Tuesday, November 29, 2022

Opinion: Without herd immunity, we need masking, ventilation, germicidal lighting, clearer messaging to prevent Covid-19

By Kevin Kavanagh

We all need to recognize the dangers of Covid-19 and the risks it imposes to our long-term health and our country’s workforce. Long Covid occurs in about 30% to 35% of cases. It commonly occurs with even mild disease and with reinfections. The severity is additive, with each exposure, and the symptoms can often persist for over a year (the longest that patients have been followed).

There is no such thing as “herd immunity” and I beg to differ with the CDC regarding “immune debt” causing the current increase in respiratory infections, and their statement regarding respiratory syncytial virus infections: “And so these children, if you will, need to become infected [with RSV] to move forward because it’s a disease very common in children.”

Kevin Kavanagh
“Immune debt” is just another push for “herd immunity,” and to use this to explain the increase in RSV infections is mind-boggling, since we had a significant number of infections last year. At the end of November this year, pediatric hospitals were filled with RSV, but at that time there were corresponding more RSV infections in the previous year. We are on track to have an even larger RSV season, but “immune debt” is an unlikely cause.

Another explanation for rising RSV hospitalizations is “immune theft” due to Covid-19, which as of last March had infected over 75% of children. Mounting research has shown that Covid-19 is associated with immune dysfunction which can persist for at least eight months (the longest time studied).

Poor ventilation

Why not make indoors as safe as outdoors? Unfortunately, increasing ventilation alone is unlikely to stop the spread of Covid-19. But poorly ventilated areas are by far the least safest places. Consumers can use a portable CO2 monitor to at least make sure minimum non-pandemic standards are being met. We do have the technology to greatly improve indoor settings. It is decades old and has an excellent safety record. It is called upper room germicidal UV-C lighting.

We also need to use well-fitted N95 masks whenever possible, especially when encountering others on short exposures during store pickups. The public repulsion to masking is both social and based on fake science. The viral particles which float in the air are droplets, much larger than one micron. But most importantly, an N95 mask is not a strainer. N95 masks work more like flypaper, trapping viruses because they stick to the fibers, and not because they are blocked by them. N95 masks are extremely good at capturing very small particles.

We need proper and clear messaging to retailers regarding standards for indoor safety and N95 masking, but the CDC is airing a commercial which appears to promote mask-less congregation in crowded indoor settings (elevator, public transportation, etc.) for those who have been boosted. This messaging ignores the suboptimal efficacy rates of boosters in preventing symptomatic disease, spread and even Long Covid.

Vaccinations

Vaccinations and boosting do provide another layer of protection, but according to a large National Institutes of Health study, they only provide 34% to 38% protection against Long Covid. They also do not eliminate symptomatic infections and spread. These are all too common. However, vaccines do provide good protection against hospitalization and death. What is needed is a mucosal vaccine which produces large quantities of immunoglobulin antibodies inside the nose, which should stop the spread of disease. There are promising vaccines being studied. The absence of an “Operation Warp Speed” initiative for these mucosal vaccines is one of the greatest failings of our pandemic effort.

Whenever possible, consumers should use online shopping, curbside pickup and as a last resort in-store pickup. Retail establishments need to offer these options, plus make sure their personnel are wearing N95 masks. Rapid testing is also important. We all should be testing immediately before indoor gatherings and family events. A recent study from Yale found this strategy could decrease spread by 40%.

Thus, testing, masking, avoiding indoor crowded settings along with keeping vaccinations and boosters up to date are the best strategies we have to stay safe during times of high viral spread. These strategies will also work with the seasonal flu and will also help to protect against RSV, for which there is no vaccine.

Above all, we need to have clear and comprehensive public-health messaging. We must be willing to make a few compromises in the way we live, for the safety of others and ourselves.

Kevin Kavanagh is a retired physician from Somerset and chairman of Health Watch USA, which is dedicated to infection control. This was originally published in the Louisville Courier Journal.

Suit claims Morehead hospital refused to grant all requests from workers for religious exemptions from Covid-19 vaccine mandate

St. Claire Medical Center (Photo from The Daily Yonder)
A woman who says she was fired by St. Claire Medical Center for not getting a Covid-19 vaccine is suing the hospital in federal court, alleging that the Morehead hospital denied the religious exemption she claimed, and those of all other employees who claimed such an exemption.

