The number of coronavirus cases is soaring.

The case count is the highest we've seen since the start of the pandemic, and the wave of illnesses caught is causing staff shortages across Southern Nevada.

♪♪♪ Support for Nevada Week is provided by Senator William H. Hernstadt and additional supporting sponsors.

(Kipp Ortenburger) Welcome to Nevada Week.

Well, a surge in coronavirus cases has left industries across Southern Nevada short-staffed.

We'll get to that part of the story in a moment, but first, joining us to talk about the spike in cases and what this most recent spike might signal for the future is Tabitha Mueller, a reporter for the Nevada Independent.

Tabitha, thank you so much for joining us.

-Thanks for having me on the show.

-You are one of the main components of what a lot of our viewers have been reading in the Nevada Independent, coronavirus contextualized, providing context and kind of that extra insight in what all the data means.

So Tabitha, I want to start there.

Let's talk about our current spike.

I mean, some really concerning numbers to the layperson like me, at least: Over 3,000 cases per day, our test positivity rate nearing 40%.

Just for reference, in November it was 5.8%, a huge precipitous climb right there, and of course hospitalization rates that we have not seen in any part of the pandemic itself.

I want to ask you, what are experts saying?

What is the data really saying as far as insight and where we are right now with this spike?

(Tabitha Mueller) So right now we're definitely in this third wave of COVID-19, and what it's caused by is this omicron variant.

The variant spreads more rapidly than any other variant we've seen, but health officials are saying it appears to be less severe than other strains.

So it's kind of burning through the population right now.

We're not at the end.

We're sort of in this weird middle part, and cases are very high.

We are seeing a bit of plateauing though, so it could go either way.

-Not as severe, but I think the public is interested in these hospitalization rates.

I want to bring one other statistic to this too: Nevada Hospital Association is reporting that 43% of patients right now that are being hospitalized are fully vaccinated.

That definitely leads to more of a severe type of illness here.

What are you hearing?

-So when we look and think about severity, we need to look at the rate that cases are increasing and the rate that hospitalizations are happening at.

When I say that it's less severe, I'm not saying people aren't getting hospitalized-- they are-- it's just that severity rate, the cases aren't going up at the same rate the hospitalizations are, if that makes sense.

-One thing that always comes up of course is our public's stamina to see this through.

Of course we've had many, many spikes.

This is another spike, this is a bigger spike.

Talking to the public here, are you getting any sense of just how resilient we still are to being able to carry forth with all the restrictions and mitigating efforts?

-So I want to ask you a little bit more on that resilience question.

Are you asking specifically about how are we able to handle this new wave, or are you asking about, you know, are we going to ever get out?

Are we going to get out of it?

I'm sorry, I just wanted clarification there.

-More so on the immediacy, yes.

Just how the public is reacting to this spike and still being able to adhere to some of our mask protocols and so forth.

-Right.

So masking mandates are in place in every county in Nevada right now.

Usually some of the rural counties, we've seen mask mandates be kind of loosened a little bit because the cases there tend to be a little bit lower.

But the governor's office has taken a hard stance of lives and livelihoods.

So they don't want to shut down the economy.

They are kind of seeing this as an opportunity to say hey, yes, cases are rising.

Take precautions, get vaccinated, wear a mask.

But in my interview with Dr. Pandori, Pandori even said we think this is heading to a level where this is just going to be present in the population continuously.

So health professionals from the Biden Administration all the way down to here at the public state health lab are saying just make sure you're taking every precaution possible, but it's likely that every single person is going to be getting this omicron variant.

-Yes, and let's transition to that.

We've got about two minutes left.

Let's talk about the debate between is this kind of the new normal, is this going to tail off?

Some experts are saying that, of course there's other experts that are saying because of the unpredictability of this virus, we could see something that is on the lines of a delta or even more severe.

What are you hearing as kind of the most convincing argument here?

-So I think first of all, no one has a crystal ball to know what's going to happen, but what we are seeing is looking at other cases in other countries, we've seen the United Kingdom cases there from the omicron variant have started to drop off.

We're expecting that to probably happen in the United States.

