Tuesday, July 28, 2020

Beshear sees signs that his mask mandate is slowing the spread of the coronavirus; both key seven-day averages show declines

Kentucky Health News chart; daily case numbers may be adjusted after initial report.
By Melissa Patrick
Kentucky Health News

Although the number of new coronavirus cases reported Tuesday in Kentucky remained high, at 532, the seven-day average of cases suggested a downward trend, and the percentage of Kentuckians testing positive in the last week dropped a bit.

Gov. Andy Beshear said it is "too early to draw conclusions," but the daily data "at least gives us hope that we may be seeing a plateau or stabilization" because "the time period is right where the facial covering requirement is starting to kick in and help."

Beshear ordered that masks be worn in public places, or in social gathering with people outside the household, starting on July 10 -- with an expectation of seeing results after two weeks, which is roughly the incubation period for the virus. He also limited non-commercial gatherings to 10 people.

But despite those measures, new cases kept escalating, prompting Beshear to take the other two measures recommended by the White House Coronavirus Task Force: closing bars and reducing indoor restaurant capacity for the next two weeks, starting Tuesday.

Then Tuesday brought hopeful signs. The seven-day rolling average for the positive test rate fell to 5.08%, the first time it's gone down in four days, and the seven-day average of daily new cases fell to 590. Four days before, it had been 668, more than triple the average of 220 on July 1.

Looking ahead: Beshear said he expects the state will be able to increase capacity in restaurants again in two weeks. He didn't mention bars, which seem to have had a harder time following the mask mandate and social distancing orders. 

"It is my expectation because I believe these steps will work," he said. "Two weeks gives us a real opportunity and our hope is that we see the impact of the facial coverings before we see some of the impact on restaurants." He said the mask mandate will likely be extended. 

Asked why his latest orders were directed only at bars and restaurants, Beshear said the White House believes they are causing significant spread of the virus. According to limited cluster data provided by the state's health departments, Beshear said 17 percent of the spread in Kentucky has been from restaurants and bars.

Dr. Steven Stack, the state's public-health commissioner, again emphasized masks. "That is the single thing, if we just do it," he said. "If we get over the cultural divide about not wearing these things, this is how we keep businesses open, we keep people working, we get people back to the activities, we get kids back to school." 

Travel risks: Beshear has also issued a travel advisory, asking Kentuckians to not travel to states with a 15% or greater positive-test rate, and to quarantine for 14 days when they get home if they choose to. The official state covid-19 website now includes a list of those states.

The governor said he is hearing that Kentuckians are still traveling to Florida, even with older parents, and "I need everybody that has plans to go to Florida or Georgia, Alabama, South Carolina, Texas, Arizona -- cancel them." 

Beshear pointed out that the virus "continues to ravage" states around the country, noting that Florida has set a single-day record for deaths and that the virus is now killing a Texan every 6 minutes and 16 seconds. 

"We have the ability to stop this before it gets anywhere close to what we've seen in those states," he said, adding later, "Our goal, and I think what we have done, is to act quickly, to not let it get dire before we take the steps we need and to fully commit, to fully commit to doing what it takes to protect our people, keep our economy open and ultimately get our kids back in school." 

Beshear said 21 of Tuesday's new cases were children under 5, the youngest a two-month-old. He said this is a nationwide trend, which could be driven by more tests, but also because more young people than ever are getting infected. "We can't live under any illusion that kids don't get the virus," he said. 

He said there isn't enough data to show how children are contracting it, but "We know one driving cause is people going on vacation and taking their kids to places that they shouldn't be taking them, and then coming back and then their kids interact with other kids."

Trump and his drug: Nationally, one of the big covid-19 stories Tuesday was President Donald Trump's tweeting, more than a dozen times, in defense of hydroxychloroquine as a treatment for covid-19, despite no evidence of its efficacy. Trump doubled down on his promotion of the drug at his press conference Tuesday.

