Thursday, December 31, 2020

Omnibus relief bill includes ban on mail sales of e-cigarette products; FedEx will not handle shipments after March 1

Foundation for a Healthy Kentucky President and CEO
Ben Chandler and state Rep. Jerry Miller, R-Louisville,
testified for a state tax on e-cigarettes in February.
The catch-all bill to keep the government open, provide pandemic relief and do many other things includes a ban on mail shipments of electronic-cigarette products, and apply federal laws on cigarette sales to online sellers of e-cigarette products.

That part of the legislation becomes law March 27, and gives the U.S. Postal Service until April 26 to impose regulations implementing it.

"With the USPS off limits for online sellers, private delivery services will immediately be pressured by anti-tobacco (and -vaping) groups to prohibit shipping of vaping products," reports Vaping360, a site that promotes the practice as an alternative to traditional cigarettes."

FedEx has announced it will stop handing e-cigarette products March 1, Vaping360 reports.

The Foundation for a Healthy Kentucky lauded the legislation. 

"More than nine in 10 times that minors try to buy e-cigarettes online, they are successful," said Ben Chandler, president and CEO of the foundation. "This provision will cut off an important avenue that e-cigarette companies have been using to get their dangerous tobacco products to kids. The bill also helps raise the price of e-cigarettes by ensuring that sellers pay the new Kentucky e-cigarette excise tax we supported this year. So, by reducing youth access to vapes and making them more expensive, the bill is another strong step forward in reducing the youth vaping epidemic in Kentucky and across our nation."

Wednesday, December 30, 2020

Positive-test rate jumps above 9% on seventh highest day of new coronavirus cases; 29 more deaths; state auditor tests positive

New York Times map, adapted by Kentucky Health News; click here for interactive version

By Al Cross
Kentucky Health News

All major measures of the pandemic increased in Kentucky Wednesday, most notably the percentage of Kentuckians testing positive in the last seven days for the novel coronavirus.

That figure jumped to 9.09%, more than a full percentage point above Monday's seven-day average and the highest since Dec. 10.

A release from Gov. Andy Beshear's office paraphrased him as saying that the rise may have been causes by holiday closures of some testing sites and labs, "increasing the percentage of tests conducted in medical settings where patients are already experiencing symptoms and suspect they may have the virus."

The release's direct quote from Beshear was, “Our report for today is higher than it has been for a number of days. The progress we have made is fragile. We have to keep working and making good decisions every day. We need everybody to be safe this New Year’s Eve. Do not gather in large groups.”

The state reported 3,784 new cases of the virus, the seventh largest one-day figure. That raised the seven-day rolling average for the first time in eight days, to 2,150, about what it was on Saturday, Dec. 26.

Beshear reported 29 more deaths attributed to Covid-19, raising the seven-day average of deaths to 22.4 and the 14-day average to 25.8. The total is 2,623.

Kentucky hospitalizations for Covid-19 also increased, to 1,673, with 433 of those patients in intensive-care units (14% higher than Tuesday) and 234 ICU patients on ventilators (11% higher than Tuesday).

A third hospital region, Barren River, jumped well above 80% ICU capacity, the threshold for concern. The state's daily report said 86.1% of the region's ICU beds are occupied. The most critical region is Lake Cumberland, at 95.6%. The easternmost region, from Lee County to Pike County, is at 85.3%.

Auditor infected: State Auditor Mike Harmon announced that he and wife tested positive for the virus, have mild symptoms, and are isolating. He said she was tested Tuesday morning after learning that she might have been exposed to the virus, and when her test was positive, he got tested, too.

Auditor Mike Harmon
Harmon, 54, was among the latest round of state officials who got the vaccine Monday, but vaccines usually take a week or two to gain full effect, and both of the coronavirus vaccines in use require a follow-up booster shot three to four weeks after the first dose to be considered fully effective.

Harmon said, “While the timing of my positive test comes one day after receiving the Covid-19 vaccine, I still have full faith in the vaccine itself, and the need for as many people to receive it as quickly as possible.”

At least one of Harmon's fellow constitutional officers turned down Democratic Gov. Andy Beshear's invitation to get the vaccine, as a way to encourage constituents to get one. Agriculture Commissioner Ryan Quarles, who like Harmon is a term-limited Republican interested in unseating Beshear in the 2023 election, issued a statement that read in part:

Commissioner Ryan Quarles
"I plan on taking the vaccine, but I will wait for my turn in line. Though I appreciate the governor’s invitation, as a healthy 37-year old man with no underlying conditions I would rather my early access vaccine be given to a high-risk individual like a frontline worker or a resident of a long-term care facility, two groups who have unfortunately borne the brunt of the coronavirus. I understand the Centers for Disease Control’s recommendation that officials like the governor and top legislators be vaccinated for the sake of government continuity, but I do not believe rank-and-file politicians should be leapfrogging over those who are at higher risk of infection."

In other coronavirus news Wednesday:
  • The 29 newly confirmed Covid-19 fatalities were two women, 63 and 75, and an 81-year-old man from Bath County; a Bell County woman, 67; a woman, 96, and a man, 82, from Boone County; a Campbell County man, 86; three women, 80, 88 and 91, and two men, 70 and 84, from Fayette County; two women, 69 and 73, and two men, 68 and 82, from Floyd County; a Hopkins County man, 96; five Jefferson County women, 54, 71, 85, 100 and 100; a Johnson County woman, 78; a Kenton County man, 88; a Lawrence County woman, 79; a Lewis County woman, 82; a Mason County man, 67; a Monroe County woman, 93; and a Perry County man, 90.
  • Counties with more than 10 new cases were: Jefferson, 527; Fayette, 259; Kenton, 141; Hardin, 125; Pulaski, 104; Christian. 101; Laurel, 99; Boone, 97; Warren, 96; Daviess, 91; Boyle, 87; Pike, 75; Oldham, 74; Bullitt, 65; Clay, 57; Greenup, 57; Boyd, 55; Bourbon, 50; Campbell, Hopkins and Whitley, 48; Bell, 41; McCracken, 40; Madison, 38; Graves, 34; Harlan, 33; Knox and Nelson, 32; Fleming, 31; Marshall, Meade, Montgomery and Muhlenberg, 29; Carter, Franklin and Jessamine, 28; Allen, Clinton and Taylor, 27; Calloway, Lawrence and Mason, 26; Henderson and Shelby, 25; Anderson and Scott, 24; Floyd, Grayson, Lincoln and Wayne, 23; Breckinridge and Woodford, 22; Clark, 21; Butler, Johnson, Perry, Rockcastle, Rowan and Todd, 18; Logan and Ohio, 17; Barren, Hancock and LaRue, 15; Breathitt, Garrard, Russell and Webster, 14; Henry, Knott, Lewis, Mercer, Simpson and Spencer, 13; Carroll, Hart, Jackson, McCreary and Monroe, 12; and Metcalfe, 11.
  • Senate Majority Leader Mitch McConnell announced that President Trump's demand for additional relief checks to Americans "has no realistic path to quickly pass the Senate." McConnell had combined the proposal with two others, which Democrats called "poison pills," but he cited the national debt and the lack of targeting: "It is hardly clear that the federal government’s top priority should be sending thousands of dollars to, for example, a childless couple making well into six figures who have been comfortably teleworking all year." He concluded, “The Senate is not going to be bullied into rushing out more borrowed money into the hands of the Democrats’ rich friends who don’t need the help. We just approved almost a trillion dollars in aid a few days ago. It struck a balance between broad support for all kinds of households and a lot more targeted relief for those who need help most."
  • "The virus does not seem to spread much within schools when they require masks, urge social distancing, have good ventilation and when community spread is low," The Washington Post reports, summarizing the latest research. "But because of a lack of a cohesive federal response, huge gaps in the data remain, and many say new information about school transmission is not sufficient to make far-reaching conclusions."

