Friday, September 17, 2021

Kentucky hospitals report record number of Covid-19 patients on mechanical ventilation; most schools will keep masks

By Melissa Patrick
Kentucky Health News

The state reported 5,133 new cases of the coronavirus Friday, one of the larger daily numbers, and a record number of Covid-19 patients on mechanical ventilation.

Folks, this is serious," Gov. Andy Beshear said in a Facebook post. "This isn't politics. This isn't a chance to blame other people or to try to re-write history. This is an important moment to do the right things, to get vaccinated, to put on masks, to remember that this is not about Democrat or Republican or red or blue, it's about life and death and we need to do what it takes to protect one another."

Kentucky hospitals reported 2,426 Covid-19 patients, 647 intensive care unit patients, and 463 patients needing mechanical ventilation, beating the record 448 set Thursday and a week earlier.

All but two of the state's 10 hospital readiness regions are using between 92% and 98.8% of their intensive-care-unit capacity. The Lake Cumberland region is using only 27.22% of its capacity and the northeast region is using 69.07% of its capacity. 

Beshear said this is the first time that Kentucky has had two straight days of fewer than 100 ICU beds available, with 95 currently open. Beshear reported on Thursday that 66 of the state's 96 acute-care hospitals are reporting critical staffing shortages. Alex Acquisto reports for the Lexington Herald-Leader that some Kentucky hospitals have begun firing staff who refused a Covid-19 vaccine. 

Monica Kast of the Herald-Leader reports that UK HealthCare is seeing its biggest surge of Covid-19 patients yet, including 15 patients under 18. Beshear said there are 24 children in Kentucky hospitals with Covid-19. 

Dr. Lindsay Ragsdale, director of the pediatric advanced-care team at UK's Kentucky Children's Hospital, told Kast, "This is everyone’s worst nightmare. Please, as a hospital, we are asking our community, please go get vaccinated. You can actually help protect children in Kentucky by just getting vaccinated.”

Health officials will discuss vaccination rates and hospital capacity issues at the 1 p.m. Sept. 22 Interim Joint Committee on Health, Welfare and Family Services in Frankfort, along with issues around health care worker shortages.

While the number of new cases Friday was the seventh largest of the pandemic, it lowered the seven-day rolling average by 10, to 4,208 because the previous Friday's number was the sixth largest.

The state reported its daily infection rate over the last seven days to be 84.65 cases per 100,000 residents. Counties with double that rate are Rockcastle, 226.8; Powell, 218.5; Whitley, 201.7; Knox, 194.5; Perry, 175.8; Floyd, 170.6; and Monroe, 166.3. The state says it reports lower rates than national sources due to different methodologies, including removal of duplicate test results.

The New York Times data shows Kentucky ranks fourth in daily infection rate, behind West Virginia, Tennessee and Alaska. It shows Knox County with the nation's top infection rate, Russell County third, Rockcastle and Powell counties fifth and sixth, and Perry and Whitley eighth and ninth. Floyd, Martin and Monroe are 15th through 17th. McCreary and Green are 23rd and 24th.

The percentage of Kentuckians testing positive for the virus in the last seven days is 12.88%. The rate has dropped for nine days; Beshear has said that could be the result of more testing.

The state reported 45 more Covid-19 deaths, bringing the death toll to 8,251. 

"We're having far too many of our people die," Beshear said. "We can stop it. Get vaccinated. Wear your mask. And we'll get through this, we'll get through it together." 

Vaccinations: U.S. Food and Drug Administration panel approved booster shots of the Pfizer-BioNTech Covid-19 vaccine only for people 65 and older or people who are considered high risk six months after being fully vaccinated. The panel said there is not yet significant evidence to show boosters for people under 65 are necessary, USA Today reports: "The committee doesn't make the decision for the FDA, but the FDA almost always takes its recommendations to heart."

The Washington Post reports, "The vote is not binding, and Peter Marks, the FDA official overseeing coronavirus vaccines indicated that the final decision could be slightly different, including people who are at higher risk of infection because of their professions, such as health-care workers and front-line workers such as teachers."

Schools: An overwhelming majority of Kentucky's public schools are requiring masks. Olivia Krauth reports for the Louisville Courier Journal. "As of Friday morning, 161 of Kentucky’s 171 school districts had said they will continue to require universal masking in classrooms." Five districts — Science Hill Independent in Pulaski County, Burgin Independent in Mercer County and Hickman, Mercer and Clinton counties — have made masks optional.

Krauth reports that after initially announcing masks would be optional, Gallatin County has said it will require them for the next two weeks, and the remaining four districts will keep mask requirements in place until school board meetings next week. 

The Centers for Disease Control and Prevention recommends universal masking inside K-12 schools, regardless of a person's vaccination status. Beshear has said not doing so is "an inexcusable decision."

"Senate President Robert Stivers said in a press conference Friday morning that the large majority of districts choosing to keep a mask mandate shows Beshear was wrong to doubt that local leaders could withstand the pressure to make such a decision," Krauth reports.

Stivers said, "Whether that's right or wrong, I don't know, but it's them who had the local dynamics and made this decision. And he said we punted? No, we have a little bit more faith in our local school boards and our local superintendents than he does."

Thursday, September 16, 2021

Beshear says school officials who don't require masks are making 'an inexcusable decision' and making themselves liable; health commissioner says misinformation spreaders 'are killing people'

By Melissa Patrick
Kentucky Health News

Top state officials' pleas to get a Covid-19 vaccine, and for universal masking in schools, were as urgent as they have ever been Thursday, when the state reported 62 more Covid-19 deaths and intensive-care beds remained in short supply.

"The situation continues to be dire," Gov. Andy Beshear said at his weekly general press conference, again dominated by the pandemic. "We need for people to continue to do their very best to protect themselves and their families." 

Beshear said the state has only 93 adult intensive-care beds available and 66 of the state's 96 acute- care hospitals report critical staffing shortages.

Kentucky Department for Public Health chart
At the press conference, hospital leaders told how the more contagious Delta variant of the virus is killing younger people in their care, and Beshear showed charts illustrating the trend: Over half of Covid-19 deaths are now among people under 50, and 12 percent are among those under 30.

“It’s one thing to have an end-of-life conversation with someone who’s had time to live and prepare. It’s a very different conversation to have when you’ve having this with a 20-, 30- or 40-year-old," Josh Bryant, an osteopath at Kings Daughters Medical Center in Ashland, said in a pre-recorded video. 

