CUDAHY, Wis. (AP) — Smithfield Foods will temporarily close its meat processing plants in Cudahy, Wisconsin and Martin City, Missouri because of the coronavirus pandemic. 

The plant near Milwaukee will be closed for two weeks while the facility in Missouri is closed indefinitely. 

The Missouri plant receives raw material from the company’s Sioux Falls, South Dakota facility, which is also closed.

 Smithfield Foods has reported 518 infections in employees in Sioux Falls and another 126 in people connected to them.

 Smithfield said a small number of employees at the Wisconsin and Missouri plants have tested positive for COVID-19.&nbsp;

CUDAHY, Wis. (AP) — Smithfield Foods will temporarily close its meat processing plants in Cudahy, Wisconsin and Martin City, Missouri because of the coronavirus pandemic. The plant near Milwaukee will be closed for two weeks while the facility in Missouri is closed indefinitely. The Missouri plant receives raw material from the company’s Sioux Falls, South Dakota facility, which is also closed. Smithfield Foods has reported 518 infections in employees in Sioux Falls and another 126 in people connected to them. Smithfield said a small number of employees at the Wisconsin and Missouri plants have tested positive for COVID-19.&nbsp;

Smithfield Foods closes plants in Wisconsin, Missouri

BELLE PLAINE, Kan. (AP) - Kansas ranchers eager to prepare their land for cattle grazing have mostly brushed off the plea from state health officials to voluntarily cut back this spring's prairie burning to reduce air pollution during the coronavirus pandemic.

With the potential of the pandemic overwhelming the state's medical facilities, the Kansas Department of Health and Environment on March 26 encouraged landowners and managers to reduce burned acres this spring in an effort to mitigate respiratory concerns connected to breathing the smoke.

Officials warned that individuals with respiratory issues, including COVID-19, as well as those with preexisting heart and lung diseases, children and elderly may experience worse symptoms due to the smoke from fires.

But air quality monitors this past week have picked up "significantly high readings" downwind from Kansas in the Lincoln and Omaha areas of Nebraska, with smoke from Kansas reaching as far north as South Dakota, said Rick Brunetti, director of the Bureau of Air at the Kansas Department of Health and Environment.

"We are seeing very little, if any, reduction in the amount of burning that is taking place in Kansas at the present time, Brunetti said.

The reasons vary, experts say. Some landowners may already have had contracts in place with the professionals hired to do the burning. Others have agreements in place to fatten cattle on those acres this summer. And still others do so because that is the way they have always done it and are more comfortable with burning in the spring.

"There is a whole infrastructure that is geared up to do this, so it doesn't surprise me," said Craig Volland, chairman of the air quality committee of the Kansas chapter of the Sierra Club.

Dr. Lee Norman, KDHE Secretary, said on Wednesday that he does not "have the inclination" to recommend now an outright ban on all rangeland burning because pollution levels aren't consistently above the thresholds set by the federal government.

"I think that would be considered if we had continued high number of coronavirus cases and influx into hospitals and that kind of thing," Norman said. "But we actually are not seeing an unusual amount of clinical activity now in those facilities.

Air quality standards were exceeded six times between April 3 and 9 in Kansas, according to the latest&nbsp;<a href="https://www.ksfire.org/new-media-archives/weeklyupdates/2020_Flint_Hills_Update_April_10.pdf" target="_blank">Flint Hills Prescribed Fire Update</a>. Pollution levels were also exceeded Saturday in Lincoln, Nebraska, as the smoke from Kansas drifted across state lines.

A day earlier, the Lincoln-Lancaster County Health Department in Nebraska issued a health advisory to the general public saying smoke in the air was expected to reach levels that are unhealthy for everyone. They especially pose an elevated risk to children, older adults and those with asthma, lung disease, other respiratory conditions or heart disease.

About 2.6 million acres (1.1 million hectares) were burned in Kansas last year, compared to 1.5 million acres (about 607,000 hectares) in 2018 and 2.4 million acres (about 971,000 hectares) in 2017, according to satellite data by the National Oceanic and Atmospheric Administration.

For decades, landowners have burned their fields each spring as a way to control invasive plant species and increase the lushness of pastures where they will graze beef cattle in the coming months.

That is especially the case in the Flint Hills, where the rock is so close to the surface and the terrain so hilly that tilling is impractical. Encompassing several hundred miles in eastern Kansas, the Flint Hills are among the last remaining tallgrass prairie ecosystems in the world.

While landowners in other parts of Kansas and states around it also burn rangeland, Brunetti said, the fires are of "significantly greater quantity" in the Flint Hills.

Flint Hills rancher Pete Ferrell said their protocol does not include yearly burning. They burn less consistently than other ranchers because they use high density stocking of beef cattle and a goat herd to control invasive species. He said they had already decided not to burn this year when health officials made their request.

"So no, that was not a factor for us, although I have shared that concern with neighbors, with associates who do burn," Ferrell said.

It is not possible yet to say definitively whether smoke impacts have changed in Nebraska because of the recommendation by Kansas health officials to not burn, said Amanda Woita, spokeswoman for the Nebraska Department of Environment and Energy. Nebraska would not have "a full picture" until after the burn season ends, she said.

KDHE spokeswoman Kristi Zears said Kansas health department officials are encouraging landowners in the Flint Hills to use the&nbsp;<a href="https://www.ksfire.org/" target="_blank">smoke model tool</a>&nbsp;to alleviate impacts to downwind communities.

"This is especially important with the current coronavirus pandemic affecting fellow Kansans and surrounding states," Zears said.

By ROXANA HEGEMAN-Associated PressBELLE PLAINE, Kan. (AP) - Kansas ranchers eager to prepare their land for cattle grazing have mostly brushed off the plea from state health officials to voluntarily cut back this spring's prairie burning to reduce air pollution during the coronavirus pandemic.With the potential of the pandemic overwhelming the state's medical facilities, the Kansas Department of Health and Environment on March 26 encouraged landowners and managers to reduce burned acres this spring in an effort to mitigate respiratory concerns connected to breathing the smoke.Officials warned that individuals with respiratory issues, including COVID-19, as well as those with preexisting heart and lung diseases, children and elderly may experience worse symptoms due to the smoke from fires.But air quality monitors this past week have picked up "significantly high readings" downwind from Kansas in the Lincoln and Omaha areas of Nebraska, with smoke from Kansas reaching as far north as South Dakota, said Rick Brunetti, director of the Bureau of Air at the Kansas Department of Health and Environment."We are seeing very little, if any, reduction in the amount of burning that is taking place in Kansas at the present time, Brunetti said.The reasons vary, experts say. Some landowners may already have had contracts in place with the professionals hired to do the burning. Others have agreements in place to fatten cattle on those acres this summer. And still others do so because that is the way they have always done it and are more comfortable with burning in the spring."There is a whole infrastructure that is geared up to do this, so it doesn't surprise me," said Craig Volland, chairman of the air quality committee of the Kansas chapter of the Sierra Club.Dr. Lee Norman, KDHE Secretary, said on Wednesday that he does not "have the inclination" to recommend now an outright ban on all rangeland burning because pollution levels aren't consistently above the thresholds set by the federal government."I think that would be considered if we had continued high number of coronavirus cases and influx into hospitals and that kind of thing," Norman said. "But we actually are not seeing an unusual amount of clinical activity now in those facilities.Air quality standards were exceeded six times between April 3 and 9 in Kansas, according to the latest&nbsp;<a href="https://www.ksfire.org/new-media-archives/weeklyupdates/2020_Flint_Hills_Update_April_10.pdf" target="_blank">Flint Hills Prescribed Fire Update</a>. Pollution levels were also exceeded Saturday in Lincoln, Nebraska, as the smoke from Kansas drifted across state lines.A day earlier, the Lincoln-Lancaster County Health Department in Nebraska issued a health advisory to the general public saying smoke in the air was expected to reach levels that are unhealthy for everyone. They especially pose an elevated risk to children, older adults and those with asthma, lung disease, other respiratory conditions or heart disease.About 2.6 million acres (1.1 million hectares) were burned in Kansas last year, compared to 1.5 million acres (about 607,000 hectares) in 2018 and 2.4 million acres (about 971,000 hectares) in 2017, according to satellite data by the National Oceanic and Atmospheric Administration.For decades, landowners have burned their fields each spring as a way to control invasive plant species and increase the lushness of pastures where they will graze beef cattle in the coming months.That is especially the case in the Flint Hills, where the rock is so close to the surface and the terrain so hilly that tilling is impractical. Encompassing several hundred miles in eastern Kansas, the Flint Hills are among the last remaining tallgrass prairie ecosystems in the world.While landowners in other parts of Kansas and states around it also burn rangeland, Brunetti said, the fires are of "significantly greater quantity" in the Flint Hills.Flint Hills rancher Pete Ferrell said their protocol does not include yearly burning. They burn less consistently than other ranchers because they use high density stocking of beef cattle and a goat herd to control invasive species. He said they had already decided not to burn this year when health officials made their request."So no, that was not a factor for us, although I have shared that concern with neighbors, with associates who do burn," Ferrell said.It is not possible yet to say definitively whether smoke impacts have changed in Nebraska because of the recommendation by Kansas health officials to not burn, said Amanda Woita, spokeswoman for the Nebraska Department of Environment and Energy. Nebraska would not have "a full picture" until after the burn season ends, she said.KDHE spokeswoman Kristi Zears said Kansas health department officials are encouraging landowners in the Flint Hills to use the&nbsp;<a href="https://www.ksfire.org/" target="_blank">smoke model tool</a>&nbsp;to alleviate impacts to downwind communities."This is especially important with the current coronavirus pandemic affecting fellow Kansans and surrounding states," Zears said.

Kansas ranchers burn land despite plea from health officials

LINCOLN, Neb. (AP) - Nebraska's unemployment claims have fallen from their recent record highs but were still far above average last week, according to new numbers released Thursday.

Nebraska residents filed 16,391 new claims during the week that ended April 11,&nbsp;<a href="https://apnews.com/d3d2181755cf0e0ac0f15c224682157f" target="_blank">down from around 27,000 the week prior</a>, according to the U.S. Department of Labor.

Nebraska set record highs for three straight weeks as state officials imposed new social-distancing restrictions on business and residents hunkered down at home to keep the virus from spreading.

Nebraska has now seen about 85,000 unemployment claims in the last four weeks, double the number it saw in 2019.

Nationally,&nbsp;<a href="https://apnews.com/fb33b19770c945bf19a40456f060e593" target="_blank">another 5.2 million people</a>&nbsp;sought benefits last week.