Dr. Pandori said here in Nevada in January, we're probably likely to see a decreased caseload toward the end of this month.

And I think that what Pandori was saying and what other health professionals have said is we don't really know what's going to happen.

This is a totally unique virus in terms of the novel coronavirus.

This is a unique situation.

But what's likely to happen is we'll see the cases decrease until the next variant comes.

So I don't want to be the bearer of bad news, but I think it's probably going to be likely in the same way that we deal with the flu-- every year we're going to deal with COVID.

-Yes, and experts are saying or predicting about six months from the peak of omicron, we could see another variant which of course brings us to the peak we saw before in the summer if I'm doing the math correctly.

We've got just about a minute left, and I want to go to herd immunity really quick.

This of course was the be-all and end-all when we first started our vaccinations as the cure.

We have the World Health Organization saying and other experts saying that we can't necessarily achieve herd immunity anymore.

Is that what you're hearing?

-Yes, that's what I'm hearing.

If you do get the virus, you are "immune."

The antibodies are there for about six months is what they're saying.

So that's the current research.

-Tabitha, thank you very much.

We appreciate your time.

-Thank you guys for having me on.

-Staff shortages forced the Clark County School District to take a two-day pause and has some hospitals scrambling to get enough healthcare workers as hospitalization rates again increase.

Joining us to talk about the tough choices that leaders have had to make are CCSD Superintendent Dr. Jesus Jara; Dr. Jeff Murawsky, HCA Healthcare, Far West Division, chief medical officer, and Mason Van Houweling, CEO of University Medical Center.

Thank you so much for being here.

We really appreciate it.

Of course it's very eclectic, maybe at the surface, of having you all on together, but there are a lot of similarities on the challenges that you are dealing with, and I want to start with that.

Let's talk about the surge.

The segment prior to you, we talked about where the numbers are, some very concerning numbers on rates of course in hospitalization rates, but also test positivity rates that of course are affecting all of your core business and your work.

Mason, I want to start with you.

Let's talk about from a leader's perspective, what are some of the biggest challenges you're having right now?

(Mason Van Houweling) Well, certainly we've gone through different phases through this pandemic here in Las Vegas, and as I reflect, we're certainly at our all-time highs with hospitalizations and positivity.

Right now at UMC we're well over 100%, actually 106% of our licensed beds.

We're about 95% of our staff beds, but the hospitalizations are at a record high.

UMC, we also do our own testing with our patients but also for the community, and we're seeing our samples and our specimens coming in at 49% positivity, reflective of what's going on the community.

But we're definitely at the peak of this tidal wave here in Las Vegas.

-And talk about just the leadership aspect for you to be able to manage this of course.

Those are concerning numbers.

I'm sure they're very concerning for your staff, very concerning for patients as well.

I mean, how do you manage a spike like that?

-You know, my colleagues here, my friends from the beginning, we've been collaborating since the beginning quite frankly, and I'd like to talk about that later on.

But UMC in particular has always been prepared for crisis, whether you look at previous infectious disease or October 1 and the current pandemic.

You know, it's kind of in our DNA to prepare for crisis so we are uniquely positioned to be able to do that, and through our county partners, our state partners, our community partners as well, our academic partners, we've really positioned ourselves well.

And I think reflective of this is constant preparation.

We drill for these types of things constantly whether it's mass casualty or pandemics or other unique exercises.

We all do a really good job of working together to be prepared for things like this.

Certainly lots of lessons learned that we're going to debrief when this is all said and done and make improvements, but again I think our community's responded extremely well through this crisis.

-Superintendent Jara, I want to come to you.

Planning of course is key.

We've had this conversation many times of the different challenges with COVID, and then here comes this huge spike.

And staff shortages, although a continuing issue in public education, have not been this acute.

How do you just address that part of it?

(Dr. Jesus Jara) Well Kipp, I'm going to tell you this.

The staff shortage as you mentioned is something we've been trying to handle in the Clark County School District, but I think as you heard in healthcare, COVID has amplified the shortage, and the spike is something that the partnership as mentioned from, you know, Mason is really something that has been so helpful for me and for the Clark County School District with Southern Nevada Health District and the local community and the state as well.

