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Here's how Nebraska's first COVID-19 patient pulled through. It wasn't medical magic

When Dr. Brian Boer got his first look at Nebraska’s first COVID-19 patient, he knew he had a battle on his hands.

Emma Hutchinson, a 36-year-old Omaha woman with birth defects that hampered her breathing, was in rough shape.

Her lungs had filled with fluid. The oxygen mask on her face wasn’t doing nearly enough. She was literally drowning on her hospital bed.

Boer, the medical director of the intensive care unit set up to treat critically ill COVID-19 patients at the Nebraska Medical Center, said he frequently treats such dire cases of lung failure, known as acute respiratory distress syndrome, in patients with other viral infections, like influenza.

But as he assumed the care of Hutchinson the day after she arrived on March 6, he saw that this was different. This new coronavirus was more contagious and more dangerous than the flu. The hospital had already started ramping up for an expected onslaught of patients. The big concern: that this novel virus could swamp and overwhelm hospitals and staff.

“The big difference is that no human body has seen this before,” Boer said. “If everyone gets it at the same time, if too many people get sick all at once, you don’t have the resources to care for all of them.

NEBRASKA MEDICINE 

Dr. Brian Boer is a pulmonologist who heads up the Nebraska Medical Center’s intensive care unit set up to treat critically ill COVID-19 patients. When Emma Hutchinson was taken off a ventilator as her health began to improve, “the first thing she asked was if she did a good job,” the doctor said. “You did an awesome job, Emma.”

“Then you have to make the hard choices about who lives or dies. That’s what happened in Italy.”

But Emma Hutchinson didn’t become a casualty of COVID-19.

After 30 days at the medical center, three weeks of isolation at her father’s home in west Omaha, including more follow-up tests for the coronavirus, she was allowed to resume eating solid food and say goodbye to “Fred,” her nickname for the feeding tube, attached to a steel pole on wheels, that she had been wheeling around.

Her first solid meal in almost two months? Her favorite sandwich at Jimmy John’s, the No. 9, called the Italian Night Club. A couple days later, she and a friend enjoyed an Irish meal donated by her favorite restaurant, Brazen Head.

Now she’s back at her own apartment and has resumed working at a structured workshop for the developmentally disabled in Omaha.

She made a podcast for her church, Christ Community near Interstate 680 and West Dodge Road, in which she thanked her family and friends, the doctors and nurses at the med center, and even strangers who prayed and urged her to endure, even as she lay in an ICU under heavy sedation.

“From the beginning of March to now, I felt like giving up on everything,” Hutchinson said. “But I had a bunch of close friends and my family and the body of God who would surround me and encourage me to fight for my life.

“They told me not to give up.”

Hutchinson and her father, Ralph, a 73-year-old Postal Service retiree who grew up in London, agreed for the first time to have their names used in a story.

He had initially reached out to The World-Herald shortly after posts on social media accused his daughter of intentionally spreading the virus by participating in a Special Olympics basketball tournament on Feb. 29 at the Fremont YMCA just after returning from a trip to England for her grandfather’s 100th birthday.

The father, who didn’t want his name used at the time to avoid even further digital abuse, made it clear that Emma had shown no symptoms until the day she was admitted to the hospital and that lifelong breathing problems made it hard to discern whether she was even sick, much less infected with the coronavirus.

Father of Nebraska's first coronavirus patient says they 'had absolutely no idea' she was sick

The father of Nebraska's first coronavirus patient says his daughter has suffered with respiratory issues her whole life and simply seemed to exhibit her usual symptoms. "Mostly, I just want people to know it wasn’t a deliberate, reckless thing that she was doing," he said. "If she was here right now coughing and sneezing, it wouldn’t bother at all ... it was just her normal irritations."

He and Emma made three trips to Methodist Women’s Hospital the same weekend as the basketball game, believing that she was suffering from migraines — a frequent problem for her — that might have been brought on when she was hit in the head by a basketball. On March 2, they visited their family doctor, who diagnosed a cold.

It wasn’t until they returned to the hospital on March 5 — five days after the tournament — that a doctor noticed that her oxygen levels were dangerously low. He ordered X-rays, which strongly suggested that she had pneumonia. When he was told that they had just been to London, COVID-19 was suspected to have invaded her lungs. She was sent to Methodist’s Dodge Street hospital.