Teffany Smith of Olive Hill filed the lawsuit in federal court, but cited the state law banning religious discrimination by employers. Smith, who was a lab assistant, says she was fired Sept. 15, 2021, the day that each hospital employee was required to be vaccinated.

The suit says Smith submitted an exemption citing several passages of Scripture and a letter from a pastor, Joyce Stapleton of New Life Victory Church in Olive Hill, who said the vaccine “violates laws put forth within us by a higher power at the time of conception. . . . We believe in healing and that is what our God provides.” The church website lists different pastors.

Smith also "alleges the hospital did not engage in a good-faith dialogue and consideration of proposed accommodations for not receiving the vaccine," Taylor Six of the Lexington Herald-Leader reports. "St. Claire Healthcare officials did not respond to request for comment."

Monday, November 28, 2022

Ky. coronavirus cases stay on rough plateau; a few more counties at higher risk; former Gov. Brown died of Covid-19 complications

CDC map shows level of risk of Covid-19 by county.
By Melissa Patrick
Kentucky Health News

The number of new coronavirus cases in Kentucky continues to fluctuate each week, but on a rough plateau. Meanwhile, the latest federal risk map shows most of the state's counties continue to have a low risk of transmission. 

The state Department for Public Health reported 3,866 new cases last week, or 552 per day. That's a 43% drop over the prior week, when the state reported 6,746 new cases, a number that was nearly double the week before that. Of last week's new cases, nearly 13% were in people 18 and younger. 

The share of Kentuckians testing positive for the virus last week was 7.03%, just slightly higher than the week prior, when the rate was 6.73%. The figures do not include at-home tests. 

The weekly new-case incidence rate was 10.61 cases per 100,000 residents, down a bit from 10.87 the week prior. Three counties had an incidence rate more than double the state rate: Robertson, at 54.2 cases per 100,000; Henry, 26.6; and Mercer, 22.8. The other top 10 counties were Johnson, 20.0; Elliott, 19.0; Edmonson, 17.6; Morgan, 17.2; Marshall, 16.5; Jefferson, 16.4; and Gallatin, 16.1.

The New York Times ranks Kentucky's incidence rate fourth among states, with a 17% increase in cases in the last two weeks. 

The number of patients in Kentucky hospitals with Covid-19 increased after dropping for two weeks in a row. Hospitals reported 281 Covid-19 patients Monday morning, an increase of 31 over the prior Monday; 40 were in intensive care, five more than the week prior; and nine were on mechanical ventilation, down five.

John Y. Brown Jr. at his home in Lexington in 2014
(Photo by Pablo Alcala, Lexington Herald-Leader)
One of those who went off mechanical ventilation and died last week, at the age of 88, was former Gov. John Y. Brown Jr. "According to Brown’s children, he died due to a series of health problems that stemmed from Covid-19 complications which began this summer," the Lexington Herald-Leader reported. Lincoln and Pamela Brown said he was in intensive care at the University of Kentucky's Albert B. Chandler Hospital in Lexington for three weeks.

The state attributed 43 more deaths to Covid-19 last week, down from 49 the week prior. Kentucky's pandemic death toll is 17,502. 

The Centers for Disease Control and Prevention risk map ,which was released Monday instead of last Thursday due to the Thanksgiving holiday, shows an increase in counties at medium and high risk in Kentucky. 

The map, which looks at both cases and hospital data to determine transmission risk, shows 15 Kentucky counties  at medium risk of Covid-19, shown in yellow, and three at high risk, shown in orange. Low risk counties are shown in green. Last week, only 10 counties were shown to have a medium risk of transmission. 

The high risk counties are Magoffin, Johnson and Floyd. In such counties, the CDC continues to recommend that you wear a well-fitting mask in public indoor spaces, and if you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

CDC map shows coronavirus transmission levels.
If you live in a medium or high-risk county, the CDC advises those who are at high risk of getting very sick to wear a well-fitting mask when indoors and in public and to consider getting tested before having social contact with someone at high risk for getting very sick and consider wearing a mask when indoors when you are with them.

The CDC also has a transmission-level map that shows the level of virus spread in each county, at one of four levels. The map shows 33 counties at moderate levels of transmission and the rest have either substantial or high levels of transmission. This data is largely used by researchers and health-care facilities.

State health officials have encouraged Kentuckians to use the other CDC map to guide their preventive measures.

