Prelude to a disaster: How Nevada prepared as COVID descended
The Legislature created of the state’s Patient Protection Commission in 2019. Sisolak appointed its eleven members. (Nevada Current file photo)
Note: This is the first of two stories.
2020. It was supposed to be a banner year for Nevada, especially Las Vegas, where the biggest problem was what to do with too much of a good thing – as many as three-quarters of a million fans expected for the NFL Draft in April, and too many cars and not enough parking when the doors opened on a gleaming new stadium in the fall.
Visitation was at record highs and unemployment was at a record low — 3.6 percent for the first month of the year.
“I am excited to see January’s numbers reflect that Nevada’s unemployment rate has hit its all-time low,” Gov. Steve Sisolak announced on March 5.
Within hours, Sisolak would notify the public of the first confirmed case of COVID-19 in Southern Nevada. A second case would surface in Washoe County before day’s end.
Within weeks, Nevada’s economy would grind to a halt. Unemployment would skyrocket to unforeseen heights.
Sisolak’s first known public reference to the coronavirus came on Feb. 28, days before the state registered its first confirmed case of COVID-19. What did the governor know about COVID-19 and when? How did he prepare for the health care emergency, the assault on government funding, and the human toll?
Opinions on how Sisolak has handled the pandemic abound. The Current turned to the paper trail, the administration’s own communications in the weeks before the virus surfaced in the state. The records offer a glimpse into the administration’s reaction and preparation in January, February and early March, as the virus’ arrival appeared inevitable.
Gov. Sisolak, who has stressed the need for transparency during the pandemic, declined to be interviewed for this story.
The topic on the eve of CES 2020 in Las Vegas Jan. 6 was U.S. cooperation with Chinese technology companies.
“We want to do more to improve the relationship between the state of Nevada and the people of China,” Gov. Steve Sisolak told the crowd at China Night, according to the Nikkei Asian Review. The governor went on to explain there was nothing he could do about tensions at the national level.
It’s unlikely the mystery virus spreading in the Wuhan province of China came up during conversation. China had yet to report the first death from the pneumonia-like illness.
Two days later, on the second day of CES, which attracted 170,000 worldwide visitors, the Centers for Disease Control began alerting clinicians to look for patients with respiratory symptoms and a history of travel to Wuhan.
China announced the first death related to the virus on Jan. 11, the day after CES wrapped up and just weeks before the Lunar New Year celebration, a time of extensive travel in Asia.
On Jan. 17, Sisolak’s policy analyst Madison Huntley sent senior policy advisor Allison Combs and Chief of Staff Michelle White a briefing on the virus based, Huntley said, on a New York Times story.
“The spread has health officials mildly concerned about the possibility of a larger outbreak, however if no new cases are identified within the next few days, the outbreak will be over,” Huntley wrote.
That same day the CDC initiated public health screening at five airports. McCarran International, one of the nation’s top ten busiest airports, was not included.
The first travel-related case of the coronavirus in the U.S. was confirmed on Jan. 21 in a person from Washington state, who had recently returned from Wuhan.
The next day, Southern Nevada Health District officials confirmed they were not revising any recommendations” for Lunar New Year or other events in Las Vegas. Instead, they reminded residents and visitors to be wary of the flu.
“While the CDC considers this to be a serious public health concern, the immediate risk to the American public is considered low at this time,” the Health District said of the coronavirus in a Jan. 22 statement to the Current.
The World Health Organization declined on January 23 to declare the outbreak an international health emergency.
With millions of people quarantined in Chinese cities, Lunar New Year celebrations canceled or scaled back in metropolitan areas throughout China, and social media ablaze with alarming videos and photos of alleged victims of the virus, Las Vegas resorts celebrated without restriction.
Las Vegas is a favored destination for Asian travelers, with some 236,970 visitors from China in 2018, according to the Las Vegas Convention and Visitors Authority. Asia is the fifth-largest feeder market of international tourists, behind Canada, Mexico, the United Kingdom and Australia.
Nevada’s Health and Human Services chief Richard Whitley reached out to the governor’s staff on Jan. 26, detailing a report of 100 cases of coronavirus under investigation in the U.S., including two confirmed in neighboring California and one in Arizona.
“Immediate health risk to the general American population is low, but the threat is serious,” Whitley reported.
The following day, U.S. Sen. Jacky Rosen wrote a letter to Health and Human Services Secretary Alex Azar, inquiring as to the “current domestic diagnostic capacity.”
The flaws in the nation’s testing program were about to become painfully apparent. The nation’s failure to provide the components for a reliable test would prompt Nevada’s Public Health Laboratory Director Mark Pandori to improvise, enabling the state to conduct tests independent of the CDC.
On February 4, the CDC added passenger screening to 15 airports. McCarran was not among them.