Dr. Traci Sanchez of Kings Daughters said in another video, “We’ve been seeing 20-year-olds and 30-year-olds and 50-year-olds come in and within 24 hours, 48 hours, die. Families are angry. They’re lost. Patients are lost because they know they’re dying. It’s hard to tell someone who is 40 years old that they’re going to be dead within 24 hours and there’s nothing we can do.”

Beshear said, “The number one thing that we can do to get through this is to get vaccinated. Now by percentage, about 90-plus percent of folks that end up hospitalized are unvaccinated. So how do we not overrun our hospitals? We get vaccinated."

Dept. for Public Health table shows rates
of Covid-19 vaccination by age group.
From March 1 to Sept. 15, 87.1% of coronavirus cases, 92.1% of Covid-19 hospitalizations, and 84.6% of Covid-19 deaths have been among unvaccinated or partially vaccinated Kentuckians, the state says.

"These are people who are getting sick and dying fast," Public Health Commissioner Steven Stack said. "It's a bad disease. . . . "If we don't want it to get even worse still, we've all got to get vaccinated."

After pointing to a Lexington Herald-Leader article about a 29-year-old teacher who died from Covid-19 after not getting vaccinated due to an unfounded fear about a side effect, Stack said, "I've said before, people who spread misinformation about these vaccines are killing people."

Stack, a physician, added later, "There's some who have tuned out when someone like me shares that message. It's a fact. And if it gets worse, and the next version is even more deadly, let's hope we don't have to get to the point where people are burying whole households in order to internalize this message that the vaccines can keep us safe and that's what we've got to come to accept."

School masks: Beshear also used sharp language to urge schools that haven’t instituted a mask mandate to do so, ahead of Friday's expiration of the Kentucky Board of Education’s school masking requirement.

"If you are a school district that is not requiring universal masking, you are directly endangering the children, the staff, the faculty, everybody who is in each of your buildings, and it is an inexcusable decision," Beshear said. "Every single public-health agency, every one, has said the universal masking is the only way to keep kids in school. We have seen story after story after story of dead administrators and teachers, and it shouldn't take that."

Beshear, who is a lawyer, added, "Anyone who is making those decisions is facing huge personal liability in the future, because once they make a decision that is against all science, that is against all evidence, that is against all advice and somebody gets hurt, they ought to expect to pay, one way or another."

Most districts are masking up. Olivia Krauth reports for the Louisville Courier Journal, "As of Thursday morning, at least 139 of Kentucky’s 171 school districts have said they will continue to require universal masking in classrooms. About 90% of Kentucky's public school students attend class in those districts. Three districts — Burgin Independent, Science Hill Independent and Gallatin County — have said they will make masks optional once the statewide mandate is lifted."

Last week, Gallatin County became one of the many districts to suspend classes due to high numbers of coronavirus cases. Its school board is scheduled to meet at 6 p.m. Tuesday, Sept. 21. For a report published in the Sept. 15 Gallatin County News, click here.

Science Hill Supt. Jimmy Dyehouse, who called Beshear a "liberal lunatic" for imposing a school mask mandate Aug. 11, told Lexington's WKYT-TV that his board's unanimous decision was based on a survey of parents, 90 percent of whom opposed a mandate.

Amanda Nutt
Beshear honored the life of Amanda Nutt, a 36-year-old teacher with Caverna Independent Schools in Hart and Barren counties, who died from Covid-19.

“We’ve all had teachers that have made a huge impact on us, I remember them, the ones who we credit for our success. Amanda was that teacher to so many. Tonight, as we light our homes up green, let us lift Amanda’s family and the entire Caverna school district up in prayer," said Beshear.  

Daily numbers: The state reported 4,891 new coronavirus patients Tuesday, bringing the seven-day rolling average to 4,218 per day. That is down 51, or 1%, from Wednesday, indicating that the state remains on a rough plateau of daily new cases. Of today's cases, 1,416, or 29%, were in people 18 and under.

The state reported its daily infection rate over the last seven days to be 84.69 cases per 100,000 residents, down 2.42 from Wednesday. Counties with rates more than double that rate are Rockcastle, 208.8; Powell, 204.6; Whitley, 204.5; Monroe, 202.5; Knox, 192.2; Wolfe, 183.6; and Perry, 173.6.

The New York Times ranks Kentucky's infection rate third in the nation, following West Virginia and Tennessee. 

The share of Kentuckians testing positive for the virus in the last week dropped for the eighth day in a row, to an even 13%. Beshear has said that this trend could be the result of more testing. 

Hospitals reported 2,453 Covid-19 patients (down 40 from yesterday), 667 of them in intensive-care patients (up 19) and 25 of them children. The 448 patients on mechanical ventilation was up 12 and equaled the record set Friday, Sept. 10. 

Only one of the state's hospital-readiness regions is not using at least 80% of its intensive-care beds: the easternmost region, from Lee to Pike counties. The northern region is using 100% of its ICU beds. 

The addition of 62 more Covid-19 deaths brings the state's toll to 8,206. The seven-day death average is 33.6, up from 29.9 yesterday. 

Deaths are the main lagging indicator of the pandemic, and Beshear indicated that they will remain high for a while. "Once we have all those big cases, the death follows," he said. "It's going to be a tough period of time."

Flu coming: In addition to getting vaccinated for Covid-19, Stack encouraged Kentuckians to get the influenza vaccine to help lessen the strain on hospitals.

“In a typical winter, flu always drives up the number of people in the hospital," he said. "In bad years . . . hospitals really get strained or taxed with the number of influenza patients who fill them. The flu vaccine . . . does protect large numbers of people and prevents substantial burden to the hospitals. So if we all get immunized for the flu, we can keep the hospitals with more capacity and more able to care for Covid patients and other patients as well.”

Stack's advice for people as they head to outdoor social and sports events this weekend: "If you are at a large event outside, you should wear a mask. . . . I get that it's outside, but with that many people that close together, I would just suggest to each person for your personal safety and [to protect] those at home to put on that mask when you are in the seats surrounded by that many folks." 

Poll shows fewer Kentuckians hesitant about vaccines, but 'hard core' 20% are dead-set against; mask views, habits deeply split

The question above was asked of those poll respondents who had said they had not been vaccinated. 
By Al Cross
Kentucky Health News

When vaccines for the coronavirus were rolling out in late winter, 29 percent of Kentucky adults said they would probably not or definitely not get vaccinated; by last month, the figure had dropped to 20%, according to polls taken for the Foundation for a Healthy Kentucky.