Saturday, November 26, 2022

Youth suicide rates are higher where mental-health providers are scarce, study of all U.S. counties says; all but 3 in Ky. rated short

U.S. Health Resources and Services Administration map, adapted by Kentucky Health News
By Melissa Patrick
Kentucky Health News

Counties that have shortages of mental-health providers tend to have seen their rates of youth suicide increase in recent years, a study has found.

The study, published in JAMA Pediatrics, found that after adjusting for demographic and socioeconomic characteristics, counties with a mental-health workforce shortage were associated with an increased youth suicide rate, and an increased youth firearm suicide rate, when compared to counties with no or partial mental health shortage designations.

Suicide is the second leading cause of death among U.S. adolescents, with rates rising over the last decade. This is also true in Kentucky. Every county in Kentucky is officially designated as a Mental Health Professional Shortage Area, except Boone, Campbell and Grant counties in Northern Kentucky.

“Our results underscore the critical need to expand the mental health professional workforce in counties across the country,” lead author Dr. Jennifer Hoffmann, an emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, said in a news release. “In addition, policies that restrict firearm access to young people may be considered as a suicide-prevention strategy."  

Using youth suicide data from every U.S. county, the researchers found there were 5,034 suicides by youth between the ages of 5 and 19 from 2015 to 2016, with an annual suicide rate of 3.99 per 100,000 youth in that age group. The study found that among all the counties where a youth suicide occurred, more than two-thirds, or 67.6%, were designated as mental-health workforce-shortage areas. 

The designation is made by the U.S. Health Resources and Services Administration, which assigns a score between 0 and 25, with higher scores indicating greater shortages. The study found that the adjusted youth-suicide rate increased 4% for every 1-point increase in the score.

It also found that there were geographic disparities, with higher suicide rates in rural and high-poverty areas, where mental-health professionals are scarce. 

"Counties with mental-health HPSA designation had more uninsured children, lower educational attainment, higher unemployment, higher poverty, higher percentages of non-Hispanic White residents, and were more often rural, compared with counties with partial/no HPSA designation," the researchers write. 

Hoffmann offered several ways to improve access to mental-health care for youth.

“Mental-health workforce capacity can be increased through integration of mental-health care into primary-care settings and schools, and through expansion of telehealth services,” Hoffmann said in a news release. “Improving reimbursement rates for mental-health services may further aid in recruitment and retention of mental health professionals, and hopefully reduce suicide rates among young people.”

Dr. Aaron Carroll of the Indiana University School of Medicine and Denise Hayes of the university's School of Public Health, argued in an accompanying editorial that money directed at hiring more mental-health care professionals alone will not solve this problem. 

"Even if the money was available, it would be nearly impossible to fix this problem through hiring alone," they write. "We have never valued mental health the way we do physical health. Of the more than $3 trillion we spend on health care each year, a pitiful amount is dedicated to behavior and psychiatric issues." 

The release says mental-health problems are among the most common precipitating factors for youth suicide. Further, it says that up to one in five children in the U.S. has a mental health condition, but only about half of children who need mental health care receive it.

"Countless youth need help," Carroll and Hayes write. "Unfortunately, help is often in short supply." 

According to the 2021 Youth Risk Behavior Survey, 19% of Kentucky's high school students seriously considered attempting suicide during the 12 months before the survey and 15% of them made a plan about how they would do it in that same time frame. And 9.5% of them said they had actually attempted suicide one or more times in the year prior to the survey. 

Further, firearm deaths among Kentucky children between the ages of 1 and 19 increased 83% between 2013-15 and 2018-20, from 3.6 to 6.6 deaths per 100,000, according to data published in the 2022 Kids Count County Data Book

Dr. Lindsay Ragsdale, chief medical officer for Kentucky Children’s Hospital, recently told Kelsey Souto of WKYT-TV that the hospital is seeing an influx of youth coming into the emergency department experiencing mental-health crises, due to gaps in outpatient resources.

"I think we have to start talking to children in adolescence about what they’re going through,” said Ragsdale. “To make it okay to say 'I’m not okay.'”

Substance Abuse and Mental Health Services Admin. photo
Kentucky's youth are asking for more mental health resources, according  to a Kentucky Youth Advocates survey that asked them what state leaders should prioritize. Some of their responses were included in the County Data Book. 

