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State_and_regional
special report
Minorities hit hard by coronavirus in U.S., but Nebraska isn’t tracking by race, ethnicity

How hard is the novel coronavirus hitting black, Hispanic, Native American and Asian communities across Nebraska?

We don’t quite know.

The Nebraska Department of Health and Human Services and many county health departments haven’t been tracking coronavirus cases by race or ethnicity — even as limited data from other states and cities show black and Hispanic residents faring worse in infection and death rates compared with their overall share of the population.

The Navajo Nation, spread out across three Southwestern states, also is battling a major coronavirus outbreak.

“As more data about the impact of the COVID-19 pandemic becomes available, it is increasingly clear that the disease is hitting the most vulnerable and disadvantaged populations in the U.S. the hardest,” said Dr. Lisa Cooper, a professor at Johns Hopkins Bloomberg School of Public Health, on the Johns Hopkins coronavirus tracking site.

The Johns Hopkins Coronavirus Resource Center says 38 states have released a breakdown of coronavirus cases by race.

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A Nebraska DHHS spokeswoman said the department is working to gather and compile that information. Nebraska is a heavily white state — about 78.6% — but has a growing Latino population. Cities and some smaller rural communities are more diverse than the state overall.

“We are aware of the requests for race/ethnicity data, and as the state public health authority, this information is important to us as well,” spokeswoman Leah Bucco-White said. “Race/ethnicity isn’t always available in the electronic data submitted to us, and we have been working with the local health departments on enhancing the process to capture that information.”

The state had 2,421 confirmed coronavirus cases as of Friday.

Even without hard data, some say it’s likely that minority groups in Nebraska are seeing higher rates of infection.

Coronavirus hot spots are cropping up in smaller Nebraska communities with large manufacturing or meatpacking plants, like Grand Island and Lexington. The workforce in those plants includes Latinos, Somalis, Sudanese and, in Omaha, several ethnic groups from Myanmar. Nearly one-third of Grand Island residents and roughly 60% of Lexington residents are Latino.

That’s even led some in Grand Island to blame those workers for the broad spread of the virus there, said Audrey Lutz, the executive director of the Multicultural Coalition of Grand Island. Hall County, home to Grand Island, has the highest number of coronavirus cases in the state.

“The reason why the racial scapegoating is happening is, who does the hardest labor in our communities? The immigrants who do jobs other people don’t want to fill,” Lutz said. “I definitely want to underline the point: They are not causing the problem. They are merely victims of the circumstances of their lives. They work in meatpacking. They work very closely together.”

“It’s just exacerbating people’s prejudices that they’re already holding,” she added.

Dannette Smith, the CEO of Nebraska DHHS, said during a town hall Thursday that she doesn’t want to alarm people with any data that shows certain groups are more susceptible to the virus, or may fare worse if they catch it. But the information could help develop prevention strategies and inform people with certain preexisting conditions.

The Douglas County Health Department is one of the few in Nebraska tracking those numbers.

Douglas County’s population, dominated by Omaha, is about 69% white, according to U.S. Census Bureau estimates. But only 50% the county’s 376 confirmed coronavirus infections, as of Friday, affect white residents.

Black residents make up 21.2% of Douglas County’s coronavirus cases, but only 12% of the county’s population. Latinos make up almost 13% of the county, and nearly 17% of current coronavirus cases.

Asian residents are over-represented, too, fueled by growing infections among refugees from Nepal and Myanmar, many of whom work in meatpacking plants. About 4% of Douglas County residents are Asian, but they make up 9.5% of the county’s coronavirus cases.

One Nepalese-Bhutanese businessman said last week that he knew of at least five confirmed cases in his tight-knit refugee community.

Douglas County’s numbers represent a relatively small sample size, and the lack of widespread testing means it’s hard to pin down the number of people who actually have COVID-19, the disease caused by the coronavirus.

It’s also unclear what information on race or ethnicity is being collected when people get their nose swabbed for testing.

“At drive-thru sites, people crack windows open and provide information to someone who writes it down on a clipboard,” David Williams, a professor of public health at the Harvard T.H. Chan School of Public Health, said on a conference call with journalists last week. “My suspicion is it is sometimes not asked. Those collecting the data don’t see it as a priority and aren’t asking it.”