LINCOLN, Neb. (AP) - Nebraska's unemployment claims have fallen from their recent record highs but were still far above average last week, according to new numbers released Thursday.Nebraska residents filed 16,391 new claims during the week that ended April 11,&nbsp;<a href="https://apnews.com/d3d2181755cf0e0ac0f15c224682157f" target="_blank">down from around 27,000 the week prior</a>, according to the U.S. Department of Labor.Nebraska set record highs for three straight weeks as state officials imposed new social-distancing restrictions on business and residents hunkered down at home to keep the virus from spreading.Nebraska has now seen about 85,000 unemployment claims in the last four weeks, double the number it saw in 2019.Nationally,&nbsp;<a href="https://apnews.com/fb33b19770c945bf19a40456f060e593" target="_blank">another 5.2 million people</a>&nbsp;sought benefits last week.

Nebraska jobless claims drop, but still far above average

News Release (NE Dept. of Energy and Environmental Quality)

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Nebraska issues guidance for indoor, outdoor pools during COVID-19 outbreak

Central Dist. Health Department: Hall County man in is 80s died from COVID-19 complications

WASHINGTON (AP) — President Donald Trump said he’s prepared to announce new guidelines allowing some states to quickly ease up on&nbsp;<a href="https://apnews.com/fa1fda126fe191425abc20ab461dfbe7">social distancing</a>&nbsp;even as business leaders told him they need more&nbsp;<a href="https://apnews.com/c335958b1f8f6a37b19b421bc7759722">coronavirus testing</a>&nbsp;and personal protective equipment before people can safely go back to work.

The industry executives cautioned Trump that the return to normalcy will be anything but swift.

The new guidelines, expected to be announced Thursday, are aimed at clearing the way for an easing of restrictions in areas with low transmission of the coronavirus, while keeping them in place in harder-hit places. The ultimate decisions will remain with governors.

“We’ll be opening some states much sooner than others,” Trump said Wednesday.

But in a round of calls with business leaders earlier in the day, Trump was warned that a dramatic increasing in testing and wider availability of protective equipment will be necessary for the safe restoration of their operations.

The new guidelines come as the federal government envisions a gradual recovery from the virus, in which disruptive mitigation measures may be needed in some places at least until&nbsp;<a href="https://apnews.com/76b614811eef32955180c8260188bc24">a vaccine</a>&nbsp;is available — a milestone unlikely to be reached until next year.

Trump said at his daily briefing that data indicates the U.S. is “past the peak” of the COVID-19 epidemic, clearing the way for his plans to roll out guidelines to begin to “reopen” the country.

He called the latest data “encouraging,” saying the numbers have “put us in a very strong position to finalize guidelines for states on reopening the country.”

<a href="https://apnews.com/ad29c4d8fd12aeb00bd05ad96708f325">Dr. Deborah Birx</a>, the White House coronavirus task force coordinator, added that data from across the country showed the nation “improving” but that Americans had to recommit to social distancing to keep up the positive momentum.

She said nine states have fewer than 1,000 cases and just a few dozen new cases per day. She said those would likely be the first to see a lifting in social distancing restrictions at the direction of their governors under the guidelines set to be released Thursday.

Birx said the White House was particularly concerned about Rhode Island, noting it is now seeing a surge in cases from the Boston metro area after seeing a spike several weeks ago from cases from New York.

Trump consulted dozens of high-profile CEOs, union officials and other executives via conference calls Wednesday.

He received a mixed message from the industry leaders. They, too, said they want to get the economy going but had worries about how to safely do so.

In a tweet midway through Trump’s round of conference calls with the executives, the president said the participants were “all-in on getting America back to work, and soon.”

But participants in a morning call that included dozens of leading American companies raised concerns about the testing issue, according to one participant who spoke on the condition of anonymity to describe the private discussion.

Another person who participated in Wednesday’s calls said it was stressed to Trump that expansion of testing and contact tracing was crucial, as well as guidelines for best practices on reopening businesses in phases or in one fell swoop.

The participant said those on the call noted to the administration that there was about to be a massive rush on personal protective equipment. Many businesses that are now shuttered will need the protective equipment to keep their employees and customers safe.

Trump was told “the economy will look very different and operations will look very different,” one participant said.

Mark Cuban, the billionaire entrepreneur and owner of the Dallas Mavericks, was among several representatives from major sports leagues to speak with Trump. During a Fox News Channel interview ahead of the calls, he credited the president with gathering some of the “best of the best” to help shape his approach on reopening the economy. Still, Cuban did not embrace Trump’s push to reopen parts of the economy May 1.

“This is such a moving target that I think the biggest mistake we can make is rush to a decision,” said Cuban, who previously had been critical of Trump’s response to the pandemic. “But I’m going to help him in every way I can, whatever he needs me to do.”

The panel, which Trump dubbed the new Great American Economic Revival Industry Groups, also could help give Trump a measure of cover. If cases surge once restrictions are lifted, as many experts have warned, Trump will be able to tell the public he didn’t act alone and the nation’s top minds — from manufacturing to defense to technology — helped shape the plan.

Rich Nolan, president and CEO of the National Mining Association, who participated in one of the calls with Trump, said there was also discussion about tax relief as well as “making sure that people are optimistic about the economy and they feel safe coming back to work.”

“I think you’ll see steps to reopen the country at different rates in different states in the not too distant future,” Nolan said.

The launch of the council was not without hiccups.

AFL-CIO President Richard Trumka didn’t know until he heard his name announced in the Rose Garden on Tuesday that he would be part of the advisory group, according to Carolyn Bobb, a spokeswoman for the union.

“We were not asked,” Bobb said in an email. It was “just announced.”

Maryland Gov. Larry Hogan said Trump has appointed some “smart people” to his task force who could offer state leaders helpful guidelines as they negotiate the way forward.

“There are certain roles that only the federal government can play and should play, but I think the governors are going to make their own decisions within those recommended guidelines,” Hogan said.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587031848543.png" alt="President Trump and Agriculture Secretary Sonny Perdue during Wednesday's Coronavirus Task Force briefing in the White House Rose Garden." />
 <figcaption>President Trump and Agriculture Secretary Sonny Perdue during Wednesday's Coronavirus Task Force briefing in the White House Rose Garden.</figcaption>
 </figure>WASHINGTON (AP) — President Donald Trump said he’s prepared to announce new guidelines allowing some states to quickly ease up on&nbsp;<a href="https://apnews.com/fa1fda126fe191425abc20ab461dfbe7">social distancing</a>&nbsp;even as business leaders told him they need more&nbsp;<a href="https://apnews.com/c335958b1f8f6a37b19b421bc7759722">coronavirus testing</a>&nbsp;and personal protective equipment before people can safely go back to work.The industry executives cautioned Trump that the return to normalcy will be anything but swift.The new guidelines, expected to be announced Thursday, are aimed at clearing the way for an easing of restrictions in areas with low transmission of the coronavirus, while keeping them in place in harder-hit places. The ultimate decisions will remain with governors.“We’ll be opening some states much sooner than others,” Trump said Wednesday.But in a round of calls with business leaders earlier in the day, Trump was warned that a dramatic increasing in testing and wider availability of protective equipment will be necessary for the safe restoration of their operations.The new guidelines come as the federal government envisions a gradual recovery from the virus, in which disruptive mitigation measures may be needed in some places at least until&nbsp;<a href="https://apnews.com/76b614811eef32955180c8260188bc24">a vaccine</a>&nbsp;is available — a milestone unlikely to be reached until next year.Trump said at his daily briefing that data indicates the U.S. is “past the peak” of the COVID-19 epidemic, clearing the way for his plans to roll out guidelines to begin to “reopen” the country.He called the latest data “encouraging,” saying the numbers have “put us in a very strong position to finalize guidelines for states on reopening the country.”<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1586989213442.png" alt="Dr. Deborah Birx, the Coronavirus Task Force Coordinator answered questions at Wednesday's briefing in the White House rose garden." />
 <figcaption>Dr. Deborah Birx, the Coronavirus Task Force Coordinator answered questions at Wednesday's briefing in the White House rose garden.</figcaption>
 </figure><a href="https://apnews.com/ad29c4d8fd12aeb00bd05ad96708f325">Dr. Deborah Birx</a>, the White House coronavirus task force coordinator, added that data from across the country showed the nation “improving” but that Americans had to recommit to social distancing to keep up the positive momentum.She said nine states have fewer than 1,000 cases and just a few dozen new cases per day. She said those would likely be the first to see a lifting in social distancing restrictions at the direction of their governors under the guidelines set to be released Thursday.Birx said the White House was particularly concerned about Rhode Island, noting it is now seeing a surge in cases from the Boston metro area after seeing a spike several weeks ago from cases from New York.Trump consulted dozens of high-profile CEOs, union officials and other executives via conference calls Wednesday.He received a mixed message from the industry leaders. They, too, said they want to get the economy going but had worries about how to safely do so.In a tweet midway through Trump’s round of conference calls with the executives, the president said the participants were “all-in on getting America back to work, and soon.”But participants in a morning call that included dozens of leading American companies raised concerns about the testing issue, according to one participant who spoke on the condition of anonymity to describe the private discussion.Another person who participated in Wednesday’s calls said it was stressed to Trump that expansion of testing and contact tracing was crucial, as well as guidelines for best practices on reopening businesses in phases or in one fell swoop.The participant said those on the call noted to the administration that there was about to be a massive rush on personal protective equipment. Many businesses that are now shuttered will need the protective equipment to keep their employees and customers safe.Trump was told “the economy will look very different and operations will look very different,” one participant said.Mark Cuban, the billionaire entrepreneur and owner of the Dallas Mavericks, was among several representatives from major sports leagues to speak with Trump. During a Fox News Channel interview ahead of the calls, he credited the president with gathering some of the “best of the best” to help shape his approach on reopening the economy. Still, Cuban did not embrace Trump’s push to reopen parts of the economy May 1.“This is such a moving target that I think the biggest mistake we can make is rush to a decision,” said Cuban, who previously had been critical of Trump’s response to the pandemic. “But I’m going to help him in every way I can, whatever he needs me to do.”The panel, which Trump dubbed the new Great American Economic Revival Industry Groups, also could help give Trump a measure of cover. If cases surge once restrictions are lifted, as many experts have warned, Trump will be able to tell the public he didn’t act alone and the nation’s top minds — from manufacturing to defense to technology — helped shape the plan.Rich Nolan, president and CEO of the National Mining Association, who participated in one of the calls with Trump, said there was also discussion about tax relief as well as “making sure that people are optimistic about the economy and they feel safe coming back to work.”“I think you’ll see steps to reopen the country at different rates in different states in the not too distant future,” Nolan said.The launch of the council was not without hiccups.AFL-CIO President Richard Trumka didn’t know until he heard his name announced in the Rose Garden on Tuesday that he would be part of the advisory group, according to Carolyn Bobb, a spokeswoman for the union.“We were not asked,” Bobb said in an email. It was “just announced.”Maryland Gov. Larry Hogan said Trump has appointed some “smart people” to his task force who could offer state leaders helpful guidelines as they negotiate the way forward.“There are certain roles that only the federal government can play and should play, but I think the governors are going to make their own decisions within those recommended guidelines,” Hogan said.___

Trump says new guidelines aim to lift some restrictions

LANSING, Mich. (AP) — Thousands of flag-waving, honking protesters drove past the Michigan Capitol to show their displeasure with Gov. Gretchen Whitmer. 

