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Doc quarantined in Omaha after Ebola exposure on experience, need to care for people facing disease

Dr. Patrick LaRochelle was just about to leave the hospital where he was working in the Democratic Republic of Congo for the day when he decided to make a quick check on a patient.

She was pregnant, but the baby had died in her womb. Her oxygen levels were low.

He had worn gloves when treating almost every patient since an Ebola outbreak began in the central African nation in August. But he didn’t put them on before he grabbed his stethoscope and listened to the woman’s heart and lungs that day in December.

“I’m not sure what made me step back and reevaluate the situation,” LaRochelle said Thursday at the University of Nebraska Medical Center. “But after about 30 seconds, I thought, ‘I need to figure out where this woman is coming from.’ ”

He later found out that she had come from a village experiencing an outbreak. The woman died about two hours later. LaRochelle learned the next morning that she had tested positive for Ebola.

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On Dec. 29, LaRochelle arrived in Omaha, where he completed the last 14 days of a 21-day monitoring period in a secure area at the Nebraska Medical Center, home of one of the few dedicated biocontainment units in the U.S.

LaRochelle did not develop the disease and was released Jan. 12. His name was not made public at the time.

He spoke publicly in Omaha about his experiences as part of the three-day National Summit on Pandemic Preparedness held by the nation’s state courts.

Hosted by Nebraska Chief Justice Michael Heavican, the summit brought together state court officials from 25 states and three U.S. territories, as well as health officials and others, to discuss ways the court system would address a pandemic, should the need arise.

Courts might have to figure out how to keep functioning in a pandemic, particularly if staff shrank because of illness or people bailed on jury duty. Public health issues can also make their way into the court system.

The recent measles outbreak in the U.S., for instance, has raised a number of legal questions. Last month, New York City Mayor Bill de Blasio mandated measles vaccination in one neighborhood in response to an outbreak there. One New York county banned non-vaccinated children from public indoor places, an order rescinded after legal challenges by some parents.

Nebraska court officials recently completed a guidebook — known as a bench book — to help court officials in case of a pandemic or other public health emergency.

While the summit had been planned for about a year, it comes as the Ebola outbreak in Congo continues . The number of cases in the outbreak stood at 1,877 on Thursday, including 1,241 deaths, according to the World Health Organization.

LaRochelle said what followed after he learned that the woman he treated had Ebola “was a blur.”

He was evacuated from the country. His family — wife Anna, and children Luke, 6, and Miriam, 4 — was evacuated to Uganda.

LaRochelle, who works for a Christian missionary organization called Serge, said his time in quarantine was an “unequivocally positive experience.”

He said that might have been different if he had been more anxious about contracting the disease. But he said he felt fairly confident that he was not ill. He hadn’t had contact with the woman or with bodily fluids, the means by which the virus usually spreads. He monitored his temperature and never developed any symptoms.

At the medical center in Omaha, his room had been stocked with snacks and drinks, and the photos his wife sent had been framed for him. Staff members brought gifts of food and drink, including Omaha barbecue and craft beer. They even brought in exercise equipment.

“I was incredibly well taken care of,” he said.

LaRochelle said quarantine efforts in Congo are more challenging. Some Congolese are reluctant to bring the sick to treatment centers, he said. In a culture that values community, isolation is a frightening concept.

Many also distrust the government, which has a history of interfering with elections, and other institutions. A string of assaults on teams working to halt the outbreak have killed several health and aid workers in the nation.

The hospital where he worked in Congo was prepared for the outbreak, with organizations supplying protective gear, training staff to recognize the illness and converting a building to an isolation unit.

LaRochelle said it will be important for health care workers and communities in the U.S. to balance managing risk with welcoming and caring for their neighbors who come here with health problems.

“We need to be prepared both technically and morally ... and show people we’re here for them,” he said in a later interview.

LaRochelle and his family returned to Congo in February. Anna LaRochelle, a nurse practitioner, said their organization set strict terms — only one of the couple can work in the hospital at a time. All have been vaccinated. They’re currently in the U.S. for several months visiting family. Their area has seen no other cases of the disease.

