Beshear defends actions to control virus as trendline keeps going up; nursing homes will likely be last to lift covid-19 restrictions

Today's report increased the upward tilt of the two-week trendline. (Kentucky Health News chart)

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

Amid further signs that the coronavirus is resurging in Kentucky, Gov. Andy Beshear offered his most comprehensive defense of his actions to control it.

"We didn't take these steps because anybody loves power or is trying to do anything; we took them to save lives," the Democratic governor said, repeatedly saying that all his moves were in step with White House guidelines.

After two weeks of a downward trajectory in new cases, a key federal metric for reopening state economies, four of the last six days have shown an increase, with today's number hitting 265. That made for a six-day average of 216, well above the previous six days' average of 128.

"I don’t think this 265 is a cause for alarm, though it is at least a reminder … that this virus is still out there and spreading," Beshear said. "We do have to watch this pretty carefully."

Health Commissioner Steven Stack used a different metric, the percentage of tests that find infection. That number has been on a slow decline for two weeks, to about 4 percent. The goal is 3 %.

Stack didn't give a number for Wednesday, but said the positive results at Kroger-sponsored testing sites, which are likely a "decent snapshot" of the overall rate in a community, are generally about 1 %, ranging from near zero to over 2%.

He said the positive rate at health departments and hospitals in the last week has ranged from 1.1% to 4.4%, and that has been "relatively consistent over the last two to three weeks." The rates have been higher at long-term-care facilities, where the state is testing all residents and employees.

"So right now the data does not say that we are in an uptick," Stack said. "At worst it would be a plateau of some sort; it may still be a downward slope."

rt.live estimate of transmission rate, with low point noted

He said the CovidActNow website estimates the rate of transmission of the virus in Kentucky to be 0.96. A rate of less than 1 means the virus should eventually stop spreading because the average number of people infected by an infected person is less than 1. However, the rate estimated by the rt.live website is 0.99, and has been on an uptick since May 7, when it was 0.95.

The CovidActNow site estimates rates for counties; Kentucky's high counties include Christian, 1.36; Shelby, 1.32; Allen, 1.24; and Logan, 1.20.

Stack, who has expressed concern about a resurgence of the virus because not enough Kentuckians are taking it seriously, cautioned that "there is significant time delay" between actions that may increase the spread of the virus and a significant increase in cases, because of its incubation period.

"So if we are going to see a surge after a major event, it is going to be two or three weeks later that maybe we start to see a signal that there is a surge, and it's probably going to be a month and a half to two months later that we really hit a bad place," he said. "So we'll keep watching carefully."

Beshear's pitch: In his presentation of his actions to combat the virus, Beshear noted that the state's mortality rate is much lower than that of the nation as a whole and the world. Kentucky's rate is 4.3%, compared to the U.S. rate of 5.7% and the world rate of 6.1%.

"We are not just beating the national and the world average, but we're doing it with a population in Kentucky that is relatively sick, that has heart and lung and kidney disease more so than many other places," he said. "Yet still, we are taking care of each other in very important ways." He estimated that the economic restrictions he imposed saved more than 10,000 lives, based on modeling that forecast tens of thousands of deaths.

Beshear said the actions he took were similar to those of other governors, and he highlighted the actions of Republican governors in Indiana, Ohio, Maryland and Massachusetts. He said actions were taken in "red states, blue states; it didn't matter." What he didn't say is that Republican governors have generally been quicker to relax restrictions than their Democratic counterparts.

Beshear reported an adjusted total of 10,410 positive cases of the virus in the state, with at least 3,283 of them having recovered. He said 488 people are hospitalized with covid-19, including 68 in intensive care, which is the lowest number for this measure the state has seen in a while.

Infant death: He said eight more people have died from the virus, including a nine-month-old girl from Hopkins County, a case he mentioned at the start of his briefing. "This is a reminder of how deadly this virus can be," he said.

Stack said that if not for the pandemic, the death would have been attributed to Sudden Infant Death Syndrome, but he said it would be counted as a covid-19 death because the infant tested positive for the virus. He said the virus may or may not have contributed to the child's death, and the truth may never be known.

He reminded parents that children "overwhelmingly do just fine" with the virus and the vast majority of them have no symptoms. Some have developed a multi-system inflammatory syndrome that is linked to the virus; Kentucky has reported four cases, and all the children have recovered. "I would encourage parents to not worry overly, but that you should be concerned," he said.

More warnings: Stack also cautioned that while younger people also tend to recover from the virus or don't have symptoms, this is not always the case, pointing to a 48-year-old man from Shelby County with no pre-existing conditions who was among the list of those who have died from the virus.

Stack cautioned that as the weather warms and normal activities resume, it becomes even more important to do everything we can to slow the spread of the disease, because there is no vaccine and no treatment, and no evidence that warm weather will slow the virus.

“I have tried all along not to be sensational about these things, but to be factual, to be even-handed,” he said. "This is a very serious disease. It is not influenza. . . . It can rapidly spread, it can rapidly overcome the health-care system."

Today's other deaths were two women, ages 91 and 99, from Edmonson County; an 84-year-old woman from Gallatin County; and three women, 91, 92 and 93, from Jefferson County.

In long-term care facilities, Beshear reported that 15 more residents and nine more staff have tested positive for the virus, bringing those totals up to 1,366 and 633, respectively. He said 10 more deaths in these facilities were attributed to covid-19, bringing that number up to 245 deaths.

Beshear said testing for the virus has been completed in about half of the state's nursing homes, and to his and others' surprise, some of them had no positive cases. Nursing home have accounted for about 58 percent of the state's covid-19 deaths.

Beshear warned against "testing fatigue," and urged Kentuckians to sign up for free, drive-thru testing sites for next week at Kroger-sponsored sites in Louisville, Lexington, Bowling Green and Elizabethtown. Spots are still available this week and sign-ups have opened for next week.

Beshear once again asked Kentuckians who are protesting against police violence to make sure they are wearing masks, social distance where possible, to protect those in their lives who may be more vulnerable to the disease, and to consider getting tested in the coming days.

In other covid-19 news Wednesday:

• The counties with the highest number of new cases Wednesday were Jefferson, 55; Fayette, 37; Boone, 30; Kenton, 27; and Warren, 24. Beshear said only one county has no reported cases. That is Robertson, which has about 2,300 people. 
• Nursing homes and medical centers will be among the last places to lift covid-19 rules, Bailey Loosemore reports for the Louisville Courier Journal. "Normal considerations where people were coming in like they used to, I think, is way down the road, maybe even until we get a vaccine or effective therapeutics," Tim Veno, president of LeadingAge Kentucky, a group that represents nursing homes and assisted-living centers, told Loosemore. "We hear from residents every day who want to see their loved ones, and it's very painful, with regard to that. But we also believe we have a paramount duty to protect their health and welfare."
• Emergency department visits declined 42% during the early part of the pandemic, with the steepest decreases in persons 14 or younger, females and the Northeast, all while the proportion of infectious disease-related visits was four times higher, according a study published in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention. The CDC advises increased health messaging about the importance of seeking immediate care for serious conditions, and to encourage virtual visits for those who have conditions that are not emergencies.
• Among other coronavirus information, The Guardian offers a coronavirus "deaths per capita" and "cases per capita" map, pointing out that the actual death toll is thought to be far higher than the tally compiled from government figures. It says that as of June 3, Kentucky has 10 deaths per 100,000 citizens and 228 cases per 100,000.  
• Becker's Hospital Review has compiled a non-exhaustive list of data and stories about why racial disparities and covid-19 matters in healthcare. 
• The Lexington Herald-Leader explores safe sexual practices during the pandemic.