Almost three-fourths of Kentucky adults have been vaccinated for the virus. Among the unvaccinated in August, one in five said they were still open to vaccination, but almost half said they would definitely not get a shot, and almost a third said nothing would persuade them otherwise.

"The greatest concern is that we have essentially a hard-core group, 20 percent or so here in Kentucky, that just simply is not going to get the vaccine," foundation President Ben Chandler said. "The underlying reason is that they are listening to people who are skeptical or anti-vaccine."

Chandler said the state has made some progress in reducing vaccine hesitancy and raising the vaccination rate, thanks in part to pro-vaccination efforts, but he said the main reason is that people are scared of the Delta variant of the virus, which is much more contagious than earlier variants.

Vaccination records show that daily vaccinations in Kentucky generally began increasing in early July, when the surge driven by the Delta variant became apparent. They have slacked off recently and are now on a rough plateau, much like the daily number of new cases.

"I think personally the Delta variant has more to do with changing people's minds than anything else because . . . people are locked into their own news sources," Chandler said. "Many of them are hearing skepticism about vaccines . . . More than anything, I think it's how we disseminate information in this country that's causing the difficulty."

Chandler said pro-vaccination campaigners "are just pulling their hair out on this subject, trying to figure out what on Earth we're gonna do to try to get these people vaccinated. . . . They seem to be immovable, despite a whole lot of facts that a  lot of people are aware of."

He said the solution lies at the local level. "You've got to find the folks who influence these people, and you've got to get them to influence them along different lines. You know, you've got influencers who feel very strongly about this and are anti-vaccine, and until we can somehow get those minds changed I think it's going to be very, very difficult. In certain respects, we're kind of stuck in concrete."

He said the hard core is "essentially prepared to act as hosts for this virus, hosts that can allow the virus to mutate, and of course, that puts everybody in jeopardy. . . . That ought to be of tremendous concern to all of us."

The latest poll was conducted Aug. 4 through Sept. 4. It asked many other questions about vaccination, and about masks, the main short-term measure experts recommend to fight the virus.

Reported mask-wearing practice split evenly, three ways. One-third said they always wear a mask in an crowded outdoor space, while another third wear a mask sometimes or occasionally, and he other third never do.

Almost half said they always wear a mask indoors in a crowded public space. That included more than a third of those who said they hadn't been vaccinated. However, almost a fourth of the unvaccinated say they never wear a mask indoors in a crowded public space.

Asked about requiring proof of vaccination, Kentucky adults' opinions depended in large part on the circumstances. Two out of three said it would be a bad idea to require proof of vaccination to enter a retail store, but just over half said it’s a good idea for sporting events and concerts to require proof, and two-thirds said that should be the case for airliners and other p public transportation.

The poll was taken during a period when the state required everyone in public schools to mask up, and the state Supreme Court upheld laws limiting the governor's emergency powers. It was completed just before the legislature abolished the statewide mask mandate, leaving the decision up to local school officials. 

It found that two-thirds of Kentuckians think it’s a good idea for schools to require children who are not vaccinated against the virus to wear masks. Those who said they have children living in their homes were about 10 percentage points less likely to say that. That split was even greater when it came to requiring vaccination of children 12 and older, who are eligible to be vaccinated. Overall, Kentuckians were about evenly divided on the issue, but two-thirds of those who said they have children at home said requiring vaccination for school would be a bad idea.

Wednesday, September 15, 2021

4th highest day of new cases; 49 deaths make average nearly 30 per day; 2 regions report all ICU beds full; vaccination slacks off

For the first time, more than one hospital-readiness region reported all its intensive-care beds full. Regions in white have fewer than 80% of their ICU beds occupied. (State chart; click to enlarge) 
By Al Cross
Kentucky Health News

Kentucky reported 5,398 new cases of the coronavirus Wednesday, the fourth largest daily total of the pandemic, turning the trend of the pandemic upward after a plateau last week. The seven-day average of new cases is 4,269, just 2.9 percent less than the record average of 4,398 recorded Sept. 5.

The state also reported 49 more Covid-19 deaths. Over the last week, Kentucky is averaging almost 30 such deaths per day; a month ago, it was nine per day. The state's Covid-19 death toll is 8,144.

"It doesn't matter if you're healthy. It doesn't matter if you're younger. This could come for you," Gov. Andy Beshear said in a Facebook video. He noted deaths of people aged 32, 33, 37, 38 40, 41, 43, 44, 45, 50 and 53.

"This is incredibly deadly right now, and we have to blunt this spread," Beshear said. "So please, do your part" by wearing a mask and getting vaccinated.

Among the states, Kentucky's daily infection rate over the last seven days ranked fourth, according to The New York Times, and fifth according to The Washington Post. The Times has West Virginia first, followed by Tennessee and Wyoming; the Post puts Tennessee first and South Carolina fourth.

The state reported its infection rate to be 87.11 per 100,000 residents, up from 80.81 four days ago. The high of 91.55 was reported Sept. 4. Counties with rates more than double the state's current rate are Whitley, 206.8; Monroe, 205.2; Powell, 198.8; Perry, 193; Rockcastle, 191.7; and Knox, 182.6.

The percentage of Kentuckians testing positive for the virus in the last seven days dropped for the seventh day in a row, to 13.02%, but Beshear has said that could be the result of more testing.

Kentucky hospitals reported 21 fewer Covid-19 patients Wednesday, but that drop was less than 1 percent of the new total of 2,493. The number of Covid patients in intensive care on the daily report declined by 18, to 648, but the number on mechanical ventilation went up by six, to 436.

The Lake Cumberland and Northern Kentucky hospital-readiness regions reported all their intensive-care beds in use, with 52% of them in the Lake Cumberland region occupied by Covid-19 patients. This was the first day more than one of the 10 regions had no intensive-care beds available.

The Lake Cumberland region is Adair, Casey, Clinton, Cumberland, Green, McCreary, Pulaski, Russell, Taylor and Wayne counties; the Northern Kentucky region is Boone, Bracken, Campbell, Carroll, Gallatin, Grant, Kenton, Owen and Pendleton counties.

Vaccinations in Kentucky, after picking up in the first two months of the surge caused by the Delta variant of the virus, have settled back into a rough plateau the last two weeks.
Chart by The Washington Post, adapted by Kentucky Health News

Tuesday, September 14, 2021

Cases and hospital numbers tick up again; state's 7-day infection rate is second in nation; positive-test rate declines again

State Department for Public Health graph; EUA is the acronym for emergency-use authorization.
The federal government is now running the antibody supplies through states due to heavy demand.

