CHEYENNE, Wyo. (AP) — Health officials in Wyoming have reported an increase of 742 confirmed COVID-19 cases from Saturday to Sunday, ahead of the Thanksgiving holiday. 

The Wyoming Eagle Tribune reported that there were 24,309 confirmed COVID-19 cases as of Sunday compared to the 23,567 cases reported Saturday. 

Health officials say Natrona County, which includes Casper, reported the highest number of newly reported cases at 115. 

Laramie County, which includes Cheyenne, reported 105 newly confirmed COVID-19 cases, while Fremont County reported the next highest number of confirmed COVID-19 cases at 95. Statewide, the number of active COVID-19 cases increased to 11,186 on Sunday, or by 482 cases.

CHEYENNE, Wyo. (AP) — Health officials in Wyoming have reported an increase of 742 confirmed COVID-19 cases from Saturday to Sunday, ahead of the Thanksgiving holiday. The Wyoming Eagle Tribune reported that there were 24,309 confirmed COVID-19 cases as of Sunday compared to the 23,567 cases reported Saturday. Health officials say Natrona County, which includes Casper, reported the highest number of newly reported cases at 115. Laramie County, which includes Cheyenne, reported 105 newly confirmed COVID-19 cases, while Fremont County reported the next highest number of confirmed COVID-19 cases at 95. Statewide, the number of active COVID-19 cases increased to 11,186 on Sunday, or by 482 cases.

Wyoming reports increase in newly confirmed COVID-19 cases

LINCOLN, Neb. (AP) — Nebraska reported one of the lowest numbers of new virus cases this month on Sunday, but the number of people hospitalized with the virus remains high and continues to strain hospital capacity in the state.

 The state reported 1,032 new virus cases Sunday. 

That was less than half of the seven-day rolling average of daily new cases in the state, which was 2,313.57. 

State data shows that 976 people were being treated for COVID-19 in the state’s hospitals, occupying 23% of the state’s hospital beds.

 The threshold of 25% that will trigger more social distancing restrictions from the state.

LINCOLN, Neb. (AP) — Nebraska reported one of the lowest numbers of new virus cases this month on Sunday, but the number of people hospitalized with the virus remains high and continues to strain hospital capacity in the state. The state reported 1,032 new virus cases Sunday. That was less than half of the seven-day rolling average of daily new cases in the state, which was 2,313.57. State data shows that 976 people were being treated for COVID-19 in the state’s hospitals, occupying 23% of the state’s hospital beds. The threshold of 25% that will trigger more social distancing restrictions from the state.

Ricketts warns imminent restrictions amid hospitalizations

LINCOLN, Neb. (AP) — Nebraska reported one of the smallest numbers of new virus cases this month on Sunday, but the number of people hospitalized with the virus remained high and continues to strain hospital capacity in the state. 

The state reported 1,032 new virus cases Sunday. 

That was less than half of the seven-day rolling average of daily new cases in the state which was 2,313.57.

 Nebraska said 976 people were being treated for COVID-19 in the state’s hospitals, so 23% of the state’s hospital beds are occupied by COVID-19 patients, which is approaching the threshold of 25% that will trigger more social distancing restrictions from the state.

LINCOLN, Neb. (AP) — Nebraska reported one of the smallest numbers of new virus cases this month on Sunday, but the number of people hospitalized with the virus remained high and continues to strain hospital capacity in the state. The state reported 1,032 new virus cases Sunday. That was less than half of the seven-day rolling average of daily new cases in the state which was 2,313.57. Nebraska said 976 people were being treated for COVID-19 in the state’s hospitals, so 23% of the state’s hospital beds are occupied by COVID-19 patients, which is approaching the threshold of 25% that will trigger more social distancing restrictions from the state.

Nebraska hospital capacity strained by coronavirus cases

SIOUX FALLS, S.D. (AP) — South Dakota health officials are reporting 42 deaths due to the coronavirus in the last day, lifting the state’s death toll to 819 since the start of the pandemic.

 There have been 404 virus fatalities in the state in the month of November. 

The COVID Tracking Project reports that South Dakota ranks No. 2 behind North Dakota for the number of virus cases per capita in the last two weeks. 

One in every 110 people in South Dakota tested positive in the past week. 

The state processed 851 positive tests since Saturday, lifting the total case count to 73.065. Hospitalizations fell by three in the last day, to 577.

SIOUX FALLS, S.D. (AP) — South Dakota health officials are reporting 42 deaths due to the coronavirus in the last day, lifting the state’s death toll to 819 since the start of the pandemic. There have been 404 virus fatalities in the state in the month of November. The COVID Tracking Project reports that South Dakota ranks No. 2 behind North Dakota for the number of virus cases per capita in the last two weeks. One in every 110 people in South Dakota tested positive in the past week. The state processed 851 positive tests since Saturday, lifting the total case count to 73.065. Hospitalizations fell by three in the last day, to 577.

South Dakota reports 42 deaths due to COVID-19 in last day

LONDON (AP) — Pharmaceutical company AstraZeneca said Monday that late-stage trials showed its coronavirus vaccine was up to 90% effective, giving public health officials hope they may soon have access to a vaccine that is cheaper and easier to distribute than some of its rivals.

The results are based on interim analysis of trials in the U.K. and Brazil of a vaccine developed by Oxford University and manufactured by AstraZeneca. No hospitalizations or severe cases of COVID-19 were reported in those receiving the vaccine.

AstraZeneca is the third major drug company to report late-stage results for a potential COVID-19 vaccine as the world anxiously waits for scientific breakthroughs that will bring an end to a pandemic that has wrought economic devastation and resulted in nearly 1.4 million confirmed deaths.

Pfizer and Moderna last week reported preliminary results from late-stage trials showing their vaccines were almost 95% effective. But, unlike its rivals, the AstraZeneca vaccine doesn’t have to be stored at ultra-cold temperatures, making it easier to distribute, especially in developing countries.

“I think these are really exciting results,” Dr. Andrew Pollard, chief investigator for the trial, said during a news conference. “Because the vaccine can be stored at fridge temperatures, it can be distributed around the world using the normal immunization distribution system. And so our goal … to make sure that we have a vaccine that was accessible everywhere, I think we’ve actually managed to do that.”

The Oxford-AstraZeneca vaccine is also cheaper. AstraZeneca, which has pledged it won’t make a profit on the vaccine during the pandemic, has reached agreements with governments and international health organizations that put its cost at about $2.50 a dose. Pfizer’s vaccine costs about $20 a dose, while Moderna’s is $15 to $25, based on agreements the companies have struck to supply their vaccines to the U.S. government.

All three vaccines must be approved by regulators before they can be widely distributed.

Oxford researchers and AstraZeneca stressed that they aren’t competing with other projects, and that multiple vaccines will be needed to reach enough of the world’s population and end the pandemic.

“We’re not thinking about vaccinations working in terms of one person at a time. We have to think about vaccinating communities, populations, reducing transmission within those populations, so that we really get on top of this pandemic,″ said Sarah Gilbert, a leader of the Oxford research team. “And that’s what it now looks like we’re going to have the ability to contribute to in a really big way.″

The results come as a second wave of COVID-19 hits many countries, once again shutting businesses, restricting social interaction and pummeling the world economy.

AstraZeneca said it will immediately apply for early approval of the vaccine where possible, and it will seek an emergency use listing from the World Health Organization, so it can make the vaccine available in low-income countries.

The AstraZeneca trial looked at two different dosing regimens. A half-dose of the vaccine followed by a full dose at least one month later was 90% effective. Another approach, giving patients two full doses one month apart, was 62% effective. The combined results showed an average efficacy rate of 70%.

The vaccine uses a weakened version of a common cold virus that is combined with genetic material for the characteristic spike protein of the virus that causes COVID-19. After vaccination, the spike protein primes the immune system to attack the virus if it later infects the body.

The vaccine can be transported under “normal refrigerated conditions” of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit), AstraZeneca said. By comparison, Pfizer plans to distribute its vaccine using specially designed “thermal shippers” that use dry ice to maintain temperatures of minus-70 degrees Celsius (minus-94 degrees Fahrenheit).

Peter Openshaw, professor of experimental medicine at Imperial College London, said the finding that a smaller initial dose is more effective than a larger one is good news because it may reduce costs and mean more people can be vaccinated.

“The report that an initial half-dose is better than a full dose seems counterintuitive for those of us thinking of vaccines as normal drugs: With drugs, we expect that higher doses have bigger effects, and more side-effects,” he said. “But the immune system does not work like that.”

The results reported Monday come from trials in the U.K. and Brazil that involved 23,000 people. Late-stage trials are also underway in the U.S., Japan, Russia, South Africa, Kenya and Latin America, with further trials planned for other European and Asian countries.

AstraZeneca has been ramping up manufacturing capacity, so it can supply hundreds of millions of doses of the vaccine starting in January, Chief Executive Pascal Soriot said earlier this month.

Soriot said Monday that the Oxford vaccine’s simpler supply chain and AstraZeneca’s commitment to provide it on a nonprofit basis during the pandemic mean it will be affordable and available to people around the world.

“This vaccine’s efficacy and safety confirm that it will be highly effective against COVID-19 and will have an immediate impact on this public health emergency,” Soriot said.

British Health Secretary Matt Hancock said he felt “a great sense of relief” at the news from AstraZeneca.

Britain has ordered 100 million doses of the Oxford vaccine, and the government says several million doses can be produced before the end of the year if it is approved by regulators.

