♪ >>> NEW CASES OF COVID-19 DECREASED SINCE A HUGE SPIKE IN NOVEMBER BUT THE VIRUS IS STILL SPREADING IN NEBRASKA.

AND THE GOVERNOR LAYS OUT HIS PLAN FOR THE STATE LEGISLATURE.

THAT'S TONIGHT ON "SPEAKING OF NEBRASKA."

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

I'M N-E-T NEWS DIRECTOR DENNIS KELLOGG.

ONE YEAR AGO, THE UNITED STATES CONFIRMED ITS FIRST CASE OF COVID-19, JOINING A SOON-TO-BE GLOBAL PANDEMIC.

SINCE THEN, NEBRASKA HAS CONFIRMED ABOUT 180,000 CASES AND AT LEAST 1,800 PEOPLE IN THE STATE HAVE DIED.

WITH VACCINE DISTRIBUTION UNDERWAY, THERE'S A LIGHT AT THE END OF THE TUNNEL.

GOVERNOR PETE RICKETTS HAD AN OPTIMISTIC PERSPECTIVE ON THE PANDEMIC IN HIS STATE OF THE STATE ADDRESS THURSDAY MORNING.

>> AS WE ALL DO OUR PART, THE STATE HAS FOLLOWED OUR NORTH STAR, PROTECTING OUR HOSPITAL CAPACITY.

OVER THE LAST TEN MONTHS WE'VE PURSUED THIS GOAL BY USING OUR SIX PILLARS: TESTING, CONTACT TRACING, PROVIDING PPE, MAKING QUARANTINE SPACE AVAILABLE, PROTECTING AT-RISK POPULATIONS, AND USING DIRECTED HEALTH MEASURES.

TIME AND AGAIN, HISTORY SHOWS NEBRASKANS RESPOND BY DOING THE RIGHT THING AND THE PANDEMIC HAS BEEN NO DIFFERENT.

OUR HEALTHCARE WORKERS HAVE STEPPED UP HEROICALLY TO KEEP NEBRASKANS HEALTHY.

DATA SHOWS THAT NEBRASKANS STAYED HOME WHEN WE ASKED THEM TO LAST SPRING.

AND NOW NEBRASKANS ARE EMBRACING THE CORONAVIRUS VACCINE.

THANKS TO THE INDIVIDUAL CONTRIBUTIONS OF COUNTLESS NEBRASKANS AND OUR SIX PILLARS, OUR STATE HAS SUCCESSFULLY ENSURED THAT EVERYONE WHO NEEDS A HOSPITAL BED, ICU BED, OR VENTILATOR HAS HAD ACCESS TO ONE.

THIS APPROACH HAS HELPED US STRIKE THAT BALANCE BETWEEN SLOWING THE SPREAD OF THE VIRUS AND ALLOWING PEOPLE TO LIVE A MORE NORMAL LIFE.

♪ >> JOINING US NOW, LESLIE MARSH, CEO OF THE LEXINGTON REGIONAL HEALTH CENTER, DR. JAMES LAWLER, AN INFECTIOUS DISEASE EXPERT AND ASSOCIATE PROFESSOR OF INTERNAL MEDICINE AT THE UNIVERSITY OF NEBRASKA MEDICAL CENTER, AND DR. BOB RAUNER, A FAMILY MEDICINE PRACTITIONER AND PRESIDENT OF THE NONPROFIT ORGANIZATION PARTNERSHIP FOR A HEALTHY LINCOLN.

THANK YOU ALL FOR JOINING US.

WE APPRECIATE YOU BEING HERE.

WELL, NEW CASES OF COVID-19 IN NEBRASKA ARE UP 19% OVER THE PAST TWO WEEKS, WITH AN AVERAGE 961 NEW CASES EVERY DAY.

THAT'S MORE THAN DOUBLE THE PEAK IN THE SPRING WHEN THE HIGHEST DAILY AVERAGE WAS JUST 435 NEW CASES.

DR. LAWLER, WE'VE HEARD DIFFERENT THINGS OVER THE PAST SEVERAL MONTHS ABOUT WHERE MOST OF THE SPREAD IS HAPPENING, MAYBE LARGE CROWDS, SMALL FAMILY GATHERINGS, WEDDINGS, BARS AND RESTAURANTS.

WHAT ARE THE LATEST TRENDS OF VIRUS SPREAD IN NEBRASKA?

>> SO I THINK THE GOOD NEWS IS THAT WE'RE DOWN FROM WHERE OUR PEAK WAS IN THE MIDDLE OF NOVEMBER, SIGNIFICANTLY DECREASED.

BUT AS YOU MENTIONED, WE ARE STARTING TO TREND BACK UP OVER THE LAST COUPLE OF WEEKS AND THAT MAY BE A RESULT OF SOME OF THE HOLIDAY GATHERINGS AND TRAVEL AND OTHER THINGS THAT HAPPENED OVER THE LAST SEVERAL WEEKS.

I THINK THAT IT'S CLEAR THAT THE VIRUS IS TRANSMITTED MOST READILY IN GROUP SETTINGS, INDOORS, WHERE PEOPLE ARE CONGREGATING, PARTICULARLY IF THEY'RE CONGREGATING WITHOUT FACE MASKS AND SO THE HIGH RISK VENUES THAT HAVE BEEN DESCRIBED IN STUDIES PRETTY CONSISTENTLY ARE PLACES LIKE RESTAURANTS, BARS, CLUBS, PLACES AGAIN WHERE PEOPLE ARE INDOORS IN CLOSE CONTACT WITHOUT WEARING FACE MASKS AND OVER THE HOLIDAYS CERTAINLY, FAMILY GATHERINGS WERE ALSO PROBABLY VERY IMPORTANT IN TRANSMISSION.

SO, INSIDE PEOPLE'S HOMES WHERE FAMILIES FRIENDS, GATHERING IN CLOSE PROXIMITY FOR LONG PERIODS OF TIME AND PARTICULARLY UNMASKED.