Tuesday, December 29, 2020

Beshear worries that New Year's on top of Christmas will reverse Kentucky's recent progress on thwarting the novel coronavirus

Table in White House Coronavirus Task Force's weekly report shows the pandemic continued to decline in Kentucky during the reporting period of Dec. 19-25. To enlarge table, click on it. 

By Al Cross
Kentucky Health News

As he gave his last briefing of 2020, Gov. Andy Beshear said he worries that the New Year's weekend, a four-day holiday for many Kentuckians, will lead to more novel-coronavirus infections like those he has reason to believe occurred during the four-day Christmas holiday.

Beshear said the traffic and commercial activity he saw on Christmas Eve “gives me some very real concern, so New Year’s Eve, we gotta be better.”

Another indicator was a big jump in the percentage of Kentuckians testing positive for the virus in the last seven days, to 8.41%. The seven-day average on Monday was 7.97%.

That was the lowest since Nov. 10-11, the last time the figure took such a big jump, so Beshear said it could be a function of less testing over Christmas; the seven-day average on Dec. 23 was almost as high as it stood Tuesday, 8.35%. But he also said it "could well be more infections coming off gatherings."

Beshear urged Kentuckians to "keep any new-year celebration small; preferably your own household and one more. . . . Giving up one New Year’s Eve in your life isn’t a lot to ask when it comes to people staying alive or people dying."

Beshear extended three emergency orders, including the one requiring facial coverings in indoor public spaces. "We know that this is one of the most powerful tools to fight this virus," he said, saying masks kept him from being infected by a state-trooper driver.

"I need people out there to try," Beshear said. "I need them to do their duty; I need business owners to enforce this. . . . This more than anything else is going to decide how many people live and how many people die."

He said businesses that plan to host new-year gatherings "have to enforce the capacity requirements … have to enforce the mask mandates … and they have to keep advising people of the risks as they arrive."

With the state fully past the Christmas holidays, measures of the pandemic in Kentucky returned to higher levels, but within recent ranges. The state reported 2,990 new cases of the virus, lowering its seven-day rolling average of daily new cases to 2,031, nine less than Monday.

Beshear noted that the figure was “slightly less than Tuesday of last week,” suggesting a plateau or decrease, but “It’s very fragile.” He said actions over the coming holidays actions “can change success into failure.”

Kentucky hospitals reported 1,635 Covid-19 cases, half a percent more than Monday, but the number of those in intensive care (380) or on ventilators (211) declined.

Beshear reported 31 more deaths from Covid-19, more than all but four days in December, which has been the deadliest month of the pandemic, with 686 fatalities. The overall death toll is 2,594.

The governor extended three of his emergency orders, including the one requiring facial coverings in indoor public spaces. "We know that this is one of the most powerful tools to fight this virus," he said, citing his own example of how masks protected him from an infected state trooper who was driving him.

"I need people out there to try," Beshear said. "I need them to do their duty; I need business owners to enforce this. . . .This more than anything else is going to decide how many people live and how many people die."

Vaccines: Beshear said it is taking longer than expected to administer vaccines because of reporting requirements and construction of a network of providers who have not administered such a vaccine before.

He said the state has asked Walgreens and CVS, pharmacy chains that have federal contracts for vaccinations at long-term-care facilities, to continue the work on the holidays, but hasn't received a response.

He complimented Walgreens for vaccinating 1,009 residents and employees in 20 facilities, and suggested that he was less than satisfied with the 501 vaccinations reported by CVS. "We believe that their program is going to increase in volume," he said.

Federal relief: Beshear said the relief bill that became law Sunday night didn’t do at all he wanted but was "an important start." He noted several items, including money for testing, tracing and mitigation that he said should last five to six months.

"Education is a big winner," Beshear said. with $928 million coming to Kentucky for elementary and secondary education, $261 billion for higher education and a $60 million emergency relief fund, two-thirds of which is earmarked for private schools. He said he hoped that much of the K-12 money would go for remedial education of students who have fallen behind in the pandemic.

Beshear, a Democrat, made clear that he wants the Republican-controlled Senate to go along with President Trump and the Democrat-controlled House and approve $2,000 checks to each American instead of the $600 in the bill Trump delayed signing for several days over the issue. He said the bill would put $2.265 billion in Kentuckians' pockets, but they would get more than $5 billion from the bill that is pending in the Senate.

In other coronavirus news Tuesday:
  • The 31 fatalities were a Boone County woman, 88; a Clinton County man, 86; a Daviess County man, 73; a Floyd County man, 52; a Graves County man, 87; a Hopkins County woman, 78; three women, 33, 91 and 93, and a man, 85, from Jefferson County; a Jessamine County man, 97; a Knott County woman, 75; a LaRue County man, 93; a Laurel County man, 95; a Marshall County man, 77; a McCracken County man, 76; an Ohio County man, 77; an Owen County woman, 76; two Perry County women, 80 and 101; two women, 79 and 83, and a man, 78, from Pulaski County; two women, 58 and 86, and a man, 61, from Taylor County; two men, 75 and 82, and a woman, 50, from Wayne County; a Webster County man, 68; and a Wolfe County man, 74.
  • Counties with more than 10 new cases were: Jefferson, 414; Warren, 207; Kenton, 118; Hardin, 92; Boone, 87; Fayette, 84; Laurel, 76; Oldham, 76; Pike, 73; Campbell, 71; Christian, 71; Daviess, 67; Nelson, 66; Boyle, 56; Whitley, 52; Knox, 42; Lawrence, 41; Pulaski, 41; Boyd, 38; Bullitt, Jessamine and Madison, 36; Clay, Graves and Greenup, 34; Hopkins, 33; Wayne, 32; Logan, 30; Rowan, 28; Floyd, 27; Allen, Anderson, Barren, McCracken, Mason and Shelby, 26; Clinton, 25; Bourbon, Muhlenberg, Scott and Simpson, 21; McCreary, Ohio and Perry, 20; Marion, 18; Bell, Franklin, Lewis and Marshall, 17; Woodford, 16; Henderson and Monroe, 15; Grant, Grayson, Montgomery and Todd, 14; Taylor, 13; Mercer, Pendleton and Rockcastle, 12; and Garrard, Hancock and Jackson, 11.
  • Enrollment in Fayette County Public Schools fell by 730 in the past year, an apparent impact of the pandemic and part of a national trend, the Lexington Herald-Leader reports. Spokeswoman Lisa Deffendall told the newspaper, “The advent of Covid-19 has disrupted almost every aspect of our daily lives and forced many families to make difficult decisions about schooling for their children in order to find solutions that work best for their individual circumstances.”
  • Health officials in Colorado reported the first U.S. case of the mutated virus that appears to be more contagious. The man had not traveled outside the country, which "means he contracted the virus in the U.S., suggesting undetected transmission of the new variant here," Stat reports.