Just months ago, “the idea that by November we would have three vaccines, all of which have got high effectiveness … I would have given my eye teeth for,” Hancock said.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602590971875.png" alt="Photo courtesy Johnson &amp; Johnson" />
 <figcaption>Photo courtesy Johnson &amp; Johnson</figcaption>
 </figure>LONDON (AP) — Pharmaceutical company AstraZeneca said Monday that late-stage trials showed its coronavirus vaccine was up to 90% effective, giving public health officials hope they may soon have access to a vaccine that is cheaper and easier to distribute than some of its rivals.The results are based on interim analysis of trials in the U.K. and Brazil of a vaccine developed by Oxford University and manufactured by AstraZeneca. No hospitalizations or severe cases of COVID-19 were reported in those receiving the vaccine.AstraZeneca is the third major drug company to report late-stage results for a potential COVID-19 vaccine as the world anxiously waits for scientific breakthroughs that will bring an end to a pandemic that has wrought economic devastation and resulted in nearly 1.4 million confirmed deaths.Pfizer and Moderna last week reported preliminary results from late-stage trials showing their vaccines were almost 95% effective. But, unlike its rivals, the AstraZeneca vaccine doesn’t have to be stored at ultra-cold temperatures, making it easier to distribute, especially in developing countries.“I think these are really exciting results,” Dr. Andrew Pollard, chief investigator for the trial, said during a news conference. “Because the vaccine can be stored at fridge temperatures, it can be distributed around the world using the normal immunization distribution system. And so our goal … to make sure that we have a vaccine that was accessible everywhere, I think we’ve actually managed to do that.”The Oxford-AstraZeneca vaccine is also cheaper. AstraZeneca, which has pledged it won’t make a profit on the vaccine during the pandemic, has reached agreements with governments and international health organizations that put its cost at about $2.50 a dose. Pfizer’s vaccine costs about $20 a dose, while Moderna’s is $15 to $25, based on agreements the companies have struck to supply their vaccines to the U.S. government.All three vaccines must be approved by regulators before they can be widely distributed.Oxford researchers and AstraZeneca stressed that they aren’t competing with other projects, and that multiple vaccines will be needed to reach enough of the world’s population and end the pandemic.“We’re not thinking about vaccinations working in terms of one person at a time. We have to think about vaccinating communities, populations, reducing transmission within those populations, so that we really get on top of this pandemic,″ said Sarah Gilbert, a leader of the Oxford research team. “And that’s what it now looks like we’re going to have the ability to contribute to in a really big way.″The results come as a second wave of COVID-19 hits many countries, once again shutting businesses, restricting social interaction and pummeling the world economy.AstraZeneca said it will immediately apply for early approval of the vaccine where possible, and it will seek an emergency use listing from the World Health Organization, so it can make the vaccine available in low-income countries.The AstraZeneca trial looked at two different dosing regimens. A half-dose of the vaccine followed by a full dose at least one month later was 90% effective. Another approach, giving patients two full doses one month apart, was 62% effective. The combined results showed an average efficacy rate of 70%.The vaccine uses a weakened version of a common cold virus that is combined with genetic material for the characteristic spike protein of the virus that causes COVID-19. After vaccination, the spike protein primes the immune system to attack the virus if it later infects the body.The vaccine can be transported under “normal refrigerated conditions” of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit), AstraZeneca said. By comparison, Pfizer plans to distribute its vaccine using specially designed “thermal shippers” that use dry ice to maintain temperatures of minus-70 degrees Celsius (minus-94 degrees Fahrenheit).Peter Openshaw, professor of experimental medicine at Imperial College London, said the finding that a smaller initial dose is more effective than a larger one is good news because it may reduce costs and mean more people can be vaccinated.“The report that an initial half-dose is better than a full dose seems counterintuitive for those of us thinking of vaccines as normal drugs: With drugs, we expect that higher doses have bigger effects, and more side-effects,” he said. “But the immune system does not work like that.”The results reported Monday come from trials in the U.K. and Brazil that involved 23,000 people. Late-stage trials are also underway in the U.S., Japan, Russia, South Africa, Kenya and Latin America, with further trials planned for other European and Asian countries.AstraZeneca has been ramping up manufacturing capacity, so it can supply hundreds of millions of doses of the vaccine starting in January, Chief Executive Pascal Soriot said earlier this month.Soriot said Monday that the Oxford vaccine’s simpler supply chain and AstraZeneca’s commitment to provide it on a nonprofit basis during the pandemic mean it will be affordable and available to people around the world.“This vaccine’s efficacy and safety confirm that it will be highly effective against COVID-19 and will have an immediate impact on this public health emergency,” Soriot said.British Health Secretary Matt Hancock said he felt “a great sense of relief” at the news from AstraZeneca.Britain has ordered 100 million doses of the Oxford vaccine, and the government says several million doses can be produced before the end of the year if it is approved by regulators.Just months ago, “the idea that by November we would have three vaccines, all of which have got high effectiveness … I would have given my eye teeth for,” Hancock said.___

Cheaper COVID-19 vaccine headed for approval

From Nebraska Dept. of Health and Human Services

LINCOLN, Neb.-Vaccine will play a critical role in protecting Nebraskans against COVID-19 as well as slowing the spread of the virus. DHHS, local health departments and other partners are planning for the arrival of COVID-19 vaccine in Nebraska. DHHS has worked to ensure that inclusion, transparency, and a sound evidence base are the foundation of Nebraska's COVID-19 vaccination plan.&nbsp;

The goal is to ensure fair and equitable access, and to distribute the vaccine in a way that provides the most protection for Nebraskans as quickly as possible.&nbsp;There are many unknowns that still remain in planning for vaccine distribution, making this plan a living document that will be revised as new information is available.

View the COVID-19 vaccination plan <a href="http://dhhs.ne.gov/Documents/COVID-19-Vaccination-Plan.pdf">HERE</a>.

From Nebraska Dept. of Health and Human ServicesLINCOLN, Neb.-Vaccine will play a critical role in protecting Nebraskans against COVID-19 as well as slowing the spread of the virus. DHHS, local health departments and other partners are planning for the arrival of COVID-19 vaccine in Nebraska. DHHS has worked to ensure that inclusion, transparency, and a sound evidence base are the foundation of Nebraska's COVID-19 vaccination plan.&nbsp;The goal is to ensure fair and equitable access, and to distribute the vaccine in a way that provides the most protection for Nebraskans as quickly as possible.&nbsp;There are many unknowns that still remain in planning for vaccine distribution, making this plan a living document that will be revised as new information is available.View the COVID-19 vaccination plan <a href="http://dhhs.ne.gov/Documents/COVID-19-Vaccination-Plan.pdf">HERE</a>.

State of Nebraska COVID-19 Vaccination Plan

U.S. health officials agreed to allow emergency use of a second antibody drug to help the immune system fight COVID-19, an experimental medicine that President Donald Trump was given when he was sickened last month.

The Food and Drug Administration authorized use of the <a href="https://www.gilead.com/news-and-press/press-room/press-releases/2020/10/us-food-and-drug-administration-approves-gileads-antiviral-veklury-remdesivir-for-treatment-of-covid19">Regeneron Pharmaceuticals Inc. drug to </a>try to prevent hospitalization and worsening disease from developing in patients with mild-to-moderate symptoms.

The drug is given as a one-time treatment through an IV. The FDA allowed its use in adults and children 12 and over who weigh at least 88 pounds and who are at high risk of severe illness from COVID-19 because of age or certain other medical conditions.

Emergency authorization allows use of the drug to start while studies are continuing to establish safety and effectiveness. Early results suggest the drug may reduce COVID-19-related hospitalization or emergency room visits in patients at high risk for disease progression, the FDA said.

Regeneron said that initial doses will be made available to roughly 300,000 patients through a federal government allocation program. Those patients will not be charged for the drug but may have to pay part of the cost of giving the IV.

Initial supplies will likely be vastly outstripped by demand as the U.S. has surged past 12 million reported cases, with the country facing what health experts say will be a dark winter due to uncontrolled spread of the virus.

Antibodies are proteins the body makes to target and help eliminate viruses, but it can take weeks for the best ones to form after an infection occurs. The drugs are concentrated versions of ones that proved best able to do this in lab and animal tests, and in theory help the body start to fight the virus right away.

The Regeneron drug is a combo of two antibodies to enhance the chances it will prove effective. Earlier this month, the FDA gave emergency authorization to a single-antibody drug from Eli Lilly that also is still being studied.

There’s no way to know whether the Regeneron drug helped Trump recover; he received a host of treatments and most COVID-19 patients recover on their own.

FDA regulators authorized the Regeneron drug using their emergency powers to quickly speed the availability of experimental drugs and other medical products during public health crises.

In normal times the FDA requires “substantial evidence” to show that a drug is safe and effective, usually through one or more large, rigorously controlled patient studies. But during public health emergencies the agency can lower those standards and require only that an experimental treatment’s potential benefits outweigh its risks.

The emergency authorization functions like a temporary approval for the duration of the COVID-19 pandemic. To win full approval, Regeneron will have to submit additional research to fully define the drug’s safety and benefit for patients.

The White House cast the decision as a victory for Trump’s efforts “to deliver cutting-edge treatments with highly promising results to protect the health and safety of the most vulnerable Americans,” according to a statement from spokesman Michael Bars.

