Monday, November 30, 2020

Ky. expects first coronavirus vaccines in mid-December, for long-term-care residents and staff, and some frontline health workers

State Department for Public Health chart, relabeled by Kentucky Health News

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced Monday that Kentucky expects to get its first shipment of coronavirus vaccines by mid-December and is making plans for how to distribute it. 

"The light at the end of the tunnel is brighter than its ever been but we still have along way to go," Beshear said at his daily briefing – where he announced record numbers of covid-19 patients in intensive care and on ventilators, and another big jump in the percentage of Kentuckians testing positive for the virus.

Beshear said that as early as mid-December, the state expects to get 38,025 doses of the Pfizer Inc. vaccine, about a third of what it had expected, Health Commissioner Steven Stack said. Beshear said the vaccine supply had been overestimated, and states' allocations are based on population. 

He said 26,000 doses will go to residents and staff of long-term care facilities and 12,000 will be given to "front-line covid health-care workers" throughout the state. Beshear said the list of health-care facilities to get the vaccine is being finalized and will be submitted to federal officials by Friday. 

Beshear and Stack explained that it's important to target long-term care first because its residents and staff have accounted for 66 percent of the state's covid-19 deaths, and limiting hospitalization of residents will also decrease the burden on hospitals, since they require more care on average. 

"Our goal is to quickly vaccinate the most vulnerable parts of our population," Beshear said. 

The initial round won't be enough to cover all the state's long-term care facility residents or staff, or all health-care workers. The Louisville Courier Journal reports that Kentucky nursing homes have 27,600 residents and 35,000 staff, and hospitals employ 80,000. 

Stack, a physician, said the smaller-than-expected deliveries will require "difficult decisions." He said he has asked hospitals to place their employees in tiers based on which ones are most at risk of infection. 

Essential workers, educators and adults with very significant conditions would be next in line for the vaccine. Beshear said educators had been "elevated" in priority, and said earlier, "There’s gonna be a big priority on teachers because once we have teachers vaccinated, school is gonna be really safe."

To fight increasing spread of the virus, Beshear has banned in-person schooling in middle and high schools until Jan. 4 and in elementaries until at least Dec. 7.

In late December, the state expects to get 76,700 doses of the Moderna vaccine, and will distribute it in the same way as the Pfizer one, said Beshear.

Moderna applied Monday for an emergency-use authorization from the U.S. Food and Drug Administration. The company said it anticipates the FDA advisory committee will discuss its vaccine Dec. 17, a week after it is set to discuss the Pfizer vaccine, with authorizations expected to come a few days after each meeting. Karen Weintraub of USA Today reports that the Moderna trial was conducted "to the gold standard" and explains why it is important to have more than two coronavirus vaccines. 

Beshear said the state is participating in a test-run of the vaccine with the Centers for Disease Control and Prevention to ensure that the state's shipping and distribution plan is in good order. 

Kentucky's final plan depends on the actions of the CDC's Advisory Committee on Immunization Practices, which is scheduled to vote Tuesday on who should get the first doses. 

Other vaccines may be approved, but none of them will be available to most Kentuckians until next summer, said Stack. "We're going to have to make sure we get it to the people who need it the most, who will benefit the most and then work forward from there," he said. 

Stack warned, "We're not out of the woods yet," and said there is a real risk that between the "cold weather, holiday gatherings, increased travel, a fatigued public who has not fully complied with the mask mandates and with the social distancing," cases and deaths will continue to soar. 

Again, Stack called on Kentuckians to wear masks, socially distance and not socialize with each other "while the disease is so high," saying this is necessary to avoid overwhelming the state's hospitals.

"There are better days ahead, and as 2021 unfolds we have every reason to be very optimistic we'll end up in a better place," he said.

Beshear defended what he called his "aggressive actions" against the virus with a graph of daily covid-19 deaths per 100,000 people in Indiana, Tennessee and Kentucky: "The distance between those lines . . . is how many more lives we are saving."

"I know it comes with sacrifice," he acknowledged, but said, "Our sacrifice, the difficulties we go through, is truly making a difference."

Beshear announced 2,124 new coronavirus cases on Monday, the second highest Monday for cases yet, with last Monday being the highest, at 2,135. Monday figures are usually low due to less testing and lab work on weekends.

The state's seven-day rolling average of daily new cases, the most widely used measure of the pandemic's trend, is 2,727, one less than it was Sunday. 

Beshear cautioned that cases could be under-reported because of the long holiday weekend, and "We may have a very large week this week or next."

The governor encouraged Kentuckians who gathered in large groups over Thanksgiving or who traveled over the holiday to act like they have the virus and get tested and to  "Please, please wear a mask." 

He said that's the advice of Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, who told The New York Times that if you traveled or met with people outside of your household for Thanksgiving, you should “assume that you were exposed [to the virus] and you became infected, and you really need to get tested in the next week.” She also urged them to avoid anyone in their family over 65 or with an underlying illness. 

The Lexington Herald-Leader provides guidance on when you should get tested in the wake of Thanksgiving. Experts told the paper that if you have symptoms, get tested right away, but those with no symptoms should wait at least five days because the average amount of time it takes to show symptoms after infection is five days – and many get the virus but no symptoms.

Daily numbers: The share of Kentuckians testing positive for the virus in the past seven days is 9.42%, the highest since testing became widely available in May.  

State Department for Public Health graph, adapted by
Kentucky Health News; for a larger version, click on it.
Covid-19 patients' use of intensive-care units and ventilators also hit new highs, at 421 and 229, respectively. Kentucky hospitals reported 1,741 covid-19 patients, just six short of the record set on Thanksgiving.

The state has begun reporting the total number of hospitalized patients in Kentucky, along with the total in intensive care and on ventilators. Its report shows 21% of hospital patients have covid-19, nearly 30% of patients in ICUs have the disease and nearly 38% of those on ventilators do. 

There were 12 more covid-19 deaths, bringing the state's toll to 1,908: two Caldwell County women, 74 and 86; a Daviess County woman, 50; a Fayette County man, 90; a Grayson County man, 68; a Jefferson County woman, 56; a Marshall County man, 77; a McLean County woman, 87; a Webster County man, 84; and a woman, 75, and two men, 67 and 75, from McCracken County.

The Herald-Leader reports that November is the highest month of coronavirus cases and covid-19 deaths since the pandemic began, with at least 71,822 cases reported in November and 433 deaths. 

In other coronavirus news Monday: 
  • Counties with 10 or more new cases were Jefferson, 354; Fayette, 219; Kenton, 97; Daviess, 90; Warren, 82; Boone, 73; Oldham, 52; Pulaski, 46; McCracken, 45; Campbell, 43; Jessamine, 40; Boyle and Mason, 37; Bullitt, 36; Grant, 33; Henderson, 31; Scott and Shelby, 30; Boyd, Greenup and Marshall, 28; Barren, Caldwell and Christian, 27; Woodford, 24; Madison, 21; Lee, Pike and Taylor, 18; Graves, 17; Calloway and Mercer, 16 each; Floyd and Laurel, 15; Rowan and Wayne, 14; Henry and Simpson, 13; Hart, Magoffin and Montgomery, 12; Franklin, Hardin, Logan, Muhlenberg and Trigg, 11; Harlan and Ohio, 10.
  • In long-term care, there are 2,259 active cases among residents and 1,252 among staff, with 445 resident cases and 292 staff cases reported since Friday. 
  • Two more veterans at the state's Thomson-Hood Veterans Center in Wilmore died of covid-19, bringing its toll to 30. He said there are only two active cases left there, but the Western Kentucky Veterans Center in Hanson now has its first active case. 
  • The state updated its travel advisory, which incudes 16 states that have a positive-test rate of 15% or higher. From highest to lowest, they are: Idaho, South Dakota, Iowa, Kansas, Wyoming, Pennsylvania, Alabama, Oregon, Oklahoma, Arizona, Utah, Missouri, Mississippi, Montana, Nevada and Ohio. Kentuckians who travel to these states are asked to isolate for two weeks upon return. The state also recommends a 14-day self-quarantine for anyone returning from any international travel.
  • Covid-19 patients are filling up rural hospital beds and making the staff sick, which is resulting in changes in how hospitals are staffing, with a greater reliance on agency supplied nurses, which come with a hefty price tag, Corinne Boyer reports for Ohio Valley ReSource. “They’re having to pay anywhere from four to 500% more than what they would normally be paying for an agency nurse,” Nancy Galvangi, president of the Kentucky Hospital Association, told Boyer. “And that is because Kentucky is in competition with other states, other states that can pay a lot more.”
  • The owners of qualifying bars and restaurants in Kentucky that have been required to stop indoor service until at least Dec. 14 can apply for $10,000 grants from the Kentucky Food and Beverage Relief Fund. The $40 million allotted to the fund from federal relief money could help at least 4,000 establishments, Chris Otts reports for WDRB, adding that the money will not be distributed until Dec. 8, and will be awarded on a first-come, first-served basis through Dec. 18. Beshear's news release said more than 2,000 applications had already been submitted, requesting nearly $19 million in aid.