After a trying night in the hospital, Hutchinson was transferred to the Nebraska Biocontainment Unit at the Nebraska Medical Center, the hospital that has worked in collaboration with the University of Nebraska Medical Center to establish one of the few centers in the nation specializing in the treatment of contagious diseases like Ebola, SARS and now, COVID-19.

A photograph of her being wheeled from an ambulance to the medical center has become one of the iconic images of the coronavirus pandemic in Nebraska, a viral attack that has infected more than 10,000 in the state and killed more than 120. 

In the photo by The World-Herald’s Chris Machian, Hutchinson, who graduated from Omaha Northwest, is encased in a clear plastic inflated tube called an isolation pod. Emergency responders are wearing masks, helmets, head-to-toe protective suits, gloves and rubber boots. It looks like a scene from a sci-fi movie.

CHRIS MACHIAN/THE WORLD-HERALD 

Emma Hutchinson was transported to the Nebraska Biocontainment Unit on March 6. At the time she arrived, the Nebraska Medical Center was ramping up for a possible surge of coronavirus patients.

Dr. Boer, a pulmonary and critical care specialist, said that when Hutchinson arrived at the hospital, personnel in the biocontainment unit were wearing the maximum protective gear. That included helmets into which filtered air is pumped by a battery-operated blower like they had worn when treating Ebola patients flown to the Omaha hospital for specialized treatment in 2014. But using those powered air-purifying respirators proved unsustainable for the several dozen nurses, techs and doctors working in the unit, who have since switched to the now-familiar personal protective equipment of face shields, N95 masks, reusable gowns and disposable gloves.

But when the state’s first patient arrived, the hospital was ramping up for a possible surge of coronavirus patients. The biocontainment unit had only four rooms and could hold a total of just eight patients. So a special COVID-19 ICU was being established.

Things were moving fast. The unit was preparing for the worst. The stress level was high.

Working in such specialized isolation wards is labor-intensive and exhausting, Boer said. Protective gear must be put on when entering a room and removed when leaving. Gloves are disposable, but masks — usually about three to each worker per day — must be sterilized for reuse each night.

Nurses, he said, have it the hardest, because they are frequently in and out of such rooms for extended periods of time. Doctors, he said, can do a lot of monitoring of patients outside the rooms.

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“Our poor nurses. They’re like heroes,” Boer said. “They’re the ones getting their butts kicked.”

Soon after Hutchinson arrived, she was put on a ventilator — a mechanical lung that breathes for a patient — because her own fluid-filled lungs were too rigid to allow her to breathe on her own. She was heavily sedated and placed in a medically induced coma, in part to prevent her body from moving and consuming more precious oxygen.

“The body doesn’t like something else breathing for you,” Boer said, and will fight against the breathing tube placed in your airway.

Because Hutchinson had surgery on her airway as an infant to improve breathing, it was tricky for Boer’s partner, Dr. Craig Piquette, to place the “vent” tube. But it was successful.

Her oxygen level at times dipped as low as 50% to 60% — anything under 90% is low — and the ventilator was pumping at its maximum.

The severity of her illness, Boer said, was causing some kidney failure and some heart problems. If her kidneys got any worse, he feared that she might have to be put on a dialysis machine, which lowers a person’s chances of survival.

“We had to do a lot of tweaking,” he said. “There was a solid week of not knowing if she was going to turn the corner.”

But she did.

Her oxygen levels slowly improved. She started breathing some on her own. Her sedation was reduced, and the induced coma ended.

Hutchinson was transferred from the biocontainment unit to the new COVID-19 ICU, and on March 24 — 18 days after she arrived at the med Center — the ventilator was removed, and she was eventually placed in a more normal hospital room.

“The first thing she asked was if she did a good job,” the doctor said.

“You did an awesome job, Emma.”

She wasn’t out of the woods yet. Prolonged use of a breathing tube can sometimes cause damage, blocking the airway, and Boer said Hutchinson was at high risk for that because of her medical history. When the breathing tube was removed, a team of doctors prepared for the worst — an immediate tracheostomy to allow her to breathe. But it wasn’t necessary.

After Hutchinson was sent home to continue her recovery on April 4, she continued to use a feeding tube as an added precaution. “Fred” was mounted on a steel pole with wheels so she could move around.

