Ky. moves above average for nursing-home virus cases and deaths, largely because of community spread, officials say

Kentucky Health News graph; case numbers are from initial, unadjusted daily reports

By Melissa Patrick

Kentucky Health News

 

Gov. Andy Beshear and his lieutenants cited the rising number of nursing-home coronavirus cases and deaths in nursing homes Wednesday in their latest effort to stop the escalation of the pandemic in Kentucky.

"We're seeing an alarming increase in long-term care facilities because we're seeing an alarming increase in community spread," Health Secretary Eric Friedlander said during Beshear's daily briefing. "It's real. I've often reported to you that we've been below the median for the country, in terms of case rate in terms of deaths in facilities. We are just now passing that median, and that is because of community spread." 

As of Oct. 18, a Centers for Medicare and Medicaid Services report shows Kentucky's nursing homes ranked 31st in virus-case rates, with 224.8 cases per 1,000 nursing-home residents, and 26th in deaths, with 42.5 deaths per 1,000.

Friedlander walked through the many protocols and programs the state has implemented to slow the spread of the virus in these facilities, but he said that when the spread is so rampant in communities, it's going to get in.

Health Secretary Friedlander urged mask wearing
to stop the spread of the virus to nursing homes.

"And you know what we can do to stop that?" he asked while holding up a mask. "We can wear one of these. We can wash our hands. We can observe the guidelines that the governor talked about around red counties. It makes a difference. We can protect our seniors. All we have to do, all we have to do is this," he said as he put on his mask. 

On Wednesday, the long-term care daily report showed 1,017 residents and 648 employees had an active case of the virus, with 116 new resident and 75 new staff cases reported today. Beshear said 16 additional deaths can now be attributed to covid-19 in these facilities, for a total of 908 resident and six staff deaths, or 60% of the state's covid-19 deaths.  

Beshear announced 1,653 new cases of the coronavirus on Wednesday, calling the number "way, way too many." 

Asked by Kentucky Health News if he had ruled out taking any further measures to thwart the spread of the virus, Beshear said, "We haven't ruled anything out, but we have not received any public-health advice, either from our federal experts or our state experts, that at this point has suggested any new additional measures beyond the red-zone recommendations."

Those recommendations, which include things such as canceling gatherings and allowing employees to work from home in counties with high case rates, have been in place for three days. Beshear said that he thinks the "vast majority of those counties" in the red zone are working to follow them and that they were working to encourage those that aren't. 

He added that some places that have disagreed with him over other guidelines are following these "because the problem has gotten that significant." 

Beshear renewed for another 30 days his mandate requiring people to wear masks when around other people outside of their homes, and cited the exit poll for Tuesday's election, which found that 51% of Kentucky voters said they strongly favored the mandate and 20% said they somewhat favored it.

The poll also found that 33% of voters said they or someone in their household "lost a job or income because of the coronavirus pandemic."

Health Commissioner Steven Stack pointed out that hospitalizations for covid-19 in Kentucky have doubled since the end of September, and intensive-care use by such patients has more than doubled.

The Kentucky Hospital Association reported Tuesday that 85 percent of the beds in its members' intensive-care units are occupied, 18 percent of them by covid-19 patients. 

Kentucky Hospital Association graphic, updated from time to time at https://www.kyha.com.

“One of the concerns we have related to hospitals is not that we will first run out of bed space but that we may not have enough health-care workers to staff all those beds,” Stack said.

Stack, a physician, urged Kentuckians to follow all public-health guidance, including wearing a mask and social distancing, saying that the more community spread there is, the more likely health-care workers and the general population will become exposed to it. 

Kentucky had record numbers of people in the hospital and in intensive care for covid-19 Wednesday, with 1,066 in the hospital, 286 in ICUs and 125 on ventilators. All of these numbers were up from yesterday. 

Stack added that Kentucky has "an alarmingly large number of red counties" right now, which means they have had at least 25 new daily cases per 100,000 residents in the last seven days. And some counties, he said, are reporting upwards of 91 cases per 100,000. What this means, he said, is that "at that level of transmission, the disease is spreading rapidly and this is a very real threat." 