By Melissa Patrick

Kentucky Health News

Kentucky reported 4,030 new cases of the coronavirus on Tuesday, bringing the seven-day rolling average of cases to 4,136. That's 239 higher than the average stood Monday, when it was depressed by a low Labor Day figure. Of the new cases, 28.6% were in people 18 and under.  

The New York Times now ranks Kentucky second for daily case rates, with a rate of 118 daily cases per 100,000 residents over the last seven says. Tennessee is ranked first with a rate of 160 per 100,000.

The state, which uses a different methodology, reports a seven-day case rate of 84.56 per 100,000 residents, returning to the level seen a week ago. Counties with rates more than double that rate are Whitley, 200.5; Perry, 191.3; Monroe, 185.1; Knox, 175.7; Leslie, 175.0; Rockcastle, 173.7; Powell, 173.4; and Harlan, 171.4.

However, the share of Kentuckians testing positive for the virus in the past seven days has dropped for six consecutive days, to 13.45 percent, but Gov. Andy Beshear has said that could be due to more testing.

Hospital numbers ticked up again Tuesday, with 2,514 Covid-19 patients, up 68 from Monday; 666 patients in intensive care, up 20; and 428 on mechanical ventilation, up 17. The Covid-19 patient count was second only to the 2,541 reported Friday.

The northeast and easternmost hospital-readiness regions continue to be the only two of the state's 10 regions to be using less than 81.6% of their intensive-care beds. 

One of the best ways to stay out of the hospital if you get Covid-19 is to see if you qualify for monoclonal antibody treatments, which must be given soon after infection as a way to help prevent severe symptoms from developing in those who are considered high risk. 

Today the federal government announced a shortage of the antibodies, due to extraordinary demand, and said it will require state governments to supervise the distribution of the treatments instead of health care providers ordering them directly, according to a news release from the governor's office. 

Yesterday, Health Commissioner Steven Stack urged Kentuckians to get vaccinated, noting that the antibodies are synthetic, laboratory-created antibodies that give the body a temporary immune boost, but do not teach the body to create its own antibodies as a vaccination does.

“Monoclonal antibodies are an important tool, but we have another alternative, vaccinations. Vaccines prime your immune system to create natural antibodies that your own body will produce to create a natural immune response that then can protect you for at least eight months or more,” said Stack. “It’s a lot easier to get vaccinated than to get monoclonal antibodies.”

During the seven days ending Tuesday, 3,642 treatment courses of monoclonal antibodies were used in Kentucky and the state's hospitals have 9,363 monoclonal antibody treatment courses on hand, the release said.

Kentucky offers such treatments in 139 locations. Senate Bill 2, recently passed in the special session, directs the state to create more monoclonal-antibody treatment centers. 

The state reported 24 more Covid-19 deaths on Tuesday, bringing Kentucky's pandemic death toll to 8,095.

As of Tuesday afternoon, at least 99 of Kentucky's 171 school districts have said they will continue to require masks. Around three-fourths of Kentucky's public school students attend a district that will require universal masking," Olivia Krauth reports for the Louisville Courier Journal.

Monday, September 13, 2021

‘The only true cure for Covid is prevention,’ worker on Covid-19 unit says as record number of hospitals report staffing shortages

Dept. for Public Health graph, adapted by Ky. Health News; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

With 69% of Kentucky's acute-care hospitals reporting critical staffing shortages, "Our hospitals are at the brink of collapse in many communities," state Public Health Commissioner Steven Stack said Monday.  

At his weekly pandemic media briefing, Gov. Andy Beshear also presented an emotional message from a health-care worker who talked about "the heartbreak that she encounters on almost a daily basis," as Beshear put it. 

Laura Gevedon, shift supervisor on a Covid-19 unit at Pikeville Medical Center, broke down in tears several times in a three-minute video while telling what it is like to take care of Covid-19 patients. 

"They beg for you to talk to their families, they beg for you to tell their families that they love them," she said. "Once they make it to the ICU to get intubated, they are sedated so whatever they've got to say, they've got to say before that."

Gevedon's unit was converted to a Covid-19 unit. Her video can be seen here.

She closed by saying that all patients regret not getting vaccinated. 

"Every patient says that they wish not only that they had got it, their family had got it, their friends had got it. They wish that they had never listened to anybody who said don't get it. They regret waiting," she said. "Our patients are a great advocate at this point, they are telling people get out and get vaccinated. You don't want this. You don't want to be stuck in the hospital."

She added, "Get a vaccine and wear a mask. That's all you can do. It is the best prevention that anybody can have. That's the best treatment for Covid. And the only true cure for Covid is prevention." 

Gevedon works on a unit that had been converted from cardiothoracic and vascular treatment to Covid-19, and she said every bed was full. 

Beshear said 66 of the state's 96 acute-care hospitals are reporting critical staffing shortages, the most yet.

But even as the governor and his health commissioner sounded the alarm, all three Covid-19 hospital metrics fell from records set Friday. Hospitals reported 2,446 Covid-19 patients, down 95 from Friday; 646 in intensive care, down 52; and 411 on mechanical ventilation, down 37.

Only two hospital readiness regions are using less than 86% of their intensive care unit beds. They are the northeast region and and the easternmost region, from Lee County to Pike County. 

After saying some hospitals are near collapse, Stack said, "It's causing consequences to people not just with Covid, but also to people without Covid who can't get some of their procedures or hospitalizations taken care of, or have a heart attack or a stroke addressed in a timely manner because there simply are no places for these patients to get their care." 

Beshear reiterated his plea for Kentuckians to "break the Thanksgiving dinner rule" and talk to their loved ones about the importance of getting vaccinated, saying that those who would be influenced by him and other local leaders have likely already been vaccinated. "Only you can make the difference," he said.

Biden's mandate: Asked by Kentucky Health News if he supports the vaccine mandates announced Friday by President Biden, Beshear equivocated, saying not all the details are clear yet.

He said Biden's vaccine mandate for any business employing more than 100 people should instead be called a testing requirement. "Your employer has, I think, a rightful desire to keep you safe, but also if you've chosen not to get vaccinated, not to infect the rest of the workforce," he said. "So I think the controversy that comes around it is more of the name than what's being asked."

He added, "I don't want to be critical of what the president's doing because at least he's trying. Right? At least he's trying to do something. He's taking action and he's willing to take criticism that comes along with it because he wants to beat the darn virus. And he doesn't want us to be here in another year. And he doesn't want to see more people die. . . . Like him or dislike him, he's trying to attack this virus and he's trying to help us win."