They don’t like her orders to keep people at home and businesses locked during the coronavirus outbreak. 

The protest, called “Operation Gridlock,” was organized by the Michigan Conservative Coalition. 

Coalition member Meshawn Maddock said Whitmer’s orders are “just a disaster.” 

The governor said the rally threatened public health because protesters were close together without masks. 

Whitmer said the stay-at-home restrictions are necessary to stop the spread of the coronavirus. 

Michigan’s cases rose about 4% to 28,059. 

Deaths from COVID-19 increased by 153 to 1,921.&nbsp;

LANSING, Mich. (AP) — Thousands of flag-waving, honking protesters drove past the Michigan Capitol to show their displeasure with Gov. Gretchen Whitmer. They don’t like her orders to keep people at home and businesses locked during the coronavirus outbreak. The protest, called “Operation Gridlock,” was organized by the Michigan Conservative Coalition. Coalition member Meshawn Maddock said Whitmer’s orders are “just a disaster.” The governor said the rally threatened public health because protesters were close together without masks. Whitmer said the stay-at-home restrictions are necessary to stop the spread of the coronavirus. Michigan’s cases rose about 4% to 28,059. Deaths from COVID-19 increased by 153 to 1,921.&nbsp;

Thousands protest Michigan governor's social distance order

Nebraska Joint Information Center daily update (April 15, 2020)

LINCOLN –&nbsp;This afternoon, Governor Pete Ricketts issued an executive order to expand childcare options for working Nebraska families and to provide relief for childcare centers participating in the State’s Child Care Subsidy Program.&nbsp;

The order suspends two regulations governing the State’s Child Care Subsidy Program.&nbsp; First, the Governor’s order allows licensed child care providers within the program to bill the State for days when a child is absent from care.&nbsp; Second, the order enables families participating in the subsidy program to obtain in-home child care when other options are unavailable. &nbsp;

Stephanie Beasley, Director of the Division of Children and Family Services (CFS) for the Nebraska Department of Health and Human Services (DHHS, joined the Governor at today’s press conference.&nbsp; She spoke about the intent of the executive order and overviewed its regulatory changes.

Additionally, the Governor announced the launch of a business response survey to gauge how Nebraska businesses are navigating the COVID-19 pandemic.&nbsp; The survey has been developed by the State’s Department of Economic Development in partnership with the University of Nebraska System; the Lincoln, Greater Omaha, and state chambers of commerce; the Center for Public Affairs Research at the University of Nebraska Omaha; and the Bureau of Business Research at the University of Nebraska-Lincoln.

Ted Carter, President of the University of Nebraska System, took part in today’s press briefing to discuss the survey.&nbsp; He talked about its purpose, the information it will collect, and how the data will inform the University’s efforts to support businesses.

Gov. Ricketts: 21 Days to Keep Nebraska Healthy

Gov. Ricketts: Child Care Executive Order

Director Beasley: Child Care Executive Order

Read the Governor’s executive order pertaining to the State’s Child Care Subsidy Program by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2F8yt0s41jvrsju5p%2FEO%252020-18%2520-%2520COVID-18%2520-%2520Network%2520of%2520Child%2520Care%2520Providers%2520.pdf%3Fdl%3D0&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838533436&amp;sdata=j%2B55xcMLSsOiVLCT7huamtVe3P%2FbhcqugwvRrg4yH4c%3D&amp;reserved=0" target="_blank">clicking here</a>.

Full video of today’s press briefing is available by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2Fej7r9hubgfstts5%2FPress%2520Conf%25204.15.2020.mp4%3Fdl%3D0&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838543391&amp;sdata=s7c8ARNCHNC%2BEKNIlXmjL1kTQpQRxIt%2Fm05Cfwdzb1Y%3D&amp;reserved=0" target="_blank">clicking here</a>.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1586996505230.png" alt="Gov. Ricketts (podium) and President of the University of Nebraska System Ted Carter (back left) at today’s press conference." />
 <figcaption>Gov. Ricketts (podium) and President of the University of Nebraska System Ted Carter (back left) at today’s press conference.</figcaption>
 </figure>LINCOLN –&nbsp;This afternoon, Governor Pete Ricketts issued an executive order to expand childcare options for working Nebraska families and to provide relief for childcare centers participating in the State’s Child Care Subsidy Program.&nbsp;The order suspends two regulations governing the State’s Child Care Subsidy Program.&nbsp; First, the Governor’s order allows licensed child care providers within the program to bill the State for days when a child is absent from care.&nbsp; Second, the order enables families participating in the subsidy program to obtain in-home child care when other options are unavailable. &nbsp;Stephanie Beasley, Director of the Division of Children and Family Services (CFS) for the Nebraska Department of Health and Human Services (DHHS, joined the Governor at today’s press conference.&nbsp; She spoke about the intent of the executive order and overviewed its regulatory changes.Additionally, the Governor announced the launch of a business response survey to gauge how Nebraska businesses are navigating the COVID-19 pandemic.&nbsp; The survey has been developed by the State’s Department of Economic Development in partnership with the University of Nebraska System; the Lincoln, Greater Omaha, and state chambers of commerce; the Center for Public Affairs Research at the University of Nebraska Omaha; and the Bureau of Business Research at the University of Nebraska-Lincoln.Ted Carter, President of the University of Nebraska System, took part in today’s press briefing to discuss the survey.&nbsp; He talked about its purpose, the information it will collect, and how the data will inform the University’s efforts to support businesses.Gov. Ricketts: 21 Days to Keep Nebraska Healthy<ol>
 <li>We are now on Day 6 of the “21 Days to Stay Home and Stay Healthy” campaign.</li><li>I want to remind people of our Six Rules to Keep Nebraska Healthy.Stay home. &nbsp;No non-essential errands and no social gatherings. &nbsp;Respect the ten-person limit.Socially distance your work. &nbsp;Work from home or use the six-foot rule as much as possible in the workplace.Shop alone and only shop once a week. &nbsp;Do not take family with you.Help kids follow social distancing. &nbsp;Play at home. &nbsp;No group sports. &nbsp;And no playgrounds.Help seniors stay at home by shopping for them. &nbsp;Do not visit long-term care facilities.Exercise daily at home or with an appropriately socially-distanced activity.</li><li>Stay home. &nbsp;No non-essential errands and no social gatherings. &nbsp;Respect the ten-person limit.</li><li>Socially distance your work. &nbsp;Work from home or use the six-foot rule as much as possible in the workplace.</li><li>Shop alone and only shop once a week. &nbsp;Do not take family with you.</li><li>Help kids follow social distancing. &nbsp;Play at home. &nbsp;No group sports. &nbsp;And no playgrounds.</li><li>Help seniors stay at home by shopping for them. &nbsp;Do not visit long-term care facilities.</li><li>Exercise daily at home or with an appropriately socially-distanced activity.</li>
 </ol>Gov. Ricketts: Business Survey<ol>
 <li>The Nebraska Business Response Survey will capture the voice of Nebraska business owners and leaders as they navigate through the impacts of COVID-19.</li><li>The results from this statewide survey will help the State and business support services better assist Nebraska businesses during this challenging time.</li><li>We are asking all business owners, along with non-profit leaders, to complete this survey as soon as possible.</li><li>We need your help for a couple of reasons:The voice of Nebraska businesses needs to be heard as we work to restore growth.Your response will help other businesses in Nebraska as we plan for the future.</li><li>The voice of Nebraska businesses needs to be heard as we work to restore growth.</li><li>Your response will help other businesses in Nebraska as we plan for the future.</li><li>The survey is live now at&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fcpar.unomaha.edu%2Fnebusinessresponse&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838523481&amp;sdata=u2ZnkJDv2rdq%2FfOZOXF6n3AOxPlIxPtBFVWQisoCKrg%3D&amp;reserved=0" target="_blank">cpar.unomaha.edu/nebusinessresponse</a>.</li>
 </ol>President Carter: Business Survey<ol>
 <li>The University of Nebraska is a proud partner in this effort to survey our state’s businesses. &nbsp;</li><li>Like the Governor, we want to understand the challenges Nebraska businesses are facing in these difficult times. &nbsp;</li><li>We want to develop the right support strategies for businesses as we look to get our economy back on track in the long term.</li><li>We join the Governor and our state’s chambers of commerce in encouraging Nebraska businesses to complete the survey.</li>
 </ol><ol>
 <li>We’re eager to monitor the results because they will inform the activities of a number of University entities that are well positioned to serve Nebraska businesses.&nbsp; For example:Nebraska Business Development Center consultants will work directly with business owners to evaluate best practices for growth as we re-open the economy.Nebraska Extension specialists will work on the ground in communities across the state to rebuild businesses for the future.Our early childhood experts will provide expertise and support to Nebraska child care providers.Our Nebraska Manufacturing Extension Partnership, housed in the Institute of Agriculture and Natural Resources, will offer training to increase the productivity of small- to medium-sized manufacturers.</li><li>Nebraska Business Development Center consultants will work directly with business owners to evaluate best practices for growth as we re-open the economy.</li><li>Nebraska Extension specialists will work on the ground in communities across the state to rebuild businesses for the future.</li><li>Our early childhood experts will provide expertise and support to Nebraska child care providers.</li><li>Our Nebraska Manufacturing Extension Partnership, housed in the Institute of Agriculture and Natural Resources, will offer training to increase the productivity of small- to medium-sized manufacturers.</li><li>These are just a few of our many activities to support businesses in the state.&nbsp; Our online platform—SourceLink—connects Nebraskans with University services that support entrepreneurship, business, and economic development.&nbsp; I invite Nebraskans to explore SourceLink at:&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fnebraska.edu%2Fsourcelink&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838533436&amp;sdata=YmApSzs7rq5SMiWDf3f4rolZQLaYFfIPZZ6e4%2Bo3vKQ%3D&amp;reserved=0" target="_blank">nebraska.edu/sourcelink</a>.</li><li>The University looks forward to supporting Nebraska businesses as we work toward recovery and growth.</li>
 </ol>Gov. Ricketts: Child Care Executive Order<ol>
 <li>Childcare is a critical need for working Nebraskans during this pandemic.</li><li>Childcare facilities have been limited to ten kids per room.</li><li>We have issued guidance for childcare providers that is available at&nbsp;<a href="http://www.dhhs.ne.gov/coronavirus" target="_blank">www.dhhs.ne.gov/coronavirus</a>.</li><li>We are taking additional steps today to make sure folks have the ability to access the childcare they need.</li>
 </ol><ol>
 <li>I have signed a new executive order waiving two regulations for the Child Care Subsidy Program.Licensed child care providers can now bill DHHS for days when the child is absent from care because the child’s parent or legal caretaker chooses to keep the child home, or is unable to utilize care, due to the COVID-19 emergency.Additionally, families participating in the child care subsidy program may obtain in-home child care when other child care options are unavailable.</li><li>Licensed child care providers can now bill DHHS for days when the child is absent from care because the child’s parent or legal caretaker chooses to keep the child home, or is unable to utilize care, due to the COVID-19 emergency.</li><li>Additionally, families participating in the child care subsidy program may obtain in-home child care when other child care options are unavailable.</li>
 </ol>Director Beasley: Child Care Executive Order<ol>
 <li>The COVID-19 public health crisis has caused a significant disruption in the lives of all Nebraskan families, including those families CFS serves through child care subsidies.</li><li>As of this morning, 16% of licensed child care programs in Nebraska have temporary closed since the COVID-19 emergency declaration. &nbsp;This means that over 4,000 children whose families receive child care subsidy from the State may not have access to safe, high-quality care as their parents or guardians work—or look for work—to provide for their families.</li><li>Today, Governor Ricketts has announced two initiatives to benefit families currently receiving child care subsidies and their child care providers.</li><li>Starting today, families currently receiving child care subsidies, and who may be experiencing a child care closure, will have the option to use a license exempt in-home child care provider.&nbsp; This is an individual who goes into the home of the child to provide care.&nbsp;This regulatory change provides an alternative child care option for families whose usual child care provider or program has closed.The change also creates new job opportunities for individuals interested in providing in-home child care. &nbsp;Such persons could be temporarily unemployed neighbors, friends, or relatives.</li><li>This regulatory change provides an alternative child care option for families whose usual child care provider or program has closed.</li><li>The change also creates new job opportunities for individuals interested in providing in-home child care. &nbsp;Such persons could be temporarily unemployed neighbors, friends, or relatives.</li><li>Starting today, CFS will also allow licensed child care subsidy providers to bill the State for times when subsidy children are absent from child care during the COVID-19 emergency declaration.This temporary change will help sustain licensed child care subsidy providers, while ensuring that child care subsidy families have access to high-quality care. &nbsp;Importantly, a child care program is eligible for this provision so long as they remain open—or reopen—and can bill for absent days.</li><li>This temporary change will help sustain licensed child care subsidy providers, while ensuring that child care subsidy families have access to high-quality care. &nbsp;</li><li>Importantly, a child care program is eligible for this provision so long as they remain open—or reopen—and can bill for absent days.</li>
 </ol><ol>
 <li>Together, these changes will help ensure continued access to high-quality child care, provide new job opportunities, and support local communities by making sure Nebraska has a strong child care network throughout the state.</li>
 </ol>Read the Governor’s executive order pertaining to the State’s Child Care Subsidy Program by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2F8yt0s41jvrsju5p%2FEO%252020-18%2520-%2520COVID-18%2520-%2520Network%2520of%2520Child%2520Care%2520Providers%2520.pdf%3Fdl%3D0&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838533436&amp;sdata=j%2B55xcMLSsOiVLCT7huamtVe3P%2FbhcqugwvRrg4yH4c%3D&amp;reserved=0" target="_blank">clicking here</a>.Full video of today’s press briefing is available by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2Fej7r9hubgfstts5%2FPress%2520Conf%25204.15.2020.mp4%3Fdl%3D0&amp;data=02%7C01%7Ctaylor.gage%40nebraska.gov%7Cb246d4fb9a6f42fdb1d608d7e18a6598%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637225856838543391&amp;sdata=s7c8ARNCHNC%2BEKNIlXmjL1kTQpQRxIt%2Fm05Cfwdzb1Y%3D&amp;reserved=0" target="_blank">clicking here</a>.