Sunday, November 29, 2020

Federal appeals panel says Beshear's ban on in-person schooling can apply to religious schools; positive-test rate jumps to 9.24%

Part of a slide published by Gov. Andy Beshear in response to federal appeals court's ruling
By Al Cross
Kentucky Health News

Gov. Andy Beshear's ban on in-person schooling will remain in effect at all Kentucky schools while federal judges consider whether it can apply to religious schools that follow social-distancing and hygiene rules.

Meanwhile, Beshear announced 2,803 new cases of the novel coronavirus, the most ever on a Sunday, and a record-high share of Kentuckians testing positive for the virus, 9.24 percent.

A three-judge panel of the U.S. Sixth Circuit Court of Appeals in Cincinnati stayed an injunction issued Wednesday by District Judge Greg Van Tatenhove, saying the religious schools were unlikely to win their case.

"As the governor explains, elementary and secondary schools pose unique problems for public health officials responding to the covic-19 pandemic," the court said in a seven-page opinion. "Compliance with masking and social distancing requirements is difficult to maintain, and students receiving in-person instruction must, in any event, remove their facial coverings to eat. … We are not in a position to second-guess the governor’s determination regarding the health and safety of the commonwealth at this point in time."

On Nov. 18, Beshear banned in-person schooling effective Monday, Nov. 23, and said middle and high schools mist remain in remote or virtual instruction until at least Jan. 4. He allowed elementary schools to resume in-person instruction Dec. 7 if they follow state guidance and are not in the state's red zone, for the highest rates of infection. The order was part of several new restrictions to thwart the pandemic.

Two days later, Danville Christian Academy filed suit against the Democratic governor and his order, and Republican Attorney General Daniel Cameron joined as a plaintiff. Several other schools joined in. Van Tatenhove ruled that the state hadn't used the least restrictive means, a requirement when the free exercise of religion is at issue. 

Cameron said on Twitter, "We’re disappointed with the Sixth Circuit’s ruling allowing the Governor to close religious schools, but we’re already hard at work to take this matter to the United States Supreme Court."

The three judges on the appeals-court panel were John M. Rogers and Helene M. White of Michigan, who were appointed by George W. Bush, and Karen Nelson Moore of Ohio, who was appointed by Bill Clinton.

They wrote, "Primarily because plaintiffs are unlikely to succeed on the merits of their free-exercise claim, the preliminary injunction should not have been entered. This is because of the likelihood that our court will rule that the order in question is neutral and of general applicability," a standard applied to cases involving religion, along with a standard of "strict scrutiny." The panel wrote, citing a key word from Chief Justice John Roberts, "Any burden on plaintiffs’ religious practices is 'incidental' and therefore not subject to strict scrutiny."

The judges also noted Beshear's arguments that Kentucky is "particularly vulnerable" to the pandemic because “leads the nation in children living with relatives other than their parents – including grandparents and great-grandparents, who are especially vulnerable to the disease,” and “Kentuckians also have high rates of comorbidities that can lead to severe cases of covid-19, including heart and lung conditions.”

Beshear said on Facebook, "Today, the Sixth Circuit recognized that we must all do our part over the next several weeks to slow this virus. Don’t try to find an exception; do your part to save lives."

In his daily press release on the pandemic, Beshear announced the positive-test rate and the new-case total without noting that the latter was the largest reported on a Sunday. The seven-day rolling average of new cases rose to 2,727 after declining for the two days after Thanksgiving, the day that the state reported the largest number of new cases in a day, 3,870.

The positive-test rate was .05 percentage points above the previous high of 9.19%, recorded one week earlier. It had declined in the days between, averaging 8.92%.

Kentucky hospitalizations for covid-19 declined slightly, to 1,709, with 407 of them in intensive care and 218 of those on ventilators, both near records.

Beshear announced 11 more covid-19 deaths, raising the state's toll to 1,896. They were two Caldwell County men, ages 70 and 80; a Fulton County woman, 87; a Hopkins County woman, 60; a 61-year-old woman and a 90-year-old man from McCracken County; a McLean County man, 88; and four Warren County women, 61, 83, 93 and 93.

Beshear's press release said he thanked Kentuckians "who sacrificed for each other and rose to the challenge of battling covic-19 together during the Thanksgiving holiday" and quoted him as saying:

“The thing about this crisis is, all of us might step up in a different way, but each of our contributions matter. To every family who changed their traditions this year to keep others safe – thank you. To our only line health care workers and first responders who have put your own safety at risk during this pandemic – thank you. To our tireless neighbors battling food insecurity and making sure Kentuckians can put dinner on the table, on Thanksgiving and every day – thank you. And to the retail, grocery, logistics and food and beverage professionals who did the right thing to keep yourselves and customers safe this week – thank you. . . . You are all the best of Team Kentucky.”

Health Commissioner Steven Stack said in the release, “The massive increase of covid-19 in the commonwealth during November has shattered prior records. As we finish the Thanksgiving weekend, we need to show our kindness and caring for each other now more than ever. The spread of the virus is at an all-time high, but science and experience have shown that we are not powerless to shape our future. If we all wear masks, stay six feet away from those outside our home, limit travel and stay home if we are sick, we can put ourselves on a better path, stay safe and suppress covid-19.”

In other coronavirus news Sunday:
  • Counties with more than 10 new cases were: Jefferson, 471; Fayette, 314; Daviess, 132; Hardin, 103; Boone, 93; McCracken, 74; Kenton, 70; Campbell, 62; Henderson, 60; Elliott, 47; Bullitt, 42; Perry, 39; Boyd, 38; Jessamine, 37; Warren, 37; Christian, 36; Simpson, 36; Greenup, 34; Graves, 33; Rowan, 32; Whitley, 31; Boyle, 29; Floyd, 29; Madison, 28; Pike, 28; Nelson, 25; Marshall, 24; Lincoln, 23; Scott, 22; Woodford, 22; Calloway, Laurel and Oldham, 21; Ohio, 20; Leslie, 19; Breathitt, Caldwell and Grant, 18; Harlan, Harrison and Johnson, 17; Muhlenberg, 16; Marion and Washington, 15; Bath, Clay, Franklin and Mercer, 14; Knox, Meade and Taylor, 13; Garrard, Magoffin, Martin and McLean, 12; and Hopkins, Knott, Montgomery, Morgan and Pulaski, 11.
  • Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on NBC's "Meet the Press" that when he warns about "a surge superimposed on that surge that we're already in . . . I don't want to frighten people, except to say it is not too late at all for us to do something about this." But he acknowledged, "I'd have to say honestly unless something changes dramatically, which I don't see that happening, because the curves, when you look at the dynamics of an outbreak, that you see usually a three, four, five-week period of time before curves start really coming down. So, I think we're going to be faced with another situation. We're going to have to make decisions as a nation, state, city, and family, that we're in a very difficult time and we're going to have to do the kinds of restrictions of things we would like to have done, particularly in this holiday season, because we're entering into what's really a precarious situation because we're in the middle of a steep slope."
  • Asked what he would say to President-elect Joe Biden if he asked on Inauguration Day, "What's the first thing you want me to do, Dr. Fauci?" the doctor replied "make sure that the vaccines get distributed in an efficient and equitable way" and "the broader testing, namely one that's less sensitive but that's testing people who are not symptomatic, namely a much broader blanket over the country in a way that's easy, that's cheap, that is even a home test. I'm going to be pushing for that because I think when you really allow us to know in a very quick way what the penetrance of infection is in any given way, I think that's going to be very important because the virus is being spread throughout the country by people without symptoms. So, we've got to go beyond the symptomatic people and get a better understanding of the asymptomatic transmission."