Legislation legal? Beshear was asked whether any of the measures the General Assembly passed last week to limit his authority to manage the pandemic, including the ability to require statewide masking or universal masking in schools, fell outside his call for the special session, which would be outside the law.

"I think it would ultimately fall to a court to decide if something was in or outside the call. I haven't looked at any of that law right now. I don't see a challenge coming from my office," he said.

"I certainly hope and pray that every school district makes the only decision that protects children and don't try to convince themselves that somehow you can protect children by letting a one every one-hundred year pandemic run through your school [in a] poorly ventilated building with unvaccinated kids."

Masks and kids: Stack, who is a physician, also stressed the need for schools to maintain universal masking if they want to maintain in-person classes. 

Stack said his department's advice is "unwavering and unequivocal" for universal masking in schools. "You have to wear these masks when you're in school," he said. "That's how kids stay in school."

Dept. for Public Health table, adapted by Ky, Health News

Those messages came as a second staff member In Lee County died from Covid-19 since the school year began, reports the Louisville Courier Journal. Since Saturday, there have been 68 more Covid-19 deaths, with 29 reported on Monday. The death toll in Kentucky from the disease is 8,071.

"So again, don't fool yourself," Beshear said. "I heard a whole lot last year about how Covid doesn't spread in schools. Covid spreads everywhere, anywhere it can. It doesn't have any rules other than it will do what it takes to kill as many of us as it can -- which means we have to make good decisions, smart decisions."

He said the highest infection rate is among 10-to-19-year-olds, and only 45% of those 12 to 17 had received at least one dose of a vaccine, and only 49% of those 18 to 29 had. Children under 12 can't be vaccinated. 

Daily numbers: The state reported 2,426 new cases of the coronavirus Monday, bringing the seven-day rolling average of cases to 3,897. That's 11.4% less than the record average of 4,398 set eight days earlier. 

However, Beshear said the Labor Day holiday may have delayed discovery of cases. "Covid is as bad in Kentucky as it has ever been in this pandemic," he said. "Right now, sadly, we are one of the hottest states in the country."

However, the share of Kentuckians testing positive for the virus in the last seven days has dropped for the last five days and is at 13.7%.

The seven-day rate of daily new cases is 79.26 per 100,000 residents. Counties with rates more than double that rate are Rockcastle, 201.9; Perry, 192.5; and Whitley, 177.7. 

The New York Times continues to rank Kentucky third for its case rate, and places six Kentucky counties in the nation's top 10: Perry, Clay, Whitley, Russell, Grayson and Rockcastle. (The Times and state rankings vary due to methodology; the state says it removes duplicates from test results.) 

In partnership with Volunteers of America Mid-states and the Kentucky Association of Health Plans, Clay County recently launched a "Take 1 for the Team" campaign for vaccination; the latest event announced is an Ohio Valley Wrestling event, with on-site vaccinations available Friday, Sept. 17. 

Since the initiative was launched, Christie Green of the Cumberland Valley District Health Department said in a news release, the percentage of the population receiving at least one dose has gone from 33% at the end of August to 39.8% as of Sept. 10. Monday's figure was 40.6%.

The statewide one-dose figure is 59%. Woodford and Franklin counties lead with 75%; Spencer, Lewis and Christian counties are at the bottom with 31%.

The state's daily vaccination average has slipped in the last week, but its rate of full vaccination has finally reached 50%, according to Centers for Disease Control and Prevention data in The Washington Post:

Sunday, September 12, 2021

Studies show that properly wearing masks slows the spread of the coronavirus, as part of a multi-layered prevention approach

Janel Carter held a "Stop The Mandates" sign as legislative action moved from the state Capitol to the Capitol Annex on the first day of the special legislative session. (Photo by Al Cross; click to enlarge) 

By Melissa Patrick
Kentucky Health News

As decisions about whether to require masks to thwart the coronavirus in Kentucky move to local school districts, governments and businesses, there's still much doubt and misinformation about whether they actually work to slow the spread of the virus, even though research shows they do. 

One Kentuckian who isn't convinced is Janel Carter of Boston, Ky., who held a "Stop the Mandates" sign outside the Capitol on Sept. 7, the first day of the special legislative session that ended statewide mandates. Carter told Kentucky Health News that she doesn't like any of the mandates. “It’s just choking us, the injections, the masks, the staying in," she said, adding, "I'm not seeing where it does” any good.  

Asked if she wanted evidence that it does, she said, “I do,” and indicated that she's seen some, but not enough. “I would like full strength. I feel like we’re at 20 percent. I used to work at Frazier Rehab in downtown Louisville.” (Rehabilitation facilities measure patients' capacity in percentages.)

Before the special session began, Democratic Gov. Andy Beshear sent the overwhelmingly Republican legislature links to 49 studies, analyses, polls and other publications on masking, mask mandates and school prevention efforts.

The largest randomized controlled study of masks, led by researchers from Stanford and Yale universities, looked at the benefits of surgical-mask use by more than 342,000 adults in Bangladesh. It found that mask usage increased 29 percent in the intervention group where masks were promoted, and the group showed an 11% reduction in Covid-19 infections, with a 35% reduction among those over 60. The Washington Post reports that the study is under peer review with the journal Science. 

The Rev. Carol Hairston sang through a surgical
mask at Highland Baptist Church in Louisville.
(Photo by Bill Campbell)
This study is the latest that clearly supports the value of wearing surgical masks for reducing infection. Cloth masks can also work, according to one of the earliest studies published by the Centers for Disease Control and Prevention.

It looked at a Springfield, Mo., hair salon where two stylists with symptomatic Coivd-19 interacted for an average of 15 minutes with each of 139 clients over an eight-day period, before either stylist was diagnosed. None of the 67 clients who consented to interviews and testing developed an infection. Both stylists wore double-layered cloth masks; one sometimes wore a surgical mask. Among the clients, almost half each wore cloth or surgical masks, and a few wore N-95 masks.

Most people wear cloth masks, and often don't wear them properly. 

In a story titled "How well do face masks protect against the coronavirus?" the Mayo Clinic advises how to choose the best cloth mask, saying,  "The most effective cloths masks are made of multiple layers of tightly woven fabric like cotton. A mask with layers will stop more droplets from getting through your mask or escaping from it."

Further, the clinic recommends that masks fit snugly over the nose, mouth and chin, and that be "well fitted to the contours of your face to prevent leakage of air from around the masks' edges."

