Wednesday, October 28, 2020

On another record day for virus and hospital cases, Beshear says people should wear masks to protect themselves, not just others

Kentucky Health News graph; case numbers are based on initial, unadjusted reports
By Melissa Patrick
Kentucky Health News

After announcing yet another record for the highest number of new coronavirus cases in a single day, Gov. Andy Beshear's messaging shifted to put more of the onus on community members to protect each other from the virus -- and for individuals to protect themselves. 

When counties have at least 25 cases per 100,000 people in the last seven days, which puts them in the "red zone," Beshear said "a coordinated effort" is needed from long-term care facilities, schools and communities to follow the guidelines to thwart the spread of the virus.

"If we can do that, if we can come together, we can make a difference in our local communities, not just protecting nameless, faceless people somewhere in Kentucky, but protecting the people you see every day," Beshear said at his daily briefing. 

The state reported 1,864 new cases Wednesday. The previous high was yesterday, 1,786. It announced 2,398 cases on Oct. 7, but 1,472 of them were from a backlog in Fayette County. 

The day's total pushed Kentucky above 100,000 cases, and even above 101,000 cases, Beshear noted, adding that many of those cases were added recently. 

Hospitalizations for covid-19 continue to increase, with 927 people hospitalized for it in Kentucky, another record, including 235 in intensive care and 110 of those on ventilators. 

The share of people testing positive for the virus in Kentucky in the last seven days is 6.07%. 

Beshear noted that the state's guidance to schools calls for more caution when the positive-test rate is below 6%, but he said schools should continue to follow the current guidelines next week, largely because the figure is barely over 6% and there will be a widespread call next week for all red-zone counties to follow his new recommendations, which includes things like not hosting gatherings of any size and allowing employees to work at home when possible. 

Beshear has asked nursing homes, schools and communities to look at the state's color-coded case incidence map on Thursdays to make decisions around what guidelines they need to follow in the week to come. The map is updated daily. Today, it showed 64 red counties, 47 orange, nine yellow and none in green. 

"We need our communities again, everybody doing their part in each of these areas, to bring those levels down," he said. 

With all metrics headed in the wrong direction, Beshear stressed that it's time for people who may not be concerned about wearing a mask to protect others, to consider wearing one to protect themselves.  

"If you're not wearing a mask, you're putting yourself at risk.. . . People now need to not just do what it takes to protect each other, but to protect themselves," said Beshear." If you're not wearing a mask now, when we passed 101,000 cases, when we have a positivity rate of 6%, when we have 64 red counties -- you're putting yourself at risk. So if you don't want to care for other people, you want to look out for number one, wear a mask." 

The White House Coronavirus Task Force report was not posted on the state's website, but Beshear said it came with several suggestions, including: keep mask requirements in place, ensure physical distancing, avoid public crowds and private social gatherings and to ensure retail establishments are complying with the guidelines. It also said, "Current transmissions are linked to home gatherings." 

Beshear said, "If you're having a Halloween party, the state believes you are spreading the virus; the federal government believes you're spreading the virus; don't spread the virus. We need your help."

Health Commissioner Steven Stack said the incidence-rate map looks the worst ever and by all indications will get worse before it gets better. 

"But we know what works. We know that the tools we have now, as frustrating as they are, are the ones that help keep us safe," he said, noting that those things include wearing masks, social distancing, washing your hands, staying home when sick and getting tested if you have been exposed or have symptoms. 

He also encouraged counties to follow the new guidelines "by aligning what we do in schools, what we do in nursing homes and what we do for all of the communities. If we were to do these things, I have absolute confidence that I could stand here two or three weeks later, and show you a map with green counties and yellow counties and orange counties and a fraction of the red counties we currently have," he said. "But if we ignore it, that whole map's gonna turn largely red and then unfortunately, we'll reach the same conclusion but at a much higher cost."

Eric Friedlander
Earlier in the briefing, Health Secretary Eric Friedlander commended the efforts of those working in long-term care facilities, saying it is due to their efforts that Kentucky is ranked 26th among states for cases and 22nd for deaths. 

Nevertheless, he said we can and should do better, and that includes individuals in a community doing what they can to decrease community spread. 

"All of you can help," Friedlander said. "All of you need to wear a mask. All of you need to practice social distancing. What is important now, in terms of what's happening in our long-term care facilities, has to do with our community spread. If you are in a red county, please . . . follow our guidelines."

Friedlander gave an update on the outbreak at Thomson-Hood Center in Wilmore, the largest nursing home operated by the state Department of Veterans Affairs, with 285 beds. He said there 54 active virus cases among veterans, and 23 active staff cases; and 11 veterans there have died of covid-19. 

“We have to follow the guidelines. That’s the best way we can give back to our veterans and protect them,” said Friedlander.

One more speaker at the briefing asked for compliance.

Virginia Moore, one of the state's American Sign Language interpreters, said in a video post that she is now cancer-free after treatment for uterine cancer. She reminded Kentuckians to not put off cancer screenings, and asked them to be as kind to those suffering from covid-19 as they have been to her. 

"Please use your mask," she said. "Let's show kindness and understanding. Let's do that one thing that we can do, and that's wearing the mask, social distance. Let's pull together as a community. Let's show everyone else the support that you showed me." 

Beshear announced 14 new deaths Wednesday from covid-19, bringing the state's death toll to 1,442. The fatalities were an 83-year-old man from Boyd County; an 80-year-old man from Breathitt County; a 61-year-old woman from Christian County; a 95-year-old woman from Fayette County; a 93-year-old woman and a 91-year-old man from Henderson County; an 87-year-old woman and three men, 70, 80 and 81 from Jefferson County; two women, 80 and 82, from Kenton County; a 64-year-old woman from Knox County; and an 85-year-old woman from Lee County.

