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Wednesday, May 20, 2020

This weekend, governor says, focus on three things to stay safe: your hands, your face and your space; he also urges more testing


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

As the holiday weekend approaches and he allows gatherings of up to 10 people, Gov. Andy Beshear is urging Kentuckians to focus on three areas to minimize risk of coronavirus infection: their hands, their face and their space.

Beshear encouraged Kentuckians to keep their hands washed; to not touch people who are not in their immediate family; to wear a mask in close quarters; to avoid touching your face; to maintain six feet of separation from each other; and to entertain outside if at all possible.

He summarized it this way at his daily briefing: "Hands clean, and to yourself. Face covered if you’re close, and don’t touch it. And, finally, space. . . . We’re going to be really excited to see folks we haven’t in a while, but stay six feet apart; do it outside if you can; it’s going to make it very safe, comparatively.”

The governor also stressed the importance of wearing masks as the state reopens its economy, and encouraged Kentuckians to share social-media posts about why they wear masks and to talk to others about it.

"I wear a mask to protect my family, to make sure I am not bringing home this virus; because I want our economy to restart and thrive," he said. "And I wear this mask because of my faith. In my faith, Jesus was asked about the two most important commandments, and he talked about loving God with all your heart, and he also talked about loving your neighbor as yourself."

Then he shifted from religion to science to politics, mentioning the last topic more explicitly than he usually does.

He said "Every scientist out there says that this helps us protect our neighbor," and "This is not a battle between political parties or ideologies. It is plain, basic public-health guidance . . . it is the same guidance on the federal and on the state level. And it is just smart, right? There is a national health pandemic, there is a virus out there that spreads based on droplets coming from the mouth, and it spreads from person to person. So this is covering your mouth so you don't infect somebody else."

Beshear also emphasized testing, saying it is absolutely critical to make sure Kentucky opens safely. It now has at least 155 testing locations, but the challenge is to get people to take advantage of them.

Signups are available for new Kroger-sponsored drive-thru testing sites in Henderson, Bowling Green, Louisville and Lexington next week. “Let’s make sure we fill every spot. Let’s not have any no-shows,” Beshear said. “Let’s make sure that we get as much testing as possible. We have the capacity, now we’ve got to have the will.”

He noted that this week's Kroger sites in Richmond and Louisville have gone well, but that Ohio County still has almost 300 spots available for tomorrow and Graves County has more than 350. Both counties have case numbers higher than the state average.

"This will be the last day that they are in either of those places," he said. "This is your chance, folks, it doesn't cost you anything. It lets you know if you have this virus, ensures that you are not infecting other people; this is one of our duties as citizens in Kentucky."

Beshear regularly says Kentucky has the capacity to test 2 percent of the population for coronavirus each month, as federal guidelines recommend, and the new challenge is a shortage of Kentuckians willing to get tested -- a problem in many states. The Washington Post explores some of the reasons, including a mistaken mindset among some that they don't need to get tested, even if they have mild symptoms, because that wouldn't change their course of treatment in any meaningful way. Also, there is confusion about who qualifies (no longer an issue in Kentucky), and "a lingering sense of scarcity, a lack of access in rural and under-served communities, concerns about cost and skepticism about testing operations," the Post reports. It notes Kentucky's success at securing testing materials from laboratories in the state when it, like other states, was facing severe shortages.

Beshear announced 166 new cases of the coronavirus, bringing the state's adjusted total to 8,167. Click here for the daily summary.

KHN chart shows two-week trendline is slightly down. Click on it to enlarge.
The daily update shifted the state's two-week trend of new cases from slightly upward to slightly downward. One of the federal guidelines for reopening state economies say it should be preceded by a two-week downward trajectory in new cases. Wednesday was the day all retail establishments in Kentucky could reopen.