AND SO WE STILL NEED TO REMAIN INCREDIBLY VIGILANT ABOUT DOING ALL OF THOSE SOCIAL DISTANCING ACTIVITIES THAT HAVE BEEN PREACHED, PARTICULARLY AVOIDING GATHERINGS, CERTAINLY GATHERINGS OF MORE THAN SIX TO TEN, WEARING A FACE MASK WHEN YOU'RE OUTSIDE OF YOUR HOUSEHOLD, AVOID INDOOR DINING AT RESTAURANTS, BARS, WHERE PEOPLE ARE GOING TO HAVE MASKS OFF AND WE HAVE A FEW MORE MONTHS OF REALLY BUCKLING DOWN BEFORE WE START TO HAVE VACCINE WIDELY AVAILABLE, SPRINGTIME COMES AND THE WEATHER GETS BETTER, PEOPLE SPEND MORE TIME OUTDOORS.

I THINK WE'LL REALLY START TO SEE THE TIDE TURN AT THAT POINT.

BUT, THAT MEANS WE HAVE THE REMAINING WINTER TO BE VIGILANT.

>> ABOUT 5,500 NEBRASKANS HAVE BEEN HOSPITALIZED WITH COVID-19 AT SOME POINT DURING THE PANDEMIC.

AS OF WEDNESDAY NIGHT, 449 PEOPLE ARE IN THE HOSPITAL.

IN NOVEMBER, THE NUMBER OF ACTIVE HOSPITALIZATIONS REACHED NEARLY A THOUSAND.

LESLIE MARSH OF LEXINGTON, TELL US ABOUT THE CAPACITY AT YOUR HOSPITAL AND HOW HAS THE CARE FOR HOSPITALIZED PATIENTS CHANGED OVER THE LAST SEVERAL MONTHS?

WHAT TREATMENTS ARE AVAILABLE?

ARE WE SEEING BETTER OUTCOMES NOW?

>> WE SAW TWO DIFFERENT DISTINCT SORTS OF POPULATIONS IN THE SPRING, COMPARING THE SPRING TO MOST RECENTLY THE FALL AND POST HOLIDAY.

SO, WE DO HAVE MORE AVAILABLE TREATMENTS AND WE'RE MUCH MORE, I GUESS, ACCLIMATED TO TAKING CARE OF THESE PATIENTS.

AND SO IT'S OLDER POPULATION NOW, AND THEY HAVE A LOT OF CO-MORBIDITIES AND STAY A LITTLE BIT LONGER AND WE DO HAVE THE ABILITY TO DELIVER HIGH FLOW OXYGEN AND SUCH.

SO THEY'RE NOT AS ACUTELY ILL WHEN THEY COME IN AND THEY END UP STAYING A LITTLE BIT LONGER.

SO WE CAN SURGE UP TO 44 IF WE -- IF WE WOULD HAVE A WAIVER FROM CMS LIKE WE DID IN THE SPRING, BUT WE ARE A 25-BED HOSPITAL, SO WE WOULD BE ABLE TO TAKE CARE OF EASILY UP TO -- WE HAD TWO COVID WINGS SET UP FOR 15 PATIENTS.

SO -- >> OKAY.

MORE THAN 380,000 AMERICANS HAVE DIED OF COVID-19 SO FAR, AND THE COUNTRY IS AVERAGING 3,000 DEATHS PER DAY FOR THE FIRST TIME IN THE PANDEMIC.

HERE IN NEBRASKA, 1,803 PEOPLE HAVE DIED, INCLUDING NEARLY 650 JUST LAST MONTH, A HUGE INCREASE COMPARED TO EARLIER IN THE PANDEMIC.

DR. RAUNER, HERE IN NEBRASKA, PEOPLE AGE 85 OR OLDER MAKE UP 2% OF ALL CONFIRMED COVID-19 CASES BUT ACCOUNT FOR 35% OF DEATHS IN THE STATE.

SINCE THAT AGE GROUP IS PRIORITIZED TO GET THE VACCINE, CAN WE EXPECT TO SEE THE NUMBER OF NEW VIRUS DEATHS START TO GO DOWN SOON?

>> HOPEFULLY IT WILL.

WE'VE PRIORITIZED NURSING HOME.

WE MOVED INTO ASSISTED LIVING, RETIREMENT COMMUNITIES.

THAT'S A PRIORITIZATION.

WE WANT TO GET HEALTH THERE BECAUSE THEY HAVE TO BE ABLE TO TAKE CARE OF YOU SHOULD YOU GET SICK.

BUT MOST OF THE MORTALITY IS IN THE OLDER POPULATION.

NOW THAT WE'RE PRIORITIZING THAT, HOPEFULLY THAT WILL HAVE SOME EFFECT.

IT'S GOING TO TAKE SOME TIME, SO I THINK SOME PEOPLE ARE HAVING -- BEING A LITTLE IMPATIENT WAITING.

IT'S GOING TO TAKE PROBABLY SIXISH WEEKS FROM FIRST SHOT TO SECOND SHOT TO FULL IMMUNITY, SO IT'S GOING TO TAKE A WHILE TO GET THERE.

THE OTHER PROBLEM THAT WE STILL HAVE TO GET OVERALL CASE COUNTS DOWN BECAUSE INEVITABLY THOSE CASES DO LEAK INTO LONGER CARE FACILITIES BECAUSE OF THE EMPLOYEES, BECAUSE OF FAMILY MEMBER VISITS, THINGS LIKE THAT, SO WE'RE NOT OUT OF THE WOODS YET.

HOPEFULLY IN THE NEXT MONTH, YOU'LL SEE A DOWNWARD TRAJECTORY, BUT WE NEED TO BE BOTH THINGS.

