Personal protective equipment, or PPE, includes items like surgical gowns, face masks, hair nets, shoe covers and gloves.

The Nebraska total of confirmed COVID-19 cases is up to 81 as of 11 p.m on March 26.

None of the cases have been confirmed in the Four Corners Health District, which covers Seward, York, Butler and Polk counties, but Four Corners Director Laura McDougall said the department is issuing tests for people on a limited basis.

So far, 15 people in the district have been tested for COVID-19 with negative results.

As of 1 p.m. March 26, community spread has begun in Omaha (2 cases), Lancaster County (1 case), Saunders County (1 case) and Sarpy County (1 case). Community spread is when a person contracts the virus, but the health department is unable to track where they picked it up.

“Things are starting to heat up a little bit and spread in our direction,” McDougall said during a conference call with Seward County stakeholders March 26. “At this time, we have 163 people in our four counties that we are monitoring for symptoms or we're monitoring them because they're isolating. We do expect some of those people to go off of monitoring or quarantine this weekend. Some were returning from spring breaks, so they're hitting their two weeks.”

McDougall said changes in testing and diagnoses have changed in the past few days. Medical providers are now issuing “presumed positive” diagnoses of COVID-19 without giving confirmative tests.

“Medical providers have been encouraged to diagnose cases if they're negative for influenza and colds, if they have all the symptoms,” McDougall said. “They can clinically diagnose without a lab test.”

That, she said, is because of a shortage of tests. Though test production is ramping up, Nebraska lab facilities are only able to process between 100 and 200 tests per day right now, so even if more people were tested, the results may not be known for several days.

A person given a “presumed positive” diagnosis for COVID-19 is then instructed to go home and self-isolate, unless they are in need of serious medical care. Those patients are hospitalized.

Once a confirmed or presumed positive diagnosis is given, medical providers are asked to contact the health department so it can begin notifying and monitoring others who have come into contact with the diagnosed person.

“If it truly is a case of COVID, we want to make sure we're stopping the spread of it,” McDougall said.

The presumed positive cases are not being recorded as part of the state's case total.

McDougall said what Nebraskans are doing is making a big difference on slowing the virus' spread.

“You can tell by the numbers in Nebraska. We were able to put some of our non-pharmaceutical interventions in place early compared to some of the other places who are experiencing large numbers of this. I thank everyone for their efforts in trying to do that,” she said.

While people are working or learning from home to follow social distancing guidelines, McDougall said physical activity is important, and people should go outside.

“Go for walks. Get some physical exercise. Enjoy the fresh air. It's not only good for our physical health, but it's good for our mental health,” she said.

In doing so, though, people should walk in ones or twos and not gather into groups, leaving at least 6 feet between each person, according to health department guidelines.

McDougall said the state legislature approved $38 million to provide personal protective equipment, like masks, gloves and gowns, to first responders and health care professionals.

“We're expecting guidance today that we're going to forward on to our partners. We'll need to be placing orders for what we expect to be needing in the next month or so,” she said.

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