU KNOW ANY DATA IS BETTER.

>> AND DR. CANTRAL I JUST WANT TO GET YOUR OVERALL OPINION AS WE GO INTO THESE WINTER MONTHS AS WHAT WE'VE BEEN THROUGH FOR THE LAST YEAR AND A HALF ARE YOU OPTIMISTIC ABOUT WHERE WE ARE IN THE PANDEMIC?

>> I THINK AT LEAST OVER THE NEXT FEW WEEKS AND IT'S REALLY HARD TO LOOK MUCH BEYOND THAT BECAUSE WE CLEARLY HAVE SEEN THAT THIS VIRUS DOESN'T NECESSARILY FOLLOW THE MODELS THAT WE TRY TO COME UP WITH TO DETERMINE WHAT IS GOING TO HAPPEN.

BUT CERTAINLY NEXT FEW WEEKS THINGS SEEM TO BE MOVING IN THE RIGHT DIRECTION.

WHAT HAPPENS BEYOND THAT IS DEPENDENT UPON TWO THINGS.

ONE, WHAT THE VIRUS DOES WHICH WE CAN'T REALLY PREDICT.

AND TWO, WHAT WE DO AS CITIZENS.

ARE WE GOING TO DO THE RIGHT THINGS, MASK UP WHEN WE NEED TO SOCIALLY DISTANCE GET VACCINATED?

THE INTERPLAY BETWEEN THOSE TWO DYNAMICS IS REALLY GOING TO DETERMINE WHAT HAPPENS.

AND AGAIN I CAN'T PREDICT ANY OF THOSE RIGHT NOW.

>> DR. DONAHUE, LAST WORD.

30 SECONDS BEFORE YOU TOLD US THIS IS BIGGER THAN THE SUPER BOWL OF PUBLIC HEALTH.

THIS IS THE PANDEMIC OF A CENTURY.

DO YOU STAND BY THOSE STATEMENTS YOU MADE BACK IN JUNE?

>> IT CERTAINLY STILL IS.

AND MORE THAN THAT, IT'S THE PANDEMIC OF THE CENTURY AND WE HAVE A VACCINE THAT WORKS WONDERS AND IS ABLE TO GET US OUT OF THIS.

SO A PANDEMIC OF A CENTURY AND WE HAVE ALL THE TOOLS WE NEED NOW TO MOVE PAST IT.

WE JUST NEED PEOPLE TO MAKE THAT CHOICE.

>> DR. MATTHEW DONAHUE THE ACTING STATE EPIDEMIOLOGIST THANK YOU FOR BEING WITH US.

DR. RENUGA VIVEKANANDAN FROM CREIGHTON AND ALSO FROM C.H.I.

HEALTH AND DR. DAVID CANTRAL PULMONOLOGIST WITH KEARNEY REGIONAL MEDICAL CENTER THANK YOU ALL FOR BEING HERE ON "SPEAKING OF NEBRASKA."

THIS DISCUSSION AND THE REST OF OUR PROGRAM ARE AVAILABLE ON OUR WEBSITE.

JUST GO TO NEBRASKAPUBLICMEDIA.ORG/ SPEAKING OF NEBRASKA.

AND YOU CAN JOIN THE CONVERSATION ON SOCIAL MEDIA.

FIND US ON FACEBOOK AND TWITTER AT NEBRASKA PUBLIC MEDIA.

AND THAT'S GOING TO CONCLUDE TONIGHT'S CONVERSATION.

NEXT WEEK, WE'LL FOCUS ON SCAMS IN OUR STATE WITH THE LOCAL PRESIDENT OF THE BETTER BUSINESS BUREAU AND AN FBI AGENT WHO SPECIALIZES IN WHITE COLLAR CRIME.

UNTIL THEN I'M NEBRASKA PUBLIC MEDIA NEWS DIRECTOR DENNIS KELLOGG.

WE'LL SEE YOU NEXT WEEK.

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