Sunday, April 11, 2021

Weekly coronavirus cases are down, but weekly percentage of positive tests is up; statewide Covid-19 death toll reaches 6,250

By Al Cross
Kentucky Health News

Kentucky had fewer coronavirus cases in the last week than the week before, but the share of residents who tested positive for the virus went up.

The state reported 366 new cases of the virus, 67 more than last Sunday, and the seven-day rolling average of new cases rose by 10, to 535 per day.

But lower daily case numbers earlier in the Monday-to-Sunday reporting week made a total of 3,742 new cases, 14 percent less than the 4,373 initially recorded last week. Those numbers are totals of unadjusted daily reports; adjusted totals are reported on Mondays.

The percentage of Kentuckians testing positive for the virus in the last seven days rose to 3.08%, almost 0.3 percentage points higher than the 2.79% average on Friday, which was the lowest in more than nine months.

The statewide average of daily new cases over the last seven days is 10.35 per 100,000 residents, a rate 0.3 above Saturday's. Kentucky's rate dropped to 38th among the states in The New York Times tracking, from 35th on Saturday.

Counties with seven-day averages more than double the state's rate were Powell, 28.9 per 100,000 residents; Robertson, 27.1; Harlan, 26.9; Allen, 26.8; Bracken, 25.8; Bath, 25.1; Menifee, 24.2; McCreary, 22.4; Lawrence, 22.4; Simpson, 22.3, Mason, 21.8; Casey, 21.2; and Floyd, 20.9.

The state added nine more fatalities to its list of Covid-19 deaths, raising the death toll to 6,250. Eight were from regular health-department reports and one was from the ongoing audit of death certificates.

The 14-day rolling average of regularly reported deaths remained at 8.93 per day. Saturday, the state corrected its Thursday report, which should have attributed nine of the day's 16 deaths to the audit. As usual for a weekend, there was no itemized list of deaths by age, county, sex and date of death.

In other pandemic-related news Sunday:

  • Counties with five or more new cases on the state's daily report were Jefferson, 87; Fayette, 58; Franklin, 11; Clark, 10; Daviess, 10; Bell, 9; Scott, 9; Carter, 8; Warren, 8; Floyd, 7; Rockcastle, 7; Bullitt, 6; Kenton, 6; Jessamine, 5; and Magoffin, 5.
  • Kentucky hospitals reported 379 Covid-19 patients, nine more than Saturday. The number in intensive care was unchanged, at 92; the number on ventilators rose three, to 51.
  • Two of the 10 hospital regions reported more than 80% of their intensive-care beds in use: Lake Cumberland, 87%; and the easternmost region, from Lee to Pike counties, 81%.
  • The U.S. set another record for daily vaccinations Saturday, 4.6 million, CNN reports.
  • More than half a million Americans have taken advantage of the special open enrollment for subsidized coverage under the Patient Protection and Affordable Care Act, the Centers for Medicare and Medicaid Services reports. "With the special enrollment period now extended through Aug. 15, to be followed by normal annual enrollment beginning in November, the number obtaining coverage in ACA marketplaces could soon top its all-time high of 12.7 million," recorded in 2016, CNN reports. "Under Biden's protection now, Obama's legacy achievement appears likely to remain a durable feature of the American landscape."
  • In Kentucky, there have been 4,280 enrollments in the period, which began Feb. 15. That is 36% more than the 3,149 who signed up during the same period last year, when enrollment was open only to people who had "qualifying life events," such as loss of health coverage, change in qualifying income status, change in marital status, a birth or adoption, a death in the family or moving to a new ZIP code. There are no such limitations in the special period.

Most in Kentucky's federal delegation seem to have done little if anything to promote vaccination, despite request from Beshear

Rep. Brett Guthrie of Bowling Green and Sen. Mitch McConnell have been the Republicans in the state's federal delegation most actively promoting vaccines. (Photo by Alan Warren, Owensboro Messenger-Inquirer)
By Melissa Patrick
Kentucky Health News

By their own account, or lack of it, most Republicans in Kentucky's congressional delegation are doing little or nothing to promote the coronavirus vaccinations, as Democratic Gov. Andy Beshear asked them to. 

On March 18, Beshear sent a letter to the eight members of Kentucky's congressional delegation, asking them to promote the safety and effectiveness of coronavirus vaccines, and to encourage Kentuckians to get one.

Kentucky Health News asked each member of the delegation how they have responded to the governor's request, with the exception of Senate Minority Leader Mitch McConnell, who has been urging audiences to get vaccinated in several stops around the state recently.  

All of the state's delegation are Republicans except Rep. John Yarmuth, D-Louisville. National polling shows that Republicans, especially male Republicans, are more resistant to getting the vaccine. An NPR/PBS NewsHour/Marist poll conducted last month found that 49% of Republican men don't plan to get a coronavirus vaccine, compared with 6% of Democratic men.

Beshear's letter cited similar surveys: a CBS News poll that showed 22 percent of American adults and 33% of Republicans would not get a vaccine when they can, and an Associated Press poll showing 32% of adults and 44% of registered Republicans would either definitely not or probably not. 

"In light of this, it is vital that we do all we can as leaders to encourage our constituents to receive the life-saving vaccine," Beshear wrote. 

He concluded, "I ask for your help in promoting the importance and safety of the vaccines through your social-media accounts and in your public appearances. The more we can all make clear to Kentuckians that receiving the vaccine is a public health issue and not a partisan one, the more lives we will save and the sooner we will be able to return to business as usual in our great commonwealth. Thank you." 

Beshear and President Joe Biden and his appointees have praised McConnell's efforts to encourage Americans to get vaccinated, and most recently with a targeted message for Republican men. 

"I'm a Republican man, and I want to say to everyone, we need to take this vaccine. These reservations need to be put aside," McConnell said at an April 5 news conference in Lexington.

U.S. Rep. Brett Guthrie of the 2nd District told Kentucky Health News he was encouraging Kentuckians to get vaccinated long before that March 18 letter. 

“The governor is late to the game. I have been encouraging Covid-19 vaccines all along," Guthrie said in an e-mail. 

S.K. Bowen, Guthrie's communications director, added that Guthrie has played an active role in the oversight of the nation's pandemic vaccine response, and continues to do so in his role as the Republican leader of the House Energy and Commerce Committee's Health Subcommittee. 

"When encouraging people to receive Covid-19 vaccines, he shares that he knows from his oversight work that vaccines are safe and have been through a rigorous review process without cutting safety corners," she said. 

