Thursday, May 13, 2021

Beshear says Ky. will follow new CDC mask guidance for fully vaccinated, an incentive for Kentuckians to get 'your shot of hope'

Centers for Disease Control chart; to enlarge, click on it.
By Melissa Patrick
Kentucky Health News

The Centers for Disease Control and Prevention issued new recommendations Thursday that drop most mask rules for people fully vaccinated against the coronavirus, and Gov. Andy Beshear says Kentucky will follow suit. 

"This is outstanding. It means that we are so close to normalcy and we're going to be changing Kentucky's mask mandate to be the same with those CDC guidelines," Beshear said in a Facebook post. "Now, folks, this means you ought to go get your shot of hope if you haven't." 

Beshear said "hundreds of thousands" vaccine appointments are available across the state, adding that when you are fully vaccinated, it is now safe to take that mask off. "Let's defeat this pandemic once and for all."

So far, 1,897,117 people have received at least one dose of a vaccine in Kentucky, or 43% of the state's total population.  The Washington Post reports 35.1% of the state's total population has been fully vaccinated. 

The new guidance allows fully vaccinated people to not wear a mask indoors, with some exceptions, and outdoors altogether. 

"Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing," CDC Director Rochelle Walensky said at a press conference. "We have all longed for this moment."

Walensky said the guidance is "based on the continuing downward trajectory of cases, the scientific data on the performance of our vaccines, and our understanding of how the virus spreads."

She cautioned that fully vaccinated people who are immune-compromised should talk to their doctor before following the new mask guidance. 

The guidance makes exceptions for crowded indoor spaces: buses, airplanes, health-care settings, congregate settings such as jails and homeless shelters, or where it conflicts with federal, state, local, tribal or territorial laws, rules and regulations, including local rules for workplaces. 

It calls on fully vaccinated people who experience Covid-19 symptoms to get tested and for them to follow the CDC and health department's travel requirements and recommendations. 

A fully vaccinated person is one who is two weeks past getting their second dose of either the Pfizer BioNTech or Moderna vaccine, or a single dose of the Johnson & Johnson vaccine. 

Republicans said it's time for the Democratic governor to follow the lead of neighboring states and end all mask mandates and capacity restrictions. House Speaker David Osborne pointed out that the state has not seen a spike in cases after hosting more than 50,000 people at the Kentucky Derby.

“Today’s announcement by the Centers for Disease Control and Prevention is just further evidence that we are well past the time for this mandate to expire and our state to go even further in eliminating capacity restrictions," Osborne said in a prepared statement. "The legislature recognized this when we chose not to extend these mandates as part of Covid relief legislation passed during the 2021 session, but the governor chose to challenge the measure in court."

The legislation would end the mask mandates if the state Supreme Court rules in Beshear's favor in an earlier lawsuit over his emergency powers.

Osborne added, "The CDC speaks clearly to the need to rely on local, more targeted approaches and guidance, as well as the fact that individuals are prepared to make the decisions necessary to protect themselves. What further evidence does this administration need to open our state?" 

In an op-ed for the Lexington Herald-Leader, Agriculture Commissioner Ryan Quarles again called for Beshear to set a firm date to reopen the state's economy. 

"While his latest announcement of loosening capacity restrictions is a step in the right direction, it is still not good enough for our small businesses, like restaurants, or where other leaders across the country are headed or have been," Quarles wrote. 

Beshear has said businesses that serve less than 1,000 people can operate at 75% capacity starting May 28. He has also said he will lift the curfew on restaurants and bars on that same day. 

Daily numbers: The state reported 674 new cases of coronavirus Thursday, with 151, or 22.4% of them in people 18 and under. That brings the seven-day rolling average to 522, about where it has been for four days. 

The percentage of Kentuckians testing positive for the virus in the last seven days is 3.04%. The average has declined for eight days, from 3.57%.

Kentucky hospitals reported 411 Covid-19 patients, 14 fewer than Wednesday; 117 in intensive care (down 12); and 47 of those on a ventilator (down 3). 

Two of the state's 10 hospital-readiness regions are using at least 80% of their intensive-care beds: the easternmost region, from Lee to Pike counties, at 85.3%, and Lake Cumberland, at 88.9%. 