Gov. Ricketts issues executive order to provide childcare relief, announces COVID-19 business response survey

NORTH PLATTE, Neb. (WCDHD)-The
West Central District Health Department (WCDHD) has now tested 280
individuals in Lincoln County for Coronavirus (COVID-19).&nbsp; Of
the tested 280, 17 have been positive. Five are travel-related,
three are community spread, and the remaining nine are due to close
contact.&nbsp; All seventeen cases are within Lincoln County. Stay
informed of new cases by visiting our website at<a href="https://wcdhd.org/">
https://wcdhd.org/</a>
(information
will be updated daily 5:45 PM).


In an effort to increase
testing within our district, The National Guard assisted WCDHD with
100 collections on 04/14/2020. The testing was prioritized according
to individuals who were symptomatic and those in high risk settings.

Social
and physical distancing help prevent the spread of COVID-19. 


Public
health officials would like to remind you that if you have a fever of
over 100.4 or symptoms of respiratory illness, please self-isolate
and contact your healthcare provider for additional guidance.&nbsp;
If you are tested, have been in direct contact of a lab-confirmed
case, or traveled outside of Nebraska in the last two weeks REGISTER
with WCDHD at
<a href="https://consultinglhd.sjc1.qualtrics.com/jfe/form/SV_a67PjRi6skYXMrP">https://consultinglhd.sjc1.qualtrics.com/jfe/form/SV_a67PjRi6skYXMrP</a>.

NORTH PLATTE, Neb. (WCDHD)-The
West Central District Health Department (WCDHD) has now tested 280
individuals in Lincoln County for Coronavirus (COVID-19).&nbsp; Of
the tested 280, 17 have been positive. Five are travel-related,
three are community spread, and the remaining nine are due to close
contact.&nbsp; All seventeen cases are within Lincoln County. Stay
informed of new cases by visiting our website at<a href="https://wcdhd.org/">
https://wcdhd.org/</a>
(information
will be updated daily 5:45 PM).<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1586996275958.png" alt="" />
 <figcaption></figcaption>
 </figure>
In an effort to increase
testing within our district, The National Guard assisted WCDHD with
100 collections on 04/14/2020. The testing was prioritized according
to individuals who were symptomatic and those in high risk settings.Social
and physical distancing help prevent the spread of COVID-19. 
This
includes:<ol>
 <li>Stay
	home and practice social and physical distancing
	Stay
		Home
		Avoid
		gatherings, if you must gather, keep individuals to 10 or less
	
	</li><li>Stay
		Home
		</li><li>Avoid
		gatherings, if you must gather, keep individuals to 10 or less
	</li><li>When
	out stay 6 foot away from others
	</li><li>Cough
	and/or sneeze into your elbow
	</li><li>Wash
	your hands with warm soapy water for at least 20 seconds
	</li><li>Do
	not touch your face
	</li><li>Wear
	a community mask - this will help mitigate the spread of the virus
</li>
 </ol>Public
health officials would like to remind you that if you have a fever of
over 100.4 or symptoms of respiratory illness, please self-isolate
and contact your healthcare provider for additional guidance.&nbsp;
If you are tested, have been in direct contact of a lab-confirmed
case, or traveled outside of Nebraska in the last two weeks REGISTER
with WCDHD at
<a href="https://consultinglhd.sjc1.qualtrics.com/jfe/form/SV_a67PjRi6skYXMrP">https://consultinglhd.sjc1.qualtrics.com/jfe/form/SV_a67PjRi6skYXMrP</a>.

WCDHD: 280 tested, 17 returned positive

In the six days after top Chinese officials secretly determined they likely were facing a pandemic from a new coronavirus, the city of Wuhan at the epicenter of the disease hosted a mass banquet for tens of thousands of people; millions began traveling through for Lunar New Year celebrations.

President Xi Jinping warned the public on the seventh day, Jan. 20. But by that time, more than 3,000 people had been infected during almost a week of public silence, according to internal documents obtained by The Associated Press and expert estimates based on&nbsp;<a href="http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51" target="_blank">retrospective infection data</a>.

That delay from Jan. 14 to Jan. 20 was neither the first mistake made by Chinese officials at all levels in confronting the outbreak, nor the longest lag, as governments around the world have dragged their feet for weeks and even months in addressing the virus.

But the delay by the first country to face the new coronavirus came at a critical time — the beginning of the outbreak. China’s attempt to walk a line between alerting the public and avoiding panic set the stage for a pandemic that has infected almost 2 million people and taken more than 126,000 lives.

“This is tremendous,” said Zuo-Feng Zhang, an epidemiologist at the University of California, Los Angeles. “If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient. We might have avoided the collapse of Wuhan’s medical system.”

Other experts noted that the Chinese government may have waited on warning the public to stave off hysteria, and that it did act quickly in private during that time.

But the six-day delay by China’s leaders in Beijing came on top of almost two weeks during which the national Center for Disease Control did not register any cases from local officials, internal bulletins obtained by the AP confirm. Yet during that time, from Jan. 5 to Jan. 17, hundreds of patients were appearing in hospitals not just in Wuhan but across the country.

It’s uncertain whether it was local officials who failed to report cases or national officials who failed to record them. It’s also not clear exactly what officials knew at the time in Wuhan, which only opened back up last week with restrictions after its quarantine.

But what is clear, experts say, is that China’s rigid controls on information, bureaucratic hurdles and a reluctance to send bad news up the chain of command muffled early warnings.&nbsp;<a href="https://apnews.com/6f2e666485e9abae4bb112251eca77be">The punishment of eight doctors for “rumor-mongering,”</a>&nbsp;broadcast on national television on Jan. 2, sent a chill through the city’s hospitals.

“Doctors in Wuhan were afraid,” said Dali Yang, a professor of Chinese politics at the University of Chicago. “It was truly intimidation of an entire profession.”

Without these internal reports, it took the first case outside China, in Thailand on Jan. 13, to galvanize leaders in Beijing into recognizing the possible pandemic before them. It was only then that they launched a nationwide plan to find cases — distributing CDC-sanctioned test kits, easing the criteria for confirming cases and ordering health officials to screen patients, all without telling the public.

The Chinese government has repeatedly denied suppressing information in the early days, saying it immediately reported the outbreak to the World Health Organization.

“Those accusing China of lacking transparency and openness are unfair,” foreign ministry spokesman Zhao Lijian said Wednesday when asked about the AP story.

The documents show that the head of China’s National Health Commission, Ma Xiaowei, laid out a grim assessment of the situation on Jan. 14 in a confidential teleconference with provincial health officials. A memo states that the teleconference was held to convey instructions on the coronavirus from President Xi Jinping, Premier Li Keqiang and Vice Premier Sun Chunlan, but does not specify what those instructions were.

“The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event,” the memo cites Ma as saying.

The National Health Commission is the top medical agency in the country. In a faxed statement, the Commission said it had organized the teleconference because of the case reported in Thailand and the possibility of the virus spreading during New Year travel. It added that China had published information on the outbreak in an “open, transparent, responsible and timely manner,” in accordance with “important instructions” repeatedly issued by President Xi.

The documents come from an anonymous source in the medical field who did not want to be named for fear of retribution. The AP confirmed the contents with two other sources in public health familiar with the teleconference. Some of the memo’s contents also appeared in&nbsp;<a href="http://www.nhc.gov.cn/xcs/fkdt/202002/e5e8a132ef8b42d484e6df53d4d110c1.shtml" target="_blank">a public notice about the teleconference</a>, stripped of key details and published in February.