One of the things that we continue to look and provide opportunities and to continue the testing, the mitigation strategy, keeping them safe in school not only our kids, but you know, our staff when they go home.

They go out into the community and come back.

What we were able to see is the spread in our campuses, in our schools because of the mitigation strategies was limited.

But we can't control the outside, so I think when we went into this pause, it was really-- it was something that was so needed because our folks needed to catch up.

Our nurses were working seven days a week and really with an effort, and every time I go visit, it was an effort.

What do we need to do and how much harder to keep our kids in school because we knew and I'll tell you, I knew that distance education didn't work to the best as we could.

We did the best we could, but we know and knew that our kids needed to be on campus with our staff.

So making sure that everybody was on point to support our children and our community was so important, and I think looking at strategizing across the board, taking the three days that we already had off, as we mentioned Saturday and Sunday and then coupling an extra two days that we're going to make up at a later day, it gave the team a pause to reset, reboot and come back.

And I've had principal meetings this week, yesterday and today, and they appreciated it.

They've seen that staff is back, ready and energized to continue to provide an essential-- you know, I would say a core business for this community is our kids being on campus.

-Yes, there's the logistics aspect of a pause like that.

Of course there's the public health aspect, but then there's the morale side of that too, and I think you just answered that question.

I want to go to maybe before that.

Teachers and educators have been through a lot, as you mentioned.

I mean, so much virtual learning and the challenges that go with that, coming back to school, the hybrid model, I could go on and on, and now you have this spike.

I mean, how was morale for educators prior to that pause?

-Well, prior to the pause, everybody's tired.

Everybody's beat up and just really trying to do the best they could.

That's why when the Board of Trustees, we discussed to say well, let's use some of these extra dollars to incentivize them.

You know, it's not-- you know, we offered $1,000 incentive for folks to come back.

It was really a thank you, using federal money to say thank you.

And then across the board at the end of the day, if they stay through the year, they'll get another $1,000.

But then also what I've seen, you know, everybody being tired, but then also everybody pitching in to really support.

My central office team has been deployed out into schools to fill the vacancies, and actually I had a great partner.

Today I was with Las Vegas Raiders.

They saw one of my principals who's also been acting as custodian, been acting as a teacher.

They just gave him tickets to the Super Bowl because what they've seen is that everybody's pitching in to really make sure that our kids are in school.

So morale, you know, I could tell you, everybody's tired, superintendent's tired, but we have to continue to provide a service to our kids and our schools.

-Jeff, I want to come to you.

Same question here.

I mean, you're talking about frontline workers that have been on the frontline the whole time.

Now you're dealing with this challenge.

What's morale like in healthcare?

(Dr. Jeff Murawsky) It's tough.

I mean, I think everyone's tired.

I can't say they're not.

It's been, you know, 2-1/2 years of a really difficult run with multiple spikes and not knowing the future.

But every healthcare worker is a hero, and I think, you know, we need to remind everyone that our first-line responders, our educators, our nurses, our folks that keep the hospital clean and serve food, they're all heroes for coming to work every day and getting our community through this.

I think that's what they're seeing now, is that maybe omicron is that chance that we're starting to see some light.

So there's a little bit of a raise in mood, but there's so much work ahead of us, you know, everybody's tired, and they just feel they need a break and some recognition.

-Let's talk a little bit about that break.

Mason, I want to come to you, and I wanted more so how a leader plans for something like this.

Obviously you have staff shortages now because of the peak.

Hopefully that peak is not going to last forever.

Strategically, is that kind of the focus here is let's focus on the immediacy of the problem or do you really have to look at staff shortage as being something we're going to be confronting two, three, four weeks down the road now?

-Yes.

This time of year is always busy for us in healthcare, and coupled with COVID and omicron has doubled down on that.

You know, we set out very early knowing that this was going to be a COVID blizzard, if you will, and we set out to how do we continue to recruit, and nationally that's become a challenge and certainly has become-- because of the shortage but also at a premium, but also how do we retain and we're very focused at UMC on making sure that we're transparent.

