Monday, August 3, 2020

Beshear: Drop in virus cases lines up with mask mandate, and 200,000 more in Ky. would follow it if Trump wore one routinely

Health Commissioner Steven Stack used this graph to compare states. For a larger image, click on it.
By Melissa Patrick and Al Cross
Kentucky Health News

The state's top doctor said Monday that from a medical standpoint, Kentucky has done "a pretty good job" dealing with coronavirus, but Gov. Andy Beshear said the state would be doing better if President Trump set a better example by wearing a facial covering.

Asked to grade Trump's efforts against the virus, Beshear declined, except to say, "I have mentioned that we really need the president to wear a mask, that if the president would routinely wear a mask, then there’s probably a couple hundred thousand Kentuckians that would wear one too, and would better protect them."

Health Commissioner Steven Stack praised Kentuckians' efforts to do what has been asked of them to keep the disease at bay, most importantly wearing facial coverings and and practicing social distancing. 

“I think we have a lot to be proud of in Kentucky. It’s been hard. It's taken a real toll on us and I never want to be dismissive of that,” Stack said. “I think that the evidence so far is showing we've done a pretty good job steering us through this in Kentucky from a medical standpoint.”

Beshear reported 323 new cases on Monday. The seven-day average is 564; the three-day average is 453. He reported 612 Kentuckians in the hospital with the virus, and 136 of them in intensive care. The state's positive test rate is 5.18%. 

The positive-test rate that Kentucky reports is lower than those in federal and other reports because the state removes duplicates, Stack said. Beshear said some days have seen as many as 22 duplicates, reflecting multiple tests of the same infected person.

While Kentucky had its largest number of overall positive cases in July, Beshear said there is reason to be hopeful, "because what the numbers are telling us is that facial coverings and masks are working."

Blue bars are cases per week, June 8 to Aug. 2. Dotted line projects numbers
if the trend of July 13-19 had continued. For a larger graphic, click on it.
He showed a graph of cases per week that showed a 48% increase in the week of July 6-12, a 52% jump July 13-19, a 4% increase July 20-26, and a 5% increase July 27-Aug. 2. The mask mandate went into effect July 10, and the incubation period for the virus can be two weeks or longer.

"This shows you how important wearing that facial covering is and its impact that it can have pretty quickly," the governor said. 

Beshear projected that if Kentucky did not have a  mask mandate, it would have continued seeing exponential growth,  as high as 1,000 new cases every day, like Oklahoma, Mississippi and so many other states have had. "That is the trajectory that we were on," he said. 

To further promote the effectiveness of wearing a mask, Beshear launched a new statewide public service campaign called MaskUpKY that will be released over the next couple of months. The message is "Don't put it off. Put it on."

“We know that if we can get the majority of Kentuckians to wear a mask when you go in public, we can make a major difference,” Beshear said. “If we want to get our kids back in school, reopen our economy, keep each other safe and get to a new normal, we need every Kentuckian to wear a mask or facial covering. It’s that simple.”

Beshear and Stack said it is still too early to see the impact of the week-old order closing bars and decreasing indoor restaurant capacity to 25%, from 50%.

Beshear said he hoped to provide additional capacity for restaurants next week. "On bars, we hope that we can have better, stronger guidelines," he said. "We may also have to consider a curfew, a closing time, because that appears to be at least semi-effective in other states."

Labeled screenshot of New York Times interactive map,
which also has estimates for schools of 100 and 1,000.
Schools: How risky will or would it be to open schools to in-person instruction in the middle of a pandemic? Researchers at the University of Texas estimated the risk on the basis of current infection rates in each county, and The New York Times created an interactive map with their data. Kentucky's risk is relatively low, but some counties are especially risky.

For example, in Warren, Barren, Monroe and Cumberland counties, a school with 500 people would be expected to have five people arriving infected with the virus in the first week of in-person classes. That is the near middle of the estimated range of three to nine.

Bell and Harlan counties are even higher, at seven, with ranges of four to 14 and four to 13, respectively. Counties with an estimate of four, and their estimates' ranges, are Boyle (3 to 8), Casey (2-7), Fulton (3-8), Graves (2-8), Metcalfe (2-7), Ohio (2-7), Oldham (2-7) and Scott (4-8). Jefferson and Fayette counties both have estimates of three, with ranges of two to seven. They have decided to begin instruction online.

In other covid-19 news Monday:
  • The state reported two more deaths from covid-19 on Monday, bringing its toll to 744. The fatalities were a 99-year-old man from Calloway County and a 75-year-old man from Floyd County. 
  • Counties with 10 or more new cases were Jefferson, 75; Fayette, 30; Warren, 24; Oldham, 20; Madison, 13; and Jessamine, 10. 
  • Twelve of the new cases were in children under the age of five, with two of them three months old. 
  • In long-term care facilities, Beshear reported nine more residents and  seven more staff tested positive for the virus, and attributed three more deaths to the disease, for a total  of 475. The state began reporting only active cases at the facilities: 417 residents and 201 employees. 
  • Beshear's travel advisory, asking people to avoid traveling to states with positive-test rates of 15% and to self-quarantine if they do, now applies to fewer states: Alabama, Arizona, Florida, Idaho, Kansas, Mississippi, Nevada and South Carolina. Alabama and Mississippi have the highest rates, 21.55% and 21.12%. 
  • Beshear followed the White House task force's advice while Tennessee Gov. Bill Lee did not, refusing to close bars or require masks, the Courier Journal notes in its weekly covid-19 roundup. It also notes that New York has added Kentucky to the list of 30 states whose citizens should quarantine for two weeks if they come to the Empire State, due to Kentucky's higher positive-test rate.
  • A federal response team of four to six people will be in Louisville this week to evaluate the city's response to the pandemic because of Jefferson County's rising case numbers and positive-test rates. Some recommendations are expected, said Eric Friedlander, secretary of the Cabinet for Health and Family Services.
  • Kroger Co. has moved its testing to its in-store clinics, but Beshear said more than 225 testing sites can be found at kycovid19.ky.gov.
  • Free drive-through testing sites will be offered in Louisville at three locations starting Aug. 5; call 502-588-0414 to sign up. In Northern Kentucky, new drive-thru testing will begin Aug. 6 at the Atlantic Corporate Center in Erlanger. The testing is free, but by appointment only. Beshear said he would announce a new site in Lexington in the next few days. 
  • "Seven young podcasters are telling the stories of the pandemic’s impact in Eastern Kentucky," reports Liz Moomey of the Lexington Herald-Leader. The interns with the Appalachian Media Institute, part of Appalshop in Whitesburg, premiered “A Mask on the Mountains”  July 23 on WMMT-FM, available online. "They focus on covid-19’s effect on life in the region, addressing a range of topics like foster care, health care disparities and canceled festivals," Moomey reports.
  • "The mask is the simplest and among the most effective weapons against the coronavirus in the public health arsenal. Yet from the start, America’s relationship with face coverings has been deeply fraught," The Washington Post reports. "Faulty guidance from health authorities, a cultural aversion to masks and a deeply polarized politics have all contributed." New York Times columnist Paul Krugman writes, "The cult of selfishness is killing America."
  • Some families are creating "pandemic pods" to provide supplemental learning or to complete at-home coursework together and to be able to socialize, others are looking to form "microschools" by hiring someone to teach their children, and others are participating in home-school co-operatives. Some have suggested that public schools should explore similar models, especially to help high-risk and high-need students and others have strongly cautioned that these models represent an inequitable model that will further widen the achievement gaps in education based on class, race and ability, Billy Kobin reports for the Courier Journal. 
  •  WDRB reports on challenges for the state's contact-tracing system, provided to the state by Deloitte under a $4.27 million contract. Key among the challenges is an inability for health departments to have quick access to the data. “We just don’t have a quick way yet to get it out, to get that information out to the public in an accurate manner,” said Dr. Sarah Moyer, Louisville's public-health director.  
  •  Ed Yong of The Atlantic offers an in-depth analysis, "How the Pandemic Defeated America." Yong opens his story by writing, "How did it come to this? A virus a thousand times smaller than a dust mote has humbled and humiliated the planet’s most powerful nation. America has failed to protect its people, leaving them with illness and financial ruin. It has lost its status as a global leader. It has careened between inaction and ineptitude. The breadth and magnitude of its errors are difficult, in the moment, to truly fathom."
  • The Kaiser Family Foundation offers a report that answers key questions about nursing-home oversight and explains how federal policy has changed in light of covid-19.