Saturday, November 28, 2020

Kentucky doubled its number of covid-19 patients on ventilators in the past month; total cases in intensive care resume uptick

Graph by Kentucky Health News
By Al Cross
Kentucky Health News

More covid-19 patients than ever are on ventilators in Kentucky hospitals, the number having doubled in the last month, from 110 to 220.

But that was the only new record in the state's daily report Saturday, as the Thanksgiving holiday weekend continued, keeping coronavirus testing and laboratory work at lower-than-usual levels.

The state reported 2,437 new cases of the virus, and its seven-day rolling average of daily new cases declined for the second day, to 2,640.

Covid-19 cases in Kentucky hospitals rose slightly, to 1,722, just 25 short of the record set two days earlier. Intensive-care units held 408, just one short of the record set Wednesday. Ventilator cases are also ICU cases.

Hospitalizations for covid-19 are expected to keep rising in Kentucky and the nation in the next four weeks, most statistical models are predicting. Nationally, hospitalizations hit another new high Saturday: 91,635.

The share of Kentuckians testing positive for the virus over the last seven days was 8.95 percent, 0.1 percentage point above Friday's figure and approximately the average of the last seven days. A week ago it was 9.19%.

Gov. Andy Beshear reported 14 more covid-19 deaths, bringing the state's toll to 1,885: a 58-year-old Barren County woman; an 86-year-old Hardin County man; a 70-year-old Hart County woman; a 74-year-old Logan County man; a 73-year-old Marshall County man; a 73-year-old McCracken County man; a 66-year-old Metcalfe County woman; a 75-year-old Monroe County man; a 79-year-old Scott County man; and five women, 57, 71, 78, 84 and 86, from Warren County.

A press release from Beshear's office "urged Kentuckians to strengthen their resolve in the fight against covid-19, with the knowledge that help is on the way," alluding to vaccines that will roll out in the next few months.

“I know we’re tired,” Beshear said in the release. “I know many of us are disappointed we couldn’t celebrate Thanksgiving or enjoy Black Friday shopping the way we usually do. But I promise you: we have come so far and we are almost there. Hang on, Team Kentucky.”

Beshear "reminded Kentuckians to shop safely, purchasing gifts online when possible and avoiding crowded stores," the release said. "If families do need to shop in person, he encouraged them to keep their time inside stores to a minimum and use curbside pickup whenever possible."

“Though we have to do it differently, please support our small businesses this weekend and holiday season,” Beshear said. “Shopping small supports some of our local businesses that have suffered the most economically as we’ve battled covid-19. Let’s show them we have their backs.”

Beshear and Health Commissioner Steven Stack again reminded Kentuckians that receiving one negative test for the virus days before a gathering can’t guarantee that you won’t infect others at that event.

“Persistence is key to limiting the spread and preventing further COVID-19 related deaths,” Stack said. “Don’t give in to mask fatigue. Wear your mask correctly. Vaccines are around the corner and may well be the weapon we need to defeat this illness; until then, every Kentuckian has to rise to this great challenge of our times to care for and protect each other by wearing masks, practicing social distancing, and staying home if you are sick.”

In other coronavirus news Saturday:
  • Counties with 10 or more new cases were: Jefferson, 474; Fayette, 224; Warren, 88; Boone, 86; Madison, 82; Kenton, 78; McCracken, 75; Boyd, 57; Christian, 51; Jessamine, 48; Laurel, 47; Campbell, 43; Pulaski, 39; Greenup, 36; Hardin, 36; Oldham, 33; Barren, 32; Lewis, 32; Floyd, 28; Whitley, 24; Nelson, 23; Garrard, 22; Bullitt, 21; Lincoln, 21; Boyle, Franklin and Lee, 20; Taylor, 19; Hart and Simpson, 18; Graves, Pike and Scott, 17; Calloway, Clinton, Hopkins and Spencer, 16; Carter, Johnson, Mason, Shelby and Woodford, 15; Estill, LaRue and Letcher, 14; Breathitt, Marshall and Menifee, 13; Anderson, Casey and Wayne, 12; Grant and Livingston, 11; and Daviess, 10.
  • The U.S. Sixth Circuit Court of Appeals received briefs opposing Beshear's appeal of a district judge's order that his ban on in-person schooling could not extend to religious schools that are obeying other state rules. Attorney General Daniel Cameron, who joined the case filed by Danville Christian Academy, said more than 20 religious schools filed briefs in support.
  • In the final minutes of Friday's basketball game between the University of Louisville and Seton Hall, two adults were ejected from the Yum Center over violations of its mask policy, the arena's manager told the Courier Journal.
  • "The number of coronavirus infections in the U.S. could be nearly eight times higher than current reported cases, according to a new model by the Centers for Disease Control and Prevention, reports Katie Camero of McClatchy Newspapers. Through September, 6.8 million infections were reported, "but when researchers adjusted for potential false-negative test results, incomplete reporting of cases and asymptomatic or mildly ill individuals who never got tested, they learned there may have actually been about 52.9 million infections." The researchers estimates that 84% of Americans have yet to catch the virus.

Covid-19 hospitalizations in Kentucky are predicted to keep increasing; much depends on how people handled Thanksgiving

Centers for Disease Control and Prevention graph, relabeled by Kentucky Health News, shows predictions of various forecasters for new covid-19 hospitalizations in Kentucky for the next four weeks, in ranges at a statistical confidence level of 95 percent. The numbers can be downloaded.
Kentucky is expected to be part of a predicted national surge in covid-19 hospitalizations after the Thanksgiving holidays. Twelve groups that do such forecasts submitted their predictions to the Centers for Disease Control and Prevention, which published them Nov. 25. Most of the forecasts are for an upward trend, and that was also the case in Kentucky.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told The Washington Post a few days earlier that if Americans “do the things that are increasing the risk—the travel, the congregate settings, not wearing masks—the chances are you will see a surge superimposed upon a surge.”

The forecasts published by the CDC are based on differing assumptions, based in large part on past and expected human behavior, but there's a big variable: how many contacts and exposures there are during the holidays.

"While it appears that many Americans . . . scaled back on their plans for Thanksgiving, heeding the CDC’s recommendation that celebrations should be limited to only household members (people who’ve lived under the same roof for at least the last 14 days), too many have not," writes Frank Diamond of Infection Control Today.

Even before the forecasts, Gov. Andy Beshear and other officials were warning that hospitals could start running short of staff and filling up. "The record for hospitalizations has been broken every day since Nov. 10," Diamond notes.

Sarah Kliff of The New York Times said on PBS's "Washington Week" Friday that there fears of surges across the country like the one that plagued New York City early in the pandemic, not just that hospitals will be overwhelmed but won't have enough staff: "There's only so many people in the U.S. who know how to operate a ventilator, how to treat this disease."

Some of the forecasting groups make assumptions about how levels of social distancing will change, but most assume that existing social distancing measures in each jurisdiction will continue through the projected four-week time period.

The University of Washington's Institute of Health Metrics and Evaluation estimates numbers of new hospitalizations based on numbers of forecasted deaths; Georgia Tech's College of Computing uses hospitalization data reported by some jurisdictions to forecast future hospitalizations; and the Karlen Working Group uses the rate of reported infections to estimate the number of new hospitalizations in a given jurisdiction, unless the rates of reported infections and hospitalizations differ. In that case, the rate of reported hospitalizations is used to forecast new hospitalizations.