We're always fostering a culture of caring and respect, but also our leaders are out being very visible and very communicative to what's going on, whether it's our supplies, our staffing volumes, why we're curtailing and delaying some of our surgeries, because we need to keep the ERs open, be able to surge in area.

So right now at UMC we've got seven surge areas for 70 additional beds, well beyond our capacity, and that's been sustained for a long time.

So as Jeff had mentioned, we're very focused on morale.

All of our staff has been on overtime for the last year and a half.

But I think as Jeff mentioned, we're very optimistic on what's going on right now because we see that we're going to get on the other side.

And then UMC and HCA and all of our hospitals, we're seeing still a lot of unvaccinated individuals, but all of us are going down.

Our staff are getting vaccinated, we're promoting those, and so again the staff is seeing the end of this coming very soon hopefully, probably in February.

But it's very tough times right now, but we're all managing and leading and again, just being very communicative with our staff and trying to find other ways to motivate and create morale.

We did the same thing at UMC.

We did our heroes' bonus, and I agree with Jeff.

They are our true heroes every single day.

Everybody, whether you're directly at the bedside or supporting that nurse or doctor or technician, it's been all hands on deck and extremely proud of our team at UMC.

-I want to bring something up for Jeff and Mason both, something that of course the staff shortages are in the press right now, and of course the public, the first thing you're going to come to is is there any change in client services, patient services at the hospitals?

Give us some context on how the shortages are or are not affecting what services would be.

-I think the shortage isn't so much the driver right now as it is the disease rate in the community.

So as our staff gets sick as the community got sick, that made us make choices around what things we're going to do and not going to do.

So all the hospitals across Nevada and all those in Southern Nevada in particular, you know, looked at the beginning of the month and through this month about what elective kinds of procedures we could delay a little bit.

Obviously those that are time sensitive, we're not going to do that.

If it's a cancer surgery, of course you don't want to push that off.

But there are some things we can move a couple of weeks and try to do that to create some balance and allow staff to be available to do other things.

I think as Dr. Jara mentioned, you know, all of our leaders got into work.

You'll find my hospital CEOs cleaning floors or moving trays.

You'll find our administrative nursing leaders at the bedside giving care.

It's you get in there and you do the work to help us get through that.

But I think this is a long-term problem, and we have to invest in the things that are going to get us out of this, you know, over the years to come.

-A great point and a great segue into what I want to talk about next.

Very interestingly enough, of course everybody around the table, you have been in your leadership positions since COVID started.

I hate to say this, but it's going on two years now.

Let that sink in a little bit.

I want to get your perspectives on reflecting back over those last three years.

Superintendent Jara, I want to start with you.

How has what leadership means changed or what leaders do maybe been redefined by this?

-Well, talk about just reflecting back, I mean, I still remember when Mason, I got a call.

I was in Reno on March 4.

We had our first patient.

We got on a call with the county Southern Nevada Health District.

I got called back.

Then when we closed schools, sitting next to the governor, as he's saying at least not till April 6, right?

I remember the 14 days; that was in 2020.

And I said, let's just get our kids back after spring break, then after summer, and we just continued.

I can tell you I was with a colleague of mine, another superintendent on the phone yesterday and said, this is harder than doing distance ed, right?

The work is hard enough when you have 300,000 children in school.

What we're doing now, it has redefined-- I would say I've never done anything this hard in my 25 years in education, but it has taught me a lot about people.

Heroes, what we do for kids why we come to work every day.

We are the-- I believe that we're the center of a community.

So it energizes me in so many ways in serving this community as a superintendent when if you think about across the country, in this last year, there's in the top 10 urban districts in America, there's only two that are still in their positions.

To me leadership has been totally redefined about serving, and we were servant leaders but now more so.

I think, you know, it has taught me how to balance my own personal life and what I've been able to do so I can come to work and be ready, be part of the team here in this community.

-Mason, I want to get your perspective as well.

-I agree with Dr. Jara, and I remember those early days and Dr. Murawsky too, and people don't realize that this group and many others whether it's our elected officials, our appointed officials, our business leaders, our community leaders, it doesn't matter what industry by the way.