In other covid-19 news Wednesday: 
  • Counties with 10 or more new cases were Jefferson, 352; Fayette, 102; Hardin, 78; Nelson, 67; Pike, 60; Kenton, 59; Warren, 49; Christian, 37; Bullitt, 35; Barren, 33; Boone and Daviess, 32 each; Madison,  Montgomery and Scott, 28 each; Campbell and Knox, 26 each; Jessamine and Marion, 24 each;  Hart, 23; Henderson, Laurel  and McCracken, 21 each; Clay and Lee, 20 each; Franklin and Taylor, 19 each; Boyd and Oldham, 18 each; Rockcastle and Shelby, 15 each; Bell and Calloway, 14 each; Caldwell, Marshall and Rowan, 13 each; Hopkins, Larue, Lincoln and Magoffin, 12 each; Martin, Monroe and Whitley, 11 each; Floyd, Greenup and Logan, 10 each. 
  • Fayette County saw its third-highest day of new cases Tuesday, 135, with Sept. 10 and 11 having more new infections, according to its health department. Spokesman Kevin Hall told the Lexington Herald-Leader that the jump in cases is not tied to any one location. He said hospitalizations are also increasing in the county; in the summer, they were seeing upwards of 40 a day, but now that is moving closer to 60. “With colder weather coming, the concern is more people will stay indoors and have gatherings inside, which could lead to more cases,” said Hall. “We also need to remind people to stay home if they’re symptomatic.”
  • Beshear announced that the state, in partnership with the federal government, is offering some new testing sites to address the surge in cases. The new sites will be in Louisville and Lexington. Each person who gets a test will get a pack of five cloth masks.  Click here to check for dates, locations and to register. 
  • In long-term care, the daily report shows 105 new resident cases and 60 new staff cases, with 928 active resident cases and 511 active staff cases. There have been 861 resident deaths and six staff deaths attributed to covid-19. 
  • The K-12 dashboard says during the current week, 292 students and 149 staff have tested positive for the virus and 2,379 students and 354 staff are quarantined. 
  • The college and university report says 463 students and eight staff have tested positive for the virus in the past 14 days. 
  • Kroger Co. said it will offer rapid antibody testing for the virus, with most results coming in 15 minutes, at all its pharmacies by the end of November. It said the $25 tests would be conducted by a health professional using a finger stick, and are already being offered in California and Michigan. Antibody testing determines whether someone has had the virus and might have developed some immunity.
  • The national seven-day rolling average of new cases topped 70,000 for the first time, "a disturbing record that comes as the number of hospitalizations climbs toward its midsummer peak, and the death rate creeps upward," The Washington Post reports.
  • President Trump is saying in campaign speeches that the national surge of cases is caused by increased testing, and has suggested that the numbers are part of a conspiracy against him. The White House's testing czar, Admiral Brett Giroir, said otherwise Wednesday. “It’s not just a function of testing,” he said on NBC’s “Today” show. “The cases are actually going up. And we know that, too, because hospitalizations are going up.”
  • Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, gave a 30-minute coronavirus update on JAMA Network's YouTube channel. "We're going into a precarious situation," he said, because cold weather has arrived and the holiday season is approaching. Asked for recommendations about the holidays, he said "You have to take a look at what the risk is to your particular situation," depending on ages, underlying conditions and other factors and ask: "Is it worth it for this year to being these people together when you don't know . . . the status of everybody?" He noted that a person can have the virus without symptoms and still pass it on.
  • Fauci said a national mask mandate is needed to get mask wearing to 90-95% of the population. "It makes a difference," he said. "It really, really does." Failing that, he said, "We have to sort of shake each other by the collar and say, 'Look at what's going on'."
  • The Centers for Disease Control and Prevention sent a letter to governors this week pushing the deadline for states to be ready to receive and distribute a coronavirus vaccine between Nov. 1 to Nov. 15, the Herald-Leader reports. Such early delivery appears unlikely.

Are there medical exceptions for mask wearing? Very few.

The Washington Post
A so-called “mask loophole” has been circulating on social media. It suggests that people who don't want to wear masks should tell store workers that they have a medical condition, and if challenged they should cite the privacy section of HIPAA, the Health Insurance Portability and Accountability Act.

To be clear, the Americans with Disabilities Act doesn't apply to people without disabilities, and HIPAA only applies to the flow of medical information through health-care providers and insurers.

“This social-media post doesn’t relay a ‘mask loophole’ so much as it encourages people to exploit a law designed to provide protections to disabled people,” the fact-checking website Snopes wrote.

There are very few conditions that would prevent someone from being able to wear a mask. The Centers for Disease Control and Prevention says people who should not wear a mask are: 1) children younger than 2 years old; 2) anyone who has trouble breathing; 3) anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.

“Anyone who has trouble breathing” is ambiguous, and this seems to be where people like to point if they don't want to wear a mask.  In an article in the medical journal JAMA, a legal expert and a medical expert wrote that “few medical conditions are truly incompatible with all forms of mask wearing.”

People with facial deformities that are incompatible with masks is one example the authors raised. People with sensory or processing disorders was another. But less clear were the cases of people with chronic lung illnesses who weren't experiencing an acute attack. There is some evidence that masks protect the wearer to a certain extent, which would be beneficial to those with underlying lung disease. Having a chronic cough is also a really good reason to wear a mask.

For asthma, it depends on the severity. For people with mild or well-controlled asthma, masks shouldn't be a problem, according to the Asthma and Allergy Foundation of America. For those with severe asthma that involves many hospital visits and medications, wearing a mask for long periods might not be best.

Tuesday, October 27, 2020

Virus cases and hospitalizations accelerate, setting new records

Gov. Beshear recognized Bobby Rorer of Lawrenceburg, who died of covid-19. He enlisted at age 16.
By Lisa Gillespie
Kentucky Health News

Kentucky's coronavirus increase accelerated Tuesday, as the state reported 1,786 new cases, the state’s highest one-day total yet. 

“We are seeing this very serious escalation of cases,” Gov. Andy Beshear said at his daily briefing. ”Just look at last week, 9,335 cases, look at how quickly it grew and by how much. I'm here to tell you that we expect this week's cases to exceed last week's cases,” which was the highest week yet.

The previous high for the number of cases found in a single day was 1,738, on Saturday. The state announced 2,398 cases on Oct. 7, but 1,472 of them were from a backlog in Fayette County. The total for the pandemic is almost 100,000.

Hospitalizations for covid-19 are also accelerating, with 913 people hospitalized Tuesday, a new record, with 233 of them in intensive care and 115 of those on a ventilator.

Also increasing is the share of Kentuckians testing positive for the virus in the last seven days. That is 5.97 percent, continuing a steady rise over the period.   

Beshear reiterated his new “red-zone reduction recommendations” that call for counties with at least 25 cases per 100,000 people in the last seven days to take more steps to thwart the spread of the virus.

The governor said Kentuckians should look at the state's color-coded case-incidence map on Thursdays to make decisions for business operations the following Monday, just as the state’s schools are doing.

“Schools are going to do their part, government should be doing their part, our employers should be doing their part,” Beshear said. “It brings all of it together in a way that where we can have the most effective response. . . . It also lets us know, week to week, how safe it is or is not in our community.” 

He added later, “It’s about everybody having to pitch in when a community is in the red, and that school system not shouldering the burden of all of it.” 

Among other things, the recommendations ask people in red zone counties to not eat in restaurants, to allow employees to work from home when possible, and to not host gatherings of any size.

Asked again why these are recommendations and not mandates, Beshear said that the recommendations put “the right type of pressure on a community to come together to do what it takes” to bring their cases down, while also following the existing mandates such as mask wearing and limited restaurant capacity. 