Friday, November 27, 2020

Thanksgiving had most new coronavirus cases in a day (3,870), 2nd highest number of confirmed covid-19 deaths (32), state says

State Dept. for Public Health map, relabeled by Ky. Health News; for a larger version, click on it.

By Al Cross
Kentucky Health News

Thanksgiving saw Kentucky's highest number of new novel-coronavirus cases and the second highest number of newly confirmed deaths from covid-19.

Reporting a day late due to the Thursday holiday, Gov. Andy Beshear said 3,870 new cases of the virus were recorded on Thanksgiving. Presumably, the cases were found by tests done before the holiday; the test numbers reported by the state indicated no surge in testing that would produce a surge in cases.

The state said the share of Kentuckians testing positive for the virus was 8.94 percent on Thursday and 8.85% on Friday. That number has generally declined since a high of 9.19% on Sunday, Nov. 22.

The previous high number of new cases was 3,825, on Friday, Nov. 20. The number for Friday, Nov. 27, was 1,747, presumably reflecting a relatively low number of tests on Thanksgiving.

The seven-day rolling average of daily new cases jumped to a record 3,119 on Thursday and fell to 2,822 on Friday.

The state's daily reports showed 32 covid-19 deaths were confirmed on Thursday and four on Friday. The number on Thanksgiving was just one short of the record 33 set Nov. 17.

In a press release, Beshear asked Kentuckians to avoid busy shopping areas to prevent more growth in cases, and noted that many retailers are making Black Friday deals last longer, in order to limit crowds.

“These new case reports are truly alarming,” Beshear said. “Please be careful when you’re shopping and consider safer options, like purchasing gifts online for delivery or curbside pick-up. Wash your hands, stay six feet apart from other shoppers and wear a mask at all times. Now is the time we need everyone to buckle down, stay strong and stop this surge in cases.”

The number of covid-19 patients in Kentucky hospitals hit a new high of 1,747 on Thursday and dropped to 1,714 on Friday. The number in intensive-care units rose from 388 Thursday to 390 Friday. That was short of the record 409 set Wednesday, but the number of ICU patients on ventilators rose from 206 to 216, equaling the ventilator record set Wednesday.

The 36 covid-19 deaths reported Thursday and Friday raised Kentucky's death toll from the disease to 1,871. Friday's four fatalities were a 64-year-old woman and a 91-year-old man from Henderson County; and two women, 61 and 83, from Monroe County.

Thursday's victims were a 73-year-old Barren County man; a 66-year-old Bell County woman; an 84-year-old Boone County man; an 81-year-old woman and an 89-year-old man from Calloway County; an 86-year-old Christian County man; a 96-year-old woman and an 86-year-old man from Fayette County; a 78-year-old Floyd County woman; an 89-year-old woman and a 67-year-old man from Graves County; an 88-year-old Hardin County woman; an 82-year-old Henderson County woman; a 100-year-old Hickman County woman; a 69-year-old Hopkins County man; two women, 82 and 95, and an 88-year-old man from Jefferson County; a 63-year-old Johnson County man; a 92-year-old woman and a 65-year-old man from Lee County; a 91-year-old Livingston County man; an 88-year-old McCracken County woman; a 91-year-old Montgomery County woman; a 96-year-old woman and four men, 73, 81, 92 and 95, from Pike County; a 75-year-old Rockcastle County man; an 86-year-old Shelby County man; and an 84-year-old Warren County woman.

In other coronavirus news Friday:

  • Counties with more than 10 new cases Thursday were: Jefferson, 755; Fayette, 292; Kenton, 150; Boone, 134; Warren, 96; Bullitt, 88; McCracken, 87; Madison, 84; Hardin, 80; Graves, 78; Daviess, 72; Campbell, 71; Shelby, 67; Oldham, 64; Boyd, 58; Nelson, 57; Christian, 55; Calloway, 49; Floyd, 48; Ohio, 43; Rowan, 39; Henderson, 38; Hopkins and Marion, 37; Pike, 33; Taylor, 31; Boyle, 30; Jessamine and Spencer, 29; Laurel, 28; Franklin, Greenup and Knox, 27; Perry and Scott, 26; Grant, 25; Adair, 24; Marshall, Muhlenberg Washington and Whitley, 23; Gallatin, Harlan, Mercer and Pulaski, 22; Russell, 21; Barren, Clark and Hart, 20; Caldwell, Grayson, Henry, Simpson and Todd, 19; Garrard, Lincoln and Mason, 18; Allen, Carter and Wayne, 16; Butler, Johnson and Trigg, 15; Anderson, Estill1, Monroe and Woodford, 14; Bell, Bourbon, Lawrence, McCreary and Owsley, 13; Breathitt, Carroll, Knott, Leslie and Martin, 12; and Bath, Casey and Trimble, 11.
  • Counties with 10 or more new cases Friday were Jefferson, 493; Fayette, 210; Warren, 63; McCracken, 53; Kenton, 46; Boone, 44; Greenup, 43; Calloway, 42; Madison, 31; Butler, 24; Barren and Floyd, 23; Bell, Campbell and Graves, 20; Carter, Elliott, Mason, McCreary and Oldham, 18; Bullitt, Henderson and Jessamine, 16; Clark, Grayson, Hardin and Lee, 15; Daviess, Franklin, Martin, Pike and Pulaski, 14; Rowan, 13; and Bourbon, Morgan and Shelby, 10.
  • The state filed suit to close a Lexington coffee shop that defied Beshear's ban on indoor dining and benefited from publicity about it. The Lexington-Fayette County Health Department wants a judge to rule that police can enforce the order; local police have declined, saying it is a civil or regulatory matter, the Lexington Herald-Leader reports. A hearing is set for Monday.
  • The U.S. Sixth Circuit Court of Appeals set a 10 a.m. Saturday deadline for responses to Beshear's appeal of a district judge's ruling that his ban on in-person schooling could not apply to religious schools that obey social-distancing and hygiene rules, as Danville Christian Academy says it does, the Herald-Leader reports.
  • Beshear's appeal said the ruling “will cause imminent, irreparable harm to the people of Kentucky beginning Monday . . . by facilitating the spread of a deadly disease,” and said the schools would not be harmed by having to conduct 15 days of remote instruction.

    Read more here:
  • Other religious schools have filed another federal lawsuit against Beshear’s order limiting indoor gatherings to eight people from two different households, the Herald-Leader reports.

Thursday, November 26, 2020

Citing his near-death experience, Pope Francis asks you to be touched by others' pain, so we can all gain from the pandemic

By Pope Francis

In this past year of change, my mind and heart have overflowed with people. People I think of and pray for, and sometimes cry with, people with names and faces, people who died without saying goodbye to those they loved, families in difficulty, even going hungry, because there’s no work.

Sometimes, when you think globally, you can be paralyzed: There are so many places of apparently ceaseless conflict; there’s so much suffering and need. I find it helps to focus on concrete situations: You see faces looking for life and love in the reality of each person, of each people. You see hope written in the story of every nation, glorious because it’s a story of daily struggle, of lives broken in self-sacrifice. So rather than overwhelm you, it invites you to ponder and to respond with hope.

These are moments in life that can be ripe for change and conversion. Each of us has had our own “stoppage,” or if we haven’t yet, we will someday: illness, the failure of a marriage or a business, some great disappointment or betrayal. As in the Covid-19 lockdown, those moments generate a tension, a crisis that reveals what is in our hearts.

In every personal “Covid,” so to speak, in every “stoppage,” what is revealed is what needs to change: our lack of internal freedom, the idols we have been serving, the ideologies we have tried to live by, the relationships we have neglected.

Pope Francis
When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness. It changed the way I saw life. For months, I didn’t know who I was or whether I would live or die. The doctors had no idea whether I’d make it either. I remember hugging my mother and saying, “Just tell me if I’m going to die.” I was in the second year of training for the priesthood in the diocesan seminary of Buenos Aires.