We all came together, and early meetings, late meetings, behind the scenes, they happened every day; they still happen today.

But you know, for me reflecting-- and I kind of use October 1 as one of the worst things that ever happened in our community.

You really see the best of Nevada and Las Vegans, and I see that through this pandemic as well.

We have brought us closer together.

There are a lot of lessons learned that we'll go back and reflect on, but we certainly couldn't have done it without collaboration.

And again to see during the shutdown, the state shutdown was difficult times for all of us but we all came together and really saw the best of Las Vegas.

But again collaboration, preparation, communication, everybody coming to the table together to solve the problems I'm extremely proud to be a part of, but more proud of the people I work side by side with, and again different industries coming together.

But yes, it's been difficult but again, very proud of our teams working together.

-Jeff, I want to come to you and get your reflections as well.

I'll change the context a little bit here.

You've been on our show a lot.

You've been in the media a lot more since COVID, I should say.

That means the leadership role changes.

It's not just you the leader of the network of HCA anymore.

It becomes a much more public response and people are looking to you in a different way.

How has that changed how leadership works for you?

-You know, I think it was mentioned before that communication has become so much more important in the role of the leader, and it's a servant leader role, right?

You're communicating not just to those employees so they know what's going on and they have the full sense of all this collaboration that's occurring across the community, but also kind of carrying that message to our community, right?

Get vaccinated.

We need blood right now, give blood.

I think those roles are so much more important that we can play for our community, and I couldn't echo Mason's comments more.

I think Nevada was so proud of what Las Vegas did in coming together to make this work.

You know, we could have had a completely different set of outcomes and yet we didn't, and I think that's that partnership that got us there and those messages that we had to deliver regularly.

-Got us there.

Let's talk about the future then.

COVID is not going away it seems, at least that's what experts are saying.

So let's talk about that.

Mason, I want to come to you really quickly.

First is I mean, how do you plan?

You know, is it realistic to say we're going to go from pandemic to endemic?

This is going to be somewhat of a, you know, cold-type thing here somewhere in the near future so we can plan that way, or can you just not do that right now?

-No.

Again, lessons learned from all this.

We've learned a lot when it comes to our supply chain and particularly now, but also very early on and very appreciative of the community stepping up and helping us with masks and sanitizers and just the process around how do we operate in this environment early on.

It's definitely something we're going to be living with for sure, and we're adjusting to that today.

But you know, the hospitals and all of our community partners are working together to problem-solve those, and that's what we do as leadership.

Again, Las Vegas has got some of the best leaders I've ever come across so we're certainly positioned well.

Again, I'm optimistic of what February is going to look like and through the summer, and again we get more and more people vaccinated and boosted is only going to make that solution come quicker.

-Superintendent Jara, I want to get your perspective too.

You've already talked about the communication that goes on here and hearing we might be getting a light at the end of that tunnel, but you can't necessarily plan for that.

It's been very unpredictable thus far.

How are you working on the planning?

-Well, involving our leaders, our schools, because they're seeing it, right?

I mean, it's exciting to see, you know, you hear February potentially, but you know what?

We have to find a way and we are, and working with our principals is how do we offer the families choice?

How do we transform such a big system where families may still feel some anxiety to come back to face-to-face instruction?

So it's involving our leaders to then find ways for our families to have well, I want to do distance education.

I want to come face to face.

We do have some pilots now.

We started thinking about that already.

But it's how do we go from 17 schools that have some potential for different instructional models to then 366, right?

So let's go small steps as we continue to move forward.

So it's just involving our boots on the ground leaders to say to the district hey, here's what we're seeing so we can move forward.

-Superintendent, Jara, Mason, Jeff, thank you so much, a great conversation.

We really appreciate it.

-Thank you.

-And thank you of course as always for joining us this week on Nevada Week.

For any of the resources discussed on the show, please visit our website at vegaspbs.org/nevadaweek.

You can also follow us on Facebook and Twitter at @nevadaweek.

Thanks again for joining us.

♪♪♪