The statewide rate of new cases over the last seven days is 9.31 cases per 100,000 residents. The rate has dropped for nine straight days, from 11.47. The New York Times ranks Kentucky's rate 23rd among the states, with a 10% drop in cases in the last 14 days. 

Counties with rates more than double the statewide rate are Powell, 37 per 100,000; Montgomery, 33; Webster, 30.9; Rockcastle, 28.2; Estill, 26.3; Bath, 26.3; Mason, 24.3; Adair, 23.1; Lewis, 22.6; Union, 21.9; Fleming, 21.6; Taylor, 21.1; Casey, 20.3; and  Fulton, 19.1.

The state's daily pandemic report shows seven more deaths from Covid-19, four from regular health- department reports and three from an ongoing audit of death certificates. The state's Covid-19 death toll is 6,637. 

The daily report lists the number and source of death reports, but not a list of fatalities by age, sex, county and date of death. That was included in the daily press releases that were discontinued this week.

In other pandemic news Thursday:
  • Counties with 10 or more new cases were Jefferson, 138; Fayette, 38; Pulaski, 30; Wayne, 27; Kenton, 26; Adair, 20; Hardin and Warren, 17; Daviess, 15; McCracken, 14; Boone, 12; Campbell, 11; Clark, Grant and Johnson, 10. 
  • In an effort to get more soldiers vaccinated, Fort Campbell's commander says unvaccinated troops will not be able to travel freely over the summer, Blake Farmer reports for WPLN, Nashville Public Radio. "Service members are able to turn down the vaccine at this point, since it only has emergency authorization from the FDA. Fort Campbell officers say roughly two-thirds of the installation has at least indicated they will get vaccinated. But they say that over the last two weeks, fewer and fewer have gotten their shot each day," Farmer reports.

Kentucky Sen. Rand Paul, Tucker Carlson and other Republicans try to blame the pandemic on Dr. Anthony Fauci

Sen. Paul struck a nerve with Dr. Fauci. (Getty Images)
By Aaron Blake

For much of the past year, Republicans have decried lead government coronavirus expert Anthony S. Fauci’s prescriptions for mitigating the pandemic — including masks, social distancing and keeping society shut down.

But increasingly in the past week, the effort has taken on a new flavor — with suggestions that Fauci might be personally to blame for the advent of the virus itself.

There remain major questions about just how the virus emerged, including the idea that it somehow escaped a lab in the city of Wuhan, China, where the virus originated. The theory, which was once highly speculative and which was downplayed by top medical experts such as Fauci, is suddenly being treated more seriously, though there is no conclusive evidence either way.

But while some Republicans have criticized the initial dismissal of that theory as evidence of a lack of curiosity from the media and health officials about the origins of the virus — or even some kind of pro-China or anti-Trump bias — the theories about Fauci’s complicity take things to another level.

With Fauci set to testify before the Senate on Tuesday, Fox News host Tucker Carlson teed things up the night before. In a commentary leading off his show, he played up the idea of a lab leak, pointing (rightly) to shifting beliefs in the medical community about its plausibility and treating it as an open question.

But then he pivoted to treating this as something amounting to fact.

While talking about National Institutes of Health funding for the Wuhan Institute of Virology, Carlson referred to “the deadly experiments that were going on there” — which is valid, given that’s the kind of thing virologists do.

But he then referred to them, as if the lab-leak theory were proved, as “the experiments that clearly went so wrong.”

Again, there is no firm evidence that the spread of the coronavirus was the result of experiments that “clearly” went “so wrong” in the Wuhan lab. Carlson has a knack for suggesting things without saying them directly, but this veered in a much more conspiratorial and unproven direction than usual.

“This wouldn’t have happened if Tony Fauci didn’t allow it to happen — that is clear,” Carlson continued, referring to the funding. “It’s an amazing story. It is a shocking story. In a functional country, there would be a criminal investigation into Tony Fauci’s role in the covid pandemic that has killed millions and halted our country, changing it forever."

The easy answer is that it’s speculative and that criminal investigations generally involve some kind of genuine evidence of wrongdoing or violations of specific laws. It has been known for a long time that U.S. health agencies funded the Wuhan Institute of Virology, and it’s valid to ask whether that funding was a good idea. But there is no evidence that such funding ran afoul of U.S. law or that it contributed to the pandemic.

