Saturday, January 16, 2021

Most Ky. measures of pandemic ease slightly, but 32 more deaths keep that trend at a high; prison in Morgan County beset by virus

State Corrections Department chart, with shading applied by Kentucky Health News
Chart is updated on weekdays at https://corrections.ky.gov/facilities/pages/covid19.aspx.
By Al Cross
Kentucky Health News

Kentucky recorded 3,096 new cases of the novel coronavirus Saturday, lowering the seven-day average for the fourth straight day, to 3,438. The percentage of Kentuckians testing positive for the virus in the past week declined again from a record high, for the fifth day out of six, to 11.74%.

But at the same time, the state reported 32 more deaths from Covid-19, pushing its mortality trends to new highs. The seven-day average is 31 deaths per day, and the 14-day average is 28.2, both records.

Morgan County, site of a major virus outbreak at a state prison, continued to have the state's highest infection rate, measured as the average number of cases per 100,000 residents over the past seven days. Counties averaging more than 100 per 100,000 (1 per 1,000) are Morgan, 596; Clinton, 200; Oldham, 173; Wayne, 131; Hancock, 111; Harrison, 107; Taylor, 106; and Butler, 104. The statewide rate is 72.6.

Yesterday's updated Corrections Department report shows that almost half the inmates at the Eastern Kentucky Correctional Complex in West Liberty have active cases of the virus: 929 out of a listed population of 1,938. Eighty employees of the prison also have active cases.

Kentucky hospitals reported fewer Covid-19 patients, 1,631, but more in intensive-care units and on ventilators: 408 and 214, respectively. Friday's respective numbers were 1,644, 392 and 203.

Hospitals continued to send warning signs. In Northern Kentucky, 83% of hospital beds were full, and in three other hospital regions, more than 80% of the ICU beds were occupied: 83% in the Barren River region and 89% in the Lake Cumberland area and easternmost region, from Lee to Pike counties. 

Of the 32 Covid-19 deaths added to the state's list, 29 were confirmed and three were probable. The death toll is 3,093, of which 2,858 have been confirmed and 235 are listed as probably caused by Covid-19, according to the state's daily report.

Following recent weekend practice, Gov. Andy Beshear only announced numbers on his Facebook page and did not list the dead by county, age and sex.

In other coronavirus news Saturday:
  • Counties with more than 10 new cases were: Jefferson, 552; Fayette, 206; Kenton, 118; Warren, 117; Daviess, 85; Boone, 83; Hardin, 74; Morgan, 66; Campbell, 59; Laurel, 59; Henderson, 54; Oldham, 53; Pike, 53; Pulaski, 50; Jessamine, 49; Clark, 46; Boyd, 44; Madison, 39; Bullitt, 38; Scott, 37; Nelson, 36; Barren, 33; Shelby, 33; Christian, 32; Graves, 31; Greenup, Knox and Wayne, 30; Harlan, 28; Floyd and Taylor, 27; Franklin, 26; Bell, Hopkins, Marshall and Montgomery, 21; Grant, Logan and Rowan, 20; Anderson, Calloway, Meade and Whitley, 19; Bourbon, 18; Simpson, 17; Clinton and Grayson, 16; Carter, McCreary, Mercer and Ohio, 14; Allen, McCracken, Union and Woodford, 13; Boyle, Caldwell, Marion and Spencer, 12; and Henry, Johnson, Lincoln, McLean, Trigg and Washington, 11.
  • U.S. Sen. Rand Paul "contradicted the Centers for Disease Control and Prevention and told people during a Fox News interview on Friday to discard their masks once they have been vaccinated against Covid-19 or have been infected with the coronavirus," reports Sarah Elbeshbishi of USA Today. "The CDC says 'not enough information is currently available' to lift its recommendations that people wear masks and practice social distancing after getting the vaccine."

Coroner in Frankfort's county says suicides doubled in 2020, while overdoses rose by almost half; those with fentanyl nearly tripled

Kentucky coroners aren't required to issue annual reports, but some do, and the 2020 report from Franklin County Coroner Will Harrod suggests it's a good time to ask your coroner for a report. As experts have warned, the pandemic seems to have increased drug overdoses and suicides, at least in Frankfort's county.

Harrod's preliminary report to the county Fiscal Court on Dec. 30 said that overdose-related deaths in the county with the state capital increased from 17 to 25 in 2020, most involving the powerful opioid fentanyl, and the number of suicides doubled, to 12.

“While we can not confirm the rise in cases are Covid-19 related, we can correlate the increase of cases with the pandemic experience,” including isolation as a result of restrictions, Harrod said.

"Those numbers may change, he said, as several investigations were still pending at the end of the year," The State Journal reports.

"Deaths involving fentanyl nearly tripled from seven in 2019 to 20 in 2020," the Frankfort newspaper reports. "In December, Franklin County Sheriff's Office Sgt. Lucas DeBorde told the Fiscal Court there had been four fentanyl-related deaths in two months. Frankfort Fire and EMS Chief Wayne Briscoe said at the time EMS crews had already worked 87 opioid overdoses, including fentanyl, since July 1. In the fiscal year that ended June 30, Briscoe said the department responded to 109 opioid-related overdoses."

Friday, January 15, 2021

As pandemic keeps us at home more, risk of lung cancer from radon gas increases; tests are available; it's Radon Action Month

Radon gas comes from rocks, so this geological map suggests risk levels, but there are other factors such as construction and ventilation. For details and more about the map, click here.
By Stacy R. Stanifer

This year alone, approximately 4,890 Kentuckians will be diagnosed with lung cancer, yet the disease remains highly preventable.

While nearly 80 percent of lung cancers are caused by tobacco smoke, exposure to radon gas is the second leading cause of lung cancer, accounting for approximately 21,000 cases of lung cancer each year in the U.S.

Radon gas exposure is an invisible threat to your health, and you cannot taste or smell it. While the naturally occurring gas is present at low levels in outdoor air, our greatest risk of exposure is in the home, where the gas enters and becomes trapped, and where we spend most of our time.

Given the global pandemic and the recommended public health guidelines, individuals and families are spending more time than ever at home. With January being National Radon Action Month, there is no better time than now to create a healthy home.

Thankfully, there is something you can do to lower your risk of exposure to dangerous radon gas. Because you cannot see, taste, or smell radon gas, the only way to know the concentration of radon in your home is to test for it. Some local health departments, as well as the Kentucky Radon Program, offer free short-term radon test kits to Kentucky residents.

When elevated radon levels are found, radon mitigation systems can be installed by certified radon mitigation professionals. In many cases these systems can reduce radon levels in homes by up to 99%.

While we are all doing our part to “Stay Healthy at Home,” we urge you to test your home for radon, and if the concentrations are high, fix or mitigate your home. Exposure to radon can be dangerous to anyone, regardless of the presence or absence of other risk factors for lung cancer.

If you haven’t tested your home for radon, National Radon Action Month is the perfect time to take action and request a free radon test kit from your local health department or the Kentucky Radon Program. Then, test your home, know your level, and take action if your home radon concentration is at or above 4.0 pCi/L. If anyone in your home uses tobacco or vape products, ask them not to use the products inside (and at least 25 feet away from entryways, windows, and building vents).

Breathing radon is dangerous for everyone but even more harmful when also exposed to tobacco smoke or e-cigarette aerosol. What better way to “Stay Healthy at Home” than with the peace of mind knowing that you are protecting you and your family from the second leading cause of lung cancer by testing for radon?

Stacy R. Stanifer, Ph.D., APRN, AOCNS, is an assistant professor in the University of Kentucky College of Nursing. Contact her at Srecke0@uky.edu or 859-323-6874.

7-day case average falls again, but 7- and 14-day death averages set new records, and virus-reproduction rate is reported high

RT.live website says Kentucky has the third highest virus reproduction rate among the states. A rate of 1.09 means that on average, 100 infected people will infect 109 others. (Click to enlarge)
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced 3,955 new cases of the novel coronavirus on Friday, bringing the state's seven-day rolling average to 3,601, down for the third day in a row and back to where it was about a week ago. 