I remember the date: Aug. 13, 1957. I got taken to a hospital by a prefect who realized mine was not the kind of flu you treat with aspirin. Straightaway they took a liter and a half of water out of my lungs, and I remained there fighting for my life. The following November they operated to take out the upper right lobe of one of the lungs. I have some sense of how people with Covid-19 feel as they struggle to breathe on a ventilator.

I remember especially two nurses from this time. One was the senior ward matron, a Dominican sister who had been a teacher in Athens before being sent to Buenos Aires. I learned later that following the first examination by the doctor, after he left she told the nurses to double the dose of medication he had prescribed — basically penicillin and streptomycin — because she knew from experience I was dying. Sister Cornelia Caraglio saved my life. Because of her regular contact with sick people, she understood better than the doctor what they needed, and she had the courage to act on her knowledge.

Another nurse, Micaela, did the same when I was in intense pain, secretly prescribing me extra doses of painkillers outside my due times. Cornelia and Micaela are in heaven now, but I’ll always owe them so much. They fought for me to the end, until my eventual recovery. They taught me what it is to use science but also to know when to go beyond it to meet particular needs. And the serious illness I lived through taught me to depend on the goodness and wisdom of others.

This theme of helping others has stayed with me these past months. In lockdown I’ve often gone in prayer to those who sought all means to save the lives of others. So many of the nurses, doctors and caregivers paid that price of love, together with priests, and religious and ordinary people whose vocations were service. We return their love by grieving for them and honoring them.

Whether or not they were conscious of it, their choice testified to a belief: that it is better to live a shorter life serving others than a longer one resisting that call. That’s why, in many countries, people stood at their windows or on their doorsteps to applaud them in gratitude and awe. They are the saints next door, who have awakened something important in our hearts, making credible once more what we desire to instill by our preaching.

They are the antibodies to the virus of indifference. They remind us that our lives are a gift and we grow by giving of ourselves, not preserving ourselves but losing ourselves in service.

With some exceptions, governments have made great efforts to put the well-being of their people first, acting decisively to protect health and to save lives. The exceptions have been some governments that shrugged off the painful evidence of mounting deaths, with inevitable, grievous consequences. But most governments acted responsibly, imposing strict measures to contain the outbreak.

Yet some groups protested, refusing to keep their distance, marching against travel restrictions — as if measures that governments must impose for the good of their people constitute some kind of political assault on autonomy or personal freedom! Looking to the common good is much more than the sum of what is good for individuals. It means having a regard for all citizens and seeking to respond effectively to the needs of the least fortunate.

It is all too easy for some to take an idea — in this case, for example, personal freedom — and turn it into an ideology, creating a prism through which they judge everything.

The coronavirus crisis may seem special because it affects most of humankind. But it is special only in how visible it is. There are a thousand other crises that are just as dire, but are just far enough from some of us that we can act as if they don’t exist. Think, for example, of the wars scattered across different parts of the world; of the production and trade in weapons; of the hundreds of thousands of refugees fleeing poverty, hunger and lack of opportunity; of climate change. These tragedies may seem distant from us, as part of the daily news that, sadly, fails to move us to change our agendas and priorities. But like the Covid-19 crisis, they affect the whole of humanity.

Look at us now: We put on face masks to protect ourselves and others from a virus we can’t see. But what about all those other unseen viruses we need to protect ourselves from? How will we deal with the hidden pandemics of this world, the pandemics of hunger and violence and climate change?

If we are to come out of this crisis less selfish than when we went in, we have to let ourselves be touched by others’ pain. There’s a line in Friedrich Hölderlin’s Hyperion that speaks to me, about how the danger that threatens in a crisis is never total; there’s always a way out: “Where the danger is, also grows the saving power.” That’s the genius in the human story: There’s always a way to escape destruction. Where humankind has to act is precisely there, in the threat itself; that’s where the door opens.

This is a moment to dream big, to rethink our priorities — what we value, what we want, what we seek — and to commit to act in our daily life on what we have dreamed of.

God asks us to dare to create something new. We cannot return to the false securities of the political and economic systems we had before the crisis. We need economies that give to all access to the fruits of creation, to the basic needs of life: to land, lodging and labor. We need a politics that can integrate and dialogue with the poor, the excluded and the vulnerable, that gives people a say in the decisions that affect their lives. We need to slow down, take stock and design better ways of living together on this earth.

The pandemic has exposed the paradox that while we are more connected, we are also more divided. Feverish consumerism breaks the bonds of belonging. It causes us to focus on our self-preservation and makes us anxious. Our fears are exacerbated and exploited by a certain kind of populist politics that seeks power over society. It is hard to build a culture of encounter, in which we meet as people with a shared dignity, within a throwaway culture that regards the well-being of the elderly, the unemployed, the disabled and the unborn as peripheral to our own well-being.

To come out of this crisis better, we have to recover the knowledge that as a people we have a shared destination. The pandemic has reminded us that no one is saved alone. What ties us to one another is what we commonly call solidarity. Solidarity is more than acts of generosity, important as they are; it is the call to embrace the reality that we are bound by bonds of reciprocity. On this solid foundation we can build a better, different, human future.

Pope Francis is the head of the Catholic Church and the bishop of Rome. This essay, taken from The New York Times, has been adapted from his new book “Let Us Dream: The Path to a Better Future,” written with Austen Ivereigh.

Kentucky newspapers offer editorial comment on acceleration of the pandemic and the governor's response to it

Kentucky's recent surge in coronavirus cases and covid-19 hospitalizations, and the governor's latest emergency orders in response, has prompted editorial commentary from several newspapers.

"November feels eerily similar to April and May, when covid-19 cases weren’t as numerous but the virus was just as furious," said The Daily Independent of Ashland. "Whether or not you agree with him, Gov. Andy Beshear has proven he’s not simply out to collect votes. He won’t shy away from making an unpopular decision, but he genuinely seems to base his actions upon how many lives might be saved."

The paper added, "The local economy will suffer, but, ideally, fewer people will be infected with the virus — and fewer will die. . . . We must band together as a community once again, just as we did in April and May, and support local businesses. If it’s not currently in your routine to do so, make it part of your daily habits. Think local, eat local (carry-out) and shop local (with a mask)."

The State Journal of Frankfort also endorsed Beshear's orders: "We firmly believe the governor is taking the steps necessary to slow an overwhelming increase in coronavirus cases and deaths in nearly every corner of Kentucky.

Noting Republican U.S. Rep. Andy Barr's criticism of Beshear's latest orders, the newspaper said, "What we have been asked to do during the last eight months — limiting our contacts, practicing social distancing and wearing face masks in public — is not difficult or political. Instead of creating division, we expect our leaders to work together toward the common goal of crushing the coronavirus."

On Nov. 18, the day that Beshear ordered in-person schooling to stop as of Nov. 23, the Bowling Green Daily News said "We believe the appropriate path forward is to continue trusting school officials to do everything in their power to make classrooms and school buildings as safe as possible. Some virus cases among staff and students are inevitable, but until it is definitively shown that the school environment itself is actively worsening the spread, we believe it is in any community’s best interest to maintain in-person teaching options for those who wish to use them."

The editorial cited "the advice of educators and mental health experts who are nearly uniform in noting that many students are harmed socially and academically by a lack of in-person instruction. Not only that, but a recent study by the Prichard Committee for Academic Excellence, as described in a report in the Daily News, offers a new round of data illustrating the burdens that remote instruction places on many working families, such as difficulty scheduling child care and accessing reliable internet service."

The Daily News hasn't opined on Beshear's latest moves, but its reliably conservative editorial page has criticized his previous orders.

Wednesday, November 25, 2020

Judge blocks Beshear's ban on in-person religious schooling as the U.S. Supreme Court shifts the same way on a similar issue

By Al Cross
Kentucky Health News

A federal judge issued an injunction Wednesday night that allows religious schools in Kentucky to continue in-person instruction, contrary to Gov. Andy Beshear's order to stop in-person schooling to prevent spread of the novel coronavirus.

“The governor has every right to impose some restrictions on all schools, religious and secular alike,” District Judge Greg Van Tatenhove wrote. “Social distancing, face masks, limits on class size, reporting requirements and other protocols may cost money and may be inconvenient for parents and students, but we give executives increased discretion in time of crisis. But in an effort to do the right thing to fight the virus, the governor cannot do the wrong thing by infringing protected values.”