WE NEED TO STILL BE MASKING AND THE VACCINE IS GOING TO HELP US, BUT IT'S GOING TO TAKE A WHILE UNTIL WE SEE THE EFFECT OF THAT.

>> SO NEBRASKA HAS DECIDED TO EXPAND THE 75 AND OLDER GROUP NOW TO INCLUDE AS FAR AS THE NEXT VACCINATION PHASE IS CONCERNED TO INCLUDE 65 AND OLDER, AND THOSE WITH MEDICAL CONDITIONS.

THAT'S GOING TO ADD MORE PEOPLE TO THAT PHASE BY SOME ESTIMATES MAYBE AS MANY AS 400,000 MORE PEOPLE.

WHAT ARE THE PROS AND CONS OF SUCH A MOVE, DR. LAWLER?

>> WELL, ULTIMATELY, VACCINE IS WHAT'S GOING TO GET US OUT OF THE PANDEMIC AND VACCINATING AS MANY PEOPLE, AS MUCH OF THE POPULATION AS WE CAN, AS QUICKLY AS WE CAN, IS GOING TO BE CRITICALLY IMPORTANT.

OBVIOUSLY THE HIGHER RISK INDIVIDUALS ARE THOSE OVER THE AGE OF 65, AND INCLUDING THEM IN HIGHER PRIORITIZATION TIERS I THINK IS APPROPRIATE.

THE REAL CHALLENGE HAS NOT NECESSARILY BEEN WHO IS PRIORITIZED AND DO WE HAVE VACCINE AVAILABLE.

IT'S BEEN GETTING IT INTO PEOPLE'S ARMS.

FORTUNATELY IN NEBRASKA OVERALL, AS A STATE HAS DONE BETTER THAN MOST.

I THINK WE'RE IN THE TOP TEN IN TERMS OF PROPORTION OF THE POPULATION WE'VE VACCINATED, BUT IF YOU LOOK COUNTRYWIDE, WE'VE ONLY GIVEN ABOUT A THIRD OR SO OF THE TOTAL NUMBER OF VACCINE DOSES THAT HAVE ALREADY BEEN DISTRIBUTED TO STATES.

AND IT'S THAT LAST MILE THAT'S REALLY THE CHALLENGE.

AND I THINK THE WORST THING WE CAN DO, IN MY OPINION, IS AT THE END OF THE DAY, IF WE HAVEN'T GIVEN EVERY DOSE OF VACCINE WE HAVE ON THE SHELF I THINK THAT'S A MISTAKE.

OUR GOAL SHOULD BE TO BOUNCE EVERY VACCINE CHECK WE HAVE AT THE END OF THE DAY.

THE LAST ONE WE WRITE, WE SHOULD BE CLEARING THE SHELF AND GETTING READY FOR THE NEXT DAY, BECAUSE AGAIN, THE MORE VACCINE WE CAN GET OUT, THE MORE PEOPLE WE CAN VACCINATE, THE BETTER OFF WE'RE ALL GOING TO BE.

>> VACCINE DISTRIBUTION IS COMPLICATED AS WE KNOW AND IT TAKES SOME TIME.

SO FAR IN NEBRASKA, ABOUT 175,000 DOSES HAVE BEEN DISTRIBUTED TO LOCAL HEALTH DEPARTMENTS AND HEALTHCARE PROVIDERS.

50% OF THOSE HAVE BEEN ADMINISTERED, WITH ABOUT 74,000 PEOPLE GETTING THE FIRST DOSE AND ANOTHER 14,000 GETTING THE SECOND DOSE.

SO DR. RAUNER, DO YOU THINK VACCINE DISTRIBUTION IS COMPLEX AND IS THERE ANYTHING THAT COULD BE DONE TO EASE THE DISTRIBUTION OF THE VACCINE?

>> WELL YEAH, IT'S COMPLEX, AND I THINK WE DID THE EASY PART FIRST, GETTING ALL THE HEALTHCARE PROVIDERS.

WE KNOW EXACTLY WHERE THEY ARE.

GETTING THE NURSING HOMES.

WE KNOW EXACTLY WHERE THEY ARE.

WHEN WE BROADEN OUT TO THE COMMUNITY, WE'RE GOING TO HAVE A MUCH BROADER APPROACH.

WE'RE GOING TO HAVE TO HAVE A BETTER COMMUNICATION STRATEGY.

I THINK YOU'RE GOING TO HAVE TO HAVE MORE OPTIONS FOR WHERE PEOPLE CAN GET THE VACCINE.

I THINK ONE CENTRAL LOCATION IS NOT A GOOD IDEA.

I THINK WE ALREADY HAVE MANY PLACES DISTRIBUTED AMONGST OUR COMMUNITY.

WE HAVE A LOT OF PRIMARY CARE CLINICS AND THAT'S WHO GIVES MOST VACCINES EVERY YEAR, YEAR IN AND YEAR OUT, SO MY BIGGEST FRUSTRATION IS THEY'RE NOT INVOLVING IN THE LAST MILE THE PEOPLE WHO ARE THE LAST MILE.

WHY AREN'T THE PHYSICIAN NETWORKS INVOLVED?

EVERY YEAR WE VACCINATE ALL OUR MEDICARE PATIENTS FOR INFLUENZA, REGULARLY GET ABOVE 80% OF THEM VACCINATED DESPITE LOGISTICAL CHALLENGES AND SO FAR THERE IS NOT BEEN ANY OUTREACH TO THE PHYSICIAN NETWORKS IN HOW WE MIGHT BE ABLE TO DO THAT.

LIKE LINCOLN, FOR EXAMPLE, I THINK WE COULD HAVE POCKETS AROUND THE COMMUNITY WHERE CLUSTERS OF CLINICS ARE.

THEY CAN ALL COOPERATE, WORK TOGETHER, USE THAT AS A SOMEWHAT CENTRALIZED, BUT WE DON'T NEED TO BE OVERLY CENTRALIZED.