"Mental health should be a big priority. As someone that has anxiety and it affects me everyday not just mentally but also physically, it is the best feeling knowing that people really care about me and the way I feel," said a 14-year-old named Elizabeth from Daviess County.

Help is available for anyone who is thinking about suicide or knows someone who is considering it. To get help, dial 988, which is the new suicide and crisis lifeline. The three-digit mental health crisis hotline offers free, confidential support and is available 24 hours a day.

Wednesday, November 23, 2022

Parents send kids to school sick, citing as reasons their need to work, concerns about missing class and pandemic weariness

At least 58 districts have closed or used non-traditional instruction days in November due to illness, affecting more than 186,500 students. (Ky. School Boards Assn. map, adapted by Ky. Health News)

Schools in Kentucky and across the nation have been hit hard by a slew of respiratory viruses, and some parents are sending their children to school sick or sending them back to school while still infected.

They cite an inability to take more time off work, concern about their children missing in-class instruction and a weariness from dealing with the pandemic, Alex Janin reports for the Wall Street Journal.

In a typical year, Jackie Follansbee, a nurse in the Yakima School District in Yakima County, Washington, would send two to three children a week back home for returning to school sick, she told Janin. Now, it’s two to three “repeat offenders” a day, she says.

Respiratory illness has been so bad in Kentucky that so far in November, 58 Kentucky school districts have closed or used non-traditional instruction days due to illness, affecting more than 186,500 students, according to the Kentucky School Boards Association.

The Pike County Board of Education has amended its attendance policy to increase the number of parent notes that can be used for excused absences from school from five to 10, Kristi Strouth reports for the Appalachian News-Express. Students will continue to be allowed an unlimited doctor's notes to excuse their absences. 

Janin reports that schools across the country are sending notes to parents urging them to not send their children back to school until their child is fever-free for 24 hours without medication and symptoms are improving. And in some cases, nurses are calling families to remind them that symptoms of viral illnesses can last for a week or more.

In addition to an influx of respiratory syncytial virus, or RSV, Covid-19, and the common cold, Kentucky's latest influenza report shows that most of the 6,061 confirmed flu cases this year have been in children under the age of 10, followed by people between the ages of 11 and 20. 

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. And while most people recover in a week or two, it can be serious for infants and older adults. 

As of Nov. 19, about 16% of PCR tests for RSV in the U.S. were positive, more than double the 7.5% at the same time last year, according to voluntary lab reports to the Centers for Disease Control and Prevention.

As of the first week of November this year, the Wall Street Journal reports, U.S. children under the age of 18 were hospitalized for flu at the highest rate since 2009, according to CDC data.

Increased infection and the need for school-aged children to stay home until they are well is also affecting workplaces.

"A new round of viral infections — flu, RSV, covid-19 and the common cold — is colliding with staffing shortages at schools and day-care centers to create unprecedented challenges for parents and teachers," Abha Bhattarai reports for The Washington Post. "More than 100,000 Americans missed work last month because of child-care problems, an all-time high that’s surprisingly even greater than during the height of the pandemic, according to new data from the Bureau of Labor Statistics." 

Tried and true public-health measures help to decrease the spread of all of these viruses, including avoiding close contact with others when you are sick, covering your nose and mouth when you cough or sneeze, keeping your hands washed and staying  home when you are sick and don't have fever for 24 hours without medication.

Tuesday, November 22, 2022

State Sen. Ralph Alvarado, head of Senate health committee, will resign to become state health commissioner in Tennessee

State Sen. Ralph Alvarado
Republican state Sen. Ralph Alvarado, a Winchester physician who chairs the state Senate's Health and Welfare Committee, is resigning his seat to become health commissioner in Tennessee.

The office of Gov. Bill Lee said Alvarado will resign his seat before taking office Jan. 16. That indicates that the special election to succeed him will not be called by Democratic Gov. Andy Beshear, but by Senate President Robert Stivers, since the legislature will convene Jan. 3.

“It’s an honor to join Governor Lee’s team to advance health and prosperity for every Tennessean,” Alvarado said in a prepared statement. “I appreciate this opportunity and look forward to serving individuals and families across the Volunteer State.”

Monday, November 21, 2022

Kentucky's Covid-19 cases took a big jump last week, but hospitalizations were down

New York Times graphs, adapted by Kentucky Health News; to enlarge any image, click on it.
By Melissa Patrick
Kentucky Health News

The number of Kentuckians with Covid-19 nearly doubled last week over the prior week, but fewer people were hospitalized with it. 