UK student maps planting and use of blackberries in Grow Appalachia program; store-bought berries too expensive for many

Lucinda Smith with blackberries (Photo via UK)
By Katie Pratt
University of Kentucky

A University of Kentucky student is contributing to nutrition research that could lead to healthier habits and fewer negative health outcomes in her native region.

“I have always wanted to give back to Eastern Kentucky,” said Lucinda Smith, a senior human-nutrition major from Corbin who is working working with Dawn Brewer, an assistant professor in the Department of Dietetics and Human Nutrition in UK's College of Agriculture, Food and Environment.

Brewer is leader of the Community Engagement Core of UK’s Superfund Research Center, which is funded by the National Institutes of Environmental Health Sciences. The core seeks to help people near hazardous waste find ways they can use nutrition to improve their health and reduce their risks of negative health impacts associated with exposure to pollutants from the sites.

This summer, Smith received undergraduate research funds from the college and department that allowed her to map the location of blackberry bushes distributed through the community engagement core and Berea College’s Grow Appalachia program earlier this year by the Cowan Community Center in Letcher County and the Red Bird Mission Community Outreach Clinic in Clay County. Each participant received six to eight bushes and growing supplies.

“In an earlier survey, many people in the project said they loved blackberries, but they were often too expensive for them to purchase,” Smith said. “Blackberries are also a plant that grows well in Kentucky and are easy to plant and maintain. They contain phytonutrients and antioxidants, which help reduce oxidation and inflammation.”

Smith's project is measuring the amount of fruit each family harvests and how they use it, and mapping where the bushes and the demographic data of the 89 project participants. She collaborated with Josh Knight, UK senior extension associate with the Center for Crop Diversification, to make the maps and received location data from Grow Appalachia.

“Lucinda’s work gives a nice visual to share with our current and potential sponsors so they can see the reach of our program, particularly throughout Eastern Kentucky,” Brewer said.

Along with the maps, Smith has helped develop supplemental material for the BerryCare Extension curriculum, which was Brewer developed to teach people the health benefits of blackberries and ways to incorporate them into their diets.

Smith says she wants to become a family doctor and hopes to practice in Eastern Kentucky, and has developed a better understanding about the connections between nutrition and health.

“Through my human nutrition classes, I have been able to learn about the importance of a good diet, and by working with the Community Engagement Core, I have learned more about the effects of nutrition on the body,” Smith said. “I have also had the opportunity to shadow a family doctor who specializes in chronic care to see how diet has contributed to her patients’ chronic diseases.”

Sunday, August 2, 2020

Almost half of counties still lack syringe exchanges, including 20 of those most vulnerable to drug-related disease outbreaks


By Melissa Patrick
Kentucky Health News

Most Kentucky counties now have harm-reduction programs to fight drug abuse, but the coronavirus pandemic has slowed their expansion and complicated the work of their syringe exchanges.

Still, they've all continued to offer some level of service during the pandemic. Sixty-three counties have harm-reduction programs, and one more is in the works, but that will still leave 56 of the 120 counties without one. 

Tony Cox, director of the Bracken County Health Department, which has the newest program, encouraged those counties to be open-minded.

"Communities are hesitant, and we do understand their concerns, but I would encourage any and all communities to educate themselves, along with their policymakers and even the citizens in the community, to find out exactly what a harm reduction/syringe exchange program is really all about," he said. "It is about getting dirty needles off the street and off of our playgrounds and off of the places we go, certainly that's a huge part of it. But it is also a program that is about helping the people in our community as well that need help because they are addicted to drugs. Be open minded and get educated." 

Such programs have been able to stay open through the pandemic because the Department of Public Health designated them an essential service.

"To ensure public safety, programs adopted strategies including face coverings, moving to outside stations, creating distance in their spaces, some appointment-only programs, limiting hours/days and decreasing number of infectious-disease testing times," the department said in an e-mail.

Harm-reduction programs are designed to prevent outbreaks of HIV and hepatitis C, which are commonly spread by the needle sharing among intravenous drug users. They also provide health screenings and vaccines, and connect drug users to treatment. 

They were approved in Kentucky under a 2015 law that requires approval by the county health board, the fiscal court and the city where the exchange is to be located.

Five added since last round-up

Kentucky has 74 operational syringe exchange locations in 63 of its 120 counties. Since mid-July 2019, when Kentucky Health News did its last syringe exchange roundup, five more counties have been marked on the state Cabinet for Health and Family Services map of exchanges and the counties deemed most vulnerable to HIV and hepatitis C outbreaks.

Besides Bracken, the new counties are Christian, LaRue, Marion and Martin.