“These case numbers are still far too high, but there is hopeful news today, too,” Beshear said in a news release. The share of Kentuckians who tested positive for the virus in the past seven days has declined on five of the last six days, and stood at 12.09% Friday.

Beshear announced 19 more deaths from Covid-19, well below most recent days, but the seven- and 14-day averages of daily deaths are at new highs, 29.3 and 27.5, respectively. The dates do not represent the date of death, but the date that the death was confirmed or, as three were Friday, listed as probable.

The number of Covid-19 patients in Kentucky hospitals continued to decline, to the level it stood at about two weeks ago. Beshear said 1,644 people were in hospital with the disease, 392 in intensive care, down 4.2% from Thursday, and 203 of those on ventilators, a bit under the average for the past week. 

The state's daily report shows that three of the state's 10 hospital-readiness regions are pushing capacity in their intensive-care units. The easternmost region is at 84.4% ICU capacity, Barren River is at 81.48%, and Lake Cumberland, which was at full capacity a few days ago, is down to 84.44%.

Vaccines: Beshear again touted a faster pace of vaccinations. “We are on track as we ramp up to meet our goal of administering 90 percent of all vaccine received within seven days of arrival. In fact, last week we administered more doses of vaccine than we received.”

The state has received 325,625 vaccine doses and 190,547 have been administered. Beshear's release sad 31,158 have been administered to residents and staff of long-term-care facilities by Walgreens and CVS through a federal contract and 159,389 doses have been administered in the state program.  

That means around 59% of the doses received by the state have been administered, while only 31% of the ones sent to the pharmacy chains for long-term care facilities have been administered. 

Beshear has regularly voiced disappointment with the pace of vaccination in the state, especially at nursing homes, which have accounted for almost 70 percent of the state's Covid-19 deaths. That prompted him and the Department for Public Health to allow more flexibility in who can get a vaccination, and set a goal of 90% of doses received to be administered each week. 

The governor has also announced plans for a drive-through vaccination program with Kroger and other partners, starting Feb. 1, for people in the first three priority phases. Also, he has said K-12 teachers and personnel who have agreed to be vaccinated will all be vaccinated by the end of the first week of February, a week earlier than planned.

Whether this increased pace of vaccination will be possible became a bit uncertain after The Washington Post revealed that federal officials' announcement this week that they would begin releasing coronavirus vaccines held in reserve for second shots wasn't going to happen because no such reserve existed, and those doses had already been shipped.

This means states' vaccine allocations will remain largely flat and they won't be able to expand their programs at the pace they had planned for, the Post's Isaac Stanley-Becker and Lena H. Sun report. They add that those in line for a second dose of the vaccine are expected to get them on schedule, but as part of a regular shipment of the vaccine and not from a reserve. 

Beshear's office did not respond to a request from Kentucky Health News for comment on the report, but Daniel Desrochers of the Lexington Herald-Leader posted on Twitter, "When asked if this would affect Kentucky's announcement that it would vaccinate K-12 employees by Feb. 1, Beshear's office said they could not confirm the information in the story. 'We are awaiting more information,' their office said."

The state Cabinet for Health and Family Services provides a weekly coronavirus vaccine progress report. Click here for the one-page report, updated Jan. 15; click here for the power-point with the data; and click here for frequently asked questions.

In other coronavirus news Friday: 
  • The 19 additional deaths brought the state's death toll to 3,061. The deaths included two Hardin County men, both 78; a Hart County woman, 87; a Hopkins County woman, 89; seven Jefferson County women, 76, 80, 83, 87, 89, 91 and 92; three Jefferson County men, 66, 69 and 76; an Ohio County woman, 67; a Warren County woman, 88; a Washington County woman, 81; a Washington County man, 71; and a Wayne County man, 64.
  • Counties with 10 or more new cases were Jefferson, 584; Oldham, 279; Fayette, 254; Kenton, 227; Boone, 160; Warren, 129; Daviess, 116; Hardin, 97; Laurel, 87; Campbell, 72; Madison, 70; Christian, 62; Pike, 60; Bullitt and Pulaski, 53; Hopkins, 51; Scott, 50; Franklin, 49; Nelson, 46; Clark, 43; McCracken, 41; Jessamine, 40; Henderson and Shelby, 39; Boyle, 38; Barren and Graves, 35; Greenup, 34; Whitley, 32; Floyd, 31; Mercer and Morgan, 30; Knox, 28; Montgomery, 27; Calloway and Ohio, 25; Meade and Woodford, 23; Bell, Boyd, Carter and Muhlenberg, 22; Marshall, 21; Bourbon, 20; Clay, Letcher and Lincoln, 19; Estill, 18; Breathitt, 17; Grant, Hancock, Harrison, Hart, Rockcastle, Simpson, Spencer and Wayne, 16; Mason and Perry, 15; Leslie and Logan, 14; Allen, Anderson, Johnson, Larue and Marion, 13; Clinton, Grayson, Henry, Jackson, Pendleton, Rowan and Union, 12; Harlan, Monroe, Russell, Taylor and Webster, 11; Garrard, McCreary and Todd, 10.
  • The Rt.live website shows that Kentucky, along with Hawaii, has the third highest rate of coronavirus spread, with a reproduction rate of 1.09, Becker's Hospital Review reports. 
  • According to the Centers for Disease Control and Prevention's Covid-19 vaccine data tracker, Kentucky ranks 11th for the percentage of Covid-19 vaccines administered, Becker's reports.
  • Kaiser Health News expands on why CVS and Walgreens have been so slow to complete vaccinations. Nationwide, they have administered about one-quarter of the doses they have been allocated, according to the CDC.
  • Norton Healthcare, U of L Health and Baptist Health announced Friday they will start offering coronavirus vaccinations to people 70 and older, Sarah Ladd reports for the Louisville Courier Journal. WDRB provides information from several Kentucky health departments and their plans for vaccinating their communities. 
  • The CJ's Morgan Watkins walks through the possible scenarios for bills the Republican-led General Assembly has passed to limit the powers of the governor, speaking to both Democrat and Republican leaders in the House and Senate. 
  • At the Friday University of Louisville Athletics Association board meeting, U of L announced it spent $871,239 in Covid-19 expenses as of Dec. 31, with more than half of that amount spent on testing, the CJ's Cameron Teague Robinson reports.
  • Hazard's WYMT reports, "Long-term care facilities in our region continue to get hit hard by Covid-19" and provides a table that shows the latest facility numbers from Jan. 1-14 in Eastern Kentucky. A separate story shows coronavirus cases and related deaths that have been reported by health departments in the region.
  • President-elect Joe Biden unveiled his incoming administration's five-part plan to get Americans vaccinated, saying he plans to greatly expand access to it by invoking the Defense Production Act if necessary, The New York Times reportsNPR summarizes the plan: "Open up vaccine eligibility to more people, create more vaccination sites, increase vaccine supply, hire a vaccination workforce, and launch a large-scale public education campaign."
  • A CDC report, based on modeling, says the highly contagious variant of the coronavirus first seen in the United Kingdom will become the dominant strain in the United States within about two months, the Post reports. So far, the emergence of this mutated strain of the virus is not causing more severe illness, but is expected to cause more infections, resulting in more deaths. "Now, more than ever, it is important to slow the spread," says the CDC. "The CDC and unaffiliated scientists have said they see no evidence that this particular variant is driving the winter surge in cases. So far, it has been involved in fewer than 0.5 percent of infections nationwide, testing data suggests," reports the Post.

Busting myths and verifying facts about coronavirus vaccines

By Mallory Olson
University of Kentucky

Over the past year, a novel, highly contagious virus has spread across the world. Scientists and researchers have worked quickly to respond with vaccine development, two of which have been approved by the U.S. Food and Drug Administration for emergency use. Others will likely follow.

Vince Venditto in the College of Pharmacy building
As the vaccine rollout continues through priority phases, a University of Kentucky pharmacy professor is helping separate fact from fiction with regard to the safety and efficacy of the vaccines.