In other covid-19 news Wednesday:
  • The counties with the most new cases are Warren (Bowling Green), 35; Jefferson, 31; Clark, 14; Fayette, 10; and Kenton, 10.
  • Beshear said if the two Bowling Green hospitals fill up with covid-19 patients, the overflow will go to UK HealthCare in Lexington.
  • Beshear announced 10 more deaths, raising the state's total to 376. He said six were in long-term-care facilities, about average.
  • The deaths were of a 73-year-old woman from Breckinridge County, a 90-year-old woman from Oldham County, a 70-year-old man from Boone County, a 79-year-old woman from Graves County, and four women and two men from Jefferson County. The women were 46, 70, 76, and 88; the men were 71 and 77.
  • In long-term-care, six more residents and six more employees tested positive for the virus, for respective totals of 1,022 and 461. There have been a total of 207 deaths in these facilities. Click here for the daily summary.
  • Health Commissioner Steven Stack said it will take several months to test all residents and staff in the 280 long-term care facilities, calling it a "big lift." The governor's daily news release said that so far more than 4,300 tests have been conducted, with plans to conduct another 2,100 over the next two days.
  • Stack also announced that the state would be providing personal protective equipment to the long-term-care facilities, since a federal shipment has been delayed until June.
  • Beshear said 474 covid-19 patients are in the hospital, 98 of them in intensive care units. The ICU number increased for weeks, reaching 269 on Tuesday, but Beshear said the state discovered that some hospitals hadn't been reporting when patients left ICUs.
  • Beshear said the state had checked on the 109 Kentucky minors who have tested positive for the coronavirus, to make sure none were developing pediatric multi-symptom inflammatory syndrome, a serious syndrome associated with covid-19. He said all were doing OK. Four Kentucky children have been diagnosed with PMIS.
  • The governor said it's too early to say what kinds of fall sports will be allowed, but the current trend looks to be games without fans. The state has not issued guidance for which youth sports will be allowed to resume June 15, but he did suggest it would likely be low-contact sports like baseball, tennis and swimming.
  • Beshear announced that $300 million from the Coronavirus Aid, Relief and Economic Security (CARES) Act will go to city and county governments to cover related expenses. An application will be available at 8 a.m. Thursday on the Department for Local Government website. Click here for eligible expenses and guidelines.
  • Experts encourage people who wear eyeglasses to disinfect them often because the coronavirus can stick to glass for nine days, the Lexington Herald-Leader reports, offering tips on cleaning.
  • Asked his view of hydroxychloroquine, which President Trump has said he is taking preventively for the virus despite warnings from the Food and Drug Administration that it can cause heart problems, Beshear said, "I believe that people need to listen to their medical provider, that none of us out there know how to treat covid-19, but our health-care professionals do. This is a drug that to date has not been proven an effective treatment. In fact, it has been proven that it can be harmful. So . . . don't push your health-care provider to prescribe to you something that they tell you can harm you."
  • The Associated Press reports that before covid-19 killed thousands of nursing-home residents across the nation, about four in 10 of the homes inspected were cited for infection-control problems, according to a Government Accountability Office report. In 2013-17, most of the violations were classified as not severe, so enforcement actions were only carried out for 1 percent of them, the AP reports. The investigators also found a recurring pattern of problems, showing that over that five-year period 82% of the homes inspected had at least one deficiency related to infection control and prevention, and about half had an infection-related deficiency in consecutive years.
  • Beshear has issued an emergency regulation for the Kentucky Health Access Nurturing Development Services, or HANDS program, which primarily serves first-time high-risk mothers in their homes. It allows admission of new families via telehealth, use of the online curriculum with currently enrolled families, and support of staff at a previously contracted rate. 
  • A study by researchers from the University of Kentucky, Georgia State University and the University of Louisville looked at the effect that certain social distancing practices had on the number of coronavirus cases between March 1 and April 27. It found that bar and restaurant closures and shelter-in-place orders slowed cases in a "statistically significant" way, while bans on large gatherings and closing schools did not have the same impact. Aaron Yelowitz, an economics professor at UK and co-author of the research, told the Post that he didn't infer from the data that schools should have stayed open, thinking that parents just traded one type of social setting for another. Likewise, he thinks people also traded social interactions that they would have had at mass gatherings for other social interactions. The study shows that cases would have been 10 times higher without stay-in-place orders and 35 times higher without any restrictions; those findings were previously reported.
  • UK Now reports on what you need to know about pediatric multi-system inflammatory syndrome, which is associated with covid-19. As of May 18, four Kentucky children had been diagnosed with it.
  • The Hill offers "A definitive guide to mask fashion on Capitol Hill," where most senators and House members are wearing them. It says Senate Majority Leader Mitch McConnell "looks pretty comfortable" in a World Series champions Washington Nationals mask, and has also worn disposable masks.
McConnell in his Nationals mask (Photo by Tom Williams, CQ Roll Call)
Paul (Win McNamee, pool/AP)
The story ends with Sen. Rand Paul, whose face covering is "a scruffy beard he grew in quarantine at home after testing positive for the coronavirus," and he says he has immunity and can't spread the virus. However, "Health experts caution that little is definitively known about the novel coronavirus and immunity," The Hill notes. "He’s not breaking any rules. While many employees at the Capitol must now wear masks in the course of their jobs, it’s still a suggestion, not a requirement, for members of Congress. By going mask-free, Paul can skip all the hard and uncomfortable parts. He doesn’t have to worry about elastic digging into his ears or fabric muffling his voice. He doesn’t have to worry about logistical headaches, like removing it for speeches or touching it too much. Meanwhile, his colleagues are doing all that and more, with mixed results." The Hill says "far the largest mask-wearing category, in Congress and around the country" is people who say “I’m still figuring this out.”

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