Carlson doubled down Tuesday night on the unproven lab leak theory and Fauci’s supposed responsibility for it, suggesting Fauci should not just be investigated but indicted. “The guy in charge of America’s response to covid turns out to be the guy who funded the creation of covid,” Carlson said, again going much further than the evidence allows. And Carlson’s guest, coronanvirus and vaccine skeptic Alex Berenson, actually pushed back on the idea of Fauci’s culpability.

GOP senators picked up that ball and ran with it Tuesday, pressing Fauci on the idea that funding the Wuhan lab put him at fault.

Sen. Rand Paul, who has clashed repeatedly with Fauci, pressed him on funding for the Wuhan lab. Paul suggested that the funding ran afoul of a prohibition on “gain-of-function” research — i.e., altering genomes to give viruses new properties, such as the ability to infect a new host species or to transmit more easily. The idea behind such research is that it might provide insight into how a virus spreads and improve efforts to counteract it, though it also carries obvious risks, which is why funding for such research is limited.

Paul claimed that the U.S. government was downplaying the link between gain-of-function research and the coronavirus because it was “self-interested” in continuing such research, or even covering up its role in the pandemic. He went on to press Fauci on the funding for the Wuhan lab, at which point Fauci said repeatedly that such funding was not intended to fund gain-of-function research (which fact-checkers have validated).

“With all due respect, you are entirely and completely incorrect that — the NIH has not ever and does not now fund gain-of-function research in the Wuhan Institute,” Fauci said.

Paul then reverted to pointing to alleged gain-of-function research that is taking place in the United States, rather than the Wuhan lab, to which Fauci offered a rather lawyerly response about what gain-of-function research is. Paul then pressed him on sending broader funding to the Wuhan lab.

Fauci did at one point say about the lab-leak theory: “I do not have any accounting of what the Chinese may have done, and I am fully in favor of any further investigation of what went on in China.”

Paul later got some backup from Sen. Roger Marshall, a Kansas Republican.

Marshall, who like Paul is a doctor, repeatedly pressed Fauci on the idea that such viral research could have led to the novel coronavirus. He asked whether Fauci could definitively say that NIH funding didn’t, in some way, play a part in a theoretical eventual lab leak, citing research on mice.

“Could some of the funding [have] indirectly ended up to the contribution of Covid-19?” Marshall asked.

Fauci, testily, responded that the question was excessively broad, because many types of research could conceivably meet the definition as having one day contributed to the spread of the virus.

“I’m not sure exactly where that question is going,” Fauci said. “I mean, you could do research on something as benign as looking at something that has nothing to do with it, and it could, indirectly, some day, somehow be involved. So if you want to trap me into saying yes or no, I’m not going to play that game.”

Wednesday, May 12, 2021

People under 18 made up about 19% of new virus cases in Kentucky Wednesday as Pfizer vaccine OKd for children 12 to 17

State Dept. for Public Health map, relabeled by Kentucky Health News; to enlarge, click on it.
By Melissa Patrick
Kentucky Health News

The Pfizer-BioNTech coronavirus vaccine has been approved for older children, and the move seems timely in Kentucky, with more than 19 percent of the state's new cases in people 18 and younger. 

Gov. Andy Beshear reported 680 new cases of the virus Wednesday, lowering the state's seven-day rolling average by four, to 520. Of those, 132, or 19.4%, were in people 18 and under.

The Centers for Disease Control and Prevention approved use of the Pfizer vaccine in children as young as 12, effective immediately. The vaccine has been authorized for people 16 and older since December.

The late-afternoon move prompted Beshear to issue a press release in which he said, “Starting tomorrow, more Kentuckians will have the opportunity to receive a Covid-19 vaccine and further protect themselves and those around them from this dangerous virus. We’ve seen new Covid-19 cases decline as more and more vaccines have been administered. Now, many Kentucky children and young teens have a chance to roll up their sleeves and become heroes for their communities by receiving their shot of hope.”

Citing a report from the Kaiser Family Foundation, the release said about 231,000 Kentuckians are in the 12-15 age group. That's approximately 5% of the state’s population.