Vince Venditto, an assistant professor in the Department of Pharmaceutical Science, has extensive expertise in vaccine design. He was trained in organic synthesis and vaccine development. He is currently working on a clinical trial with community pharmacies to understand the prevalence of the novel coronavirus in Kentucky.

Here are some vaccine beliefs and what Venditto has to say about them:

The vaccine has been rushed, so it cannot be safe. Fiction. While the timeline from the start of the pandemic to the approval of the vaccine has been faster than any other vaccine, the technology has been in development for many years. Messenger RNA, the technology behind Pfizer and Moderna’s vaccines, were touted as a quick and efficient method to produce vaccines at unprecedented speed, and this proved true for SARS-CoV-2, the novel coronavirus. Pfizer and Moderna have been working in this space for many years and it was because of their strong foundation in this technology that they were able to generate a vaccine in less than a year.

There has not been enough testing. Fiction. The Covid-19 vaccines, like all drugs that are approved for human use, undergo significant scrutiny from various independent evaluators to ensure efficacy and safety during the clinical trials, and then by the FDA for approval. After FDA approval, safety and efficacy continue to be monitored for adverse events. Some of the Covid-19 vaccines being tested in clinical trials were halted because of a serious illness in a few people, but the illnesses were not associated with the vaccine. Pausing a clinical trial is a very common event and indicates that the independent safety monitoring boards are ensuring that only safe vaccines are approved for use.

Since approval, there have been a few reports of a rare, but serious, allergic response in a small number of patients, and the safety monitoring boards continue to evaluate these events to ensure the safety of those who receive the vaccine.

There is an advantage to having multiple vaccines, not just one that works. Fact. While one vaccine is a significant achievement, it is critical that multiple vaccines, based on different technologies, are approved for use. There are several reasons. First, the number of doses necessary to immunize the whole U.S. and the entire world is not practical using one vaccine, given the different reagents necessary to produce the vaccines. Approval of multiple effective vaccines will reduce the burden on a single manufacturer to ensure that everyone across the world can have access to a vaccine in a timely manner.

Second, not all vaccines work well in all populations. Historically, there are examples of vaccines that are more effective in specific ethnic populations for reasons that are not well understood. Because of this, multiple vaccines will ensure that everyone has access to an effective vaccine.

We do not know what is in the vaccine. Fiction. We know exactly what is in the vaccine. This varies from vaccine to vaccine, based on the company’s specific design, but the first two approved vaccines from Pfizer and Moderna contain oil droplets with genetic materials to express non-infectious pieces of the virus.

We do not know anything about the side effects. Fiction. Each of the clinical trials are being conducted in more than 30,000 people from around the world, and all subjects are monitored for side effects. Half of the subjects get placebos, and half get the vaccine. In general, they report soreness and swelling at the injection site, as well as fever, chills, tiredness and headache, which go away after a few days. This is exactly what you want to happen because it means your immune system is active and doing its job.

The subjects in the clinical trials continue to be followed for any additional side effects and none have been observed. Everyone who receives the vaccine in the trial or after approval will continue to be monitored for side effects to ensure continued safety in different populations and conditions.

Covid-19 will eventually go away on its own. Fiction. It is unlikely that SARS-CoV-2 will go away on its own. Just like the common cold – which is also a coronavirus – it continues to make kids sick every year, but as we age and continue to be exposed, we generate an immune response that prevents us from getting sick. The vaccine helps to accelerate this process to protect us. However, we are only a year into this pandemic and scientists will continue to monitor how many people are infected each year.

Receiving an mRNA vaccine will not affect your DNA/genetics. Fact. The mRNA vaccine is fantastic technology because it has no way to get into your DNA but can still induce a strong immune response. It does so by generating pieces of the virus for our immune systems to respond to. Once the mRNA is used by our cells, it is destroyed and has no long-term effects on our cells.

The vaccines are just placebos. Fiction. Clinical trials require vaccine groups and placebo groups to show that the vaccine is effective. Once a proper comparison between these groups can be made, all vaccines administered will contain the active ingredients to induce an effective immune response.

There is a chip or marker in the vaccine used to track you. Fiction. This is simply not true.

Thursday, January 14, 2021

On a day with much death from Covid-19 in Kentucky, governor touts progress, optimism about rollout of coronavirus vaccines

Kentucky Department of Public Health graph; 172,537 doses have been administered.
By Al Cross
Kentucky Health News

As the specter of Covid-19 deaths grew larger, Gov. Andy Beshear announced progress on getting Kentuckians vaccinated to quell the pandemic.

The state attributed 51 more deaths to Covid-19, pushing the total to 3,042 and the 14-day rolling average to a new high, 27.1. The daily total was the third highest, replacing the 47 recorded the day before. The dates do not represent the date of death, but the date that the death was confirmed or listed as probable. Five of the latest deaths were probable and the rest were confirmed.

"A really hard death count today," Beshear said just after starting his last briefing of the week, taking more than two minutes to read the list of the dead and announcing 4,084 new cases of the novel coronavirus. 

He noted that the number was smaller than those of the last two Thursdays; the seven-day rolling average of new cases, which hit a record 4,002 Tuesday, fell for the second straight day, to 3,715.

The share of Kentuckians testing positive for the virus in the last seven days rose slightly, to 12.34%, but hospitalizations fell below 1,700 for the first time in 11 days. Of the 1,661 Covid-19 patients, 409 were in intensive care and 196 were on ventilators, a 13% drop from Wednesday, but as Beshear noted, "That's not always the result of a good outcome."

On the vaccine front, Beshear had encouraging news. He said the pace of vaccinations has picked up, and announced that a drive-through vaccination program with Kroger and other partners would begin Feb. 1 for people in the first three priority phases.

Some localities have already entered the second and third phases, and Beshear said he believed that all the elementary and secondary school personnel who have agreed to take a vaccine will be vaccinated by the end of the first week of February, which originally was the week their shots were to start.
 
“The pace is really picking up. I am very optimistic about where we’re going,” he said, adding later, “I think we’re gonna reach the point pretty soon where our ability to get the vaccine out quickly is gonna exceed the amount of vaccine were actually gonna get” from the federal government.

“We’ve got to get as many people vaccinated as quickly as possible to reach herd immunity to defeat this virus. And even, if you see some people that are maybe getting it out of turn, most of the time the reason is, doing that sometimes is going to be what’s required to keep the pace up to get to immunity. So everybody who gets it, regardless of when they get it, are one step closer to getting immunity.”

Beshear named Transportation Secretary Jim Gray to oversee vaccine distribution. Gray said, "We are committed to ensuring equitable distribution of the vaccine … everyone will have their turn." He said a website and hotline to schedule vaccinations will open Jan. 28, and depending on supply, the state "will get the vaccine in every arm of everyone who wants it as quickly and safely as possible.”

Kentucky ranks 26th in percentage of population vaccinated, says The Washington Post's vaccine tracker. Interviewed on MSNBC, Beshear said, “We’re gonna get this done; it’s gonna be messy at times. it’s the largest logistical challenge we’ve faced since World War II, but it’s how we protect the lives of our citizens, so we’ve got to have urgency, and every day we gotta improve how we do it.”


Slide from Beshear's briefing
The governor and his lieutenants reiterated at his briefing that the slow rollout is largely due to the slow pace at long-term-care facilities, which are being handled by CVS and Walgreens under a federal contract. Every state accepted the arrangement but West Virginia, which decided to use independent pharmacies because it had few of the big chain stores. It is outpacing all other states.

In response to a question about shut-ins, Beshear said the state would try to reach them through independent pharmacies and heath departments.

He said the slow pace is also because many employees and residents of the facilities are reluctant to take the vaccine.

Asked what he would say to the estimated one-third or more of Kentuckians who appear reluctant, he said there is time to bring them around.

“We’re finding that 30 percent aren’t all hard ‘no’s,” he said. “They are, ‘I want to see other people take it.’ In the long-term-care setting, we’re seeing folks who originally said no coming around and then wanting the vaccine.”