Pandemic thrusts Health Commissioner Steven Stack from usually low-profile job into often harsh spotlight of public scrutiny

State Health Commissioner Steven Stack, M.D., made a point during a news conference as Gov. Andy Beshear listened. (Photo by Matt Stone, Louisville Courier Journal
Less than a month after Dr. Steven Stack moved from running a hospital emergency department to running the state Department for Public Health, the first case of the novel coronavirus was reported in Kentucky and he immediately became the point person for handling it.

"I had no idea I was signing up for this," Stack told Deborah Yetter of the Louisville Courier Journal. "There was no way to anticipate this once-in-a-century pandemic, the likes of which no one alive has had to confront."

Yetter writes that the pandemic also thrust Stack from a job that "tended to be occupied by low-profile bureaucrats . . into the glare of public scrutiny," to which he wasn't accustomed, though he had been president of the American Medical Association in 2015.

"I didn't expect to be a TV personality," Stack told a legislative committee in August, Yetter notes. "I expect most governors forget their public-health commissioner once they announce the appointment."

Stack, 48, "said he has no regrets about taking on the job that has come with grueling hours and political firestorms over restrictions the state imposes, often on his advice, to try to limit the spread of Covid-19," Yetter reports.

"Yes, I would do it again," Stack said. "How many times do each of us have an opportunity in our lives to have such a meaningful impact?"

Stack was the second youngest president of the AMA and brought an unusual background to his medical and governmental career.

"Bespectacled and scholarly, partial to bow ties, Stack looks and speaks like the classics major he was at College of the Holy Cross, a Jesuit liberal arts school in Massachusetts he attended after attending St. Ignatius High in Cleveland, Ohio, also a Jesuit school," writes Yetter, a fellow Catholic.

"Holy Cross is the same college attended by the nation's top public infectious diseases expert, Dr. Anthony Fauci, 79 — though several decades apart, Stack once noted at a news conference. Stack often mentions his undergraduate studies, which included Greek, Latin and history as good preparation for the political heat he sometimes encounters as he seeks to convince a skeptical public and politicians about steps to curb the spread of Covid-19."

Stack asked, "Am I surprised by the by the intensity of the feelings expressed and the accusatory nature in which it is sometimes communicated? That's well-established throughout history. That's not new."

The strongest criticism of Stack has come from Republicans who control the General Assembly and are poised to cut back Beshear's emergency powers in the legislative session that begins Tuesday, Jan. 5.

At legislative committee meetings, Stack has been the lightning rod for criticism of Beshear's pandemic restrictions, on which he has advised, and more directly on his lack of responsiveness to emails and phone calls from legislators and the state's use of data that measures the pandemic.

When a deputy acknowledged at an August meeting that the reported positivity rate -- the percentage of Kentuckians testing positive for the virus in the previous seven days -- was imperfect because negative tests don't have to be reported, Sen. Danny Carroll, R-Paducah called the rate "totally inaccurate."
Stack replied that while the number is not perfect, does show trends, and is just one data point on which decisions are made. A few weeks later, the state started basing the rate only on electronically reported test results, and it did not appear to make a significant difference in the percentage.

Yetter's story ends with a statement Stack made to the committee: "I'm not here trying to save everybody. I can't save everyone. We're all dying, just some a little more quickly than others. I'm not here to separate people from their deaths, but I do want to prevent it from happening on a mass scale in people who should not have to or would not have to die."

Monday, December 28, 2020

Beshear says people 70 and older will be in the next phase of vaccinations; he faces a major task in deciding who will come next

CDC chart adapted by state Health Commissioner Steven Stack; numbers are national 
By Al Cross
Kentucky Health News

If you're 70 or older and live in Kentucky, you may be able to get vaccinated against the novel coronavirus in about a month.

That will be a younger threshold than in most states, because Covid-19 deaths in Kentucky are disproportionately among residents of nursing homes, Health Commissioner Steven Stack said as he and Gov. Andy Beshear laid out the second phase of vaccinations in the state.

The second phase will include people 70 and older, K-12 educators, and first responders who were not included in the first phase, which is for residents of long-term-care facilities, facility employees and other health-care workers who work in places where care is provided.

The Centers for Disease Control and Prevention recommended to states that the second round include workers key to the function of society, including teachers, police officers, firefighters and grocery workers, and people over 75.

State Department for Public Health chart; click on it to enlarge
Kentucky will use a threshold of 70, Stack said, because "We have such a disproportionate burden of death" among older people. He said 68 percent of Kentucky's Covid-19 fatalities have been nursing-home residents, while the national share is 40%.

Beshear said the second phase, officially called Phase 1b, will begin Feb. 1, "plus or minus a week," depending on availability of vaccines, and will take most of February.

The next step, Phase 1c, would be for people 65 and older, essential workers not included in the first two phases, and those 16 and over who have high-risk medical conditions. Stack said the latter group is "staggeringly enormous," numbering 110 million nationally. Kentucky has a larger percentage of high-risk individuals than the national average.

Slide used in Monday's briefing, adapted
With only 50 million doses of vaccines expected to be available in the U.S. by March 1, Stack said, “There’s not enough to get to all these people by March,” so the state will have to determine subgroups and their priorities. “If they weren’t further subdivided, there's no way we’d get through these in a reasonable and orderly fashion.”

Beshear said, “We’re building the airplane while were flying it. I'm sure there are going to be mistakes all around.” He added later, “The virtue I've got to ask everybody to show is patience, and its going to be harder and harder and harder” as time goes on. “Please have patience; I know we’re doing the best that we can.”

The first known miscue in Kentucky's vaccination plans came on Christmas Eve, when two Walgreens pharmacies in Louisville and Lexington made the Pfizer Inc. vaccine available to the general public after the company thawed too many doses for nursing homes, which it serves under a federal contract.

Beshear said he didn't know how many doses were involved, but said the company should have taken them to the next nursing homes on its schedule. He said the state doesn't "have operational control" over the Walgreens and CVS contracts for long-term care, but "We’re gonna be working with these facilities to make sure the right thing happens next time," and if another nursing home can't be served in time, distribution should be limited to people who are most at risk.

"We have to understand that with an undertaking this massive, mistakes are going to happen," the governor said. "I don’t think it was intentional, but it should have been done differently." He said Walgreens will have to follow up with the lucky recipients to make sure they get their second dose.

Walgreens told Lexington's WKYT-TV that a nursing home needed fewer doses than it requested, and in such cases offers the vaccine to first responders and then Walgreens employees before offering it to the general public. Once thawed, the vaccine is supposed to be used within 12 hours.

Health and Family Services Secretary Eric Friedlander said about 3,000 residents and 2,500 employees in more than 30 Kentucky nursing homes had been vaccinated. "This is a great start," he said. "We’re making a down payment on the promises to take care of those who are most vulnerable first. We’re learning as these roll out what the best way to proceed is."

Daily numbers: The state reported 1,455 new cases of the virus, lowering its seven-day rolling average to 2,040, the lowest since Nov. 10. Beshear said reporting was limited due to the holidays and perhaps by disruption of communications systems by the bombing in Nashville, but another leading indicator, the percentage of Kentuckians testing positive for the virus in the last seven days, again fell below 8%, to 7.97%.