Bracken County Health Department photo on Facebook
Christian County's program is the latest to be approved, but is not yet operational. Bracken County's exchange is still marked as not yet operational on the state's map, but it started operating July 8. 

Among the 54 Kentucky counties that the U.S. Centers for Disease Control and Prevention has identified as being most vulnerable to outbreaks of HIV and hepatitis C among IV drug users, 34 have operational exchanges.

The vulnerable counties that have not approved an exchange include Bell and Clinton, which rank sixth and 11th on the national list of 220 vulnerable counties; Cumberland, Casey, Edmonson, Harlan, Johnson, Lawrence, Lewis, Menifee, Monroe, Rockcastle and Wayne, also in Appalachian Kentucky; and eight in the rest of the state: Carroll, Gallatin, Green, Breckinridge, Grayson, Green, Allen and Hickman.

Harm reduction and the pandemic

Christie Green, public health director of the Cumberland Valley District Health Department, said their program saw a brief dip in participation in March and April, and it has since increased. Early in the pandemic they only offered services every two weeks as a way to limit interactions, she said, but have since gone back to their weekly schedule. 

"As restrictions were lifted," she said. "most of our participants preferred to come every week."

Green said they also increased usage of their mobile harm-reduction unit in Clay and Jackson counties. "So, instead of bringing them into the van, which is set up kind of like a little lab on the inside, we shifted it all to outside, under a canopy with a table beside the van," she said. "If someone wants a test, then we mask them and bring them inside." 

Scott Lockard, public health director of the Kentucky River District Heath Department, which has a program in each of the seven counties in the district, said its use has held steady or better. 

"People are still thankfully coming in and getting the supplies they need, because the last thing we would have wanted to see was a big uptick in HIV or hep C right now too," he said. "Our services are being utilized more than ever."

John Moses, harm-reduction team leader at the Lexington-Fayette County Health Department, said it has seen a steady increase in participation, with record numbers in the last month.

"The good thing about our program is that we were able to continue all of our services through the syringe exchange with really minimal interruption because of covid," he said. "We simply moved our program outside and are using our mobile unit to see our clients."

Jamey Whaley, harm-reduction and peer-support specialist with the Buffalo Trace District Health Department, said that one of the biggest changes he's seen in its program since the beginning of the pandemic is a shift from methamphetamine to heroin, because limited meth supply has driven its price up.

"So I have seen more people who have gone in the direction of heroin, which is a little unsettling because of the risk of potential overdose," Whaley said. He added that he has seen some of the program's former participants relapse since the pandemic hit, and that he has added a good number of new participants. 

Whaley said Buffalo Trace shut down its program down for six weeks at the beginning of the pandemic and re-opened in mid-May. Since then, "I've been very busy, especially the last month I have really been steady." 

Only a few in the works

Logan County has received approval from its Board of Health for a syringe exchange program, but still needs the approval of the Russellville City Council and the county Fiscal Court. 

Alexis Bigham, who was the public-health educator at the Barren River District Health Department when interviewed, and now works on harm reduction in Edmonson County through the University of Kentucky, said two of the district's eight counties (Warren and Barren) have exchanges.

The agency wants Logan to be next "because we have a lot of people traveling from Logan County to here in our Warren County program." she said. But the pandemic has put that push on the back burner because everyone at the health department has been working on covid-19.

The Lincoln Trail District Health Department is based in Hardin County, but its efforts to start a program there haven't been successful. In the meantime, Marion and LaRue counties have joined adjoining Nelson County in the program, largely due to local support, said Melissa Phillips, a harm-reduction specialist.

"You really need both pieces, you need your buy-in from your policymakers, and data is usually what sells them, and knowing that there is no cost associated with it," she said. "And when you have a local champion, it makes the process so much smoother. They really do a lot of the leg work for us."

She said the need in Hardin County is supported by data on drug arrests, HIV and hepatitis C, but the pandemic has slowed the effort, largely because they aren't able to participate in face-to-face meetings with policymakers and the community, which she said is an essential part of the process.

July 26 federal report said that in most of Ky., nursing-home visits should stop, and obese, diabetics, hypertensive should stay home

Chart from White House report, adapted by Kentucky Health News; for a larger version, click on it.
This story has been updated.

By Al Cross
Kentucky Health News

The latest weekly report to states from the White House Coronavirus Task Force contains many recommendations for state and local officials that Kentucky officials have not implemented or even revealed.

For example, it recommends that the state prohibit visitation at long-term-care facilities in most Kentucky counties, those in the red and yellow danger zones as defined by the task force.

It recommends that people with obesity, diabetes and high blood pressure in those counties shelter in place, much as Gov. Andy Beshear ordered Kentuckians to do from late March to early May.

Beshear spokeswoman Crystal Staley told Kentucky Health News Monday morning that Beshear met with Dr. Deborah Birx, the task force's response coordinator, "to gather recommendations directly, and the actions taken by Gov. Beshear follow her advice. She would agree that too many Kentucky counties are in danger and that action was needed statewide."

Still, the recommendation to stop visitation at long-term-care facilities will be at the top of the agenda for Tuesday's meeting of the task force that the state has assembled to help the facilities get through the pandemic, task-force coordinator Keith Knapp said Monday morning.

The White House report also recommends that public officials "Ensure that all business retailers and personal services require masks," something that is not being done in much of the state, if anecdotal reports of limited mask wearing and enforcement in many businesses are indicative.

Beshear has acknowledged the need for better enforcement by businesses, and backup enforcement by health departments. "There's not been enough enforcement out there; we can admit to that," he said July 27.

Beshear has gone farther than the recommendations in at least one case, limiting social gatherings to 10 people -- something the task force recommended by done only in red zones.

The latest White House report, dated July 26, was sent to state officials. It was obtained and published by The New York Times. Kentucky officials have not responded to requests for a copy of the report; one of Beshear's emergency pandemic orders gives custodians of public records 10 days to respond to requests for records instead of the usual three.

Here are the recommendations to red and yellow zones in Kentucky in the July 26 report. Most are the same for both zones; this list notes major differences.