While some people are “anti-vaccine, there are some that are just nervous,” he said. “There are some that want to talk to doctor about their own conditions; and there are some want to see other people take it before they do.”

Asked if he had considered requiring any group to be vaccinated, he said, “At this point we don’t anticipate any requirements for individuals to get it. We believe that over time and within the schedule of when we’re going to get vaccines, that we’ll see more and more people, as they see others getting the vaccine.” 

He said the state would involve “more influencers, faith leaders and others stepping out and working with us. . . . We need more voices than just mine . . . so we’re gonna have that as we move forward with educating and encouraging those that maybe don’t have enough information too.”

Because “some people only get their news from Facebook, you can understand that they don’t have the information that they need to say yes to it, so we need to find people who are where they are at, that communicate with them in everyday life and can communicate how safe the vaccine is,” Beshear said. “There will be a point where everybody will know somebody that has had the vaccine and can watch and see that they are just fine.”

In other coronavirus news Thursday:
  • Beshear said all but one county, which he did not name, had a new case. Counties with more than 10 new cases on the state's daily report were: Jefferson, 642; Kenton, 235; Boone, 176; Oldham, 176; Fayette, 172; Warren, 139; Pulaski, 131; Campbell, 126; Morgan, 115; Daviess, 101; Hardin, 86; Madison, 81; Laurel, 79; Pike, 68; Nelson, 59; Calloway, Clark and McCracken, 51; Bullitt, 50; Boyd, 41; Scott, 38; Hopkins, 37; Barren and Marshall, 36; Floyd and Graves, 35; Rowan, 34; Christian, Greenup and Montgomery, 32; Franklin and Knox, 31; Henderson, 30; Harlan and Letcher, 29; Jessamine and Mason, 27; Bell, Breckinridge, Carter and Shelby, 26; Butler, 25; Boyle, 24; Mercer and Rockcastle, 23; Meade, Ohio. Perry and Whitley, 21; Allen and Hart, 20; Bourbon and Simpson, 18; Clay, Grant and Grayson, 17; Fleming and Taylor, 16; Casey, Johnson, Marion and Woodford, 15; Hancock, Lawrence, Logan, Muhlenberg, Pendleton and Wayne, 13; Adair. Anderson, Lincoln, Union and Washington, 12; and Caldwell and Powell, 11.
  • Morgan County, a county of 14,000 that is the scene of a major virus outbreak at a state prison, continues to have by far the highest seven-day average daily infection rate, 869 per 100,000 residents. Counties above 100 per 100,000 (1 per 1,000), are: Clinton, 202.7; Clay, 164.4; Carroll, 162.6; Oldham, 150.8; Harrison, 133.9; Wayne, 120.8; Hancock, 116.3; Caldwell, 112.1; Taylor, 110.9; Webster, 109.3; Ohio, 109; Henderson, 106.2; Butler, 105.4; Nelson, 103.2; and Cumberland, 101.5.
  • Hardin, Jefferson and Whitley counties each had four people added to the list of Covid-19 deaths. The Hardin deaths were a woman, age 86, and three men, 77, 82 and 77. Jefferson lost two women, 76 and 80, and two men, 63 and 77. The Whitley deaths were two women, 47 and 83, and two men, 62 and 86.
  • Other fatalities were a Bath County man, 81; a Carroll County man, 78; two Carter County women, 73 and 89; a Clay County woman, 68; a Daviess County woman, 86; a Fayette County woman, 89; a Gallatin County man, 69; a Graves County woman, 87; a Henry County woman, 76; a Hopkins County woman and man, 63 and 84; a Lincoln County woman, 85; two Livingston County men, 55 and 68; a Logan County woman and man, 71 and 86; a Lyon County woman, 95; a Madison County man, 61; a Mason County man, 89; a Mercer County man, 86; two Montgomery County women, 85 and 95, and a man, 99; a Muhlenberg County woman and man, 90 and 92; two Ohio County women, 79 and 90; two Pulaski County women, 60 and 73, and a man, 77; a Robertson County woman, 93; a Rockcastle County woman, 52; a Russell County woman, 55; a Taylor County woman, 72; two Wayne County men, 76 and 80; and a Woodford County woman and man, 74 and 78.
  • In long-term-care facilities, 64 more residents and 34 more employees tested positive for the virus, making for 1,005 active cases in residents and 637 in staff. An additional 22 resident deaths were confirmed, making a total of 2,026.
  • Deaths in long-term-care facilities and other congregate settings such as prisons now account for 69 percent of the Covid-19 deaths in Kentucky. The figure has risen in recent months, and has done likewise in most states examined by a Kaiser Family Foundation study. "Among the 38 states that reported at least four months of trend-able data on LTCF cases since April 2020, four states reported highest average weekly new cases in November 2020, and 24 states reported their highest average weekly new cases in December 2020," KFF reports. "This pattern aligns with timing of when many states experienced their highest state-wide new cases and deaths. Kentucky was among the 24 states. It was also among the 21 of 39 reporting states that had their highest average Covid-19 deaths among long-term care residents and staff in the last two months of 2020, mostly in December.
  • The Department of Veterans Affairs in Lexington is offering vaccinations to veterans age 50 and up. It has been vaccinating veterans by appointment, but this weekend will have a walk-in clinic with no appointment necessary.
  • Dollar General Corp. will pay employees who get vaccinated an extra four hours' wages, making it one of the first major retailers to incentivize shots, The Washington Post reports.
  • Health Commissioner Steven Stack expressed thanks for "the outpouring of support" that he, his wife and daughter have received since their mailbox was vandalized Sunday. "The goodness in the world far outweighs the bad," he said.
  • President-elect Joe Biden announced a plan, priced at just under $2 trillion to appeal to Republicans, proposed a plan that "would direct billions of dollars toward a nationwide vaccination program intended to reduce delays in production and delivery, hire medical workers to administer shots, and create a public awareness campaign to convince people to take them," the Post reports. "The same plan would extend enhanced unemployment aid through September, send $2,000 stimulus checks to many Americans, and significantly expand benefits for poor and middle-class children. New jobless claims rose by 181,000 to nearly 1 million last week, the largest increase since the beginning of the pandemic."

4 Kentucky lawyers have killed themselves in the last 3 weeks

Four Kentucky lawyers have committed suicide in the last three weeks, according to the Kentucky Bar Association.

"The suicides have prompted many to encourage colleagues to seek help if they need it and renewed calls for more continuing education about suicide, mental health, substance abuse and depression for the legal community," report Beth Musgrave and Valarie Honeycutt Spears of the Lexington Herald-Leader.

"Lawyers are 3.6 times more likely to suffer from depression than non-lawyers, according to the American Psychological Association. Substance abuse rates for lawyers are also much higher than non-lawyers."

Lexington lawyer Corey Fannin killed himself on Christmas.
(Lexington Herald-Leader photo illustration)
Three of the lawyers who killed themselves practiced in Lexington and one was from Paintsville.

John Meyers, executive director of the bar association, said its board of governors will talk Friday about what additional resources “we can bring to the table to try to help this problem.”

Louisville lawyer Wilson Greene wants the association to require one hour of education for lawyers focusing on mental health, substance abuse, depression and stress management, partly so they are aware of how to get help. “This is a problem that lawyers have known about for a while,” Greene said. “Because of the stresses, lawyers are more prone to suicide and substance abuse.”

Greene and other lawyers told the reporters that many attorneys are afraid to get help or go into treatment, for fear of losing referrals from other lawyers. 

"Lawyers are also problem solvers and fixers," and can spread themselves too thin, the reporters note. "The legal profession is also adversarial. That sets up a win/loss situation."

Greene said, “Your clients are looking for positive outcomes and sometimes that doesn’t occur. That’s unfortunately a reality of the practice of law. But that drains you, and and can pull you down.”

Wednesday, January 13, 2021

State reports third largest number of deaths from coronavirus in one day, fourth largest number of new cases in a day

By Al Cross
Kentucky Health News

Kentucky reported the fourth largest number of new coronavirus cases Wednesday, along with the third largest number of additional deaths.