“I believe now we've not only plateaued it,” Beshear said, “we’re starting to see cases decrease.” He said his bans on in-person schooling and indoor food service, and other restrictions imposed in mid-November, “made a real difference” both in cases and demand on hospitals.

Kentucky hospitals reported 1,552 Covid-19 patients Monday, 411 of them in intensive care and 217 of those on ventilators. The first two figures were well below the average of the past week, and all were well below the records of 1,817, 460 and 254 that were reported on Dec. 16 or 17. 

State Department for Public Health chart; to enlarge, click on it.

Beshear noted just two of the state's 10 hospital readiness regions have more than 80% of their ICU beds occupied; he did not note that the Lake Cumberland region is using 97.8% of its ICU capacity, as one of his slides and the state's daily report notes. The region has been a hotbed of cases recently.

Counties with 10 or more new cases were Jefferson, 225; Kenton, 83; Warren, 52; Pulaski, 51; Boone, 49; Boyle, 49; Fayette, 47; Marshall, 40; Henderson, 39; Mercer, 39; Daviess, 32; Campbell, 30; Bullitt, 29; Pike, 29; Greenup, 25; Knox, 24; McCracken, 24; Madison, 22; Calloway, 20; Graves, 20; Boyd, 19; Oldham, 19; Floyd, Rockcastle and Taylor, 17; Perry, 16; Carter, Clark and Russell, 15; McCreary and Shelby, 14; Franklin, 13; Grayson, 12; Clinton, Grant, Muhlenberg and Ohio, 11; and Allen, Bell, Casey, Rowan and Wayne, 10.

Beshear reported eight more deaths from Covid-19, bringing the state's total to 2,563: a Bath County man, 92; a Grayson County woman, 74; a Henderson County woman, 64; a woman, 93, and three men, 41, 67 and 79, from Jefferson County; and a Madison County woman, 80.

Dr. Don Miller
Beshear memorialized Dr. Don Miller of Bowling Green, who died of Covid-19 on Dec. 21. He was an emergency doctor at Med Center Health and had 11 children. His boss, colleague and good friend, emergency director Dr. William Moss, paid tribute in a video during Beshear's press conference.

In other coronavirus news Monday:
  • Beshear said the CDC has extended its moratorium on evictions through Jan. 31, and he renewed his executive order applying the moratorium to Kentucky.
  • He said the new federal relief bill gives Kentucky $297 million for rental assistance, plus separate allocations for Louisville and Lexington. The funds can be used for past due rent, future rent payments, as well as to pay utility and energy bills and prevent shutoffs.
  • The New York Times notes that the relief from the bill will come "over the objection of one of Kentucky’s Republican senators, Rand Paul, who was one of just six to vote against the package in the Senate, on the grounds that it amounted to handing out 'free money.' And it would be smaller and later than it might otherwise have been because of the work of the state’s other senator, Mitch McConnell, who as majority leader fought to limit the package." McConnell, who has Senate majority leader had more say-so than anyone else, said, “The compromise bill is not perfect, but it will do an enormous amount of good for struggling Kentuckians and Americans across the country who need help now.” The Times said Paul’s office didn't respond to requests for comment.

Sunday, December 27, 2020

Legislation to fix surprise medical billing won't apply to ground ambulances, but may produce data that will spur their inclusion

The new law will apply to air ambulances of Lifeguard Emergency Services of Eastern Kentucky and those of other U.S. ambulance services, but not to their ground ambulances. (Lifeguard photo)
The congressional fix for surprise medical bills, contained in the legislation to keep the government open, provide pandemic relief and do many other things, does not apply to ground ambulances, which "have the highest out-of-network billing rate of any medical specialty," The New York Times reports.

Congress "had little data on the actual costs of ambulance trips, and worried about tussling with the local governments that often oversee these services — especially those whose budgets have been battered by the economic downturn," Sarah Kliff and Margot Sanger-Katz report for the Times.

Research by Dr. Karan Chhabra of Boston's Brigham and Women’s Hospital found 71 percent of ambulance rides "have the potential to generate a surprise bill, with an average cost to the patient of $450," the Times reports. "Whether an ambulance company chooses to pursue this bill is something his research cannot determine, which is why it is merely potential." An earlier study found most ambulance rides "resulted in an out-of-network bill, a substantially higher rate than the medical specialties that the new legislation covers."

In the world of surprise medical bills, $450 is relatively small, and many ambulance services write off unpaid out-of-network bills as bad debts. But the new Congress could extend the new law — which President Trump signed Sunday night and will take effect in 2022 — to include ground ambulances.

"Medicare, which pays ambulances set rates and bans surprise billing for the patients it covers, is reviewing its payment rates," the Times reports. "As part of that process, the government is collecting detailed data from ambulance companies about their costs and prices. And the surprise-billing legislation passed this week establishes a commission to study the problem of ground ambulance bills, another way for lawmakers to learn more about how things are currently working."

Beshear's Facebook post shows generally stable virus numbers; comments on it reveal support, skepticism and unhappiness

Ky. Health News graph; click it to enlarge. New cases reflect unadjusted initial daily reports.
By Al Cross
Kentucky Health News

Measures of the novel-coronavirus pandemic remained generally stable Sunday, as Gov. Andy Beshear made only a Facebook post giving the day's numbers.

The state reported 1,509 new cases, marking the fifth consecutive Sunday that the number has been lower than the previous Sunday. Reporting on Sundays and Mondays is limited due to less testing and lab work on weekends; on top of that, this is the end of a four-day holiday weekend for most people.

The share of Kentuckians testing positive for the virus in the past seven days is 8.06 percent, which is also the average of the last four days.

The number of Covid-19 patients in Kentucky hospitals continued to decline, to 1,504, the lowest total since 1,442 on Nov. 16. Intensive-care units had 411 of those patients, about the average of the last 10 days. ICU patients on ventilators totaled 217, about the average of the last five days.

The state attributed the deaths of 21 more people to Covid-19, for a total of 2,555, but did not publish the usual list of deaths by gender, age and county.

Counties with 10 or more new cases were: Jefferson, 169; Fayette, 101; Henderson, 64; Boone, 63; Daviess, 60; Kenton, 56; Hardin, 43; Bullitt, 41; Calloway, 40; McCracken, 37; Pulaski, 36; Boyd, 34; Warren, 34; Boyle, 32; Letcher, 32; Campbell, Henry  an Lincoln, 25; Shelby, 23; Nelson, 22; Christian and Wayne, 21; Graves and McCreary, 20; Breathitt, 18; Madison, 17; Franklin, 16; Carter, 15; Grayson, 14; Scott, 13; Meade and Taylor, 12; Elliott, Floyd and Oldham, 11; and Clark and Union, 10. 

African Americans' share of Kentucky coronavirus cases and Covid-19 deaths continue to decline. The state's latest daily report says 9.5% of cases and 9.8% of deaths are among Blacks, who are about 8.5% of the state's population.

Not-always-social media: Beshear's Facebook post at around 3 p.m. generated more than 400 comments by 5 p.m. Most were favorable, but some reflected skepticism and unhappiness.

"I guess these fake numbers will get better every day until inauguration day," one man wrote, prompting several replies, such as "Yeah, just like it was gonna disappear after Election Day!" and "What a heartless thing to say. People are losing loved ones. I hope you don’t have to experience that to start believing it."