But he added, “If increases continue, if communities can't get things under control, we're not ruling out additional steps.” 

Prison report: J. Michael Brown, Beshear’s executive cabinet secretary, said there are 263 active inmate cases and 20 active staff cases in state correctional facilities, most of them at the Little Sandy Correctional Complex in Elliott County, where at least 239 inmates and nine staff have contracted the virus.

Beshear asked that residents and businesses in Elliott County, which currently has the highest incidence rate in the state, follow the red-zone recommendations because employees and vendors regularly move between the facility and the community. 

“There’s 300 plus employees that go in and out on a daily basis,” he said. “It means that the community is at risk based on that level of transmission.” 

The governor announced 18 more deaths from covid-19, bringing the state’s death toll to 1,428. The Lexington Herald-Leader reports that with four days left, October is already the deadliest month of the pandemic, with 254 deaths.

Victims' stories: Beshear recognized the late Bobby Rorer of Lawrenceburg, who died Oct. 16 of covid-19. Rorer, a familiar figure at Democratic Party events, was a veteran who “never met a stranger” and was the father and step-father of two sons and two daughters, and had nine grandchildren. 

Rorer was a resident of the Thomson-Hood Veterans Center in Wilmore, where he passed away separated from his family and called for his wife Dana in his final days. 

“That’s what this virus does to our people, makes the hardest moments more unbearable,” Beshear said. 

Kelly Alexander, chief of staff at the Department for Public Health, told the story of her 40-year-old husband, Josh, who contracted the virus in his work as a Louisville firefighter. She said he had been “extremely healthy and loved hiking and the outdoors” and had no pre-existing conditions, but after getting the virus “couldn't even talk without being short of breath, or suffering from a coughing attack.” 

She said he had acute respiratory failure, pneumonia in both lungs and liver inflammation. and is now home, but still fighting pneumonia. 

“I do not want to see any more Kentuckians hospitalized with covid-19, or in the ICU; we must come together and act with compassion for our families, friends and communities,” Alexander said. “Please stay home, if you are sick, seek medical care when and if you need it, stay physically distant from others who are not within your immediate household, wear a mask and practice proper hand hygiene.”

Here's a video of Alexander's presentation, via the Herald-Leader:

In other covid-19 news Tuesday:

  • UK HealthCare is again preparing for an "expected increase" in covid-19 patients, but likely will not need an overflow facility, like the unused $7 million field hospital that was deconstructed months ago, reports the Herald-Leader's Alex Acquisto. At a virtual news conference Monday, Dr. Mark Newman, UK's health vice president, said the current models "are peaking much lower, within the range of [hospital] capacity" currently across the state. 
  • WDRB reports that the three largest health-care providers in Louisville, Baptist Health, Norton Healthcare and the University of Louisville, are seeing an increase in covid-19 patients, but not intensive-care patients. However, hospital officials told WDRB that they worried about capacity during cold weather and flu season. 
  • Pfizer Inc. will likely say whether its coronavirus vaccine works after the election, with hopes to be able to apply for emergency use authorization by the end of November, CEO Albert Bourla said Tuesday, Inside Health Policy reports.
  • Becker's Hospital Review reports, "The number of people with covid-19 antibodies decreased by 26.5% between June 20 and Sept. 28, suggesting that contracting the virus might not mean gaining long-lasting immunity, according to a study conducted by Imperial College London and Ipsos Mori, a London-based polling organization . . . If the study's findings are confirmed, the prospect of widespread long-term herd immunity may be difficult to achieve."
  • The latest Children and Covid-19: State Data Report, by the American Academy of Pediatrics and the Children's Hospital Association, says almost 800,000 U.S. children have been infected by the coronavirus, making up 11% of the 8.4 million cases in the U.S. -- about 1,053 cases per 100,000. From Oct. 8 to 22, 94,555 new youth cases were reported, a 14% increase. Hospitalizations and deaths remain very low. As of Oct. 22, the reports says 15.4% of Kentucky's cases have been in people under age 20, with a rate of 1,251 cases per 100,000. 
  • The 18 deaths reported Tuesday were a 99-year-old woman from Christian County; a 79-year-old woman from Henderson County; a 70-year-old woman from Hopkins County; three women, 79, 82 and 86, and five men, 62, 62, 70, 88 and 93, from Jefferson County; two men, 96 and 97, from Jessamine County; a 76-year-old man from Nicholas County; a 72-year-old man from Ohio County; two women, 77 and 91, from Scott County; and a 72-year-old woman from Wayne County.  
  • Counties with 10 or more new cases were: Jefferson, 379; Fayette, 118; Warren, 68; Kenton, 60; Hardin, 49; Pike, 45; Barren, Laurel and Madison, 42; Boone, 41; Bullitt, 40; Campbell and Nelson, 36; Clay and LaRue, 25; Hart, 23; Daviess, 22; Lee, 21; Calloway and Logan, 20; Floyd, 19; Christian and Whitley, 18; Jessamine, Johnson, Knox, Marion and McCracken, 16; Garrard, Henderson, Montgomery and Todd, 14; Clark, Hancock, Martin and Rockcastle, 13; Boyd, Grant, Perry and Shelby, 12; Estill, Lincoln, Monroe and Scott, 11; and Carter, Franklin, Graves and Ohio, 10. 
  • In long-term care, 57 new residents and 33 new staff have tested positive for the virus, with 906 active resident cases and 500 active staff cases. There have been 852 resident deaths and six staff deaths from covid-19. 
  • The college and university report shows 30 new student cases and three new staff and faculty cases, with 518 new student cases and eight new staff and faculty cases in the last 14 days.
  • The K-12 public health report, which includes verified case numbers, shows 563 students and 260 staff tested positive for the virus in the last 14 days.

Monday, October 26, 2020

Beshear gives recommendations, not mandates, for red-zone counties; health chief says infection risk has never been higher

Department for Public Health graph; numbers for most recent week are unadjusted
By Melissa Patrick
Kentucky Health News

As coronavirus cases escalate across Kentucky like never before, Gov. Andy Beshear made new recommendations, not mandates, for high-infection counties. That put the responsibility for thwarting the virus squarely on communities, much as he did with school districts. 

"I believe that we, as each one of these communities, have a duty first to prevent our county, our area from becoming red because that puts everybody that we live around in danger," Beshear said at his daily briefing. "But I think we certainly have a responsibility when our county becomes red, to look at all of the things that we can do, to lessen the spread, to tamp down the numbers, to get back to orange and yellow."

A county is considered in the red zone if it has at least 25 cases per 100,000 people. As of Oct. 26, 55 of the state's 120 counties are in the red zone.