Beshear's office announced Tuesday that he would no longer issue regular pandemic press releases on days he does not hold news conferences, about two days a week. The number of new cases and the positive-test rate are posted on social media and the daily report on the Department for Public Health website.

Most measures of the pandemic in Kentucky declined slightly Wednesday. The share of Kentuckians testing positive for the virus in the last seven days is 3.08%, down for the seventh consecutive day. 

The state rate of new cases in the last seven days is 9.52 per 100,000 residents, down for the eighth straight day. The New York Times ranks Kentucky's rate 24th among the states, with a 7% drop in the last 14 days. 

Counties with new-case rates double the statewide rate are Powell, 42.8 per 100,000; Montgomery, 36.5; Rockcastle, 35.1; Webster, 29.8; Estill, 27.3; Lewis, 24.8; Bath, 21.7; Fulton, 21.5; Owen, 21; Fleming, 20.6; Hickman,19.6; Casey, 19.4; and Taylor, 19.4.

So far, 1,898,937 people have received at least one dose of a vaccine in Kentucky, or 43% of the state's total population. Go to vaccines.gov/search/ to find a Covid-19 vaccination site.

Last week's State Profile Report for Kentucky showed that about 1.5 million Kentuckians were fully vaccinated, or nearly 34% of the total population. 

The state's vaccine dashboard highlights the top and bottom counties for percentage of population with at least one dose. The top five are Woodford, 56%; Franklin, 56%; Fayette, 53%; Scott, 47%, and Campbell, 46%. The bottom five are Spencer, 18%; Christian, 18%; Ballard, 19%; Lewis, 20%, and McCreary, 20%. 

The state reported 10 more Covid-19 deaths, nine from usual health-department reports and one from an ongoing audit of death certificates. The 14-day death average remains 9.29 per day. Kentucky's Covid-19 death toll is 6,630.

The state's daily Covid-19 report lists the number and source of death reports, but not a list of fatalities by age, sex, county and date of death. That was included in the daily press releases that have been discontinued.

Kentucky hospitals reported 425 Covid-19 patients, 10 more than Tuesday, with 105 of them in intensive care (down 4), and 50 of those (down 1) on ventilators. 

Two of the state's 10 hospital-readiness regions are using at least 80% of their intensive-care beds: the easternmost region, from Lee to Pike counties, 83%; and Lake Cumberland, 87%. 

Counties with 10 or more new cases reported Wednesday were Jefferson, 127; Fayette, 36; Pulaski, 32; Kenton, 31; Warren, 26; Boone, 22; Daviess, 19; Henderson, 15; Grant, 14; Campbell, Hardin, McCracken and Scott, 13; Lincoln, Madison, Montgomery and Shelby, 11; and Oldham, 10.

Tuesday, May 11, 2021

Most Ky. Covid-19 metrics remain stable, but deaths are up

Ky. Health News graph; does not include deaths found by death-certificate audit; click it to enlarge.
By Melissa Patrick
Kentucky Health News

Most of the metrics used to measure the coronavirus remain on a plateau in Kentucky, but with 23 deaths reported on Tuesday, it is clear that the virus remains deadly for some.

Health Commissioner Steven Stack emphasized that point at Gov. Andy Beshear's news briefing Monday, saying several times that "Covid is a bad disease" and begging Kentuckians to get vaccinated.

So far, 1,882,396 people have gotten at least one shot of a vaccine in Kentucky, amounting to 53% of Kentuckians 18 and older and 42% of the state's population. 

“No matter where you are in the state, you can sign up for a Covid-19 vaccine near where you live or work,” Beshear said in a news release. “Now, when you get a shot of hope at many Kroger or Walmart locations, you can even earn a free shot at winning the lottery. It’s easier than ever.”

Soon, children between the ages of 12 and 15 can also get the vaccine. The Pfizer-BioNTech vaccine has been approved by the U.S. Food and Drug Administration for this age group, and awaits final approval from a federal advisory committee Wednesday. Go to vaccines.gov/search/ to find a Covid-19 vaccination site. 

Cassie Prather, director of the Woodford County Health Department, told WKYT that adolescent cases are 20 percent of their total now, up from 3 percent, and she worries that youth are Petri dishes for more contagious variants. Statewide, nearly 18% of Tuesday's cases, 136, were in people 18 and younger.