“We’re going to pass 3,000 Covid-19 deaths in the commonwealth,” Gov. Andy Beshear said in a news release. “That is tragic. We can stop this. We need to wear masks. We need to follow the rules and restrictions, and now is not the time to pull away the authority that keeps us safe. That allows us to be fluid and flexible with a virus that appears to be mutating and spreading more aggressively.”

The state's Covid-19 death toll rose to 2,991 with the addition of 47 to the state's list. The largest one-day figures are 54 and 53, respectively, on Dec. 24 and Dec. 17. The dates do not represent the date of death, but the date that the death was confirmed or listed as probable.
 
The number of new cases, 4,560, is the fourth largest of any day. The three largest (5,742, 4,911 and 4,750) were on consecutive days last week.

The seven-day rolling average of new cases fell to 3,833, because the record day was eight days ago. The average set a record of 4,002 Tuesday.

Hospitalizations for Covid-19 declined 1.8%, to 1,702, but the number of patients in intensive care rose 1.5%, to 403 and those on ventilators rose 9.8%, to 225.

Hospitals in the Lake Cumberland hospital-readiness region reported that all their intensive-care beds were occupied, apparently the first time that has happened. Their overall bed occupancy was 62.45%.

Two other regions had figures over 80%, putting them in red on the state's daily report. Barren River reported 80.1% of its beds were full, and the easternmost region, from Lee to Pike counties, reported 89% of its intensive-care beds were occupied.

One encouraging sign is that the percentage of Kentuckians testing positive for the virus in the last seven days fell for the third straight day, to 12.29%. But the rate is twice as high as it was Nov. 1, and anything over 5% is worrisome to public-health experts.

Counties with prisons such as Morgan and Oldham continued to have high rates of new infections. Morgan's average over the last seven days has been 954 cases per 100,000 population; it is followed by Clinton, 221; Carroll, 168; Clay, 162; Wayne, 147; Harrison, 146; Cumberland, 138; Oldham, 134; Webster, Taylor, 112.5; Nelson, 111.5; Hancock, 111.4; Graves, 111.2; Mercer, 108.8; Butler, 108.7; Henderson, 106.2; Ohio, 106; Caldwell, 105.3; and Boyd, 102.4.

The Corrections Department's daily report shows 1,466 active cases among prisoners and 151 among employees. Five staff and 39 employees have died.

In other coronavirus news Wednesday:
  • Nine of the newly listed deaths were in Jefferson County: six women, 65, 81, 82, 89, 89 and 93; and three men, 71,787 and 90. The state's smallest county, Robertson, had two deaths, a 63-year-old woman and a 78-year-old man.
  • The other fatalities were an Adair County man, 64; a Bell County woman, 80; a Boyle County man and woman, 77 and 91; a Caldwell County woman, 63; a Carter County woman, 71; two Carter County men, 81 and 92; a Clay County woman, 80; a Clinton County man, 76; a Grayson County woman, 72; a Hardin County woman, 59; two Hopkins County women, 83 and 87; a Jackson County man, 54; two LaRue County men, 66 and 67; a Leslie County woman, 75; a Letcher County woman, 58; a Livingston County man, 77; a McCracken County man, 70; two McCreary County women, 68 and 76; a Madison County woman, 81; a Metcalfe County woman and man, 65 and 67; two Muhlenberg County men, 79 and 91; a Pulaski County man, 81; two Rockcastle County women, 73 and 88; two Russell County women, 80 and 86; a Scott County man, 72; and a Washington County man and woman, 78 and 89.
  • Counties with more than 10 new cases were: Jefferson, 664; Oldham, 247; Kenton, 241; Fayette, 237; Daviess, 170; Boone, 160; Morgan, 119; Campbell, 106; Pulaski, 104; Warren, 97; Pike, 80; Hardin, 74; Bullitt, 71; Boyd, 70; Christian, 69; Madison, 661; Nelson, 64; Laurel, 62; Clark, 61; Henderson, 58; Scott, 58; Knox, Taylor and Whitley, 54; Harrison, 51; Hopkins and Ohio, 50; Wayne, 48; Graves, 46; Calloway, 42; Boyle and Franklin, 39; Clinton, Perry and Shelby, 38; Jessamine, 37; McCracken and Russell, 34; Floyd, 33; Grayson and Montgomery, 31; Todd, 27; Bell, Lincoln and Rowan, 25; Greenup and Woodford, 24; Barren and Marion, 22; Grant and McCreary, 20; Meade, 19; Carter, Lawrence, Mason and Washington, 17; Johnson, Logan, Mercer and Muhlenberg, 16; Allen, Anderson, Bourbon, Fleming and Webster, 15; Bracken and Garrard, 14; Breathitt, Cumberland, Hart, Leslie, McLean and Rockcastle, 13; Hancock, Harlan, Marshall and Union, 12; and Butler, Carroll, Martin and Trimble, 11. 
  • Researchers at Ohio State said they have discovered in one patient a new strain of the coronavirus that is likely to be more infectious. They said it is similar to the one discovered in the United Kingdom, but likely originated in the U.S., and the discovery suggests that the same mutation may have occurred around the world in the past few months. There is no data to suggest yet that the mutations will have any impact on the effectiveness of current vaccines, they said.
  • West Virginia is outpacing the rest of the nation in coronavirus vaccine distribution because the state has taken more direct control of the process than other states, instead of relying on big pharmacy chains. "All 49 other states signed on with a federal program partnering with CVS and Walgreens to vaccinate long-term care and assisted living facilities," Yuki Noguchi reports for NPR. "But those chain stores are less common in West Virginia, so the state instead took charge of delivering its vaccine supply to 250 pharmacies — most of them small, independent stores." Harnessing existing pharmacy-nursing home relationships also helped speed things up. "Many long-term care sites in the state already use local pharmacies for other vaccines and medicines as well as twice-weekly coronavirus testing of residents and staff," Noguchi reports. "The state decided to piggyback off those existing relationships. Because those pharmacies already had data on many patients, it was easier to begin scheduling appointments in early December, securing consent forms and matching doses to eligible patients — logistics that are confounding efforts in many other states."

Tuesday, January 12, 2021

7-day average of new coronavirus cases, most common measure of the pandemic, goes above 4,000 for the first time in Kentucky

Kentucky Health News graph, based on unadjusted initial daily reports; click on it to enlarge
By Al Cross
Kentucky Health News

The coronavirus pandemic kept accelerating on most fronts in Kentucky Tuesday, as the seven-day average of daily new cases broke 4,000, almost double what it was two weeks ago, and hospital cases increased.

After reporting 3,085 new cases, the fourth most on a Tuesday, Gov. Andy Beshear took hope in a two-day drop of the percentage of Kentuckians testing positive for the virus in the last seven days: 12.23%, down from the 12.45% average recorded Sunday, the highest since testing became widely available.

“We are sure that this is a surge caused by gatherings through the holidays, but there is a chance . . . they’ve changed their behavior back to being very careful,” Beshear said. “Hopefully, we’ll see a leveling off, but only the data over the next couple of days and into next week is going to let us know.”

Asked about possible new restrictions to stanch the surge, Beshear said he had “no plans at this time . . . It looks like we have jumped up but may already be stabilizing.” But he added, “It may be that we are still in the increase . . . We know it was created by holiday gatherings primarily but we’re still trying to determine what people have been doing since.”

Health officials had voiced suspicion that the post-holiday surge and a broader, longer increase nationwide were driven by more contagious strains of the virus. Experts say there is no evidence of that, “but they acknowledge their battlefield awareness is limited,” The Washington Post reports. “The increase . . . has been so rapid in recent weeks that scientists cannot rule out the possibility that an undetected variant is accelerating the spread. Other factors may be behind the surge, including holiday gatherings and the lack of adherence in some communities to public health guidelines designed to limit transmission, such as social distancing and wearing masks.”

Kentucky hospitals reported 1,733 Covid-19 patients, with 397 of them in intensive care, both more than recent days but still not as many as a week ago; 205 patients are on ventilators.