UNMC and clinical partner Nebraska Medicine, as well as two other health centers, are tasked with training hospitals and health care workers across the U.S. to respond to the disease.

In September, the National Center for Health Security and Biopreparedness will open inside a new facility on the UNMC campus. The new training, simulation and quarantine center will be used to help federal workers train to treat Ebola and other infectious diseases.

17 rare and unusual health stories out of Omaha

Articles
Congress, at long last, is on the cusp of delivering aid
DISASTER BILL

WASHINGTON (AP) — The Senate on Thursday passed a long-overdue $19 billion disaster aid bill by a broad bipartisan vote, but only after Democrats insisted on tossing out President Donald Trump's $4.5 billion request to handle an unprecedented influx of migrants at the U.S.-Mexico border.

The relief measure would deliver money to Nebraska, Iowa and other Midwestern states deluged with recent floods; Southern states suffering from last fall's hurricanes; and fire-ravaged rural California, among others. Puerto Rico would get help for hurricane recovery from the legislation, which has more than doubled in size since the House first addressed the issue last year.

Several military facilities would receive money to rebuild, including Offutt Air Force Base in Nebraska and Camp Lejeune in North Carolina.

The Senate approved the bill by an 85-8 vote. House lawmakers have left for the Memorial Day recess but the chamber probably will try to pass the bill by voice vote Friday, said a spokesman for House Speaker Nancy Pelosi, D-Calif.

Trump said he will sign it even though money to deal with the border has been removed.

"I didn't want to hold that up any longer," Trump said. "I totally support it."

All four GOP senators from Nebraska and Iowa supported the disaster aid package.

Trump was speaking to reporters at an event announcing billions in aid to farmers to help offset the hit they are taking from trade disruptions.

His administration had previously objected to the disaster package including more assistance for Puerto Rico. The administration also sought to include billions in border-related funding.

The Senate measure included more Puerto Rico funding and left out the additional border money Trump was seeking. But Trump said the disaster bill had to be approved to take care of farmers.

"If you look at what happened in Nebraska and Iowa and a lot of different places — they got wiped out," Trump said. "They got hurt badly. And I didn't want to hold that up any longer."

Sen. Joni Ernst, an Iowa Republican, welcomed the bill's passage after saying a House-passed version had too many extraneous provisions.

"I think people understand there's a need to get this done and provide relief for some of the folks we have back home," Ernst said.

Sen. Deb Fischer, R-Neb., said the legislation is important so Nebraskans can start rebuilding.

She said the disaster bill includes money in areas ranging from agriculture to military bases such as Offutt Air Force Base, which was swamped by the flooding.

"What we passed today is a critical first step to help Nebraskans rebuild and move forward in a positive direction," Fischer said.

Disaster aid bills are invariably bipartisan, but this round bogged down.

After weeks of fighting, Democrats bested Trump and won further aid to Puerto Rico, the U.S. territory slammed by back-to-back hurricanes in 2017. Trump has feuded with the island's Democratic officials, and his statements about the amount of aid offered to Puerto Rico has been disputed.

Trump originally wanted no money for Puerto Rico before agreeing to $600 million for its food stamp program.

But ultimately, Democrats said they secured about $1.4 billion, including money to help Puerto Rico's cash-poor government meet matching requirements for further disaster rebuilding efforts.

Talks this week over Trump's border request broke down, however, over conditions Democrats wanted to place on money to provide care and shelter for asylum-seeking Central American migrants. Talks were closely held, but aides said liberal and Hispanic forces among House Democrats could not come to terms with administration negotiators.

Democrats secured a provision that would block Trump from diverting any of the money in the bill for military projects toward building his border wall. Trump has declared a national emergency and has said he is considering transferring up to $3.6 billion from military construction to border barriers.

But border needs are increasingly desperate and lawmakers will face intense pressure to act when they return next month from vacation.

Money to house and care for migrants is expected to run out in June.

World-Herald staff writer Joseph Morton contributed to this report.


Courts
Building commission votes to issue $114 million in bonds for controversial justice center; what's next?