THE MORE YOU DO IT IN THE COMMUNITY, THE BETTER.

THE OTHER THING IS WE'LL GET VACCINE HESITANCY AND RESISTANCE.

THE STUDIES WILL SHOW THE PERSON PEOPLE TRUST MOST IS THEIR PRIMARY CARE DOCTOR FOR THIS, SO IF YOU WANT TO CARRY THAT MESSAGE TO THEM, OVERCOME THE RESISTANCE, YOU REALLY NEED TO INVOLVE THE PRIMARY CARE DOCTORS IN THE PLANNING.

>> LESLIE MARSH, TALK TO US ABOUT THE ROLE OF THE HOSPITALS IN THE VACCINE DISTRIBUTION, IN PARTICULAR THE ONE IN YOURS, IN LEXINGTON.

WHAT ARE WE SEEING IN CENTRAL AND WESTERN NEBRASKA AS FAR AS THIS VACCINE DISTRIBUTION IS GOING?

>> WELL, WE ARE GOING TO GET OUR SECOND SHOTS STILL, IN THE NEXT TWO WEEKS, I THINK.

AND SO WE HAD 200 DOSES THAT WE'VE GIVEN.

SO WE'RE JUST ON THAT, WE'RE JUST THERE RIGHT NOW.

BUT I DEFINITELY AGREE WITH DR. RAUNER IN JUST SAYING THAT'S MOSTLY -- MOSTLY WHERE PATIENTS DO GET THEIR VACCINES, AND SO HAVING THEM INVOLVED IN THE PLANNING IS REALLY IMPORTANT BECAUSE WE HEAR SO MANY PEOPLE ARE AFRAID OF THIS OR THAT AND IF THEY'RE GOING TO, YOU KNOW, GET THE VACCINE, IT'S GOING TO BE BECAUSE THEY HAVE THAT TRUSTING RELATIONSHIP WITH THEIR PHYSICIAN.

WE PLAN TO HELP IN WHATEVER CAPACITY WE CAN AND OUR PHARMACIST IS THE LEAD ON THIS, ALONG WITH OUR CNL IN TERMS OF MANAGING THE VACCINE PLAN AT THE HOSPITAL.

>> SO WHETHER IT'S VACCINE DISTRIBUTION, OR DEALING WITH COVID ITSELF, WHAT DO YOU SEE AS THE MAJOR DIFFERENCES BETWEEN WHAT YOU'RE DEALING WITH IN CENTRAL OR RURAL NEBRASKA AS OPPOSED TO WHAT MAYBE WE'RE SEEING IN EASTERN NEBRASKA?

>> WELL YEAH, I THINK IT'S REALLY NICE THAT WE HAD GREAT RELATIONSHIPS WITH OTHER FACILITIES THAT WERE ACUTE CARE FACILITIES, BECAUSE WHEN WE HAD THAT FIRST SURGE, WE HAD A LOT OFF PATIENTS WHO WERE REALLY SICK AND HAVING THAT GOOD RELATIONSHIP THEY NEEDED TO BE TRANSFERRED OUT IMMEDIATELY FOR BEST OUTCOMES.

AND SO, YOU KNOW, OBVIOUSLY, WE CAN'T DO AS GOOD OF A JOB AS TAKING CARE OF ICU VENTILATED PATIENTS AS THOSE PLACES THAT DO THAT REGULARLY.

AND I KNOW THE MEDICAL CENTER WAS FOR THE SICKEST OF THE SICK, TOO SO I THINK THAT IT'S REALLY NICE TO BE THE ABLE TO HAVE THAT RANGE OF CARE THAT YOU CAN PROVIDE.

>> DR. LAWLER, GOVERNOR RICKETTS HAS SAID THE STATE WILL FOLLOW CDC GUIDELINES AND ADMINISTER THE FIRST AND SECOND DOSES OF THE VACCINES THAT REQUIRE THOSE DOSES AND NOT JUST THE FIRST DOSE AND THEN USE THE OTHER DOSE FOR OTHER PEOPLE.

WHICH APPROACH DO YOU THINK IS BETTER, GETTING MORE DOSES TO PEOPLE QUICKLY OR USING THE DOSES AS INTENDED TO INCREASE THE EFFECTIVENESS?

>> SO THAT'S AN INTERESTING QUESTION.

THE UK HAS ALREADY DECIDED TO MOVE TO DISTRIBUTING FIRST DOSES AS WIDELY AS POSSIBLE, WAITING TO GET A SECOND DOSE.

AND IT IS TRUE THAT RIGHT NOW WE DON'T HAVE THE SAME LEVEL OF CLINICAL TRIAL DATA TO SUPPORT MOVING TO ONE DOSE AND THEN DELAYING THE SECOND DOSE, ALTHOUGH I THINK FROM A GENERAL PERSPECTIVE OF VACCINOLOGY THERE'S GOOD EVIDENCE THAT THAT DOESN'T NECESSARILY DRAMATICALLY IMPACT THE IMMUNOGENICITY.

TO BE HONEST, I SUSPECT THAT WE MAY SEE A CHANGE IN NATIONAL GUIDANCE AT SOME POINT TO TRY AND GET MORE VACCINE DOSES OUT AS QUICKLY AS POSSIBLE, BECAUSE AGAIN, GETTING THAT FIRST DOSE INTO PEOPLE IS PROBABLY THE MOST IMPORTANT STEP.

THERE ARE SOME DATA FROM THE CLINICAL TRIALS THAT INDICATE THAT PROTECTIVE EFFECT EVEN AFTER ONE DOSE FOR THE TWO VACCINES THAT WE'RE USING IN THE U.S.

RIGHT NOW IS QUITE GOOD.