Her father became her nurse and attendant, crushing pills twice a day every day, mixing them with fluid, then injecting them with a syringe into the tube.

“She always said, ‘Dad, you’re doing it too fast.’ She could feel it into her throat,” said Ralph Hutchinson, whose first wife, now deceased, had taken in Emma as a foster child at age 2, then adopted her three years later.

ANNA REED/THE WORLD-HERALD 

Hutchinson with a note she made for the staff of the Nebraska Medical Center. She spent 30 days at the hospital.

She was among the 1,063 critically ill COVID-19 patients across the globe who were enrolled in a randomized, controlled trial of the drug remdesivir, an antiviral medicine that had been used on Ebola patients. Because it was a blind study, neither the Hutchinsons nor Emma’s doctor were told whether she received the drug or a placebo.

Boer said personnel at the med center had their suspicions about who received remdesivir and who didn’t, based on patients who seemed to recover faster than others.

But he said the recovery of Emma Hutchinson, from near death, wasn’t due to some “miracle” drug but rather to “evidence-based, supportive care” like that given to people with severe cases of flu. That’s sticking to the basics, he said, and not trying unproven therapies outside of controlled trials, like hydroxychloroquine, that more often than not make things worse.

“These people need time, not a lot of tinkering,” he said. “You just have to ride it out, weather the storm and buy her time to fight the virus on her own.

“These are marathon cases, not sprints.”

Emma Hutchinson, in her podcast, said battling COVID-19 taught her to not take her family and friends for granted and to recognize that possessions aren’t that important.

Her father said he’s grateful for neighbors and friends, for the doctors and nurses, and for the emails from well-wishers he didn’t know.

“I’d like to name them all, but it would get as tedious as an Academy Award acceptance speech,” he said.

“We were lucky,” he added. “Many were not, and the toll will rise. Our hearts go out to everyone affected, directly and indirectly, by this awful virus.”


Our best staff photos of May 2020

Photos: Our best staff photos of May 2020

Local
Susie Buffett-linked real estate company has quietly acquired $4 million in North Omaha property

A company affiliated with philanthropist Susie Buffett’s Sherwood Foundation has been buying real estate in North Omaha, quietly amassing more than 35 buildings and vacant lots within four blocks of 24th and Lake Streets.

Those acquisitions occurred from 2014 through April of this year and totaled almost $2 million, according to public records. And that doesn’t include at least $2.3 million in additional land that the company, RH Land Management LLC, has bought recently in other parts of North Omaha.

North Omaha has endured decades of economic decline and depopulation, with revitalization occurring only in fits and starts.

But the area is showing new energy and signs of a comeback, with a renewed emphasis on North 24th Street.

The 24th and Lake properties position the Sherwood Foundation and Buffett to have a major say in shaping the future redevelopment of the historic heart of North Omaha.

What they intend to do with the property is unclear.

Buffett, the daughter of Omaha billionaire Warren Buffett, declined to comment for this article. Calls and emails over more than a week seeking comment from Sherwood Foundation and RH Land Management officials were not returned.

REBECCA S. GRATZ/THE WORLD-HERALD 

RH Land Management, which is affiliated with philanthropist Susie Buffett’s Sherwood Foundation, has been quietly amassing more than 35 buildings and vacant lots within four blocks of 24th and Lake Streets.

Silence and a lack of community engagement has bred concern. Leaders of two neighborhood groups where RH Land Management has bought multiple properties said they have not been contacted by the company or Sherwood and have not been consulted about what should happen there. They said they were not even aware of most of the acquisitions until a World-Herald reporter told them.

Tanya Cooper, president of the OIC Neighborhood Association north of Lake Street, said RH Land Management and Sherwood “need to be talking to the community about what they want and not just coming in and doing whatever they want to do.”

“People have lives, and they have stuff that is already going on down here,” she said. “And I’m just going to be frank with you. ... White people need to stop coming into a black community and making it all about what they want to see for us. ... We are not the children, and they need to start bringing us to the table at the beginning instead of trying to put us in the seat that they have made for us on the tail end of things.”

Juanita Johnson, president of the Long School Neighborhood Association, home to about 500 people southwest of 24th and Lake Streets, also said she wants more engagement with nonprofit groups and others who want to develop her neighborhood.

“Because we will be directly impacted,” she said. “We welcome community input, but we’d like to see a definition regarding what community is. ... Does everybody have a weigh-in on what happens to us all the way out to Elkhorn?”