Phil Rooney, a spokesman for the Douglas County Health Department, said the county is collecting that data during its follow-up investigations, after someone tests positive and health workers try to trace how they were exposed and with whom they’ve had contact. “We are investigating all the cases, and some jurisdictions may not be able to do that,” he said.

Data from Iowa shows that black and Latino residents there are getting sick at a disproportionate rate. Four percent of Iowa residents are black, and roughly 6 percent are Latino. But 14.2% of those with confirmed coronavirus cases are black, and 21.3% of those testing positive are Latino. The race or ethnicity of almost 16% of people is unknown.

The virus is highly contagious and can infect anyone, regardless of race. Most people will experience mild to moderate symptoms and recover.

But black and Latino populations, for example, often have higher rates of diabetes, heart problems or high blood pressure, conditions that can worsen the effects of COVID-19.

They are also more likely to have jobs — such as grocery store workers, nursing home nurses or aides, meatcutters or bus drivers — that can’t be done from home. Those jobs also may involve greater interaction with the public or involve higher-risk populations including patients in hospitals or nursing facilities.

“The minority populations in a lot of the states that have been seriously affected at this point are more likely to be living in communities that have less access to care, who are also more likely to be essential workers who cannot stay home and work from home and are more likely to need public transportation,” Dr. Jasmine Marcelin, an infectious disease specialist at the University of Nebraska Medical Center, said during a Facebook Live chat on Wednesday.

The ACLU of Nebraska and 22 other organizations, including several Latino and workers advocacy groups, sent a letter to Nebraska Gov. Pete Ricketts and state health officials Tuesday, asking that they collect and release coronavirus infection and mortality rates by race or ethnicity.

“We’d like to see concrete numbers and with that, language accessibility,” said Rose Godinez, legal and policy counsel for ACLU of Nebraska.

The letter asked for more translation of county health department news, press releases and other handouts related to the coronavirus into languages other than English, something Ricketts said state and local staff are working on, and that a portion of coronavirus relief dollars be allocated for the needs of nonwhite Nebraskans.

“The data released so far has shown that by and large black people are dying at disturbingly disproportionate rates,” the letter said. “For example, black people represent 43 percent of COVID-19 deaths in Illinois, but make up only 14 percent of the state’s population.”

Kenny McMorris is the president and CEO of Charles Drew Health Center, which has several clinics in predominantly black North Omaha. The virus is magnifying existing health inequities along lines of race and class, he said. People living in poverty are more likely to lack health insurance and a primary care doctor or provider.

Health care providers must gain the trust of minority patients, provide interpreters and translated materials into different languages and not make assumptions about people’s level of health literacy, he said. Not everyone is following up on the ever-evolving news and guidelines from the U.S. Centers for Disease Control and Prevention.

Common coronavirus prevention strategies aren’t feasible for everyone, McMorris said.

“It’s very difficult to have someone isolate in a one-bedroom apartment that houses eight people,” he said.

More testing and contact tracing of people potentially exposed to the virus will help give a clearer picture of infection rates everywhere, including among different racial and ethnic groups, Marcelin and McMorris said.

In the meantime, McMorris said health care providers need to make “sure we are providing care that’s nonjudgmental, that’s free of fear and supports people where they are.”

April photos: Nebraska faces coronavirus

State_and_regional
Ricketts easing Nebraska coronavirus restrictions as of May 4; limited reopening of economy

LINCOLN — By May 4, diners can begin returning to restaurants in the Omaha area and several other areas of Nebraska lightly impacted by the coronavirus, Gov. Pete Ricketts announced on Friday.

The decision to begin relaxing the state’s COVID-19 restrictions, the governor said, was based on “hard data” that hospitals and intensive care units are not being swamped, and not on pressure to reopen the economy.

“If we’re not overwhelming our health care system, we’re winning,” Ricketts said.

The decision also includes a resumption of religious services, weddings and funerals, with restrictions. Tattoo parlors, hair salons and massage studios will also be allowed to reopen. And child care centers will be allowed to have 15 children per room, up from 10.

The announcement came as some other states, including Georgia, Oklahoma and Alaska, are moving to reopen restaurants, personal care and some other businesses, according to CNN. Six states, including Colorado and Minnesota, are easing some restrictions next week.