Long-term-care facilities reported 71 more cases among residents and 53 more among staff, for a total of 1,142 and 676 active cases, respectively. The state added 28 more residents to the list of those whose lives were ended early by the virus, for a total of 2,004.

The state's daily report listed 22 more deaths, 21 confirmed as caused by Covid-19 and one probable. Beshear noted that seven were men from Boyle County, ranging in age from 51 to 88, and attributed that to "a lag in reporting" and said three of them were in correctional facilities.

The state's Northpoint Training Center is in Boyle County, though its address is the Mercer County town of Burgin. The Corrections Department's daily Covid-19 report shows that four inmates and one employee at Northpoint have died from the disease, and there are 60 active cases among inmates and 18 in staff. The prison has had 897 inmate cases, the most of any in the state system.

Vaccines: Beshear said he welcomed federal officials' decision to stop holding back doses of vaccines as a reserve for the booster shots that are needed three or four weeks after the first inoculation, but said the state would have to be careful in managing when he expects to be a temporary surge in supply.

"Some of those doses that come in may have to wait a week," he said, but added later, "I feel very good about where it’s going; I feel we are improving every day."

Beshear noted the possibility that a third vaccine, from Johnson & Johnson, might become available soon. "The top advisor of the Trump administration’s Operation Warp Speed predicted on Tuesday that Johnson & Johnson would seek approval for its single-shot Covid-19 vaccine candidate later this month — and that it could get the greenlight in February," the New York Post reports.

Federal officials also changed their recommendations to urge states to vaccinate anyone 65 and older. Kentucky's plan calls for the next phase to include those 70 and older, followed by a third phase including those 60 and older. Beshear said he would announce detailed third-phase plans Thursday.

Asked about the report that CVS Health and Walgreens have administered only 22% of the doses that the federal government is paying them to give at long-term care facilities in Kentucky, Beshear said. "We have to send certain amounts to Walgreens and CVS even though their pace might not be the same as we are setting and improving on. I believe they have allocated and sent to them all the doses they will need for the first round of vaccine shots. . . . No doses have expired that I know of." 

The Washington Post reports the administration "has been holding back roughly half the vaccines to ensure sufficient supply for people to get a required second shot. The expectation is that people will still get their second doses as planned."

Impeachment: Beshear spent several minutes talking about two of the four people who filed petitions with the state House asking that he be impeached for violating the state constitution with his emergency pandemic orders. He has called the petition groundless, noting the state Supreme Court upheld him.

He identified one petitioner, Tony Wheatley of Mercer County, as organizer of two rallies on the state Capitol grounds, the first where a man hung him in effigy and "They stormed past all the barricades in front of the governor’s mansion and stood on the other side of the windows where my kids play." Those at the second rally, last weekend, included a heavily armed man who prominently carried plastic zip-ties, which can be used as handcuffs.

He said the other, Jacob Clark of Grayson County, produced a video in which he said God would smite Beshear. "That is his handgun, right above his left shoulder," Beshear noted. He said later, "This is exactly what we saw in D.C.; these are the people that are out there trying to undermine our democracy in any way that they can. . . . I cannot believe that a part of our state government would, and shouldn’t, support those who have engaged in activities of intimidation and of hate."

Beshear was asked if he meant that the House's creation of a special committee to consider the petition was support of the petitioners. "I just meant that if the committee moves forward with it," he said. "There’s an argument you’ve got to form a committee under law; in the past that hasn’t happened, they’ve just sent it to an existing committee." Then he qualified his statement, saying "That’s the process that a number of these have previously followed," and said there may have been a special committee to consider impeachment of a judge last year. There was.

Rep. Jason Nemes, R-Louisville, the committee chair, said in an interview that special panels have often been created to consider impeachments, citing a state Legislative Research Commission publication as his authority. He said the committee would meet Wednesday, probably during a House recess, and would ask Beshear to respond to the petition.

In other coronavirus news Tuesday:

  • Besides the seven deaths in Boyle County, the others announced were a Carter County woman and man, ages 76 and 78; a Harrison County man, 60; two Hopkins County women, 61 and 75; two Jefferson County women, 56 and 97; two Jefferson County men, both 78; a Jessamine County man, 80, two Lewis County men, 73 and 74; a Muhlenberg County man, 69; and two Pulaski County women, 43 and 83.
  • Counties with more than 10 new cases were: Jefferson, 368; Madison, 142; Kenton, 139; Fayette, 138; Boone, 94; Warren, 90; Pulaski, 84; Pike, 70; Daviess, 66; Campbell, 62; Wayne, 62; Laurel, 59; Hardin, 55; Christian, 53; Nelson, 51; Taylor, 50; Barren, 48; Boyle, 42; Whitley, 41; Henderson, 39; Clark, 32; Bell, 31; Graves, 31; Montgomery, 30; Russell, 30; Bullitt, Clinton, Floyd, Hopkins, Johnson and McCreary, 28; Calloway and Jessamine, 27; Adair, 26; Clay and Muhlenberg, 25; Bourbon, Harrison, Ohio and Oldham, 24; Scott, 21; Hart and Mercer, 20; Anderson and Knox, 19; McCracken, 18; Breckinridge, Logan and Pendleton, 17; Greenup, Harlan and Mason, 16; Lawrence, Perry and Rockcastle, 15; Carroll, Garrard, LaRue, Leslie, Lincoln, Owen and Shelby, 14; Butler, Franklin, Green, Letcher, Marshall and Meade, 13; Boyd, Casey, Grayson, Hancock and Jackson, 12; and Grant, Monroe and Simpson, 11.

Monday, January 11, 2021

Beshear dismisses legislators' complaints about not consulting with them on pandemic, says 'A phone works both ways'

State health department graph, adapted by Kentucky Health News; to enlarge it, click on it.

By Melissa Patrick
Kentucky Health News

Faced with a sheaf of potential laws that are likely to limit his emergency powers in the coronavirus pandemic, Democratic Gov. Andy Beshear dismissed complaints of the Republican-controlled legislature and reiterated his plan for vetoes and court action if they are overridden as expected.

Beshear said he would veto any bill "that I think will hamper our ability to effectively fight this virus," and "Any bill that we believe unconstitutionally removes emergency powers that are absolutely necessary to fight a pandemic like this, we will challenge in court."

The General Assembly's Republican supermajorities passed six of their primary bills during rare Saturday meetings, four of them aimed at limiting Beshear's powers and two to further regulate abortion. Beshear is expected to veto them and to be overridden. 

One of Republican lawmakers' ongoing complaints is Beshear's lack of consultation with them regarding the pandemic. Asked if he regretted that, Beshear again pointed to the 40 times and 30 hours that he says members of his administration have testified before legislative committees about the virus, adding that sometimes there were "fairly hostile attitudes or questions." 

"Obviously, we were working every day, all day in the midst of a crisis, and a phone works both ways," he said. "We granted, I think, every meeting that was requested from us. We did not provide Stack in a room without somebody else from the administration, but that's just normal practice." Legislative leaders had asked for a private meeting with Health Commissioner Steven Stack.

Beshear continued, "In the midst of a pandemic, the concept that you don't call and meet with me enough, and therefore we're going to remove rules that are keeping people alive, I just don't think we ought to spend a lot of time talking about that, because we all ought to be able to put our egos aside and just do the right thing for our people during this period of time." 

Beshear spoke at some length about some of the bills, primarily House Bill 1, which would allow businesses to follow rules set by Beshear or guidelines of the Centers for Disease Control and Prevention, whichever is least stringent.

He shared a letter dated Jan. 11 sent by CDC Director Robert Redfield, cautioning that the CDC's recommendations are not meant to be interpreted as law. He also shared slides regarding CDC guidance around restaurants, bars, schools and gyms that supports the state's guidance.

Further, he warned Republican lawmakers to be careful what they ask for, since the CDC's entire focus is on public health, without consideration to the economy.  "I believe we strike the right balance," he said, referring to the state's existing guidance on reopening schools and businesses.