To the numbers of cases, the sick and the dead, one man replied, "Great, now what about unemployment? That’s just as important as these numbers are."

Many defended Beshear. One said, "Some people refuse to listen and they have caused the senseless deaths of others."

That brought this reply: "Just as the governor did not cause unemployment, permanent shuttering of small businesses, and collateral damage to students through online education, the people who refused to listen did not cause 'the senseless deaths of others.' The pandemic virus caused each. Playing the blame game helps no one." And that brought this rejoinder: "Those not doing what it takes to slow transmission of the virus are most definitely to blame for the deaths."

In other coronavirus news Sunday:
  • The smaller-than-expected initial supplies of vaccines are nothing unusual and should not keep most Americans from being able to get the vaccine by late April, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN's "State of the Union: "I believe we'll catch up with the projection."
  • State Rep. Thomas Huff, R-Shepherdsville, said on Facebook that has spent the past week in intensive care after testing positive the virus, the Courier Journal reports, adding that Huff "has expressed doubt on the validity of Covid-19 data and has been seen without a mask in the Capitol."
  • "President Trump on Sunday abruptly signed a measure providing $900 billion in pandemic aid and funding the government through September, ending last-minute turmoil he himself had created over legislation that will offer an economic lifeline to millions of Americans and avert a government shutdown," reports Emily Cochrane of The New York Times. "The signing was a sudden reversal for the president, who last week appeared poised to derail the bill. But the move came after two critical unemployment programs lapsed, guaranteeing a delay in benefits for millions of unemployed Americans."

Saturday, December 26, 2020

Trump helped get vaccines produced quickly, but he and some of his allies are complicating efforts to get people to take them

Fox News commentator Laura Ingraham, shown March 31, posted a story on Facebook from a right-leaning tabloid "that purported to show documents claiming that Chinese Communist Party loyalists worked at pharmaceutical companies" that made the vaccine, The Washington Post reports.
"President Trump and his allies have spent years stoking disinformation and doubt in official accounts about the election, the coronavirus, and other topics. Now those efforts are making it harder to rally support around his administration’s vaccine push," report Elizabeth Dwoskin and Josh Dawsey of The Washington Post.

The phenomenon has implications for Kentucky, because Trump carried the state by large margins: 29.8 percentage points in 2016 and 25.9 points in 2020. Though he lost, he has a large following and media allies.

Trump "has hailed his administration’s investments in vaccine development," but he "has a history of questioning vaccines" and has not committed to taking a vaccine, and misinformation experts told the Post that his "messaging that people should distrust authority has made it harder for the administration to take a victory lap over vaccine development," Dwoskin and Dawsey report.

White House spokesman Brian Morgenstern told the Post, “President Trump has repeatedly referred to the vaccines as ‘miracles’ and encouraged the American people to take them — including when he hosted an hours-long, live-streamed and nationally televised summit to educate the American people about the vaccine development and distribution process, build confidence in the safety and efficacy of the vaccines, and commemorate their creation as a national achievement that will save millions of lives.”

But Trump is only part of the puzzle, Dwoskin and Dawsey report: "Conspiracy theories about the vaccine are also brewing within Trump’s base, particularly among evangelical Christians and followers of the QAnon conspiracy theory, according to a report by the misinformation research group Zignal Labs."

The group "found that the most popular misleading story line about the coronavirus vaccine in recent weeks was about people who took the Pfizer vaccine developing the disease Bell’s palsy, which temporarily paralyzes muscles in the face," the Post reports. "An article from the Daily Mail, which reported that four volunteers who took the vaccine then developed the disease, garnered more than 179,000 shares on Facebook and 12,000 shares on Twitter, with an evangelical Christian community on Facebook contributing the single largest number of shares."

PolitiFact, a service of the Tampa Bay Times, says social-media users have exaggerated and distorted the story. "While the original Daily Mail story was accurate, and therefore allowed by the social-media companies, scientists have said that the number of people who developed Bell’s palsy — 4 in a group of 22,000 — is consistent with the number of people who have the disease in the actual population, and may have nothing to do with the vaccine, the fact-checking group said. The FDA is monitoring the issue," the Post reports. "At the same time, a popular Facebook meme appearing to depict the volunteers was actually recycling a photo from 2019."

Social-media chatter may be filling a vacuum left by Trump, who "has been somewhat absent from the conversation, frustrating aides who say that he could have a major impact on drumming up support for vaccination, say people familiar with the discussions who spoke on the condition of anonymity to discuss sensitive matters freely," Dowskin and Dawsey write.

"With so many Americans expressing doubt about the vaccine, aides say Trump could convince tens of millions of Americans — his most fervent supporters — that it was safe if he took it himself, the people said. But so far, he has not publicly announced plans to do so and has not held any major event to promote it. He has tweeted praising the vaccine, but he has eschewed any public appearances since its release to either take it or laud it."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that Trump should not take a vaccine until 90 days after taking monoclonal antibodies when he contracted the virus in October. That will be Dec. 31. Asked about that on CNN's "State of the Union" Sunday, Fauci said, "I would get him vaccinated; he is still the president of the United States, a critical person."

This story has been updated.

State reports Christmas Eve was pandemic's second-deadliest day, with 53 Covid-19 deaths, but positive-test rate fell below 8%

Screenshot of adapted New York Times interactive map shows Kentucky better than adjoining states but with hotspots like Clinton and Clay counties, with 102 and 101 cases per 100,000, respectively.
By Al Cross
Kentucky Health News

Christmas Eve was Kentucky's second-deadliest day of the pandemic, with confirmation of 53 deaths from Covid-19, Gov. Andy Beshear announced Saturday in a three-day report, his first since before the two state holidays.

Eleven deaths were confirmed Friday and four Saturday. The 53 deaths reported Thursday were second only to the 54 confirmed on Dec. 17.

“The number of deaths we’re announcing today is truly heartbreaking – another wake-up call,” Beshear said in a press release. “But one piece of good news is that our positivity rate continues to decline. It was even under 8 percent on Christmas Day.”

Kentucky Health News graph; click on it to enlarge
On Friday, the share of Kentuckians testing positive for the coronavirus in the last seven days was 7.95%. It was 8.2% Thursday and 8.04% Saturday. (The rate had been above 8% since Nov. 11 and peaked at 10.07% Dec. 3.)

“That means our sacrifices are making a difference,” Beshear said. “Thank you for doing the holidays differently this year to protect each other. Let’s keep working hard so we don’t have more days like today where we have to announce we’ve lost so many of our neighbors, family and friends.”

Probably due to limited testing-laboratory activity and reporting, reported numbers of new cases declined over the period, from 2,742 Thursday to 1,803 Friday to 764 Saturday.

The pattern resembled the one at Thanksgiving, when the day after the holiday had fewer than half the cases reported on the holiday. The periods are not fully comparable, since many people and laboratories take holidays on the day after Thanksgiving but the day before Christmas.

The seven-day rolling average of daily new cases fell to 2,725 Thursday, 2,528 Friday and 2.153 Saturday, the lowest since Nov. 13.

Kentucky hospitals reported 1,689 Covid-19 cases Thursday, 1,601 Friday and 1,511 Saturday, the  fewest since Nov. 16. However, Covid-19 patients on ventilators jumped to 237 on Saturday, the most in a week.