Daily numbers: Beshear reported 758 new cases of the virus Tuesday, bringing the seven-day rolling average to 524, down two from Monday. 

The share of Kentuckians testing positive for the virus in the past seven days is 3.15%. This average has been under 4% for two months.

The state's daily rate of new cases over the last seven days is 9.89 per 100,000 residents, falling below 10 for the first time since April 9. This rate has dropped 13.6% in the last week, from 11.47 on May 4. 

Counties with rates more than double the statewide rate are Powell, 50.9; Montgomery, 45.2; Rockcastle, 31.7; Webster, 27.6; Owen, 27.5; Lewis, 26.9; Bath, 26.3; Estill, 23.3; Mason, 22.6; Fleming, 20.6; Taylor, 20.5; Union, 19.9; and Menifee, 19.8.

The New York Times ranks Kentucky's rate 24th among the states, with a 1% increase in cases over the last 14 days. Only six other states, including Indiana at 3%, have seen increases over that period. Louisiana and Arkansas lead at 15% and 13%, respectively.

The state reported 23 more deaths from the virus, all of them from regularly reported health department reports. This is the most deaths reported in one day since March 28, when 27 were reported. These numbers vary widely because of how health departments report them. The 14-day death average is 9.29 deaths per day; on April 30, it hit a recent low of seven per day. Kentucky's death toll from the disease is now 6,620.

Kentucky hospitals reported 415 Covid-19 patients, 109 of them in intensive care and 51 of those on a ventilator. The latter numbers were the same as Monday; Covid-19 hospitalizations were up by 11.

Among the state's 10 hospital-readiness regions, the only one using at least 80% of its intensive-care-unit capacity is the easternmost region, from Lee to Pike counties, at 81.6%. 

Starting Wednesday, May 12, the daily Covid-19 report will be posted daily on Beshear's social media channels around 5 p.m., instead of being posted in a news release. A full release will be sent on days that the governor holds a Covid-19 press conference. Recently he has done those two days a week. 

In other pandemic news Tuesday:

  • Counties with 10 or more new cases were Jefferson, 93; Fayette, 51; Boone, 45; Campbell, 28; Taylor, 24; Pulaski, 23; Kenton, 21; Bullitt, 20; Warren, 19; Pike, 16; Shelby, 15; McCracken, Mercer and Oldham, 14; Christian and Madison, 13; Rockcastle and Webster, 12; Breathitt, Hopkins, Jessamine and Lewis, 11; and Hardin, 10.
  • Tuesday's fatalities were an Anderson County man, 64; a Barren County woman, 42; a Bullitt County man, 68; a Carter County man, 101; a Daviess County man, 94; a Fayette County man, 59; a Grant County woman, 92; a Graves County woman, 84; a Henderson County woman, 90; two Jefferson County women, 95, 97; a Lawrence County woman, 87; a Letcher County man, 79; a McCracken County woman, 92; a McCracken County man, 55; a Menifee County woman, 90; a Monroe County woman, 70; a Muhlenberg County woman, 96; a Rockcastle County man, 62; a Simpson County woman, 59; a Taylor County woman, 74; a Wayne County woman, 71; and a Whitley County woman, 57.
  • States will get no Johnson & Johnson vaccine next week because of production problems, federal officials told governors in a private call, Politico reports.
  • Some people have found they prefer to wear masks, for a variety of reasons, Julia Carrie Wong writes for The Guardian. They include anonymity, hiding their ethnicity, avoiding unwelcome attention, simpler dealing with customers, and just feeling free to not smile. 
  • Katie Camero of McClatchy News answers two questions about the Pfizer-BioNTech vaccine and children, including: Is the shot for teens different than those given to adults?  And how well does the Pfizer vaccine protect children? The article also provides a video that walks through how the FDA and CDC authorize vaccines for children. 
  • "In The Associated Press-NORC Center for Public Affairs Research poll released Tuesday, 64% of respondents said they have gotten a Covid-19 vaccine and 35% said they haven’t. Of the respondents who haven’t gotten a shot, 61% said they wouldn’t get a Covid vaccine, with 34% saying they would “definitely” not get a shot and 27% said they “probably” wouldn’t," Summer Lin reports for McClatchy. The poll also found fewer of the respondents in this poll were willing to get a vaccine than in the last one, taken in March, 61% and 43% respectively

Monday, May 10, 2021

Beshear to lift bar and restaurant curfew; says expansion of Pfizer to young teens will let Ky. set a date for ending capacity limits

State Dept. for Public Health table shows coronavirus vaccination rates decline with age.
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced he will lift the curfew on restaurants and bars and allow at-the-bar seating on May 28, the same day businesses serving fewer than 1,000 people can expand their capacity to 75%.