Under a section titled “sober understanding of the situation,” the memo said that “clustered cases suggest that human-to-human transmission is possible.” It singled out the case in Thailand, saying that the situation had “changed significantly” because of the possible spread of the virus abroad.

“With the coming of the Spring Festival, many people will be traveling, and the risk of transmission and spread is high,” the memo continued. “All localities must prepare for and respond to a pandemic.”

In the memo, Ma demanded officials unite around Xi and made clear that political considerations and social stability were key priorities during the long lead-up to China’s two biggest political meetings of the year in March. While the documents do not spell out why Chinese leaders waited six days to make their concerns public, the meetings may be one reason.

“The imperatives for social stability, for not rocking the boat before these important Party congresses is pretty strong,” says Daniel Mattingly, a scholar of Chinese politics at Yale. “My guess is, they wanted to let it play out a little more and see what happened.”

In response to the teleconference, the Center for Disease Control and Prevention in Beijing initiated the highest-level emergency response internally, level one, on Jan. 15. It assigned top CDC leaders to 14 working groups tasked with getting funds, training health workers, collecting data, doing field investigations and supervising laboratories, an internal CDC notice shows. The memo directed Hubei province, where Wuhan is located, to begin temperature checks at airports, bus and train stations, and cut down on large public gatherings.

The National Health Commission also distributed a 63-page set of instructions to provincial health officials, obtained by the AP. The instructions ordered health officials nationwide to identify suspected cases, hospitals to open fever clinics, and doctors and nurses to don protective gear. They were marked “internal” — “not to be spread on the internet,” “not to be publicly disclosed.”

In public, however, officials continued to downplay the threat, pointing to the 41 cases public at the time.

“We have reached the latest understanding that the risk of sustained human-to-human transmission is low,” Li Qun, the head of the China CDC’s emergency center,&nbsp;<a href="http://tv.cctv.com/2020/01/15/VIDEVPaxZBFtDLGUA6mk5PW2200115.shtml" target="_blank">told Chinese state television on Jan. 15</a>. That was the same day Li was appointed leader of a group preparing emergency plans for the level one response, a CDC notice shows.

On Jan. 20, President Xi issued his first public comments on the virus, saying the outbreak “must be taken seriously” and every possible measure pursued. A leading Chinese epidemiologist, Zhong Nanshan,&nbsp;<a href="https://apnews.com/14d7dcffa205d9022fa9ea593bb2a8c5">announced for the first time that the virus was transmissible from person to person on national television.</a>

If the public had been warned a week earlier to take actions such as social distancing, mask wearing and travel restrictions, cases could have been cut by up to two-thirds,&nbsp;<a href="https://www.medrxiv.org/content/10.1101/2020.03.03.20029843v3.full.pdf" target="_blank">one paper later found</a>. An earlier warning could have saved lives, said Zhang, the doctor in Los Angeles.

However, other health experts said the government took decisive action in private given the information available to them.

“They may not have said the right thing, but they were doing the right thing,” said Ray Yip, the retired founding head of the U.S. Centers for Disease Control’s office in China. “On the 20th, they sounded the alarm for the whole country, which is not an unreasonable delay.”

If health officials raise the alarm prematurely, it can damage their credibility — “like crying wolf” —and cripple their ability to mobilize the public, said Benjamin Cowley, an epidemiologist at the University of Hong Kong.

The delay may support accusations by President Donald Trump that the Chinese government’s secrecy held back the world’s response to the virus. However, even the public announcement on Jan. 20 left the U.S. nearly two months to prepare for the pandemic.

During those months,&nbsp;<a href="https://apnews.com/6a8f85aad99607f313cca6ab1398e04d">Trump ignored the warnings of his own staff and dismissed the disease as nothing to worry about</a>, while the government&nbsp;<a href="https://apnews.com/090600c299a8cf07f5b44d92534856bc">failed to bolster medical supplies</a>&nbsp;and&nbsp;<a href="https://apnews.com/c335958b1f8f6a37b19b421bc7759722">deployed flawed testing kits</a>. Leaders across the world turned a blind eye to the outbreak, with British Prime Minister Boris Johnson calling for a strategy of “herd immunity” —&nbsp;<a href="https://apnews.com/193a0cfe074685144ade169084a68255">before falling ill himself.</a>&nbsp;Brazilian President&nbsp;<a href="https://apnews.com/b21a296383694c6726d03e027134daf1">Jair Bolsonaro sneered at what he called “a little cold.”</a>

The early story of the pandemic in China shows missed opportunities at every step, the documents and AP interviews reveal. Under Xi, China’s most authoritarian leader in decades, increasing political repression has made officials more hesitant to report cases without a clear green light from the top.

“It really increased the stakes for officials, which made them reluctant to step out of line,” said Mattingly, the Yale professor. “It made it harder for people at the local level to report bad information.”

Doctors and nurses in Wuhan&nbsp;<a href="http://archive.vn/OLdHs#selection-871.108-890.0" target="_blank">told Chinese media</a>&nbsp;there were plenty of signs that the coronavirus could be transmitted between people as early as late December. Patients who had never been to the suspected source of the virus, the Huanan Seafood Market, were infected. Medical workers started falling ill.

But officials obstructed medical staff who tried to report such cases. They set tight criteria for confirming cases, where patients not only had to test positive, but samples had to be sent to Beijing and sequenced. They required staff to report to supervisors before sending information higher,&nbsp;<a href="https://archive.is/SYydC" target="_blank">Chinese media reports show.</a>&nbsp;And they punished doctors for warning about the disease.

As a result,&nbsp;<a href="https://apnews.com/b981ea744ee2a25f89c5abb0e8c1e92f">no new cases were reported for almost two weeks from Jan. 5</a>, even as officials gathered in Wuhan for Hubei province’s two biggest political meetings of the year, internal China CDC bulletins confirm.

During this period, teams of experts dispatched to Wuhan by Beijing said they failed to find clear signs of danger and human-to-human transmission.

“China has many years of disease control, there’s absolutely no chance that this will spread widely because of Spring Festival travel,” the head of the first expert team, Xu Jianguo,&nbsp;<a href="https://takungpao.com/news/232108/2020/0105/400593.html#10006-weixin-1-52626-6b3bffd01fdde4900130bc5a2751b6d1" target="_blank">told Takungpao, a Hong Kong paper,</a>&nbsp;on Jan. 6. He added there was “no evidence of human-to-human transmission” and that the threat from the virus was low.

The second expert team, dispatched on Jan. 8, similarly failed to unearth any clear signs of human-to-human transmission. Yet during their stay, more than half a dozen doctors and nurses had already fallen ill with the virus,&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2001316" target="_blank">a retrospective China CDC study published in the New England Journal of Medicine would later show.</a>

The teams looked for patients with severe pneumonia, missing those with milder symptoms. They also narrowed the search to those who had visited the seafood market — which was in retrospect a mistake, said Cowling, the Hong Kong epidemiologist, who flew to Beijing to review the cases in late January.

In the weeks after the severity of the epidemic became clear, some experts accused Wuhan officials of intentionally hiding cases.

“I always suspected it was human-to-human transmissible,” said Wang Guangfa, the leader of the second expert team, in a Mar. 15 post on Weibo, the Chinese social media platform. He fell ill with the virus soon after returning to Beijing on Jan. 16.

Wuhan’s then-mayor, Zhou Xianwang, blamed national regulations for the secrecy.

“As a local government official, I could disclose information only after being authorized,” Zhou told state media in late January. “A lot of people didn’t understand this.”

As a result, top Chinese officials appear to have been left in the dark.

“The CDC acted sluggishly, assuming all was fine,” said a state health expert, who declined to be named out of fear of retribution. “If we started to do something a week or two earlier, things could have been so much different.”

It wasn’t just Wuhan. In Shenzhen in southern China, hundreds of miles away, a team led by microbiologist Yuen Kwok-yung used their own test kits to confirm that six members of a family of seven had the virus on Jan. 12.&nbsp;<a href="https://www.caixinglobal.com/2020-03-09/exclusive-qa-with-hong-kongs-yuen-kwok-yung-who-helped-confirm-coronaviruss-human-spread-101526079.html" target="_blank">In an interview with Caixin</a>, a respected Chinese finance magazine, Yuen said he informed CDC branches “of all levels,” including Beijing. But internal CDC numbers did not reflect Yuen’s report, the bulletins show.

When the Thai case was reported, health authorities finally drew up an internal plan to systematically identify, isolate, test, and treat all cases of the new coronavirus nationwide.

Wuhan’s case count began to climb immediately — four on Jan. 17, then 17 the next day and 136 the day after. Across the country, dozens of cases began to surface, in some cases among patients who were infected earlier but had not yet been tested. In Zhejiang, for example,&nbsp;<a href="http://www.zjwjw.gov.cn/art/2020/1/21/art_1202101_41786033.html" target="_blank">a man hospitalized on Jan. 4 was only isolated on Jan. 17 and confirmed positive on Jan. 21.&nbsp;</a>In Shenzhen, the patients Yuen discovered on Jan. 12 were finally recorded as confirmed cases on Jan. 19.

The elite Peking Union Medical College Hospital held an emergency meeting on Jan. 18, instructing staff to adopt stringent isolation — still before Xi’s public warning. A health expert told AP that on Jan. 19, she toured a hospital built after the SARS outbreak, where medical workers had furiously prepared an entire building with hundreds of beds for pneumonia patients.

“Everybody in the country in the infectious disease field knew something was going on,” she said, declining to be named to avoid disrupting sensitive government consultations. “They were anticipating it.”

