Wednesday, April 29, 2020

Beshear starts saying what businesses can open when; analysis says Ky. shutdown saved lives; study shows promising treatment

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 and Al Cross
Kentucky Health News

Gov. Andy Beshear announced details of the first broad phase of his plan to re-open Kentucky's economy in May, while saying child care, restaurants, and businesses that require increased human contact are not yet on the list of what will be allowed to open.

"I hope everybody also sees that these are cautious steps that are going to be done with strict compliance, and I would not be suggesting these if I did not think that we could not do them safely," he said. "And if it proves that we can't do any of them safely, it is always subject to pause."

Beshear stressed that it's important that the state not open up in such a way that it causes a second spike of cases, a common occurrence in pandemics.

Beshear went over a list of 10 rules that he said will apply to every group that is planning to reopen, including such things as continuing to allow telework when possible; opening gradually, in phases; doing daily onsite temperature checks; providing access to personal protective gear if needed; maintaining and enforcing social distancing; and making special accommodations for those who need it, such as those who do not have child care or who are over 60 with underlying health conditions.

He said it's also important to have immediate testing of those who show up to work with a temperature, and systems for tracing contacts of those who test positive for the coronavirus.

The big day is May 11, when non-essential manufacturing, construction companies, and vehicle and vessel dealerships can open, Beshear said. Auto and boat dealers will be doing business differently, he said; for example, test drives will have to be done solo.

Professional services will be allowed to open, at half-staff, and pet grooming and boarding will be allowed to resume, but with no person-to-person contact.

Beshear also announced that horse racing will be allowed to open on May 11, starting at Churchill Downs -- but with no fans. "This is one of the most detailed plans that we have seen," he said.

On May 20, retail may re-open and churches may hold in-person services, both at reduced capacity. Beshear said they are working on details, and it will likely be a percentage of normal occupancy. He said they are also working with churches to make plans for things like Sunday school, and "All of this is contingent on being able to keep social distancing, on the type of cleaning that needs to occur."

On May 25, "provided the virus is where we think it will be at that stage," he said, social gatherings of 10 or fewer people will be allowed, with social distancing and masking where necessary.

"We want you to know that we think this is possible, but it is all contingent on all of us doing this right, on making sure that we don't see a spike in the virus," he said "But there is at least a light, I hope you see at the end of the tunnel where we can get together a little more."

Barbers, salons, cosmetology businesses and similar services will also be allowed to open May 25.

Beshear said restaurant openings would have to come later, and the state is working with them to figure out how to they can open safely.

He said day-care centers will also not be allowed to open this month because they increase contacts to a level that can easily spread the virus: "We go from a controlled amount of contacts to almost exponential growth."

He said gyms, movies, camp grounds, youth sports are also scheduled to open in the second phase. As for youth sports, he said he is hopeful some of these sports can resume in June or July, but "Public pools will not be in phase one or phase two." He said summer camps will not open in phase one, and it will be hard to open them in phase two.

Beshear said the "healthy at home" approach and social distancing are still keys to defeating the virus, "so healthy-at-work doesn't stop being healthy-at-home."

Reopening plans also presume that testing will continue to increase, to keep better track of the virus. Asked why Kentucky lags in testing behind other states, particularly Tennessee, Beshear said one differences is that large health-care companies that are in Tennessee are doing almost all the testing, with only 5 percent done by the state. "With us, it's over 30 percent."

He said the state hopes to see more private-sector testing, to increase the state's capacity much faster. He said the rates of infection seen in Kentucky's testing are promising and compare well to other states.

A University of Kentucky study released Wednesday estimates that without Beshear's restrictions on economic activity, the state would have had 10 times more coronavirus inflections and and 2,000 more deaths than it did through last week.

"What’s really interesting is that the study was authored by professors at the UK Institute for the Study of Free Enterprise, which is funded by the Koch Foundation and home to the same free-market philosophy that advocates reopening the economy without delay," writes Linda Blackford, who runs the opinion page of the Lexington Herald-Leader.

Study co-author Aaron Yelowitz, an economics professor, told Blackford, “What we do is we look at data and follow it where it goes. If the data told us something different, we would have written a different paper, but the data very clearly spoke to the fact that social distancing and the stay at home orders really do matter.”

Yelowitz did the study with Institute Director Charles Courtemanche, University of Louisville professor Joshua Pinkston, and graduate students Anh Le and Joseph Garuccio. They compared Kentucky's data and policies with states in the South and Midwest, covering 2,477 counties.

“These results suggest that Kentucky policymakers should be cautious when opening up the economy. Returning to partial restrictions without a broader shelter-in-place directive may not be enough to contain the spread of the virus,” Courtemanche said in a UK news release. “However, the public health benefits from strong social distancing restrictions need to continue to be weighed against the massive economic losses that disproportionately affect low-wage sectors of the economy.”

Asked about the study, Beshear said, "This is what we were seeing in our data, but I want to say it indicates that healthy-at-home gets the credit. I don't get the credit; everybody out there, every Kentuckian, gets the credit for being willing to do what it takes."

He added, "I don't know of any other state that people have come together in the way that we have seen, that have followed a set of restrictions and have stayed calm in the midst of a worldwide pandemic. . . . Now we've got to keep it going forward. That is our challenge. Making sure that as we change the restrictions a little to be healthy at work, if we can follow them just as well we can have those good results. So let's make sure that we keep that up."