“Be reasonable. Just because you can, doesn’t mean you should,” Beshear said at a news conference. “Look at your own facilities, look at the ability for air to move in and out, look at what your vaccination rates are in your county and what your incidence rates are and try to make good decisions.”

After the news conference, the U.S. Food and Drug Administration announced it had expanded the emergency use authorization for the Pfizer-BioNTech coronavirus vaccine to include children 12 to 15 years old. 

“Today’s action allows for a younger population to be protected from Covid-19, bringing us closer to returning to a sense of normalcy and to ending the pandemic,” acting FDA Commissioner Dr. Janet Woodcock said a news release. “Parents and guardians can rest assured that the agency undertook a rigorous and thorough review of all available data, as we have with all of our Covid-19 vaccine emergency use authorizations.”

In anticipation of that announcement, state Health Commissioner Steven Stack said a Centers for Disease Control and Prevention committee will meet Wednesday to adopt the FDA's recommendations. 

Beshear said once the Pfizer vaccine can be given to children 12-15, the state will be able to set a timeline for ending capacity limits on events, venues and businesses with fewer than 1,000 people. 

"What we want to do is give time for this age group to get vaccinated because they are certainly out and about in those types of activities," he said. 

Stack encouraged parents to get their children vaccinated, noting that the side effects have been similar to those seen in adults, mainly some soreness at the injection site and some aches and fatigue.

"They have found the Pfizer [vaccine] to be incredibly safe and very well tolerated," Stack said. "Additionally, they have found that it has been, at least in the initial studies, 100 percent protected from serious illness. So that's been very good to see as well."

He added that the state is working with local health departments and Wild Health to offer the vaccines at schools. "We'd like to make this as easy as possible for everybody," he said.

Kentucky is now using the CDC's vaccines.gov website to help Kentuckians to find a vaccination site near them. The site also allows users to look for sites with the vaccine they would like to take. 

So far, 1,875,554 people have received at least one dose of a vaccine in Kentucky, an increase of 8,517 from Sunday's report.

Beshear said 80% of Kentuckians 65 and older had received at least one dose of a vaccine; with each younger age group, the percentage is less; 53% of Kentuckians 16 and older have received at least one dose. 

The state has identified 540 cases with coronavirus "variants of concern;" 486 were the B.1.1.7. variant, which was first identified in the United Kingdom and is now the dominant strain of the virus in the U.S.

Beshear's daily news release said 852 out of 856, or 99.42%, of the Kentuckians who died of Covid-19 since Feb. 1 were not vaccinated. 

"Folks, we need people to keep getting vaccinated," he said. "It's proven to be incredibly safe. The vaccines have been incredibly effective." 

Stack said likewise: "I encourage you all to please get vaccinated as quick as you can. The governor's already said we're going to lift more restrictions, and the safest way for us to do that is for everyone to be protected through the vaccine."

Asked the import of the CDC's new guidance that the virus is spread by aerosolization, Beshear and Stack said that this has been suspected for a while and is why mask and ventilation efforts have been so important. 

"There is a responsibility for any business owner, school, et cetera, that's poorly ventilated to really look at what is possible and what is safe," said Beshear.

Stack said ventilation is the "single biggest distinction" between indoor and outdoor spaces and it's important to continue to do activities outdoors to the fullest extent possible and to increase ventilation indoors.  

"It's very important until people are all vaccinated that we continue to exercise caution, particularly in interior spaces and around people who are vulnerable or not vaccinated," he said. He added later, "Now remember, Covid is a bad disease. It does bad things to people and it's caused a lot of harm, not only death, but disability in Covid long-hauler problems. . . . Covid is not good and vaccinations are a way to help us get out of this and get back fully to life."  