Guthrie toured vaccine clinics in his district last week, encouraging vaccinations, and was covered by the Owensboro Messenger-Inquirer and Bowling Green's WNKY and WBKO-TV. “We have safe vaccines,” he said in Owensboro. “You can call here today and get your vaccine without a waiting list anymore.”

In Bowling Green, where he lives, Guthrie said, "Whatever your political perspective is, you have presidents on both sides and both parties that have pushed this and promoted it and so therefore, I just encourage everybody to get a vaccine so we can put our masks behind us," 

In Glasgow, he also noted bipartisan support, but gave Republicans an extra nudge: “If you think that it’s a political problem, so you are not going to get vaccinated, that is just not the right way to look at it, because it has been across both administrations. As a matter of fact, most of the work was done under President Trump’s administration, so if you are politically conservative and are concerned about vaccines because of the government, most of this was done under President Trump." 

Yarmuth's communication director, Christopher Schuler, said the Louisville congressman is talking about the importance of vaccination nearly every day, in social media, meetings and public events. 

"He’s been discussing it throughout the pandemic and passage of these relief bills he helped craft, but we were certainly glad to see the governor urging the entire delegation to do more," Schuler said in an e-mail.

Sen. Rand Paul has sparred repeatedly with Dr. Anthony Fauci, most recently about mask wearing by vaccinated people. In an April 5 opinion piece for The Hill, which covers Congress, Paul wrote "I'm in favor of vaccines," but is also in favor of people making their own medical and personal decisions. 

"I’m a Duke Medical School-trained M.D. and I studied immunology before moving on to my career in eye surgery. Vaccines are a marvel of modern medicine, and the speed and effectiveness of the Covid vaccines have been great," he wrote. "I urge everyone to get the vaccine if you think you need or want it. And then I urge everyone in America to throw away their masks, demand their schools be open, and live your lives free of more government mandates and interference."

The other libertarian-leaning Republican in Kentucky's congressional delegation, Rep. Thomas Massie of the 4th District, indicating that he's not promoting vaccines because he's not getting one himself.

"I’m leaving personal medical decisions up to the individuals and won’t be undertaking a vaccine promotion campaign," he said in a email. "It would be somewhat disingenuous for me to do so when I have no plans to receive the vaccine myself, in the absence of data showing that it’s beneficial to those who’ve already recovered from the virus."

Asked about people who haven't been exposed, he replied, "Ultimately, people should listen to their personal doctors. It would be foolish for the general public to take health advice from my cohort of politicians, who are themselves fairly unhealthy, uneducated in science or medicine, don’t think that being $30 trillion in debt is a concern, and are conditioned to say what will most benefit themselves."

The other members of the delegation have been less active or less responsive.

The office of 6th District Rep. Andy Barr noted that he was vaccinated in Washington in December, and posted a video of it on YouTube, but did not provide any recent examples of Barr promoting vaccination.

Comer's Instagram post
Barr is 47. Rep. James Comer of the 1st District, who is 48, said earlier that he would delay getting vaccinated because he didn't want to put himself ahead of constituents in his rural district, which he expected to have "logistical challenges" in vaccine distribution. On March 30, after Beshear opened vaccinations to anyone over 40, Comer posted a picture of his vaccination on Instagram, saying he was "glad to help America recover from Covid-19."

Comer's office didn't provide any other examples of vaccine promotion, other than a March 21 CNN interview on several topics, in which he was asked if he would recommend to his constituents that they be vaccinated, he said "Absolutely. I don't think the government should mandate it, but I do think that everyone should get vaccinated." 

Fifth District Rep. Hal Rogers, 83, did not respond to repeated requests for comment. On Dec. 18, he issued a press release saying that he had been vaccinated: "While many have reservations about the vaccine, I received the first dose of the Covid-19 vaccination today with confidence, knowing that this is the first step for America to beat this pandemic and revive our economy."

Most health experts say a vaccination rate of 75 to 80 percent is needed to reach herd immunity, which provides some protection to people who are unwilling or unable to be vaccinated.

So far, 46% of Kentucky adults have received at least one dose of a vaccine and 30% have been fully vaccinated, according to the Centers for Disease Control and Prevention.

Saturday, April 10, 2021

Virus numbers remain stable; 34% of Kentuckians have been vaccinated, 22% fully; daily death average is now below 10

Centers for Disease Control and Prevention chart, adapted by Ky. Health News; click to enlarge.
By Al Cross
Kentucky Health News

The share of Kentuckians testing positive for the coronavirus rose two-tenths of a percentage point Saturday, to 2.99%, but that was still within the range in which the key indicator has been for three weeks.

The state reported 505 new cases of the virus, lowering the seven-day rolling average by 12, to 525 per day. That was the lowest in almost nine months.

However, the statewide rate of daily new cases increased to 10.05 per 100,000 residents, an increase of 0.1. Kentucky's rate remained 35th among the states, according to The New York Times data tracker.

Counties with rates more than double the statewide rate were Harlan, 29.7; Bracken, 25.8; Allen, 25.5; Powell, 25.4; Bath, 25.1; Casey, 24.8; Menifee, 24.2; Lawrence, 21.5; Simpson, 20.8; McCreary, 20.7; Logan, 20.6; Floyd, 20.5; and Robertson, 20.3.

Counties with more than five new cases were Jefferson, 81; Fayette, 22; Warren, 21; Kenton, 15; Green, 14; Trigg, 14; Montgomery, 13; Boone, Daviess and Laurel, 12; Campbell, 11; Pulaski, 10; Allen, Graves, Henderson and Perry, 9; Christian, Greenup, Hardin, and Lincoln, 8; Bullitt and Franklin, 7; and Barren, Boyd and Lewis, 6.

Vaccination update: Gov. Andy Beshear announced on Facebook that 1.5 million Kentuckians, just over one-third of the population, had been vaccinated for the virus. That is the figure for people who have received at least one dose; two of the three available vaccines require two doses for full effectiveness.

The Centers for Disease Control and Prevention data tracker says more than 1.51 million Kentuckians have been vaccinated with a total more 2.47 million doses, and 22.2% of Kentucky's total population has been fully vaccinated.

Youth under 16 are not yet eligible for the vaccine, pending clinical trials, and one of the vaccines is authorized only for adults, those 18 and up. The CDC says 28.5% of Kentuckians 18 and up are fully vaccinated. That is higher than any adjoining state but West Virginia, which is barely ahead at 28.6%.

Woodford County leads Kentucky in the percentage of residents and adults fully vaccinated, 32.2% and 41.1%, respectively. The lowest is Spencer County, with 9.8% of total adults fully vaccinated.