Last week, as Kentucky's recorded the most new coronavirus cases ever, Beshear said it's not the time to limit his emergency powers. Measures of the pandemic slacked a bit on Monday, as they often do immediately after weekends, but he expressed concern after noting that the percentage of Kentuckians testing positive for the virus in the past seven days is 12.35%, down slightly from yesterday's rate of 12.45%, the highest since testing became widely available in early May. 

"Now is when it is at its most serious and where we will lose the most people if we are not incredibly careful," Beshear said. "This ought to be another wake-up call, it ought to be a bright red warning light that tells us that we all got to protect ourselves, we've got to wear those masks, we've got to do everything almost perfectly under the guidance and the state rules to ensure that this thing doesn't get any further out of hand." 

Asked if he was considering any new restrictions, Beshear said, "We haven’t had those discussions yet."

Kentucky Department for Public Health graph, adapted by Ky. Health News; click on it to enlarge.

Daily numbers: Beshear reported 2,085 new cases Monday and said he hopes the surge comes from holiday gatherings and will subside, but said it could be "a lasting increase that builds on itself" and could stem from more contagious strains of the virus, one of which was recently identified in Indiana. 

Monday's new-case number was 234 fewer than last Monday's. The seven-day rolling average for new cases is 3,820, down slightly from yesterday when it was 3,854, which set a new record. 

All but one of the state's 120 counties, Hickman County, is in the "red zone," which means they have had at least 25 new daily cases of the virus per 100,000 residents in the last seven days. The state rate is 80.57.

Kentucky hospitals reported 1,708 Covid-19 patients, 381 of them in intensive care and 207 of those on ventilators. Beshear said three Kentucky hospital readiness regions had more than 80% of their intensive-care beds occupied: the easternmost region, at 80.9%; Barren River, at 87%; and Lake Cumberland, at 91.1%.
Kentucky Department for Public Health map; to enlarge it, click on it.
Beshear said Kentucky still has adequate hospital capacity statewide, but it's important to understand the urgency of the situation. 

"We still have room especially if we use the other ICU beds in other regions," he said. However, he said Kentuckians still need to understand the urgency of this situation so that the state does not end up like California, where ambulances are not taking taking patients to the hospitals that they think won't survive because there aren't enough beds available. 

Other topics: Beshear also spent a fair amount of time objecting to the attack on the U.S. Capitol and Saturday's rally outside the state Capitol, which included a "self-proclaimed militia" with armed protesters, one with zip-ties who has been reported as saying he had them "just in case." They can be used as handcuffs.

Beshear said the state would "do whatever necessary" to ensure the safety of the state Capitol, but would not disclose any specific plans. "We will not allow what happened at the U.S. Capitol to happen here," he said. 

Dr. Steven Stack
He noted that Stack's mailbox was vandalized Sunday when someone spray-pained the words "Covid is PCR fraud" on it. PCR stands for polymerase chain reaction, which is the gold-standard test for the virus.

"To the cowards out there who did it, we're working to find you. It is not acceptable. This is not how we act in our society and in a democracy," said Beshear. 

He said that isn't about the vandalism, but about deterring bullies who try to create terror by saying: "We know where you live, we know how to get to you. . . . Trying to create fear in his family is the lowest form of low."

Sara Jo Best, president of the Kentucky Health Departments Association, told Deborah Yetter of the Louisville Courier Journal that nearly all of the state's health departments have encountered some hostile reactions as they work to notify people about pandemic restrictions.

"I think probably every one of us has a story to tell at this point," said Best, who is director of the Lincoln Trail District Health Department.

Deaths: Beshear announced 21 more deaths from Covid-19, bringing the state's death toll to 2,922. He said only five were in long-term care facilities. 

Beshear honored the life of Simone Parker, 46, who died of Covid-19 this month. He said she taught at Trigg County High School for 19 years and was described by everyone who knew her as an "extraordinary educator." 

Beshear said Parker was hospitalized the Monday before Christmas, intubated and sedated, and couldn't speak. William, her husband, told Beshear that the hardest part was not being able to truly say goodbye to his wife of 23 years.

"We lift William and the rest of Simone’s family and community in prayer," he said, "including her students, colleagues and friends who she cared for."

In other coronavirus news Monday:
  • The latest confirmed or probable Covid-19 deaths were an Adair County man, 76; two Allen County women, 67 and 71; a Boone County woman, 73; a Christian County man, 81; a Cumberland County man, 81; a Fleming County man, 76; a man and woman from Graves County, 82 and 88; two Hardin County women, 68 and 87; a Hopkins County man, 86; a Meade County man, 88; three men from Nelson County, 57, 68 and 69; a Pulaski County woman, 86; two Pulaski County men, 74 and 78; a Russell County man, 83; and a Taylor County woman, 68. 
  • Beshear announced a new case at the state veterans nursing home in Radcliff, and said there had been another Covid-19-related death at the facility. 
  • Counties with 10 or more new cases were Jefferson, 358; Fayette, 183; Kenton,79; Boone, 77; Madison, Morgan and Warren, 68; Henderson, 58; Bullitt, 57; Campbell, 47; Graves, 46; Boyd, 35; Boyle, 31; Daviess, 29; Shelby, 28; Scott, 27; Clinton, 25; Barren and McCracken, 23; Carter, 22; Casey and Pike, 20; Caldwell and Laurel, 19; Wayne, 18; Jessamine, Marshall, Oldham and Taylor, 17; Estill, Greenup and Whitley, 16; Bath, Crittenden and Perry, 15; Harrison, Mercer, Nelson and Pulaski, 14; Butler, Calloway and McCreary, 13; Grayson, Hardin, Marion and Rowan, 12; Letcher and Montgomery, 11; and Allen, Grant, Knox, Russell and Trigg, 10.    
  • As Kentucky schools begin to reopen to in-person classes, the K-12 School Covid-19 Self-Reported Dashboard shows that in the week ending January 8,, 1,674 students and 1,062 staff tested positive for the virus and 3,212 students and 774 staff were quarantined. 
  • In long-term care, 121 new residents and 132 new staff have tested positive for the virus and 23 new deaths have been attributed to Covid-19, bringing the total deaths up to 1,976.  
  • The Food and Drug Administration warned health-care providers that a mutant strain of the virus may make it escape testing, creating false negative results. "The FDA is taking additional actions to ensure authorized tests remain accurate by working with test developers and conducting ongoing data analysis to evaluate all currently authorized molecular tests," the agency said. "The FDA believes the risk that these mutations will impact overall testing accuracy is low."
  • Senate Majority Leader Mitch McConnell said Kentucky got $297.5 million for coronavirus testing and vaccine distribution from the Coronavirus Response and Relief Supplemental Appropriations Act that Congress passed in December. Most of the money was for testing, contact tracing, and other pandemic-fighting measures; $40.4 million was earmarked for vaccine distribution.
  • Pope Francis said he would soon get a vaccination, and called it a moral duty for humanity. “I believe that ethically, everyone needs to receive the vaccine,” he said in an interview with Italy’s TG5 that will air Sunday, The Washington Post reports.

Beshear 'cautiously optimistic' vaccine rollout will get up to speed and meet first goal; Stack says feds made unrealistic projections

Walgreens pharmacist Tera Hayes gave licensed practical nurse
Angela Williams a coronavirus vaccine at Somerset Nursing and
Rehabilitation Dec. 22. 
(Photo: Caleb Lowndes, Commonwealth Journal)
Kentucky Health News

Gov. Andy Beshear said Monday that he is "cautiously optimistic" that Kentucky will meet its self-imposed goal of Feb. 1 for starting the second phase of vaccinations against the novel coronavirus, despite problems getting the shots up to speed, especially in long-term-care facilities.

"I’m not satisfied with the pace, but it has picked up significantly," Beshear said at a news conference. But he said the real test will come when many more people become eligible after the second phase, which is designated for people 70 and older, first responders and K-12 school personnel.  He said some places have already started that phase.

Most doses in the first phase of vaccination are earmarked for long-term-care facilities, with the shots being given under federal contracts by CVS Health and Walgreens, which have experience running flu-vaccination clinics. But the novel coronavirus is not the flu, and long-term care companies have been staggering employees in groups to get their shots, in case of negative reactions that could keep them from working at a critical time.