Here are the new "red zone" recommendations:
  • Employers should let employees work from home when possible;
  • Government offices that do not provide critical services need to operate virtually;
  • Reduce in-person shopping; order online or pickup curbside as much as possible;
  • Order take-out; avoid dining in restaurants or bars;
  • Prioritize businesses that follow and enforce the mask mandate and other guidelines;
  • Reschedule, postpone or cancel public events;
  • Do not host or attend gatherings of any size;
  • Avoid non-essential activities outside your home; and
  • Reduce overall activity and contacts, and follow existing guidance, including the "10 Steps to Defeat Covid-19."
For a larger image, click on it.
Asked why he didn't issue new mandates, Beshear said “We know encouragement will do more than enforcement to get people on board. It puts ownership in each community.”

If the recommendations are followed, he said, it should only take a week or two to get a county out of the red zone.

He said the recommendations wouldn't be necessary if everyone would follow those that have been in place for months: wearing a mask, social distancing, limiting the size and number of social gatherings, staying home when sick, and getting tested if you are exposed or have symptoms. 

"Fatigue and, I guess, a cultural war that's somehow sprung up around what keeps you alive and keeps people around you alive have led to less compliance as the summer ended and as we move into fall," Beshear said. Later, he said, "We're in a dark, difficult time that's about to get darker."

He said an unnamed Republican governor told him in a conversation about Halloween parties, "We are seeing a striking disregard for the health of our neighbor." Addressing people who won't mask up, he said, "Talk to your minister. Read your Bible. Wearing a mask isn’t a statement about your own personal freedom. It’s about how much you care about somebody else."

Health Commissioner Steven Stack, a physician, said the danger from the virus is the greatest ever, and gave a statewide warning, beyond the red zones.

"It is not a good time to be out in public," Stack said. "The likelihood you will come into contact with someone and get infected if you're sitting too close at a restaurant, if you're at a bar having drinks with folks, if you're at a place where people are shouting and cheering, if you're engaged in personal parties or gatherings in your own home, where you're mixing people from outside of your house -- the risk of you getting infected in the state of Kentucky has never been higher than it is today.

"And so I have to urge, if you're listening to this, if you can be persuaded, you should stay healthy at home, to the fullest extent possible. You should stay with your immediate family, minimize your physical contact with other people. And if you go out, you should wear your mask and you should maintain the distance with others."

Alluding to the controversy attached to masks, Stack said, "Please be kind to each other. People have made controversies where there should not be controversies. This is public health. There's no politics in this, it's a silly piece of cloth that keeps your spit from hitting other people and the air you breathe from coming into contact with other people. This is pure public health. It is the tool we have, as inelegant as it seems and as uncomfortable as it sometimes feels, this is what we can do along with distancing, and it's both, it's not one or the other. It's six feet plus a mask."

DPH map, relabeled by Ky. Health News; to enlarge, click it.
Referring to the state map that shows 55 of the 120 counties in red, Stack said that if the guidance as followed for a month to six weeks, "We would find most of that map would turn yellow, not the orange or red. . . . We could get back to a more normal life, have kids in school, people at work. So I have to encourage you, if you won't listen for the well-being of others, for yourself now, it is every bit as important that you follow these rules in this guidance and please stay healthy at home to the fullest extent possible."

The new recommendations were made at a time when the positive-test rate and hospitalizations for covid-19, not just virus cases, are rising. 

Beshear announced 953 new cases, the most ever on a Monday, a day that typically has fewer cases because of limited testing on Sundays. 

The share of people who have tested positive for the virus in the past seven days has been above 5 percent for five days in a row. Today, it is 5.84%.

Beshear said 848 people are hospitalized in Kentucky for covid-19, another record, with 253 in intensive care and 112 on ventilators. He said the state still has adequate hospital capacity, with 64% of beds and 70% of intensive care beds occupied and 27.6% of ventilators in use. 

The governor announced three more deaths from covid-19, bringing the state's death toll to 1,410: a 75-year-old man from Garrard County, a 73-year-old woman from Graves County and a 54-year-old man from Lewis County. 

To those who would dismiss covid-19 deaths, saying that most who die from it also have another health condition, Beshear pointed out that high blood pressure and diabetes are a few of the most common "co-morbidities" that people have who die from it, both of which are common in Kentucky. 

"And that doesn't mean you're a walking corpse; you are far from dead," he said. "It means that when covid hits you, it makes a serious impact." 

In other covid-19 news Monday:
  • Jefferson County had nearly 35% of Monday's new cases, 331. Other counties with 10 or more new cases were: Fayette, 61; Kenton, 24; Floyd, 23; Barren, Boone and Bullitt, 22 each; Hardin, 21; Campbell, 19; McCracken, 17; Boyd and Scott, 16 each; Greenup and Taylor, 14 each; Madison and Marshall, 13 each; Daviess, Jessamine, Perry, Shelby and Warren, 10 each.
  • In long-term care, 26 new residents and 23 new staff have tested positive for the virus, with 963 active resident cases and 556 active staff cases. There have been 848 resident deaths and six staff deaths related to the virus.
  • Beshear gave an update on the outbreak at Thomas-Hood Veterans Center in Wilmore, reporting that there have been eight more total covid-19 deaths from the facility, 10 patients from the facility are in the hospital, there are 51 active resident cases and 49 active staff cases and that four residents and 26 staff have recovered.
  • The college and university report shows 71 new student cases and four new staff and faculty cases, with 522 new student cases and six new staff and faculty cases in the last 14 days.
  • The K-12 public health report, which includes verified case numbers, shows 592 students and 280 staff tested positive for the virus in the last 14 days. The K-12 dashboard was last updated on Oct. 23. 
  • Ten states are on Kentucky's travel advisory because they have a positive-test rate of 15% of higher. They include: South Dakota, Idaho, Wyoming, Iowa, Alabama, Nebraska, Kansas, Nevada, Utah and Wisconsin.  Kentuckians who travel to these states are asked to isolate for two weeks upon return. The list also includes Florida, which has a positivity rate of 10.25%, "due to the removal of public health restrictions." Today, Beshear said, "We advise that you do not travel to these states, though depending on where you're living right now in Kentucky, we may be advising you, do not travel at all."

Poll taken Oct. 7-15 gave Beshear 66% approval for his work on pandemic, found 60% support state law mandating masks

Graphs from Spectrum Networks
By Al Cross
Kentucky Health News

Kentuckians polled Oct. 7-15 gave Gov. Andy Beshear good grades for handling the coronavirus pandemic and supported the idea of a state law to require wearing of masks in public.