Deaths keep declining: The state added 14 fatalities to its list of Covid-19 deaths, raising the toll to 6,421. Ten were from regular health-department reports and four from the ongoing audit of death certificates.

The daily rate of regularly reported deaths, as a 14-day average, has been falling almost daily for three weeks. It is now 9.6 8.9 per day. That is a little more less than one-fifth of the highest daily average of 45.3, set in early February. (Updated numbers reflect the state's correction of its reported data.)

As usual for a weekend, the state did not release a list of fatalities itemized by age, county, sex and date of death. Click here for the state's daily report.

In other pandemic news Saturday:
  • Kentucky hospitals reported 370 Covid-19 patients, 12 fewer than Friday, with 92 of them in intensive care (down 14) and 48 of those on ventilators (down 12).
  • The state came close to having none of its hospital regions using more than 80% of intensive-care beds, a level of concern. The Lake Cumberland region, which has long run around 90%, fell to 82%.
  • The New York Times published a list of food processing plants that have had more than 50 coronavirus cases. The Perdue Farms facility at Cromwell in Ohio County ranked 22nd, with 342 cases. Others on the list were Tyson Foods, Robards, Henderson County, 103; Pilgrim's Pride, Hickory, Graves County, 96; and JBS, Louisville, 78. All are meat plants. The Nestle frozen-foods processing plant in Mount Sterling has had 74.

Friday, April 9, 2021

Georgetown judge blocks enforcement of Beshear's bar-and-restaurant orders against 5 bars in 4 cities; governor appeals

Goodwood Brewing in Louisville owns three of the bars. (Courier Journal photo by Marty Pearl)
A Scott County judge issued an injunction Friday exempting several businesses from Gov. Andy Beshear's emergency orders, and Beshear appealed to the Court of Appeals.

Scott Circuit Judge Brian Privett ruled in a suit filed by Trindy’s in Georgetown; Goodwood Brewing Co., doing business as Louisville Taproom, Frankfort Brewpub and Lexington Brewpub; and Kelmaro, doing business as The Dundee Tavern, in Louisville, the Lexington Herald-Leader reported.

The firms are represented by Oliver Dunford of the Pacific Legal Foundation, a libertarian-oriented group that says it "defends Americans’ liberties when threatened by government overreach and abuse." 

Dunford told the Herald-Leader that the suit was filed in Scott County because of Trindy’s. Privett has ruled against Beshear in similar instances.

Privett wrote that his order applied only to the businesses in the case. It exempts them from orders that limit restaurants and bars to 60% capacity and requires them to stop serving by midnight and close by 1 a.m.

He said it's likely that the Court of Appeals will stay his order quickly, and that the Supreme Court will consider his order and that of Franklin Circuit Judge Phillip Shepherd, who extended his injunction blocking the legislature's efforts to limit Beshear's emergency powers during the pandemic.

Privett noted that the case before Shepherd involves only the governor and the legislature, while his includes businesses: “By issuing this temporary injunction, the court gives these plaintiff businesses, the business community, and general citizenry of the commonwealth a real say in the matters.”

Positive-test rate falls a bit, to a historic low, but 7-day average of new cases rises slightly; state's trajectory compares well to others

Chart adapted by Kentucky Health News shows how states' trends compare. Click on it to enlarge.
By Al Cross
Kentucky Health News

The share of Kentuckians testing positive for the novel coronavirus in the last seven days fell Friday to 2.79 percent, the smallest share since late June, soon after testing for the virus became widely available. The rate has been under 3.4% since March 20 and was 2.81% Thursday.

“It’s encouraging to see our positivity rate decrease again, but we need to work even harder to make sure our weekly case numbers start decreasing again as well,” Gov. Andy Beshear said in a press release. “Every Kentuckian 16 and older should get their Covid-19 vaccine as soon as possible. It’s fast, it’s safe, it’s easy and you could save a life by doing so, maybe even your own life.”

The seven-day average of new cases rose to 537 per day, with the state's Friday report of 744 cases.

The statewide rate of daily new cases over the last seven days rose 0.28, to 9.95 cases per 100,000 residents. Kentucky's rate dropped to 36th among the states, according to The New York Times.

Counties with rates more than double the statewide rate were Harlan, 29.7; Robertson, 27.1; Whitley, 25.2; Powell, 24.3; Menifee, 24.2; Bracken, 24.1, McCreary, 24; Casey, 23; Floyd, 21.7; Simpson, 21.5; Mason, 20.9; Bath, 20.6; Lawrence, 20.5; Allen, 20.1, and Logan, 20.

All those counties are in Appalachia, or border other states where the recent trajectory of the pandemic has not been as favorable as in Kentucky. The Times published a geographic chart of the states (above) showing their new-case rates since Feb. 1 and highlighting the increase since their lowest point of 2021.

The state added nine fatalities to its list of Covid-19 deaths, making the toll 6,223. Four were from regular health-department reports and five from the ongoing audit of death certificates. One deaths in the regular report was listed as occurring in December, before four of the five in the audit report.

The audit fatalities were a 65-year-old Jefferson County woman, on Nov. 17; a Christian County woman, 52, on Dec. 28; a Daviess County man, 91, Jan. 1; a Calloway County woman, 83, Jan. 8; and a Shelby County man, 86, Jan. 12.

The regularly reported fatalities were a Boyle County man, 75, Dec. 9; a Marion County woman, 86, Feb. 15; a Boyd County man, 73, April 6; and an Allen County woman, 80, April 7.
      
In other pandemic news Friday:
  • Counties with 10 or more new cases were Jefferson, 168; Fayette, 54; Christian, 25; Kenton, 21; McCracken, 18; Warren, 18; Boone, 16; Scott, 15; Daviess, 14; Campbell, 12; Pike, 12; Pulaski, 11; and Franklin, Greenup, Hardin and Nelson, 10.
  • Kentucky hospitals reported 382 Covid-19 patients, five more than Thursday, with 106 of them in intensive care (up four) and 60 of those on ventilators (up seven).
  • The University of Kentucky announced that it had administered its 200,000th dose of coronavirus vaccine and was offering students, and those newly admitted for the fall semester, their choice of the Pfizer or Johnson & Johnson vaccines. It said about 80% of faculty and 70% of staff had been vaccinated or were in the process of being vaccinated.
  • Nursing homes would have to tell the CDC how many of their health-care workers have been fully vaccinated against the virus, under a proposed rule released Thursday, and the data would be public on a quarterly basis. Such reporting is now voluntary.
  • "Appointees in the Department of Health and Human Services last year privately touted their efforts to block or alter scientists’ reports on the coronavirus to more closely align with then-President Donald Trump’s more optimistic messages about the outbreak, according to newly released documents from congressional investigators," The Washington Post reports.