Omaha City Councilman Ben Gray said he does not know what Sherwood’s plans are for the properties.

But he said he is confident that the foundation has the community’s best interests in mind. Gray said it is likely that the land and buildings will eventually be turned over to nonprofit developers that do redevelopment that’s good for the community, such as past Buffett-affiliated efforts including The Union for Contemporary Art and the Highlander project along North 30th Street.

MATT MILLER/THE WORLD-HERALD 

Past Susie Buffett-affiliated efforts in North Omaha include the Union for Contemporary Art at the historic 24th and Lake Streets intersection.

He noted that 75 North Revitalization Corp., which is behind the Highlander housing, business and community redevelopment project and whose backers include Buffett and the Sherwood Foundation, is following the model of Purpose Built Communities, which has been successful in Atlanta and elsewhere.

“I expect them to do what they’ve been doing in the past,” Gray said.

LaVonya Goodwin, president of the North 24th Street Business Improvement District board, said 24th Street and 30th Street are in various phases of revitalization “and North Omaha residents have an opportunity to participate.”

“First, I urge people to start with what they and their families own,” she said in an email. “Secure it by making sure that property taxes are paid and estate planning is done.”

Goodwin said investment in predominantly black North Omaha is long overdue.

“Omaha is home to one of the wealthiest families in the world,” she said. “It makes sense that organizations like Sherwood and Purpose Built Communities would be strong contributors in the revitalization efforts happening in Omaha.”

Besides the properties near 24th and Lake, RH Land Management purchased a former church at 3025 Parker St. for $800,000 last fall, then gave the property to the 75 North nonprofit.

In March, RH bought the former St. Paul Lutheran Church and School at 5020 Grand Ave. for $1.5 million.

Meanwhile, 75 North recently purchased the former Omaha Small Business Network building and land on the northeast corner of 24th and Lake Streets.

Othello Meadows, 75 North’s president and CEO, said his organization sometimes buys properties that aren’t necessarily in high demand but could become more run-down or be misused.

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“A lot of the stuff that we end up with is kind of opportunistic and just trying to make sure that it doesn’t further deteriorate,” he said. “Unfortunately, there’s a lot of properties that will just sit there for years, and eventually those things become eyesores and really are kind of a blight on the neighborhood.”

Meadows said he didn’t know of plans for the RH Land Management-owned vacant lots but said he expects good things based on Sherwood’s track record.

“The biggest thing is: Really, he or she who controls the land, their priorities kind of carry,” he said. “If your priority is equity and affordable housing and kind of more community-centered development, and you own the land, then you can kind of carry that out.”

RH Land Management, a for-profit limited liability company, was created in 2011. Real estate transaction records list Sherwood Foundation Finance Director Shari Lecci as the company’s “sole manager.”

RH has been in the middle of two significant arts and cultural renovation projects. In Dundee, the company bought the property that housed the historic Dundee Theater, saving the building and helping Film Streams renovate it into cinemas.

In North Omaha, the City of Omaha sold RH Land Management several vacant buildings of the former Blue Lion Center job training center for $650,000 in 2014. The Blue Lion buildings, at the southeast corner of 24th and Lake Streets, were renovated in 2017 into The Union for Contemporary Art, whose mission statement says it “strengthens the cultural and social landscape of our community by using the arts as a vehicle to inspire positive social change.”

Mayor Jean Stothert, in urging the City Council to approve the Blue Lion sale, said it would be the first step in a revitalization of the area.

Another set of purchases by RH in 2014 received less public attention.

The company bought the former site of Greater Beth-El Temple at 25th Street and Lizzie Robinson Avenue and several nearby lots that the church owned. The $507,000 purchase of 11 lots made RH Land Management the owner of almost two square city blocks of residential property at the main entrance to historic North Omaha from the North Freeway. Several neighbors interviewed in recent weeks said they have not been contacted by RH, Sherwood or city officials about possible future uses for the land.

“I would like to know what they’re going to do with this property they’re buying,” said Joyce Beacham, whose house is surrounded on three sides by RH-owned vacant lots.

She and her husband bought the house decades ago after they were displaced by the construction of the North Freeway.

He renovated it. They raised three sons there. Beacham likes the neighborhood and would welcome redevelopment, especially more housing, which would bring more people.