In Omaha, restaurant owners and health officials greeted Friday’s news with a mixture of elation and caution. Dine-in service at restaurants and fast-food outlets has been shut down for more than a month.

“I may pop a cork tonight,” said John Wade, director of operations for Restaurants Inc., which operates six eateries in Omaha, including Stokes and Taxi’s.

He predicted a mixed reaction from patrons.

“Certainly there are going to be those who are more at risk, who are going to be cautious and continue to do takeout,” Wade said. “But I think there are others who have been cooped up and chomping at the bit to get out.”

Some health professionals, including one with experience in Lexington — one of the state’s hot spots — expressed doubt about relaxing restrictions now.

And State Sen. Ernie Chambers of Omaha criticized Ricketts’ decision, saying it was much too soon to relax restrictions.

“He is a miniature Trump. He is trying to replicate Trump,” said Chambers, a frequent critic of the governor, in reference to calls by the president to reopen the nation’s economy.

State Sen. Megan Hunt wrote on Twitter, “I am concerned that the motivation for allowing restaurants/churches/salons/etc to reopen is to get people off unemployment + ineligible for pandemic assistance checks. We can’t ask people to expose themselves or their employees to danger and then give them no financial support.”

But Ricketts said his decision was all about statistics that show the state’s health care resources are not being overwhelmed by the virus.

In the Omaha area, for instance, 75% of the ventilators are available for COVID-19 patients, the governor said. As of Friday afternoon, 38 of the state’s 93 counties had reported no positive tests for the coronavirus, though Ricketts said the state will be monitoring to make sure cases don’t surge there or elsewhere in the state.

The hardest-hit areas of the state will not see restrictions relaxed on May 4, Ricketts said, and the ban on gatherings of more than 10 people — which is enforceable by law — will remain in effect statewide through May.

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But in the 10 public health districts across the state that have been “lightly impacted,” Ricketts said, restaurants can partially reopen, religious services can resume with proper social distancing, and barbershops and beauty salons will be back in business.

The regional public health districts where restrictions are loosening, besides the Douglas County Health Department and the Sarpy/Cass Health Department: East Central, Four Corners, Loup Basin, North Central, Northeast Nebraska, Panhandle, Southeast and Southwest.

Ricketts said Lancaster County, the state’s second-most populous county, was not included in Friday’s announcement because the directed health measures there expire later, on May 6. The Central Health District, which includes Hall County — the county with the highest number of cases in the state — was not included, nor was the Two Rivers Public Health Department, which includes Lexington, another hot spot.

“We want to tailor this in each region,” the governor said. “The things we are doing are very incremental ... and are appropriate for those districts.”

Religious services, prayer gatherings, weddings and funerals will be allowed statewide as long as household groups are separated by 6 feet and nothing is passed among participants.

Tattoo parlors, barbershops, beauty salons and massage studios will be allowed to reopen as long as both patrons and the service providers are wearing masks.

Restaurants will be allowed to serve at 50% capacity with parties of no more than six, seated at least 6 feet from other tables. Bars and movie theaters will remain closed, and people will not be allowed to sit at the bar in a restaurant. Self-serve buffets will not be allowed.

Bottle clubs will not be allowed to reopen for sit-down service under the new health directives. Nursing homes, because of their vulnerable residents, will also remain off-limits to visitors.

Adi Pour, the head of the Douglas County Health Department, urged caution, and said she would not recommend that people in the high-risk category, like the elderly or those with existing health problems, resume outings to restaurants or church.

“We’ll phase this in, with some input from the different sectors,” Pour said. “If anything changes, I’m not against going to the governor and saying can we look at this again.”

Even Ricketts, as he left his coronavirus briefing on Friday, said he didn’t expect churches to immediately fill with worshippers.

Omaha Mayor Jean Stothert said she plans to patronize restaurants again, but people must strike a balance between safety and being able to socialize again.

“We have to let people get out a little,” Stothert said.

Two other health professionals expressed concern about relaxing restrictions.

Dr. Bob Rauner, the Lincoln-based chief medical officer for a network of 58 independent medical clinics in Nebraska, said easing some restrictions in Omaha might be OK if its rates of infection are stable. But the concern is if testing levels aren’t adequate, the virus could spread undetected before official case counts catch up.

