Monday, May 18, 2020

Beshear promotes contact tracing to find people with virus, 1/4 of whom may have no symptoms, and need for testing signups

Click above for a video about contact tracing in Kentucky. Official guidance is at kycovid19.ky.gov

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear spent much of his coronavirus update Monday talking about the importance of testing for the virus and tracing the contacts of people who have it -- and then their contacts -- to keep the virus in check as the state begins to re-open its economy.

"Contact tracing along with testing is absolutely critical for our re-opening and for being healthy at work," Beshear said, adding later, "It doesn't work without you buying in, without your voluntary commitment to making sure that we are safe as we reopen."

The concept is that increased testing will determine who actually has the virus, including many who are infectious but have no symptoms -- about one in four, said Health Commissioner Steven Stack, noting that studies vary.

Testing leads to contact tracing: tracking down people who have been in contact with an infected person, then asking them and their contacts to isolate for two weeks, the incubation period for the virus.

All this is called for by the guidelines from the White House and the Centers for Disease Control and Prevention for reopening the economy, Beshear noted.

"So when we are talking about calling you and you picking up, this isn't just me, this is the president, too," he said. This is Democrats and Republicans, federal government, state government, this is just public-health experts saying what's got to happen for us to have a safe reopening and to restart our economy without pausing it."

Beshear assured Kentuckians that any information provided through the tracing would be kept private. "Information provided is completely confidential, entirely," he said. "And we will be looking at every privacy concern out there."

He said contact tracing is not a new process, but something public-health agencies have long done to fight communicable diseases, in ways that also "require significant privacy and trust of Kentuckians. We can do this the same way."

The state's contact-tracing program will be led by Mark Carter, a certified public accountant with 40 years of experience in health care, most recently as CEO of Passport Health in Louisville, the state's only nonprofit Medicaid managed-care company. He was widely mentioned as Beshear's likely secretary of health and family services, but Eric Friedlander got that job last week after being acting secretary for five months.

Carter showed a video about contact tracing and said, "So we have to reopen the economy, but we also have to protect our children and our families, our friends from another outbreak of covid. One of the key ways to do that, in addition to effective and expanded testing that has been accomplished, is through the contact tracing program. . . . I've always been an optimist, and I know we can have it both ways. It's not a binary choice between reopening the economy and protecting people's health. We can do both, but we need to do it together."

Health Commissioner Steven Stack stressed that the effort will require Kentuckians' cooperation. His sales pitch: "Contact tracing is the way we get back as much as possible to what normal used to be like."

But to be effective, tracing must be backed up with robust testing, Beshear said, because so many people with the virus don't have symptoms.

Map shows high numbers of cases in Western Kentucky counties.
In particular, he pointed to two covid-19 hotspots: Ohio and Graves counties, which have had very few signups for free, Kroger-sponsored testing available this week.

He said that in Ohio County, only 87 people had signed up for testing Tuesday, 45 on Wednesday and 13 on Thursday, at a site with a capacity of 300 or more spots each day.

In Graves County, he said 136 had signed up for Tuesday and just over 55 had signed up for Wednesday and Thursday combined, with similar capacity. Testing at these locations are open to anyone in the region.

"Folks, if we are going to combat this, if we are going to reopen our economy in these areas, we've got to do better than that," he said.

Ohio and Graves counties are in Western Kentucky, the part of the state hit hardest by the virus. As of May 18, Graves County had 154 cases and 18 deaths, and Ohio County had 116 cases.

In other covid-19 news Monday: 
  • Noting that gathering of 10 or fewer people will be allowed starting Friday, Beshear said, "There is a way to do it that is not safe, there is a way to do it that is safer and we want to make sure that we spend this week, all of us together, thinking through all the different ways we can protect ourselves while seeing people for the first time in a while."
  • Beshear announced 122 new cases of the coronavirus on Sunday (when he did not hold a briefing) and 138 new cases today, bringing the state's adjusted total to 7,935. Click here for Sunday's daily summary and here for Monday's daily summary. 
  • He reported three deaths on Sunday and nine on Monday, all in Jefferson County, raising the state's total to 346. Sunday's were men aged 68,78 and 79; Monday's were two men, 50 and 96, and seven women, aged 69, 76, 77, 79, 83, 89 and 102. 
  • He said 447 covid-19 patients are in the hospital, 277 in intensive care, and 2,785 have recovered. The Lexington Herald-Leader reports that this is the highest number of people hospitalized since April 16.
  • Beshear said two more Kentucky children have been diagnosed with pediatric multi-symptom inflammatory syndrome, which is associated with covid-19: a five-year old who has been allowed to return home after being hospitalized, and an 11-year-old who is in the hospital. Of last week's cases, he said a 10-year-old remains in intensive care and a 16-year-old is recovering at home.
  • In long-term care facilities, 22 more residents and 19 more employees have tested positive for the virus, for respective totals of 1,004 and 423. Beshear reported two new deaths, for a total of 198 resident deaths and two staff deaths. Click here for the daily update. 
  • Stack said the state continues to ramp up testing in long-term-care facilities, and this week would be testing at 23, with more than 3,000 tests expected to be completed in the next two days.  
  • Signature HealthCare at Fountain Circle in Winchester, which has "a history of infection control deficiencies, including inadequate hand washing, reported on Monday that at least 13 residents and five staff have been infected," John Cheves reports for the Lexington Herald-Leader. The firm said the numbers reflect the fact that it is testing everyone in the facility. Asked if employees had unwittingly brought the virus into the facility, a spokeswoman said patients and staff are screened daily, but acknowledged that some infected people are asymptomatic. She also said some patients could have had exposures from medical appointments outside the facility. 
  • The state's "Healthy at work" website now has guidance for barbershops, cosmetology, hair salons, tanning salons, and tattoo parlors. The businesses will be allowed to open May 25.

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