“Our hospital, which is the most important within the state by quite a bit, has had, clearly, a reasonably intense give attention to preparedness for high-consequence infections and pandemics,” he mentioned. UNMC already had an aggressive stockpile program for N95 masks and different PPE in early 2020. However “even earlier than the pandemic actually began affecting Nebraska, we form of checked out what was happening and mentioned, you recognize, we’re all going to expire of PPE except we do one thing.” A workforce got here up with a method to reuse N95s by clipping them to clotheslines in a room with UV lightbulbs and UV-reflective partitions and irradiating them for just a few hours. They shared the approach with different hospitals across the state, serving to them protect their very own provides. A minimum of at UNMC, “we by no means ran out of N95s.”

Elsewhere, the state was aggregating knowledge from native well being departments to establish shortages and utilizing the Nationwide Guard as logistics assist to get provides round Nebraska — in no way a seamless course of however one which, in accordance with Jason Jackson, head of the Division of Administrative Companies, benefited from not counting on the federal authorities. “I do suppose different states fell into that entice. … I don’t know what knowledgeable that confidence that the federal authorities was going to have the ability to are available and meet that want,” Jackson mentioned. “However that by no means ruled our response.” There’s no good knowledge on this, however such efforts doubtless saved well being care employees’ lives at a time when thousands were dying across the country, partly because of lack of sufficient protecting tools.

UNMC was additionally instrumental in an infection prevention and management for susceptible corners of the state — and right here once more, Nebraska had a head begin. The college and its related well being community, Nebraska Medication, already had a workforce engaged on serving to nursing properties enhance an infection management across the state earlier than Covid hit, a job that took on new urgency within the early months of the pandemic, when some 40 percent of Covid fatalities had been amongst nursing residence residents and employees. They labored as nicely with different susceptible services, together with meat-processing vegetation (Nebraska is likely one of the top meatpacking states in the country, with practically 27,000 employees) and prisons (it additionally has among the nation’s most overcrowded prisons, with greater than 5,000 inmates). By June 2020, Muhammad Salman Ashraf, head of the Nebraska An infection Management Evaluation and Promotion Program, had assessed that lower than 1 p.c of Nebraska’s nursing-home inhabitants had died from Covid, versus 10 p.c in another states (Andrew Cuomo’s authorities was famously accused of covering up New York’s staggering nursing-home death toll of greater than 15,000 folks). Lawler says this was a serious contributor preserving Nebraska’s total demise toll down.

He doesn’t give excessive marks to the state’s Covid response total, nonetheless.

“We did very nicely for the primary few months of the pandemic,” he says, when many different states had been caught without warning. Ricketts moved shortly to restrict gathering sizes and sure in-person companies — gents’s golf equipment, tattoo parlors and the like — with out forcing the entire state to close down, although he did ask folks to voluntarily keep residence for 21 days to assist the state shield and develop hospital capability. Lawler thinks avoiding reflexive lockdowns and as an alternative utilizing tailor-made well being measures was the best method to go, however that the state bought too laissez-faire too shortly, and was too keen to maneuver on as soon as the vaccine was out there. He referenced the March 2020 article “The Hammer and the Dance,” which argued for a limited period of strict containment measures (the “hammer” of extreme limits on social exercise), adopted by a longer-term, extra versatile technique of adjustable measures to maintain the virus in test (the “dance” of continued testing and tracing, isolating infections, social distancing and masking, with the choice to implement stricter measures in case of worsening outbreaks).

“That was form of the strategy that we had been advocating,” Lawler mentioned. “The issue is, I feel we by no means adopted by way of on that, by way of persevering with to modulate our response primarily based on illness exercise. … We didn’t do the dance half. We simply form of took our dance card and went residence.”

After I requested Ricketts if he noticed a tradeoff between progress and well being, he mentioned he took a “holistic” strategy to the pandemic, that public-health individuals are solely taking a look at one a part of the image and that whereas he values their enter, he’s bought to weigh extra elements than they do. “We centered on slowing the unfold of the virus and letting folks dwell as regular a life as attainable,” he mentioned, which to him meant, amongst different issues, no statewide mandates.

“I feel different states tried to be very heavy-handed and order folks to do issues, and I feel that breeds resistance” — particularly when governors wouldn’t even comply with their very own guidelines (see: California governor Gavin Newsom’s “French Laundry moment”). Whereas some nationwide information shops swooned over Andrew Cuomo’s each day press conferences, which Selection known as “the hottest property in daytime TV,” Ricketts’ personal low-key, wonkish each day updates rarely even made C-SPAN.