A review of data from 10 studies published in the Journal of the American Medical Association concluded that mask wearing substantially reduces the spread of the virus. The researchers reported that "multilayer cloth masks were more effective than single-layer masks, blocking as much as 50% to 70% of exhaled small droplets and particles." The researchers also point to a Covid-19 outbreak on the USS Theodore Roosevelt, where persons who wore masks experienced a 70% lower risk of testing positive for the disease. The researchers provide a table that reviews the study findings. 

Another study involved a high-speed laser-light video experiment, which caused oral fluid droplets to appear as flashes in the light. "When observed, between 227 and 347 oral fluid droplets flashed when participants said the words “stay healthy” without a mask. When the same phrase was spoken with a mask, "the flash count remained close to background level." The study was published in The New England Journal of Medicine, and cited in a report by KXAN of Austin, Texas, with 48 other scientific studies explaining how masks can slow the spread of the virus. 

Slow, not stop. Another CDC-published study found that a Covid-19 outbreak in California was traced to an unvaccinated, mildly symptomatic teacher who reportedly read to her 24 masked, unvaccinated students while unmasked, infecting half of them. Parents and students said social distancing and masking adherence among the students was high. The closer students sat to the teacher, the more likely they were to be infected.

The CDC guidance on universal masking in schools says: "Because of the highly transmissible nature of [the Delta] variant, along with the extent of mixing of vaccinated and unvaccinated people in schools, the fact that children under 12 years of age are not currently eligible for vaccination, and low levels of vaccination among youth ages 12-17, CDC recommends universal indoor masking for all students (age 2 years and older), teachers, staff, and visitors to K-12 schools regardless of vaccination status."

The American Academy of Pediatrics recommends that "all eligible individuals receive the Covid-19 vaccine" and that "all students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use)." 

It is also important to remember that masking is meant to be part of a "layered prevention" strategy to protect against the coronavirus that also includes vaccinations, social distancing, hand hygiene, testing, and a need for people to stay home when sick. 

Saturday, September 11, 2021

Ky. infection rate is still 3rd, and it has 12 of top 25 counties, N.Y. Times says, but ranks better on shots than most adjoining states

National Geographic map, adapted by Kentucky Health News; to enlarge, click on it.
Kentucky's coronavirus infection rate over the last seven days is still the nation's third-highest, and its rate has remained stable for the last two weeks while Tennessee and West Virginia moved ahead of it in rankings by The New York Times.

The Times, using Centers for Disease Control and Prevention data, says the state has had 91 daily cases per 100,000 residents over the last week, a decline of only 1 percent over the last 14 days. West Virginia's rate is 92 and Tennessee's is 100, the Times says.

Kentucky reports lower rates for itself, most recently 82 per 100,000 residents. State health officials have said they remove duplicate test results from their data, which results in lower rates of positive tests.

In the Times rankings, 12 of the top 25 counties are in Kentucky, which has smaller counties than most states. The 12 counties and their rates are: Perry, 252 (highest in the nation); Clay (third in the nation), 207; Whitley (fifth), 189; Russell (seventh), 186; Grayson (ninth), 183; Rockcastle (10th), 182; Knox (11th), 181; Bell (15th), 171; Monroe (18th), 168; Harlan (19th), 168; Powell (22nd), 164; and Metcalfe (23rd), 163. All except Grayson County are in Appalachia.

While Kentucky's infection rate remains high, daily vaccinations in the state have generally increased over the last four weeks. They have decreased this week, but the state is about to get 50 percent of its population fully vaccinated. It ranks 27th in full vaccination, three notches below Illinois and 14 below Virginia, but better than other adjoining states.
Chart by The Washington Post, adapted by Kentucky Health News

Friday, September 10, 2021

Corbin mayor asks the unvaccinated to 'shelter in place' to keep city's 273-bed regional hospital from being overwhelmed

Suzie Razmus (via Facebook)
Voicing worry that Corbin's regional hospital can't cope with the raft of Covid-19 patients, Mayor Suzie Razmus is advising unvaccinated people to stay home.

“I just wanted to let everyone know what is going on in our hospital right now – what is going on in our community right now,” Razmus said in a Facebook video. “Please, if you are unvaccinated consider sheltering in place, wear a mask if you have to be out, socially distance yourself from people, and please consider getting vaccinated. Our rates are starting to go up but not fast enough, and the next two weeks are crucial.”

Razmus told the Corbin News Journal that her video "was born from a state of helplessness after speaking to health-care workers" at Baptist Health Corbin, where more than half the patients have Covid-19, reporter Jennifer Perkins writes. The hospital's chief medical officer, Dr. David Worthy, said the 273-bed facility has had to contact facilities as far away as Pittsburgh to find intensive-care beds for patients.

Razmus started her video by saying, “I just wanted to take a moment to reach out to the community to talk about something that is very, very serious in our community right now. The Covid Delta variant has run rampant, and it is getting very, very serious at our hospital right now. They are completely overrun, overwhelmed, and overworked. They are trying to save as many people as they can, but things are dire especially for the unvaccinated.”

Vaccination rates in the area are low. Knox County, which includes part of Corbin, has one of the lower rates in the state; only 32.2% of its residents have received at least one dose of vaccine, according to the state Department for Public Health's Covid-19 Vaccination Dashboard. Whitley County has 37.7% and Laurel County 38.4%.

Razmus urged her audience to get vaccinated against Covid-19. “I just don’t want to lose any more people in our community,” she said. “I understand if you feel nervous about getting the vaccine. To be honest, I was nervous about it too, but this is a very, very serious illness for people that are unvaccinated.”

Beshear says legislature now 'owns this pandemic' and urges local school officials to impose their own mask mandates

Ky. Health News graph; case numbers are from initial, unadjusted reports; click it to enlarge.
By Al Cross
Kentucky Health News

"The legislature owns this pandemic moving forward" because it banned statewide mask mandates, Gov. Andy Beshear said Friday as Covid-19 hospitalizations set more records and the death toll passed 8,000.

Beshear called a press conference to give his reactions to the special legislative session he called to fill the void left by the court decision upholding laws the General Assembly passed to limit his emergency powers.

"For 18 months I've been able to quarterback Kentucky through this pandemic," he said. "I've made the tough calls, sometimes the unpopular calls, and I've taken the hits that go along with them . . . but the legislature wanted that ball . . . so the legislature owns this pandemic moving forward. If I still had the authority, we'd be masking indoors. It works. We'd reduce cases, we'd provide relief to our hospitals, we'd save lives. The inability to take this step, and all its ramifications, or even its devastation, falls squarely on the legislature."