By Associated PressIn the six days after top Chinese officials secretly determined they likely were facing a pandemic from a new coronavirus, the city of Wuhan at the epicenter of the disease hosted a mass banquet for tens of thousands of people; millions began traveling through for Lunar New Year celebrations.President Xi Jinping warned the public on the seventh day, Jan. 20. But by that time, more than 3,000 people had been infected during almost a week of public silence, according to internal documents obtained by The Associated Press and expert estimates based on&nbsp;<a href="http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51" target="_blank">retrospective infection data</a>.Six days.That delay from Jan. 14 to Jan. 20 was neither the first mistake made by Chinese officials at all levels in confronting the outbreak, nor the longest lag, as governments around the world have dragged their feet for weeks and even months in addressing the virus.But the delay by the first country to face the new coronavirus came at a critical time — the beginning of the outbreak. China’s attempt to walk a line between alerting the public and avoiding panic set the stage for a pandemic that has infected almost 2 million people and taken more than 126,000 lives.“This is tremendous,” said Zuo-Feng Zhang, an epidemiologist at the University of California, Los Angeles. “If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient. We might have avoided the collapse of Wuhan’s medical system.”Other experts noted that the Chinese government may have waited on warning the public to stave off hysteria, and that it did act quickly in private during that time.But the six-day delay by China’s leaders in Beijing came on top of almost two weeks during which the national Center for Disease Control did not register any cases from local officials, internal bulletins obtained by the AP confirm. Yet during that time, from Jan. 5 to Jan. 17, hundreds of patients were appearing in hospitals not just in Wuhan but across the country.It’s uncertain whether it was local officials who failed to report cases or national officials who failed to record them. It’s also not clear exactly what officials knew at the time in Wuhan, which only opened back up last week with restrictions after its quarantine.But what is clear, experts say, is that China’s rigid controls on information, bureaucratic hurdles and a reluctance to send bad news up the chain of command muffled early warnings.&nbsp;<a href="https://apnews.com/6f2e666485e9abae4bb112251eca77be">The punishment of eight doctors for “rumor-mongering,”</a>&nbsp;broadcast on national television on Jan. 2, sent a chill through the city’s hospitals.“Doctors in Wuhan were afraid,” said Dali Yang, a professor of Chinese politics at the University of Chicago. “It was truly intimidation of an entire profession.”Without these internal reports, it took the first case outside China, in Thailand on Jan. 13, to galvanize leaders in Beijing into recognizing the possible pandemic before them. It was only then that they launched a nationwide plan to find cases — distributing CDC-sanctioned test kits, easing the criteria for confirming cases and ordering health officials to screen patients, all without telling the public.The Chinese government has repeatedly denied suppressing information in the early days, saying it immediately reported the outbreak to the World Health Organization.“Those accusing China of lacking transparency and openness are unfair,” foreign ministry spokesman Zhao Lijian said Wednesday when asked about the AP story.__The documents show that the head of China’s National Health Commission, Ma Xiaowei, laid out a grim assessment of the situation on Jan. 14 in a confidential teleconference with provincial health officials. A memo states that the teleconference was held to convey instructions on the coronavirus from President Xi Jinping, Premier Li Keqiang and Vice Premier Sun Chunlan, but does not specify what those instructions were.“The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event,” the memo cites Ma as saying.The National Health Commission is the top medical agency in the country. In a faxed statement, the Commission said it had organized the teleconference because of the case reported in Thailand and the possibility of the virus spreading during New Year travel. It added that China had published information on the outbreak in an “open, transparent, responsible and timely manner,” in accordance with “important instructions” repeatedly issued by President Xi.The documents come from an anonymous source in the medical field who did not want to be named for fear of retribution. The AP confirmed the contents with two other sources in public health familiar with the teleconference. Some of the memo’s contents also appeared in&nbsp;<a href="http://www.nhc.gov.cn/xcs/fkdt/202002/e5e8a132ef8b42d484e6df53d4d110c1.shtml" target="_blank">a public notice about the teleconference</a>, stripped of key details and published in February.Under a section titled “sober understanding of the situation,” the memo said that “clustered cases suggest that human-to-human transmission is possible.” It singled out the case in Thailand, saying that the situation had “changed significantly” because of the possible spread of the virus abroad.“With the coming of the Spring Festival, many people will be traveling, and the risk of transmission and spread is high,” the memo continued. “All localities must prepare for and respond to a pandemic.”In the memo, Ma demanded officials unite around Xi and made clear that political considerations and social stability were key priorities during the long lead-up to China’s two biggest political meetings of the year in March. While the documents do not spell out why Chinese leaders waited six days to make their concerns public, the meetings may be one reason.“The imperatives for social stability, for not rocking the boat before these important Party congresses is pretty strong,” says Daniel Mattingly, a scholar of Chinese politics at Yale. “My guess is, they wanted to let it play out a little more and see what happened.”In response to the teleconference, the Center for Disease Control and Prevention in Beijing initiated the highest-level emergency response internally, level one, on Jan. 15. It assigned top CDC leaders to 14 working groups tasked with getting funds, training health workers, collecting data, doing field investigations and supervising laboratories, an internal CDC notice shows. The memo directed Hubei province, where Wuhan is located, to begin temperature checks at airports, bus and train stations, and cut down on large public gatherings.The National Health Commission also distributed a 63-page set of instructions to provincial health officials, obtained by the AP. The instructions ordered health officials nationwide to identify suspected cases, hospitals to open fever clinics, and doctors and nurses to don protective gear. They were marked “internal” — “not to be spread on the internet,” “not to be publicly disclosed.”In public, however, officials continued to downplay the threat, pointing to the 41 cases public at the time.“We have reached the latest understanding that the risk of sustained human-to-human transmission is low,” Li Qun, the head of the China CDC’s emergency center,&nbsp;<a href="http://tv.cctv.com/2020/01/15/VIDEVPaxZBFtDLGUA6mk5PW2200115.shtml" target="_blank">told Chinese state television on Jan. 15</a>. That was the same day Li was appointed leader of a group preparing emergency plans for the level one response, a CDC notice shows.On Jan. 20, President Xi issued his first public comments on the virus, saying the outbreak “must be taken seriously” and every possible measure pursued. A leading Chinese epidemiologist, Zhong Nanshan,&nbsp;<a href="https://apnews.com/14d7dcffa205d9022fa9ea593bb2a8c5">announced for the first time that the virus was transmissible from person to person on national television.</a>If the public had been warned a week earlier to take actions such as social distancing, mask wearing and travel restrictions, cases could have been cut by up to two-thirds,&nbsp;<a href="https://www.medrxiv.org/content/10.1101/2020.03.03.20029843v3.full.pdf" target="_blank">one paper later found</a>. An earlier warning could have saved lives, said Zhang, the doctor in Los Angeles.However, other health experts said the government took decisive action in private given the information available to them.“They may not have said the right thing, but they were doing the right thing,” said Ray Yip, the retired founding head of the U.S. Centers for Disease Control’s office in China. “On the 20th, they sounded the alarm for the whole country, which is not an unreasonable delay.”If health officials raise the alarm prematurely, it can damage their credibility — “like crying wolf” —and cripple their ability to mobilize the public, said Benjamin Cowley, an epidemiologist at the University of Hong Kong.The delay may support accusations by President Donald Trump that the Chinese government’s secrecy held back the world’s response to the virus. However, even the public announcement on Jan. 20 left the U.S. nearly two months to prepare for the pandemic.During those months,&nbsp;<a href="https://apnews.com/6a8f85aad99607f313cca6ab1398e04d">Trump ignored the warnings of his own staff and dismissed the disease as nothing to worry about</a>, while the government&nbsp;<a href="https://apnews.com/090600c299a8cf07f5b44d92534856bc">failed to bolster medical supplies</a>&nbsp;and&nbsp;<a href="https://apnews.com/c335958b1f8f6a37b19b421bc7759722">deployed flawed testing kits</a>. Leaders across the world turned a blind eye to the outbreak, with British Prime Minister Boris Johnson calling for a strategy of “herd immunity” —&nbsp;<a href="https://apnews.com/193a0cfe074685144ade169084a68255">before falling ill himself.</a>&nbsp;Brazilian President&nbsp;<a href="https://apnews.com/b21a296383694c6726d03e027134daf1">Jair Bolsonaro sneered at what he called “a little cold.”</a>_________________________The early story of the pandemic in China shows missed opportunities at every step, the documents and AP interviews reveal. Under Xi, China’s most authoritarian leader in decades, increasing political repression has made officials more hesitant to report cases without a clear green light from the top.“It really increased the stakes for officials, which made them reluctant to step out of line,” said Mattingly, the Yale professor. “It made it harder for people at the local level to report bad information.”Doctors and nurses in Wuhan&nbsp;<a href="http://archive.vn/OLdHs#selection-871.108-890.0" target="_blank">told Chinese media</a>&nbsp;there were plenty of signs that the coronavirus could be transmitted between people as early as late December. Patients who had never been to the suspected source of the virus, the Huanan Seafood Market, were infected. Medical workers started falling ill.But officials obstructed medical staff who tried to report such cases. They set tight criteria for confirming cases, where patients not only had to test positive, but samples had to be sent to Beijing and sequenced. They required staff to report to supervisors before sending information higher,&nbsp;<a href="https://archive.is/SYydC" target="_blank">Chinese media reports show.</a>&nbsp;And they punished doctors for warning about the disease.As a result,&nbsp;<a href="https://apnews.com/b981ea744ee2a25f89c5abb0e8c1e92f">no new cases were reported for almost two weeks from Jan. 5</a>, even as officials gathered in Wuhan for Hubei province’s two biggest political meetings of the year, internal China CDC bulletins confirm.During this period, teams of experts dispatched to Wuhan by Beijing said they failed to find clear signs of danger and human-to-human transmission.“China has many years of disease control, there’s absolutely no chance that this will spread widely because of Spring Festival travel,” the head of the first expert team, Xu Jianguo,&nbsp;<a href="https://takungpao.com/news/232108/2020/0105/400593.html#10006-weixin-1-52626-6b3bffd01fdde4900130bc5a2751b6d1" target="_blank">told Takungpao, a Hong Kong paper,</a>&nbsp;on Jan. 6. He added there was “no evidence of human-to-human transmission” and that the threat from the virus was low.The second expert team, dispatched on Jan. 8, similarly failed to unearth any clear signs of human-to-human transmission. Yet during their stay, more than half a dozen doctors and nurses had already fallen ill with the virus,&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2001316" target="_blank">a retrospective China CDC study published in the New England Journal of Medicine would later show.</a>The teams looked for patients with severe pneumonia, missing those with milder symptoms. They also narrowed the search to those who had visited the seafood market — which was in retrospect a mistake, said Cowling, the Hong Kong epidemiologist, who flew to Beijing to review the cases in late January.In the weeks after the severity of the epidemic became clear, some experts accused Wuhan officials of intentionally hiding cases.“I always suspected it was human-to-human transmissible,” said Wang Guangfa, the leader of the second expert team, in a Mar. 15 post on Weibo, the Chinese social media platform. He fell ill with the virus soon after returning to Beijing on Jan. 16.Wuhan’s then-mayor, Zhou Xianwang, blamed national regulations for the secrecy.“As a local government official, I could disclose information only after being authorized,” Zhou told state media in late January. “A lot of people didn’t understand this.”As a result, top Chinese officials appear to have been left in the dark.“The CDC acted sluggishly, assuming all was fine,” said a state health expert, who declined to be named out of fear of retribution. “If we started to do something a week or two earlier, things could have been so much different.”It wasn’t just Wuhan. In Shenzhen in southern China, hundreds of miles away, a team led by microbiologist Yuen Kwok-yung used their own test kits to confirm that six members of a family of seven had the virus on Jan. 12.&nbsp;<a href="https://www.caixinglobal.com/2020-03-09/exclusive-qa-with-hong-kongs-yuen-kwok-yung-who-helped-confirm-coronaviruss-human-spread-101526079.html" target="_blank">In an interview with Caixin</a>, a respected Chinese finance magazine, Yuen said he informed CDC branches “of all levels,” including Beijing. But internal CDC numbers did not reflect Yuen’s report, the bulletins show.When the Thai case was reported, health authorities finally drew up an internal plan to systematically identify, isolate, test, and treat all cases of the new coronavirus nationwide.Wuhan’s case count began to climb immediately — four on Jan. 17, then 17 the next day and 136 the day after. Across the country, dozens of cases began to surface, in some cases among patients who were infected earlier but had not yet been tested. In Zhejiang, for example,&nbsp;<a href="http://www.zjwjw.gov.cn/art/2020/1/21/art_1202101_41786033.html" target="_blank">a man hospitalized on Jan. 4 was only isolated on Jan. 17 and confirmed positive on Jan. 21.&nbsp;</a>In Shenzhen, the patients Yuen discovered on Jan. 12 were finally recorded as confirmed cases on Jan. 19.The elite Peking Union Medical College Hospital held an emergency meeting on Jan. 18, instructing staff to adopt stringent isolation — still before Xi’s public warning. A health expert told AP that on Jan. 19, she toured a hospital built after the SARS outbreak, where medical workers had furiously prepared an entire building with hundreds of beds for pneumonia patients.“Everybody in the country in the infectious disease field knew something was going on,” she said, declining to be named to avoid disrupting sensitive government consultations. “They were anticipating it.”