The poll, and released Oct. 21, found that 37 percent of Kentucky adults strongly approved Beshear’s handling of the crisis, with another 28% saying they somewhat approved, for total approval of 66%, with addition of decimals. Beshear's overall approval rating was 63%.

Though Beshear is the most powerful person in state government, only 53% approved of the overall state-government handling of the pandemic, rating it excellent or good, while 41% rated it fair or poor. That could reflect perception of other statewide constitutional officers, such as Attorney General Daniel Cameron, who has sued to void Beshear's emergency orders. The poll did not ask opinions of Cameron's work on the pandemic; only 33% said Beshear's orders have overstepped the authority state law gives governors.

Local governments' response to the pandemic won approval, 51% to 42%, but only 34% approved the response of the Trump administration, while 60% disapproved. "Republicans were the only group in which at least half gave the federal response a passing grade, with 55% approving," Spectrum reported.

The poll found that 45% said President Trump's comments about masks and social distancing had made them less favorable toward him, while 24% said they had improved their favor for him.

Asked if they agreed or disagreed with the statement, "There should be a state law in Kentucky mandating that masks be worn at all times in public," 60% agreed, 37% strongly; and 33% disagreed, 10% strongly. Republicans were about evenly divided on the idea, while Democrats were strongly in favor of it. Beshear, who issued a mask mandate in July, is a Democrat.

The poll was taken by Ipsos Group for Spectrum Networks, which operates digital information systems, including cable news channels with state newsrooms. It surveyed 1,001 Kentucky adults online and had a margin of error of plus or minus 3.5 percentage points.

Asked to name the main problems facing Kentucky, 50% named covid-19, 39% mentioned drug addiction, and 34% said unemployment. Other results in double digits were: 24% health care, 22% crime and violence, 19% racial injustice, 17% education, 13% affordable housing.

Beshear recommended in early August that in-person schooling be delayed until Sept. 28, but left decisions up to local officials. Overall, Kentuckians approved of his approach, 53% to 37%. Asked if schools should have started the year with in-person learning, only 31% said yes and 62% said no.

The poll asked several questions about management of schools in the pandemic; 58% of adults said their local school district was doing a good job, while 27% said it wasn't. Among those who have a child in the house the split was 60%-30%, and 51% said they did not think their child would be safe attending school in person, while 44% said they would.

Asked about the statement “My child is falling behind in school because of covid-19,” they were evenly split. "Working parents, 59% of whom agreed with the statement, were among those most concerned about their children’s progress in school," Spectrum reported. "Meanwhile, only 35% of those who are out of work believe their children are falling behind."

Kentuckians were pandemic's economic effects have made it hard for them to pay their bills; 43%. said they have had trouble with that and 52% said they had not. Half of those making under $50,000 a year reported trouble, as did 55% of those with a child in the home. "The problem is particularly acute among those living in urban areas, 55% of whom cited problems with bills," Spectrum reported. "The number falls to 44% in rural areas and 33% in the suburbs."

Other results of the poll included:

  • "All colleges and universities in Kentucky should be closed and only offer virtual classes:" 59% agree, 32% disagreed.
  • "I feel comfortable dining inside a restaurant:" 46% agree, 48% disagreed.
  • 3% said they had been tested and diagnosed with covid-19, and 7% said they suspected that they have it, or have had it.

To 'celebrate' or not to celebrate Halloween; that is the question


As Halloween 2020 approaches, many families want to know if it's safe to let their children go trick-or-treating in the middle of a pandemic. There is no easy answer to this question, but here is some expert advice on how to make the experience as safe as possible.
  
Step 1: Figure out how much health risk your household is comfortable assuming.

Do you live or regularly interact with people who are especially vulnerable to covid-19? Then you'll want to err on the side of caution and consider staying in on Halloween. That's always the safest option, of course, but there are still reasons some families might want to observe the High Holiday of American Children.

"Not having a routine really impacts kids, and as we come into the holidays, trick-or-treating and participating in Halloween activities can help kids with their minds,” Phoenix pediatrician Kristin Struble said in a recent Perspective article for The Washington Post.

Step 2: Try to figure out the general risk level in your community. Infection rates are trending up in most U.S. states right now, but what really matters are the specifics of your trick-or-treat route, which for most people will be their neighborhood. For example “the risk may be higher in a crowded apartment building than spread-out houses in the suburbs,” the article says.

What you really need is public-health data for your area, but this isn't always easy or possible to find. Jon McGreevy, chief of pediatric emergency medicine at Phoenix Children’s Hospital, told The Post that some form of trick-or-treating would be acceptable so long as your community's daily rate of positive tests does not exceed 10 percent. 

Kentucky offers a regularly updated color-coded map that shows the coronavirus incidence rate in each county as well as a daily statewide positivity rate. Both can be found on kycovid19.ky.gov
  
Step 3: After weighing the amount of covid-19 risk your family can afford to take on against your kids' mental health and the infection level in your community, the Post offers some safety tips if you do go trick-or-treating:  
  • Have kids wear a face mask. (Many costumes could easily incorporate one.)
  • Adhere to social-distancing guidelines by standing six feet apart.
  • Have a parent accompany children, regardless of age, to hold them accountable with mask-wearing and social distancing.
  • Avoid congregating around doorsteps and porches.
  • Use hand sanitizer after receiving candy from each house.
  • Do not eat candy while trick-or-treating: Parents should make certain hands are clean before kids start touching their faces and eating candy.
  • Make sure kids wash their hands as soon as they get home.
  • Have kids remove their costumes and shower.
  • No need to disinfect candy wrappers.
If you don't, check out the article for suggestions from experts and parents to make Halloween a treat for your kids, even without the walkabout. They can still dress up and show off their costumes, for example! There are also tips for how to hand out candy without putting you or your neighbors at unnecessary risk. 

Dr. Kevin Kavanagh, a retired Somerset physician who heads Health Watch USA, which focuses on infection control, reminded Kentuckians on the Jack Pattie Show on Lexington's WVLK that just because an activity is outdoors doesn't mean it's safe. He noted that the Centers for Disease Control and Prevention has declared traditional trick-or-treating, in which treats are handed to children who go door to door, a high-risk activity. 

Don't think that wearing a Halloween mask, is going to protect you from the coronavirus, Kavanagh said. "If screaming will likely occur, greater distancing is advised," he said. "The greater the distance, the lower the risk of spreading a respiratory virus.” 

The CDC also advises against wearing both a regular mask and a costume mask: "Do not wear a costume mask over a cloth mask because it can be dangerous if the costume mask makes it hard to breathe. Instead, consider using a Halloween-themed cloth mask."

The state Department for Public Health has issued Halloween safety guidance at https://chfs.ky.gov/agencies/dph/covid19/cv19halloweenguidance.pdf.