Public Messaging
Wear a mask at all times outside the home and maintain physical distance
Limit social gatherings to 25 people or fewer (10 in red zones)
Do not go to bars or nightclubs
Use takeout, outdoor dining (indoor dining in yellow zones when strict social distancing can be maintained)
Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene (in red zones, handwashing and surface cleaning are emphasized)
Reduce your public interactions and activities to 50% of your normal activity (25% in red zones)
Public Officials
Limit gyms to 25% occupancy and close bars until percent positive rates are under 3; create outdoor dining opportunities with pedestrian areas (gyms in red zones should be closed)
Institute routine weekly testing of all workers in assisted living and long-term care facilities; require masks for all staff and prohibit visitors
Ensure that all business retailers and personal services require masks and can safely social distance Increase messaging on the risk of serious disease for individuals in all age groups with pre-existing obesity, hypertension and diabetes, and recommend to shelter in place
Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community-level testing
Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours
Provide isolation facilities outside of households if positive individuals can't quarantine successfully
Testing
Move to community-led neighborhood testing and work with local community groups to increase access to testing (in red zones, increase community-level testing)
Surge testing and contact-tracing resources to neighborhoods and ZIP codes with highest case rates
Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours; consider pools of three to five individuals
Surveillance pooling: For family and cohabiting households, screen entire households in a single test by pooling specimens of all members into single collection device

The report also includes, for each state, four maps showing new cases, positive-test rates and the change in each from week to week. Here are Kentucky's maps from the July 26 report, comparing the week of July 18-24 with the previous week, July 11-17. For a larger version of the image, click on it.


Limited Sunday report keeps the coronavirus in Ky. on a plateau

Kentucky Health News chart; for a larger version, click on it.
By Al Cross
Kentucky Health News

Kentucky reported 463 new cases of the novel coronavirus Sunday, a little more evidence that the state has settled into another plateau, but one much higher than the one it was on a month ago.

“We appear to be seeing what we all hope is a plateau in the alarming growth of coronavirus cases in the commonwealth,” Gov. Andy Beshear said in a press release. “It shows that wearing a mask, social distancing and not traveling to virus hot spots is working. We need to see this trend continue to avoid having to make more hard choices and sacrifices.”

Beshear has also cited a decline in the percentage of Kentuckians testing positive for the virus. He did not report on testing or hospitalizations Sunday.

Reports are limited on Sundays, when fewer testing laboratories report to the state, and numbers are typically lower. But the record number of daily new cases, 979, was set on a Sunday, July 19.

Health Commissioner Steven Stack said in the news release that he was “cautiously optimistic we have blunted our steep covid-19 escalation with the mask requirement, restriction of gatherings to 10 or fewer people, bar closings and restaurant capacity restrictions. This is a prolonged challenge, though.”

The state reported two more deaths from covid-19 Sunday, a 56-year-old man from Oldham County and a 70-year-old woman from Muhlenberg County.

Counties with five or more new cases on Sunday's daily report were Jefferson, 91; Fayette, 80; Warren, 23; Kenton, 20; Pulaski, 19; Calloway, 14; Daviess, 13; Boone and Jessamine, 12 each; Oldham, nine; Graves, seven; Campbell, six; and Boyd, Casey, Franklin, Russell, Scott and Shelby, five each.

On the national level, the response coordinator of the White House Corinavirus Task Force warned that the virus is now widespread across the nation. She said, "To everybody who lives in a rural area, you are not immune or protected from this virus."

Saturday, August 1, 2020

Pandemic calls for local leadership and trusted voices

By Al Cross
Kentucky Health News

This was originally published as a column in KyForward.com.

Norman Chaffins and Donnie Keeton probably never expected to see their name in a column about Kentucky politics. But they’re elected officials who have done the right thing when it comes to the coronavirus, and they and their kind should be exalted.

Chaffins, a Republican, is the sheriff of Grayson County, in west-central Kentucky. Keeton, a Democrat, is a magistrate in Morgan County, in Eastern Kentucky. They both got the virus, and they went above and beyond the call of duty, telling others about it.

And they think we should all be wearing masks, probably the biggest single thing we can do to thwart the virus and its covid-19 disease – but something that has become way too controversial and politicized, just like so much else about the pandemic.

After recounting his covid horrors in a Facebook post, Chaffins, 51, wrote, “I’m telling you this because I want you to wear your mask. Not because I am the sheriff, not because the governor said so, and not because the business tells you to. I want you to wear a mask because I do not want anyone to have to go through what I went through. I want you to wear a mask because I don’t want my kids or grandbabies to get sick. I want you to wear a mask because it’s just the right thing to do. It may not 100% guarantee that you won’t contract it, but wearing a mask will certainly reduce your chances. Please understand this: I am not telling you to wear a mask. We are not going to fine you or insist that you wear a mask. As your friend, I am asking you to wear a mask when you are around others and when you go out into public at least until there is a vaccine.”

Chaffins, a former state trooper, published 929 words on July 12. Keeton, a disabled heavy-equipment operator, kept his July 16 post simple, but in white type on a red background: “For those who don’t think covid-19 is real, it is. I tested positive. . . . Sue hasn’t got her results yet.” (His wife tested negative.)

Yes, Keeton knew people who didn’t think the virus was real, he told me: “They think it’s all about the election, or it’s going to be over after the election.”

That’s what happens when a president politicizes public health, downplays a deadly pandemic and uses Twitter to peddle conspiracy theories and quack medicine, apparently in an effort to so confuse Americans that they don’t know what to believe.

Keeton, 52, told me he voted for Trump because “It’s kind of hard to go with the national Democratic Party right now,” but he had the president’s words in mind when he told his local newspaper, the Licking Valley Courier, “It’s not a hoax and it’s probably not going away anytime soon.”

Trump implied Feb. 28 that the pandemic, or Democrats’ criticism of his response to it, was Democrats’ “new hoax” after their failed impeachment of him. He walked that back, but Keeton told me that the phrase probably gave a lot of people the wrong idea.

Trump was elected partly because a lot of Americans, especially in rural areas, thought they were being left behind and disregarded by the urban elite. Many if not most of those people have never liked elites and experts telling them what to do (remember the debates about seat belts?), and Trump appealed to their resentment.

That approach turned dangerous when Trump started contradicting public-health experts and scientists, but he was operating in a friendly environment, as the unchallenged boss of a political party that has fueled and capitalized on skepticism about science, primarily the evidence of climate change. But it is also a friendly place for skepticism about vaccines, which could be the long-term obstacle in quashing the coronavirus.

That’s why it’s more important than ever for public officials at all levels to set good examples. Chaffins told me he has tested negative for the virus, and doesn’t think government should mandate masks, but he wears one to be “a good role model.”

And in an age where social media have more sway than news media, it’s important to hear covid-19 stories from authoritative victims. Chaffins said his nurse practitioner told him his post was helpful because “a lot of people don’t know anybody who’s had this and had a bad case of it.”

In other words, stories about people you know always have greater impact. Licking Valley Courier Editor Miranda Cantrell put a note at the end of her story about Keeton asking other victims to tell their stories, because locals wonder “whether the effects are as severe as mainstream media outlets have reported.”