Health officials fear another surge in cases as a result of contacts during the holidays, but Health Commissioner Steven Stack sounded a positive tone.

“Many Kentuckians found new ways to celebrate Christmas yesterday, including limiting their in-person interactions with others,” Stack said in the news release. “Your sacrifices are appreciated, and a gift of kindness to your loved ones and your neighbors, as we keep this dreadful disease from spreading more rapidly. Please make sure you’re familiar with symptoms of this virus, and if you aren’t feeling well, please stay home until you are better or see a health-care provider.”

The 53 Covid-19 deaths confirmed Thursday included six from Hopkins County – four women, aged 67, 74, 92 and 94, and two men, 74 and 77 – and five from Pulaski County: three women, 52, 87 and 90; and two men, and 91. Each county also had a Covid-19 death on Friday.

The other deaths Thursday were a 67-year-old man from Boyle County; a 72-year-old Breckinridge County woman; two Bullitt County men, 55 and 74; a Campbell County man, 77; two women, 90 and 91, and man, 89, from Christian County; a Cumberland County woman, 71; two Daviess County men, 63 and 65; a Floyd County woman, 82; a Franklin County man, 83; a Graves County woman, 84; a woman, 94, and a man, 87, from Grayson County; a Hardin County woman, 100; a woman, 85, and three men, 70, 80 and 90, from Jefferson County; two Jessamine County men, 74 and 89; three Madison County women, 64, 68 and 73; a Mason County woman, 69; two Monroe County men, 73 and 77; two Muhlenberg County women, 77 and 90; an Ohio County woman, 77; an Owen County man, 91; a Rockcastle County woman, 66; three Russell County women, 86, 87 and 90; two Taylor County women, 82 and 84; a Trigg County man, 86; a Warren County man, 73; and a Wolfe County woman, 75. 

Friday's fatalities were an Anderson County man, 84; a Barren County woman, 71; a Cumberland County man, 60; a Franklin County woman, 71; a Hopkins County woman, 71; a Logan County woman, 87; a Madison County woman, 81; two McCracken County men, 62 and 91; a Monroe County man, 58; and Pulaski County woman, 85. Saturday's were a Hart County woman, 71; a Jefferson County man, 99; a Monroe County woman, 94; and a Simpson County man, 76.

In other coronavirus news:

  • Counties with 10 or more new cases Thursday were: Jefferson, 377; Warren, 150; Fayette, 147; Daviess, 97; Kenton, 90; Boyle, 77; Boone, 76; Marshall, 60; Boyd, 59; Christian, 59; Campbell, 55; Pulaski, 52; Muhlenberg, 44; Hardin, 42; Laurel, 40; Hopkins, Anderson, 34; Knox, 33; Lawrence, 33; Madison, 32; Bullitt, 31; Oldham, 31; Graves, 30; Harlan, 30; Calloway, 29; McCracken, 29; Nelson, 28; Wayne, 27; Floyd, 26; Grant, 26; Henderson, 25; Logan, Shelby and Simpson, 24; Letcher, 23; Greenup, 22; Carlisle, 21; Clark, Scott and Whitley, 20; Jessamine, 19; Allen, Estill, Lincoln and Pike, 17; Bourbon, 16; Fleming, Ohio, Rowan and Washington, 15; Lewis and Meade, 14; Jackson, Montgomery and Perry, 13; Barren, Clinton, Lyon, Mercer and Rockcastle, 12; Carter and Union, 11; and Bell, Clay, Livingston, Marion, Martin, Taylor and Woodford, 10.
  • Counties with 10 or more new cases Friday were: Jefferson, 428; Fayette, 177; Kenton, 89; Laurel, 51; Madison, 49; Christian, 42; Boyle, 41; Clay, 41; Boone, 40; Greenup, 39; Warren, 39; Graves, 29; Oldham, 29; Campbell, 28; Daviess, 28; McCracken, 27; Hardin, Letcher and Lincoln, 25; Pike, 24; Jessamine and Mercer, 21; Mason, 18; Harlan, 17; Bullitt, 16; Bell and Franklin, 15; Wayne, 14; Carter and Grayson, 13; Anderson, Fleming and Floyd, 12; and Allen, Calloway, Muhlenberg and Powell, 11.
  • Counties with 10 or more new cases Saturday were: Jefferson, 228; Fayette, 97; Warren, 29; Kenton, 27; Boone, 24; Fleming, 17; Franklin, 15; Campbell, 14; Greenup, 12; Madison, 12; Hopkins, 11; Logan, 10; and Whitley, 10.
  • "Scientists initially estimated that 60% to 70% of the population needed to acquire resistance to the coronavirus to banish it. Now Dr. Anthony Fauci and others are quietly shifting that number upward," reports Donald McNeil of The New York Times. “We really don’t know what the real number is,” Fauci told McNeil. But McNeil writes, "Having a good estimate is important. It gives Americans a sense of when we can hope to breathe freely again. . . . In the pandemic’s early days, Fauci tended to cite the same 60 to 70 percent estimate that most experts did. About a month ago, he began saying '70, 75 percent' in television interviews. And last week, in an interview with CNBC, he said '75, 80, 85 percent' and '75 to 80-plus percent.' . . . Fauci acknowledged that he had slowly but deliberately been moving the goal posts. He is doing so, he said, partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks. Hard as it may be to hear, he said, he believes that it may take close to 90 percent immunity to bring the virus to a halt — almost as much as is needed to stop a measles outbreak. Asked about Fauci’s conclusions, prominent epidemiologists said that he might be proven right."
  • The Centers for Disease Control and Prevention took 46 days to produce a working test for the coronavirus; scientists in Thailand did it in hours. The Washington Post explains what went wrong: "An overly ambitious test design and laboratory contamination . . . CDC leaders underestimated the threat posed by the new virus, and overestimated the agency’s ability to design and rapidly manufacture a test. Quality-control measures failed to prevent the shipping of compromised kits to dozens of state and local public health labs. . . . Without tests to identify the early cases, health authorities nationwide were unable to isolate the infected and trace the rapid spread among their close contacts. Those who were asymptomatic, yet contagious, went undetected. CDC Director Robert Redfield, an appointee of President Trump, took a hands-off approach while the in-house manufacturing efforts foundered and agency scientists clashed over whether to alter the design of the problem-plagued test, according to CDC and other federal officials."

Wednesday, December 23, 2020

As state heads into a long holiday weekend, new-case average keeps ticking up but Beshear emphasizes recent successes

White House Coronavirus Task Force chart; for a larger version, click on it.
By Al Cross
Kentucky Health News

Kentucky's averages of recent coronavirus cases and deaths continued to increase slightly Wednesday, but the percentage of Kentuckians testing positive for the virus continued to decline, and Gov. Andy Beshear remained upbeat as he issued his last pandemic report until after Christmas.

“This war is far from over, but we’ve won another battle, beating back exponential growth of this virus in our state before Christmas,” Beshear said in a press release.

“I hope you all enjoy a wonderful holiday, even if it looks a little different this year. Please be careful so we can hold on to the progress we’ve made. What I love about this holiday most is that it’s not about the gifts; it’s about people taking care of each other and appreciating their loved ones and community more than ever. Let’s all live up to the true spirit of Christmas this year, and every year in the future after we get through this together.”