In Grand Island and Lexington, he said, local doctors knew hot spots were forming a week or two before they showed up.

“By the time you know it’s a problem in Omaha, it will be too late,” said Rauner, who has a master’s in public health from Johns Hopkins University. “You’re supposed to see a decline in new cases for two weeks before you do this.”

Right now, labs in the state are performing between 600 and 800 tests a day. The state health department on Friday encouraged health care providers to test additional Nebraskans. Ricketts’ testnebraska.com initiative, under which up to 3,000 tests will be conducted daily, is still several days away.

Dr. Joe Miller of Omaha, a retired physician who practiced in Lexington for more than 30 years, said Omahans have done a fairly good job of physical distancing. But he, too, is concerned about opening up without more testing.

“You have to have good testing in place … so you can catch it right away and shut it down right away,” Miller said. He spoke Friday after dropping off 462 sterile gowns in Lexington.

Wade, the Omaha restaurateur, said that his management team was in a meeting, planning for a May 1 reopening — the day after directed health measures were set to expire in Douglas, Sarpy and Cass Counties — when they learned of Ricketts’ announcement.

His eateries had switched to carryout meals only, but with greatly diminished staffing. Now, he’s working on how to make sure diners are spread out. Wade said safety will be foremost on the minds of restaurant operators.

“We had already some things in motion for May 1. But May 4, we are very excited for,” he said.

The governor made the announcement one day after the number of confirmed cases passed 2,000 in Nebraska.

As of Friday, the total hit 2,421 and the number of deaths reached 50.

The number of cases in Nebraska continues to climb as the state sees outbreaks tied to meatpacking plants. More than 11% of tests now are coming back positive, reflecting the virus’s spread, with rates as high as 40% in Dawson County, Ricketts said.

The rate of positive tests, he said, was taken into consideration when deciding where — and where not — to relax restrictions. Ricketts added that the total number of positive tests was less of a factor, because that number has been expected to rise with expanded testing.

April photos: Nebraska faces coronavirus

Local
Reopening is 'life-saver' to some Omaha businesses, but others worry over rise in coronavirus cases

Paul McCrae, owner of the Corner Kick Street Tacos and Tequila Cantina, was thrilled to learn Gov. Pete Ricketts will ease some coronavirus restrictions on restaurants May 4.

“That’s a life-saver,” he said, especially because Cinco de Mayo is the day after the reopening date. “That’s a big day for us.”

McCrae figures he can comply with the new rules, which require establishments to operate at 50% capacity and to keep tables 6 feet apart, if he removes half of the tables in his restaurant near 138th and Millard Avenue. He estimates the restaurant can accommodate between 30 and 40 customers.

His dining room manager will make sure the guidelines are followed. Parties of no more than six will be allowed, under the state rules.

McCrae plans to still offer takeout, which should help when the dining room is at capacity.

Many business owners in the Omaha area went into planning mode Friday after Ricketts announced a series of new directed health measures that will allow restaurants, barbershops, tattoo parlors, salons and massage therapists to reopen on a limited basis.

The news was met with mixed reactions.

CHRIS MACHIAN/THE WORLD-HERALD 

Paul Mansfield prepares to-go orders at Dante. To his left are to-go containers with times on them for when the orders need to be done.

Sticking with carry out was working for Dante Pizzeria, owner Nick Strawhecker said. He said he was surprised that the restrictions were being lifted so soon.

The restaurant, near 168th Street and West Center Road, will have to make some adjustments before opening at 50% capacity, he said.

“We’re going to have issues if carryout doesn’t stay strong with 50% occupancy,” Strawhecker said. “We’ve discussed possibly having guest minimums. It’s just like when we were shutdown, it’s just a big question mark. We don’t know what’s going to happen until it’s happening.”

When Dan O’Brien heard about the new guidelines, he started to think aloud about how to reconfigure his restaurant, Acadian Grille at 114th Street and West Dodge Road.

Though he joked that he’d have to find a measuring stick to make sure that tables are 6 feet apart, he said his space was perfect to fulfill the requirements. He’ll have diners order at the counter to reduce contact, and use wait staff as food runners and to package to-go food.

He won’t immediately reopen his other restaurant, the Acadian Grille in Dundee, he said.