“In some cases, we have had to make 10 to 12 phone calls’’ to lock down a schedule for a visit, Larry J. Merlo, chief executive of CVS, told The Washington Post, which reports, "Part of the reason for slow uptake has been hesitancy among staff members, with only about 30 to 40 percent willing to get shots, according to officials and executives."

The rest of the first phase is for health-care workers, with hospitals taking the lead, but they have had problems, too. Hospital executives also highlighted as cumbersome the prioritization tiers for vaccine imposed by different states, with large numbers of employees not responding to emails inviting them to get vaccinated and others opting to wait until after the holidays.

"The delayed and disjointed vaccine rollout is the product of poor coordination between the federal government and the 50 states and additional jurisdictions tasked with carrying out the most ambitious immunization campaign in history," says a story by seven reporters at the Post.

"Late last year, Health and Human Services Secretary Alex Azar and other top administration officials spent weeks predicting that 20 million people would be immunized by the end of 2020. But by the time the New Year’s Eve Ball fell, just over 3 million doses had been administered, prompting a blast of criticism from dismayed public health officials who said the Trump administration used the vaccines’ development as a political tool in a bid to win reelection without planning sufficiently for their rollout."

One surprising aspect of the slow rollout is hesitancy by health-care workers, some of whom "have rejected the shots out of unfounded fears about their safety — problems that veterans of immunization campaigns worldwide say could have been addressed through comprehensive, centralized planning and communication," the Post reports. Trump administration officials blamed the delays on states and health systems "too rigidly adhering to guidance about who should receive priority for shots."

Azar told the Post, “It was always . . . agreed to that we needed to use and leverage existing systems of vaccine administration through the United States, with the states playing the leading role. . . . We bought the vaccine. We’re paying for the distribution costs. We’ve kitted the syringes, needles and [personal protective equipment] for it.” He said the estimate of 20 million was "accidentally used shorthand" for an estimate of 10 million getting an initial dose and a booster shot.

But 3 million is far short of even that, and "The public perception is damaging," the Post reports, quoting Kentucky Health Commissioner Steven Stack.

“Had we just projected realistic quantities, the public wouldn’t have seen this as a shortcoming,” said Stack, a former president of the American Medical Association. “They would have recognized it for the incredible accomplishment it was to even have this much vaccine this fast.”

Unnamed federal health officials said part of the problem was that Azar's agency sidelined the more cautious and less political Centers for Disease Control and Prevention, which has been "the nation’s premier organizer of vaccination drives," the Post reports. "Had the CDC played a bigger role, those officials said, forecasts about the number of doses would have been tempered, along with public expectations."

There is also vaccine hesitancy among school employees. "Someone has got to reach them. Someone has got to tell them it's OK to take it," Bobbie Lester, Indian Trail Elementary School nurse, told Jess Clark of Louisville's WFPL, regarding getting her co-workers to get a vaccine. Clark reports, "The vaccine is not mandatory, and around 6,000 JCPS employees and contractors haven’t signed up. 1,900 employees declined the vaccine, and about 4,000 did not respond to the vaccine survey."

Meanwhile, thousands of people who didn't meet priority criteria for vaccinations will get them anyway because Baptist Health's scheduling tool for health-care workers allowed anyone to sign up. "More than 6,000 Kentuckians created appointments using the new online portal that was intended for use by health care professionals, who are prioritized in Phase 1A of the state's vaccination rollout, the Courier Journal's Emma Austin reports. Baptist Health said, "While the state website linked to a page that clearly outlined that the vaccines are available for Phase 1A healthcare personnel, the scheduling tool did not include this information." Now it does.

UPDATE, Jan. 12: The Post's vaccine tracker says 3% of Kentucky's population has been vaccinated, ranking it 20th among the states.

Sunday, January 10, 2021

Bills filed to let cities and counties regulate marketing and sale of tobacco products and vaping materials more strictly than state

By Melissa Patrick
Kentucky Health News

Lawmakers in both the House and Senate have filed bills to let cities and counties more strictly regulate marketing and sale of tobacco products, a power the legislature took from them nearly 25 years ago. 

Sen. Julie Raque Adams, R-Louisville, filed Senate Bill 81 and Rep. Kim Moser, R-Taylor Mill, filed House Bill 147. The bills say "A city or county government may impose restrictions or requirements on the use, display, sale, and distribution of tobacco products or vapor products that are stricter than those imposed under state law." 

Coalition for a Smoke-Free Tomorrow illustration

Adams said at a news conference, "Our bills do not mandate that local communities pass tobacco control laws. Rather, the bills give communities the tools that they can use, if they so choose. Also, this measure does not take away any power from the state legislature in any way. If there comes a time that another proven statewide measure to improve health by reducing tobacco use is warranted and supported by my colleagues, the state would still have the right to do that."

Adams explained that the bill would allow local control of tobacco policies that was taken away in 1996 when cigarette manufacturers lobbied to pre-empt local control as a way to overturn existing local laws and prevent future community measures to reduce tobacco use. 

Moser said the law is needed to make Kentucky a healthier place, noting that nearly 9,000 Kentuckians die from a smoking-related disease each year; Kentucky has the second highest rate of chronic obstructive pulmonary disease, or COPD; and the highest cancer incidence and death rates in the nation, with one-third of the cancer cases tied directly to smoking.

"That means that more than one-third of the cancers in Kentucky can be prevented, " she said, adding later, "There's simply no reason that local communities that have the political will and the constituents support to adopt measures to limit the marketing and the sale of tobacco products in their community should be prohibited from doing so." 

Nearly 25 years after the pre-emption law was enacted in March 1996,  Kentucky continues to have nearly the highest adult smoking rate in the nation, at 24 percent, with rates as high as 49% in some areas. In 16 Kentucky counties, more than 30 percent of women smoke while pregnant. 

Meanwhile, electronic cigarettes are addicting a whole new generation of youth to nicotine, with one in four Kentucky high-school students and nearly one in six middle schoolers regularly using e-cigarettes. 

Hannah Abdon, a student at Randall Cooper High School in Union, spoke about the prevalence of e-cigarette and tobacco advertising is in her area. 

"While driving to my own high school, I pass four different stores that heavily advertised tobacco products in their store fronts," she said. "Most of these places are very close to my school. . . . Tobacco advertising is virtually everywhere I look. This is why we need special laws . . . so that my community and others in Kentucky can try new ways to prevent youth from vaping and other tobacco use. "  

Abigail Birman, a junior at McCracken County High School in Paducah, said without this law, it's useless for her to advocate for any local changes: "What is crazy is that I have not done any local advocacy work in my area because there is a state law that prohibits my local community from doing more to protect me and my friends from tobacco advertising."

Representing the business community, Betsy Clemons, executive director of the Hazard-Perry County Chamber of Commerce, expressed strong support for these bills. She talked about the importance of building a healthy workforce in Eastern Kentucky, which has some of the highest health disparities in the nation, to attract potential companies to locate or expand their operations in the region.

Clemons said smoking costs Kentucky businesses nearly $2.8 billion every single year in lost productivity and an additional $5,800 per year for every employee that smokes.

"We need more tools to help reduce tobacco use, improve our workforce, health, productivity and reduce our costs. We need the freedom to innovate and try things in our community that might not work elsewhere in Kentucky," she said. "That's what local control of tobacco marketing and sales is all about in it's the next logical step for Kentucky." 

Dr. Pat Withrow, a retired Paducah cardiologist and advocate for prevention of youth tobacco use, said limiting youth exposure to e-cigarette and tobacco advertising is a proven strategy to decrease teen use of the products. 

"We know that 90% of tobacco use starts before age 18," he said. "If local communities could reduce youth exposures to ads of vapes and other tobacco products, they could also reduce youth tobacco use."

The bills are supported by the Coalition for a Smoke-Free Tomorrow, comprising of more than 220 Kentucky businesses, health care providers, faith-based and health advocacy organizations.