Health officials from several counties with low rates of fully vaccinated residents say vaccine hesitancy is a problem

Photo illustration from Forbes.com
By Melissa Patrick
Kentucky Health News

As Kentucky's coronavirus vaccine supply exceeds Kentuckians' demand for it, with only about 43% of those eligible having received at least one dose, health officials in counties with low vaccine rates say vaccine hesitancy is playing a role in that. 

"I think the people who want it have found it . . . and I think what's left are people that are still a little hesitant to take it," said Anita Bertram, director of the Lewis County Health Department. "Because you know, I've got it. I've got it today. They could come right now and I could get it in their arms."  

Bertram said the health department is holding a mass clinic on April 14, with more than 200 slots still available. Further, she said the health department offers about 100 vaccine slots each week, and for two weeks running they have struggled to fill them. 

"I feel like a broker, trying to get people to come and take vaccines -- like before you call over to the Dollar Store trying to ramp somebody up to take a Johnson & Johnson," she said. 

According to the Centers for Disease Control and Prevention, Lewis County has one of the lowest percentages of residents who are fully vaccinated in Kentucky. On April 8, the CDC's Covid Data Tracker showed 12.3 percent of the population has been fully vaccinated. The county with the highest rate was Woodford, at 31.3%. 

Bertram said the health department has given 1,590 people a vaccine and 2,490 doses, including both prime and booster shots.  

Until recently, the department has been the only place to offer a vaccine in Lewis County, but this week the county's federally qualified health center got its first batch. 

It's important that the state's FQHCs, generally known as community health centers, will be getting a "bolus of vaccines" in the upcoming weeks, since they provide primary care to more than 500,000 Kentuckians, said David Bolt, CEO of the Kentucky Primary Care Association. He said the next phase of getting Kentuckians vaccinated will require a "ground game" that takes the vaccines out into the community.

He also pointed to a survey in Jefferson County that found most of the participants said they would prefer to be vaccinated by their health-care provider.

"We have over 500,000 in our clinics," he said. "And most of those folks, they rely on those clinics and they trust the providers there. A lot of this is about trust. If someone's got a fear of the vaccine, most of them feel free to talk to their doctor. . . . and in some instances, their pharmacist." 

Lewis County, with its seat and nearby cities (Wikipedia, adapted)
Bolt, who said he had worked at the Lewis County FQHC for about 10 years, also suggested that another possible reason for the low vaccine rates in the county is because it is a "goodly drive" to the closest Walgreens and Walmart, which also offer the vaccines. 

Shawn Crabtree, director of the Lake Cumberland District Health Department, said he has been able to move the 1,000 weekly doses of vaccine allocated to his health district, but other vaccine providers in his 10-county district are having trouble moving their vaccine. Several counties  have low vaccination rates.

"It seems like there is enough vaccine right now; the supply right now is sufficient for the demand. I wish the demand was greater at this point," Crabtree said. There is some vaccine hesitancy among those who are younger than 50, he said, largely because they don't see their immediate health risk. 

"The problem with that is even if you don't get extremely sick, if you catch it, you still spread it and we're wanting to nip this thing out before it mutates enough that it becomes resistant to the vaccine," he said. 

So far, the state has detected 113 cases with mutated "variants of concern" in Kentucky. All but two were the highly contagious B.1.1.7, which was first found in the United Kingdom. The CDC website says only 1,085 cases in Kentucky have undergone genomic testing to detect variants, and the B.1.1.7 variant is now dominant in the U.S.

Crabtree said vaccination scheduling at his county health departments had slowed down for the two-dose Moderna vaccine and that the one-dose Johnson & Johnson vaccine had become more popular. 

On Thursday, Gov. Andy Beshear pleaded with Kentuckians at a news briefing to take whatever vaccine is available to them, and not wait for the single-dose vaccine, saying Kentucky only got 7,800 doses of that vaccine this week, a drop from 65,000 last week, and state officials don't know how many it will get in the upcoming weeks. 

He said if people "wait on the Johnson & Johnson vaccine, we might not win the race against the variants" of the virus that are more contagious and "It's going to take us longer to be able to fully ease the restrictions that we all want to get rid of." 

The Lake Cumberland district has two of the counties with some of the lowest rates for fully vaccinated people: Casey, at 11.6% and Wayne, at 12.2%. The district's counties with the highest rates are Cumberland, 18.7%, and Russell, 18.3%. 

The Kentucky county with the lowest rate of fully vaccinated residents is Spencer, at 9.4%, This county is also last for fully vaccinating its adults and seniors, at 12.1% and 28.2% respectively . 

Stephanie Lokits, director of nursing at the North Central District Health Department, which serves Spencer County, said in an e-mail that they have not seen any increased vaccine hesitancy in that county and have worked closely with partners in that community to ensure that vaccine is available. 

"However, NCDHD is working to address vaccine hesitancy across the district through multiple avenues, including a social media campaign and planning targeted events in counties with lower uptake such as Spencer County, to increase vaccination," she said. 

Like Bertram, she said the district's vaccine appointment bookings are a "bit slower than usual" and that they have responded to this by opening up the clinics to anyone 18 and older and to allow walk-ins. 

NCDHD serves Shelby, Spencer, Henry and Trimble counties. Of those, Henry County has the highest rate of fully vaccinated residents, 21%. 

For several weeks, Beshear has listed regional vaccine sites with thousands of slots available for the following week. This week's list included U of L Health at Cardinal Stadium, with more than 11,000 slots open; Kroger Health at Greenwood Mall in Bowling Green (2,000) and the Kentucky Horse Park in Lexington (1,800); Baptist Health Corbin; the Christian County Health Department (1,000); and Pikeville Medical Center (1,000).

Education is key: Bertram said vaccine education needs to come from all fronts, including providers, local leaders and the news media. 

"We just need to reassure folks that it's a safe vaccine and it's the right thing to do," she said. "And to get back to any kind of sense of normalcy, we've got to get some herd immunity going on."

Herd immunity, which provides some protection to people who are unwilling or unable to be vaccinated, requires a vaccination rate of 75 to 80 percent for this virus, most health experts say.

Bolt, of the Primary Care Association, also spoke to the need for education. 