Bars were left off the list of businesses with eased restrictions. That doesn’t bother Josh Soto, the manager at Laka Lono Rum Club, near 12th and Howard Streets.

CHRIS MACHIAN/THE WORLD-HERALD 

The dining room at Dante Pizzeria has been converted to help with the restaurant’s take out-only service. This may change with the new directed health measures.

He’s finally found a good rhythm with the club’s adapted business model — delivering and providing curbside cocktails and alcohol.

While business is not as strong as it was when they were open as a full-service cocktail bar, the to-go service has helped bridge the gap.

“It’s been helping us survive,” he said.

Soto doesn’t believe bars, music venues or other large gathering spots should open until there’s a vaccine for the coronavirus.

“I certainly feel that we shouldn’t be rushing to get back together again and negate all the work that we’ve done already by social distancing and isolating ourselves,” he said. “I’d hate to see a big jump in cases.”

Sarah Boyce, owner of ONEsalon in Waterloo, Nebraska, was on a Zoom call with other area stylists, when Ricketts’ press conference began Friday afternoon.

“We stopped our discussion and listened in,” Boyce said. Then they sprang into action. “If we’re not organized, and don’t have our systems in place, it could be a catastrophe,” she said of the May 4 reopening.

Friday evening, she was busy asking clients via social media to verify their email addresses so she could begin rescheduling appointments.

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“I’m just going to do what I’m told. I’m a rule follower,” she said.

Cindy Bailey said that by Friday night, seven people had already called to make appointments for May 4 at her salon, Hair Envy.

Bailey said she doesn’t have concerns about reopening.

“I know my clients, they wouldn’t come in ill,” Bailey said. “I know sometimes symptoms don’t show, but we’ll follow all the guidelines, and everyone will wear masks.”

While Bailey is ready to get up and running again, co-owners Kelsey Poulsen and Sarah Root of The Copper Pin Salon & Spa in the Old Market are mulling whether to open on May 4. About half of the 14-person staff, which includes hairstylists, massage therapists and estheticians, don’t yet feel safe to return.

“We’re thinking about taking the hit financially and keeping it closed until we can figure out how to safely operate,” said Poulsen, a licensed massage therapist.

Guidelines that workers and patrons need to wear masks clash with the very services the salon provides, Poulsen noted. How can a client get a facial while wearing a mask? And what does a mask protect if Poulsen is touching a client’s body for an hour?

“We don’t want to be the reason to cause a spike,” she said.

World-Herald staff writer Chris Christen contributed to this report.

April photos: Nebraska faces coronavirus

Education
NU system aims to hold classes on its campuses in the fall; not clear when sports might resume

The University of Nebraska system expects to hold classes on its campuses in the fall, NU’s president said Friday.

Ted Carter said the NU system would work with public health officials and the NU Medical Center to be sure students, professors and staffers can work safely on campus.

“We will always be informed by the science, and we will act decisively if we need to change course to protect our community,” Carter said through a statement to the NU system. “We continue to plan for a variety of scenarios for the fall, including a shift” back to online classes if necessary, he said.

Carter also said that he remained optimistic but couldn’t predict when concerts, sports and other activities might resume. The NU system includes institutions in Omaha, Lincoln and Kearney.

He said NU remains committed to on-campus, in-person classes, which provide “richness to the collegiate experience.”

NU will use a checklist that will be provided by UNMC for sound protocols on cleaning, protective facewear, hygiene and other matters, he said.

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University of Nebraska-Lincoln Chancellor Ronnie Green issued a statement later Friday in which he said he expected residence halls to be open for business in the fall.

The coronavirus pandemic has compelled most colleges and universities across the country to use online classes this spring so students and professors don’t have to gather in close proximity on campus. Now colleges are beginning to determine whether they will return to some form of on-campus teaching in the fall.

The University of Oklahoma announced similar intentions Friday to those of NU. The Chronicle of Higher Education this week reported that some schools, such as San Jose State University, expect to stick with online classes in the fall. Others, such as the University of Arizona, plan to return to campus. Others haven’t decided.

Green said in his statement that he expects more data to be available on exposure to the virus by fall, and with it, greater ability to protect the community.

Some classes might blend online and in-person teaching, he said. Settings for certain classes might change to allow for social distancing, he said.

April photos: Nebraska faces coronavirus