Stack, asked about the effectiveness of hydroxychloroquine, provided a lengthy answer about its lack of efficacy:

"All the credible evidence I have seen so far is hydroxychloriquine and chloriquine are not materially helpful; they do not help enough to be worth while for coronavirus. They don't effectively prevent you from getting the disease after you've been exposed to it. When you are sick, they don't help you get better more quickly. When you are sick, they don't help prevent you from having a bad outcome. So, maybe someday there will be some example or some narrow situation where that is not the case, but hydroxychloriquine and chloriquine, with or without the antibiotic Zithromax, which is known as azithromycin, the generic name, have not been shown to meaningfully improve your outcomes."

Stack added, "People, when they are desperate or unwilling to listen to science and facts and evidence, do things . . .that are foolish. O.K. People were taking aquarium chemicals and ingesting them because they thought that it was somehow going to help them with the coronavirus. Ingesting aquarium chemicals will kill you, it won't help you with the coronavirus. So please don't do those things."

Asked if Trump's comments undermined public-health messaging, Stack reiterated the question as asking about when "leaders and others" communicate things that are not supported by science. 

"I would continue to urge everyone in the public, please find people who have dedicated their lives and their professional lives to studying and learning about these things that are important, and listen to credible sources," he said. "I would look to a physician or a public-health expert to advise me on public health stuff. I don't take my car to a medical doctor to get fixed." 

In other covid-19 news Tuesday:
  • Beshear reported that 584 Kentuckians are in hospitalized with covid-19 and 115 of them are in intensive care, declines of 4 and 12 percent from Monday, respectively.
  • He reported that 77 more long-term care residents and 31 more staff had tested positive for the virus, and attributed nine more nursing-home deaths to covid-19. 
  • Beshear reported 10 new deaths from the virus, bringing the total to 719: a 74-year-old woman from Butler County; an 84-year-old man from Fayette County; a 37-year-old man from Lyon County (an inmate at the Kentucky State Penitentiary); a 73-year-old woman from Oldham County; and three each from Jefferson County (two women, 86 and 87, and a man, 82) and Logan County (two women, 89 and 101, and a man, 83). 
  • Counties with 10 or more new cases included Jefferson, 130; Kenton, 24; Madison, 19; Warren, 17; Barren and Graves, 14 each; Boone and Harlan, 12 each; Christian, 11; and Laurel, 10.
  • The Lexington-Fayette County Health Department, which reports on a different schedule than the state, reported a record 116 new cases Tuesday. "The number of cases reported in the last two weeks has matched the total number of cases reported in all of June," 2,972, the Lexington Herald-Leader reports. The new one-day high means each of Lexington’s top five case days have come since July 10." 
  • Health and Family Services Secretary Eric Friedlander said the state will not continue temporary Medicaid plans beyond July 31, and is working to sign up those who qualify up for regular Medicaid plans. 
  • The Kentucky High School Athletic Association Board of Control voted Tuesday to delay football games until Sept. 11 due to the pandemic. The previously scheduled start date had been Aug. 21.
  • As schools make plans to re-open this fall, their budgets are being stretched by the added cost of the coronavirus, Kristen Kennedy reports for Lexington's WKYT-TV: “We’re spending about $50,000 to replace water fountains with water-bottle fillers. We’re spending another $40,000 with new no-touch cleaning equipment,” said Scott County Supt. Kevin Hub. “We’ve got about $25,000 we’ve already spent on the point and shoot thermometers to meet the requirement, the temperature check, before school entry.” Hub said the county had received about $1.2 million in federal relief funding as well as money from the governor's allotment to school districts. 
  • A recent survey of 1,011 parents by Vanderbilt University found that since covid-19 hit, nearly 27% said their mental health had worsened, 14.3% said their children's behavioral health had declined, and 9.6% said both their mental health and their children's behavioral health had declined, Medpage Today reports.
  • Becker's Hospital CFO Report notes that seven of the nine things in Senate Republicans' proposed $1 trillion covid-19 relief package.  Inside Health Policy expands on the details of the package. Jason Bailey, executive director of the Kentucky Center for Economic Policy, said in a detailed statement that this proposal "provides nowhere near the aid Kentucky and the nation needs to get through the re-surging covid-19 economic and health crisis." 

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