A controversial proposal to build a courthouse annex and a new, smaller juvenile detention center in downtown Omaha took a big leap forward Thursday with a bond issue vote, but a bumpy road may still lie ahead.

The Omaha-Douglas Public Building Commission voted 3-2 Thursday to issue $114 million in bonds for the project, reversing a January vote against funding it. The vote came after more than two hours of public testimony Thursday, most of it from people opposed to the detention center.

“This has been kind of an arduous process, but it actually has given us a better product,” Clare Duda said. “We still need City Council approval, but I feel confident about it.”

Duda voted yes Thursday along with fellow Douglas County Board member Mike Boyle and Public Building Commission Chairman John Christensen.

The two Omaha City Council members on the commission, Aimee Melton and Brinker Harding, voted no.

The project, planned for 17th and Harney Streets at the MUD headquarters site, calls for erecting an eight-story tower to house Douglas County Juvenile Court, plus the County Attorney’s and Public Defender’s Offices and community programs. It also would renovate MUD’s office building into space for juvenile and family services, and erect a four-story juvenile detention center with space for 64 youths.

The City Council will have a say in whether the complex is actually built.

The county and building commission can’t move ahead unless the council approves changes to an agreement between the City of Omaha, Douglas County and the building commission.

The council could be asked to vote in June.

It’s unclear how the council will vote, and what position Mayor Jean Stothert will take.

There also has been talk at City Hall that people may file legal challenges against funding it through the building commission and using a nonprofit corporation to develop it.

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“This is not over,” Douglas County Board member Jim Cavanaugh said.

He has led opposition to the downtown juvenile detention center part of the project and the funding and development process. Cavanaugh has pushed for building the courthouse annex, but for renovating the current juvenile detention center at 42nd and Poppleton Avenue instead of building a new one downtown.

Boyle cast the swing vote Thursday. After originally supporting the project, he become an opponent.

But in recent weeks, Boyle changed his mind again.

He said Thursday that he has come to believe the downtown justice center complex will be best for Douglas County children and families.

He said that more programming for alternatives to detention and diversion, including mental health treatment, has been emerging and that more is on the way. Boyle said he still doesn’t like putting the new detention center downtown but said “in life, you can’t always get what you want.”

He added that having a detention center downtown would mean that youths would no longer have to be put in shackles and driven from 42nd Street to go to court, which Boyle said is a traumatizing experience.

“These are our children,” Boyle said. “We should support them.”

Harding said everyone on the commission shares the common goal of helping youths become productive members of the community, but have different ways of getting there. He said the county should first develop programs, then see what kind of building they need.

Melton sounded a similar note. While opponents, including the Omaha police union, have said 64 beds is too few when the current juvenile detention center has an average daily population of 75 to 80, Melton said the county might need fewer if it’s successful in developing programs and processes that reduce youth detention further.

She said Ramsey County, Minnesota, home to St. Paul, only has about 25 youths in its detention center.

Duda countered that a new detention center, built to modern standards and co-located with courts and services, is essential to reforming juvenile justice in Omaha. He said more programming would be coming.

Melton tried to split the two main parts of the project.

She moved to approve $91.6 million in bonds for the courthouse annex, and not build the detention center.

Her motion failed 3-2, with Harding providing the other yes vote.

The bonds most likely would require an increase in Douglas County property taxes. County Finance Director Joe Lorenz said Thursday that it would require an additional 1.1 cents per $100 in assessed property values.

He said that would amount to about $30 a year on a $200,000 house.

Noting that the courthouse annex part of the project has received near-unanimous support from elected officials and the public, Duda asked how much taxes would be needed to service debt on $91.6 million for just the courthouse annex. That would cost 0.9 of a cent per $100 in assessed value.

“We would be foolish for two tenths of a cent to turn our backs on the kids,” Duda said.

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breaking
A horrible mess: How Omaha got its sewage treatment plant back online after the flood

Dried corn stalks on a debris-crumpled fence and an administration building ripped to the studs hint at what happened here two months ago.

