Friday, July 24, 2020

As case numbers hit a near-record and positive-test rate surges, Beshear asks churches to drop in-person services and says he will limit some business activity Monday if the surges don't abate

By Melissa Patrick and Al Cross
Kentucky Health News

After reporting Kentucky's second highest daily number of new coronavirus cases and a surging positive-test rate, Gov. Andy Beshear asked churches to avoid traditional services the next two Sundays -- and said if the surge doesn't stop by Monday, he would have to impose more restrictions on businesses. 

"I recommended for the next two Sundays, with the escalating number of cases that we have . . . that people do the virtual or the drive-up services," Beshear said. If not, "I just ask people to double-down on making sure everybody is wearing a mask, that we do even extra cleaning and that people are spread out."

Beshear said he made the request because health officials have noticed a trend of Kentuckians going on vacation and bringing the virus back with them to church gatherings. He has asked Kentuckians to not travel to states with a 15 percent or higher positive-test rate, and that if they do travel to such states to quarantine for 14 days when they return to Kentucky. 

Beshear said he made his request, which he stressed was not a mandate or an order, in a phone call with the Kentucky Council of Churches and that senior adviser Rocky Adkins was reaching out to the Kentucky Baptist Convention, the largest group in the state's largest denomination. However, the convention's news outlet, Kentucky Today, reported at 7 p.m, "Leaders of the Kentucky Baptist Convention have not been notified of a request to shut down in-person services."

The governor reported 797 new cases of the coronavirus Friday, raising the seven-day rolling average to 631, which is 38 higher than yesterday. The only higher daily total was 979, reported Sunday.

"We are continuing to see an increase and a growth that we absolutely have to stop," Beshear said. "And we'll be watching these very carefully through the weekend and if we do not see the numbers come down, we are going to have both a series of recommendations and steps that we'll need to take sometime early next week."

He said 5.28% of Kentuckians who were tested for the virus in the last week tested positive, pushing the rate over the 5% mark that the White House Coronavirus Task Force and others consider a "danger zone."

The task force recommended last week that Beshear close bars and reduce restaurant capacity to 25% from 50%. It also recommended that he limit gatherings not involving businesses or organized groups to 10 people, which he did, and that he mandate mask wearing, which he did July 10.

Beshear said he would defer any further orders until Monday in hopes that the mask mandate will kick in. "We need to start seeing some impact from it," he said, adding that any actions would be based on the numbers he sees Monday, not observations of activities over the weekend.

"We've got to have a real change in the data," he said. "Our hope is that any demonstrations this weekend, that everybody wears masks, that everybody spreads out, and in bars and the rest -- you've got to do it. I mean, we're going to have to close bars if we don't get control of this. If you are a bar and you are not requiring anybody to do what is required, you are shutting yourself down." 

He noted that today's case numbers reflect activity from two weeks ago, due to the incubation period of the virus. "We'll be looking at the cases, the positivity rates, the hospitalizations and the ICUs," he said. "We need to see a stabilization or the beginning of a decrease in positivity rate."

Hospitalizations for covid-19 rose to 618 Friday, making the week's average 575. Last week, the Tuesday-Saturday average (some cases were missed on Monday of that week) was 456.

"How we manage this crisis, whether we can bring down cases, is going to determine how many lives we lose, it's going to determine what economic impact we have going forward . . . and it is going to be directly related to when we can get our kids back in school for in-person classes," he said.  

Stressing a point he made Thursday about schools, Beshear said, "If we can't get the numbers under control by the beginning of next week, I think you can expect that we will recommend to superintendents that they push their start date back if it is in early August. . . . We cannot allow an escalation to continue."

"Interim education commissioner Kevin Brown encouraged district leaders to consider starting virtually with nontraditional instruction if they are currently planning an in-person first day on or before Aug. 14," the Courier Journal reported.

Asked it it was possible to apply any new requirements on a limited basis, Beshear said, "I believe that the first set of steps that we'll need to take will likely be statewide. That doesn't mean that there aren't more surgical steps that we can take as related to potentially specific businesses. . . When it reaches a certain level though, you need a full statewide reaction to make sure it doesn't just hop from one county to another. . . . The challenge right now is the spread is so significant that we want to make sure that we are stopping it everywhere and then when we believe that we've generally got it under control, or stabilized . . . that allows us to take much more specific action." 

Beshear was asked about the annual US 127 Yard Sale, scheduled Aug. 6-9. He said he wasn't familiar with it, but noted the state's yard-sale requirements, including wearing a mask, keeping hands washed and practicing social distancing. He also encouraged booth owners to wear gloves and to not allow shoppers to handle the merchandise, unless they plan to buy it. 

Beshear reported seven more deaths and noted that with a known mortality rate of 3%, the state can expect the rising case numbers to accelerate its death toll, now at 691.