Daily numbers: Gov. Andy Beshear announced 167 new cases on Monday, lowering the seven-day rolling average to 526 per day, about where it was two weeks ago before a slight increase in cases.

The share of Kentuckians testing positive for the virus in the past seven days is 3.25%. The figure has declined for five straight days, from a recent high of 3.57%.

The weekly number of cases and positive-test rate also dropped slightly this week, showing Kentucky continues to be on plateaus for both measures.  
State Dept. for Public Health graph, relabeled by Ky. Health News; for a larger version, click on it.
The state's daily rate of new cases over the last seven days is 10.26 per 100,000 residents. Counties with more than double that rate were Powell, 61.3; Montgomery, 47.7; Lewis, 25.8; Bath, 25.1; Grayson, 23.2; Rockcastle, 23.1; Simpson, 23.1; Estill, 22.3; Mason, 21.8; Henderson, 21.2; Fleming, 20.6; and Taylor, 20.5.

The New York Times ranks Kentucky's new-case rate 22nd among the states, with a 5% rate of increase over the last 14 days. The Times says five states had a higher rate of increase: Mississippi, 9%; Hawaii, 10%; Arkansas and Wyoming, 12%; and New Mexico, 18%. Indiana also had a 5% increase. 

In addition to the new-case rates, the state's desktop dashboard now provides a county-level positive-test rate, which businesses and institutions can use to help gauge the level of risk in their communities. Stack said, "I think the incidence rate is still the single best metric for you to use in general to see how common the disease is in your area."

Hospital numbers also remain on a plateau. Kentucky hospitals reported 404 Covid-10 patients, down eight from Sunday; 109 of them in intensive care, down five; and 51 of those on a ventilator, unchanged. The Lake Cumberland hospital readiness region remains the only one of 10 that is using at least 80% of its intensive care unit capacity, at 87%. 

The state reported 11 more Covid-19 deaths, nine of them from regular health-department reports and two from an ongoing audit of death certificates. The death toll in Kentucky from the virus is 6,597. 

The regularly reported fatalities were a Ballard County woman, 83; a Fayette County man, 68; a Floyd County woman, 92; a Gallatin County woman, 79; a Gallatin County man, 85; a Grayson County woman, 53; an Owsley County man, 67; a Pendleton County man, 86; and a Russell County woman, 79. The audit deaths, both in December, were a Fayette County woman, 89; and a Muhlenberg County woman, 84.

In other pandemic news Monday: 
  • Counties with five or more new cases were Jefferson, 28; Warren, 11; Daviess, 10; Laurel, 8; Boone and McCracken, 7; Greenup and Henderson, 6; and Kenton, 5. 
  • Beshear reported one more resident and seven more staff in long-term care facilities had tested positive for the virus, bringing active case numbers to 66 residents and 104 staff. He said two more deaths in the facilities can be attributed to Covid-19, for a total of 2,231. 
  • The Kentucky Lottery is offering an incentive program to encourage Kentucky adults to get a coronavirus vaccine, Jack Brammer reports for the Lexington Herald-Leader. Those 18 or older who get a first or second vaccination at more than 170 Kroger and Walmart locations will receive a coupon for a free Cash Ball 225 ticket. Each ticket usually costs $1 and the top prize in the nightly Cash Ball 225 game is $225,000. The offer is good through next Friday, May 21, or until the 225,000 tickets run out.
  • The University of Kentucky is looking to enroll students from any postsecondary institution between 18 and 26 for a study that will see whether people can pass on the virus to others after being vaccinated with Moderna, Sarah Ladd reports for the Louisville Courier Journal. Students who are interested in the study can fill out prescreening questions at http://stopcovidky.com/. After that, eligible people will be contacted regarding next steps. "The goal of the study is to determine whether vaccines like Moderna halt the spread of COVID-19 in addition to providing protection for a vaccinated person," Ladd reports.
  • The World Health Organization has declared a coronavirus variant first identified in India as a global "variant of concern," The Wall Street Journal reports. This is the fourth "variant of concern" classified by the WHO. 