While children's cases are often asymptomatic or less severe than adults, it's important to remember that they can spread it to others unknowingly. 

As of Oct. 8, more than 697,633 children had tested positive for the coronavirus, according to the American Academy of Pediatrics. Children represented 10.7% of all cases. The report says between Sept. 24 and Oct. 8, there was a 13% increase in child cases. 

As of Oct. 14, 12,950 Kentucky children between the ages of 1-19 have tested positive for the coronavirus, making up 15.8% of the total cases, according to the state health department. 

The bottom line, there's no easy answer to this question and whatever you choose will involve tradeoffs. But that's life in a pandemic.

Sunday, October 25, 2020

'Covering the Pandemic' program is available for viewing

Reporters and news managers who are covering the pandemic discussed their work and the challenges they face Thursday night in an online program held by the Bluegrass Chapter of the Society of Professional Journalists. A recording of the Zoom meeting is available here.

The panelists were Alex Acquisto, health reporter for the Lexington Herald-Leader; Jennifer P. Brown of Hopkinsville, who recovered from covid-19 and wrote about it in her online newspaper, Hoptown Chronicle; Ben Sheroan, editor of The News-Enterprise of Elizabethtown, who spoke to the pushback newspapers receive from coverage of the pandemic; and Brian Neal, news director of Lexington’s WLEX-TV, who addressed the fatigue factor experienced by journalists.

School Nurse Task Force says every Ky. school needs a full-time nurse; asks lawmakers for $3 million to conduct a pilot program

By Melissa Patrick
Kentucky Health News

"Every school needs a nurse every day, all day."

So says the Kentucky Nurses Association School Nurse Task Force, which has worked for this goal for more than five years. It says only 43% of Kentucky schools meet the National Association of School Nurses recommendation for a minimum of one nurse for every 750 students

On Oct. 20, the task force made its case to the legislature's Interim Joint Committee on Education, saying there is no more important time than now for it, in the middle of the coronavirus pandemic, when a coordinated school health approach is most needed.

"We know that when students are healthy, they succeed academically," task-force spokesperson Gannon Tagher told the committee. She is a pediatric nurse practitioner and the associate dean for academic affairs on Northern Kentucky University's College of Health and Human Services. 

National Association of School Nurses chart
Tagher ticked off a long list of well-documented reasons why every Kentucky school needs a nurse every day, all day. She said, among other things, that schools with nurses have improved attendance rates, higher high-school graduation rates, reduced transmission of infectious diseases, and positive outcomes related to covid-19.

She also spoke to the major health and socioeconomic challenges facing Kentucky's children, noting that they rank in the bottom 10 states for physical and mental health, diabetes, asthma, obesity, oral health and substance abuse. She said 16% live in high-poverty areas, and the share of Kentucky children without health insurance increased 29% from 2016 to 2019. 

"The ability to learn is affected by health," she said. "If children are hungry, if they're tired, if they haven't had a home to sleep in, if their chronic conditions such as diabetes and asthma are poorly controlled -- then learning falls to the bottom of the hierarchy. They just don't have the ability to learn." 

Tagher said that in addition to addressing the health needs of students, school nurses also regularly address the "social determinants of health," which include very practical things such as housing and transportation.  

School nurses are an integral part of a school's trauma-informed care team, she said, and are often the first to recognize factors like bullying and mental-health issues that increase the risk of a student becoming a perpetrator or a victim of school violence.

She also stressed that school safety is more than just preventing violence: "When we have children with food allergies and children with asthma, children with diabetes in our schools, they have the potential to face life threatening emergencies during the school day, and a nurse can prevent these life threatening emergencies from happening."

During the 2018-19 school year, according to Tahger's slides, 21,074 Kentucky students had food allergies, 47,805 had asthma, and 1,507 had Type I diabetes.

Patricia Burkhart, co-chair of the task force said in an e-mail, "Legislators need to prioritize school nurses just as they did school safety. We would argue that health and safety go hand-in-hand."

Tagher said funding is often the reason given for a district's inability to have a full-time nurse in every school. With an annual salary for a full time nurse, including benefits, estimated at $52,406 a year, it would cost about $65 million for every school to have a full time nurse, according to task-force calculations.

To fund a full-time nurses in every school, the task force offered three solutions, including:

  • New rules that allow Kentucky schools to bill Medicaid for "medically necessary" care for students who qualify for the program; 
  • Partnerships with community agencies, like local health departments, federally qualified health centers or local health systems, who can share the cost of full-time nurses in each school; or
  • Kentucky's share of funds from the Every Student Succeeds Act, the main source of federal money for elementary and secondary education.

The task force has talked about funding sources since it started asking for a full-time nurse in every school, but this year for the first time it is asking legislators to fund a $3 million pilot program that would allow it to place 56 school nurses in schools with the greatest need and measure the impact.

"A nurse in every school all day every day is an integral part of ensuring the health of our children and the future of our state," said Tagher. "We cannot afford to not fund school nurses right now."

There was no public reaction from legislators at the meeting because time ran out as Tagher concluded her presentation. 

Worst-ever Sunday for novel coronavirus cases makes for worst week yet as escalation steepens; hospitalizations remain high

Kentucky Health News graph, based on unadjusted daily reports
By Al Cross
Kentucky Health News

On Sunday, Kentucky recorded 1,462 new cases of the novel coronavirus, the most of any Sunday and more than the state recorded in an entire week after the initial surge in cases began to subside five months ago.

The state also counted a record number of covid-19 hospitalizations, 841, one more than the day before, with 231 of those patients in intensive case and 106 of them on ventilators.

The new-case number increased the steepest sustained growth in the seven-day rolling average of daily new cases. It is now 1,348, almost double what it was a month ago and far above the previous record of 1,255, set Saturday. In the last 100 days, since the second major surge of cases in mid-July, it has more than tripled.

The new case numbers also gave the state the most in an official Monday-through-Sunday reporting week, with 9,335. The numbers will be adjusted downward slightly on Monday, once duplicate test results are eliminated.

“Since March 6, Kentuckians have been fighting covid -19, yet we are facing the highest number of cases ever reported on a Sunday, and the highest week of new cases. We must do better,” Gov. Andy Beshear said in a press release. Sunday usually has a lower number of cases due to limited testing and reporting.

Beshear added, “We all know the steps we need to take to stop the spread of this virus – wear a facial covering, wash your hands, stay six feet apart and limit gatherings and travel – let’s all do these simple things to protect each other.”

The release noted that Beshear said after Saturday's "frightening" new daily record of 1,738 cases that he would talk Monday about new recommendations to counties that are in the "red zone," those with 25 or more average daily cases per 100,000 residents.