“It’d be nice,” Beacham said Thursday on her front step, next to a carved sign carved that said “The Beacham Family” and surrounded by neatly tended beds of lilies and other flowers. “I’d like to see it.”

In 2019, the city sold the vacant former Simple Simon building at 24th Street and Willis Avenue to RH Land Management for $120,000.

In February, the company bought a row of buildings northwest of 24th and Lake Streets from the OSBN.

In April, RH bought another retail bay there that most recently housed a CBD products store. Those retail bays stretch north for half a block from Love’s Jazz & Arts Center, a cultural, arts and community event center. Love’s remains an independent, community-based organization in a city-owned building, although it has struggled financially.

Late week, contractors were hard at work in one of those retail bays, a former hair salon. After gutting the building down to its brick bones, they were framing up new interior walls for a future occupant.

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The North Omaha Village Revitalization Plan, adopted in 2011, spells out concepts for redevelopment in the area. Another planning process, Forever North, is underway now. The city has not received any requests for changes to future land use or Planning Board applications in the 24th Street corridor, said Chris Wayne, the city’s neighborhood planning manager.

“The RH Land Management properties are certainly significantly located, and the contribution of developments on those parcels could be consequential to the well-being of the area and the corridor,” he said in an email. “We would encourage development of the properties in a manner that matches the strategy to create compact, mixed-use, pedestrian oriented places that is expressed in Forever North, and echoes the spirit of prior plans seeking to build a vibrant community.”

Terrell McKinney, a law student from North Omaha who is running for the Nebraska Legislature, said there should be more transparency and community involvement.

“The community should have equal say in what goes on,” he said. “It can’t be just, buy up a bunch of land and place something there and say look what I did for you. It should be something that is led by the community, not led by a foundation or land management group.”

Johnson, the Long School Neighborhood president, said Omaha Economic Development Corp. projects in the neighborhood are good models for including the community.

Councilman Gray said he is confident that any redevelopment efforts involving Sherwood or 75 North “will follow all the proper procedures in terms of meeting with the public, talking to the community and those sorts of things. I have no concerns about that.”


Our best staff photos of May 2020

Photos: Our best staff photos of May 2020

State_and_regional
Group behind TestNebraska was looking nationwide, registering web domains in nearly every state

LINCOLN — The Utah group behind Nebraska’s and Iowa’s multimillion-dollar ventures to increase COVID-19 testing was dreaming big after it developed what it calls its “crisis response service.”

On the same day in March when the group inked its first contract to provide coronavirus testing in Utah, one of the firms in the group registered web addresses similar to TestUtah.com for 47 other states.

A few days later, URLs were registered for Puerto Rico and some Canadian provinces.

Today, most of the sites redirect you to crushthecurve.com, another site registered by Domo, of American Fork, Utah. Crushthecurve.com provides a marketing pitch for states to sign up for the Utah group’s services.

The only exceptions are TestUtah.com, TestIowa.com and TestNebraska.com, where people can register for COVID-19 testing after those states signed contracts with the Utah group.

Whether the aggressive web registrations by the Utah group were just good business or are an example of attempted profiteering during a crisis sparked a debate between those who back Nebraska’s $27 million contract with the group led by Nomi Health and those who question the wisdom of entering into the hastily arranged, no-bid deal.

One state senator, who has been involved in Internet startup firms and has questioned the transparency of the TestNebraska contract, said it looks like the Utah group found a good idea and, like a lot of high-tech startups, decided to shoot for the moon with only a couple weeks of experience.

Megan Hunt

“It’s opportunism at its worst,” said State Sen. Megan Hunt of Omaha. “And we fell for it.”

A spokeswoman for Domo said the numerous registrations were made “early” in case other states signed up for the same testing program provided to Utah. So far, only Nebraska and Iowa, which signed a $26 million contract just before Nebraska, have taken up the offer.

Domo spokeswoman Julie Kehoe would not say how many states were offered contracts by the firm.

Gov. Pete Ricketts, who has touted TestNebraska as the way to expand testing and return the state to normal, said it was only “a few.”

The Republican governor, who had been trying without success to obtain COVID-19 tests elsewhere, made it clear last week that Nebraska needed to sign up, or it would lose an opportunity to increase testing dramatically, from 600 to 800 a day to eventually 3,000 a day.

