Trump says he has power, political if not actual, to 'open up the states'; but Beshear says, 'In this state, the buck stops with me'

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item will be updated. Official state guidance is at https://kycovid19.ky.gov.

By Melissa Patrick and Al Cross
Kentucky Health News

President Trump, eager to restart the economy amid the covid-19 pandemic, said yesterday that it will be his decision, not governors', to "open up the states" by relaxing safeguards against the coronavirus. Gov. Andy Beshear sees it somewhat differently.

Asked at his daily briefing how much sway Trump would have on his decisions, Beshear said, "I think we're all anxious to move past this, and I think we all want to give voice to that at different times. I can understand that. I do think that the president, when looking at the data, looking at how important social distancing is, when looking at what is happening in Japan right now and [how] we may see a resurgence of this in China, will ultimately determine that May 1st is probably not a realistic date." That is the date the current federal recommendations will expire.

Noting that Trump "was aiming for Easter," but changed his mind "when the data was different," Beshear said, "It could be that his motivation is to keep us all very interested and engaged, wanting to know that there is a light at the end of the tunnel; I can't quite speak to that. But I have confidence in, whether it is working with the different groups that we do, that ultimately where we are in the data at that point will guide his recommendations."

Beshear added, "Now, I don't know about the authority question that they asked; they've issued recommendations, we've issued orders, and our orders are a state deal; and I will want to collaborate with the federal government as much as possible, but at the end of the day in this state, the buck stops with me, and I'm going to protect our people."

Trump, at his daily briefing that started later and ran longer than Beshear's, said “If some states refuse to open, I’d like to see that person run for election.” Beshear, a Democrat who can seek re-election in 2023, has said that he is acting without regard to political consequences.

Trump, a Republican who is running for re-election, said on Twitter Monday morning: “For the purpose of creating conflict and confusion, some in the Fake News Media are saying that it is the Governors decision to open up the states, not that of the President of the United States & the Federal Government. Let it be fully understood that this is incorrect. It is the decision of the President, and for many good reasons. With that being said, the Administration and I are working closely with the Governors, and this will continue. A decision by me, in conjunction with the Governors and input from others, will be made shortly!”

State Senate Majority Floor Leader Damon Thayer said Monday night that Beshear has done a good job with the crisis, but Kentuckians are getting impatient and “I think they want him to multi-task a little bit” and talk about “gradual re-engagement.”

Specifically, Thayer said he wishes Beshear would lift the ban he placed on elective surgeries, because Kentucky hospitals are losing $20 million a day. "We’re not maxing out the need for beds, and we need a return to normalcy right away," Thayer said, adding later, "Their main cash flow comes from these elective procedures."

In other covid-19 news Monday:

• Kentucky has 87 new coronavirus cases, making a corrected total of 2,048. Of those, at least 673 have been hospitalized and at least 299 are currently hospitalized, with 136 in the intensive care. He said at least 629 of the 2,048 have recovered. (Many have no symptoms but have to self-quarantine for 14 days after testing positive.) 
• Kentucky reported seven new deaths today, for a total of 104. Beshear again encouraged people to light up their homes green to let the families know they are not alone, and announced an extra step: "Now that we've lost 100 people here in the commonwealth, starting tomorrow morning we are going to fly our flags at the Capitol at half mast," for the next week.
• The deaths were a 70-year-old man from Laurel County; an 81-year-old woman from Muhlenberg County; an 81-year-old-man from Jefferson County; and women 67, 70, 81 and 84 from Jefferson. 
• Beshear said there had been five more deaths in long-term-care facilities, raising the toll to 30.  
• As Kentucky heads toward the peak of hospitalizations and deaths, Beshear reminded Kentuckians that it's even more important than ever to keep your hands washed. 
• Asked about churches violating his order against mass gatherings, Beshear said they have not been singled out, and noted that 18 businesses had been cited for violation of closure orders. He said that while news media have focused on the few violators, it is more important to recognize that most have chosen not to gather. "That means that we have been able and committed to doing the right thing at a level that I have never seen before." He ended his response by saying, "I'm not going to give any more oxygen to those that aren't doing it right. I'm going to celebrate all of those that are."
• Showing a graph from a Kaiser Family Foundation site that compares states' coronavirus cases and covid-19 deaths, with Kentucky ranking low, Beshear said, "Kentucky, you are flattening the curve. What that means is you are reducing the number of cases we have right now. You are making sure we have the health-care capacity to care for the people that need it; you are saving lives." He acknowledged that the graph does not account for the amount of testing done in each state. 
• Kroger tested 97 people in its first day of drive-through testing in Frankfort, with the hopes of eventually testing up to 20,000 people with symptoms in multiple locations across the state. Beshear said testing would start in Kenton County on Wednesday. To make an appointment, go to thelittleclinic.com/drivethru-testing or call 888-852-256 and select option 1, then option 3 to see if you qualify. Beshear said testing has been opened up to all people with symptoms in contiguous counties. 
• Beshear said getting personal protective equipment continues to be a challenge, but many across the state have provided significant donations of masks and gloves. Major donors he named included Ford Motor Co., 50,000 surgical masks, Old Kentucky Chocolates, 25,000 pairs of gloves, GE Appliances, 100,000 surgical masks and 100,000 pairs of gloves; and Toyota and UPS, which each gave 10,000 N95 masks. 
• Beshear said he hoped the legislators returning to Frankfort on Tuesday will do only what they need to do, and do it as quickly as possible, so that they don't spread or contract the virus.
• Eleanor Klibanoff of the Kentucky Center for Investigative Reporting reports in detail about the state's crisis standards of care plan, which was sent to hospitals on March 30 with a letter from state Health Commissioner Steven Stack. "The 54-page plan lays out how hospitals respond to 'ethical challenges as a result of scarce critical resources,' in an effort to minimize illness, death and adverse effects on social order and economic stability," Klibanoff reports. The American Association of People with Disabilities has asked the state to issue guidance to all hospitals reminding them of the federal law banning discrimination against people with disabilities.
• The United States now has the world's deadliest outbreak, with a death toll surpassing Italy's. As of 8 a.m ET Monday, the unofficial number of U.S. cases was at 557,590, with 22,109 deaths, reports Medpage Today.
• The World Health Organization says covid-19 immunity is still an unknown and that the virus is "10 times deadlier" than the 2009 influenza, NPR reports.
• The Washington Post reports that at least 41 grocery workers have died of covid-19 and thousands more have tested positive. “Grocery workers are risking their safety, often for poverty-level wages, so the rest of us can shelter in place,” said John Logan, director of labor and employment studies at San Francisco State University. “The only way the rest of us are able to stay home is because they’re willing to go to work.”
• The Post also reports, "Education leaders across the country have concluded that millions of children’s learning will be severely stunted, and are planning unprecedented steps to help them catch up." The Lexington Herald-Leader reports on how some school districts are adjusting.
• Alex Acquisto of the Lexington Herald-Leader reports on the challenges people with addictions face in seeking treatment. “Coronavirus is scary for all of us, but people with substance use disorders are really vulnerable,” Dr. Amanda Fallin-Bennett, co-founder of the Lexington recovery support center Voices for Hope, said. “Recovery support services rely on connection," especially during the outbreak.
• The Louisville Courier-Journal tells the stories of some who have died of covid-19.
• Two Democratic members of Congress have requested details about the sensitivity and specificity data the U.S. Food and Drug Administration has received from makers of coronavirus tests, how the FDA is handling that data and which labs are meeting regulatory guidelines, Modern Healthcare reports."While it is imperative that testing becomes widespread, FDA needs to do its part to ensure people are getting accurate results, as well as address any mistakes that have been made to date," said Rep. Rosa DeLauro, D-Conn.
• Kentuckians with diabetes still need care and education amid the pandemic, and UK HealthCare's Barnstable Brown Diabetes Center is working to meet those needs through TeleCare, says a UKNow news release. Diabetes diagnoses have sharply declined during the pandmeic, and more type 1 patients are going into diabetic ketoacidosis, which can be deadly, because they are avoiding hospitals, the center says.
• Tom Frieden, director of the Centers for Disease Control and Prevention under President Obama, notes that the last CDC public briefing was March 9 and says the U.S. is "less safe" from the coronavirus because the agency is not communicating regularly with the public, Stat reports. Frieden, president and CEO of the cardiovascular advocacy group Resolve to Save Lives, calls for a four-step approach to end the national lockdown: widespread diagnostic testing to detect the virus; the ability to safely isolate all infected people; the ability to find all people who have been exposed, and quarantining them.
• The latest Kaiser Family Foundation poll, March 25-30, found that 72 percent of Americans say their lives have been disrupted "a lot" or "some" by the outbreak, up 32% from the last poll, taken two weeks earlier. It also found that partisan differences on the question have largely been erased and three-fourths of those polled said "the worst is yet to come."
• The Medicaid and CHIP Payment and Access Commission urged the Center for Medicare and Medicaid Services to prioritize safety-net providers in distributing the remaining $70 billion for health-care providers from the $2.1 trillion CARES Act. The first $30 billion was distributed based on Medicare reimbursements, not covid-19 burdens. That "one-size-fits-all approach" has created a furor, Kaiser Health News reports.