Yes, they can be that severe, but many don’t trust those outlets – especially after four years of “fake news” bashing from a president who has uttered more than 20,000 falsehoods. Local news media are more trusted, so they need to step up, tell these stories and help their audiences understand how to deal with the pandemic. The politicians can only go so far.

New coronavirus case numbers and 7-day average drop below 600; positive-test rate declines for third day but remains above 5%

Kentucky Health News chart
By Al Cross
Kentucky Health News

Kentucky's coronavirus numbers were almost all improved Saturday.

The number of new cases, 572, was more than 200 less than Friday's fourth-highest figure of 778. The latest report lowered the seven-day rolling average to of daily new cases to 571. The three-day average dropped from 685 to 670.

The number of Kentuckians hospitalized with covid-19 increased slightly, to 602 from Friday's total of 597, but the number in intensive care dropped substantially, to 128 from 150.

The strongest trend line at the moment is the percentage of Kentuckians who have tested positive for the virus in the last seven days: 5.22 percent, the third straight day of decline from a recent high of 5.81% on Wednesday.

Since July 24, the rate has been above 5 percent, which the White House Coronavirus Task Force says is a "danger zone." That and the surge of cases in July prompted Gov. Andy Beshear to close bars, tighten restaurants' indoor capacity and advise school districts not to start in-person classes until the third week of August.

In a news release, Beshear urged obedience of the mask mandate he issued July 9, days after the July surge began. "Facial coverings work," he said. "They are our best chance of saving lives and protecting the health of our people, ensuring our economy can stay open, and getting our kids back in school."

Health Commissioner Steven Stack reminded Kentuckians of another order, one that depends more on public cooperation because it is harder to enforce.

“Gatherings should be limited to 10 or fewer guests, especially informal ones going on in backyards, parks, lakes and similar settings,” Stack said. “The commonly more personal, informal social behavior in these situations is a big risk. If you and your guests are not keeping at least a six-foot social distance and if you’re not wearing masks, this spreads the disease. It places the people you care about most at risk and it endangers others if they spread the disease throughout the community.”

Stack added, “I don’t want to sound like an alarmist, but a big part of this is about the decisions made and behaviors practiced by every one of us as individuals. Public gatherings and social activities can be tinderboxes for covid-19 transmission. Until we get a vaccine or cure to neutralize this threat, we all must continue practicing social distancing and wearing masks.”

The state's covid-19 death toll rose to 740 with five more fatalities, including three men in Oldham County, aged 55, 61 and 67. The others were an 81-year-old man from Jefferson County and an 84-year-old woman from Simpson County. Beshear's office did not immediately respond to a question asking if the Oldham County deaths were connected to the three state correctional facilities in thatg county, at least one of which has had an outbreak of covid-19.

Most county fairs in Kentucky appear to have been canceled, but the Oldham County Fair is planning to open Tuesday, despite advice to the contrary from the county health department, the Louisville Courier Journal reports. The fair plans to screen attendees and require masks, but County Judge-Executive David Vogele voiced doubt about the fair's ability to enforce mask wearing and keep up with necessary cleaning of surfaces over five days. The fair has the same midway as the state fair, Kissel Entertainment.

Counties with more than five new cases Saturday were Jefferson, 152; Fayette, 43; Warren, 32; Kenton, 28; Campbell, 23; Boone, 22; Whitley, 19; Jessamine, 14; Bullitt, 11; Daviess and Madison, 10 each; Barren, 9; Fulton, Graves, Hopkins Perry, Pike and Scott, 7 each; and Hardin, Knox and Laurel, 6 each.

As cases surge in southeastern Ky., public-health and local officials join forces to combat it and tamp down the politics

Like much of the nation, stopping the spread of the novel coronavirus in Appalachia isn't just a public-health effort, but also involves convincing its citizens that it isn't a political issue, Chris Kenning reports for the Louisville Courier Journal. 

The Bell County Health Department's Leighann Baker brings groceries
to Alan Smith, who is quarantined. (Photo by Pat McDonogh, Courier Journal)
Kenning went to Bell and Harlan counties in the southeast corner of Kentucky, which recently recorded some of the state's highest increases in average daily cases per person.

"Bell went from 20 cases to more than 200 in two weeks. Harlan saw 85 in a single week, twice as many as it had over four months. Bell, Clay, Knox and Harlan counties combined, for example, saw deaths more than triple to 18 in the month ending July 30," he reports. 

“We were one of the last counties to see any cases," Trissa Wilder, nurse supervisor for the Bell County Health Department, told Kenning. "We got lax, feeling that we were safe and secure” because of Central Appalachia’s geographic isolation.

Officials across several Kentucky Appalachian counties told Kenning that the virus first spread from "Carolina beach trips, Fourth of July parties, weddings, football practices, a four-day church revival — and even an illegal Clay County cockfight," he reports.

Health officials have voiced concern that covid-19 will have a disproportionate impact on Appalachia because it has fewer hospitals and intensive-care beds, high rates of poverty and conditions such as diabetes and heart and lung disease that make people more vulnerable to the virus.

"All that has meant special challenges for health departments hollowed out by budget cuts, such as those in Bell County, which battle distance, poverty, spotty cellphone coverage, neglected health, difficulty getting some residents to testing and distrust amid the growing politicization of public health," Kenning reports. 

In addition to their ongoing daily work to keep a community safe, public health departments have been stretched even thinner as they have increased their their contact-tracing efforts to identify those who have been infected, then tracking down everyone they have come into contact with and asking them to self-quarantine. 

The state has provided some relief on this front by expanding the number of tracers with federal coroanavirus money, "even as the effort's effectiveness wanes as cases increase," Kenning reports. The state says it recently added 455 tracers to the 431 who were already doing this job, and so far, the tracing is keeping up with the demand.

That added help is critical, Kenning reports, since the number of public-health workers in Kentucky has fallen 34% since 2012, according to the Kentucky Center for Economic Policy. 

"We’ve got a small health department, and we did get a little overwhelmed," Harlan County Judge-Executive Albey Brock told Kenning. "Contact tracing is no joke. It’s laborious. They keep daily communication. If we have 104 active cases, they each have to be called every day. That’s on top of having to track down people they've had contact with, getting them a letter, let them know to quarantine. 

Judge-Executive Albey Brock
"And then you run into the knuckleheads who don't want to stay quarantined because they’re not positive . . . Some of them don’t want to cooperate." 

And then there's the politics. Kenning writes from the Bell County seat of Pineville, "The area remains a conservative place, where every elected official but one constable is Republican. When cases were slow to materialize, some found it easy to dismiss alarms over the coronavirus as a Democratic plot to make President Donald Trump look bad or infringe on rights by requiring masks, local residents and officials said." 