AND SO THAT MAY BE A DECISION THAT THE CDC OR OTHER FEDERAL OFFICIALS MAKE TO TRY AND ENHANCE NATIONAL UPTAKE AS I MENTIONED WE'RE STILL LAGGING BEHIND THE PACE AT WHICH WE HAD INITIALLY PLANNED TO ROLL VACCINE DISTRIBUTION AND ADMINISTRATION OUT.

SO RIGHT NOW THE PACE WE'RE GOING, IT WILL TAKE US TWO YEARS TO VACCINATE 75% OF THE POPULATION.

THAT'S OBVIOUSLY NOT AN APPROACH WE CAN CONTINUE.

SO, I WOULD WELCOME THAT CHANGE IN GUIDANCE FROM THE FEDS TO BE HONEST, BECAUSE I THINK ULTIMATELY THAT'S A STRATEGY THAT GETS US BETTER RESULTS.

>> DR. RAUNER, DO YOU AGREE WITH THAT?

>> YEAH, I THINK THERE IS AN OLD SURGEON'S ADAGE, "DON'T LET PERFECT BE THE ENEMY OF THE GOOD."

YES, THE STUDIES SHOW THREE WEEKS EXACTLY FOR PFIZER.

HOWEVER, OVER TIME WE'VE LEARNED THAT DOSAGES CHANGE IN VACCINES.

WHEN I WAS AT COLLEGE, A KID AT CREIGHTON 30 YEARS AGO, WE HAD A MEASLES OUTBREAK BECAUSE IT TURNED OUT THAT ONE DOSE WASN'T GOOD ENOUGH, YOU HAD TO GET A SECOND DOSE.

NOW EVERYBODY GETS A SECOND DOSE OF MEASLES VACCINE.

ON THE OTHER HAND, WHEN HPV VACCINATIONS CAME OUT, IT WAS THREE DOSES, BUT WE FOUND OUT IN YOUNGER KIDS, ADOLESCENTS, TWO WAS ENOUGH, SO NOW THEY ONLY NEED TWO.

DOSAGES CHANGE OVER TIME.

WE FOUND OVER TIME THAT IN INFLUENZA THE ELDERLY DON'T REACT AS WELL, SO THERE'S A HIGHER DOES INFLUENZA VACCINE, FOR EXAMPLE, SO I THINK WE COULD SEE CHANGES.

SOMETIMES YOU DISCOVER THESE THINGS ACCIDENTALLY BECAUSE THEY ACCIDENTALLY GAVE PEOPLE HALF DOSE AND IT TURNED OUT TO WORK BUT I THINK YOU'RE GOING TO SEE ARMS OF STUDIES JUST TRYING TO FIGURE THIS OUT.

I WOULD RATHER GET THE FIRST SHOT IN FIRST EVEN IF IT'S ONLY 80%.

I WOULD RATHER HAVE 80% OF THE PEOPLE WITH 80% OF EFFECTIVENESS THAN 40% WITH 95%.

IT'S A NUMBERS GAME.

I THINK WE SHOULD PUSH IT OUT AS SOON AS WE CAN.

>> AND IF I CAN ADD TO THAT VERY QUICKLY, I THINK THAT THE IMPORTANT THING TO KEEP IN MIND THERE IS THAT ALSO WOULD NOT EFFECT THE SAFETY PROFILE OF THE VACCINE.

WE'RE ONLY TALKING ABOUT THE EFFICACY, AND THAT'S A GEEKY ARGUMENT THAT EPIDEMIOLOGISTS CAN GET IN ABOUT HOW EFFECTIVE ONE STRATEGY CAN BE VERSUS THE OTHER, BUT FOR THE GENERAL PUBLIC'S CONCERN, YOU KNOW, ONE DOSE VERSUS TWO DOSES IS NOT GOING TO CHANGE THE SAFETY PROFILE.

SO FAR WHAT WE'VE SEEN FROM THESE VACCINES THEY'RE VERY SAFE, THEY HAVE A VERY LOW RATE OF ADVERSE OUTCOMES IN LINE WITH ALL OF THE OTHER VACCINES THAT WE ROUTINELY USE.

AND SO THAT SHOULD NOT -- THAT SHOULDN'T EFFECT PEOPLE'S CONFIDENCE IN THE VACCINE.

>> A RECENT POLL FROM THE KAISER FAMILY FOUNDATION SHOWS 71% OF AMERICANS ARE WILLING TO GET A COVID-19 VACCINE.

THAT FINDING FROM LAST MONTH IS HIGHER THAN VACCINE CONFIDENCE IN SEPTEMBER, WHEN 63% WERE WILLING TO BE VACCINATED.

BUT, THE LATEST RESULTS SHOW THERE ARE SOME WIDE GAPS IN WHO TRUSTS THE VACCINE AND WHO DOESN'T.

OLDER ADULTS, URBAN RESIDENTS, AND DEMOCRATS HAVE HIGH CONFIDENCE, WHILE AGES 30-49, RURAL RESIDENTS AND REPUBLICANS ARE LEAST LIKELY TO WANT THE VACCINE.

LESLIE MARSH, WHAT CONCERNS ARE YOU HEARING, IF ANY, ABOUT THE VACCINES AND WHAT ARE YOU TELLING PEOPLE IN LEXINGTON, IN CENTRAL NEBRASKA ABOUT GETTING THE VACCINE OR NOT?

>> WELL, WE ARE HEARING SOME CONCERNS FROM SOME POPULATIONS, AND SOME OF THEM ARE EVEN SAYING LIKE "THERE IS A CHIP THAT IS GOING TO BE INSERTED INTO YOU," AND SO WE JUST ACTUALLY DO ENCOURAGE THEM TO HAVE A CONVERSATION WITH THEIR PHYSICIAN, AND TO TALK THROUGH THOSE CONCERNS, BECAUSE THERE IS NO EVIDENCE THAT ANYTHING OTHER THAN WHAT WOULD HAPPEN WITH AN INFLUENZA TYPE VACCINE IS LIKELY TO OCCUR.