By MARILYNN MARCHIONE, Associated PressU.S. health officials agreed to allow emergency use of a second antibody drug to help the immune system fight COVID-19, an experimental medicine that President Donald Trump was given when he was sickened last month.The Food and Drug Administration authorized use of the <a href="https://www.gilead.com/news-and-press/press-room/press-releases/2020/10/us-food-and-drug-administration-approves-gileads-antiviral-veklury-remdesivir-for-treatment-of-covid19">Regeneron Pharmaceuticals Inc. drug to </a>try to prevent hospitalization and worsening disease from developing in patients with mild-to-moderate symptoms.The drug is given as a one-time treatment through an IV. The FDA allowed its use in adults and children 12 and over who weigh at least 88 pounds and who are at high risk of severe illness from COVID-19 because of age or certain other medical conditions.Emergency authorization allows use of the drug to start while studies are continuing to establish safety and effectiveness. Early results suggest the drug may reduce COVID-19-related hospitalization or emergency room visits in patients at high risk for disease progression, the FDA said.Regeneron said that initial doses will be made available to roughly 300,000 patients through a federal government allocation program. Those patients will not be charged for the drug but may have to pay part of the cost of giving the IV.Initial supplies will likely be vastly outstripped by demand as the U.S. has surged past 12 million reported cases, with the country facing what health experts say will be a dark winter due to uncontrolled spread of the virus.Antibodies are proteins the body makes to target and help eliminate viruses, but it can take weeks for the best ones to form after an infection occurs. The drugs are concentrated versions of ones that proved best able to do this in lab and animal tests, and in theory help the body start to fight the virus right away.The Regeneron drug is a combo of two antibodies to enhance the chances it will prove effective. Earlier this month, the FDA gave emergency authorization to a single-antibody drug from Eli Lilly that also is still being studied.There’s no way to know whether the Regeneron drug helped Trump recover; he received a host of treatments and most COVID-19 patients recover on their own.FDA regulators authorized the Regeneron drug using their emergency powers to quickly speed the availability of experimental drugs and other medical products during public health crises.In normal times the FDA requires “substantial evidence” to show that a drug is safe and effective, usually through one or more large, rigorously controlled patient studies. But during public health emergencies the agency can lower those standards and require only that an experimental treatment’s potential benefits outweigh its risks.The emergency authorization functions like a temporary approval for the duration of the COVID-19 pandemic. To win full approval, Regeneron will have to submit additional research to fully define the drug’s safety and benefit for patients.The White House cast the decision as a victory for Trump’s efforts “to deliver cutting-edge treatments with highly promising results to protect the health and safety of the most vulnerable Americans,” according to a statement from spokesman Michael Bars.___

2nd emergency use of a COVID-19 antibody drug approved

OMAHA, Neb. (AP) — Nebraska Gov. Pete Ricketts is acknowledging that state officials should have moved more quickly to interview people who contracted the coronavirus in recent weeks so they could warn others who may have been exposed.

 Ricketts says the recent surge in virus cases created a backlog of people who needed to be called, and officials within his administration didn’t add more workers to help with the extra workload. 

The state now has a backlog of 2,600 people who still need to contacted. 

Some people who tested positive recently have waited more than a week for one of the state’s “contract tracers” to ask where they’ve been and who they might have infected, part of a broader effort to slow the virus’ spread.

OMAHA, Neb. (AP) — Nebraska Gov. Pete Ricketts is acknowledging that state officials should have moved more quickly to interview people who contracted the coronavirus in recent weeks so they could warn others who may have been exposed. Ricketts says the recent surge in virus cases created a backlog of people who needed to be called, and officials within his administration didn’t add more workers to help with the extra workload. The state now has a backlog of 2,600 people who still need to contacted. Some people who tested positive recently have waited more than a week for one of the state’s “contract tracers” to ask where they’ve been and who they might have infected, part of a broader effort to slow the virus’ spread.

Ricketts: 'We didn't do our job' with recent virus-tracing

Five additional COVID-related deaths in the Panhandle are being reported: a Cheyenne County male in his 70s, two Morrill County males, one in his 60s and one in his 90s, a Scotts Bluff County male in his 60s, and a Sheridan County male in his 90s. This brings the total deaths in the Panhandle to 47.

“We share our deepest sympathy with the friends and loved ones of these gentlemen. As we enter November and December, a time of traditional gratitude sharing, please keep our most vulnerable Panhandle residents in your hearts. This is not the time to let our guard down so we all can remain safe during the COVID pandemic,” expressed Kim Engel, Panhandle Public Health District Director.

This public health emergency requires the public to be caring citizens and to contribute to the solution for the sake of our communities and those we love.

As individuals and as communities, we have the power to choose our actions in the COVID response and recovery process. We can again reverse the trends if everyone comes together to take important steps in our daily lives to protect our communities.

Panhandle Public Health District, Region 21, 22, and 23 Emergency Management, and Scotts Bluff County Health Department are working as a unified command on this evolving situation. Essential updates will be regularly communicated to the public and community partners.

The Panhandle COVID dashboard is updated weekdays at 4:30 pm MT and available at&nbsp;<a href="http://www.pphd.org/" target="_blank">www.pphd.org</a>. For the most up to date information from the CDC, visit&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">https://www.cdc.gov/coronavirus/2019-ncov/index.html</a>.

Panhandle Public Health District is working together to improve the health, safety, and quality of life for all who live, learn, work, and play in the Panhandle.&nbsp; Our vision is that we are a healthier and safer Panhandle Community. Visit our website&nbsp;<a href="http://www.pphd.org/" target="_blank">www.pphd.org</a>.

By PPHDFive additional COVID-related deaths in the Panhandle are being reported: a Cheyenne County male in his 70s, two Morrill County males, one in his 60s and one in his 90s, a Scotts Bluff County male in his 60s, and a Sheridan County male in his 90s. This brings the total deaths in the Panhandle to 47.“We share our deepest sympathy with the friends and loved ones of these gentlemen. As we enter November and December, a time of traditional gratitude sharing, please keep our most vulnerable Panhandle residents in your hearts. This is not the time to let our guard down so we all can remain safe during the COVID pandemic,” expressed Kim Engel, Panhandle Public Health District Director.This public health emergency requires the public to be caring citizens and to contribute to the solution for the sake of our communities and those we love.As individuals and as communities, we have the power to choose our actions in the COVID response and recovery process. We can again reverse the trends if everyone comes together to take important steps in our daily lives to protect our communities.<a>Avoid the Three Cs:</a><ul>
 <li>Avoid Crowded Places – Avoid gathering in groups where you cannot maintain 6-feet of distance from others</li><li>Avoid Close Contact – Wear a mask over your nose and mouth or maintain 6-feet distance when you are spending more than 15 total minutes with people you don’t live with</li><li>Avoid Confined Spaces – Avoid enclosed spaces with poor ventilation</li>
 </ul>Panhandle Public Health District, Region 21, 22, and 23 Emergency Management, and Scotts Bluff County Health Department are working as a unified command on this evolving situation. Essential updates will be regularly communicated to the public and community partners.The Panhandle COVID dashboard is updated weekdays at 4:30 pm MT and available at&nbsp;<a href="http://www.pphd.org/" target="_blank">www.pphd.org</a>. For the most up to date information from the CDC, visit&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">https://www.cdc.gov/coronavirus/2019-ncov/index.html</a>.Panhandle Public Health District is working together to improve the health, safety, and quality of life for all who live, learn, work, and play in the Panhandle.&nbsp; Our vision is that we are a healthier and safer Panhandle Community. Visit our website&nbsp;<a href="http://www.pphd.org/" target="_blank">www.pphd.org</a>.

PPHD: 5 more virus related deaths reported in the Panhandle

LINCOLN, Neb. (AP) — Nebraska retained its status last month as the state with the nation’s lowest unemployment rate. 

According to data released Friday. Nebraska’s seasonally adjusted unemployment rate for October fell to 3%, down from 3.6% in September.

 U.S. Bureau of Labor Statistics numbers show Nebraska’s latest rate is less than half the national rate of 6.9%. 

Vermont and Iowa had the second- and third-lowest rates for October at 3.2% and 3.6%, respectively. 

Hawaii had the highest rate nationwide, at 14.3%. Nebraska’s rate has remained low compared to other states despite the coronavirus pandemic, which resulted in widespread business closures and layoffs.

LINCOLN, Neb. (AP) — Nebraska retained its status last month as the state with the nation’s lowest unemployment rate. According to data released Friday. Nebraska’s seasonally adjusted unemployment rate for October fell to 3%, down from 3.6% in September. U.S. Bureau of Labor Statistics numbers show Nebraska’s latest rate is less than half the national rate of 6.9%. Vermont and Iowa had the second- and third-lowest rates for October at 3.2% and 3.6%, respectively. Hawaii had the highest rate nationwide, at 14.3%. Nebraska’s rate has remained low compared to other states despite the coronavirus pandemic, which resulted in widespread business closures and layoffs.

Nebraska retains status with lowest unemployment in nation

LINCOLN, Neb.-Governor Pete Ricketts held a press conference at the State Capitol to provide an update on the State’s work to slow the spread of the coronavirus and protect hospitals. &nbsp;The Governor reminded Nebraskans that the State will move to the most restrictive “red” phase of its pandemic response when coronavirus hospitalizations reach 25% of staffed hospital beds in Nebraska.&nbsp; Currently, the State is in the “orange” phase, which is the second most restrictive.

Ashley Newmyer, Chief Data Strategist for the Nebraska Department of Health and Human Services (DHHS), joined the Governor for today’s briefing.&nbsp; She outlined the State’s work to increase resources to conduct contact tracing.

Coronavirus survivors Christina St. Hilaire and Elizabeth Griffith of Dwight shared their story of recovering from the coronavirus.

Dr. Gary Anthone, the State’s Chief Medical Officer and Director of the DHHS Division of Public Health, gave an update on the distribution of monoclonal antibodies in Nebraska.&nbsp; These antibodies are a new therapy, and they have potential to reduce the need for people with the coronavirus to require hospital care.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Currently, we have 983 coronavirus hospitalizations.&nbsp; That’s more than four times the amount we had on October 1st.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;To slow the spread and limit hospitalizations, we need every Nebraskan to stay committed to good health habits.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’re urging all Nebraskans to avoid the Three Cs:

§&nbsp;&nbsp;Avoid gathering in groups where you can’t maintain six-feet distance from others.

§&nbsp;&nbsp;Wear a mask or maintain six-feet distance when you’re with people you don’t live with.

§&nbsp;&nbsp;Avoid enclosed spaces with poor ventilation.&nbsp;

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Let’s all do our part to slow the spread so that we can protect our hospitals and help our healthcare workers.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Contact tracing is an important tool to slow the spread of the coronavirus.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;As a reminder, contact tracing is a confidential process that starts with a positive test result being reported to the state or local health department.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Next, a trained contact tracer calls the person who received a positive test result and asks them a series of questions about what symptoms they may be experiencing.&nbsp;

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The contact tracer also asks if they know where and when they were exposed, as well as who they were in close contact with during the few days prior to their symptom onset or positive test result.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Due to the rise in coronavirus cases, contact tracers are dealing with a high volume of work.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;To most efficiently manage the workload, we’ve taken the following temporary measures:

o&nbsp;&nbsp;Reducing the questions asked during the interview.

o&nbsp;&nbsp;Reducing the number of call attempts from five to two.

o&nbsp;&nbsp;Focusing on calling those who test positive for the coronavirus.