Judge Greg Van Tatenhove
Van Tatenhove exempted from Beshear's order "any religious private school in Kentucky that adheres to applicable social distancing and hygiene guidelines," saying that Danville Christian Academy and schools that joined its lawsuit were likely prevail if the lawsuit goes to trial. The school's attorneys had noted that the Boyle County Health Department said the school was following proper precautions.

Van Tatenhove wrote, "Danville Christian has presented evidence of the significance of in-person instruction" protected by the First Amendment, including the "prayer throughout the day" and weekly chapel services, and he knows "the role of daily in-person mentorship of religious values that occur in religious schools that is simply not as feasible in a virtual setting."

Beshear has appealed to the U.S. Court of Appeals for the Sixth Circuit and has asked it to stay the injunction, said his communications director, Crystal Staley.: "Let's be clear: lives are on the line, and everyone must do their part to defeat the virus."

The governor argued that his order applied equally to public and private schools, but Van Tatenhove said the Sixth Circuit court has said regulation of religious activities must follow "the least restrictive way."

The appeals court said that in a case involving Beshear's early-in-the-pandemic order against mass gatherings and his use of state police to put notices on cars of attendees at Maryville Baptist Church in  Bullitt County saying, in effect, that "their attendance at the drive-in service amounted to a criminal act." Actually, the service was held inside the church.

"Ultimately, the Sixth Circuit opted to enjoin enforcement of the orders only as they pertained to drive-in services," Van Tatenhove noted. "While Maryville Baptist does not decide this case, it is indicative of what might come. Maryville Baptist Church was motivated by a sincerely held belief that Christians should have the ability to meet in person. Similarly, Danville Christian is motivated by a 'sincerely held religious belief that it is called by God to have in-person religious and academic instruction for its students'," as the school argued.

Van Tatenhove also said the state hadn't explained why schools should be closed when other activities such as preschools are allowed to continue in-person activity. "If social distancing is good enough for offices, colleges, and universities within the commonwealth," he wrote, "it is good enough for religious private K-12 schools that benefit from constitutional protection." He also noted that Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said Nov. 19 that "for kids K-12, one of the safest places they can be, from our perspective, is to remain in school."

Attorney General Daniel Cameron, who joined the Danville school's lawsuit, said he was glad that the courts "have affirmed that the freedoms provided by our Constitution are stronger than the fears of the moment and cannot be case aside by the governor or any leader."

Staley said that this is the second case in which Van Tatenhove "has refused to acknowledge the U.S. Supreme Court decision that found an action like this is both legal and constitutional." Van Tatenhove wrote that Chief Justice John Roberts' controlling opinion in that 5-4 decision "is not dispositive in this case" because the factual and procedural circumstances are different. The Supreme Court merely declined to grant injunctive relief from a lower court's decision.

And since then, the Supreme Court has changed. Hours after Van Tatenhove ruled, the high court stayed orders by New York Gov. Andrew Cuomo that limited gatherings, including worship services, to 10 people. Roberts, voting with the court's three liberals, said there was no need to intervene because Cuomo had relaxed the restrictions. But the majority, unsigned opinion said, “Even in a pandemic, the Constitution cannot be put away and forgotten. The restrictions at issue here, by effectively barring many from attending religious services, strike at the very heart of the First Amendment’s guarantee of religious liberty.” The New York Times notes, "The order was the first in which the court’s newest member, Justice Amy Coney Barrett, played a decisive role."

Hospitalization figures again set new records, but poll suggests Kentuckians are less likely to give thanks outside their households

Polling for The New York Times showed Kentuckians are less likely than people in neighboring states to have Thanksgiving dinner outside their household.

By Al Cross
Kentucky Health News

The covid-19 burden on Kentucky hospitals got heavier Wednesday, as the state began a long holiday weekend that officials and health-care workers worry will bring so many more infections that hospitals will be overrun.

Every data point on covid-19 cases from Kentucky hospitals was a new record: 1,734 patients, 409 of them in intensive care, and 216 of those on ventilators.

The state reported 3,408 new cases of the novel coronavirus, its fourth largest daily total. The higher numbers were 3,825 last Friday, 3,711 last Saturday and 3,649 last Thursday.

Kentucky's seven-day rolling average of new coronavirus cases, perhaps the best measure of the pandemic's course, is a new record: 3,087.

Gov. Andy Beshear announced 26 more deaths from covid-19, bringing the state's toll to 1,835. The dead are listed below by age, sex and county.

In a press release, Beshear again asked Kentuckians to follow preventive measures he has ordered and recommended during the holidays.

“Thanksgiving is one of my favorite holidays, and usually we get together with about 15 people,” Beshear said. “This year, we just can’t do that. I’m really disappointed, like all of us are, but protecting my parents, my kids, our neighbors and all of our health care workers has to come first. I’m grateful for all Kentuckians who are sacrificing this year to keep each other safe.”

There were at least two hopeful signs. The share of Kentuckians testing positive for the virus in the last seven days declined slightly for the third day, to 8.88 percent, and Kentuckians appeared more likely than people in neighboring states to follow official advice and not observe Thanksgiving with people outside their household, based on polling done for The New York Times Nov. 13-23.

The Times published a detailed, interactive map showing the share of people planning to eat Thanksgiving dinner with people outside their household. The findings are part of a "large number of interviews conducted by the global data and survey firm Dynata" at the paper's request, it said.

As their hospital beds fill up with covid-19 patients, the heads of U of L Health and Baptist Health gave a stern warning to the Louisville community in an open letter: "It is critically important that we take action now. Please, for the health and safety of yourself, your loved ones and your neighbors, wear a mask. Avoid gatherings — not just with strangers, but with extended family members. Don’t stand or be near people who don’t live with you. Wash your hands often.With Thanksgiving and the holidays coming, please celebrate responsibly in a scaled-back fashion that limits the virus’s spread."

The executives stressed that after eight months of fighting the virus, health-care workers in the region need their neighbors' help. "We are prepared to handle a surge of patients, but there is a limit," they said. "There will be a point when our hospitals will be too full to treat all of you with the virus and those with other medical needs "We are at a crossroads and desperately need your assistance with curbing the spread of the virus."

Beshear's release noted that getting one negative test days before a gathering "can’t guarantee that you won’t infect others at that event."

Last week, Beshear banned in-person schooling and indoor dining, and imposed other new restrictions in an effort to stop the recent surge in cases. The school order brought a lawsuit by the Danville Christian Academy and Attorney General Daniel Cameron, joined by other private schools, and some restaurants defied the inside-service ban and began losing their licenses as a result. U.S. District Judge Greg Van Tatenhove is expected to rule in the case soon.ruled in the school case Wednesday night that Beshear couldn't stop in-person instruction at religious schools.

Beshear also limited informal group gatherings to two households and no more than eight people, while acknowledging that it would be difficult if not impossible to enforce. Two families filed a lawsuit against Beshear Tuesday, saying the order “criminalized their family dinner.” One family includes seven children.

At his Tuesday briefing, the last before the holidays, Beshear called this claim “ridiculous,” “dumb,” and “a distraction,” and said, “Nobody’s saying a family of 10 can’t continue to live together and eat together,” he said. “What we’re saying is if one family wants to have another family over, it [should only] be two households.”