AND SO IT'S REALLY JUST HAVING THAT SITTING DOWN AND TAKING TIME AND HAVING A CONVERSATION AND MOSTLY IT'S WE'RE FINDING THAT THAT'S TRUE, AND MINORITY POPULATIONS ARE PRETTY RESISTANT EVEN NOW TO GETTING THE VACCINE, SO WE'RE HOPEFUL.

>> ARE YOU TAKING SPECIAL EFFORTS TO REACH THOSE MINORITY POPULATIONS?

>> YES, WE ARE, WE ARE.

BUT AGAIN, I THINK WHEN WE DO LOTS OF DIFFERENT YOU KNOW FACEBOOK LIVE SORTS OF VIDEOS, AND JUST INFOGRAPHICS AND THINGS LIKE THAT AND THEN WE HAVE A COMMUNITY HEALTH WORKER THAT GOES OUT AND VISITS WITH THEM, AS WELL.

>> DR. LAWLER, STATE HEALTH OFFICIALS SAY IT'S LIKELY THAT THE NEW STRAIN OF THE COVID-19 IS ALREADY IN NEBRASKA.

IS THAT A GAME CHANGER?

DOES IT AFFECT ANYTHING?

>> I THINK WE'RE GOING TO HAVE TO WAIT AND SEE.

THERE ARE NOW, I THINK, THERE'S COMPELLING EVIDENCE THAT THE U.K. NEW VARIANT STRAIN IS WIDELY CIRCULATING IN THE UNITED STATES AND FROM THE DATA IN THE U.K., IT DOES APPEAR THAT THAT STRAIN TRANSMITS MORE EASILY FROM PERSON TO PERSON.

AND THAT'S OBVIOUSLY A CONCERN IF THAT REMAINS TRUE HERE.

THERE IS ALSO OTHER NEW VARIANT STRAINS THAT HAVE BEEN FOUND IN SOUTH AFRICA, IN BRAZIL, IN NIGERIA.

THERE SEEM TO BE A LOT OF THESE POPPING UP NOW.

AND THEY ALL SEEM TO SHARE SOME CONCERNING MUTATIONS THAT MAY MAKE THEM MORE EASILY COMMUNICABLE.

WE'RE IN A RACE, AND THAT JUST INCREASES THE PRESSURE ON US TO FIRST OF ALL CONTINUE TO DO ALL OF THE NON-PHARMACEUTICAL INTERVENTIONS, THE SOCIAL DISTANCING, THINGS THAT PUBLIC HEALTH HAS BEEN RECOMMENDING, BUT ALSO TO ACCELERATE OUR RATE OF VACCINATIONS SO THAT WE CAN MAKE AS MUCH OF THE POPULATION AS IMMUNE AS POSSIBLE TO AVOID THESE NEW STRAINS FROM CATCHING AND MOVING MORE QUICKLY THROUGH THE POPULATION.

>> DR. RAUNER, WE'VE TALKED ABOUT SAFETY, WHAT WE SHOULD BE DOING BUT WHAT ABOUT RESTRICTIONS?

DIFFERENT PARTS OF NEBRASKA, YOU'LL SEE DIFFERENT RESTRICTIONS, LANCASTER COUNTY IS MORE STRICT THAN SOME OTHER PARTS OF THE STATE.

ARE WE SEEING ANY DATA THAT SHOWS THAT'S HAD AN IMPACT?

WHAT DO YOU THINK ABOUT THE CURRENT LEVEL OF RESTRICTIONS?

>> THE EVIDENCE IS REALLY CONCLUSIVE NOW THAT MASKING WORKS, WHETHER YOU WANT TO LOOK AT REGIONS OF SPAIN OR GERMANY, WHETHER YOU WANT TO LOOK AT AIRCRAFT CARRIERS, WHETHER YOU WANT TO LOOK AT NEBRASKA ACTUALLY, SO LINCOLN WAS THE FIRST COUNTY AND HEALTH DEPARTMENT TO PUT IN A MASK ORDINANCE.

WE ALSO HAVE THE LOWEST MORTALITY RATE AND WE HAVE THE LOWEST NUMBER PER CAPITA INFECTIONS.

THE MASK ORDINANCES DO WORK.

PEOPLE DON'T LIKE THEM.

I DON'T LIKE TO BEING TOLD TO DO, EITHER BUT THE END OF THE MATTER IS IT WORKS AND WE HAVE THE DATA NOW TO PROVE IT.

WE'VE HAD A LOT OF MUNICIPALITIES THAT HAVE GONE AHEAD AND PUT MASK ORDINANCES IN PLACE, AND THE NEXT HIGHEST MORTALITY IS OMAHA WHICH WAS HAD A PARTIAL AND THEN RURAL IT'S MUCH HIGHER BECAUSE OF THE MASK RESISTANCE.

AND WE'VE LEARNED IT WORKS.

ONE OF OUR BIGGEST EXAMPLES IS OUR SCHOOLS.

WE'VE HERE IN LINCOLN, I THINK, 99.5% PLUS ARE WEARING MASKS.

IT'S REALLY KEPT OUR SCHOOLS PRETTY SAFE.

WE'VE BEEN ABLE TO OPEN THEM SAFELY WITH SOME DE-DENSIFICATION, BETTER VENTILATION, AND OTHER THINGS, BUT IT'S KEPT OUR SCHOOLS FOR THE MOST PART SAFE.

MASKS WORK.

WE JUST GOT TO GET A HIGHER PERCENTAGE OF PEOPLE WEARING THEM.

>> LESLIE MARSH, I WANT TO ASK YOU ABOUT STAFFING.

WE KNOW THAT NATIONWIDE THERE IS A NURSING SHORTAGE.

ESPECIALLY IN A SMALLER HOSPITAL, HOW DO YOU COMPETE WITH OTHER HOSPITALS AROUND THE COUNTRY TO GET STAFF AND DO YOU HAVE ENOUGH STAFF?