China didn't warn public of likely pandemic for 6 key days

By BRIAN GRIMMETT, <a href="https://www.kcur.org/health/2020-04-15/kansas-hospitals-wont-say-how-full-theyre-getting-with-coronavirus-patients">Kansas News Service</a>

WICHITA, Kansas — Flatten the curve: A phrase that didn’t mean
 anything two months ago is now the driving factor behind social 
distancing, stay-at-home orders and limiting the number of people who 
can gather in one place.

The idea is to make sure hospitals aren’t
 overrun with severe COVID-19 cases, as well as help hospitals conserve 
limited resources such as personal protective equipment.

But in 
Kansas there isn’t publicly available data on whether a hospital is 
close to filling up. And few are willing to share that information.

At this point, the <a href="https://www.coronavirus.kdheks.gov/" target="_blank">Kansas Department of Health and Environment</a>
 said 327 people have been hospitalized with COVID-19, but it doesn’t 
provide which hospitals or whether patients have gone home.

<a href="https://www.stormontvail.org/" target="_blank">Stormont Vail in Topeka</a>
 is a rare exception. Every day, the hospital publishes a dashboard with
 information like how many patients it's treating for COVID-19, 
ventilator usage and tests administered. While it strays from giving 
specific numbers of available beds, it does provide a percentage of how 
many of its hospital and intensive care beds are in use.

“It displaces rumor,” Stormont Vail CEO Dr. Rob Kenagy said of releasing the information. “It displaces fear.”

He said early on there were a lot of questions from the community and staff about whether the hospital would be the next <a href="https://www.reuters.com/article/us-health-coronavirus-italy-ethics-speci/special-report-all-is-well-in-italy-triage-and-lies-for-virus-patients-idUSKBN2133KG" target="_blank">Italy</a>, Spain or <a href="https://www.npr.org/sections/coronavirus-live-updates/2020/03/30/823970536/cuomo-makes-plea-to-medical-workers-nationwide-please-come-help-us-in-new-york" target="_blank">New York City</a> in terms of being overwhelmed. In their crisis plan, he said, transparency seemed like the best option.

The
 hospital is also providing a daily color-coded indicator of where they 
stand with personal protective equipment; green for good, yellow for 
getting low and red for critical need.

“If we were to get into a 
place where our capacity would be tested, we felt like it would be best 
for our community and our team members to know the detail of those 
capacity constraints,” Kenagy said.

Lawrence Memorial Hospital sends out a similar daily dashboard.

The <a href="http://www.medicalnewsnetwork.org/NewsNetwork/DocTalk/C/Coronavirus%20Media%20Briefing%20Thursday%204-9-20" target="_blank">University of Kansas Health System in Kansas City, Kansas</a>,
 isn’t going quite that far. But it has provided a daily total of how 
many COVID-19 cases it's treating — hovering at about 30 for a few days.

“That’s
 really what’s telling us where we are on the curve because we haven't 
tested enough people out in the community,” said Dr. Steve Stites, the 
chief medical officer at the University of Kansas Health System. “We 
don’t have the same public health structure we once did. We don’t have 
the same testing we once had.”

In a news conference Tuesday, he 
said stagnant hospitalization numbers likely mean that the Kansas City 
area is flattening the curve.

Meanwhile, most other hospitals are 
keeping mum. Salina Regional Health Center, Saint Catherine Hospital in 
Garden City and the St. Luke’s Hospital system declined to provide 
capacity information. Ascension Via Christi in Wichita and HCA hospitals
 in the Kansas City metro did not respond to a request for data.

Some
 might not be used to giving out the information, others may be worried 
about competitors knowing any weaknesses. Either way, the information 
exists. It’s just not public.

<a href="https://www.kha-net.org/AboutKHA/" target="_blank">The Kansas Hospital Association</a>
 provides services for and lobbies on behalf of Kansas hospitals. In an 
emailed statement, KHA vice president Cindy Samuelson said its members 
are working with government officials on a daily basis to monitor and 
report system capacity, as well as planning for increased demand.

The
 good news, if there is such a thing during a pandemic, is that one of 
the main models predicting hospital resource use shows Kansas will have 
plenty of capacity.

Kansas is expected to <a href="https://covid19.healthdata.org/united-states-of-america/kansas" target="_blank">reach peak resource use on April 20, needing 485 beds</a>
 for coronavirus patients, according to the Institute for Health Metrics
 and Evaluation. The organization’s model shows the state has enough 
capacity for 4,810 COVID-19 patients. (IMHE calculated capacity based on
 a hospital's total number of beds minus their historical average daily 
use for other types of patients.)

“Quite honestly, we’re not at 
capacity yet,” KDHE Secretary Lee Norman said. “We have a lot of ability
 to surge in terms of the beds and the type of beds.”

Even the 
worst-case scenario of the IMHE model predicts Kansas would need only 
about 1,500 hospital beds — again, well under the system’s total 
capacity.

But a model is only as good as its assumptions, and doesn’t represent the individual needs of each region or hospital.

“If you actually have real data, that trumps any kind of model,” said <a href="http://www.centerforhealthsecurity.org/our-people/adalja/" target="_blank">Amesh Adalja</a>,
 an infectious disease physician and researcher at John Hopkins 
University. “We want our models to accurately reflect reality, but 
they’re not a substitute for reality.”

Local hospital 
administrators agreed that making sure the actual hospitalization 
numbers line up with the latest model depends on continued social 
distancing and staying at home efforts.

“The fact is that it has helped a tremendous amount,” Kenagy said. “And we will be able to weather the size of the surge.”

Correction: A previous version of this story incorrectly stated the name of the University of Kansas Health System.

Brian
 Grimmett reports on the environment, energy and natural resources for 
KMUW in Wichita and the Kansas News Service. You can follow him on 
Twitter <a href="https://twitter.com/briangrimmett?lang=en" target="_blank">@briangrimmett</a> or email him at grimmett@kmuw.org.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1586981245204.png" alt="Stormont Vail Hospital in Topeka is among those preparing for the worst when it comes to the COVID-19 outbreak. Celia Llopis-Jepsen / Kansas News Service" />
 <figcaption>Stormont Vail Hospital in Topeka is among those preparing for the worst when it comes to the COVID-19 outbreak. Celia Llopis-Jepsen / Kansas News Service</figcaption>
 </figure>By BRIAN GRIMMETT, <a href="https://www.kcur.org/health/2020-04-15/kansas-hospitals-wont-say-how-full-theyre-getting-with-coronavirus-patients">Kansas News Service</a>WICHITA, Kansas — Flatten the curve: A phrase that didn’t mean
 anything two months ago is now the driving factor behind social 
distancing, stay-at-home orders and limiting the number of people who 
can gather in one place.The idea is to make sure hospitals aren’t
 overrun with severe COVID-19 cases, as well as help hospitals conserve 
limited resources such as personal protective equipment.But in 
Kansas there isn’t publicly available data on whether a hospital is 
close to filling up. And few are willing to share that information.At this point, the <a href="https://www.coronavirus.kdheks.gov/" target="_blank">Kansas Department of Health and Environment</a>
 said 327 people have been hospitalized with COVID-19, but it doesn’t 
provide which hospitals or whether patients have gone home.<a href="https://www.stormontvail.org/" target="_blank">Stormont Vail in Topeka</a>
 is a rare exception. Every day, the hospital publishes a dashboard with
 information like how many patients it's treating for COVID-19, 
ventilator usage and tests administered. While it strays from giving 
specific numbers of available beds, it does provide a percentage of how 
many of its hospital and intensive care beds are in use.“It displaces rumor,” Stormont Vail CEO Dr. Rob Kenagy said of releasing the information. “It displaces fear.”He said early on there were a lot of questions from the community and staff about whether the hospital would be the next <a href="https://www.reuters.com/article/us-health-coronavirus-italy-ethics-speci/special-report-all-is-well-in-italy-triage-and-lies-for-virus-patients-idUSKBN2133KG" target="_blank">Italy</a>, Spain or <a href="https://www.npr.org/sections/coronavirus-live-updates/2020/03/30/823970536/cuomo-makes-plea-to-medical-workers-nationwide-please-come-help-us-in-new-york" target="_blank">New York City</a> in terms of being overwhelmed. In their crisis plan, he said, transparency seemed like the best option.The
 hospital is also providing a daily color-coded indicator of where they 
stand with personal protective equipment; green for good, yellow for 
getting low and red for critical need.“If we were to get into a 
place where our capacity would be tested, we felt like it would be best 
for our community and our team members to know the detail of those 
capacity constraints,” Kenagy said.Lawrence Memorial Hospital sends out a similar daily dashboard.The <a href="http://www.medicalnewsnetwork.org/NewsNetwork/DocTalk/C/Coronavirus%20Media%20Briefing%20Thursday%204-9-20" target="_blank">University of Kansas Health System in Kansas City, Kansas</a>,
 isn’t going quite that far. But it has provided a daily total of how 
many COVID-19 cases it's treating — hovering at about 30 for a few days.“That’s
 really what’s telling us where we are on the curve because we haven't 
tested enough people out in the community,” said Dr. Steve Stites, the 
chief medical officer at the University of Kansas Health System. “We 
don’t have the same public health structure we once did. We don’t have 
the same testing we once had.”In a news conference Tuesday, he 
said stagnant hospitalization numbers likely mean that the Kansas City 
area is flattening the curve.Meanwhile, most other hospitals are 
keeping mum. Salina Regional Health Center, Saint Catherine Hospital in 
Garden City and the St. Luke’s Hospital system declined to provide 
capacity information. Ascension Via Christi in Wichita and HCA hospitals
 in the Kansas City metro did not respond to a request for data.Some
 might not be used to giving out the information, others may be worried 
about competitors knowing any weaknesses. Either way, the information 
exists. It’s just not public.<a href="https://www.kha-net.org/AboutKHA/" target="_blank">The Kansas Hospital Association</a>
 provides services for and lobbies on behalf of Kansas hospitals. In an 
emailed statement, KHA vice president Cindy Samuelson said its members 
are working with government officials on a daily basis to monitor and 
report system capacity, as well as planning for increased demand.<h2>Predicting the future</h2>The
 good news, if there is such a thing during a pandemic, is that one of 
the main models predicting hospital resource use shows Kansas will have 
plenty of capacity.Kansas is expected to <a href="https://covid19.healthdata.org/united-states-of-america/kansas" target="_blank">reach peak resource use on April 20, needing 485 beds</a>
 for coronavirus patients, according to the Institute for Health Metrics
 and Evaluation. The organization’s model shows the state has enough 
capacity for 4,810 COVID-19 patients. (IMHE calculated capacity based on
 a hospital's total number of beds minus their historical average daily 
use for other types of patients.)“Quite honestly, we’re not at 
capacity yet,” KDHE Secretary Lee Norman said. “We have a lot of ability
 to surge in terms of the beds and the type of beds.”Even the 
worst-case scenario of the IMHE model predicts Kansas would need only 
about 1,500 hospital beds — again, well under the system’s total 
capacity.But a model is only as good as its assumptions, and doesn’t represent the individual needs of each region or hospital.“If you actually have real data, that trumps any kind of model,” said <a href="http://www.centerforhealthsecurity.org/our-people/adalja/" target="_blank">Amesh Adalja</a>,
 an infectious disease physician and researcher at John Hopkins 
University. “We want our models to accurately reflect reality, but 
they’re not a substitute for reality.”Local hospital 
administrators agreed that making sure the actual hospitalization 
numbers line up with the latest model depends on continued social 
distancing and staying at home efforts.“The fact is that it has helped a tremendous amount,” Kenagy said. “And we will be able to weather the size of the surge.”Correction: A previous version of this story incorrectly stated the name of the University of Kansas Health System.Brian
 Grimmett reports on the environment, energy and natural resources for 
KMUW in Wichita and the Kansas News Service. You can follow him on 
Twitter <a href="https://twitter.com/briangrimmett?lang=en" target="_blank">@briangrimmett</a> or email him at grimmett@kmuw.org.