§&nbsp;&nbsp;We’ve temporarily suspended calling close contacts of positive cases.&nbsp; We’re asking people who’ve tested positive to notify their close contacts.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We are also increasing contact tracing staff.&nbsp; We’re activating our DHHS reserve contact tracers who had performed this work earlier in the year.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’re also working with PRC, Nelnet, and North End Teleservices to add additional contact tracers.

Christina St. Hilaire: Coronavirus Survivor Testimonial

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;A year-and-a-half ago, my mother was diagnosed with metastatic thyroid cancer. &nbsp;She was given 3-6 months to live at the time.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Thanks to the excellent care of the Southeast Nebraska Cancer Center, she’s still with us.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;In September, our family contracted the coronavirus despite taking a lot of precautions against it.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;My mother woke up feeling exhausted.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Initially, we thought her cancer was back.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;She developed a low-grade fever, loss of appetite, and some chest pain.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;I took her to Bryan Hospital, and she eventually tested positive for the coronavirus.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;At first, we monitored her symptoms.&nbsp; After she became much weaker, we took her to St. Elizabeth’s.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Her oxygen levels had fallen, and she had pneumonia in both lungs.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;She received convalescent plasma as a treatment, along with antibiotics.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Within a day of receiving the plasma, she had improved significantly.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;My mom has recovered amazingly well.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We don’t want people to be discouraged or to despair if they get coronavirus.&nbsp; There are great treatments available.

Dr. Gary Anthone: Coronavirus Treatment

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The monoclonal antibody therapy is a great breakthrough.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Scientists have been able to make a specific antibody to target the coronavirus (SARS-CoV-2).

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;This therapy can help prevent persons with the coronavirus from needing to go to the hospital.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The State of Nebraska has received our allocation of the monoclonal antibodies.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’ve set up a process of getting the antibodies to hospitals throughout the state.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’ve sent it to the hospitals first, since they have the capability of administering it on an outpatient basis.

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The therapy is already being used at this time, and we’re hopeful it will help to reduce the need for hospitalization.

Video from this afternoon’s press conference is available by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2Fbltorgwzix66uh2%2FPress%2520Conf%252011.20.2020.mp4%3Fdl%3D0&amp;data=04%7C01%7C%7C1980b9128a4041401e3708d88dbbff87%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637415185879079105%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&amp;sdata=iufDBGCIWbl0tUayDFYy62be1CpwhmJA92zG2l0GYHc%3D&amp;reserved=0" target="_blank">clicking here</a>.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605965209652.png" alt="Gov. Ricketts (TV screen) looks on as Christina St. Hilaire (podium) and her mother&nbsp;Elizabeth Griffith (left of podium) share their story of surviving the coronavirus." />
 <figcaption>Gov. Ricketts (TV screen) looks on as Christina St. Hilaire (podium) and her mother&nbsp;Elizabeth Griffith (left of podium) share their story of surviving the coronavirus.</figcaption>
 </figure>News Release Gov. Ricketts OfficeLINCOLN, Neb.-Governor Pete Ricketts held a press conference at the State Capitol to provide an update on the State’s work to slow the spread of the coronavirus and protect hospitals. &nbsp;The Governor reminded Nebraskans that the State will move to the most restrictive “red” phase of its pandemic response when coronavirus hospitalizations reach 25% of staffed hospital beds in Nebraska.&nbsp; Currently, the State is in the “orange” phase, which is the second most restrictive.Ashley Newmyer, Chief Data Strategist for the Nebraska Department of Health and Human Services (DHHS), joined the Governor for today’s briefing.&nbsp; She outlined the State’s work to increase resources to conduct contact tracing.Coronavirus survivors Christina St. Hilaire and Elizabeth Griffith of Dwight shared their story of recovering from the coronavirus.Dr. Gary Anthone, the State’s Chief Medical Officer and Director of the DHHS Division of Public Health, gave an update on the distribution of monoclonal antibodies in Nebraska.&nbsp; These antibodies are a new therapy, and they have potential to reduce the need for people with the coronavirus to require hospital care.Gov. Ricketts: Three Cs Reminder·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Currently, we have 983 coronavirus hospitalizations.&nbsp; That’s more than four times the amount we had on October 1st.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;To slow the spread and limit hospitalizations, we need every Nebraskan to stay committed to good health habits.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’re urging all Nebraskans to avoid the Three Cs:o&nbsp;&nbsp;Crowded Places§&nbsp;&nbsp;Avoid gathering in groups where you can’t maintain six-feet distance from others.o&nbsp;&nbsp;Close Contacts§&nbsp;&nbsp;Wear a mask or maintain six-feet distance when you’re with people you don’t live with.o&nbsp;&nbsp;Confined Spaces§&nbsp;&nbsp;Avoid enclosed spaces with poor ventilation.&nbsp;·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Let’s all do our part to slow the spread so that we can protect our hospitals and help our healthcare workers.Ashley Newmyer: Contact Tracing·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Contact tracing is an important tool to slow the spread of the coronavirus.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;As a reminder, contact tracing is a confidential process that starts with a positive test result being reported to the state or local health department.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Next, a trained contact tracer calls the person who received a positive test result and asks them a series of questions about what symptoms they may be experiencing.&nbsp;·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The contact tracer also asks if they know where and when they were exposed, as well as who they were in close contact with during the few days prior to their symptom onset or positive test result.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Due to the rise in coronavirus cases, contact tracers are dealing with a high volume of work.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;To most efficiently manage the workload, we’ve taken the following temporary measures:o&nbsp;&nbsp;Reducing the questions asked during the interview.o&nbsp;&nbsp;Reducing the number of call attempts from five to two.o&nbsp;&nbsp;Focusing on calling those who test positive for the coronavirus.§&nbsp;&nbsp;We’ve temporarily suspended calling close contacts of positive cases.&nbsp; We’re asking people who’ve tested positive to notify their close contacts.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We are also increasing contact tracing staff.&nbsp; We’re activating our DHHS reserve contact tracers who had performed this work earlier in the year.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’re also working with PRC, Nelnet, and North End Teleservices to add additional contact tracers.Christina St. Hilaire: Coronavirus Survivor Testimonial·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;A year-and-a-half ago, my mother was diagnosed with metastatic thyroid cancer. &nbsp;She was given 3-6 months to live at the time.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Thanks to the excellent care of the Southeast Nebraska Cancer Center, she’s still with us.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;In September, our family contracted the coronavirus despite taking a lot of precautions against it.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;My mother woke up feeling exhausted.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Initially, we thought her cancer was back.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;She developed a low-grade fever, loss of appetite, and some chest pain.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;I took her to Bryan Hospital, and she eventually tested positive for the coronavirus.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;At first, we monitored her symptoms.&nbsp; After she became much weaker, we took her to St. Elizabeth’s.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Her oxygen levels had fallen, and she had pneumonia in both lungs.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;She received convalescent plasma as a treatment, along with antibiotics.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Within a day of receiving the plasma, she had improved significantly.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;My mom has recovered amazingly well.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We don’t want people to be discouraged or to despair if they get coronavirus.&nbsp; There are great treatments available.Dr. Gary Anthone: Coronavirus Treatment·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The monoclonal antibody therapy is a great breakthrough.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Scientists have been able to make a specific antibody to target the coronavirus (SARS-CoV-2).·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;This therapy can help prevent persons with the coronavirus from needing to go to the hospital.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The State of Nebraska has received our allocation of the monoclonal antibodies.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’ve set up a process of getting the antibodies to hospitals throughout the state.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;We’ve sent it to the hospitals first, since they have the capability of administering it on an outpatient basis.·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The therapy is already being used at this time, and we’re hopeful it will help to reduce the need for hospitalization.Video from this afternoon’s press conference is available by&nbsp;<a href="https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.dropbox.com%2Fs%2Fbltorgwzix66uh2%2FPress%2520Conf%252011.20.2020.mp4%3Fdl%3D0&amp;data=04%7C01%7C%7C1980b9128a4041401e3708d88dbbff87%7C043207dfe6894bf6902001038f11f0b1%7C0%7C0%7C637415185879079105%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&amp;sdata=iufDBGCIWbl0tUayDFYy62be1CpwhmJA92zG2l0GYHc%3D&amp;reserved=0" target="_blank">clicking here</a>.

Gov. Ricketts, DHHS leaders discuss ramping up contact tracing

LINCOLN – The Nebraska State College System Board of Trustees convened for&nbsp;<a href="https://www.nscs.edu/board-materials/2020/2020-11-12-Nov-Mtg" target="_blank">its regular business meeting Thursday</a>&nbsp;via videoconferencing systems at the three state colleges and the System Office’s location in Lincoln.

The meeting was originally scheduled to be hosted by Wayne State College, but due to rising cases of COVID-19 in Nebraska, the meeting occurred virtually.

The Board approved several items that directly impact Chadron State College, including the approval of a new comprehensive major in the English department. Chadron State College will now offer a Bachelor of Arts in Advanced English Studies in response to the growing number of students who minor in Creative Writing.

“We are obviously pleased that the Board approved our proposed new comprehensive major. This is the culmination of a variety of changes we have made to our program starting about six or seven years ago when we hired our first full-time Writing Specialist with an emphasis on growing the Creative Writing portion of our program,” said Department Chair and Professor Dr. Matt Evertson. “Whereas we formerly offered just one creative writing course, in 2015 we adopted a new introduction to creative writing course, and upper-division courses in Fiction, Nonfiction and Poetry. Two years later, our Writing Minor became a Creative Writing Minor, with the addition of a final creative project or capstone. In the few years since these changes, we have seen our ranks of creative writing students grow from just a couple each year to over 30.”