In Harlan, about 30 miles up the Cumberland River from Pineville, Brock, a Republican, told Kenning that he has attempted to depoliticize the pandemic by sending public-health messages via social media and radio and having stern talks. 

“We’ve tried real hard locally to stamp that down. If you want to fight with Trump or Biden, have at it. Just wear a mask,” he said, adding jokingly, “Some believe we never walked on the moon, so I can’t help them.” 

Since Gov. Andy Beshear mandated masks and Walmart required face coverings, mask use has “gone up dramatically,” which has been “a pleasant surprise,” Ben Barnett, Bell County’s Emergency Management director, told Kenning.

Christie Green, public health director for the Cumberland Valley District Health Department. which overs Clay, Jackson and Rockcastle counties, told Kenning that contact tracing has thwarted the spread of the virus in several cases. "But she's still fighting distrust of public health fueled by national politics." She said, "People don’t know what to trust or believe. . . . How do you parse out all the soundbites you get?"

Friday, July 31, 2020

Hospitals overall are losing money, and it's likely to get worse; Cynthiana hospital says it's 'at a negative 25% margin'

A report prepared for the American Hospital Association predicts half of the nation's hospitals will be losing money by the end of the year unless Congress gives them more relief money, and some of those hospitals are in Kentucky.

Overall, hospitals usually have an operating margin of 3.5 percent, but that is expected to be minus 3% for the second quarter of this year, once the figures are compiled, and could sink to minus 7% in the third and fourth quarters -- and half of all hospitals are likely to operate with a negative margin, said the report by Kaufman Hall, a health-care consulting firm.

"That drop would have been negative 15% without funding from Congress, which gave providers $175 billion a few months ago," Robert King reports for Fierce Healthcare. Hospitals had to give up their most profitable function, elective surgery, in the early months of the pandemic, and now many Americans are reluctant to enter a hospital.

AHA organized a call with reporters and hospital executives, including Sheila Currans, CEO of Harrison Memorial Hospital in Cynthiana. She said the hospital tries to get an 0.6% operating margin in a good year, but “We are at a negative 25 percent margin.”

Rural hospitals like Cynthiana's have struggled most, and that's par for the course, says Alan Morgan, CEO of the National Rural Health Association. “For the last 20 years, rural hospitals have been struggling,” Morgan said. “That’s kind of who they are.” NRHA says "Many rural hospitals are also facing workforce reductions at a time when residents need care most," and quotes Debrin Jenkins of the West Virginia Rural Health Association: “I think it’s redline dangerous … I think it will be a huge increase in death.”

New virus cases up for 5th day; covid-19 patients' ICU use spikes; positive-test rate declines; studies don't look good for school

By Al Cross and Melissa Patrick
Kentucky Health News

New cases of the novel coronavirus in Kentucky increased for the fifth straight day, to 778, the fourth largest number yet, and the number of Kentuckians in intensive care for the virus's covid-19 disease rose to the highest in months.

Gov. Andy Beshear emphasized the third consecutive decline in the percentage of Kentuckians testing positive for the virus in the last seven days.

The 5.43 percent rate was slightly under the daily average for the week so far, 5.51%, and notably under the 5.81% reported Wednesday. Last week, the rate rose above 5 percent for the first time since testing became generally available, helping prompt Beshear to impose new restrictions.

"We still have too many cases and we need to do everything we can to try to decrease those," Beshear said in a press release. "We’re also seeing an increase of patients in the ICU."

The release didn't mention the intensive-care-unit numbers from the state's daily report: 150, up from 110 on Thursday, a 36% increase, and exceeding the recent ICU high of 145, reported July 22. Higher numbers were reported in the spring, during the pandemic's first surge in Kentucky.

Beshear continued to say the latest surge has slacked off to a plateau, based on weekly figures. He said it appears that this week will end with about the same number of cases that were reported last week. That is speculative, because two days remain in the reporting week, which runs from Monday through Sunday.

Two different snapshots of the data illustrate how different it can look. The state's seven-day rolling average stands at 609, close to where it has stood for the last five days. But the three-day average is at 685, the highest since the 748 recorded on July 25, when the state recorded its third-highest number of new daily cases, 836. Here are graphs of the three-day and seven-day averages this month:
Kentucky Health News graphs, based on daily reports from state Department for Public Health
Counties with more than 10 new cases Friday were Jefferson, 203; Fayette, 51; Warren, 45; Madison, 26; Graves, 23; Boone and Mercer, 19 each; Kenton, 17; Bullitt and Hardin, 16 each; Harlan and Pulaski, 15 each; Barren and Scott, 13 each; Campbell, McCracken ans Oldham, 12 each; and Shelby, 11.

Studies on virus spread by children have implications for schools

A study released today by the Centers for Disease Control and Prevention suggests that children of all ages are susceptible to the novel coronavirus, SARS-CoV-2, and can spread it to others. The study is one of the few that documents spread among children, so it could guide school officials as they decide when and how to resume classes.

"Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported," CDC said. "This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection and, contrary to early reports might play an important role in transmission."

The study looked at an outbreak at an overnight camp in Georgia last month, where 260 children and staff got the virus. The median age of the campers was 12, all were required to test negative before arriving, and staff were required to wear masks, but the campers were not.

Another study has found that children under age 5 with mild to moderate covid-19 had as much or more virus in their their upper respiratory tract as adults, Dennis Thompson reports for MedicineNet. The authors wrote in a research letter in JAMA Pediatrics that "Young children can potentially be important drivers of SARS-CoV-2 spread in the general population."

The studies "could have massive impact when it comes to school reopenings," CNN's Jake Tapper reported. Dr. Michael Saag, professor of medicine and infectious diseases, University of Alabama at Birmingham, told him, "This is a giant experiment; we don't know what to expect."