Beshear reported three more deaths from covid-19: an 87-year-old woman from Fayette County; a 74-year-old woman from Grayson County and an 83-year-old man from Spencer County. They brought the state's death toll to 1,407.

Jefferson County, which has 17% of Kentucky's population, had 26% of Sunday's new cases, 379. Tiny Elliott County again had a huge number, 137. The Little Sandy Correctional Complex, a state prison there, has 55 cases (32 employees and 23 inmates), said Susan Dunlap, chief spokeswoman for the state Cabinet for Health and Family Services.

Other counties with more than 10 new cases were Kenton, 53; Fayette, 40; Warren, 37; Bullitt, 36; Shelby, 35; Boone, 33; Campbell, 32; Montgomery, 29; McCracken, 28; Barren, 26; Christian, 26; Hardin, 19; Calloway, 18; Scott, 17; Daviess, 16; Hart, 16; Nelson, 16; Jessamine, 15; Marion, 15; Knox, Madison and Mercer, 14 each; Allen and Henderson, 13 each; Boyd and Pike, 12 each; and Muhlenberg, 11.

Saturday, October 24, 2020

New cases hit another record; Beshear calls it 'frightening,' says he will talk Monday about new recommendations for red zones

Kentucky Health News graph, from unadjusted reports of daily cases, discounting large backlogs
By Al Cross
Kentucky Health News

Calling the total "frightening," Gov. Andy Beshear announced 1,738 new cases of the novel coronavirus Saturday, the state's highest one-day total yet.

“This is exploding all over the country. Yesterday was the highest amount of cases ever reported in a single day in the United States,” Beshear said in a news release. That record was repeated Saturday, it was announced later.

“We've got to do better, and on Monday we'll be talking about new recommendations to counties that are in the red,” Beshear said. “We've got to tamp down these cases. The more cases, the more people that end up in the hospital and the more people die.”

Hospitalizations also set a record, at 840, including 208 in intensive care and 107 of those on ventilators. And the percentage of Kentuckians testing positive for the virus jumped again, to 5.63%. Eight additional covid-19 deaths were reported, raising the state's toll to 1,404.

Health Commissioner Steven Stack said, “We’re all tired of covid-19 and the problems it has brought. People are hurting, whether from the virus itself or the impact it has had on the rest of our lives. It’s all worse, though, when we don’t do simple things like wearing masks and socially distancing. As October comes to a close, please be kind to each other and remember that we help each other, and ourselves, when we focus on defeating the virus rather than arguing with each other.”

Beshear said on Twitter that he was "officially out of quarantine after following the advice of the Department for Public Health" after a member of his security detail tested positive and then developed covid-19. He said he and his family have tested negative "multiple times, which I contribute to the fact we were wearing masks at the time of contact." He added, "Thank you to all who have sent supportive messages. We are very blessed."

The previous high for number of cases found in a single day was 1,487, on Wednesday. The state announced more cases on Oct. 7, but more than 1,400 of them were from a backlog in Fayette County.

The growth of cases in the last 10 days appears to be the worst since the first two months of the pandemic, and shows in the county-by-county list. Elliott County, which has about 7,500 people, reported 74 new cases -- about 1 per 100 in just a single day. Lee County, with about the same population, reported 27 cases; a nursing home there has counted 128 in a current outbreak.

In other covid-19 news Saturday:

  • Other counties with more than 10 new cases were Jefferson, 390; Fayette, 86; Shelby, 63; Kenton, 57; Boone, 44; Hardin, 44; Daviess,  McCracken and Nelson, 39 each; Clark, 35; Calloway, 34; Warren, 31; Campbell, 30; Lee and Whitley, 27 each; Christian and Hopkins, 24 each; Bullitt and Laurel, 23 each; Knox, 22; Pike, 20; Barren, 18; Franklin and Marion, 17 each; Henderson and Logan, 16 each; Hart, 14; Adair, 13; Floyd, Garrard, Montgomery and Taylor, 12 each; and Bourbon, Jessamine, Madison and Oldham, 11 each.

  • The state's report on long-term care showed 55 new cases among residents and 25 among employees.

  • Maggie Menderski of the Courier Journal writes about Demetrius Booker, 40, of La Grange, who was hospitalized in four different facilities for 95 days with covid-19.

Friday, October 23, 2020

Judge tells state to keep Anthem in Medicaid managed care, cites role of former Beshear aide working for another successful bidder

A Frankfort judge ordered the state Friday to keep Anthem Inc. as one of its managers of Medicaid, an $8 billion program that pays for health care for one of every three Kentuckians.

Franklin Circuit Judge Phillip Shepherd's order "comes just days before the state is set to begin enrolling people in Medicaid health plans for 2021 on Nov. 2, and as the state is facing record enrollment of 1.6 million Kentuckians in Medicaid, largely because of the covid-19 pandemic," notes Deborah Yetter of the Courier Journal.

Judge Phillip Shepherd
Shepherd ruled in a lawsuit Anthem filed in May after it lost out in bidding for new contracts. He said the huge insurer had raised "a substantial question" about the contract-award process and demonstrated "a substantial likelihood" that it would win the case.

Anthem alleged, among other things, that one of the new contractors, California-based Molina Health, had hired a former employee of Gov. Andy Beshear who was privy to key documents that other bidders couldn’t see. Shepherd said the role of Emily Parento "creates the appearance that Molina had the inside track on the bidding process."

"He also cited multiple irregularities of the scoring and evaluations process the state used to select the five companies that initially won the contract," Yetter reports. "Shepherd found the process to be 'arbitrary' and poorly documented."

Passport Health Plan, the main Medicaid manager for the Louisville region, also lost out in the bidding but sold its assets to Molina, which is using the Passport name and says it plans to complete a new headquarters in western Louisville, a major boost in jobs for a poor and Democratic-voting area.

Emily Parento
Parento, who was health-policy director for the governor’s father, then-Gov. Steve Beshear, signed a non-disclosure agreement to see “non-public files” about the bidding as part of the transition team at the start of Andy Beshear's administration. She “had unfettered access to inside information” about other bidders “as well as the evaluators’ notes regarding the strengths and weaknesses of each of those bids,” Anthem said in its suit.

Molina "denied there was any conflict with Parento working for it as a consultant," Yetter reports, and said "she did not get access to any confidential information that would have helped it win a contract."

The Finance and Administration Cabinet said Molina swore that Parento did not have access to confidential information about the proposals and didn't "divulge any confidential information she obtained prior to working as a consultant to the company," Yetter writes. "But Shepherd found otherwise and devoted a considerable portion of his order to examining Parento's role in the case."

Shepherd "said that under state ethics guidelines, she should have been barred for at least a year from working for any company involved in the Medicaid contracts after leaving the Beshear transition team," Yetter writes. The judge said that created at least "the appearance of impropriety."