So does the faint, musty odor of flood-soaked ground at the 260-acre Papillion Creek Wastewater Treatment Plant in Sarpy County.

The City of Omaha’s plant, which cleans sewage from about two-thirds of the metro area, was knocked offline March 15 by historic flooding.

On May 16, the plant resumed full treatment. That includes removing toilet paper, flushable wipes and other debris that don’t dissolve, along with treating number 1 and number 2.

To those who saw what the plant looked like on March 15, including plant manager Dave Sykora, it’s a minor miracle that the plant is already back in business.

“I thought it would take four or five months of work to get us back to where we are,” he said Wednesday. “It’s hard to explain how bad it was.”

Damage was so severe — about $35 million worth — that it forced the Public Works Department to shut down the plant and pump raw sewage into the Missouri River for 33 days. (Some plant operations resumed in April.) The longest the plant had released sewage directly into the river previously was three days, after a tornado damaged the plant in 2017.

Here’s what the plant’s 33 workers encountered in mid-March:

  • Half of the plant’s 30 buildings were inundated by two to three feet of floodwater.
  • The systems that deliver electricity to the pumps and controls that help the plant break down waste were underwater.
  • The command center that hosts the servers that automate much of the plant flooded. The administration building next door flooded, too.
  • About a mile of tunnels that connect the plant’s buildings and carry many of the pipes and fiber-optic cables that tie it to the outside world were full of water.
  • Human waste coated much of the plant, requiring hazardous waste crews to clean up the mess before repairs could start.
  • The road to the plant also flooded. The first crews to visit the plant after it was abandoned had to get permission to drive over a levee to reach it.
MEGAN MCGILL/THE WORLD-HERALD 

The men's locker room on the Papillion Creek Wastewater Treatment Plant's campus is gutted after it was damaged by flood waters.

When the waters pulled back over the next two weeks, crews confronted mountains of debris, including corn stalks, propane tanks, telephone poles and pieces of roadway.

Recovery was a 24/7 operation for up to 300 people for more than a month, including outside crews from HDR Inc., Eriksen Construction and others.

Some Public Works employees didn’t get a day off after the flood until mid-April, said Jim Theiler, the department’s assistant director who oversees the plant.

The department hasn’t had time yet to calculate the hours crews worked to reclaim the plant.

One reason for the long hours: Much of the plant’s equipment is being operated manually until new cables and computers can be installed.

MEGAN MCGILL/THE WORLD-HERALD 

One of the tunnels at the Papillion Creek Wastewater Treatment Plant was cleaned out after it was submerged in flood water. The plant is in the recovery stages after historic flooding shut it down in March.

“You figure out real quickly how much work automation saves,” Sykora said.

About half of the plant remains under construction. The administration building and operations center still need to be finished. Equipment with temporary fixes needs to be replaced. The department expects to finish that work in six to eight months.

The final tab and who pays won’t be known for some time. The Federal Emergency Management Agency typically pays 75 percent of public damage claims. The state picks up about 12.5 percent, and the city and its private insurer pick up the rest.

Workers are running the plant in construction trailers on the property. They’re putting up a new fence to slow down looters.

But off the east end of the property, you can still see the remnants of the flood, water on once-dry land that looks like the nearby Papillion Creek.

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The plant is protected by the same levees as Offutt Air Force Base, which also faced massive flooding in March.

But the plant is on lower ground to allow gravity to bring sewage its way. It sits along the east end of the Papio Creek, where it flows into the Missouri River.

Improvements to the levee system are vital, officials say. Once the levee repairs are done, work will begin on a $30 million project to raise the levees by two feet. The entire project is expected to be complete by December 2020.

Congress could speed up the completion of the flood defenses if the Senate passed an appropriations bill that lets all the work on the levees be done simultaneously, local officials said. Currently, the levees have to be repaired before improvements can be made.

“With the levee improvement, a majority of damage to the base and the treatment plant would’ve been negated,” said John Winkler, general manager of the Papio-Missouri River Natural Resources District.

“It would’ve limited it tremendously.”

Photos: Omaha's sewage treatment plant is back in business