In other covid-19 news Friday:
  • Kentucky's covid-19 death toll rose to 735, with the deaths of a 75-year-old man from Fayette County, an 86-year-old woman from Jefferson County, a 63-year-old man from Perry County and an 80-year-old woman from Taylor County.
  • "The $1 trillion coronavirus relief plan U.S. Senate Majority Leader Mitch McConnell and other Senate Republicans unveiled this week will not meet the needs of struggling Kentuckians, said a group Thursday representing restaurants, the homeless, education and local governments," Jack Brammer reports for the Lexington Herald-Leader.  Ryland Barton of WFPL also reports on critics of the plan, and USA Today breaks down what Democrats and Republicans want, along with easy to read graphs.  
  • Dr. Anthony Fauci, the nation's top infectious-disease expert, told the House Select Subcommittee on the Coronaviurs today that he was "cautiously optimistic" we could have a vaccine by late fall or early winter. A Herald-Leader story offers a short overview of the vaccine's progress. 
  • The Hispanic population in Kentucky has been particularly hard hit by the coronavirus.  Only 3.9% of the state's population is Hispanic, but 14.4% of coroanavirus cases and 4.19% of covid-19 deaths are among Hispanics. Louisville health officials plan to expand testing sites aimed at Hispanic communities, Deborah Yetter reports for the Courier Journal. 
  • The U.S. Food and Drug Administration offers a Q&A page on antibody, or serology, testing for the virus. Antibody tests can help identify people who may have been infected but had no symptoms. 
  • As scientists have converged on a theory that the virus is largely spread among people through large droplets expelled in sneezes or coughs, or through smaller aerolsolized droplets, like those created by talking, public-health experts have put more emphasis placed on wearing masks and social distancing, and less emphasis on extensive surface cleaning in public places, except in health-care settings. It is also important to remember the importance of keeping hands washed, Derek Thompson reports for The Atlantic. Emanuel Goldman, a microbiology professor at Rutgers New Jersey Medical School, told him, “Masks, social distancing, and moving activities outdoors. That’s it. That’s how we protect ourselves. That’s how we beat this thing.”

UK HealthCare again best Ky. hospital in U.S. News & World Report rankings; Baptist Health has two of seven on state list

By Melissa Patrick
Kentucky Health News

Seven Kentucky hospitals are included in the nation's "Best Regional Hospitals" in the latest annual rankings by the magazine U.S. News & World Report

They are, in order: the University of Kentucky hospital; in a tie for second, Baptist Health Louisville and St. Elizabeth Healthcare Edgewood-Covington Hospitals, Louisville's Norton Hospital and Baptist Health Lexington; and in sixth, the University of Louisville's Jewish Hospital and Saint Joseph Hospital-Lexington. 

To make the list, a hospital must offer a full range of services; either be ranked nationally in one of 12 measured specialties or have three or more high-performance rankings for procedures and conditions; and have at least two more high-performing than below-average rankings for procedures and conditions. The last criterion is new.

The report offers an overview of 122 Kentucky hospitals with a breakdown of each of the measured categories, as relevant to the services the hospital provides. 

UK HealthCare, for the fifth consecutive year, claimed the No. 1 ranking with its Albert B. Chandler Hospital. The hospital also ranked in the top 50 for cancer care for the fourth straight year, and moved up to its highest ranking yet in that specialty, 29th. The hospital's Markey Cancer Center is the state's only National Cancer Institute-sponsored center, one of 71 in the nation. 

Dr. Mark F. Newman, UK executive vice president for health affairs, said in a news release, “This has been a challenging year, to put it mildly. But in these times, it’s more important than ever that Kentuckians with complex health problems have a medical center they can come to for best treatment options possible.”

UK also ranked as high-performing in these specialties: gastroenterology and gastrointestinal surgery, geriatrics, nephrology (kidneys), orthopedics and urology.

The 31st annual rankings compared more than 4,500 hospitals in 26 specialties, procedures and conditions. A release said 134 were nationally ranked in at least one specialty, and 563 were ranked among the Best Regional Hospitals in a state or metro area. Data used for the rankings predate the covid-19 pandemic.

Baptist Health had two of the state's top seven hospitals. Baptist Health Paducah fell off the Best Regional Hospital list this year, after being added last year for the first time ever, but it continued to be rated high-performing in heart failure and COPD.

Baptist Health CEO Gerard Colman said in a news release, “Baptist Health has long been known for its compassionate clinical care, and the U.S. News & World Report Best Hospitals rankings validate the high quality care provided by our physicians, nurses and staff as they live out our mission of leading in clinical excellence, compassionate care and growth to meet the needs of our communities.”

The report recognizes hospitals that are "high-performing" for 10 common adult procedures and conditions, including repair of abdominal aortic aneurysms, aortic valve surgery, trans-catheter aortic valve replacement (added this year) chronic obstructive pulmonary disease, colon-cancer surgery, heart-bypass surgery, lung-cancer surgery, hip replacement, knee replacement and congestive heart failure.

UK Healthcare ranked high-performing in all those categories except abdominal aortic aneurysms and trans-catheter aortic valve replacement, both dealing with the body's main artery, and knee replacement. It ranked average in those three categories. 

Baptist Health Louisville ranked high-performing for all procedures and conditions except trans-catheter aortic valve replacement and lung-cancer surgery. It ranked average in both.

St. Elizabeth Healthcare ranked high-performing in all the categories except aortic valve surgery, trans-catheter aortic valve replacement and heart-bypass surgery, in which it ranked average. It ranked high-performing in one specialty, orthopedics.

Baptist Health Lexington ranked high-performing in all but four categories, in which it ranked average: aortic valve surgery, trans-catheter aortic valve replacement, colon-cancer surgery and hip replacement.

Norton Hospital ranked high-performing for four procedures and conditions: heart failure, hip replacement, knee replacement and COPD. It ranked average for the other seven. 

Saint Joseph Hospital-Lexington ranked high-performing for colon-cancer surgery, heart failure and COPD, and average for the rest.

UofL Health-Jewish Hospital ranked high-performing for lung cancer surgery, heart failure and COPD. It ranked average for the remaining categories. 

Click here for information about how the magazine ranks the hospitals, including details on this year's methodology changes. 

Nationally, the Mayo Clinic in Rochester, Minn., claimed the No. 1 spot, followed by Cleveland Clinic and Johns Hopkins Hospital in Baltimore, according to a news release

Thursday, July 30, 2020

Cases up, positive-test rate down; Beshear says mask mandate having effect, but suggests more people should work from home

State chart adapted by KHN; current period has 3 of 7 days remaining; at current rate would be 3845.
By Al Cross and Melissa Patrick
Kentucky Health News

Thursday's coronavirus numbers were mixed, but Gov. Andy Beshear kept accentuating the positive, saying he sees the impact of his July 9 order requiring Kentuckians to wear masks in indoor public spaces and outdoors when they can't stay six feet apart.

"It appears that face coverings are making a difference," Beshear said as he announced 659 new cases of the virus, raising the seven-day rolling average by seven, to 612. But Beshear pointed to week-to-week trends.

"We at least stopped the significant escalation in that last week we're showing, and we believe we are going to be somewhere in that zone at the end of this week," he said. "We believe what we are generally seeing is a leveling off or at least a significant decrease in the escalation" that began in early July.

