As coronavirus cases escalate, officials warn hospitals could reach capacity; say it's time to aggressively minimize contacts

State Department for Public Health map; for a larger version, click on it.

By Lisa Gillespie
Kentucky Health News

As coronavirus cases continue to escalate in Kentucky, Gov. Andy Beshear said hospitals are beginning to see big increases in the number of patients with covid-19, and warned that if the trend continues they could soon run out of beds for patients.

“If we cannot control the increase, then it is a real possibility that we could face some real concerns with capacity – having enough beds – here in Kentucky,” Beshear said at his daily briefing.

Beshear said 1,037 people were hospitalized with covid-19 in Kentucky on Tuesday, a new record, with 259 in intensive care and 116 on a ventilator. He added that since the time the report was prepared for him, 20 more patients had been admitted to intensive care. He called the increases "very concerning." 

Earlier in the day, Louisville's top health official, Dr. Sarah Moyer said the city's hospitalizations are about three and a half times higher in the first days of November than in early October, and that number is expected to increase rapidly in coming weeks, Kate Stringer reports for WDRB. 

Moyer said it's time for people to cancel events and gatherings, to reduce in-person shopping, to order out instead of dining in, and for employers to allow their employees to work from home if possible. In other words, it's time for Kentuckians to stay home. The recommendations reflect those that the state makes for counties in its "red zone," which includes Jefferson County.

"If we aren't starting to be more aggressive now, our hospitals are going to be over capacity in the next two, three, four weeks," Moyer said. "We have so much covid in our community that the regular risk reduction measures like wearing a mask, washing your hands, staying six feet apart are not enough to curb the spread alone."

Asked about this, Beshear said several hospitals across the state are reporting that they are near capacity, noting that the Barren County Progress reported that the Glasgow hospital is about 80 percent full. 

“We’re seeing, in certain areas, hospital systems becoming taxed,” Beshear said. “And just about every hospital system is reporting to us that the numbers of hospitalized Kentuckians is going up, and it's starting to go up a lot faster.”

He said Kentucky has a plan for how to expand its number of hospital beds if needed, but if the state can't get control the increase in cases, it could end up like Texas, Florida and New York, where hospitals have filled up and patients had to go to temporary field hospitals. 

Beshear commended the state's hospital administrators, saying they have been responsible and proactive in their efforts to ensure adequate capacity. 

“They will start dialing back some of the other activities they engage in to make sure they have the capacity,” Beshear said. “From all of our health care warriors -- from the person doing admissions to the CEO -- we have seen a real commitment when it comes down to do what it takes to defeat this virus.”

Beshear again called on people, institutions and governments in counties in the red zone to follow the state's recommended precautions to slow the spread of the virus, calling this a comprehensive plan that ultimately places the responsibility on individual communities.

"It's not enough for me to stand up here and say, 'We can't be doing that.' It's not," he said. "We need to make sure that when people are thinking about their actions, they're thinking about their neighbors."

Beshear said no matter who wins the election, the covid-19 pandemic will still be surging on Wednesday.

“When you wake up tomorrow, I hope you realize that no matter who wins or who loses, we’re still at war with this virus,” Beshear said. "This virus isn’t going away the day of the election; the day of the election it is continuing to surge. So let’s remember tomorrow, we’re all Americans, we're all  Kentuckians, all of our actions impact everybody else." 

Beshear reported 1,795 new coronavirus cases, the fifth highest day yet. The top four days, and the sixth largest, all occurred last week. (Those rankings do not count a day that a backlog of more than 1,400 cases in Fayette County pushed the daily total above 2,300.)  

Today's case numbers bring the seven-day rolling average to 1,695, also a new record, beating yesterday by two.

The state’s positivity rate – or the share of people who tested positive among all those who received a coronavirus test in the past seven days – was 6.24%. 

Beshear announced 11 new deaths from covid-19, bringing the state's death toll to 1,503. 

"That is a grim milestone," he said. "And it appears that we are going to lose a significant number of additional Kentuckians unless we pick it up, unless we do better." 

In other covid-19 news Tuesday: 

• Today's fatalities were a 71-year-old man from Hardin County; four women, 86, 91, 92 and 94, and a 59-year-old man from Jefferson County; an 88-year-old woman from Monroe County; a 76-year-old man from Montgomery County; an 82-year-old woman and a 71-year-old man from Muhlenberg County; and a 78-year-old man from Ohio County. 
• Counties with 10 or more new cases were Jefferson, 414; Fayette, 107; Warren, 68; Laurel, 67; Boone, 57; Kenton, 50; Campbell, 40; Hardin, 40; Madison, 38; Daviess, 36; Pike, 36; Bullitt, 31; Whitley, 31; Henderson, 25; Nelson, 24; Floyd, 23; Hopkins, 21; Rowan, 21; Jessamine, 20; McCracken, 20; Breckinridge, Christian, Knox and Montgomery,19 each; Boyd, Magoffin and Monroe, 17 each; Barren and Greenup, 16 each; Caldwell and Oldham, 15 each; Franklin, 13; Harlan, Pulaski, Scott and Taylor, 12 each; Bell, Marion and Rockcastle, 11 each; and Graves, Jackson, Marshall, Trigg and Webster, 10 each.
• Beshear said 255 of the 1,795 cases reported to day were in children 18 and under: "We continue to see not only a surge in the virus, but more and more of our kids by percentage getting it." 
• A Nov. 2 report from Deborah Birx, coordinator of the White House Coronavirus Task Force, "sounded alarms Monday about a new and deadly phase" in the pandemic, The Washington Post reports.  “This is not about lockdowns … It’s about an aggressive balanced approach that is not being implemented," says the internal White House report that challenges many of President Trump’s pronouncements, including his claims that the country is "rounding the turn." 
• What is “essential at this time point,” the report said, is “consistent messaging about uniform use of masks, physical distancing and hand washing with profound limitation on indoor gatherings especially with family and friends.” It adds: “This is about empowerment [sic] Americans with the knowledge and data for decision-making to prevent community spread and save lives.”
• The Post says Birx’s report "goes to pains to dispute Trump’s false claims that coronavirus cases are increasing only because of increases in testing," noting that although testing is flat, a rising number of tests are positive, suggesting “community spread is much worse than is evident by current [measurements].”
• The Post reports that officials have described Birx as frustrated with Trump's new medical adviser, Scott Atlas, a neuroradiologist with no infectious-disease experience, who has called for allowing people to return to daily living without restrictions to hasten herd immunity and bolster the economy. They say she has challenged these views in task force meetings, saying this would lead to thousands of deaths. 
• The latest Children and Covid-19 State report, by the American Academy of Pediatrics and the Children's Hospital Association, says that as of Oct. 29, 61,447 new children had been infected by the coronavirus, making up 11% of U.S. cases. -- about 1,134 cases per 100,000 children. The report says this is the highest since the pandemic began. From Oct. 15 to 29, 111,744 new youth cases were reported, a 15% increase. Hospitalizations and deaths remain very low.  As of Oct. 29, the report says 15.7% of Kentucky's cases have been in people under 20, with a rate of 1,421 per 100,000 children. 
• Findings from an ongoing study that includes systematic and daily follow-ups has found that 53% of people living with a person who was infected with the virus contracted it themselves, and that cases can originate from both children and adults. The study, published by the Centers for Disease Control and Prevention, also found that at least 75% of secondary infections occurred within five days of the first person in the home experiencing symptoms. “In the absence of an efficient approach for identification of infections without regard to symptoms, these findings suggest that prompt adoption of isolation measures as soon as a person feels ill might reduce the probability of household transmission,” the researchers said a Vanderbilt University release.