The state Department for Public Health reported 6,746 new cases last week, or 963 per day. That's an 89 percent increase over the prior week, when the state reported 3,570 new cases. Gov. Andy Beshear has said that the state's up-and-down weekly case rates could indicate a longer-term plateau. 

Of the new cases, 14% were in people 18 and younger. 

The number of Covid-19 patients in Kentucky hospitals dropped again this week. As of Monday, hospitals reported 250 Covid-19 patients, down from 310 the week before; 35 were in intensive care, down seven; and 14 were on mechanical ventilation, down five. 

The share of Kentuckians testing positive for the coronavirus was 6.73%, down a bit from 7.29% the week before. The figures do not include at-home tests. 

The weekly new-case incidence rate was 10.87 cases per 100,000 residents, slightly up from 10.8 the week prior. Trimble County was the only county that had an incidence rate more than double the state rate, at 27 cases per 100,000. The other top 10 counties were: Russell, 19.9; Union, 19.9; Metcalfe, 19.9; Owsley, 19.4; Letcher, 17.2; Floyd, 16.9; Nelson, 16.4; Hickman, 16.3; and Powell, 16.2.

The New York Times ranks Kentucky's incidence rate 20th among the states, with a 51% drop in cases over the last two weeks. 

The state attributed 49 more deaths to Covid-19 last week, up from 47 the week before. Kentucky's pandemic death toll is 17,459.

There is no vaccine for hepatitis C, so all adults should get tested

Photo by jarun011, iStock/Getty Images Plus
By Takako Schaninger
University of Kentucky  

The hepatitis vaccines you receive as a child don’t protect you from getting hepatitis C, a serious disease that can have fatal consequences including liver damage, cirrhosis and liver cancer.

Hepatitis is an inflammation of the liver most often caused by three viruses: hepatitis A, hepatitis B and hepatitis C. There is a vaccine for hepatitis A and hepatitis B, but not for hepatitis C. . 

Most people who get hepatitis C develop a chronic, long-lasting infection that sometimes doesn’t present symptoms for months or even years, meaning they can unknowingly spread the virus to others.

Millions of Americans have hepatitis C, yet many don’t know they are infected. The only way to know for sure is to get tested.

The infection is transmitted mainly by blood-to-blood exposure. Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment used to prepare and inject drugs.

The Centers for Disease Control and Prevention estimates that 2.4 million people in the U.S. have chronic hepatitis C, with Kentucky having some of the highest infection rates in the country.

The CDC recommends that all adults get tested for hepatitis C. Getting tested is important to find out if you are infected and get lifesaving treatment. Treatments are now available that can cure most people with hepatitis C in eight to 12 weeks.

Hepatitis C is easily preventable. 

For people who inject drugs, the best way to prevent hepatitis C is to stop injecting. Drug treatment including buprenorphine can lower your risk for hepatitis C since there will no longer be a need to inject. 

If you are unable or unwilling to stop injecting drugs, there are steps you can take to reduce the risk of becoming infected including using new, sterile equipment for each injection and avoiding sharing equipment with others.

Kentucky has 82 syringe exchange programs in 63 counties. Click here to find their locations and hours. Here's a map:
Kentucky Cabinet for Health and Family Services map

Beshear defends pandemic mitigation strategies that hurt student learning, saying that loss can be made up but lives can't

Gov. Andy Beshear (Official portrait)
Gov. Andy Beshear discussed a number of health topics during an interview with Bill Bryant on WKYT-TV's "Kentucky Newsmakers," including medical cannabis, Delta-8 THC, abortion and the state's response to the pandemic as it relates to education. 

Asked if he could have done anything differently in the pandemic to mitigate the loss of learning among Kentucky's school children, Beshear told Bryant that regardless of the varied approaches taken by states, "Everybody has suffered this learning loss." 

Noting that Covid-19 has killed 17,400 Kentuckians and would have killed many more, he said, "We can make up for learning loss. But we can't make up for the loss of life of a single parent whose kids are left without them, or from a grandparent." 

The question was prompted by statewide test scores, released in October, that showed fewer than half of Kentucky public-school students were reading at grade level, with even lower scores posted in mathematics, science and social studies, the Louisville Courier Journal reported in October.  