Thursday's best number on the state's daily report was 5.66 percent, the share of Kentuckians testing positive for the virus in the last seven days. Wednesday's seven-day percentage was 5.81.

Beshear said the state remains in "a danger zone, but again with the time to do things right." In a new suggestion, he said businesses could help by letting more of their employees work from home.

"I think the further that we've gotten into this virus, the more people have tried to pull 100 percent of their employees back in the office, and that doesn't help," he said, adding later that he had heard, anecdotally, that many workplaces are operating at 100%. "I would still really suggest people stay down around 50 percent," he said. "If people are productive virtually, don't mess with their production."

Health Commissioner Steven Stack also pointed to the bar graph of weekly case numbers showing that Kentucky was able to maintain a long, sustained plateau for almost three months, but has recently started to escalate in such a way that he said "is scary again."

"We are all dying, some just more quickly than others. So I accept that; that's called mortality," said Stack, an emergency-room physician by trade. "I am not here to separate you from your death. I would just like to delay it as long as I reasonably can." 

The old and the young: Stack said some people have been "cavalier" about the facts that 97% of Kentuckians killed by the virus were over 50, and 90% were over 60, suggesting that these are people who are going to die anyway. He said people in those age groups seek his help.

"I get letters every day from people who tell me they really don't want to die, that they kind of value the one life they have, and so for them it does matter. And so if you are in those high-risk categories, it really matters. They are relying upon the rest of us to behave responsibly so they don't pay a price with the one life they have." 

Though younger people don't often die from covid-19, it is a disease with many effects, and we still don't know a lot about it, Stack said. 

He noted that we didn't know for months that it could cause multi-system inflammatory disorder in children, and we still don't know what kind of long-term or permanent damage it will cause.

And in young adults, he said the virus can cause blood-clotting disorders, including strokes, pulmonary embolisms and heart problems, that can cause permanent damage. Recent studies show that as many as one in five young adults still have symptoms up to three weeks after diagnosis, he said.

"That's not the flu," he said, using a familiar comparison used by skeptics. "The flu lays you low for a while and then you bounce back, that's a lot longer recovery." And people over 50 are twice as likely as young adults to have symptoms three weeks after diagnosis, he said.

Also, some people suffer irreversible lung damage. "There's a lot we don't know," he said. "And so, I'm not trying to fear-monger. I'm just trying to tell you there's a lot we don't  know," he said. The New York Times published a long update about the pandemic with a rundown of strange things the virus can do.

Contact tracing: The July surge did not overwhelm the state's contact tracers, the employees who call people who have had contact with those who have tested positive for the virus, said Mark Carter, the official overseeing them.

Carter said the tracers are reaching 70% to 75% of those identified as contacts, and they have "overwhelmingly" been cooperative when asked to self-quarantine for 10 days or until they get a negative test of their own.

"They want to protect their health, they want to protect their loved ones," Carter said. "Certainly, there are those that are uncooperative, but so far those have been far in the minority."

He said more cases could overwhelm the program, so it's important to recognize it as one measure of the state's response to the pandemic. He suggested that its big test will come when students return to classrooms. "Indoor settings are an issue," he said, "and as we look at school returning, whenever that happens, that is of significant concern to us."

In other covid-19 news Thursday:
  • The state reported seven more deaths from covid-19, raising its toll to 731. The fatalities were a 75-year-old man from Casey County; a 65-year-old man from Christian County; a 92-year-old woman from Green County; an 82-year-old man from Greenup County; an 81-year-old woman from Ohio County; a 63-year-old woman from Simpson County; and a 70-year-old woman from Warren County.
  • Counties with more than 10 new cases were Jefferson,138; Fayette, 42; Warren, 22; Laurel, 20; Hardin, 18; Shelby, 17; Graves and Henderson, 15 each; Christian and Daviess, 14 each; Kenton and Mercer, 13 each; Barren, Oldham and Scott, 12 each; and Franklin and Pulaski, 11 each.
  • Beshear said the day's 659 new cases included 22 children under 5.
  • In long-term care facilities, 12 more residents and 18 more employees tested positive for the virus, but no new deaths were attributed to the facilities. Five more facilities were added to the list of those with a least one case, raising the total to 253.
  • He cast some doubt on the Sept. 5 Kentucky Derby, to be held at 60% spectator capacity, when asked if he would go if it were held now. "I think everybody wants us to see improvements on where our numbers are," and if the recent escalation continued, "I would have to think long and hard before really going anywhere and that's about a decision for me and my family," he said. "If the numbers are still where they are right now in September, that means we've done a great job plateauing them, and if that's the case I probably would go and hand out that trophy." He said he hopes Churchill Downs is continuing to find ways to make the event safer.
  • Asked abut the state fair, set for Aug. 20-30, he said the Department for Public Health "sent an additional series of recommendations . . . for them to consider in light of where we are right now. And remember, anything that is held out there or anywhere else around Kentucky that is large, if not done well, can ultimately upset other opportunities to do large events." He said he did not know what the agency's recommendations were. 
  • Beshear said mediation failed to resolve Northern Kentucky landlords' lawsuit challenging his ban on evictions, so the suit will head toward trial. The state Supreme Court is allowing eviction cases to be filed, but Beshear's order bans execution of eviction judgments. He acknowledged that some renters are "gaming the system . .. but are there people out there that are suffering because of this virus or its economic impact that we can't allow to be kicked out on the street? Yes."
  • Muncie McNamara, whom Beshear fired as unemployment insurance director, told legislators that during the early-spring crush of jobless claims, the Beshear administration approved thousands that should have been investigated, until the U.S. Department of Labor “got wind that we were doing that and told us that we had to stop.” He "also said the unemployment insurance system wasn’t technologically prepared when Beshear in March offered the jobless aid to people who wouldn’t normally qualify such as independent contractors, ahead of the federal government taking similar action," Chris Otts reports for WDRB.
  • Beshear replied that it's not unusual for a fired official to make "big allegations" that don't pan out. "I believe here we have somebody who, their relationships certainly got messy by the end, but it appears that the termination was valid and they are not kind of exhibiting some of these same things that we have seen in the past. My understanding is that everything that was raised by that individual as they were leaving was addressed."
  • Regarding a data breach that McNamara said he reported, Beshear said McNamara forwarded" an email to people who are getting thousands of emails, and then went home. If you are the head of something, you've got a bigger obligation than that." Still, he said the pending inspector general's report on the data breach will "show a number of people in leadership positions should have done more. And we're going to make sure that we correct that and we're going to make sure we are transparent about it."