The percentage of Kentuckians who tested positive for the virus in the past seven days continues to rise. It is now 6.3%. 

Beshear said 11 more Kentuckians had died from covid-19, bringing the state's death toll to 1,514. 

The fatalities were two women, ages 79 and 96, from Hancock County; three women, 60, 81 and 89, and four men, 59, 71, 72 and 72, from Jefferson County; an 82-year-old woman from Knott County; and a 91-year-old woman from McLean County.

In other covid-19 news Wednesday: 

• Counties with 10 or more new cases were Jefferson, 332; Fayette, 159; Kenton and Warren, 64 each; Laurel and McCracken, 56 each; Boone, 46; Campbell, Daviess and Hardin, 38 each; Christian, 34; Floyd, 31; Bullitt, 28; Henderson, 25; Caldwell, 24; Barren and Montgomery, 22 each; Graves, Grayson, Greenup and Shelby, 17 each; Lincoln and Nelson, 16 each; Franklin, 15; Madison, Monroe and Pike, 14 each; Scott, 13; Hart, Marshall, Oldham, Simpson and Spencer, 12 each; and Breckinridge, Pulaski and Woodford, 10 each.
• The K-12 public health report of confirmed cases showed 751 students and 363 staff tested positive for the virus in the last 14 days, with 108 students and 37 staff reported today. Click here for the K-12 dashboard.
• The college and university report shows 554 students and nine staff tested positive for the virus in the last 14 days, with 58 students and two staff being reported today. 
• Beshear signed an executive order to continue allowing pharmacists the ability to dispense 30-day refills.
• Beshear announced a new company is scheduled to open in Paris that will produce medical-grade gloves. The company, U.S. Medical Glove Co. LLC, is expected to help provide Kentucky and other states with its ongoing need for personal protective equipment. 
• Norton Healthcare and Baptist Health Lexington have been chosen as partner sites for a clinical trial of the coronavirus vaccine, WDRB reports. A clinical trial from Janssen is being led by the University of Kentucky's Center for Clinical and Translational Science in Lexington. Anyone interested in volunteering for the trial can click here to fill out a prescreening questionnaire. Officials told WDRB that completing the questionnaire does not obligate the person to participate in the trial and that volunteers will be compensated. 
• Starting Monday, Norton will begin seeing patients at a drive-thru location at the corner of Breckenridge Lane and Taylorsville Road, Lexie Ratterman reports for WDRB. The facility has two drive-thru bays that will offer diagnostics testing, vaccinations and lab work seven days a week with a Norton doctor referral, she reports. The hospital's CEO told WDRB that the idea stemmed from an effort to find innovative ways to keep patients out a waiting rooms, while providing full access to health care.
• A review of 36 published studies on the coronavirus, covering thousands of patients, found that 18% had gastrointestinal symptoms, such as loss of appetite, nausea, vomiting, diarrhea and stomach pain, along with some other more common symptoms, like fever, cough, fatigue and labored breathing. And about 16% of the patients had only gastrointestinal symptoms and nothing else, reports the Lexington Herald-Leader. 
• An analysis of about 400,000 women covid-19 patients, aged 15-44, found that they were more likely than non-pregnant women to be admitted to intensive care, to be put on a ventilator, and to receive extra-corporeal membrane oxygenation, a process by which blood is pumped outside the body to a machine that removes the carbon dioxide and then sends the oxygen-filled blood back to the body, bypassing the heart and lungs, allowing them time to rest and heal. The study also found that the pregnant women had a 70% increased risk of dying, compared to those who were not pregnant, according to a report by the Centers for Disease Control and Prevention. The Herald-Leader reports on this study. 
• The U.S. Food and Drug Administration issued an alert Nov. 3 warning that the rapid antigen test, like the ones provided by the federal government, can produce incorrect positive results. The alert says problems are more likely in populations with low prevalence of infection, or when the test is improperly performed. This comes after Louisiana officials recommend against using the rapid test for asymptomatic people and that anyone who gets one of these tests  be informed of its limitations, Crain's New York Business reports. 
• The U.S. for the first time surpassed 100,000 new coronavirus cases in a single day, The Washington Post reports.