The Board also approved an amendment to the college’s agreement with the City of Chadron’s pool for college use, a revenue bond audit report for the fiscal year ending June 30, 2020, and waiving ACT/SAT scores for Board of Trustees’ scholarships, among other items.

Near the close of the meeting, Chancellor Paul Turman provided updates on the NSCS 2025 Strategic Plan and selecting Student Trustees.

Finally, Chadron State College reported it received six grants, including major funding for its TRiO and Upward Bound programs.

By CSC College Relations<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605902816371.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>LINCOLN – The Nebraska State College System Board of Trustees convened for&nbsp;<a href="https://www.nscs.edu/board-materials/2020/2020-11-12-Nov-Mtg" target="_blank">its regular business meeting Thursday</a>&nbsp;via videoconferencing systems at the three state colleges and the System Office’s location in Lincoln.The meeting was originally scheduled to be hosted by Wayne State College, but due to rising cases of COVID-19 in Nebraska, the meeting occurred virtually.The Board approved several items that directly impact Chadron State College, including the approval of a new comprehensive major in the English department. Chadron State College will now offer a Bachelor of Arts in Advanced English Studies in response to the growing number of students who minor in Creative Writing.“We are obviously pleased that the Board approved our proposed new comprehensive major. This is the culmination of a variety of changes we have made to our program starting about six or seven years ago when we hired our first full-time Writing Specialist with an emphasis on growing the Creative Writing portion of our program,” said Department Chair and Professor Dr. Matt Evertson. “Whereas we formerly offered just one creative writing course, in 2015 we adopted a new introduction to creative writing course, and upper-division courses in Fiction, Nonfiction and Poetry. Two years later, our Writing Minor became a Creative Writing Minor, with the addition of a final creative project or capstone. In the few years since these changes, we have seen our ranks of creative writing students grow from just a couple each year to over 30.”The Board also approved an amendment to the college’s agreement with the City of Chadron’s pool for college use, a revenue bond audit report for the fiscal year ending June 30, 2020, and waiving ACT/SAT scores for Board of Trustees’ scholarships, among other items.Near the close of the meeting, Chancellor Paul Turman provided updates on the NSCS 2025 Strategic Plan and selecting Student Trustees.Finally, Chadron State College reported it received six grants, including major funding for its TRiO and Upward Bound programs.

Nebraska State College System Board of Trustees hosts virtual meeting

🎙Post Podcast: Alliance City Council meeting, Nov. 17

A special COVID-19 announcement was added to the Alliance City Council agenda for the Nov. 17 meeting. Three Box Butte General Hospital staff members were in attendance to stress the importance of the community coming together to help slow the spread of the virus.&nbsp; Alliance Mayor Mike Dafney had the COVID-19 announcement added to the agenda after a special meeting on Nov. 16 with Panhandle Public Health District, Mayors and County Commissioners throughout the panhandle, and hospital personnel.&nbsp; "This is a dire pandemic," said Dafney. "As far as I heard we're just about at panic mode. There's a lot of things that people aren't understanding about this and consequences. We're kind of divided on just how serious it is. Just in the last 24 hours here in the United States we've had 156,000 cases. Some of the things that aren't being thought of, is our hospitals are filling up with COVID and we have other things going on like heart attacks. This makes it hard to get everything done. People aren't realizing that if you catch it, a loved one catches it...they're going to be in there by themselves. I've asked some of the medical people in the panhandle and the community to be here tonight to give us a recap of what they're faced with and what they're trying to deal with...and how important these masks are." Box Butte General Hospital CEO Lori Mazanec stressed to the public that panhandle citizens need to come together to fight this pandemic. "For the seventh week in a row, Nebraska set records for COVID-19 cases," said Mazanec. "The state also recorded a new weekly high for deaths related to the novel coronavirus.&nbsp;The deaths of 74 Nebraskans were reported during the seven-day period that ended Saturday. That was up from 55 deaths reported in each of the previous two weeks.&nbsp;The number of patients hospitalized with COVID-19 in Nebraska peaked at 918 on Friday, then dipped to 889 Saturday before rising to 914 on Sunday." Mazanec said the panhandle reported 138 new cases today[Nov. 17], with 7 additional deaths. "Box Butte County currently has 110 active cases and 2 related deaths," Mazanec stated. "The largest number of our positive cases is among the 20-49 age group, which is likely they are healthy enough to not be hospitalized, however we have no way to tell if they quarantined during their illness and maintained the isolation for the full recommended 14 days."

The State of Nebraska issued a new Directed Health Measure (DHM) effective statewide as of Monday, Nov. 16.&nbsp; "This basically secured our decision early last week which temporarily halts elective surgeries requiring an overnight stay and that can wait four weeks or longer without substantially changing a patient’s outcome," Manzanec continued.&nbsp; "Of course, this impacts our financial viability, but also delays care for our patients. "The Nebraska State COVID Transfer Center was established earlier this year out of the dire need for hospitals to help find acceptance to a higher level of care", said Mazanec. "The Transfer Center is a 24/7 service designed to mitigate the impact of hospitalization surges resulting from COVID-19. Hospitals seeking to transfer patients with COVID-19 or suspected to have COVID-19 are strongly encouraged to use the State Transfer Center. Clinical staff will seek placement at the nearest hospital with the capability and capacity to care for the patient. Due to the significant rise in COVID-19 and the corresponding impact on hospitals across the state, patient preference will not be a consideration in determining where the patient will transfer. If contacting a hospital through normal transfer processes, you may be redirected to the State COVID Transfer Center due to capacity constraints. There have also been many instances where patients are transferred out of state. The nearest facility having bed availability – St. Louis, MO, Iowa hospitals, and Salt Lake City, Utah are just a few instances of transfers from this area." Box Butte General Hospital Covid hospitalizations over the past three weeks have ranged from 5 to 12 patients at a given time. "This has been as high as 67% of our total staffed beds and continues to impact admissions overall", Mazanec said.&nbsp; "The care requires isolation protocols and focused on one to one care. BBGH has 25 beds, we have seen multiple days where we had 21 and 22 patients in beds at one time. This is when we see the stress not knowing when the next ambulance will bring an ill patient or some other family walks through the front door. We have seen the impact of not being able to transfer a patient out due to hospitals not accepting patients, Covid or otherwise." "To illustrate the growth in cases, which has impacted overall hospitalizations, our daily case totals did: the first of September, Box Butte County had 32 total cases," Mazanec said. "By September 17, we had doubled our cases to 58. By October 1, showed 103 overall confirmed cases. By November 1, the total was 348, and now currently sit at 514 with 110 active cases. So that is a few of the statistics and facts. This doesn’t even compare to the emotional, mental, and physical fatigue and strain this is placing on our staff caring for these patients. Initially, 8 months ago, we saw the mental fatigue from all the planning and preparation for what seemed like nothing would come. Fast forward to now, and it has multiplied to the impact of exhaustion. Just last week, the difficult decision to allow one family member to be in the hospital as a loved one dies was made. Who wants to make that decision? I never thought I would be put in a position to weigh the risks of having a healthy person into an isolation room so they could hold the hand of their loved one. This is our reality right now. While it may not have impacted you yet, it will. I pray it only impacts you with the mild symptoms so many are fortunate to get. But we are now seeing it is not discriminating to anyone. Even the healthy are succumbing to this virus." "We are asking for a unified stance from our community leaders to promote the essentials of keeping the virus from spreading faster", Mazanec added. "These things will slow the virus. I’ve always said we cannot stop it from spreading, however we can control the pace. We must have the community get behind and stand with us on: wearing a mask in public or places where there are other people; washing or sanitizing your hands frequently, and watching your distance with other people. Avoid large groups and even small groups of larger than 6-8 people." Box Butte General Hospital PA-C – Emergency Department&nbsp;Steve Van Noy echoed what Mazanec spoke about.&nbsp; "It's been very eye opening the last few months," Van Noy said. "It's frightening to have somebody suffocate in front of me. They asked me if they were going to die...and I knew what the answer was. It's&nbsp;frustrating when we don't see people wearing masks and then I see the same people in the ER. And then they test positive for COVID. They're some of the same people that put some of the odd arguments out as to why they don't need to wear [a mask], but it is a life saver. The panhandle of Nebraska is just out of control right now. I can't believe how many deaths there's been. I can't believe how many positive cases there's been." Van Noy told all in attendance that his daughter got the virus and didn't do very well. She ended up in the ER four different times.&nbsp; "It's frustrating. It's scary," Van Noy added. "It's making going to work not very much fun anymore. I see so many positive cases. Two weeks ago when I worked I couldn't ship anybody to Rapid City, Omaha, Cheyenne, Fort Collins, and Loveland. I finally called Denver Health and they had three beds. It was scary. I thought I wasn't going to get this patient out and this wasn't a COVID patient. We're getting killed by this and I feel like we can control it. We can do a better job at controlling it."