In other coronavirus news Wednesday:
  • The latest covid-19 fatalities were a 60-year-old woman from Barren County; an 82-year-old Christian County man; a 94-year-old Daviess County woman; a 62-year-old Edmonson County man; an 87-year-old Floyd County man; a 91-year-old Hancock County woman; a 90-year-old Hardin County man; two women, 67 and 89, and three men, 62, 68 and 79, from Jefferson County; an 83-year-old Jessamine County man; a 61-year-old Lewis County woman; a 74-year-old woman and a 91-year-old man from Martin County; a 73-year-old McLean County woman; a 98-year-old woman and a 66-year-old man from Monroe County; an 84-year-old Ohio County man; two men, 79 and 87, from Oldham County; a 56-year-old Spencer County woman; and two women, 77 and 86, and a man, 77, from Warren County.
  • "Two more inmates have died from covid-19 in Kentucky state prisons, raising this years death toll in the system to 15 prisoners and two Department of Corrections employees," John Cheves reports for the Lexington Herald-Leader. Beshear has said that rampant community spread is responsible for the current surge of cases in Kentucky, noting that with prison employees coming and going in and out of the facilities every day, when case rates are so high, it is hard to contain it. Cheves reports that an analysis of state prison data ranks Kentucky 17th for per-capita inmate deaths during the pandemic.
  • Counties with more than 10 new cases were Jefferson, 732; Fayette, 264; Kenton, 138; Boone, 116; Warren, 114; Hardin, 111; Madison, 100; Campbell, 69; Daviess, 69; Bullitt, 62; Christian, 61; Greenup, 52; Oldham, 48; Hopkins, 42; McCracken, 42; Pike, Scott and Wayne, 41; Magoffin, 40; Laurel 38; Franklin and Shelby, 35; Boyd, Clark and Muhlenberg, 32; Nelson, 31; Graves, Ohio and Pulaski, 29; Floyd, Henderson and Mercer, 28; Jessamine, 27; Carter and Whitley, 25; Knox, 23; Johnson, 22; Adair and Anderson, 20; Marshall, 19; Boyle and Calloway 18; Allen, Caldwell, Pendleton, Perry and Spencer, 17; Fleming, Grayson, Harrison, Rockcastle and Taylor, 16; Crittenden, Leslie and Logan, 14; Grant and Knott, 13; Clay, Garrard, Harlan and Woodford, 12; and Breathitt, Estill, Lee, Lincoln, Marion and Washington, 11.
  • The state has issued guidelines for outdoor dining. The version posted by the Franklin County Health Department says tents qualify as outdoor seating if at least 50% of the perimeter is open and 6 feet of space is kept between customers at different tables; if two sides of the tent are not open, the tent is considered interior space and may not be used for seating until Dec. 14, under Beshear's order.
  • The AstraZeneca coronavirus vaccine announced this week isn't proven yet, Hilda Bastian reports for Wired magazine: "The price of AstraZeneca’s shares actually dropped on the news, and an analysis from an investment bank concluded, 'We believe that this product will never be licensed in the U.S.' Over at Stat News, Anthony Fauci cautioned that we’ll need to see more data before coming to a conclusion. . . . Monday’s announcement did not present results from a single, large-scale, Phase 3 clinical trial, as was the case for earlier bulletins about the BNT-Pfizer and Moderna vaccines."
  •  "Government officials said the first 6.4 million doses of a vaccine will be distributed to all states around mid-December, assuming the FDA grants an emergency-use authorization," McClathy Newspapers report. "The first doses will be given to states based on population size. Earlier plans had called for distribution based on the number of people in high-risk groups, such as health care workers, first responders, people over 65, and those with underlying medical conditions. The general population likely won’t get vaccinated until spring or summer, experts say."
  • Maggie Menderski of the Louisville Courier Journal tells the story of Demetrius Booker, a 40-year-old La Grange man, who spent 95 days in the hospital battling covid-19.

Tuesday, November 24, 2020

Kentucky is still in the most dangerous zone for virus cases and positive tests; White House calls for 'significant behavior change'

White House Coronavirus Task Force table; for a larger version, click on it.
By Melissa Patrick
Kentucky Health News

For the second week in a row, Kentucky is in the worst danger zone for both coronavirus cases and the share of Kentuckians who tested positive for the virus in the past seven days, according to this week's White House Coronavirus Task Force report. 

Kentucky has been in the red zone for case numbers, indicating 101 or more new cases per 100,000 people, every week since the Sept. 27 report, but this is only the second week it has been in the most dangerous zone for test positivity, meaning it has a rate above 10%.

Gov. Andy Beshear has noted several times that the state uses a different data stream than the White House, which results in a lower positive-test rate. The White House reports a 13% percent positivity rate in Kentucky. On Nov. 24, the state reported that rate to be 8.82%. 

As other states have surged even more, Kentucky's ranking in the White House report has fallen a bit. The latest report, which covers Saturday, Nov. 14, through Friday, Nov. 20, says Kentucky ranks 24th highest in the country for cases and 20th for positivity.

It says 92% of Kentucky's counties had a moderate or high level of community transmission, with 70% of them having high levels. That's up from 89% and 55%, respectively, in last week's report. 

It shows Kentucky with 433 new cases per 100,000 people. This number continues to show huge weekly increases. It was 344 per 100,000 in the prior week, and 274 per 100,000 the week before. The national average is 356 per 100,000.

In the state's Monday-to-Sunday reporting week, last week Kentucky had most cases ever: 20,514, up 22% from the week before. 

The number of counties in the White House red zone increased by 18, from 66 to 89; the orange zone number decreased by 11, from 24 to 13; and the yellow zone decreased by three, to 14. 

This week's report included a strong warning, saying the "aggressive, rapid, and expanding" spread of cases requires both "proactive, focused testing" to identify asymptomatic and pre-symptomatic individuals, combined with "significant behavior change of all Americans." 

Those behaviors include wearing a mask at all times in public, social distancing, significant reductions in public and private indoor capacity limits, and making sure that "every American understands the clear risks of ANY family or friend interactions outside of their immediate household indoors without masks." 
Some argue that Kentucky does not have a reliable estimate of the virus' spread because it depends on "convenience samples" from voluntary tests instead of statewide random testing. Beshear has argued that the state does so much testing that it has a pretty accurate picture of how many people have the virus, especially among those with symptoms. 

He was asked Tuesday about White House's recommendation for "proactive, focused testing" to catch the virus in people without symptoms, and the latest analysis from the University of Louisville's Co-immunity Project – which does random testing in Jefferson County, finding that the infection rate is now 10 times what it was two months ago and that the infection rate is nearly five times higher than the publicly reported number of cases.

Beshear said the state is doing a study with LabCorp, a large testing laboratory, "that is giving us data on how widespread that we think the virus is in Kentucky." He said Health Commissioner Steven Stack would talk about it next week. "It's got some different numbers than the co-immunity project, but it's also statewide."

The White House report also called for "strong Thanksgiving messaging" that encourages people to limit events to individuals in their household and to wear masks while indoors around high-risk and vulnerable people. In addition, it says to expand public-health messaging to all media platforms, to warn people about the risks of social gatherings and re-emphasize the need for masks and social distancing. 

The report also called on Kentucky to stay vigilant to protect nursing home residents and staff, ensuring that they have full testing capacity and are properly isolating those who test positive. It also calls on the state to ensure that all hospitals have expansion and contingency plans and up-to-date treatment protocols.

The report has a graph showing covid-19 hospitalizations by age and by week.

White House Coronavirus Task Force graph; for a larger version, click on it.

Hospitalizations up 5% in one day; health-department workers are afraid to enforce orders because of threats, abuse, Beshear says

Beshear showed a video of nurse practitioner Katie Rogers asking Kentuckians to take care at Thanksgiving in order to keep hospitals from being overwhelmed.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced a 5.4 percent jump in Kentucky's covid-19 hospitalizations Tuesday, making for another record high, while making a final plea for Kentuckians to keep their Thanksgiving gatherings small – and saying health-department workers are afraid to enforce his emergency orders because of abuse and threats. 

Beshear said covid-19 hospitalizations totaled 1,658, 85 more than Monday; 390 of them are in intensive care, and 207 of those are on a ventilator. 

The governor warns almost daily that a main reason Kentuckians need to stop spreading the novel coronavirus and bring case numbers down is to keep the state's health-care system from being overwhelmed – and there are already signs that that is beginning to happen. 

Beshear pointed to newspaper headlines across the state reporting that local hospitals were either at capacity or near capacity. 

The Albert B. Chandler Hospital at the University of Kentucky announced that it will close five of its 32 operating rooms to make room for an influx of covid-19 patients, whose number has jumped from about 30 in late October to 81 early Tuesday, notes Alex Acquisto of the Lexington Herald-Leader.