Anthem also objected to Molina making confidential required information about lawsuits in which it had been involved and any official sanctions levied against it. It says in a footnote, “It appears that the decision to waive scoring of this item occurred at the final stages of the process and apparently after the individual evaluators had completed their preliminary scoresheets.”

The scores were close. WellCare got 1,662; Aetna 1,653, Humana 1,605, United HealthCare 1,520, Molina 1,507, Anthem 1,491 and Passport, 1,409, according to the bid protest.

Shepherd had already ordered the state to delay sending notices to Medicaid beneficiaries asking them to choose a managed-care provider until he could decide on Anthem's request for an injunction or a temporary restraining order.

His latest order says, "Public interest supports allowing Anthem to participate in this contract, bringing more competition and a wider variety of choices to Medicaid recipients," his order said. "Most significantly, Medicaid recipients currently enrolled in Anthem will not be required to change providers and disrupt their medical care."

2nd highest number of new virus cases; week already deadliest, with a day to go; Beshear says his experience shows masks work

State health department map, relabeled by Kentucky Health News; for a larger version, click it.
Lee County is blank, but had many new cases this week, many at a nursing home; see below.
By Melissa Patrick
Kentucky Health News

Kentucky recorded 1,457 new cases of the novel coronavirus Friday, the second highest daily total, exceeded only by 1,487 on Wednesday. That pushed the seven-day rolling average to 1,191, the highest yet, and 29 above yesterday, the previous record. 

“This week has been a tough week, with three out of the five highest days,” Gov. Andy Beshear said in a news release. “This virus is everywhere. It is in your community. We need every community doing what it takes to defeat it.”

Beshear reported 16 more deaths from covid-19 on Friday, bringing the state's death toll to 1,396. The Lexington Herald-Leader reports that even with one day left in the week, Kentucky has already had 84 covid-19 deaths, surpassing its highest previous weekly toll, 72 between Aug. 30 and Sept. 5. 

The fatalities were a 69-year-old woman from Boyd County; two women, 77 and 84, from Daviess County; a 71-year-old woman from Fayette County; three women, 84, 101 and 102, and three men, 73, 76 and 84, from Jefferson County; a 64-year-old man from Knott County; an 87-year-old woman from Lee County; an 84-year-old woman from Leslie County; a 75-year-old woman from Logan County; an 86-year-old woman from Marshall County; and an 80-year-old man from Todd County.

The release said a record 818 people were hospitalized in Kentucky for covid-19 on Friday, up 18 from Thursday; 205 are in intensive care, nine fewer than Thursday; and 97 are on a ventilator, eight fewer than Thursday.  

The share of people testing positive for the virus in the past seven days continued to inch up, to 5.34 percent.

Beshear and his family will finish their two week quarantine on Saturday after being potentially exposed to the virus on Oct. 10 by a member of their security detail who tested positive for the virus, the release said.

“Wear a mask. It saves lives. I’ve now tested negative four straight times after sitting in the passenger seat next to someone driving who was infectious with covid,” Beshear said. “I was wearing a mask. He was wearing a mask. That shows you that it works.”

In other covid-19 news Friday: 
  • Counties with 10 or more new cases Friday are Jefferson, 312; Fayette, 112; Warren, 60;  Hardin, 47;  Barren, 35; Daviess and Lee, 27 each; Hart, 26; Pike, 25; McCracken, 24;  Kenton and Madison, 22 each; Boone, 21; Clay, Laurel, and Nelson, 20 each; Scott and Shelby, 19 each; Henderson, Montgomery, Perry, and Whitley 17 each; Bullitt and Christian, 16 each; Campbell and Floyd, 15 each; Clark, Logan and Martin, 14 each;  Bell and Hopkins, 13 each; Johnson and Marion, 12 each; Boyd, Franklin, Jessamine, Knott and Oldham, 11 each; Adair, Calloway, Fleming, Marshall, McLean and Wayne, 10 each.
  • The Lee County Care & Rehabilitation Center is reporting 128 cases of the virus, involving 75 residents and 53 staff, Hazard's WYMT reports. “A person can be asymptomatic -- they can contract the virus and not show any symptoms, like a fever, which allows them to pass health screenings at work.” said Scott Lockard, the district public-health director. “This is by far the biggest outbreak in the Kentucky River District and we have seen some bigger outbreaks in nursing homes across the state, but this is the event that we have feared that would happen the most.”
  • In long-term care facilities, 35 more residents and 73 more staff have tested positive for the virus, with 941 active resident cases and 567 active staff cases reported. The facilities have seen 827 residents and six staff die of covid-19. 
  • The K-12 school dashboard shows 366 students and 202 staff tested positive for the virus this week, resulting in 3,080 students and 532 staff being quarantined. 
  • The college and university report shows 301 more students have tested positive, 499 of them in the past 14 days. Eight staff and faculty tested positive in the past 14 days. 
  • "The U.S. Food and Drug Administration on Thursday approved the antiviral drug remdesivir for the treatment of hospitalized coronavirus patients in the U.S. -- the first and only approved covid-19 treatment as of yet," the Herald-Leader reports in an article headlined "Coronavirus weekly need to know: remdesivir, air filters, national lockdown & more." 
  • Grace Schneider and Deborah Yetter of the Courier Journal write about "pandemic fatigue" that is resulting in a surge of cases. They write that public-health messaging and practices known to slow the spread of the virus, like social distancing and wearing a mask, are not resonating with worn-out Kentuckians, especially at a time when President Donald Trump is telling his rally-goers that "we are rounding the turn" on the pandemic -- even though that is not true. Click here for a Kentucky Health News story about pandemic fatigue and how to overcome it.
  • Schneider and Yetter report that pandemic fatigue is also wearing down doctors and nurses. Donald Lloyd, chief executive at St. Claire HealthCare in Morehead, which serves five counties and is a regional testing site, told the CJ that the hospital had recently hired additional emergency room doctors and travel nurses to spell staffers who are beyond exhausted, especially those working in the three virus “hot spots” inside the 149-bed facility.  
  • Jefferson County high-school sports, after a delayed start, have been suspended because of a rise in local virus cases, WDRB reports. Jefferson County moved to the most dangerous "red zone" this week, which under state guidance requires schools to assess whether they will hold classes or sporting events in the following week. Following the guidance, JCPS will: Allow contests this weekend and those such as volleyball that are already under postseason jurisdiction; follow the state high-school athletic association's guidance that allows practice, but no games or game-like simulations for teams not already in postseason play; reschedule regular-season contests planned for next week, when possible; and review the data again on Thursday evening and make another determination about athletics next Friday morning.