"Kentucky is a diverse state," he said. "You have some large counties that are sparsely populated, and there are a lot of people here that can't drive, don't drive, rely on neighbors or friends. And it's, it's gonna take us a while to get to everybody. But I think the push to have people really understand the importance of the vaccine is imperative and then getting it out to the public." 

Counties at top and bottom: The CDC Covid Data Tracker on April 8 showed the Kentucky counties with the highest fully-vaccinated percentages were about the same as reported March 28 in The Washington Post: Woodford, 31.3%; Fayette, 28.7%; Pike, 28.5 %; Franklin 27.4%, and Perry, 27.4%. 

Letcher, Floyd, Hancock and Nicholas counties have also fully vaccinated at least one-fourth of their population, according to the data tracker.

The counties with the lowest percentages of people fully vaccinated on April 8 were Spencer, 9.4%; Christian, 10.5%; Casey, 11.6%; Ballard, 12.1%, Wayne, 12.2% and Lewis, 12.3%.

Every county has fully vaccinated at least 28.2% of its 65-and-older population, with three counties having fully vaccinated at least 70%: Hancock, Nicholas and Franklin. 

The CDC's data tracker is updated daily. The agency notes that there could be some missing data, which could result in vaccination coverage by county appearing artificially low.  It also says it has "excluded from county-level summary measures vaccination records missing county of residence." It says county-of-residence data are missing for nearly 60,000 more Kentuckians who are fully vaccinated, so the actual figures for each county could be slightly higher or lower. 

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Thursday, April 8, 2021

As vaccines go begging, Beshear says doses need to go where people are, and local leaders need to urge folks to get a shot

State table shows how supply of vaccines has exceeded demand for vaccinations recently.
By Melissa Patrick
Kentucky Health News

Almost every coronavirus-related question at Gov. Andy Beshear's news briefing Thursday ended with a call from him to get vaccinated, and that came after repeated pleas in his relatively short presentation for Kentuckians to sign up for one of the thousands of open vaccination slots across the state.

"While we vaccinated 125,210 new Kentuckians this last week, we received about 214,000 doses. So what that means is there are open appointments . . . not because we're not vaccinating still at a steady pace, but because we're getting more vaccine," Beshear said, "so we need people to get out there and to sign up." 

Beshear again listed regional vaccine sites with thousands of slots available next week, including U of L Health at Cardinal Stadium, with more than 11,000 slots open; Kroger Health at Greenwood Mall in Bowling Green (2,000); and the Kentucky Horse Park in Lexington (1,800); Baptist Health Corbin; the Christian County Health Department (1,000); and Pikeville Medical Center (1,000). 

He pleaded with Kentuckians to take whatever vaccine is available, and not wait for the single-dose Johnson & Johnson vaccine, saying Kentucky only got 7,800 doses of that vaccine this week, a drop from 65,000 last week, and state officials don't know how many it will get in the upcoming weeks. 

State table of variants by county; for a larger version, click on it.
He said if people "wait on the Johnson & Johnson vaccine, we might not win the race against the variants" of the virus that are more contagious and "It's going to take us longer to be able to fully ease the restrictions that we all want to get rid of. So come on, get out there, get your vaccine."

Beshear said so far, the state has detected 113 cases with "variants of concern" in Kentucky. All but two were the highly contagious B.1.1.7, which was first found in the United Kingdom. The Centers for Disease Control and Prevention website says 1,085 cases in Kentucky have undergone genomic testing to detect variants.

More than 1.5 million Kentuckians have received at least one dose of a vaccine, about 33% of the population. 

Reluctance to get the vaccine has been reported to be more common among rural whites, especially evangelicals, and urban Blacks.

Sarah Ladd and Chris Kenning of the Louisville Courier Journal report that the real reason vaccinations have lagged among Kentucky Blacks are lack of access, including things like "little or no transportation, no internet access, few if any nearby pharmacies and struggles trying to sign up online." 

Kentucky Health News asked Beshear if these are some of the reasons rural whites have been slow to get vaccinated, or if it had to do more with politics. Beshear said that while there are some similarities between rural and urban areas, there are also other nuances that must be recognized. 

He said some parts of the state have shown some higher hesitancy, naming Western Kentucky as one. 

He suggested it is time to try some new strategies, like programs that offer incentives for vaccination and getting more doses into places people regularly go to, such as pharmacies and grocery stores. 

The politics can be local, he said: "Some of the areas where we see the least amount of people taking vaccines are ones where we saw local leaders push back against what we were doing to protect people" earlier in the pandemic. "If you see enough of that, and someone is beating that drum beat long enough, again, it's going to make it harder to then convince people to get vaccinated. And so we're going to need help, both from those that have disagreed with us as we've gone along and those that have agreed with us to get it done."

Beshear suggested that on Monday, he would give Kentuckians a broad incentive to get a shot: set a vaccination level at which he would remove capacity restrictions, even for events of up to 1,000 people. 

"We still may be needing to wear masks, whether it's our restaurants, our bars, our offices and the rest, [but] we can get back to that 100 percent capacity," he said, "and it's all dependent on how quickly and how many people we can vaccinate."

Beshear said he thought if done safely and masking is strictly enforced, it will be safe to attend the Kentucky Derby on May 1, and he plans on being there. He also encouraged people to go ahead and get vaccinated now if they plan on being there, or anywhere that involves large crowds. 

"That ought to be on anybody's checklist who is planning on going," he said. 

Beshear said the state is tailoring some of its efforts toward young people, who he said weren't necessarily vaccine-hesitant, but more likely indifferent because the virus has not affected their age group as harshly. He noted that young people in other states have been hospitalized with variants.

Asked about a study, published in The Lancet Psychiatry journal, that shows one in three people who have had Covid-19 have suffered a neurological or psychiatric disorder within six months of infection with the virus, Beshear said he was still looking at the study, and that he expects there will be many more like it. He  also noted that Health Commissioner Steven Stack has warned all along that we don't know the long-term effects of having Covid-19. 

"Again, it has real health impacts. So get vaccinated, continue to wear your mask until we get to the end. And don't be cavalier, because while you may think that it's not going to hurt you the person you could spread it to could be could be suffering from this," he said.

Daily numbers: Beshear reported 645 new cases of the virus, bringing the state's seven-day average to 529, the lowest it's been since Aug. 11, when it was 528.

The share of Kentuckians testing positive for the virus in the past seven days was 2.81%, almost equal to the recent low of 2.8% on March 26 and 27. 

In long-term care, Beshear reported no new Covid-19 deaths, and only six new cases, five of them among employees. "That is the power of vaccinations," he said, referring to the fact that significantly more residents than employees have been vaccinated.