Beshear said the disease is beginning to overwhelm the health-care capacity of the state and the region. "If we do not stop the exponential growth of cases, we will exceed our health-care capacity," he warned. "We will experience more loss and more death than we have to."

In the question session of his daily briefing, Beshear was quick to confirm that Kentucky's health-department workers are being targeted by death threats and doxxing – malicious posting of personal information online – over the enforcement of coronavirus orders, similar to episodes in other states. 

"It's going on every day, in every local health department, to every single worker," Beshear said. "It is awful and it is disgusting. Our local health department workers are scared. They're scared to release their local numbers, they're scared to do basic enforcement. They're people's neighbors, fighting for the lives of neighbors, and people treating them this way is unacceptable. It is not in accordance to our values. It's not in accordance to my faith. It is not Christian." 

Health departments have been tasked with enforcing Beshear's mask mandate since July, and now they are being asked to enforce his new orders that include, among other things, banning indoor service in bars and restaurants. 

Some restaurants have refused to follow that mandate, forcing health departments to become involved, and in some cases suspending their food service permits. 

One such restaurant is Bean's Cafe and Bakery in Dry Ridge. Rachel Cheatham reports for the Grant County News that the bakery has decided to keep its dining room open, despite the order to close all indoor dining by 5 p.m. Nov. 20. Outdoor dining is allowed, under certain requirements.  

Bean's owner Richard Hayhoe told Cheatham, “It is our understanding that to defy an order like we have will bring out the situation to a head and make the governor’s office prove that they have the legal authority to strip business owners of their constitutionally protected ability to earn a living. These regulations are the political overreach of an office that is bent on controlling every aspect of life and taking away your ability to make your own decisions.”

A Bean's Facebook post said the restaurant had received a notice from the Northern Kentucky District Health Department that its food-service permit had been suspended. "We will remain open until it can be proven that this is unlawful for them to do in a court of law." The office of Grant County Attorney Stephen Bates II declined to comment other than to say the case will be a matter of public record. 

In London, Bill Estep of the Herald-Leader reports that the Laurel County Health Department planned to shut down Wingz 2.0, a restaurant that had not shut down its dining room. Janet Patton of the Herald-Leader reports that the Lexington health department has ordered closure of a coffee shop, Brewed, and suspended its permit, but its dining room remains open. 

Asked what level of enforcement defiant restaurants can expect, Beshear noted that the state Supreme Court recently ruled – in a case involving Bean's and other Northern Kentucky businesses – that he has legal authority to issue such orders, and offering indoor dining is a violation of the rule of law. 

"Our society can't move forward with people who openly violate the law if they don't like it," Beshear said. "Once the Kentucky Supreme Court has ruled, that's supposed to be it." 

Beshear noted that there has been a rush on testing in the last few days. He said that is a good thing, but cautioned that it is not safe to think that a negative covid-19 test means you can safely gather for Thanksgiving, because it can take time for an infection to show up on a test. The incubation period for the virus is 14 days. 

"A single [negative] test can't guarantee a safe Thanksgiving," pointing to a Time article that expands on this topic.

The state Department for Public Health has asked Kentuckians to avoid travel and only have dinner with people who live in their household, or at a maximum, people from two households (no more than eight people total).

 “Please keep your Thanksgiving celebration as small as you can," he said. 

Beshear reported 2,690 new coronavirus cases on Tuesday, bringing the state's seven-day rolling average down to 2,994, 1 percent below yesterday's average. He also reported 17 more covid-related deaths, bringing the state's death toll to 1,809.

The deaths were a 90-year-old woman from Calloway County; two women, 64 and 81, and a 52-year-old man from Daviess County; an 81-year-old Hardin County man; a 67-year-old Henry County man; an 86-year-old woman and five men, ages 64, 67, 75, 76 and 88, from Jefferson County; a 78-year-old Kenton County woman; a 60-year-old Martin County man; a 90-year-old McLean County woman; an 88-year-old Metcalfe County woman; and an 81-year-old Shelby County woman.

The share of Kentuckians testing positive for the virus in the past seven days remained under 9% for the second day in a row, after being above that threshold since Tuesday, Nov. 17. Today, it was 8.82%.

In other coronavirus news Tuesday:
  • Counties with 10 or more new cases were Jefferson, 394; Fayette, 201; Hardin, 118; Madison, 80; Daviess, 73; McCracken, 72; Boone, 71; Warren, 70; Boyd, 65; Nelson, 54; Pike, 49; Kenton, 45; Graves, 43; Oldham, 39; Hopkins, 38; Bullitt, Jessamine, Laurel and Pulaski, 34 each; Montgomery, 33; Henderson and Shelby, 32 each; Marion, 31; Carter, Greenup and Mercer, 29 each; Scott, 27; Barren and Lincoln, 26 each ; Campbell, 25; Larue and Simpson, 23 each; Clark, Franklin and Johnson, 22 each; Christian, 21; Magoffin, Muhlenberg, Ohio and Pendleton, 20 each; Washington, 19; Calloway, 18; Lee, 17; Floyd, Marshall, Meade and Whitley, 16 each; Martin, 15; Clay, Harlan, Logan and Webster, 14 each ; Grant, 13; Boyle, Garrard, Harrison, Leslie, Monroe and Spencer, 12 each; Bell, Knox, Powell and Wayne, 11 each; and Metcalfe, Rowan and Woodford, 10 each.
  • In long-term care facilities, there are 1,572 active cases among residents and 1,044 among staff cases, with 92 resident cases and 115 staff cases reported Tuesday. There are 1,173 resident deaths and seven staff deaths attributed to covid-19, with 18 resident deaths reported today. 
  • Beshear announced another covid-19 death at the Thomson-Hood Veterans Center in Wilmore, bringing the total there to 28. He said the facility has gone 10 days without a new case and that none of the other three veteran facilities in the state have reported any cases. 
  • Fifteen states are in Kentucky's travel advisory because they have a positive-test rate of 15% or higher. From highest to lowest, they are: Wyoming, South Dakota, Iowa, Idaho, Kansas, Pennsylvania, New Mexico, Missouri, Alabama, Utah, Montana, Arizona, Mississippi, Oregon and Ohio. Kentuckians who travel to these states are asked to isolate for two weeks upon return. The state also recommends a 14-day self-quarantine for anyone returning from any international travel.
  • The U.S. Department of Labor has abruptly ended extended unemployment benefits for 4,723 Kentuckians, according to a state news release. Claimants who continue to be off work due to the pandemic may be eligible for another form of benefit through the end of the year. This also does not affect the ability of Kentuckians losing their jobs to qualify for traditional unemployment benefits, the release says. 
  • "Some Americans downplaying the novel coronavirus insist improved treatments have made the virus far less deadly than last spring, but that’s a far too rosy take," writes Paige Winfield Cunningham of The Washington Post. "Better treatments are now available, but their impact isn’t nearly big enough to avoid an impending surge of deaths" as hospitals reach or exceed capacity. "While the case-fatality rate declined early in the pandemic, it hasn’t budged since the summer" from 1.7 percent.
  • Essential workers are likely to move ahead of adults 65 and older and people with high-risk medical conditions on the Centers for Disease Control and Prevention's priority list, coming after health care workers and those living in long-term care facilities, members of the Advisory Committee on Immunization Practices said on Monday, Stat reports. No formal vote has been taken. Stat writes that the intention is to bring "many people of color closer to the front of the vaccine priority line -- should they want to be vaccinated -- in recognition of the fact that the pandemic has disproportionately hit Black and Latino communities." Further, one expert notes that essential workers have less opportunity to social distance, compared to seniors and those with high-risk medical conditions.
  • Matthew Glowicki of the Louisville Courier Journal tells the stories of grieving families who have lost a loved one to covid-19 as they prepare for the Thanksgiving holiday. 
  • Local health departments in Eastern Kentucky release a report with their covid-19 numbers on Monday's; this week's report includes three deaths, WYMT reports.