A lot of people are getting upset about wearing masks.&nbsp; "I don't understand why," Van Noy added. "We have to wear a seat belt. I have to wear a helmet when I ride my motorcycle. So why not wear a mask, I don't understand it. We're all peaking out and tired. We've had more staff get sick than what I'd like to admit. That's just put us all in a bind. It just doesn't seem like things are getting any better. As Lori said the numbers are doubling every fourteen days. It's frightening...it's frightening. I can't look at any of you and tell you who's going to do well with it and who's going to get sick and die with it." After Van Noy was done speaking, BBGH&nbsp;MD - Hospitalist Terri Myers came up to the&nbsp;podium.&nbsp; "I take care of most, if not all of the patients who are admitted to the hospital for any reason," said Myers. "I have never experienced a patient load like we've had in the last three to four weeks. As Lori said we can hold up to 25 patients. In the last three or four weeks we've consistently had upwards of 18, 19, 20 patients. We're not seeing that outflux like we normally get. We are seeing COVID patients who aren't able to be dismissed in the normal 3 or 4 days.&nbsp; Are typical illnesses that we admit people for are chest pain to make sure they're not having a heart attack, pneumonia, heart failure...that kind of stuff...this is different, this is taking a hospitalization to the next level. These patients don't go home in 3 or 4 days. Most of them are there 5 to 10 days, if not more." Myers said her nurses are taking care of COVID patients day after day. She said some days nurses aren't getting a lunch break

"We have excellent nurses. Our staff right now is just&nbsp;phenomenal," Myrers added. "I can't tell you enough about them. We're all here for the patients. That's our number one priority. Second to that, they're the ones that keep me coming everyday. I said if you guys can do this, I can do this. We work together very well as a team. I love my nurses and I wish I could do more to help them. I try to do as much as I can with patient care when I'm in the rooms because these patients are in isolation. Which means that every trip into a patients room needs an N95 face mask, a face shield, a gown and gloves. You do what you need to do with the patient...come back out...as you're coming out you take off the gown and gloves. The face shield and N95 mask can stay if you're going into another room. You wash your hands, you go put on a new gown and gloves and into the next room. It's just&nbsp;cumbersome to have to do that every time you go into take care of a patient. It's fatiguing to say the least for our nurses." Myers said she thinks there is a disregard in the community from what hospital staff and public health officials are advising people to do with the virus.&nbsp; "I went to a store in town two days ago on Sunday," said Myrers. "Myself and one other nurse that I ran into were the only ones in the store wearing masks including all of the employees. Maybe these people don't mean it to be this way, but I kind of take it as a disregard...you know that they don't feel like it's a big deal. When we try to tell people it's a big deal, they don't believe us. I think it would be a great thing to have the backing of our community leaders to say, 'hey Box Butte County this is a big deal...this is something we need to step up and get this under control." Mayor Dafney replied by saying, "We're just going to have to keep pounding it and pounding it." "It's doing exactly what it said it was going to do here," said Dafney. " They predicted it would start moving in and that's where we are at. I've been&nbsp;reluctant to even throw this out to council...on a mask mandate. We're so divided. The enforcement on something like that is hard. I hate putting things out there, but we do have the authority if we decide to...to mandate this town to mask up. I know that makes legal a little nervous because we're going to have those out there that protest it. When I requested that we mask up here [city council]...I no more go home and got a call from two to three people that were so upset. One of them was so upset that he'd never vote for me again. I could give a damn. That's&nbsp;asinine. But I'm putting that out there, council has the authority to do that if this thing gets too far away from us...we'll look at it." Councilwoman Annora Bentley replied to Dafney's comments. She said her mother just passed away from the virus. "I would like to beg everyone to wear a mask," said Bentley. "Because you don't want to have to go through what my family has just gone through. Not being able to see your Mother in the hospital. You should not have to depend upon a nurse to hold her hand while she's dying. Those nurses didn't sign up for that. I wish we would have a mask mandate. Thank you for all of the caring that you provided."&nbsp;&nbsp;

By Kalin Krohe, Panhandle PostA special COVID-19 announcement was added to the Alliance City Council agenda for the Nov. 17 meeting. Three Box Butte General Hospital staff members were in attendance to stress the importance of the community coming together to help slow the spread of the virus.&nbsp; Alliance Mayor Mike Dafney had the COVID-19 announcement added to the agenda after a special meeting on Nov. 16 with Panhandle Public Health District, Mayors and County Commissioners throughout the panhandle, and hospital personnel.&nbsp; "This is a dire pandemic," said Dafney. "As far as I heard we're just about at panic mode. There's a lot of things that people aren't understanding about this and consequences. We're kind of divided on just how serious it is. Just in the last 24 hours here in the United States we've had 156,000 cases. Some of the things that aren't being thought of, is our hospitals are filling up with COVID and we have other things going on like heart attacks. This makes it hard to get everything done. People aren't realizing that if you catch it, a loved one catches it...they're going to be in there by themselves. I've asked some of the medical people in the panhandle and the community to be here tonight to give us a recap of what they're faced with and what they're trying to deal with...and how important these masks are." Box Butte General Hospital CEO Lori Mazanec stressed to the public that panhandle citizens need to come together to fight this pandemic. "For the seventh week in a row, Nebraska set records for COVID-19 cases," said Mazanec. "The state also recorded a new weekly high for deaths related to the novel coronavirus.&nbsp;The deaths of 74 Nebraskans were reported during the seven-day period that ended Saturday. That was up from 55 deaths reported in each of the previous two weeks.&nbsp;The number of patients hospitalized with COVID-19 in Nebraska peaked at 918 on Friday, then dipped to 889 Saturday before rising to 914 on Sunday." Mazanec said the panhandle reported 138 new cases today[Nov. 17], with 7 additional deaths. "Box Butte County currently has 110 active cases and 2 related deaths," Mazanec stated. "The largest number of our positive cases is among the 20-49 age group, which is likely they are healthy enough to not be hospitalized, however we have no way to tell if they quarantined during their illness and maintained the isolation for the full recommended 14 days."<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605736835091.jpeg" alt="Box Butte General Hospital CEO Lori Mazanec&nbsp;" />
 <figcaption>Box Butte General Hospital CEO Lori Mazanec&nbsp;</figcaption>
 </figure>The State of Nebraska issued a new Directed Health Measure (DHM) effective statewide as of Monday, Nov. 16.&nbsp; "This basically secured our decision early last week which temporarily halts elective surgeries requiring an overnight stay and that can wait four weeks or longer without substantially changing a patient’s outcome," Manzanec continued.&nbsp; "Of course, this impacts our financial viability, but also delays care for our patients. "The Nebraska State COVID Transfer Center was established earlier this year out of the dire need for hospitals to help find acceptance to a higher level of care", said Mazanec. "The Transfer Center is a 24/7 service designed to mitigate the impact of hospitalization surges resulting from COVID-19. Hospitals seeking to transfer patients with COVID-19 or suspected to have COVID-19 are strongly encouraged to use the State Transfer Center. Clinical staff will seek placement at the nearest hospital with the capability and capacity to care for the patient. Due to the significant rise in COVID-19 and the corresponding impact on hospitals across the state, patient preference will not be a consideration in determining where the patient will transfer. If contacting a hospital through normal transfer processes, you may be redirected to the State COVID Transfer Center due to capacity constraints. There have also been many instances where patients are transferred out of state. The nearest facility having bed availability – St. Louis, MO, Iowa hospitals, and Salt Lake City, Utah are just a few instances of transfers from this area." Box Butte General Hospital Covid hospitalizations over the past three weeks have ranged from 5 to 12 patients at a given time. "This has been as high as 67% of our total staffed beds and continues to impact admissions overall", Mazanec said.&nbsp; "The care requires isolation protocols and focused on one to one care. BBGH has 25 beds, we have seen multiple days where we had 21 and 22 patients in beds at one time. This is when we see the stress not knowing when the next ambulance will bring an ill patient or some other family walks through the front door. We have seen the impact of not being able to transfer a patient out due to hospitals not accepting patients, Covid or otherwise." "To illustrate the growth in cases, which has impacted overall hospitalizations, our daily case totals did: the first of September, Box Butte County had 32 total cases," Mazanec said. "By September 17, we had doubled our cases to 58. By October 1, showed 103 overall confirmed cases. By November 1, the total was 348, and now currently sit at 514 with 110 active cases. So that is a few of the statistics and facts. This doesn’t even compare to the emotional, mental, and physical fatigue and strain this is placing on our staff caring for these patients. Initially, 8 months ago, we saw the mental fatigue from all the planning and preparation for what seemed like nothing would come. Fast forward to now, and it has multiplied to the impact of exhaustion. Just last week, the difficult decision to allow one family member to be in the hospital as a loved one dies was made. Who wants to make that decision? I never thought I would be put in a position to weigh the risks of having a healthy person into an isolation room so they could hold the hand of their loved one. This is our reality right now. While it may not have impacted you yet, it will. I pray it only impacts you with the mild symptoms so many are fortunate to get. But we are now seeing it is not discriminating to anyone. Even the healthy are succumbing to this virus." "We are asking for a unified stance from our community leaders to promote the essentials of keeping the virus from spreading faster", Mazanec added. "These things will slow the virus. I’ve always said we cannot stop it from spreading, however we can control the pace. We must have the community get behind and stand with us on: wearing a mask in public or places where there are other people; washing or sanitizing your hands frequently, and watching your distance with other people. Avoid large groups and even small groups of larger than 6-8 people." Box Butte General Hospital PA-C – Emergency Department&nbsp;Steve Van Noy echoed what Mazanec spoke about.&nbsp; "It's been very eye opening the last few months," Van Noy said. "It's frightening to have somebody suffocate in front of me. They asked me if they were going to die...and I knew what the answer was. It's&nbsp;frustrating when we don't see people wearing masks and then I see the same people in the ER. And then they test positive for COVID. They're some of the same people that put some of the odd arguments out as to why they don't need to wear [a mask], but it is a life saver. The panhandle of Nebraska is just out of control right now. I can't believe how many deaths there's been. I can't believe how many positive cases there's been." Van Noy told all in attendance that his daughter got the virus and didn't do very well. She ended up in the ER four different times.&nbsp; "It's frustrating. It's scary," Van Noy added. "It's making going to work not very much fun anymore. I see so many positive cases. Two weeks ago when I worked I couldn't ship anybody to Rapid City, Omaha, Cheyenne, Fort Collins, and Loveland. I finally called Denver Health and they had three beds. It was scary. I thought I wasn't going to get this patient out and this wasn't a COVID patient. We're getting killed by this and I feel like we can control it. We can do a better job at controlling it."<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605737135126.jpeg" alt="Box Butte General Hospital PA-C – Emergency Department Steve Van Noy" />
 <figcaption>Box Butte General Hospital PA-C – Emergency Department Steve Van Noy</figcaption>
 </figure>A lot of people are getting upset about wearing masks.&nbsp; "I don't understand why," Van Noy added. "We have to wear a seat belt. I have to wear a helmet when I ride my motorcycle. So why not wear a mask, I don't understand it. We're all peaking out and tired. We've had more staff get sick than what I'd like to admit. That's just put us all in a bind. It just doesn't seem like things are getting any better. As Lori said the numbers are doubling every fourteen days. It's frightening...it's frightening. I can't look at any of you and tell you who's going to do well with it and who's going to get sick and die with it." After Van Noy was done speaking, BBGH&nbsp;MD - Hospitalist Terri Myers came up to the&nbsp;podium.&nbsp; "I take care of most, if not all of the patients who are admitted to the hospital for any reason," said Myers. "I have never experienced a patient load like we've had in the last three to four weeks. As Lori said we can hold up to 25 patients. In the last three or four weeks we've consistently had upwards of 18, 19, 20 patients. We're not seeing that outflux like we normally get. We are seeing COVID patients who aren't able to be dismissed in the normal 3 or 4 days.&nbsp; Are typical illnesses that we admit people for are chest pain to make sure they're not having a heart attack, pneumonia, heart failure...that kind of stuff...this is different, this is taking a hospitalization to the next level. These patients don't go home in 3 or 4 days. Most of them are there 5 to 10 days, if not more." Myers said her nurses are taking care of COVID patients day after day. She said some days nurses aren't getting a lunch break<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605737247628.jpeg" alt="Box Butte General Hospital MD - Hospitalist Terri Myers&nbsp;" />
 <figcaption>Box Butte General Hospital MD - Hospitalist Terri Myers&nbsp;</figcaption>
 </figure>"We have excellent nurses. Our staff right now is just&nbsp;phenomenal," Myrers added. "I can't tell you enough about them. We're all here for the patients. That's our number one priority. Second to that, they're the ones that keep me coming everyday. I said if you guys can do this, I can do this. We work together very well as a team. I love my nurses and I wish I could do more to help them. I try to do as much as I can with patient care when I'm in the rooms because these patients are in isolation. Which means that every trip into a patients room needs an N95 face mask, a face shield, a gown and gloves. You do what you need to do with the patient...come back out...as you're coming out you take off the gown and gloves. The face shield and N95 mask can stay if you're going into another room. You wash your hands, you go put on a new gown and gloves and into the next room. It's just&nbsp;cumbersome to have to do that every time you go into take care of a patient. It's fatiguing to say the least for our nurses." Myers said she thinks there is a disregard in the community from what hospital staff and public health officials are advising people to do with the virus.&nbsp; "I went to a store in town two days ago on Sunday," said Myrers. "Myself and one other nurse that I ran into were the only ones in the store wearing masks including all of the employees. Maybe these people don't mean it to be this way, but I kind of take it as a disregard...you know that they don't feel like it's a big deal. When we try to tell people it's a big deal, they don't believe us. I think it would be a great thing to have the backing of our community leaders to say, 'hey Box Butte County this is a big deal...this is something we need to step up and get this under control." Mayor Dafney replied by saying, "We're just going to have to keep pounding it and pounding it." "It's doing exactly what it said it was going to do here," said Dafney. " They predicted it would start moving in and that's where we are at. I've been&nbsp;reluctant to even throw this out to council...on a mask mandate. We're so divided. The enforcement on something like that is hard. I hate putting things out there, but we do have the authority if we decide to...to mandate this town to mask up. I know that makes legal a little nervous because we're going to have those out there that protest it. When I requested that we mask up here [city council]...I no more go home and got a call from two to three people that were so upset. One of them was so upset that he'd never vote for me again. I could give a damn. That's&nbsp;asinine. But I'm putting that out there, council has the authority to do that if this thing gets too far away from us...we'll look at it." Councilwoman Annora Bentley replied to Dafney's comments. She said her mother just passed away from the virus. "I would like to beg everyone to wear a mask," said Bentley. "Because you don't want to have to go through what my family has just gone through. Not being able to see your Mother in the hospital. You should not have to depend upon a nurse to hold her hand while she's dying. Those nurses didn't sign up for that. I wish we would have a mask mandate. Thank you for all of the caring that you provided."&nbsp;&nbsp;