The state added 16 deaths to its list of Covid-19 fatalities. The state's death toll from the disease is 6,214. The 14-day average of regularly reported deaths is 11.6 a day, half what it was two and a half weeks ago.

The state said all 16 deaths were from regular health-department reports and none from the death-certificate audit. However, 10 of them were from 2020, with two dated in July. UPDATE, April 11: The Cabinet for Health and Family Services said nine of the 16 deaths were actually from the audit, which recently went farther back into 2020. "The first of these cases were incorrectly classified Thursday as regular rather than audit deaths because of the pathway through which they were submitted," cabinet spokeswoman Susan Dunlap said in an email.

The July fatalities were both from Jefferson County: a 64-year-old man and a 59-year-old woman. Later in 2020 were three Jefferson County women, 73, 80 and 87; two Jefferson County men, 61 and 72; a Laurel County woman, 77; an Oldham County man, 45; and a Carroll County man, 41.

All the 2021 fatalities on the daily death report were listed as occurring after March 19. They were a Christian County man, 68; a Daviess County man, 54; two Hopkins County women, 73 and 88; a Hopkins County man, 62; an an Ohio County man, 76.  

Unemployment: The state Labor Cabinet said it would shut the state's unemployment system for four days, starting at midnight Thursday to fight a "massive amount of fraud" that is affecting unemployment systems across the nation.

"We hate that we have to do this, to make things more difficult, but these criminals are relentless; they will not stop," said Amy Cubbage, Beshear's general counsel. 

During the shutdown, no new claims can be filed and claimants will be unable to request benefits. Staff will continue to work on existing claims. 

Cubbage said there have been attempts to change 300,000 personal identification numbers on claimants' accounts, not all of them current accounts.  

Claimants will need to set up new accounts next week with a new eight-digit PIN  that they will receive in by U.S. mail, as well as a new 12-digit password. Cubbage said active claimants will not need to file new claims.

In other pandemic news Thursday:

  • The state's daily new-case rate over the past seven days was 9.67 per 100,000 residents, 0.1 less than Wednesday. Its rate ranked 34th among the states, according to The New York Times.
  • Counties with rates more than double the statewide rate were Simpson, 43.8; Harlan, 29.1; McCreary, 28.2; Bracken, 27.5; Whitley, 27.2; Powell, 26.6; Floyd, 22.5; Knox, 22; Menifee, 22; Robertson, 20.3; Allen, 20.1; Mason, 20.1; Lawrence, 19.6; and Casey, 19.4.
  • Counties with 10 more more new cases on the state's daily report were: Jefferson, 125; Fayette, 43; Clark, 23; Warren, 19; Boone, 18; McCracken, 16; Kenton, 14; Letcher, 14; Hardin, 13; Christian, 12; Harlan, 12; Floyd, Logan, Madison and Simpson, 11; and Allen, Daviess and Powell, 10.
  • Kentucky hospitals reported 377 Covid-19 patients, six fewer than Wednesday, with 102 of them in intensive care (down 10) and 53 of those on ventilators (down 13).

Judge blocks bill that would have removed mask mandate and some other emergency orders if legislature prevails in lawsuit

Franklin Circuit Court Judge Phillip J. Shepherd
A Frankfort judge has widened his roadblock of legislative efforts to limit Gov. Andy Beshear's emergency powers in the pandemic.

Franklin Circuit Judge Phillip Shepherd added House Joint Resolution 77 to the injunction he issued last month that blocked earlier legislation including Senate Bill 1, which would have limited Beshear's emergency orders to 30 days unless extended by the General Assembly.

The legislature has adjourned. It passed HJR 77 to implement SB 1 in case it wins its appeal of Shepherd's injunction. It kept some of Beshear's orders in effect but left out several others, including his mask mandate.

“In general, it appears that the General Assembly has ratified the governor’s actions related to economic relief for regulated businesses and professions but has attempted to impose a general termination of executive authority to impose public health restrictions (such as masking in public, social distancing, seating capacity or limitations on public gatherings),” Shepherd wrote. “Whether HJR 77 represents a valid exercise of legislative authority or an unconstitutional usurpation of executive authority” is a legal issue that justifies an injunction to maintain the status quo, he said.

Shepherd said Beshear’s emergency orders and regulations are “proper responses to a public health crisis” and “should remain in full force and effect until the entry of a final judgment or until after notice and a hearing on any motion to terminate any such specific executive action.”

On a related issue, Shepherd declined to grant Beshear’s request to block parts of the budget that prohibit spending funds on certain pandemic regulations and activities, because it won't take effect until July 1. He said Beshear could change those orders of regulations before July 1, and “In any event, the court should be able to fully address the merits of those claims prior to the end of the current fiscal year on June 30.”

In another matter, Shepherd "directed the parties in the lawsuit to meet and confer within the next two days to resolve any concerns related to the implementation of Senate Bill 148," the Lexington Herald-Leader reports. "The measure limits the state’s authority to reduce class sizes at child care centers in an emergency."

Virus variant first found in U.K. now dominant in U.S.; vaccinations limit its impact, and mutations that make more contagious strains

False-color electron micrograph of a B.1.1.7 variant, the
increased transmissibility of which is believed to be due
to the structure of its spike proteins, shown in green.
By
Paulo Verardi
University of Connecticut

Spring has sprung, and there is a sense of relief in the air. After one year of lockdowns and social distancing, more than 171 million Covid-19 vaccine doses have been administered in the U.S. and about 19.4% of the population is fully vaccinated. But there is something else in the air: ominous SARS-CoV-2 variants.

I am a virologist and vaccinologist, which means that I spend my days studying viruses and designing and testing vaccine strategies against viral diseases. In the case of SARS-CoV-2, this work has taken on greater urgency. We humans are in a race to become immune against this cagey virus, whose ability to mutate and adapt seems to be a step ahead of our capacity to gain herd immunity. Because of the variants that are emerging, it could be a race to the wire.

Five variants to watch

RNA viruses like SARS-CoV-2 constantly mutate as they make more copies of themselves. Most of these mutations end up being disadvantageous to the virus and therefore disappear through natural selection.

Occasionally, though, they offer a benefit to the mutated or so-called genetic-variant virus. An example would be a mutation that improves the ability of the virus to attach more tightly to human cells, thus enhancing viral replication. Another would be a mutation that allows the virus to spread more easily from person to person, thus increasing transmissibility.