>> WELL, ACTUALLY, TO DR. RAUNER'S POINT, WHEN THE PHASES SORT OF, YOU KNOW, REALLY BECAME MUCH LESS RESTRICTIVE, PEOPLE WERE OUT AND GOING TO WEDDINGS AND THAT INCLUDED OUR STAFF, AND MANY OF THEM EITHER BECAME POSITIVE, COVID POSITIVE, ABOUT 44, I THINK WERE COVID POSITIVE IF I'M REMEMBERING RIGHT, AND THEN ANOTHER 120 PATIENTS -- STAFF OVER THE COURSE OF THE -- FROM JULY TO NOVEMBER WERE EITHER QUARANTINED WITH A SICK CHILD AND MUCH OF THAT COVID POSITIVITY RATE CAME FROM BEING WITHOUT MASKS AND YOU KNOW, IN SETTINGS THAT WERE JUST MORE I GUESS THEY WERE RISKIER PLACES TO BE PERHAPS.

BUT IT DID REALLY IMPACT US.

AND IT WAS REALLY A STRAIN AND A STRESSOR.

I MEAN, WE HAD PEOPLE THAT WERE WORKING, NURSES THAT WERE WORKING, YOU KNOW, PRETTY MUCH SIX DAYS A WEEK, YOU KNOW.

WE WERE WORKING ON ALL OF US WERE WORKING THAT COULD WORK IN ANY CAPACITY TO HELP.

AND WE'RE FINALLY GETTING OUT OF THAT BECAUSE WE'RE A LITTLE BIT DIFFERENT I GUESS IN OUR TIME LINE.

WE HAD OUR PEAK PROBABLY BY JANUARY 14TH, IT WAS SORT OF STARTING TO SLOW DOWN.

BUT WE REALLY DID SUFFER, AND WE REALLY DID KIND OF MANAGE TO MAKE IT THROUGH.

WE DO OKAY WITH -- WE HAVE A GOOD TEAM, A GREAT TEAM ACTUALLY, AND SO WE DON'T HAVE A LOT OF VACANCIES NORMALLY, BUT WITH THE SICKNESS IT REALLY DID IMPACT.

>> WE JUST HAVE ABOUT A MINUTE LEFT, DR. LAWLER, I WANT TO ASK YOU.

WE'VE BEEN DEALING WITH THIS PANDEMIC FOR ALMOST A YEAR.

WHAT'S THE LESSON THAT WE'VE LEARNED OR LESSONS YOU THINK, IN A MINUTE?

CAN YOU GIVE US THAT?

>> SURE.

I THINK YOU KNOW THE OVERALL LESSON IS THAT WE'RE VULNERABLE TO EMERGING INFECTIOUS DISEASES AND WE'RE GOING TO CONTINUE TO BE VULNERABLE.

THIS WILL NOT BE PROBABLY THE ONLY PANDEMIC IN OUR LIFETIMES, AND WE HAVE TO DO MORE TO INVEST IN PUBLIC HEALTH INFRASTRUCTURE, TO INVEST IN INNOVATION, SO THAT WE'RE NOT CAUGHT IN THIS SAME SITUATION AGAIN.

WE NEED TO BE THE ABLE TO PRODUCE VACCINES MORE RAPIDLY AND WE NEED TO BE ABLE TO HAVE AWARENESS OF WHEN THESE DISEASES ARE SPREADING WITHIN OUR COMMUNITY SO WE CAN TAKE ACTION MORE QUICKLY.

>> DR. RAUNER, IN 20 SECONDS, ARE YOU OPTIMISTIC ABOUT THE NEXT FEW MONTHS?

>> I'M GUARDED.

I THINK IF WE CAN GET ENOUGH PEOPLE WEARING MASKS, THE VACCINES FAST ENOUGH, WE COULD START RETURNING TO SOME SEMBLANCE OF NORMAL BY THE SUMMER.

OBVIOUSLY BY THE SPRING IF WE CAN GET PEOPLE TO EAT OUTSIDE AND QUIT EATING INSIDE, THAT COULD HELP.

WE'VE GOT TO MAKE IT THROUGH THE NEXT COUPLE MONTHS BUT I'M OPTIMISTIC WE'LL GET TO SOME SEMBLANCE OF NORMALITY BY THE SUMMER.

>> THAT WOULD BE GREAT.

DR. BOB RAUNER, PRESIDENT OF PARTNERSHIP FOR HEALTHY LINCOLN THANK YOU VERY MUCH FOR BEING WITH US.

DR. JAMES LAWLER, WHO'S AN ASSOCIATE PROFESSOR OF INTERNAL MEDICINE AT UNMC, THANK YOU FOR BEING WITH US, AS WELL, AND LESLIE MARSH, THE CEO OF LEXINGTON REGIONAL HEALTH CENTER, THANKS FOR COMING IN AND TALKING WITH US TODAY.

THIS INTERVIEW AND TONIGHT'S PROGRAM ARE AVAILABLE ON OUR WEBSITE.

JUST GO TO NETNEBRASKA.ORG/ SPEAKINGOFNEBRASKA AND JOIN THE CONVERSATION ON SOCIAL MEDIA.

FIND US ON FACEBOOK AND TWITTER AT N-E-T NEWS NEBRASKA.

♪ >>> THE NEBRASKA UNICAMERAL KICKED OFF THE 2021 LEGISLATIVE SESSION LAST WEEK, AND GOVERNOR PETE RICKETTS LAID OUT HIS AGENDA FOR THE SESSION THURSDAY MORNING.

N-E-T NEWS REPORTER FRED KNAPP COVERS THE LEGISLATURE AND JOINS US NOW.