“Every state was out there trying to find ways to expand testing, and they still are looking,” Ricketts said. “We found a consortium of companies that had access to all of these (testing) materials that was able to set up very, very quickly.”

Kehoe did not respond to a question about whether the Utah companies were cashing in on a crisis but said there was “no correlation” between the more than 50 URLs registered and the number of states and provinces contacted.

Indeed, a spokeswoman for Montana Gov. Steve Bullock said several companies selling coronavirus testing had contacted her state, but she didn’t recall the Utah firms.

Marissa Perry, the spokeswoman, said Montana successfully obtained its testing materials by working with the federal government and private vendors.

Taylor Gage, a spokesman for Ricketts, said it was his understanding that the Utah group could work with only a “limited number” of states because of constraints on the supplies it could obtain.

Crushthecurve.com makes it clear that the group is looking for more states.

“Join the nationwide Crush-the-Curve movement,” it says, displaying a U.S. map with Utah, Nebraska and Iowa highlighted and maintaining that its “crisis response service” will “increase the rate of COVID-19 testing, save lives, and restore normalcy.”

Hunt is not alone in questioning the program.

Last week, four state lawmakers, led by Sen. Machaela Cavanaugh of Omaha, called on the governor to cancel the contract and instead work with Nebraska providers.

Ricketts called that request “ludicrous” and said the senators didn’t realize how hard it is to find someone who could deliver so many tests so quickly. While there have been some glitches, he said, they’ve been addressed. And meanwhile, TestNebraska has provided two weeks’ of tests.

Pete Ricketts

“We rushed this to get it out as quickly as possible,” Ricketts said. “We certainly could have spent a month or two testing this, but we thought the better deal here was to make sure we had more testing.”

The governor signed the first of three contracts for TestNebraska.com on April 19 and announced the launch of the testing program two days later — the same day Iowa launched its program.

One key was that the Utah group pledged provide 540,000 COVID-19 test kits — kits that were in short supply — and promised to ramp up to 3,000 tests a day by the end of May.

The launch of TestNebraska.com has had bumps. The website initially did not recognize that health care providers should be given priority to schedule a test, and, until last week, test result data was not being provided to local health districts. But those problems have been fixed.

Gage said Saturday that one of the four high-tech polymerase chain reaction (PCR) machines used to analyze the tests that was provided to TestNebraska broke down, but it has been replaced. That did not harm the quality of test results, he said.

And it appears that Nomi Health has honored its pledge to deliver test kits. The company, in a statement Friday, said it had already delivered 200,000 test kits each to Nebraska and Iowa. That is ahead of contract deadlines and above the 180,000 that were scheduled to be delivered.

“These states told us what they needed in the midst of a crisis and we delivered,” the company said.

Still, the test programs have drawn criticism in Utah and Iowa, as well as Nebraska.

In Nebraska and Utah, the tests done by the Nomi Health group produce far fewer “positive” tests than testing done by other labs in those states. Failure of analytical machines in Iowa has delayed test results. And early on, questions were raised about ties the CEO of Nomi Health has with a company that stockpiled hydroxychloroquine, an antimalarial drug once touted by President Donald Trump as a possible coronavirus treatment. A question about the drug that was initially on the TestNebraska.com assessment was removed shortly after questions were raised.

The drug has been shown to be ineffective, and even harmful, in some early trials.

Hunt said that she’s not opposed to public-private partnerships but that the speed at which the Utah firms ramped up and signed up Utah, Iowa and Nebraska reminded her a lot of high-tech startups that “overpromise” and then figure out the details later.

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“My concerns are about accountability and transparency,” the senator said.

The Nebraska contract with Nomi calls only for COVID-19 tests that produce “accurate results a majority of the time.” Hunt said medical professionals tell her that is “as good as no test.”

“That could give people a false sense of security,” she said. “I’d rather people get bad news than be misled.”

The World-Herald reviewed dozens of pages of emails, documents and text messages released by the Governor’s Office to get a flavor of the steps taken in inking the contracts with Nomi Health, Domo, Qualtrics, and the Utah-based test manufacturer, Co-Diagnostics.

They portray a rush to sign up with the Utah firms, based on a recommendation from Utah Gov. Gary Herbert. Iowa Gov. Kim Reynolds has said the TestUtah group was recommended to her by actor Ashton Kutcher, a native Iowan and a friend of Ryan Smith, the CEO of Qualtrics.