In other coronavirus news Wednesday:
  • Beshear reported 184 new coronavirus infections, with the top three counties for cases being Jefferson, with 60; Warren, 50; and Daviess, 16.
  • 10 more Kentuckians have died of covid-19. They include five deaths in Jefferson County, including four men, 58, 72, 84, and 94, and a woman, 66; a 56-year-old man from Warren County; two from Grayson County, a 96-year-old man and a 101-year-old woman; a 94-year-old man from Jackson County, and a 94-year-old woman from Hopkins County.  
  • Beshear announced that 29 more long-term-care residents and eight more staffers have tested positive for the virus, along with 18 new deaths. To date, there have been 693 residents and 302 staffers to test positive, 119 resident deaths, and one staff death from covid-19. Click here for a list of facilities with positive cases and deaths. 
  • Kentucky nursing homes struggle to purchase personal protective equipment, such as masks and gloves, Deborah Yetter reports in detail for the Louisville Courier Journal., which published the story April 22 and in its print edition April 27. Signature HealthCare, which operates 41 nursing homes in the state, said its PPE costs have risen 200%. 
  • Beshear said the four Kroger-sponsored drive-thru testing locations in Louisville, Lexington, Bowling Green and Owensboro did about 950 tests Wednesday. This week testing will run through Friday in Louisville, Lexington and Bowling Green and through Thursday in  Owensboro. Next week, Kroger will sponsor testing in Louisville, Lexington and Bowling Green, with a new site in Ashland. Beshear said signup portals are open. Click here to see all drive-through locations.
  • Kentucky and Ohio are "not even close" to the amount of testing needed to safely reopen the economy, Dan Horn reports for the Cincinnati Enquirer, citing recent studies.  
  • Inmates at the Green River Correctional Complex in Central City are asking judges to order their release, while some of their lawyers are accusing the warden of “cruel and unusual punishment,” Louisville's WDRB reports. The prison has about 900 inmates, two of whom have died of covid-19; Beshear said 250 have been tested, and all will be by Friday. Before the mass testing began, 43 had tested positive, as well as 28 employees.
  • The Tyson Foods plant in Henderson County will shut down for cleaning, after 71 employees  tested positive for the coronavirus. The Perdue Farms plant in Ohio County also reported a number of cases, and more than 200 employees at meatpacking facilities across the state have tested positive," the Lexington Herald-Leader reports. "Kentucky has at least 26 USDA-inspected meat processors, according to the Kentucky Department of Agriculture. Fearing that meat processing plants across the country may shut down over the health concerns, President Donald Trump ordered them to remain open Tuesday."
  • Beshear reiterated that he wants to resolve all of the March unemployment insurance claims by week's end. He said there are still 29,000, many with verification issues. He encouraged anyone who has not gotten their unemployment benefits to make sure they are answering their phones and checking their e-mails, including their spam or junk-mail boxes. 
  • A preliminary study of the drug remdesivir shows that it can speed recovery from covid-19 and lessen its severity. "What it has proven is that drug can block this virus," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which is doing the study. Dr. Sanjay Gupta said on CNN, "It's the best news in terms of a therapeutic that I think we've heard in some time." However, it made no statistical difference in the death rate.
  • The Wall Street Journal reports on the race for a coronavirus vaccine, reporting that Pfizer Inc. will begin testing of its experimental vaccine in the U.S. as early as next week.
  • The left-leaning Kentucky Center for Economic Policy has released a detailed report titled, "Lessons from the Great Recession: Kentucky and Other States Need More Federal Relief." Jason Bailey says the lessons are: Federal aid to states works, and should be robust and last until full recovery; without such aid, state budget cuts drag the economy further; now, such cuts can hinder the responses of Medicaid, public health, mental health, first responders and more.
  • The University of Texas Health Science Center has created a covid-19 dashboard with state and global data. A news release says the site not only provides information on the number of cases and deaths, but also shows processed data instead of raw numbers.
  • New provisional death statistics from the Centers for Disease Control and Prevention shows that total deaths are likely higher than the reported statistics capture, The New York Times reports.
  • Costco Wholesale announced that it will require customers to wear masks as of Monday, and admit only one member per card in Kentucky, Puerto Rico and El Paso, Texas. Elsewhere, it is allowing two members per card; it did not explain the difference. It said stores would have a special hour, 9-10 a.m., for members over 60 and those with disabilities.
  • "Covid-19 patients are reporting the terrible second week of symptoms they experience," The Washington Post reports. "People who seem to be handling the infection well suddenly suffer the most severe reactions in days five through 10. There is little consensus among doctors and experts about why that period seems to be so dangerous."
  • The Post also reports that scientists know ways to help stop viruses from spreading on airplanes, but too late for this pandemic: "It is a problem of biology, physics and pure proximity, with airflow, dirty surfaces and close contact with other travelers all at play." 
  • CNBC reports that JetBlue will require passengers to wear masks; American Airlines and Delta Air Lines will require employees to wear masks and will provide them for passengers; and United Air Lines requires masks for its flight attendants, as does Jet Blue and Frontier Airlines.

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