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Sunday, April 26, 2020

As he and Beshear take the first small steps to reopen the state, Health Commissioner Stack asks for 'patience and tolerance'

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Al Cross
Kentucky Health News

As Kentucky takes small steps toward reopening businesses, starting gingerly with much of health care, you can almost see top officials crossing their fingers.

“As hard it was to say no to so many things, it will be challenging to say ‘yes, but’ to a lot more things,” Health Commissioner Steven Stack said at Gov. Andy Beshear's daily briefing, recalling the early days of the crisis.

“We would probably prefer to wait even longer before lifting any restrictions but we’re trying to balance competing societal needs – people’s need to get back to work, people’s need to perform other important functions in society, people’s need to pursue their lives – with the need to also keep people safe. So as we work through this, I ask everyone’s patience and everyone’s tolerance . . . ”

Stack and Beshear both said they, and their counterparts in other states, are doing something that's ever been done.

“None of us have ever had to reopen an economy during a worldwide pandemic before, Beshear said. “Some of the time, our decisions are not going to be fully consistent with others … What we're trying to do is do it safely. . . . I'm gonna make the best decisions I can, treating your family like they were my family.”

Beshear and Stack said health care is the logical business area to start opening first because it is best equipped to control infection, it can provide a gauge for reopening other areas, and people are in need of medical attention and showing up at emergency rooms in worse shape than usual.

Stack at the April 19 briefing
Beshear said Saturday that dentists wouldn't open Monday because rules for them had not been agreed on. Stack said Sunday he had received "a very well thought-out proposal" from dental groups and, "We will use this in coming up with more detailed requirements. . . . You should use this as a guiding place to start your preparations. . . . Don’t open until you’re ready to comply."

Stack said Beshear's order detailing the rules for health-care providers wouldn't be issued until Monday, probably in the afternoon. “We’ve got things backward a little bit,” he said, but are responding to “societal demands.”

Stack, an emergency-room doctor who has been president of the American Medical Association, said he wanted to make clear that the first phase of reopening health care will not include elective surgeries or invasive procedures. Those are the chief moneymakers for hospitals, which have been pressing for a green light to restart them.

Senate Majority Leader Mitch McConnell said in a Wednesday interview, broadcast Sunday, that hospitals "need to be able to engage in elective surgery" and said of Beshear, "Hopefully, he’ll take a look at the regions of Kentucky that are less impacted and begin to let them begin to open up." Beshear said Saturday that there could come a time when reopenings could be done regionally, but “It’ll still have to have a lot of thought.”

Beshear said Sunday that Kentucky's houses of worship are doing better than those in any other state at complying with his social-distancing orders, which unlike some states allow drive-in services. “It’s one of the reasons we have flattened the curve,” he said, “and it’s one of the reasons I believe we get to our new normal faster than other places.”

Beshear concluded his briefing by saying “I feel hopeful, because we are in a better place today, a far better place, than any thing, any model, any expectation, I was ever given. . . . We need you to stick with us and stay strong.”

In other covid-19 news Sunday:
  • Beshear announced 202 new coronavirus cases in Kentucky, for a corrected total 4,074. "As we increase our testing we are gonna see more cases," he said. Counties reporting 10 or more new cases were Warren, 35; Jefferson, 28; Grayson, 16; Muhlenberg, Boone, 11; and Hopkins, 10.
  • The governor announced the state's lowest daily death toll "in a while," three. All were 88 years old; two were in Adair County and one was in Jackson County; both have had major covid-19 outbreaks in nursing homes.
  • Beshear said long-term-care facilities had the fewest additional cases "in a number of days, partly due to reporting" that can be spotty on weekends: eight residents and seven staff. The state's daily report is at https://chfs.ky.gov/agencies/dph/covid19/LTCupdate.pdf.
  • “Social distancing will be with us through the summer to really ensure that we protect one another as we move through these phases,” Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, said on NBC's "Meet the Press." She was answering a question about Vice President Pence's notion that the pandemic would be "largely behind us" by Memorial Day.
  • McConnell made another suggestion on "Newsmakers" on Lexington's WKYT-TV, citing the leading federal experts: "As we open up, people need to listen to Dr. [Anthony] Fauci and Dr. Birx and practice social distancing and don’t be stigmatized by wearing a mask. It doesn't necessarily mean you’re sick; it means you're concerned about others."
  • Beshear displayed a mask and said wearing the devices will be "incredibly important" in preventing a resurgence of covid-19.
  • The Democratic governor said he had not spoken with the Republican leader since McConnell suggested Wednesday that states could take bankruptcy and wouldn't be getting federal aid to solve employee-pension problems that existed before the pandemic. “I have not had a personal conversation with Senator McConnell,” he said. “I need to.”
  • House Speaker Nancy Pelosi vowed on CNN, "We will have state and local [aid], and we will have it in a very significant way."
  • Dr. Scott Gottlieb, former head of the Food and Drug Administration under President Trump, said on Twitter, "We're not out of the woods in U.S. on #covid. While there are signs of slowing in some areas, and nationally we may have hit a plateau, we're still recording more than 30,000 infections a day. The trip down the epidemic curve will be far more gradually than the trip up. . . . Our mitigation steps were not as stringent as China's, they were leakier, and our epidemic was far more pervasive across our country. We're likely to see a much slower decline in new cases spread across weeks not days. While there are signs of U.S. improvement, it'll be slow. We all want this to be over. And things are mostly trending in right direction. But we're still very much in the thick of the epidemic. What we do over next few weeks will determine if we can get this wave more firmly behind us, or whether covid remains a combustible threat."
  • "There are two faces of public opinion surrounding covid-19," Jan Hilliard writes for the Northern Kentucky Tribune. "One face represents the roughly 75 percent of the public who support science, believe that covid-19 requires widespread caution, and trusts the government’s response. This is the face of science and reason. The other face represents 25% of the public who does not believe the scientific facts about covid-19 and are suspicious of government’s motives in responding to the virus. This is the face of denial and conspiracy."
  • T.A. Frank offers five "surprising facts" about the virus for Vanity Fair: "Singing looks like a big danger," according to a study and anecdotal evidence; "Children aren't significant spreaders," at least in relative terms; the similar virus SARS "had its own once-promising drug combo, reminiscent of hydroxychloroquine today; "If your mask has a valve, it’s dangerous to others;" and "You have to work hard to catch it outside," according to "one impressive Chinese study," still in review. But wait: "There’s a Belgian study on the potential hazards of 'exposure to slipstream droplets' left by runners."

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