By April 15 — four days before the first TestNebraska contract, with Nomi Health, was signed — the Cornhusker State had received a copy of the TestIowa contract.

“Amara, start reading this,” said an email from Doug Carlson, the chief procurement officer for the State of Nebraska to Amara Block, the legal counsel for the Nebraska Department of Administrative Services, the agency that deals with state contracts.

Several email exchanges followed, including one from the state asking that the contract stipulate a 36-hour turnaround on results after tests are administered. (After Ricketts initially indicated that TestNebraska was supposed to provide test results in 48 hours, the TestNebraska site now pledges to have them in 72 hours. But he said last week that the “average” turnaround time for TestNebraska was 1.8 days, which was faster than the state’s labs.)

Block, in an email the morning of April 19, emphasized that “time is of the essence” and said she was “comfortable” that Nomi Health could deliver the test kits it promised, which were 180,000 by 5 p.m. May 19 and 540,000 total.

But she added, “I’m not certain how to ensure quality control or accuracy” because the CDC-approved tests would be administered by workers hired by the State of Nebraska, which so far have been CHI Health employees.

By 12:10 p.m. on April 19, a Sunday, a “final draft” was in the hands of Nebraska officials, and less than two hours later, a signed contract with Nomi Health was in hand.

But that was just the start of contract discussions.

The emails indicate that a contract with Domo wasn’t signed until 3:30 p.m. April 21, a few minutes after the governor announced the launch of TestNebraska.com at his daily coronavirus briefing. The contract with Qualtrics, a Utah firm that has done work for the University of Nebraska-Lincoln, wasn’t signed until two days later, and only after Nebraska insisted on adding an extra clause to block the use of the information provided by residents to TestNebraska.com from any private use.

CHRIS MACHIAN/THE WORLD-HERALD 

Medical workers wait for people at a tent at a drive through testing site in Lot D of the CHI Health Center. This was part of the TestNebraska initiative launched two weeks ago by Gov. Pete Ricketts.

The emails released included requests from the Governor’s Office to well-known Nebraskans including Husker football coach Scott Frost and University of Nebraska President Ted Carter to use social media to encourage people to sign up for testing.

There was optimism about TestNebraska, but also concerns expressed, in some emails.

Dr. John Vann, a pediatrician from Omaha, sent an email to the Governor’s Office saying he was happy about the testing but asking about “the sensitivity and specificity” of the tests being used. The records released by the Ricketts administration did not include a response to that email.

The accuracy of COVID-19 tests is vital, to ensure that infected people don’t spread the virus after being cleared by false negative test results. Also, there have been questions raised about whether certain coronavirus tests are sensitive enough to glean results from a small sample of the virus.

In one email, Michael Harvey, a hospital administrator in Syracuse, Nebraska, said “many of the hospital laboratory directors across the state are very frustrated at the state’s approach” with TestNebraska. The concern, he said, was that the state program would gobble up the hard-to-obtain materials to conduct COVID-19 testing, leaving smaller hospitals without any.

Jerel Katen, the lab director at the hospital, Syracuse Area Health, also complained in an email that the state was deploying testing kits to a small hospital in Osmond but not to a hospital in Hastings, where the coronavirus was spreading rapidly.

Gage said that states are vying with one another for testing materials but that the Ricketts administration has tried to work with local hospitals and labs. The Utah group, he added, uses supply chains to which the state doesn’t have access.

“(It) doesn’t compete with the other testing supply chains we’re using,” he said.

Gage added that testing performed by the TestNebraska lab set up at St. Elizabeth Hospital in Lincoln was validated before the launch of testing two weeks ago, and has been validated twice since then. The state is working with the Nebraska Public Health Lab to “ensure the integrity” of the test results, he said.

Hunt, the state senator, said she’s still not convinced. Sure, she said, Nebraska needed to move fast, but she sees no evidence that the state’s authorities on pandemics were consulted before signing up with a group of Utah firms that had no prior medical experience. Meanwhile, there’s too many stories across the country of companies promising COVID-19 supplies and services that never delivered, she said.

“I’d like to be wrong (about TestNebraska), but show me that I’m wrong,” Hunt said.


Our best staff photos of May 2020

Photos: Our best staff photos of May 2020