Schools advised to close for rest of academic year; nine deaths in nursing homes raise their share of Ky. death total to 39 percent; study suggests obesity is top risk for a severe case of covid-19

Nutter Field House at the University of Kentucky is now a 400-bed field hospital. (UK photo by Mark Cornelison)

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 Melissa Patrick
Kentucky Health News

Gov. Andy Beshear has recommended that Kentucky schools not hold in-person classes for the rest of the school year and continue nontraditional instruction and food service for students.

"Every health care professional had advised us that this is the right course of action to take," Beshear said at his daily covid-19 briefing.

The move follows the White House's guidance for re-opening the economy, which calls for schools and day-care centers to stay closed in the first phase. Beshear noted that Ohio, Indiana and Tennessee have decided likewise.

“I know for many this is hard,” Beshear said. “We have seniors that were looking forward to an in-person graduation and a prom.” He encouraged schools to be creative in finding ways to celebrate graduation, virtually or in drive-up ceremonies.

“The experience you are losing is hard," he said, "but your willingness to do it is going to help us save lives."

Beshear reported that six more Kentuckians had died from the disease, bringing the total up to 154. He said that because the state has exceeded 150 deaths, a State Police honor guard would hold a wreath-laying ceremony in the Capitol rotunda tomorrow.

The governor said 59 of those deaths have occurred in long-term care facilities. That is nine more than the total he reported Sunday; he said some happened earlier in the weekend. So far, 39 percent of the state's deaths have been in such facilities, much higher than the national average of about 25%.

Beshear acknowledged that the facilities are a challenge and said the state would direct a large portion of its available testing capacity toward them. He said 22 more residents and 12 more staffers had tested positive, bringing the totals to 408 and 184, respectively.

William Dean Smith

One of the nursing-home residents who died over the weekend was William Dean Smith of Leitchfield, 96, a retired music teacher and decorated airman in World War II and the Korean War. Beshear cited him as an example to follow, "a mentor and life-shaping force."

“We’ve now lost at least a couple of war heroes,” Beshear said. “Let’s make sure we’re doing our part. Let’s make sure we’re living up to the example that his generation set for us. Let’s make sure that we protect people from this virus.”

Beshear said that tomorrow he would introduce a plan for associations and trade groups to submit proposals on how they could re-open under the new Centers for Disease Control and Prevention's guidelines. That approach is similar to one that was included in a bill amendment that was added in the last days of the legislative session that failed to pass. In particular, he said he was looking forward to seeing plans from pet boarders and chiropractors. He said that by the end of this week or early next week, some additional health-care providers will be able to offer certain services.

In other covid-19 news Monday:

• The six new deaths included a 59-year-old woman from Crittenden County; a 92-year-old woman from Adair County; an 85-year-old woman from Hopkins County; and a 64-year old man and two women, 62 and 76, from from Jefferson County. 
• Beshear said the state had 102 new positive tests, bringing the statewide adjusted total to 3,050. He said it continues to look like the state's number of cases is plateauing.
• In all, he said, 32,830 people have been tested, 263 are hospitalized, 147 are in intensive care, and 1,034 of the 3,050 people who have tested positive have recovered.
• Beshear said another staffer has tested positive at Western State Hospital, a psychiatric center in Hopkinsville, where two people have died of covid-19 and 13 patients and 28 staff have tested positive for the virus. 
• John Cheves reports for the Lexington Herald-Leader that inmates at Green River Correctional Complex in Central City "complain of inadequate cleaning of common areas; a reduction of meals to once a day, usually served late; failure to test people inside the complex for the coronavirus unless they are showing symptoms, such as fever or cough; and an inability to properly segregate sick inmates from the rest of  the population because of a lack of available space." A wife of an inmate said, "It's a death trap at this point." 
• Beshear said there have been seven new cases of covid-19 at Green River, five inmates and two staff. In all, there have been 46 total cases, 29 inmates and seven staff; one inmate has died of the disease. 
• The New York Times reports that new studies (not peer-reviewed) find that the most important predictor of severe covid-19 is obesity, especially for younger patients who are otherwise healthy. Kentucky ranks fifth in adult obesity, with a rate of 36.6%; and more than one of five Kentucky children between 10 and 17 are obese, ranking the state third in the nation. 
• Drive-through testing will begin in Madisonville, Paducah, Somerset and Pikeville tomorrow through Thursday, with a goal of testing 1,000 people at each location. To sign up for testing, go to thelittleclinic.com/drivethru-testing. 
• Lt. Gov. Jacqueline Coleman, secretary of the Education and Workforce Development Workforce, said via a video-link report that the state processing 13,000 new unemployment claims a day and answering about 25,000 calls. She said applicants who haven't received benefits should not reapply, which slows the system. She said that the priority now is reaching out to people who were past the two-week waiting period to be paid. She said only those whose original benefits have expired should reapply. 
• "Ripples from the coronavirus impact on meat-processing plants are hitting Kentucky farmers hard," Janet Patton reports for the Herald-Leader. Covid-19 has shut down large processing plants across the nation, and now that it's time for Kentucky farmers to sell their beef and hogs, the prices are so low they won't be able to make a profit, she reports. In Kentucky, the Tyson Foods chicken-processing plant near Albany closed for one day this month after a worker tested positive for covid-19. What all this means for most of us is probably that meat will continue to be scarce.
• The number of children infected with the coronavirus is far more extensive that what is currently being reported, according to a University of South Florida study. It estimates that for each child who requires intensive care for covid-19, there are 2,381 children infected with the virus, said a news release about the study. From March 18 to April 6, it found that 74 U.S. children were admitted to pediatric intensive-care units, signaling that an additional 176,190 children were likely infected during that period. "Researchers point out the infection rate will be much higher for children in low-income families with parents in blue-collar and service jobs, which preclude the option of working from home," the release says. "There's also an increased risk to children who live in urban public housing projects due to the close proximity of housing units and small communal recreation and commons areas." 
• Becker's Hospital CFO Report breaks down how the Centers for Medicare and Medicaid Services will divvy out the next $30 billion in hospital aid: "About $20 billion will be distributed based on a hospital's proportion of total revenue, including money from private insurers and Medicaid. The remaining $10 billion in the second round of funding will be distributed to hospitals with large numbers of covid-19 patients, according to The Washington Post."
• CMS is now requiring nursing homes to report covid-19 cases directly to the Centers for Disease Control and Prevention, as well as to patients and their families. This marks a "significant change in practice," since the CDC has not formally tracked this information while thousands in nursing homes have died, Politico reports.
• Betsy Johnson, president of the Kentucky Association of Health Care Facilities, told Cheves this month that the state's roughly 280 nursing homes are "pretty much sitting ducks if we get someone who is infected in our buildings." Cheves writes about the need for more personal protective gear, beds, staff and access to testing for the virus, saying nursing homes have been left out of the supply chain. On Sunday, Beshear reported that there have been 50 covid-19 deaths in long-term-care facilities, with 386 residents and 172 staffers testing positive. 
• Frank Romanelli, professor and associate dean of the University of Kentucky College of Pharmacy, writes for UKNow, "What Medications are Safe in Cases of Covid-19?" He says the World Health Organization does not recommend against the use of ibuprofen, based on currently available information, despite reports from France that it might impede recovery. 
• The conversion of the UK football team's practice facility, Nutter Field House, to a temporary 400 bed field hospital to care for covid-19 patients is now complete, according to a UK news release. 
• The Supreme Court of Kentucky will hear oral arguments by video conference Wednesday, for the first time in its history, since the justices are not meeting in person. A news release says the public may watch arguments in a family-law case from Oldham County at 10 a.m. ET Wednesday, April 22, via livestream on the KET website.