None of this is surprising for a virus that is a fresh arrival in the human population and still adapting to humans as hosts. While viruses don’t think, they are governed by the same evolutionary drive that all organisms are – their first order of business is to perpetuate themselves.

These mutations have resulted in several new SARS-CoV-2 variants, leading to outbreak clusters, and in some cases, global spread. They are broadly classified as variants of interest, concern or high consequence.

Currently there are five variants of concern circulating in the U.S.: the B.1.1.7, which originated in the United Kingdom; the B.1.351., of South African origin; the P.1., first seen in Brazil; and the B.1.427 and B.1.429, both originating in California.

Each of these variants has a number of mutations, and some of these are key mutations in critical regions of the viral genome. Because the spike protein is required for the virus to attach to human cells, it carries a number of these key mutations. In addition, antibodies that neutralize the virus typically bind to the spike protein, thus making the spike sequence or protein a key component of Covid-19 vaccines.

India and California have recently detected “double mutant” variants that, although not yet classified, have gained international interest. They have one key mutation in the spike protein similar to one found in the Brazilian and South African variants, and another already found in the B.1.427 and B.1.429 California variants. As of today, no variant has been classified as of high consequence, although the concern is that this could change as new variants emerge and we learn more about the variants already circulating.

More transmission and worse disease

These variants are worrisome for several reasons. First, the SARS-CoV-2 variants of concern generally spread from person to person at least 20% to 50% more easily. This allows them to infect more people and to spread more quickly and widely, eventually becoming the predominant strain.

For example, the B.1.1.7 U.K. variant that was first detected in the U.S. in December 2020 is now the prevalent circulating strain in the U.S., accounting for an estimated 27.2% of all cases by mid-March. Likewise, the P.1 variant first detected in travelers from Brazil in January is now wreaking havoc in Brazil, where it is causing a collapse of the health care system and led to at least 60,000 deaths in the month of March.

Second, SARS-CoV-2 variants of concern can also lead to more severe disease and increased hospitalizations and deaths. In other words, they may have enhanced virulence. Indeed, a recent study in England suggests that the B.1.1.7 variant causes more severe illness and mortality.

Another concern is that these new variants can escape the immunity elicited by natural infection or our current vaccination efforts. For example, antibodies from people who recovered after infection or who have received a vaccine may not be able to bind as efficiently to a new variant virus, resulting in reduced neutralization of that variant virus. This could lead to reinfections and lower the effectiveness of current monoclonal antibody treatments and vaccines.

Researchers are intensely investigating whether there will be reduced vaccine efficacy against these variants. While most vaccines seem to remain effective against the U.K. variant, one recent study showed that the AstraZeneca vaccine lacks efficacy in preventing mild to moderate Covid-19 due to the B.1.351 South African variant.

On the other hand, Pfizer recently announced data from a subset of volunteers in South Africa that supports high efficacy of its mRNA vaccine against the B.1.351 variant. Other encouraging news is that T-cell immune responses elicited by natural SARS-CoV-2 infection or mRNA vaccination recognize all three U.K., South Africa, and Brazil variants. This suggests that even with reduced neutralizing antibody activity, T-cell responses stimulated by vaccination or natural infection will provide a degree of protection against such variants.

Stay vigilant, and get vaccinated

What does this all mean? While current vaccines may not prevent mild symptomatic Covid-19 caused by these variants, they will likely prevent moderate and severe disease, and in particular hospitalizations and deaths. That is the good news.

However, it is imperative to assume that current SARS-CoV-2 variants will likely continue to evolve and adapt. In a recent survey of 77 epidemiologists from 28 countries, the majority believed that within a year current vaccines could need to be updated to better handle new variants, and that low vaccine coverage will likely facilitate the emergence of such variants.

What do we need to do? We need to keep doing what we have been doing: using masks, avoiding poorly ventilated areas, and practicing social distancing techniques to slow transmission and avert further waves driven by these new variants. We also need to vaccinate as many people in as many places and as soon as possible to reduce the number of cases and the likelihood for the virus to generate new variants and escape mutants. And for that, it is vital that public health officials, governments and nongovernmental organizations address vaccine hesitancy and equity both locally and globally.

Paulo Verardi is an associate professor of virology and vaccinology at the University of Connecticut. This was first published in The Conversation, a site for journalistic writing by academics.

Wednesday, April 7, 2021

Pandemic numbers hold steady; even with two days of delayed reporting, new-case average continues downward trend

State Department for Public Health map, relabeled by Kentucky Health News; click on it to enlarge.
By Al Cross
Kentucky Health News

Measures of the pandemic held steady in Kentucky on Wednesday.

The state reported 1,028 new cases of the novel coronavirus, including 300 from Monday and Tuesday that "could not be confirmed and announced until today due to a technical issue on the reporting platform," a news release from Gov. Andy Beshear's office said.

That raised the seven-day rolling average of new cases to 568, 30 more than Tuesday but still lower than any other day since Sept. 10. Beshear had said Monday that limited reporting due to testing-lab closures on Easter weekend would leave the true course of the pandemic in the state unclear until today.

“Today’s case report reminds us that even though we’ve come so far in the fight against Covid-19, this isn’t over yet,” Beshear said Wednesday. “Please, if you’re 16 or older, get vaccinated. Keep masking up in public spaces even if you have been vaccinated. None of us want to throw away our progress.”

Vaccination sites and free transportation options to and from vaccination appointments can be seen at vaccine.ky.gov. A list of vaccination sites with openings this week is at vaccinemap.ky.gov.

The percentage of Kentuckians testing positive in the last seven days declined slightly, to 2.87%. The percentage has been between 2.8% and 3.08% for the last 18 days, an unusual run of stability. The high was 12.45% on Jan. 10, around the time the state was setting daily and weekly records for new cases.

The statewide rate of daily new cases for the last seven days rose to 9.77 per 100,000 residents. Counties with rates more than double the statewide rate were Simpson, 45.4; Harlan, 33.5; Whitley, 31.5; Powell, 31.2; McCreary, 29.8; Menifee, 28.6; Robertson, 27.1; Floyd, 23.7; Mason, 22.6; Morgan, 22.5; Knox, 22.5; Bracken, 20.6; and Bath, 19.4.

Kentucky's seven-day rate of new case was 34th among the states, according to the pandemic data tracker of The New York Times.

Counties with more than 10 new cases were Jefferson, 137; Fayette, 65; Laurel. 39; Warren, 34; Boone, 33; Hardin, 32; Kenton, 29; Christian, 25; Whitley, 25; Daviess, 22; Madison, 22; McCracken, 18; Scott, 18; Harlan, 16; Logan, 16; Campbell, Casey and Grayson, 15; Bullitt, Hopkins and Knox, 14; Barren and Montgomery, 13; Clinton, Floyd and Pulaski, 12; and Pike, 11.