GOVERNOR RICKETTS ADDRESSED HOW THE STATE HAS HANDLED COVID-19, SAYING WE'VE STUCK TO THAT NORTH STAR, WHICH IS HOSPITAL CAPACITY AND WE SPENT A LOT OF TIME TALKING ABOUT COVID IN THIS PROGRAM, BUT I WANT TO ASK YOU ABOUT ANOTHER INITIATIVE THAT HE FOCUSED ON AND THAT WAS PROPERTY TAX LIMITS.

WHAT'S HIS PROPOSAL LOOK LIKE?

>> WELL, YOU'LL REMEMBER LAST YEAR THEY PASSED A NEW PROPERTY TAX INCENTIVE CREDIT FUND WHICH IS GETTING BACK TO PEOPLE A CERTAIN AMOUNT OF WHAT THEY PAY FOR SCHOOL PROPERTY TAXES ON THEIR INCOME TAXES.

BUT, THE GOVERNOR SAID THAT'S NOT ENOUGH.

>> THAT'S WHY SENATOR LINEHAN AND I ARE PROPOSING TO LIMIT THE GROWTH OF LOCAL GOVERNMENT PROPERTY TAXES TO 3%.

NEW LOCAL SPENDING CONSTRAINTS ARE CRITICAL TO ENSURING THE RELIEF WE PROVIDE GOES INTO PEOPLE'S POCKETS AND TO MAINTAIN LOCAL CONTROL IN FUTURE YEARS.

>> THE GOVERNOR SAYS PROPERTY TAXES HAVE GONE UP 4.5% A YEAR FOR THE LAST TEN YEARS WITH A CUMULATIVE INCREASE OF 55%, WHICH IS WHY HE WANTS THIS NEW PROPOSAL.

BUT IT'S BOUND TO ATTRACT RESISTANCE FROM NOT ONLY SCHOOLS BUT ALSO CITIES AND COUNTIES WHO ARE GOING TO ARGUE THAT IT ERODES LOCAL CONTROL.

>> ANOTHER ISSUE HE'S ZEROED IN WAS THE CONSTRUCTION OF A NEW PRISON.

WHAT IS THAT GOING TO COST?

>> $230 MILLION, $115 MILLION OVER THIS BIENNIUM, AND THEN ANOTHER -- THE REST OF IT OVER THE NEXT.

BUT, IT'S LIKELY TO SET OFF A DEBATE BETWEEN CONSTRUCTION AS THE WAY TO SOLVE THE STATE'S PRISON OVERCROWDING PROGRAM VERSUS SENTENCING REFORM AND A DIFFERENT LEVEL OF CONSTRUCTION.

HE'S TALKING ABOUT A MAXIMUM SECURITY PRISON, MOSTLY DIFFERENT CLASSES, BUT TO REPLACE THE NEBRASKA STATE PENITENTIARY, WHICH WOULD BECOME A MINIMUM SECURITY AND SENATOR STEVE LATHRUP, THE CHAIR OF THE JUDICIARY COMMITTEE, WANTS $52 MILLION INSTEAD, OR PERHAPS IN ADDITION TO, FOR COMMUNITY CORRECTIONS IN OMAHA.

>> ANOTHER ISSUE THAT THE GOVERNOR FOCUSED ON IN THE STATE OF THE STATE WAS RURAL BROADBAND.

WHAT'S HIS PLAN TO ATTACK THAT LONGTIME PROBLEM?

>> WELL, HE SAYS THERE ARE 80,000 HOUSEHOLDS IN THE STATE THAT DON'T HAVE ACCESS TO BROADBAND AT THE FCC STANDARD OF 25 MEGABITS PER SECOND FOR DOWNLOADS AND THREE FOR UPLOADS.

AND THE CARES ACT MONEY IS SUPPOSED TO HELP START ADDRESSING THAT FOR ABOUT 17,000.

THE GOVERNOR WANTS TO SPEND $20 MILLION IN EACH OF THE NEXT TWO YEARS TO ADDRESS ANOTHER 30,000 HOUSEHOLDS.

>> RIGHT NOW, WE'RE STILL INVOLVED WITH BILL INTRODUCTION AND FIGURING OUT THE RULES FOR THE SESSION?

>> THAT'S RIGHT.

THERE IS GOING TO BE A BIG DEBATE ON THAT THIS COMING WEEK AND THAT'S WHEN BILL INTRODUCTIONS CLOSE AND THEY GET DOWN TO DEBATING THE ISSUES.

>> ALL RIGHT.

FRED KNAPP, THANK YOU.

FRED KNAPP KEEPS US INFORMED ON WHAT'S HAPPENING IN THE LEGISLATURE EACH DAY.

LISTEN FOR HIS UPDATES ON N-E-T RADIO AT 5:45 AND 7:45 WEEKDAY MORNINGS, AND 5:45 IN THE EVENING, AND YOU CAN READ HIS STORIES EACH DAY ON OUR WEBSITE AT NETNEBRASKA.ORG/NEWS.

♪ THAT'S ALL FOR THIS WEEK ON "SPEAKING OF NEBRASKA."

THANKS TO DR. JAMES LAWLER, DR. BOB RAUNER, AND LESLIE MARSH FOR JOINING US, AND TO FRED KNAPP FOR HIS REPORTING.

ALSO, A VERY SPECIAL THANK YOU TO BECCA COSTELLO, WHO IS OUR PRODUCER, AND HAS PUT COUNTLESS HOURS INTO OUR "SPEAKING OF NEBRASKA" PROGRAMS.

THIS IS HER LAST ONE.

WE WISH HER THE BEST AS SHE RETURNS TO HER HOMETOWN OF CINCINNATI TO CONTINUE HER CAREER IN PUBLIC MEDIA.

BECCA, YOU WILL BE MISSED!

NEXT WEEK, JOIN US FOR A DISCUSSION ABOUT FOOD DESERTS AND FOOD INSECURITY IN NEBRASKA.

UNTIL THEN, I'M N-E-T NEWS DIRECTOR DENNIS KELLOGG.

THANKS FOR WATCHING.

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