BBGH, Alliance council implore citizens to take COVID serious and wear a mask

OMAHA, Neb. (AP) — More Nebraska cities are making moves to require faces coverings in public as the coronavirus outbreak worsens in the state and across the country.

 The Omaha World-Herald reports that the Omaha suburbs of Bellevue, Papillion, Ralston, Gretna and La Vista are either weighing or have scheduled emergency meetings to consider requiring masks in public.

 Earlier in the week, the cities of Beatrice and Kearney passed mask mandates. 

Grand Island will consider doing so next week. 

The uptick in such mandates comes as Nebraska set a record for hospitalizations across the state, with 983 people hospitalized on Thursday.

OMAHA, Neb. (AP) — More Nebraska cities are making moves to require faces coverings in public as the coronavirus outbreak worsens in the state and across the country. The Omaha World-Herald reports that the Omaha suburbs of Bellevue, Papillion, Ralston, Gretna and La Vista are either weighing or have scheduled emergency meetings to consider requiring masks in public. Earlier in the week, the cities of Beatrice and Kearney passed mask mandates. Grand Island will consider doing so next week. The uptick in such mandates comes as Nebraska set a record for hospitalizations across the state, with 983 people hospitalized on Thursday.

More Nebraska cities adopting mask orders as outbreak rages

Pfizer said Friday it is asking U.S. regulators to allow emergency use of its COVID-19 vaccine, starting the clock on a process that could bring limited first shots as early as next month and eventually an end to the pandemic -- but not until after a long, hard winter.

The action comes days after Pfizer Inc. and its German partner BioNTech announced that its vaccine appears 95% effective at preventing mild to severe COVID-19 disease in a large, ongoing study.

The companies said that protection plus a good safety record means the vaccine should qualify for emergency use authorization, something the Food and Drug Administration can grant before the final testing is fully complete. In addition to Friday's FDA submission, they have already started “rolling” applications in Europe and the U.K. and intend to submit similar information soon.

With the coronavirus surging around the U.S. and the world, the pressure is on for regulators to make a speedy decision.

“Help is on the way,” Dr. Anthony Fauci, the top U.S. infectious disease expert said on the eve of Pfizer's announcement, adding that it's too early to abandon masks and other protective measures. “We need to actually double down on the public health measures as we're waiting for that help to come.”

Friday’s filing sets off a chain of events as the FDA and its independent advisers debate if the shots are ready. If so, still another government group will have to decide how the initial limited supplies are rationed out to anxiously awaiting Americans.

How much vaccine is available and when is a moving target, but initial supplies will be scarce and rationed. About 25 million doses of the Pfizer vaccine may become available in December, 30 million in January and 35 million more in February and March, according to information presented to the National Academy of Medicine this week. Recipients will need two doses, three weeks apart.

Not far behind is competitor Moderna Inc.’s COVID-19 vaccine. Its early data suggests the shots are as strong as Pfizer’s, and that company expects to also seek emergency authorization within weeks.

The public’s first chance to see how strong the evidence really is will come in early December at a public meeting of the FDA’s scientific advisers.

So far, what's known is based only on statements from Pfizer and BioNTech. Of 170 infections detected to date, only eight were among people who'd received the actual vaccine and the rest had gotten a dummy shot. On the safety side, the companies cites results from 38,000 study participants who've been tracked for two months after their second dose. That's a milestone FDA set because historically, vaccine side effects don't crop up later than that.

“We’ll drill down on these data,” said FDA adviser Dr. Paul Offit of the Children’s Hospital of Philadelphia.

Think of it like science on trial. A few days before the meeting, the FDA will release its own internal analysis. That sets the stage for the advisers’ daylong debate about any signs of safety concerns and how the new vaccine technology works before rendering a verdict.

They’ll recommend not just whether FDA should allow broader use of the vaccine generally but if so, for whom. For example, is there enough proof the vaccine works as well for older, sicker adults as for younger, healthier people?

There’s still no guarantee. “We don’t know what that vote’s going to be,” said former FDA vaccine chief Norman Baylor.

EMERGENCY USE ISN’T THE SAME AS FULL APPROVAL

If there's an emergency green light, “that vaccine is still deemed investigational. It’s not approved yet,” Dr. Marion Gruber, chief of FDA’s vaccine office, told the National Academy of Medicine this week.

That means anyone offered an emergency vaccination must get a “fact sheet” describing potential benefits and risks before going through with the shot, she said.

There will be a lot of unknowns. For example, the 95% protection rate is based on people who developed symptoms and then were tested for the virus. Can the vaccinated get infected but have no symptoms, able to spread the virus? How long does protection last?

That’s why the 44,000-person study needs to keep running -- something difficult considering ethically, participants given dummy shots at some point must be offered real vaccine, complicating the search for answers.

And at least for now, pregnant women won't qualify because they weren't studied. Pfizer only recently began testing the vaccine in children as young as 12.

A decision on Pfizer's vaccine won't affect other COVID-19 vaccine candidates in the pipeline, which will be judged separately.

Brewing vaccine is more complex than typical drug manufacturing, yet the millionth dose to roll out of Pfizer’s Kalamazoo, Michigan, factory must be the same purity and potency as every dose before and after.

That means the FDA decision isn’t just based on study data, but on its determination that the vaccine is being made correctly.

The Pfizer-BioNTech vaccine -- and Moderna's shots -- are made with brand-new technology. They don’t contain the actual coronavirus. Instead, they’re made with a piece of genetic code for the “spike” protein that studs the virus.

That messenger RNA, or mRNA, instructs the body to make some harmless spike protein, training immune cells to recognize it if the real virus eventually comes along.

Another government group -- advisers to the Centers for Disease Control and Prevention -- decides who is first in line for scarce doses. Health and Human Services Secretary Alex Azar said he hopes that decision can be made at the same time as FDA’s.

The Trump administration’s Operation Warp Speed has worked with states to line up how many doses they’d need to cover the populations offered vaccine first.

Pfizer will ship those supplies as ordered by the states -- only after FDA gives the OK.