The state added 14 deaths to its list of Covid-19 fatalities, raising the death toll to 6,198. Ten were from regular health-department reports and four were from the ongoing audit of death certificates.

The 10 regularly reported fatalities included six deaths from this month: a Daviess County man, 64; a Henderson County man, 63; a Jefferson County woman, 45; a Jefferson County man, 93; a Mercer County woman, 67; and a Nelson County man, 70.. Three were from Laurel County in January: a 94-year-old woman and two men, 51 and 77.

Kentucky hospitals reported 383 Covid-19 patients (seven more than Tuesday), 112 of them in intensive care (down 4) and 66 on ventilators (up 9).

The four deaths found by death-certificate audit were all in late November: a Lee County woman, 82; a Union County woman, 89; and two Warren County men, 82 and 83.

In other pandemic news Wednesday:
  • The highly contagious B.1.1.7 variant first identified in the United Kingdom is now the most common strain of the virus in the United States, Centers for Disease Control and Prevention Director Rochelle Walensky said. She said the variants is more transmissible and infectious among younger people and is partly responsible for rising case numbers in recent weeks.

Tuesday, April 6, 2021

Virus case numbers keep falling, but reporting may have been limited; Covid-19 hospital cases, ICU and ventilator use are up

By Al Cross
Kentucky Health News

Some key measures of the pandemic in Kentucky continued to fall Tuesday, but it remains to be seen how much that has to do with testing labs being closed during Easter weekend.

The state reported 344 new cases of the novel coronavirus Tuesday, well under than half the number reported last Tuesday. That reduced the seven-day rolling average of new cases by almost 10 percent, to 538 per day. That is the lowest average since Aug. 11, almost eight months ago, but Gov. Andy Beshear said Monday that it would be "hard to tell what's going on until Wednesday" because of lab closures.

The statewide rate of daily new cases in the last seven days fell to 9 per 100,000 residents. Counties with rates more than twice the state rate were Simpson, 48.5; Powell, 38.1; McCreary, 31.5; Whitley, 28; Morgan, 21.5; Allen, 20.8; Robertson, 20.3; Knox, 19.7; Floyd, 19.7; Lee, 19.3; Mason, 19.2; and Metcalfe, 18.4.

Counties with more than five new cases were Jefferson, 56; Christian, 22; Scott, 17; Carter, 16; Fayette, 12; Laurel, 11; Pulaski, 10; Harlan, 9; Boone, Floyd and Pike, 8; Hardin and McCreary, 7; and Daviess and McCracken, 6.

The percentage of Kentuckians testing positive for the virus in the last seven days stayed stable, at 2.89%, but hospital numbers were up.

Kentucky hospitals reported 376 Covid-19 patients, 23 more than Monday; 116 of them were in intensive care, 19 more than Monday; and 57 were on ventilators, 11 more than Monday.

The state added eight more deaths to its list of Covid-19 fatalities, four from regular health-department reports and four from the ongoing audit of death certificates. The state's death toll from the disease is 6,184.

Beshear's press release quoted him on one topic: vaccinations. “If you haven’t gotten your Covid-19 vaccine yet, look at our list of where you can get your shot of hope this week, at vaccinemap.ky.gov. If you’ve already been vaccinated, reach out to one friend or family member who is still trying to get signed up and see if you can help them. This is an all-hands-on-deck effort. We are in a race against harmful Covid-19 variants that could threaten the progress we’ve all sacrificed so much to achieve.”

President Biden asked Americans to wait until July 4 to resume normal activities, pointing to increasing case and hospitalization numbers in many states, especially among young adults. "We're still in a life and death race against this virus," he said. "The virus is spreading because we have too many people who see the end in sight and think we're at the finish line already. Let me tell you deadly seriously: We're not."

Unemployment insurance: Beshear announced that in-person services for unemployment benefits will open April 15 at more than a dozen regional sites, by appointment only. At 1 p.m. EDT Wednesday, April 7, Kentuckians can begin scheduling appointments at kcc.ky.gov for weekday appointments April 15-30. The sites are in Ashland, Bowling Green, Covington, Elizabethtown, Hazard, Hopkinsville, Lexington, Louisville, Morehead, Owensboro, Paducah, Prestonsburg and Somerset.

A photo ID will be required to enter, and temperatures will be taken before entering. Anyone attending an appointment must wear a mask at all times. "Accommodations will not be made for those without appointments," a press release from Beshear's office said. "While staff make every effort to answer all questions during this appointment, UI specialists may not be able to provide a resolution during a single appointment. Some claims could require additional paperwork or take additional time to complete. An additional appointment will not be necessary."

In other pandemic news Tuesday:
  • The regularly reported Covid-19 deaths were an Allen County man, 91, on April 4; a Boyle County woman, 83, Jan. 14; a Fayette County woman, 84, Dec. 20; a Hopkins County man, 79, March 31; a Jefferson County woman, 63, April 3; a Laurel County woman, 80, April 1; and a Warren County woman, 92, Dec. 2.
  • The Covid-19 deaths found by audit were a Greenup County woman, 83, on Nov. 20; a Jefferson County woman, 82, on Nov. 11; three Jefferson County men: 71, on Nov. 18; 89, on Dec. 18; 91, on Dec. 18; and a Wayne County woman, 79, on Jan. 1.
  • Indiana ended its mask mandate, but kept face coverings mandatory in state buildings and schools and allowed local governments, private businesses and other entities to have stricter guidelines.
  • Youth sports leagues may be driving outbreaks of the more contagious B.1.1.7 strain of the virus first identified in the United Kingdom, The Washington Post reports, citing outbreaks in Nevada and near Minneapolis. “Until now we haven’t seen transmission like this in kids in the pandemic,” said infectious-disease specialist Michael Osterholm of the University of Minnesota.
  • "Nearly half of new coronavirus infections in the United States are in just five states — a situation that is putting pressure on the federal government to consider changing how it distributes vaccines by sending more doses to hot spots," CNN and The Associated Press report. "New York, Michigan, Florida, Pennsylvania and New Jersey together reported 44%" of new cases in the last week.
  • "You won’t remember the pandemic the way you think you will" is the title of a story by Melissa Fay Greene in The Atlantic, which says, "The stories you hold on to will be colored by your own experience—but also by the experiences of those around you."