"It's going to be heartbreaking," he said. "So let's make sure that we are more committed than ever, let's make sure that we are not violating these basic rules that we know can help us, let's make sure we realize that each and everyone of our actions can impact someone else and let's just realize that this thing is escalating in Kentucky, that we are seeing more cases than we ever imagined before and now is the time for everybody to recognize the severity of the situation that we are in." 

Friday's fatalities were an 81-year-old man from Boone County; a 59-year-old woman from Hardin County; an 85-year-old woman and an 82-year-old man from Jefferson County; a 66-year-old man from Oldham County; and two women, ages 54 and 74, from Warren County.

People 65 or older have accounted for 84 percent of deaths in Kentucky, higher than the national average of 80%, according to an analysis by the Kaiser Family Foundation, using CDC data. "The analysis finds that states that have seen the largest share of covid-19 deaths among people 65 and older include those that have had a disproportionate number of deaths in long-term care facilities," the foundation said. States raking ahead of Kentucky were Idaho (94%), New Hampshire (92%), Massachusetts (90%), Rhode Island (90%), Minnesota (89%), Connecticut (89%), Pennsylvania (87%) and Ohio (86%).

In other covid-19 news Friday: 
  • Counties with more than five new cases were Jefferson, 206; Fayette, 76; Warren, 41; Kenton, 27; Boone, 26; Bell, 23; Harlan, 17; Bullitt, 16; Barren, Hardin McCracken and Scott, 15 each; Laurel, 14;  Campbell, Henderson and Shelby, 12 each; Jessamine, 11; Knox, 10 1.25 Pike, 9; Ohio and Oldham, 8; Perry Pulaski and Whitley, 7 each; and Adair and Daviess, 6 each.
  • The Lexington-Fayette County Health Department, which follows its own reporting schedule, reported 100 new cases, "marking the first triple-digit spike in cases the city has seen during the coronavirus pandemic," Jeremy Chisenhall reports for the Lexington Herald-Leader. Eleven of the cases were in children and the health department said in a Facebook post that the steady increase in cases show "no signs of slowing." 
  • In long-term-care facilities, four more residents and 18 employees tested positive for the virus, and six more deaths were recorded, bringing the respective totals to 2,300, 1,267 and 458 (including four employees, one who died this week).
  • The Fayette County school board voted unanimously to begin the school year remotely; the start date has not yet been announced, reports the Herald-Leader. Jefferson County schools will also begin remotely, the Courier-Journal reports.
  • The Centers for Disease Control and Prevention's expanded guidance for reopening schools, rewritten to please President Trump, now "heavily emphasize sending students back to school this fall, despite what the CDC described as "mixed evidence about whether returning to school results in increased transmission or outbreaks" of covid-19, CBS News reports. The guidance "reads more like a political document than public-health guidelines," anchor Norah O'Donnell said on the "CBS Evening News."
  • New guidance from the CDC says most people who test positive for the virus can stop isolating themselves and take other preventive measures 10 days after their symptoms begin, and if they have been fever free for at least 24 hours without the use of medications. The guidance notes that a limited number of people with sever illness may have to isolate and take precautions for up to 20 days after symptom onset. Those who never show symptoms need to quarantine for 10 days after testing positive. The CDC says these recommendations "are based on the best information available in mid-July 2020 and reflect the realities of an evolving pandemic." The guidance also offers key findings that support this change in guidance. 
  • A new CDC study found that recovery from covid-19 can take a long time, even in young adults with no chronic conditions. The study found that 35% of those who had tested positive had not returned to their usual state of health two-three weeks after testing and that one in five previously healthy 18- to 34-year-olds were not back to usual health 14-21 days after testing positive. 
  • Beshear often warns that if the number of cases of coronavirus continues to surge, it could easily overtake the state's hospital capacity. McClatchy tells the story of a town in Texas where this has happened, and they are now having to decide who will be sent home to die. 
  • Don't forget to wear your mask when you go through drive-thru banking and food services. "Wear a cloth face covering when doing any in-person exchanges and unable to stay at least 6 feet apart from other people," the CDC says on its "running errands" guidance
  • Health and Human Services Secretary Alex Azar on Thursday signed a continuation of the covid-19 public health emergency that was set to expire July 25, extending temporary payment and enforcement flexibility for a whole range of stakeholders, Inside Health Policy reports.
  • If anyone is in the driver's seat for the next coronavirus stimulus bill, it's Senate Majority Leader Mitch McConnell, the editor of a leading liberal magazine told The Hill. David Dayen, executive editor of The American Prospect, said Democrats appear to be allowing the leader to do what he did with the last relief bill: "McConnell writes the bill in his office and then Democrats get a chance to tweak it."
  • One sign of the national surge: More new infections were reported yesterday that at any time since the pandemic started, CBS reported. The number: 77,255.

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