Dentists and state officials scramble to set rules for reopening dental offices; Beshear says they won't reopen Monday, but soon

About 15 motorists, most honking their horns, circled the Capitol about 15 minutes before Gov. Andy Beshear's briefing, conducted in the white-curtained room at the building's southeast corner. State police have restricted access to the area near the room, but provided an area for protesters to park. The yellow sign says "The cure is worse than the virus;" the white one says "Gov. Andy, you lied; every life matters," apparently referring to Beshear's veto of a bill that would have required medical care for a baby born alive after an attempted abortion. He said existing law provides full protection in such cases.

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

Gov. Andy Beshear said Saturday that dentists' offices won't be able to open Monday because they and state officials haven't agreed on rules for it, but suggested that other businesses might reopen on a regional basis.

Beshear had planned to allow reopening of medical, dental and other health-care providers Monday, but said “Dentists aren’t gonna be ready to reopen on Monday because there isn’t agreed-upon guidance. . . . We have to make sure were doing it right, given how those oral secretions happen in a dentist’s office.”

He said in response to a question at his 5 p.m. briefing, “Before a dentist’s office can reopen we need agreed-upon rules. . . . “We think that the guidelines will come together fairly quickly.” He said they will leave “some risk, but we believe we will have mitigated that risk.”

Sharon Turner, secretary-treasurer of the Kentucky Dental Association, said in an email at 7 p.m. that KDA, the Kentucky Board of Dentistry, the Kentucky Dental Hygenists Association and the Kentucky Oral Health Coalition "all agreed on a plan today. It will be filed later today."

She said acceptance of the plan is still up to Health Commissioner Steven Stack, "but we worked with the state director of public health dentistry, Dr. Julie McKee. We tried to address each bullet point that Stack provides in terms of his concerns needing to be addressed. We have scientific evidence behind recommendations."

Turner said in a telephone interview that KDA cited research from the University of Washington about what sort of personal protective equipment is appropriate for the wide range of procedures that dentists, hygenists and oral surgeons perform. She said rubber mouth dams, which neither providers or patients like, are likely to be used more, as well as high-powered suction.

She said some dentists may not be ready to reopen, or may want to test patients for the coronavirus before treating them, and the proposed plan allows room for professional judgment. "We hope it'll be accepted," she said. "If it's not, it will only be around what's enhanced aerosol protection." The virus travels on droplets that are so tiny they remain suspended in the air.

Turner, former dental dean at the University of Kentucky, added that KDA "heard about the need for the filing of the plan Thursday evening," when Stack issued a call for help during Beshear's briefing. "I think we have done a remarkable job of getting consensus from a large group of divergent stakeholders pretty darn quick."

On Friday, Beshear dismissed the idea that other relaxation of social-distancing rules could occur on a county-by-county basis, as some officials in Clark and Jessamine counties requested. Saturday, he opened the door to the possibility of regional differences, but remained cautious.

Asked about those requests, he said, "If a county makes the wrong decision and causes an outbreak, that sets the whole state back." Then he added that there could come a time when reopenings could be done by region, but “It’ll still have to have a lot of thought.”

At the start and end of his daily briefing, Beshear kept urging Kentuckians to stick with his emergency restrictions.

“Today, I'm tired, just like I know so many of you are, but every day we’ve got to bring it,” he said at the start. “We have to be strong, we have to be patient, we have to be resilient.” At the end, he said, “Let’s not be the generation that got halfway through meeting covid-19 and then just decided it was gonna be too hard. . . . There is hope, there is light, but we gotta do it the right way; we have sacrificed too much … to not finish it out the right way.”

Some protesters returned to the Capitol to protest restrictions, circling the Capitol and honking their horns before the briefing, and chanting during it. Without referring to them directly, Beshear said, “We might have some out there that are anxious but I believe we are more united than we have ever been.”

In other covid-19 news Saturday:

• The governor reported 171 new coronavirus infections in Kentucky, for a corrected total of 3,905. The number was lower than the previous two days; he said that could be a result of some labs not reporting on Saturdays, “but we still think we are plateaued, or we’re somewhere in the very top part of that curve.” He said the state “could be potentially starting our decline” needed for major reopenings, but several more days would be needed to confirm that.
• Beshear corrected some news-media reports that major reopenings can't occur unless the number of new cases decline every day for 14 days. “We just have to have a declining rate for 14 days; one day we may have a little more,” he said.
• The number of deaths reported daily declined for the third day, to five, and Beshear said he thought all were “in senior-living settings.” They were an Adair County woman, 79; a Graves County woman, 92; and three Jefferson County women, 87, 88 and 93. He said 17 percent of the deaths have been of African Americans, twice their percentage of the state's population.
• Counties with more than five new cases were Jefferson, 33; Graves, 20; Warren, 19; and Fayette, 9.
• Long-term-care facilities added 24 residents and five employees to the list of those testing positive, for a total of 602 and 273, respectively. Of the 205 covid-19 deaths in Kentucky, 94, or 46 percent, have been in such facilities. The state is issuing a daily report on each facility with a case.
• Beshear cited the number of cases in Warren County as he announced that a planned three days of testing next week at South Warren High School would be expanded to four days and the following week. He said labs have processed 46,558 tests, and “Our testing capacity is significantly increased; we need to do a lot more.”
• Of the approximately 3,900 Kentuckians who have been identified as having the virus, 1,266 have been hospitalized, and 301 remain so, Beshear said; 605 have been in intensive care and 164 still are; and 1,501 have recovered.
  
  Read more here: https://www.kentucky.com/news/coronavirus/article242296216.html#storylink=cpy
• After some recovered patients retested positive, a three-county health department has adopted a stricter definition for being free of the virus. The Wedco District Health Department, which serves Harrison, Nicholas and Scott counties, said 41 people thought to be recovered were retested and 11 tested positive for the virus. Now the department considers patients to be recovered and able to stop quarantine only after they have tested negative and have had the disease for at least 14 days, with seven of those days symptom-free, including at least three without fever. "The decision is crucial to determining who no longer quarantines to prevent spreading the virus, Rick Childress reports for the Lexington Herald-Leader. "There is no indication other counties are following Wedco’s lead." Harrison County had Kentucky's first covid-19 case.
• Emergency-room use at the University of Kentucky hospital has dropped by more than half in the last month, UK officials said. The likeliest explanation? "People are avoiding hospitals — even when they really need to go — because they’re scared of catching the novel coronavirus from patients who are infected, John Cheves of the Herald-Leader reports. "Similar no-show stories are being repeated at hospital emergency rooms around the country, worrying doctors who say people could be putting their lives at risk by not seeking health care right away for serious ailments."