Beshear imposed a mask mandate in July 2020, during a surge in cases. It remained in effect until June 2021. "It's worked to stop every single surge we've faced," he said. "It is proven, and it is the second best tool behind vaccines and now I can't use it. So the General Assembly has to own that piece."

He said "strong, centralized leadership" is needed in pandemics, and "We've had better success than most states; without it, right now we're suffering more than just about any other state."

Beshear has been in charge during the current national surge, during which Kentucky's infection rate rose to the top five among the states. He lifted the mask mandate about two and a half weeks before the current surge began, driven by the Delta variant of the virus.

Maintaining his football analogy, Beshear said, "The legislature asked to go in at QB, and what did they do? They punted on first down. . . . Instead of making a call setting a matrix, saying when we would need to mask in schools, they now push it to local superintendents and local school boards."

Only a third of school districts had imposed mask mandates by Aug. 10, when Beshear issued a statewide school mask mandate. The state school board soon issued one that was limited to public schools. The legislature banned such mandates until June 1, 2023, making the decision a local one.

"My message to local school districts is there's only one decision, only one right answer, where you don't endanger children and your entire community," Beshear said. "If you don't have universal masking in your school system, your kids won't be in school, because Covid will spread too much. It's happened in every school system that's tried to get by without it."

Republicans who control the legislature, and a few Democratic lawmakers, have said they trust local school officials to make the right decisions. To that, Beshear said, "All over the country school systems have chosen not to do the right thing . . . Either our school systems follow the science, and do universal masking, or they endanger our children."

Beshear said later, "The two most effective tools in fighting Covid-19 are vaccines and masks, and now we, I, have to proceed forward with one arm, one of those tools, tied behind my back. . . . Our path ahead is going to be more difficult but we will continue to rise to the challenges, to do the very best that we can, and to call on others to make good decisions."

The governor said a 19 year-old from Daviess County was on Friday's list of 32 deaths, which pushed the toll of the pandemic in Kentucky to 8,003.

Kentucky hospitals reported a record 2,541 Covid-19 patients, 62 more than Thursday, with 698 in intensive care and 448 on mechanical ventilation, both records.

"Our hospitals are at a breaking point," Beshear said, adding that only 93 intensive-care beds are available, "despite hospitals opening up more and more and more of them every day."

Some Republicans blamed hospital staffing shortages on Beshear's ban on elective procedures early in the pandemic, which they said prompted staff to leave for other jobs and started a sellers' market for hospital staff. Beshear said every state stopped elective procedures, at the behest of then-President Trump.

The state reported 5,197 new coronavirus cases, the fifth largest daily total of the pandemic. Thursday's 5,252 figure was the fourth largest. The seven-day rolling average of new cases is 3,989; the record of 4,398 was set Sunday.

The state's seven-day rate of new cases, which had dropped for five days in a row, rose slightly, to 81.57 cases per 100,000 residents. Counties with rates more than double that rate were Perry, 208.5; Clay, 205.3; and Whitley, 194.6. Perry County retained the nation's highest infection rate, according to The New York Times, which ranks Kentucky's rate third, behind Tennessee and South Carolina.

The state Department of Education said it would pay local school districts $100 for each employee who gets vaccinated against the virus, to encourage them to offer the incentive to the employees.

Asked if he were considering other incentives, Beshear said the remaining unvaccinated population is so resistant to getting a jab that they are likely to be persuaded only by someone who "loves them so much they are willing to lose that relationship if that means protecting that person. . . . We need everybody's direct help."

Beshear had a parting shot for legislators who faulted him for not consulting with them about decisions related to the pandemic, noting the expiration date of the ban on statewide mask mandates.

"When your masking option runs out right after the primary for governor, going into the general [election], can we also admit there's a lot of politics being played here by the body? And then maybe that some of these comments going back in time have been political, too? I mean, listen: I threw politics out the window a long time ago." Beshear has said he will run for re-election in 2023.

Thursday, September 9, 2021

Lawmakers pass bill to not allow statewide mask mandate until 2023, along with other health-related pandemic measures

By Melissa Patrick
Kentucky Health News

The Kentucky General Assembly has passed a bill to prevent a statewide mask mandate until June 2023, and shifting the responsibility for such mandates to local governments and businesses. 

Speaker of the House David Osborne, R-Prospect
signs Senate Bill 2 after the House overrode the
governor's veto. LRC photo.
Democratic Gov. Andy Beshear quickly line-item-vetoed the bill, and the Republican controlled legislature over-rode the veto about as quickly.

Senate Bill 2, sponsored by Sen. Ralph Alvarado, R-Winchester Senate President Robert Stivers, R-Manchester, also directs the state to create more monoclonal-antibody treatment centers, used for early treatment of Covid-19 under a federal emergency-use authorization; allows paramedics to work in hospitals and nursing homes; and allows families of nursing-home patients to name an "essential caregiver" who would have the right to visit the patient.

It also tells the the state health cabinet to partner with universities and health-care organizations to produce public-service announcements about the severe effects of Covid-19 and "talk with their doctor about the benefits of receiving a Covid-19 vaccination;" and to implement a plan to improve access to Covid-19 vaccinations in doctor's offices. It also calls on the state health department to assist and support the distribution of Covid-19 tests. 

The bill also includes an eleventh-hour addition allowing Kentuckians to have a conscientious objection to getting a Covid-19 vaccination if local health departments require them. 

The Senate passed the measure on a vote of 26-10 and the House passed it 69-24. 

During the Senate debate, Sen. Reggie Thomas, D-Lexington, called the elimination of the mask mandate "irresponsible." 

Sen. Karen Berg, D-Louisville, called the measure an "embarrassment" and said she viewed the lack of willingness to tell constituents that a mask mandate is needed to keep schools open as "cowardice."  

In quick response, Stivers walked through several of the Democratic governor's responses to the pandemic that he said resulted in poor outcomes, and noted that the Kentucky Supreme Court unanimously agreed to remove some of the governor's emergency powers during the pandemic (by upholding laws the Republican-controlled legislature passed).

"If you want to sit here and talk about unmitigated failure, where we are today – there has been no decisions by this body, or that body down there," meaning the House. "Only the decisions made on the first floor that were wrong," Stivers said. 

House Democrats were quick to point out that Republicans were doing the same thing to them that House Majority Leader Steven Rudy said the governor had done in refusing to work with them on pandemic related policies.