Republicans have strongly criticized Beshear's pandemic policies that  closed schools to in-person learning, saying they contributed to the dismal test scores. State party spokesman Sean Southard told Bruce Schreiner of the Associated Press, “Despite his efforts to run away from his pandemic actions, students and parents will not forget the biggest contributor to learning loss in the Commonwealth of Kentucky: Governor Andy Beshear." 

Beshear has introduced an Education First Plan to address the teacher shortage and loss of learning for students during the pandemic that includes, among other things, a 5% pay raise for school staff and universal pre-K. Funding  for this initiative would require the approval of the General Assembly and opening the biennial budget in an off-year. Republicans who run the legislature have ignored similar proposals from him.

Medical cannabis and Delta-8 THC

Beshear told Bryant that his recent executive order to allow possession of up to 8 ounces of cannabis for medical purposes is "limited and specific" because he can only do so much through executive authority. 

The executive order allows individuals who have one of 21 conditions that are certified by a medical professional to legally purchase medical marijuana in one of the 37 states where it is  legally sold. The order takes effect Jan. 1, 2023. 

Beshear went on to encourage the legislature to pass a medical marijuana bill during the next legislative session, which begins in January. A bill passed the House this year but got no hearing in the Senate.

"I'd say to our General Assembly I'm not trying to fight with you, but something has to be done and  that's why we've taken our actions," he told Bryant. "So please come in, pass medicinal marijuana. I'll rescind both orders happily if you do."

Beshear's other executive order about cannabis regulates Delta-8 tetrahydrocannabinol, a legal psychoactive substance that comes from hemp-derived cannabidiol, or CBD. The main psychoactive compound in marijuana is Delta-9, which is more potent. 

"We just need to ensure that since it's a legal product, at least at the moment, that we are properly regulating it," Beshear told Bryant. He added that the process will also set up a system of regulation that could easily be expanded to medical marijuana. 

Sen. Paul Hornback, R-Shelbyville, sponsored Senate Bill 170 during the last legislative session to ban Delta-8 THC in Kentucky. It passed out of the Senate, but was not considered in the House. 

Abortion

Asked if he thought the failure of Amendment 2 on Nov. 8 meant that Kentuckians want abortion restrictions to be loosened going forward, Beshear said he thought it showed Kentuckians were opposed to the state's current abortion law, which does not allow for exceptions for rape or incest. 

"I think that vote shows that Kentuckians oppose the most extremist law in the country," he told Bryant. 

The amendment would have amended the state constitution to say that nothing in it should be construed to create a right to abortion or funding of abortion. After it failed by 5 percentage points, the state Supreme Court heard arguments in a lawsuit against current laws, one of which took effect after the U.S. Supreme Court overturned its 1973 Roe v. Wade decision in June. 

Saturday, November 19, 2022

2022 County Data Book from Kids Count measures well-being of Kentucky's children, by county; smoking in pregnancy goes down

By Melissa Patrick
Kentucky Health News

This year's 2022 Kentucky Kids Count County Data Book, which looks at the well-being of children in each county, focuses on the importance of putting forth meaningful policies to support Kentucky's youth, with an emphasis on listening and acting on what young people say is important to them. 

"We want to challenge our lawmakers to be reading and to listen to this data, listen to policy solutions and listen to young people," Terry Brooks, executive director of Kentucky Youth Advocates, said at a press conference. " We know those lawmakers listen to national groups that bring dark money into Kentucky. They certainly listen to people who contribute to political action committees. They listen to high paid lobbyists. We want to know if they have the bravery to listen to young people." 

Brooks notes in the Data Book that the partisan rhetoric will continue to abound as we head in to the gubernatorial election in 2023 and the presidential election of 2024, making it even more important for children's advocates to "stand above the political fray." 

"We must ensure that this becomes a moment of affirmation rather than a turn to a radical ideology that dilutes the well-being of our children," he said. 

In an effort to allow youth in Kentucky to share their reality and to address what is important to them, KYA surveyed them to ask them what their hopes and concerns were. The survey found that their top four concerns were around issues that dealt with safety at school, increased access to safe community spaces for youth to gather, increased youth mental health supports and a desire for adequately funded schools that offer meaningful pathways to opportunity.  