The state reported 2,953 new virus cases Wednesday, raising the state's seven-day rolling average of daily new cases to 2,811. That was the third daily increase in a row; it was 2,761 on Dec. 20.

Beshear reported 26 more deaths from Covid-19, raising the state's toll to 2,466 and pushing the seven- and 14-day averages of deaths to 29.1 and 24.9, respectively.

Deaths are a lagging indicator. A leading indicator, the percentage of of Kentuckians testing positive for the virus in the last seven days, declined again, to 8.35%. That is the lowest rate since Nov. 12.

"Through the leadership of the governor, public-health officials, and Kentuckians adapting safe behaviors, virus level continue to decrease," said the latest White House Coronavirus Task Force report on Kentucky, for Dec. 12-18.

The report said "Hospitals are reporting critical staffing shortages, but the state is managing."

Wednesday's case numbers from Kentucky hospitals were generally stable. They reported 1,644 Covid-19 cases, 413 of them in intensive care and 222 of those on ventilators.

Coleman shows her shot site.
More state officials were vaccinated Wednesday: Lt. Gov. Jacqueline Coleman, Chief Judge Denise G. Clayton of the Kentucky Court of Appeals, acting State Police Commissioner Phillip Burnett Jr., Emergency Management Director Michael Dossett. Beshear Chief of Staff La Tasha Buckner, Senior Adviser Rocky Adkins and Virginia Moore, executive director of the Commission on the Deaf and Hard of Hearing, the lead sign-language interpreter at Beshear's briefings.

Beshear and other top-ranking officials were vaccinated Tuesday. He 
said Health Commissioner Steven Stack urged top officials to be vaccinated for the continuity of state government and to demonstrate to Kentuckians that the vaccine is safe and effective. The latter reason was cited by the director of the Centers for Disease Control and Prevention in requesting governors to be publicly vaccinated as soon as possible.

The 26 fatalities announced Wednesday were a 95-year-old woman and a 77-year-old man from Adair County; a Allen County man, 82; a woman, 90, and a man, 69, from Bath County; a Carter County man, 85; a Casey County man, 85; a Clinton County woman, 87; a Daviess County woman, 89; two Fayette County women, 85 and 89; a Greenup County man, 69; two Harlan County men, 73 and 89; a Hopkins County woman, 85; a woman, 82, and two men, 66 and 90, from Jefferson County; a Letcher County man, 69; two Lincoln County women, 69 and 79; a Madison County man, 83; a Mason County woman, 90; and from Pulaski County, a man, 76, and two women, 62 and 63.

In other coronavirus news:

  • Counties with more than 10 new cases were: Jefferson, 415; Fayette, Kenton, 124; Daviess, 103; Boyle, 98; Warren, 80; Boone, 77; Pike, 77; Laurel, 73; Hardin, 72; Christian, 68; Whitley, 60; Pulaski, 54; Wayne, 53; Lincoln, 50; McCracken, 47; Graves, 46; Madison, 45; Hopkins, 43; Oldham, 41; Harlan, 40; Bullitt, 38; Shelby, 36; Clay, 34; Marshall, 33; Henderson, 31; Anderson, 30; Marion, 28; Scott, 28; Campbell, 26; Taylor, 26; Barren, 24; Johnson, 24; Greenup, 23; Calloway, 22; Clinton, 21; Bath, Clark, Floyd, Franklin and Mercer, 20; Fleming, 19; Allen and McCreary, 18; Carter, Grayson, Jessamine and Todd, 17; Bell, Knox and Nelson, 16; Bourbon and Grant, 15; Rowan, 14; Breathitt, McLean, Rockcastle and Woodford, 13; Lawrence, 12; and Lewis, Martin and Union, 11.
  • State Auditor Mike Harmon says the state doesn't know how much money it owes people for backlogged unemployment benefits, the Lexington Herald-Leader reports.

Tuesday, December 22, 2020

As virus cases, hospitalizations and deaths tick back up, Beshear says holiday actions may determine who's around for next year's

Kentucky Health News graph; virus case numbers are based on unadjusted daily reports.
By Al Cross
Kentucky Health News

As Kentucky headed into another holiday with cases, hospitalizations and deaths from covid-19 trending slightly upward, Gov. Andy Beshear's parting message was upbeat but cautious.

“With the rest of the country on fire, with hospitalizations escalating in almost every other state, we are seeing a stabilization that is protecting the lives of our people, and we want to make sure we continue to plateau or even decrease cases as we move toward this vaccine,” Beshear said, referring to the shots he and other top officials got earlier in the day

“How we do Christmas and New Year’s, those celebrations, is gonna be critical to protecting as many Kentuckians as possible until we can get this vaccine disseminated,” the governor said. At the end of his last briefing until next week, he said, “How you handle Christmas and New Year’s may determine who’s around next Christmas and New Year’s.”

While the pandemic has hit a rough plateau in Kentucky, the state reported 3,057 new cases of the coronavirus Tuesday, pushing the seven-day rolling average upward for the second day in a row, to 2,803.

“Our numbers are high but pretty close to what we saw last week,” Beshear said. Last Tuesday's new-case number was 2,946.

At the other end of the disease process for some, Beshear reported 28 deaths, raising the state's 7-day and 14-day death means to new highs, 28.7 and 24.1.

As he usually does, Beshear urged Kentuckians to display green lights and ring bells in memory of the 2,440 Kentuckians who have died of Covid-19.

“You never know who’s listening; you may never know who will find a moment of help in them,” he said, adding that green lights and the sound of the bells may make survivors of Covid-19 victims realize that “even though we don’t see and get close, we are in this together.”

Norris Hardison, who served in the Army, was the first vet
at the center to get a shot. (Photo from governor's office)
As vaccinations at nursing homes and hospitals continued, the first were performed at the Thomson-Hood Veterans Center in Wilmore, one of four state facilities for vets, which has lost 34 residents to Covid-19.

The first was Norris Hardison, who was quoted in Beshear's press release: “I am not afraid. I want everyone to see me take it and know that it is safe. Every single person should get this vaccine. I have been talking to my family, and even my daughter, who is afraid of needles, is going to take it. It’s the best way to protect us all from this Covid virus, and I am just so happy that it’s finally here.”

Beshear said 90 vets and more than 100 employees at the center were vaccinated Tuesday, and the two homes in the east and west would be next, on Jan. 9, with the Radcliff home soon afterward. 

“This is a great step forward, but it’s gonna take time,” he said, noting that preventive measures will still be needed for months, and that even people who have been vaccinated may still catch the virus and spread it.

Kentucky's long-term care facilities have accounted for two-thirds of the state's Covid-19 deaths. Yesterday they reported 115 more cases of the virus among residents and 72 among staff, and the state attributed 18 more deaths of residents to Covid-19. There are 3,346  active cases in 408 facilities.

Beshear said it will take a few weeks, maybe all of January, before the state can move on to vaccinations of other groups. He said the state could easily set up a program for people 75 and over, as the Centers for Disease Control and Prevention has recommended, but it will be impossible to include at the same time all of the "essential workers" the CDC listed. He said he would probably have more information next week on that front.