Company projections of how much it will ship each month are just predictions, Baylor warned.

“It’s not like a pizza,” he said. Manufacturing is so complex that “you don’t necessarily end up with what you thought.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1604926559777.png" alt="Photo courtesy Pfizer" />
 <figcaption>Photo courtesy Pfizer</figcaption>
 </figure>BY LAURAN NEERGAARD, AP Medical WriterPfizer said Friday it is asking U.S. regulators to allow emergency use of its COVID-19 vaccine, starting the clock on a process that could bring limited first shots as early as next month and eventually an end to the pandemic -- but not until after a long, hard winter.The action comes days after Pfizer Inc. and its German partner BioNTech announced that its vaccine appears 95% effective at preventing mild to severe COVID-19 disease in a large, ongoing study.The companies said that protection plus a good safety record means the vaccine should qualify for emergency use authorization, something the Food and Drug Administration can grant before the final testing is fully complete. In addition to Friday's FDA submission, they have already started “rolling” applications in Europe and the U.K. and intend to submit similar information soon.With the coronavirus surging around the U.S. and the world, the pressure is on for regulators to make a speedy decision.“Help is on the way,” Dr. Anthony Fauci, the top U.S. infectious disease expert said on the eve of Pfizer's announcement, adding that it's too early to abandon masks and other protective measures. “We need to actually double down on the public health measures as we're waiting for that help to come.”Friday’s filing sets off a chain of events as the FDA and its independent advisers debate if the shots are ready. If so, still another government group will have to decide how the initial limited supplies are rationed out to anxiously awaiting Americans.How much vaccine is available and when is a moving target, but initial supplies will be scarce and rationed. About 25 million doses of the Pfizer vaccine may become available in December, 30 million in January and 35 million more in February and March, according to information presented to the National Academy of Medicine this week. Recipients will need two doses, three weeks apart.Not far behind is competitor Moderna Inc.’s COVID-19 vaccine. Its early data suggests the shots are as strong as Pfizer’s, and that company expects to also seek emergency authorization within weeks.Here’s what happens next:MAKING THE DATA PUBLICThe public’s first chance to see how strong the evidence really is will come in early December at a public meeting of the FDA’s scientific advisers.So far, what's known is based only on statements from Pfizer and BioNTech. Of 170 infections detected to date, only eight were among people who'd received the actual vaccine and the rest had gotten a dummy shot. On the safety side, the companies cites results from 38,000 study participants who've been tracked for two months after their second dose. That's a milestone FDA set because historically, vaccine side effects don't crop up later than that.“We’ll drill down on these data,” said FDA adviser Dr. Paul Offit of the Children’s Hospital of Philadelphia.Think of it like science on trial. A few days before the meeting, the FDA will release its own internal analysis. That sets the stage for the advisers’ daylong debate about any signs of safety concerns and how the new vaccine technology works before rendering a verdict.They’ll recommend not just whether FDA should allow broader use of the vaccine generally but if so, for whom. For example, is there enough proof the vaccine works as well for older, sicker adults as for younger, healthier people?There’s still no guarantee. “We don’t know what that vote’s going to be,” said former FDA vaccine chief Norman Baylor.EMERGENCY USE ISN’T THE SAME AS FULL APPROVALIf there's an emergency green light, “that vaccine is still deemed investigational. It’s not approved yet,” Dr. Marion Gruber, chief of FDA’s vaccine office, told the National Academy of Medicine this week.That means anyone offered an emergency vaccination must get a “fact sheet” describing potential benefits and risks before going through with the shot, she said.There will be a lot of unknowns. For example, the 95% protection rate is based on people who developed symptoms and then were tested for the virus. Can the vaccinated get infected but have no symptoms, able to spread the virus? How long does protection last?That’s why the 44,000-person study needs to keep running -- something difficult considering ethically, participants given dummy shots at some point must be offered real vaccine, complicating the search for answers.And at least for now, pregnant women won't qualify because they weren't studied. Pfizer only recently began testing the vaccine in children as young as 12.A decision on Pfizer's vaccine won't affect other COVID-19 vaccine candidates in the pipeline, which will be judged separately.MANUFACTURINGBrewing vaccine is more complex than typical drug manufacturing, yet the millionth dose to roll out of Pfizer’s Kalamazoo, Michigan, factory must be the same purity and potency as every dose before and after.That means the FDA decision isn’t just based on study data, but on its determination that the vaccine is being made correctly.The Pfizer-BioNTech vaccine -- and Moderna's shots -- are made with brand-new technology. They don’t contain the actual coronavirus. Instead, they’re made with a piece of genetic code for the “spike” protein that studs the virus.That messenger RNA, or mRNA, instructs the body to make some harmless spike protein, training immune cells to recognize it if the real virus eventually comes along.GETTING INTO PEOPLE’S ARMSAnother government group -- advisers to the Centers for Disease Control and Prevention -- decides who is first in line for scarce doses. Health and Human Services Secretary Alex Azar said he hopes that decision can be made at the same time as FDA’s.The Trump administration’s Operation Warp Speed has worked with states to line up how many doses they’d need to cover the populations offered vaccine first.Pfizer will ship those supplies as ordered by the states -- only after FDA gives the OK.Company projections of how much it will ship each month are just predictions, Baylor warned.“It’s not like a pizza,” he said. Manufacturing is so complex that “you don’t necessarily end up with what you thought.”___

Pfizer seeking emergency use of its COVID-19 vaccine in US

The following COVID-related deaths in the Panhandle are being reported:

“We wish to express our sincerest condolences in the passing of eleven Panhandle residents.&nbsp;We send their friends and loved ones peace and comfort during their time of loss,” expressed Kim Engel, Panhandle Public Health District Director.

The fall and winter holiday seasons are traditionally a time to gather with loved ones and celebrate. Participating in virtual gatherings or limiting celebrations to with those within your own household pose the lowest risk for COVID spread. Please help slow the spread of COVID and preserve hospital capacity.

By PPHDThe following COVID-related deaths in the Panhandle are being reported:<ul>
 <li>Box Butte County female in her 80s</li><li>Dawes County male in his 80s</li><li>Grant County male in his 70s</li><li>Kimball County male in his 60s</li><li>Morrill County male in his 80s</li><li>Scotts Bluff County: Two females: one in her 60s and one in her 90s, Two males: one in his 60s and one his 70s</li><li>Sheridan County: two females in their 80s</li>
 </ul>“We wish to express our sincerest condolences in the passing of eleven Panhandle residents.&nbsp;We send their friends and loved ones peace and comfort during their time of loss,” expressed Kim Engel, Panhandle Public Health District Director.The fall and winter holiday seasons are traditionally a time to gather with loved ones and celebrate. Participating in virtual gatherings or limiting celebrations to with those within your own household pose the lowest risk for COVID spread. Please help slow the spread of COVID and preserve hospital capacity.If you choose to celebrate with people outside of your household, it is recommended to hold only small, outdoor gatherings and ensuring that attendees maintain a safe social distance.If you plan to host or attend a small, indoor celebration: wear a mask, keep your distance, wash your hands often, and limit the number of people who handle and serve food.Traveling increases your risk of exposure and the spread of COVID-19. The best way to prevent the spread of COVID this holiday season is to stay home.<ul>
 <li>Avoid the Three Cs:</li><li>Avoid Crowded Places – Avoid gathering in groups where you cannot maintain 6-feet of distance from others</li><li>Avoid Close Contact – Wear a mask over your nose and mouth or maintain 6-feet distance when you are spending more than 15 total minutes with people you don’t live with</li><li>Avoid Confined Spaces – Avoid enclosed spaces with poor ventilation</li>
 </ul>Unified Command confirms 444 more cases of COVID in the Panhandle since last reporting on Monday, November 16. Recoveries are available on the Panhandle dashboard at&nbsp;<a href="http://www.pphd.org/" target="_blank">www.pphd.org</a>.&nbsp;The investigations are underway, all close contacts will be quarantined.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/11/1605822843798.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>Testing information and access for the Panhandle area:<ul>
 <li>You can sign up for the following free testing at&nbsp;<a href="http://www.testnebraska.com/" target="_blank">Testnebraska.com</a>&nbsp;or 402-207-9377:</li><li>Box Butte General Hospital in&nbsp;Alliance: Monday-Friday, 9-10am</li><li>212 East 24th Street&nbsp; &nbsp;</li><li>Chadron&nbsp;Community Hospital: Mondays &amp; Fridays, 7-9am</li><li>821 Morehead Street (Old Hospital ER Entrance next to Wilson Park)</li><li>Other testing opportunities for symptomatic patients may be available through the hospital as ordered by your Primary Care Practitioner, call the hospital at 747-2466 with questions.</li><li>Gordon&nbsp;Memorial Hospital: Tuesdays &amp; Thursdays, 2-4pm</li><li>Regional West Health Services in&nbsp;Scottsbluff: Monday &amp; Wednesday, Noon-3pm; Tuesdays &amp; Fridays, 1pm-4pm; Call 308-630-2100 for other testing opportunities for symptomatic patients.</li><li>Sidney&nbsp;Regional Medical Center: Tuesdays, Wednesdays, &amp; Thursdays, 7-9:30am</li><li>Community Action Health Center in&nbsp;Gering: Tuesdays, Wednesdays, &amp; Thursdays, 7-8am</li><li>Testing is free, sign up at&nbsp;<a href="https://tinyurl.com/yydxr5mc" target="_blank">https://tinyurl.com/yydxr5mc</a></li><li>Alliance Community Pharmacy in&nbsp;Alliance: Monday-Friday, 7:30am-6pm; Saturday-Sunday, 9am-5pm</li><li>For people experiencing symptoms, same day results. Call 308-629-1045 for appointment, fee is $125.</li><li>Morrill County Community Hospital in&nbsp;Bridgeport: Daily</li><li>Call 308-262-1616 for testing, same day results, insurance can be billed.</li><li>Contact your local hospital or clinic for information on testing access.</li>
 </ul>

Coronavirus Update