The data book, released Nov. 16 by KYA and the Kentucky State Data Center at the University of Louisville, is part of the 32nd annual release of Kids Count, a national initiative of the Annie E. Casey Foundation to track the status of children in the United States.

The County Data Book rates children's overall well being through 16 indicators in four major domains: economic security, education, health and family and community. "While the Covid-19 pandemic has continued to impact many families in ways that do not yet show up in the data, the book identifies ongoing challenges and areas of needed improvement," says a news release.

Photo from News-Medical.net
Statewide, 15.7%, or nearly one in six, of Kentucky's babies were born to women who reported smoking during pregnancy in 2018-20, down from 19% in 2013-14. Seven counties had smoking during pregnancy rates of less than 10%: Warren (7.4%); Daviess (7.5%); Oldham (7.5%); Jefferson (8.5%); Hancock (8.6%); Shelby (9.3%) and Fayette (9.3%).

All 12 counties with rates of 30% or more were in Appalachian Kentucky: Harlan (30.8%); Breathitt (30.8%); Bell (31%); Elliott (31.1%); Jackson (31.6%); Lee (32%); Perry (33%); Leslie (34%); Wolfe (34.2%); Clay (34.9%); Owsley (35.3%); and Martin (38.4%). 

Smoking during pregnancy increases the risk of health problems for developing babies, including birth before full term, low birthweight, and birth defects of the mouth and lip. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome, according to the Centers for Disease Control and Prevention.

The number of low-birthweight babies in Kentucky stayed the same between 2018-20 and 2013-15, at 8.7%, above the national percentage. A low-birthweight baby is defined as less than 5.5 pounds. 

The March of Dimes says the national figure is about 8%, and babies born with low birthweight are more likely to have certain health conditions later in life, including diabetes, heart disease, high blood pressure, intellectual and developmental disabilities, metabolic syndrome and obesity.

Just over half of the state's counties saw an increase in low-birthweight babies since 2013-15. The rates varied from a low of 5.9% in Oldham County to a high of 13.6% in Elliott County. 

Kentucky continues to have fewer teens giving birth, with 24.5 per 1,000 females aged 15-19 in 2018-20, down from 26.3 in 2017-19. This rate has decreased steadily since 2009-11 when it was 45.9 per 1,000. 

This rate varies greatly among counties, ranging from a low of 5.6 teen births per 1,000 females aged 15-19 to a high of 56.1 births in Floyd County. 

Seven counties had higher teen-birth rates in 2018-20 than they did in 2017-19: Bourbon, 25.1 births per 1,000; Hickman, 38; LaRue, 36.8; Lyon, 28.7; Mason, 35.7; Morgan, 48.2; and Robertson, 52.6. Bourbon, Hickman, and LaRue counties also saw increases from 2012-14 to 2017-19.

The share of Kentuckians under 19 who were covered by some form of health insurance in 2020 stayed the same as in 2015, at 95.7%, but 53 counties saw a decrease in these numbers since 2015. 

Other key findings about Kentucky's children in the report include: 

  • While child poverty rates improved in 116 out of 120 counties compared to five years ago, 19% of children statewide continue to live in poverty.
  • Just 44% of kindergarteners entered school ready to learn last school year, which is underscored by declining rates in 124 of 170 school districts with available data. Only 46% of fourth graders scored proficient in reading – ranging from 12% in Bourbon County to 81% in Anderson County – and only 36% of eighth graders scored proficient in math, ranging from 9% in Jackson County to 77% in the Anchorage Independent School District in Louisville.
  • Comparing 2014-2016 to 2019-2021, 88 counties showed an increase in the rates of children in foster care, reflecting a 31% increase in the rate statewide. Similarly, the percentage of children exiting foster care to reunification with their parents or caregivers declined, in which nine counties had a rate lower than 20% of children being reunited, while Lee County had the highest reunification rate at 63%.
  • 8,010 youth were incarcerated in 2019-21, making the rate nearly half what it was in 2014-16 (13.7 per 1,000 compared to 26.4 per 1,000).

The report was made possible with support from the Casey foundation and other sponsors, including Aetna Better Health Kentucky, Kosair Charities and Charter Communications. 

The Kids Count Data Center provides easy access to county and school district data for about 100 indicators and allows the user to rank states, counties and school districts; to create customized profiles of the data; to generate customized maps; and to embed maps and graphs in websites or blogs. Click here to see your county's profile.