The 28 Covid-19 fatalities reported Tuesday were a 91-year-old woman from Boyd County; two Calloway County women, 91 and 94; a Casey County man, 66; two women, 64 and 87, and a man, 71, from Daviess County; a Fleming County man, 67; a Graves County woman, 67; two women, 57 and 63, and two men, 58 and 83, from Henderson County; a Henry County man, 67; a Hopkins County man, 67; a Jackson County woman, 74; a woman, 53, and a man, 62, from Jefferson County; a Knott County man, 81; three Marion County women, 86, 94 and 96; two McCracken County men, 79 and 85; a woman, 87, and a man, 59, from Monroe County; a Perry County woman, 60; and a Todd County woman, 54.

In other coronavirus news Tuesday:

  • Counties with more than 10 new cases were: Jefferson, 468; Warren, 136; Madison, 127; Fayette, 125; Kenton, 113; Christian, 105; Daviess, 89; Boone, 88; Laurel, 81; Pike, 61; Clay, 53; Campbell, 47; Henderson, 44; Knox, 43; Hardin, 42; Pulaski, 40; Wayne, 39; Lincoln, Logan and Oldham, 38; Barren and McCreary, 37; Bullitt, 36; Whitley, 32; Scott, 31; Hopkins and Simpson, 30; Grant and Nelson, 29; Boyle, 28; Jessamine, 27; Allen and Mercer, 26; Clinton, 25; Clark, Ohio and Taylor, 24; Carter and Harlan, 23; Graves, 22; Johnson, 21; Bath and Grayson, 20; Boyd Franklin and Muhlenberg, 19; Greenup and Monroe, 18; Calloway and McCracken, 17; Bourbon and Letcher, 16; Anderson and Perry, 15; Harrison and Montgomery, 14; Adair, Lewis and Trigg, 13; Estill, Marion, Marshall, Meade and Russell, 12; and Breathitt, Butler, Fleming, Jackson and Shelby, 11.
  • Beshear said that while the pandemic relief bill passed by Congress doesn't include general budget relief he wanted, "It includes a lot of things that help us out, such as hundreds of millions of dollars for vaccines and distribution, testing and contact tracing. "That’s what we needed the very most."
  • The bill gives states another year to spend money that they received from last spring's relief bill. Beshear said Kentucky will have $200 million to $250 million of that remaining on Dec. 31, the original spending deadline, but will use most of the money to pay off the loan it obtained for unemployment benefits.
  • Kentucky has been one of the slowest states to deliver unemployment benefits. Beshear has blamed an avalanche of claims and a system not maintained by previous administrations. He said the state had received such differing guidance from the U.S. Department of Labor that the department's inspector general "has launched an investigation."
  • Beshear said the next state budget needs money to improve that system and others. The Democratic governor said the Republican-heavy legislature will have to decide, in Depression-era terms, “whether this state is gonna be FDR or Herbert Hoover."

Governor, legislative leaders, chief justice, cabinet secretary, health commissioner, first lady get vaccinated in Capitol rotunda

First lady Britainy Beshear watches as nurse Michelle Searcy
of the Franklin County Health Department gives the governor
a dose of the Moderna vaccine. (Governor's office photos)
By Al Cross

Kentucky Health News

Gov. Andy Beshear, first lady Britainy Beshear, state Senate President Robert Stivers, House Speaker David Osborne, Health Commissioner Steven Stack and other officials took vaccinations for the novel coronavirus in the rotunda of the state Capitol this morning.

The event showed "broad, bipartisan support for the safe, effective Covid-19 vaccination," a news release from Beshear's office said. It said the Beshears' two children, aged 11 and 10, will be vaccinated when a vaccine is approved for children.

“I would not risk my life or the life of my family, which I love more than life itself, if I didn’t believe this vaccine was safe and highly effective,” Beshear said. “These vaccines are a gift and our best vehicle to end this evil pandemic, allow our children and educators to safely return to school and reignite our economy.”

Senate President Robert Stivers gets his vaccination.
The event was an unusual joint effort for the Democratic governor and the leaders of the legislature's heavy Republican majorities, who have criticized his approach to the pandemic and have vowed to limit his emergency powers -- but recently got a briefing, courtesy of Beshear, from the response coordinator of the White House Coronavirus Task Force.

In the news release issued by Beshear's office, Stivers said, “The arrival of the Covid-19 vaccine signals an optimistic turning point in our fight against the virus. This bipartisan group of leaders chose to take the vaccine together to send a message that the vaccine is safe and it is crucial for the health and welfare of the commonwealth. The importance of taking the vaccine cannot be overstated, because you are protecting yourself and your fellow Kentuckians. I encourage everyone who is able to get vaccinated when the opportunity arises.” Stivers told reporters afterward that he participated to show "there's no politics in this."

House Speaker David Osborne gets his vaccination.
Osborne said in the release, “As health care workers and medical providers line up to receive theirs, Kentuckians should begin talking to their physicians about their plans to take the vaccine. We are here today because as leaders of all three branches of state government, we know there are those who question whether or not the vaccine is right for them. While it is a personal choice, we have full faith in its safety and supportive of the state’s work to make it available.” 

Chief Justice John Minton gets his vaccination.
Minton said, “I appreciate the governor’s request for the heads of the three branches of government to be vaccinated. I recognize this is a privilege most Americans don’t yet have, but Dr. Steven Stack and the Centers for Disease Control recommended that we get the vaccine to ensure the continuity of state government. I’ve already begun advocating for our judges, circuit clerks and deputy clerks to get the vaccine as soon as they’re eligible based on the federal distribution schedule. They’re essential workers who have frequent contact with the public and we want to ensure their safety as they conduct the important business of the courts.”

Secretary J. Michael Brown gets his shot.
Also vaccinated in the rotunda was J. Michel Brown, secretary of the Executive Cabinet, the office that oversees the executive branch of state government, and Stack, who has been the state's point person for dealing with the pandemic. “I’m grateful that the senior leaders of Kentucky’s government have come together today for a shot of hope and to lead through their example,” Stack said. “These vaccines offer new hope just in time for the holidays that 2021 will bring healthier, happier times.”

Beshear encouraged other elected officials and community leaders, including business executives and faith leaders, to get vaccinated when it is their turn.

Searcy also got her shot, from a colleague.
Asked later why he got a shot when he is the nation's second youngest governor, at 43, and the youngest, Republican Ron DeSantis of Florida, 42, said he would wait because he is under 45, Beshear said the CDC director advised governors in a conference call to get publicly vaccinated as soon as possible "to build confidence" in the vaccines. "There is real hesitancy out there."

Beshear said DeSantis hasn't followed some other CDC recommendations: "Maybe he ought to listen to the CDC director a little bit more."
In other coronavirus news Tuesday:
  • The pandemic relief and government funding bill includes several provisions for rural health care including a reform of Medicare’s payment formula for rural health clinics, Inside Health Policy reports: "The package ensures no Rural Health Clinic has its reimbursements reduced while phasing in over eight years a steady increase in the Rural Health Clinic statutory cap. All new clinics will be subject to a uniform per-visit cap, and uncapped clinics with payments above the upper limit will have their annual rate of growth controlled."
  • Sen. Rand Paul and Rep. Thomas Massie, who often split with other Republicans on spending issues, were "outraged" at the bill and voted against it, the Lexington Herald-Leader reports.