Kan. hospitals won't say how full they're getting with virus patients 

LINCOLN, Neb. (AP) - Nebraska state officials and business groups on Wednesday asked companies and nonprofits to outline what can be done to help them recover financially after the coronavirus pandemic subsides.

The Department of Economic Development, the University of Nebraska and the Nebraska Chamber of Commerce &amp; Industry released&nbsp;<a href="https://nam05.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbit.ly%2FNE-Biz-Survey-2020&amp;data=02%7C01%7Cgschulte%40ap.org%7Cfcf5fc01fee643ab445b08d7e174d119%7Ce442e1abfd6b4ba3abf3b020eb50df37%7C1%7C0%7C637225764192473167&amp;sdata=GQuOD6fLOV8rP6Vxbs%2FRMPTV%2FccMBL0OkX%2BFrJLUt3M%3D&amp;reserved=0" target="_blank">a survey</a>&nbsp;that asks business owners and nonprofits whether they plan to cut staff, what their top concerns are and whether they plan to seek federal assistance, among other questions.

"This is an opportunity for Nebraska businesses to have their voices heard and to be able to share with us what's going on as we think about how we plan for future growth," Gov. Pete Ricketts said at a news conference.

University of Nebraska President Ted Carter said the university will start compiling the answers as soon as they're received.

"We're very hopeful that people will start filling out those surveys to help bring businesses back to life," he said.

Nebraska had 901 confirmed coronavirus cases and 20 deaths as of Tuesday evening, according to data compiled by the state Department of Health and Human Services. More than 10,800 people have tested negative. Nebraska reported 34 new cases on Tuesday, down from 64 the day before.

Also Wednesday, the Nebraska state employees' union delivered more than 1,600 petitions to Gov. Pete Ricketts' office demanding that he give all state workers the option to work from home if their jobs allow it.

The petitions also call for an extra $2 an hour in "hazard pay" for those who have to work in-person during the coronavirus pandemic. The petition was a follow-up to a letter&nbsp;<a href="https://apnews.com/d7e9a8585de51d73d06204de18ef05f3" target="_blank">the union sent to Ricketts</a>&nbsp;earlier this month with the same demands.

"State employees are concerned and they are anxious," said Justin Hubly, executive director of the Nebraska Association of Public Employees. "We need the governor to take action to ensure their safety."

Hubly said the only safeguard in some state offices is a bottle of hand sanitizer. The union has also questioned why call-center employees aren't allowed to do their jobs from home.

Ricketts, a Republican, has said it isn't possible for all state employees to work from home because the state still has to provide essential services. He has said employees with concerns about their work environment should talk to their managers.

"We've got a lot of people who are working very, very hard in very trying circumstances," Ricketts said Wednesday when asked about the petitions. "These folks are doing their part, and we've got to do our part."

By GRANT SCHULTE-Associated PressLINCOLN, Neb. (AP) - Nebraska state officials and business groups on Wednesday asked companies and nonprofits to outline what can be done to help them recover financially after the coronavirus pandemic subsides.The Department of Economic Development, the University of Nebraska and the Nebraska Chamber of Commerce &amp; Industry released&nbsp;<a href="https://nam05.safelinks.protection.outlook.com/?url=https%3A%2F%2Fbit.ly%2FNE-Biz-Survey-2020&amp;data=02%7C01%7Cgschulte%40ap.org%7Cfcf5fc01fee643ab445b08d7e174d119%7Ce442e1abfd6b4ba3abf3b020eb50df37%7C1%7C0%7C637225764192473167&amp;sdata=GQuOD6fLOV8rP6Vxbs%2FRMPTV%2FccMBL0OkX%2BFrJLUt3M%3D&amp;reserved=0" target="_blank">a survey</a>&nbsp;that asks business owners and nonprofits whether they plan to cut staff, what their top concerns are and whether they plan to seek federal assistance, among other questions."This is an opportunity for Nebraska businesses to have their voices heard and to be able to share with us what's going on as we think about how we plan for future growth," Gov. Pete Ricketts said at a news conference.University of Nebraska President Ted Carter said the university will start compiling the answers as soon as they're received."We're very hopeful that people will start filling out those surveys to help bring businesses back to life," he said.Nebraska had 901 confirmed coronavirus cases and 20 deaths as of Tuesday evening, according to data compiled by the state Department of Health and Human Services. More than 10,800 people have tested negative. Nebraska reported 34 new cases on Tuesday, down from 64 the day before.Also Wednesday, the Nebraska state employees' union delivered more than 1,600 petitions to Gov. Pete Ricketts' office demanding that he give all state workers the option to work from home if their jobs allow it.The petitions also call for an extra $2 an hour in "hazard pay" for those who have to work in-person during the coronavirus pandemic. The petition was a follow-up to a letter&nbsp;<a href="https://apnews.com/d7e9a8585de51d73d06204de18ef05f3" target="_blank">the union sent to Ricketts</a>&nbsp;earlier this month with the same demands."State employees are concerned and they are anxious," said Justin Hubly, executive director of the Nebraska Association of Public Employees. "We need the governor to take action to ensure their safety."Hubly said the only safeguard in some state offices is a bottle of hand sanitizer. The union has also questioned why call-center employees aren't allowed to do their jobs from home.Ricketts, a Republican, has said it isn't possible for all state employees to work from home because the state still has to provide essential services. He has said employees with concerns about their work environment should talk to their managers."We've got a lot of people who are working very, very hard in very trying circumstances," Ricketts said Wednesday when asked about the petitions. "These folks are doing their part, and we've got to do our part."

Nebraska officials seek business input for virus recovery

LINCOLN, Neb. (NSP)-The Nebraska State Patrol (NSP) has partnered with two Lincoln businesses to develop a product that could save thousands of pieces of personal protective equipment. The product will allow NSP troopers and investigators to use gas masks with reusable filters rather than N95 masks at crime scenes.

Every NSP trooper and investigator has a gas mask, but filters for the current gas masks are in short supply during the COVID-19 pandemic. In searching for a solution, NSP personnel located several hundred filters that were made to fit a different design of gas mask, which was previously used by NSP. However, those filters did not fit the current gas masks.

Working with Lincoln businesses Kawasaki Motors and IntoMetal, an adapter has been produced that allows current gas masks to work with the different model of filter. Kawasaki was able to perfect a design for the adapter and IntoMetal was able to quickly produce the adapter using a 3D printer. The adapters are already being distributed for use throughout the state.

“This is tremendous work by our team and personnel from Kawasaki and IntoMetal,” said Colonel Bolduc. “This project has the potential to save thousands of pieces of PPE, such as N95 masks and face shields. By reducing our need for those valuable resources, hopefully, the limited supplies can be diverted to medical workers and others working on the front lines against COVID-19.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1586985948171.jpeg" alt="NSP Photo" />
 <figcaption>NSP Photo</figcaption>
 </figure>LINCOLN, Neb. (NSP)-The Nebraska State Patrol (NSP) has partnered with two Lincoln businesses to develop a product that could save thousands of pieces of personal protective equipment. The product will allow NSP troopers and investigators to use gas masks with reusable filters rather than N95 masks at crime scenes.Every NSP trooper and investigator has a gas mask, but filters for the current gas masks are in short supply during the COVID-19 pandemic. In searching for a solution, NSP personnel located several hundred filters that were made to fit a different design of gas mask, which was previously used by NSP. However, those filters did not fit the current gas masks.Working with Lincoln businesses Kawasaki Motors and IntoMetal, an adapter has been produced that allows current gas masks to work with the different model of filter. Kawasaki was able to perfect a design for the adapter and IntoMetal was able to quickly produce the adapter using a 3D printer. The adapters are already being distributed for use throughout the state.“This is tremendous work by our team and personnel from Kawasaki and IntoMetal,” said Colonel Bolduc. “This project has the potential to save thousands of pieces of PPE, such as N95 masks and face shields. By reducing our need for those valuable resources, hopefully, the limited supplies can be diverted to medical workers and others working on the front lines against COVID-19.”This project is intended for the masks to be used at crime scenes or during investigations. Troopers will not be wearing gas masks during regular patrols or on traffic stops.NSP is also eager to share this design with any other law enforcement entities throughout the country that could potentially benefit from combining the MSA Millennium gas mask with the MSA 3-lug bayonet filter cartridges designed for the MSA Advantage 1000 mask. Any agency that would like to receive design specifications can find the&nbsp;<a href="https://statepatrol.nebraska.gov/respirator-adapter-design" target="_blank">design at the NSP website</a>.<div><iframe width="560" height="315" src="https://www.youtube.com/embed/3rig4oJf7W4" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe></div>

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