"The same things that are being complained about with the first floor -- that's happening to the minority party," said Rep. Buddy Wheatley, D-Covington. "We are not being heard. And if we would work together, we would have had an opportunity to talk about our amendments, had them voted upon. We would have something that we could say, yes, we're working together. But we're not doing that. We're obviously not doing that." 

Wheatley said the bill's ban on a statewide mask mandate through June 1, 2023, is "highly, highly political." That date falls soon after the next primary elections for governor, in which Beshear says he is running.

General Assembly leaves masking authority to school districts; Republicans block votes on Democrats' amendments

Photo by Mary Altaffer, The Associated Press
By Al Cross and Melissa Patrick
Kentucky Health News

The Kentucky House and Senate gave final passage Thursday night to a bill eliminating the state's requirement to wear masks in schools and giving that authority back to local school districts.

Democratic Gov. Andy Beshear quickly vetoed the mask-mandate parts of the bill but the Republican-controlled legislature overrode him just as quickly, and adjourned the special session he had called in the wake of a state Supreme Court decision upholding laws the legislature passed last winter to limit the governor's emergency powers.

"This bill will also nullify, null and void the Kentucky Board of Education's mandated masking protocol," said. said Sen. Max Wise, R-Campbellsville, the sponsor of Senate Bill 1. "This bill will give local control back to the districts, not mandating they do, not mandating they don't. They make the decision of what they think is best for their constituents and their communities."

Democrats in both chambers said some districts wouldn't impose mask mandates, raising the threat of the coronavirus not only in schools but the general population, leading to more deaths from Covid-19.

"The global pandemic is ravishing Kentucky, and yet we're sending our kids into the lion's den," said Rep. Pamela Stevenson of Louisville. "Many of our students will not be protected."

Wise acknowledged that the bill is not a perfect bill, but called it a "tactical approach for the now," designed to keep students in the classroom. 

SB1 would guarantee school funding, which is normally based on average daily attendance; address staffing shortages; set rules for how school districts can manage in-home learning; and require the state Department for Public Health to develop an optional "test-to-stay" model to avoid quarantines for students who have been exposed to the virus but test negative and have no symptoms. Students would be tested for a period of days to see if they can remain in the classroom or be quarantined. 

The bill passed the Senate 28-8 and the House 70-25, largely along party lines. The Senate overrode the veto 21-6, and the House did likewise 69-24. Both Republican floor leaders said the veto was unconstitutional because the bill is not an appropriations bill, but Democrats said it was such a bill because it has an appropriation.

Education Commissioner Jason Glass, who was hired by the state school board that Beshear appointed, said in a Twitter statement that the law does not go far enough in providing the flexibility that schools need.

“Further, the politically motivated effort to remove masking requirements in public schools weakens our virus mitigation efforts as a state at the very time they are needed most,” Glass said. “We will be working with Kentucky's school districts as they continue to try to keep students in school safely and do our best to manage the consequences of the decisions made by our legislature in this special session.”

Sen. Gerald Neal, D-Louisville, said the bill needed to give Glass authority to deal with unforeseen issues. "We don't know what's going to happen between here and the next time we come back" in January, he said. 

Neal spoke at length about how the process used during the special session to pass bills at such a rapid pace did not allow amendments to be considered. Rep. Al Gentry, D-Louisville, voted against the bill after saying "I cannot support a rushed, partisan process that doesn't allow sensible amendments."

Gentry's statement was read by Rep. Angie Hatton, D-Whitesburg, who said she trusts her school districts to make the right decisions, but voted for the bill "very reluctantly" because it goes in the wrong direction.

"We went from being a model . . . to an example of how it shouldn't be handled," Hatton said of the pandemic. Earlier, she said people in some school districts listen too much to "politics or to a vocal minority. . . . We have school boards in this state that have refused to meet in person because they've been threatened."

The most popular amendment in the House was offered by Rep. Ashley Tackett Lafferty of Prestonsburg, to allow former health-department workers to return to work to relieve staffing shortages and help with the test-to-stay option, which her local health department said it couldn't help with because of limited staffing and test materials. He motion was favored 27-11, but was defeated by Republicans who didn't vote; suspending the rules requires a majority of House members.

Democrats said the bill flies in the face of science.

"Why do we refuse to listen to science and experts on such a deadly virus, and think we can handle it better?" asked Rep. Mary Lou Marzian of Louisville. "Masks are not that difficult,"
Rep. Tina Bojanowski of Louisville cited several studies showing that masks can prevent the spread of disease, and said Republicans had presented no research showing "local control as the best way to manage a viral pandemic." She said they were making "a value-based decision rather than a scientific-based decision. . . . I carry the weight of each child's heath on my shoulders."

Sen. Reggie Thomas, D-Lexington, called it a "life and death bill" and noted that school mask mandates are recommended by the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. "If we eliminate mask mandates, then we are putting all children and all school personnel at severe risk, and I cannot tolerate that," Thomas said.

Rep. Rachel Roberts of Newport told the story of a toddler who died of Covid, then warned, "If we get this wrong, another . . . may die for lawmakers waiting to leave their egos behind." Rep. Josie Raymond of Louisville gave a similar warning and said, "This bill takes masks off of kids when Covid is at its most dangerous."

That was challenged by one of the relatively few House Republicans who spoke, Rep. John Blanton of Salyersville.  "We are not taking masks away from your children today," he said, while giving schools the tools they need, such as 20 days of remote learning.

McGarvey said he agreed with much of the bill, but said there were two main points of contention, masks and the lack of local control over days used for non-traditional instruction. Pointing to the recent surge in Covid-19 cases, especially among children, most of whom are not eligible to be vaccinated,  McGarvey said, "It's irresponsible of us to take away the ability to protect our kids." 

But Sen. Danny Carroll, R-Benton, said, "I have complete faith in our local school districts to make the decisions related to Covid. . . . These are the people that see the kids every day. They live next to their parents, to their families. They are responsible every day for these kids. They will go through great pains to make sure that the decisions that they make in every area of the Covid response for their school district is in the best interest of their employees." 

Rep. Cherlynn Stevenson of Lexington said her constituent messages were 10 to 1 in favor of universal masking in schools, and said people from all over the state come to Lexington daily, so "If everybody's not doing their part, It's all going to fall apart."

Beshear reiterated before yesterday's legislative action that masks are essential to keeping children in school.

"Now, thankfully, I think most superintendents know that now, even the ones who didn’t think it was true in the beginning," he said. "There’s also the question of how many people at this point would be foolish enough — because that’s what it would be — would put that many kids in danger by not requiring masking in schools."