Friday, November 18, 2022

Four Kentuckians have died from the flu this season; Beshear urges Kentuckians to get vaccinated for flu and Covid-19

By Melissa Patrick
Kentucky Health News

Influenza continues to spread across Kentucky, and three more residents of the state have died from it, according to the state Department for Public Health.

Kentucky Department for Public Health graph
The state's latest report shows that flu activity keeps increasing. In the week ended Nov. 12, the state confirmed 2,719 cases of flu, up from 2,082 the prior week. So far, the total number of confirmed cases during this flu season is 6,061. 

Most of the cases are in Kentuckians under the age of 20. 

So far in November, at least 36 Kentucky school districts have closed or used non-traditional instruction days due to illness with more than 125,700 students affected, according to the Kentucky School Boards Association. 

The state has confirmed four deaths from the flu, all adults. One was due to a co-infection of the flu and Covid-19. Nationwide, the Centers for Disease Control and Prevention reports that there have been seven pediatric flu deaths this season, none of them in Kentucky. 

"An annual flu vaccine is the best way to protect against flu," the CDC says. "Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu. CDC recommends that everyone ages 6 months and older get a flu vaccine annually." 

At his weekly press conference, Gov. Andy Beshear also encouraged Kentuckians to get their flu shot, noting that during the last flu season, fewer than half of Kentucky's children got a flu shot. 

"Please," Beshear said when asking Kentuckians to get their flu shot and a Covid-19 booster. "Influenza is at a widespread level. It's earlier and greater at this time than it has been in other flu seasons. So get the shot, get the booster and folks consider especially if you're concerned about your health or other conditions, consider wearing a mask at indoor get togethers right now. It's not forever. It's just as we get through what is being a really crazy flu and RSV season." 

RSV stands for respiratory syncytial virus, a common virus that usually causes mild, cold-like symptoms. And while most people recover in a week or two, it can be serious for infants and older adults.

All 16 of Kentucky's health regions have confirmed flu cases, and 12 of the 16 are reporting that their rates are increasing. 

Some of the counties hit hardest by the flu in this latest report were: Allen, with 101 new cases; Boone, with 100; Campbell, 54; Fayette, 113; Graves, 80; Hopkins, 64; Jefferson, 723; Kenton, 195; Madison, 83; Marshall, 50; McCracken, 118; Pike, 64; Simpson, 45; and Warren, 122.

Provisional drug overdose data shows hopeful trend in Ky. and the nation, with numbers dropping in each of last three months

By Melissa Patrick
Kentucky Health News

Preliminary data suggests that drug-overdose deaths are declining in Kentucky and the nation. 

The Centers for Disease Control and Prevention's latest provisional overdose death data for the first six months of this year showed a 5.5% year-to-year increase in the number of predicted overdose deaths in the 12-month period ending June 2022, but the latest numbers are promising. 

Predicted provisional counts represent estimates of the number of deaths, with adjustments for incomplete reporting that always occurs. 

After reaching a high of 110,202 estimated U.S. overdose deaths in the 12 months ending in March, that number declined for each of the following three months. In the 12-month period ending in June, it had dropped to an estimated 107,582, down 2.4% from March. 

Centers for Disease Control and Prevention graph; click to enlarge
In Kentucky, the provisional report shows that there has been a steady, though slight, decrease in the number of estimated overdose deaths in all but one of the 12-month periods since September 2021.

The year-to-year decline in predicted overdose deaths from the 12 months ended June 2021 was 13, a decrease of 0.6%. 

But just like the rest of the nation, there has been a decrease in overdose deaths in the last three months, dropping from an estimated total of 2,372 in the 12 months ended in March to 2,299 in the 12 months ended in June. That 3% drop is slightly higher than the national average. 

"Today's data continue to show a hopeful trend of a decrease in overdose deaths," but more work is needed for "expanding care for substance use disorder, making naloxone more accessible and dismantling drug trafficking operations," Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said in a statement

Centers for Disease Control and Prevention graphic; click to enlarge
The report also includes data about drug-overdose deaths by drug or class of drugs. In Kentucky, it shows that in the 12-month period that ended in June 2022, natural opioids were involved in 1,830 of the reported deaths and synthetic opioids such as fentanyl were involved in 1,673 of them. 

People who are struggling with drug abuse or who are concerned about a family member's substance use can search for treatment providers at www.findhelpnowky.org.