Weeks before the novel coronavirus hit Nebraska, medical experts from around the nation communicated regularly by email, pondering the severity of the outbreak, sharing frustrations and planning for the worst.
The chain of emails includes several messages from Dr. James Lawler, a director in the University of Nebraska Medical Center’s Global Center for Health Security, who worked with Gov. Pete Ricketts to develop Nebraska’s pandemic plan.
The group of experts nicknamed the email chain “Red Dawn,” a nod to the 1984 film starring Patrick Swayze and Charlie Sheen about an invasion of the United States. The emails were obtained by the New York Times.
Lawler came to UNMC in 2018 after a Navy career that included White House assignments dealing with biodefense, pandemic response and health preparedness.
Though he never refers to Nebraska specifically, Lawler seemed to predict early on that the coronavirus would become a major global public health threat.
In a Jan. 28 email, Lawler wrote:
“Great Understatements in History:
Napoleon’s retreat from Moscow — ‘just a little stroll gone bad’
Pompeii — ‘a bit of a dust storm’
Hiroshima — ‘summer heat wave’
Wuhan — ‘just a bad flu season’ ”
That email was in response to Dr. Carter Mecher, a senior medical adviser at the Veterans Affairs Department. Mecher wrote that “the chatter on the blogs is that the (Centers for Disease Control and Prevention) is behind the curve. … Anyway you cut it, this is going to be bad. You guys made fun of me screaming to close the schools. Now I’m screaming, close the colleges and universities.”
In a statement provided to The World-Herald on Sunday, Lawler said:
“The emails obtained by the New York Times were part of an ongoing correspondence with a group of individuals with long experience in pandemic and public heath preparedness. My statements were strictly my personal opinions.”
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Many in the chain mention “NPIs,” or nonpharmaceutical interventions, which are actions that people and communities can take to help slow the spread of illnesses. Those often include closing schools and businesses.
In a Feb. 9 email, Lawler stressed the importance of such interventions:
“I think we also mostly agree that without dramatic NPI we can expect 30-40% infection rate by the end of community epidemic — and even with dramatic NPI, that total may only be slightly reduced.”
It’s a point reiterated in a March 13 email in which Lawler and others criticize the CDC for questioning the value of closing schools.
“CDC is really missing the mark here,” Lawler wrote. “By the time you have substantial community transmission it is too late. It’s like ignoring the smoke detector and waiting until your entire house is on fire to call the fire dept. Plus, how are you supposed to know when you have community transmission when they haven’t been able to provide a diagnostic assay that can be used widely and at high volume?”
Around the time Lawler sent that email, the CDC had quietly updated its guidance on school closings, advising educators that closing for at least eight weeks might be the most effective way to contain the coronavirus, according to the Times. But many schools across the country were ahead of that advice.
Major school districts in the metro area, including the Omaha Public Schools and the Millard, Papillion-La Vista and Bellevue school districts, announced indefinite closures on March 16.
By March 23, all 244 Nebraska districts had announced that they were closing to students.
After its first confirmed case on March 6, Nebraska for most of two weeks had more coronavirus cases per capita than the neighboring states of Iowa, Kansas, South Dakota and Missouri, a World-Herald analysis found.
Nebraska’s first case of community spread was March 15.
On March 16, Nebraska limited gatherings to 10 people — the same day it was recommended by the CDC. The move had the effect of shutting the doors to most bars and restaurants. Ricketts had three days earlier been among the nation’s first governors to set any kind of gathering limit, having declared a 250-person limit March 13.
Ricketts and Lawler said last week that it’s possible that Nebraska’s early actions helped flatten the state’s coronavirus curve.
On April 3, Lawler said publicly that he didn’t think Nebraska needed a stay-at-home or shelter-in-place order.
“What I think we should really focus on is improving compliance and adherence,” he said. “This depends on people taking this seriously and doing the right thing.”