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Monday, March 9, 2020

As covid-19 cases grow, Beshear tells those over 60 not to fly or take cruises; health chief gives advice on when to see a doctor

Kentucky Department for Public Health chart; for a larger version, click on it.
By Melissa Patrick
Kentucky Health News

Kentucky has confirmed two more cases of covid-19, the disease caused by the new coronavirus, bringing the state's total to six. All of the patients are in isolation, Gov. Andy Beshear said.

"As time goes on, we will have more cases," Beshear said. "We need to expect that."

Three cases are in Harrison County, where the first case was confirmed Saturday. Two are in Fayette County and one is in Jefferson County. A March 9 news release says that Kentucky has done 34 tests, with 28 of them coming back negative.The figures are updated at kycovid19.ky.gov, along with other information about the virus.

Saturday, the U.S. Centers for Disease Control and Prevention recommended that all Americans over 60 or those with heart, lung or kidney disease avoid public gatherings. Monday evening, Beshear also advised those 60 and older against flying or taking cruises.

Dr. Steven Stack, Kentucky's public health commissioner, offered some advice on when a person should go to the doctor at a morning news conference.

He said if you are "worried, but well," do not go to a hospital, emergency room or doctor's office -- stay home. If you are feeling ill, but otherwise would not have sought out medical care, do not seek care at an ER, hospital or doctor's office. If you need advice, call the state hotline at 1-800-722-5725 or call your local health care provider. If you are sick and feel you have an emergency, call your doctor or seek medical care.

“For 80 percent or more of people who get infected, you are going to be just fine. You’ll probably either have cold symptoms or no symptoms,” said Stack.

Beshear said in the news release, “I know many people are concerned, but I want Kentuckians to know the risk remains low and there is no need to panic. Everyone can help protect themselves, their loved ones and their communities by taking simple measures to reduce their risk.”

Those measures include: washing your hands with soap and warm water for at least 20 seconds; only use alcohol-based hand sanitizer if soap and water are not available; avoid touching your eyes, nose and mouth with unwashed hands; avoid close contact with people who are sick; stay home if you are sick; do not visit with seniors or people with chronic health conditions if you are sick; cover your cough or sneeze with a tissue and then throw it away; get a flu shot; and clean and disinfect frequently touched objects and surfaces. It is also suggested to engage in social distancing, which means trying to stay six feet apart.

At a Monday news conference, Dr. Nancy Messonnier, director of the CDC National Center for Immunization and Respiratory Diseases, emphasized that older Americans are at the highest risk for a serious infection of the coronavirus, and that so far only about 2 percent of infected patients were people younger than 19. She was using data from China that analyzed more than 70,000 cases of covid-19.

"This seems to be a disease that affects adults," she said.

She said the study found 80% of those infected had a mild case of covid-19 and recovered, and 15 to 20% had a serious illness, with those 60 and older and those with underlying health conditions at the greatest risk of serious illness. She said the greatest risk of serious illness and death was among those 80 and older.

The state has not recommended that schools or public gatherings close at this time, though schools can make that decision.

Harrison County has decided to close through at least March 13, while Fayette and Jefferson counties have decided to stay open. A Jefferson County Public Schools tweet said Monday, "Dr. Sarah Moyer -- health department director -- says several factors would have to be present before @LouMetroHealth would recommend closing schools, the biggest being wide spread of virus between children."

Beshear said the first covid-19 patient in Kentucky is an employee at the Walmart in Cynthiana. Crystal Miller, the county's public health director, said that six other employees have self-isolated, but have not shown any symptoms. Beshear said there was no reason not to visit the Cynthiana Walmart "right now." .

WLEX-TV published a statement from Wal-Mart Stores Inc. that says, in part, "Upon learning about the case from health officials we reinforced our cleaning and sanitizing protocols with guidance from Walmart’s chief medical officer."

To make sure factual information about covid-19 reached all of its citizens, The Cynthiana Democrat worked through the weekend to be able to send a special edition today to every mailbox in Harrison County.

Cynthiana Mayor James Smith told The Rural Blog he thought this was a good idea because ""Not everyone, especially in a rural county like Harrison County, has internet connection; not everybody is on Facebook; not everybody listens to the local radio," and some watch TV stations based in Cincinnati, not Lexington. "Some people in the county didn't even know we had a case in the county."

Beshear said that two of the Harrison County patients were linked and that a travel history was found in only one of the individuals.  He added that they believe that  Kentucky is experiencing some "community spreading."  People can get the virus and display no symptoms, and can pass it along for days without showing symptoms

“We believe, and this seems to be the case nationally, that this is community spreading, spreading from person to person,” he said. “Again that has been expected, we are ready for it, it is what we always thought that we would see with this novel coronavirus.”

Beshear issued an executive order Monday to waive all cost-sharing, including co-payments, coinsurance, and deductibles for screening and testing for covid-19, to waive any prior authorization requirements for screening and diagnostic testing for covid-19, and to allow insured individuals to obtain refills of their prescriptions early, with approval of the provider. It also requires insurers to ensure that provider networks are adequate to handle an increase in the need for care, including by offering access to out-of-network services where appropriate. The order applies to both private and state insurers, and will remain in effect for the duration of the state of emergency.

The governor has also removed any impediments, like prior authorizations,  for treatment of Medicaid patients for anything related to coronavirus.

He has also issued an executive order to prohibit price gouging. If Kentuckians have information regarding possible price gouging call the attorney general's consumer protection hotline at 888-432-9257.

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