On the same day, Macau ordered its casinos closed, signaling the first blow to Las Vegas-based companies with properties in the enclave.
Las Vegas, meanwhile, had not skipped a beat and had yet to change its marketing strategy as a result of the virus.
“We are trying to stay sensitive to how our visitors are feeling and we don’t want to be inappropriate,” said Billy Vassiliadis of R and R Partners, the advertising agency for the LVCVA, noting 350,000 workers depend on the tourism industry for their livelihoods. “Obviously, we’ll be ready to stop on a dime.”
The closure of Macau casinos lasted only two weeks, but revenue for 2020 remains off 80 percent for the year.
The Southern Nevada Health District announced Feb. 10 the Southern Nevada Public Health Laboratory “has received a CDC-developed test kit and will have the capacity to test for the 2019 novel coronavirus.”
“Our laboratory will be able to test,” SNHD spokesperson Jennifer Sizemore said the next day. “Once the kit is received they have to go through a process to set up and prepare to test so they haven’t tested any specimens yet.”
The test was ultimately discovered to be flawed and recalled by the CDC
At a press briefing on Valentine’s Day, HHS Secretary Azar boasted again of the CDC’s diagnostic test, already determined to be flawed. “One of the things that we did – the CDC – within a week of getting the genetic sequencing, developed a test, we had a diagnostic there at CDC. We’ve now deployed that around the country in over 170 public health labs.”
In late February, national and international media descended on Southern Nevada for the Democratic Presidential Caucus.
“We’ve tried to make it as easy, as convenient, as accessible as we possibly could. You can go to any of the locations (in your county) and caucus, which I think is really important,” Sisolak told the Las Vegas Sun. “I wanted to encourage everybody and really I’m here to show them how easy it is.”
Sisolak said party staff and volunteers who organized the caucuses “are working so hard. They’re doing everything they possibly can to provide people the assurances and the confidence that this is going to work out.” he told the Las Vegas Review-Journal.
The governor made no mention of the coronavirus.
“This particular virus, with good public health awareness, limiting where the exposure is, we can contain this virus,” Assemblywoman Robin Titus, a Republican and family medicine doctor said at a legislative hearing on Feb. 19, the Las Vegas Review-Journal reported. “So I don’t want folks leaving here thinking, ‘Oh, my God, we’re going to die if this virus gets out,’ because that’s just not the case. We just have a golden opportunity to contain this virus, and, frankly, it’s probably less deadly than influenza from what I’m reading.”
On that day, the SNHD was monitoring more than 100 travelers from China. They were said to be asymptomatic and “maintaining 14-day quarantine,” according to minutes from the Nevada Resilience Advisory Committee.
Southern Nevada’s Incident Command System (ICS) had been activated “on a rather small scale, but that is expected to grow as the virus spreads,” the minutes read.
“Currently N95 masks are on a six-month backorder. There is also difficulty in acquiring gowns and gloves and work is being done in conjunction with the Nevada Hospital Association. This is a national issue,” the minutes said.
On Feb. 20, state Department of Public Safety Director George Togliatti took part in a call with the White House, the Department of Health and Human Services, and the Department of Homeland Security, according to an email from Togliatti to White and Kyle George, counsel to the governor.
“In summary, the message was to urge all states to ensure coordination among all stakeholder agencies to ensure a coordinated response in the event of an (sic) pandemic in our state.”
In February, before the spectacle of the Democratic Caucus in Las Vegas on the 22nd, there are no records of Sisolak taking part in COVID-related issues, including calls with the federal government.
“We strongly encourage your Governor to try to participate,” said the Feb. 20 email invitation to a conference call from the Department of Health and Human Services’ Director of Intergovernmental Affairs.
Instead, senior advisor Scott Giles replied only he was able to attend the “very end” of the meeting. “I’m not sure what I missed from the call. Is there a 1-pager or summary of any updates that you could possibly share?”
On the agenda for the call were seminal questions for the nation’s governors:
Have you reviewed the scope of your emergency authorities as Governor to respond to a public health crisis in your state?
When have you last exercised these authorities?
What are your quarantine and isolation authorities, roles, and responsibilities? Do you have plans for canceling large events and community gatherings? Do you have a mechanism to encourage or compel school closures, if necessary?
What public health and human resource resources do you have for local governments, the private sector, and non-profits on hygiene or social distancing?
What are your critical infrastructure, key resources, and essential services that might face personnel shortages?
Do you have policies and plans in place for state and local government workers?
In late February, the Southern Nevada Health District still lacked the ability to test for the coronavirus.
“The CDC is beginning to send out new kits. We have not received ours and are not testing here yet,” Sizemore, the SNHD spokesperson, said via email on Feb. 25.
On Feb. 24, the governor tweeted about the Census. He had yet to mention the virus publicly.
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