Sunday, May 9, 2021

Ky. virus numbers decline slightly after a rise; McConnell says masking is getting complicated but getting vaccinated is not

Kentucky Health News graph; click on it to enlarge
By Al Cross
Kentucky Health News

Measures of the pandemic in Kentucky ebbed again Sunday, confirming a downward trend after a recent rise.

The percentage of Kentuckians testing positive for the virus fell for the fourth straight day, to 3.28%, and the state reported only 195 new cases of the coronavirus, the lowest in five weeks. That lowered the seven-day rolling average by 25, to 547 per day, the lowest in 11 days.

The state's daily rate of new cases over the last seven days is 10.5 per 100,000 residents, down for the fifth day in a row. Counties with rates more than double that rate were Powell, 57.8; Montgomery, 51.2; Lewis, 26.9; Bath, 25.1; Rockcastle, 23.1; Hickman, 22.8; Grayson, 22.7; Simpson, 22.3; and Estill, 22.3.

Kentucky Health News graph; click on it to enlarge.
The New York Times ranks Kentucky's new-case rate 23rd among the states, but the state ranks much higher in the paper's ranking of new-case trends over the last 14 days; only four states had higher rates of increase than Kentucky's 9%: Wyoming, 12%; Arkansas, 17%; Hawaii, 18%; and New Mexico, 18%. Indiana is the only other state with an increase, 6%; West Virginia ranks next, with a decline of 2%.

Kentucky ranks 29th among the states in the percentage of population that is fully vaccinated, at 34%. Ohio, at 35%, and Virginia, at 37%, are the adjoining states with higher percentages.

The state reported eight more Covid-19 deaths, all from regular health-department reports, bringing Kentucky's death toll from the disease to 6,586. Over the last seven days, the state has averaged eight deaths per day; over the last 14 days, the average is nine per day. On weekends, the state does not issue itemized lists of fatalities by age, sex, county and date of death.

Senate Republican Leader Mitch McConnell kept telling audiences around the state to get vaccinated against the virus. Asked by Renee Shaw of KET if Donald Trump, in whose presidency the vaccines were developed in record time, should have done more to encouraged his supporters to get shots, McConnell said "It’s not just Republican men" who are hesitant about getting a jab. "We have a problem with younger women as well, because there are rumors floating around on the internet that it somehow interferes with fertility . . . We just have to keep talking about this and encouraging people, regardless of what their reservations are."

Asked what he thinks now of mask wearing, which some of his fellow Republicans say vaccinated people no longer need to practice, the longtime mask advocate said he wears a mask "depending on where I am." He said the subject "is getting complicated now . . . I think the American people are getting impatient with that . . . What is not complicated is, we need to get shots in arms. Every American who’s eligible needs to do that . . . Do it for your neighbor, if not for yourself; do it for your family, if not for yourself."

In other pandemic news Sunday:

  • Kentucky's hospitals reported 396 Covid-19 patients, 21 fewer than Saturday; 114 of them were in intensive care, up 7; and 51 were on a ventilator, up 2.
  • Counties with five or more new cases were Jefferson, 44; Fayette, 26; Rockcastle, 6; and Grayson, Madison and Powell, 5.
  • Dr. Anthony Fauci said the acknowledgement by the Centers for Disease Control and Prevention that the virus can aerosolize, and spread beyond six feet of an infected person, means there needs to be an emphasis on proper ventilation and following the CDC recommendations to wear masks indoors. He said it is “quite possible” that use of masks will become seasonal, saying the U.S. has had a “practically non-existent flu season” because of precautions taken against the coronavirus.
  • The other side of that coin is that fewer people than usual developed immunity to flu strains this year, and that could result in more flu cases than usual next winter, several experts told Lauren Dunn of NBC News.

When settlement with opioid makers and distributors is reached, Kentucky and local governments will split it half and half

Photo: Forbes.com
By Melissa Patrick
Kentucky Health News

When a global settlement with opioid manufacturers and distributors is settled, Kentucky will allocate half of any proceeds to the state and the other half to local governments  and all of it must be spent to fight the opioid epidemic, under a new law. 

"It's a victory against the opioid crisis epidemic," Rep. Danny Bentley, R-Russell, sponsor of the legislation, told Kentucky Health News. "The bill gets the money to people who need it the most."

This victory is much needed. Preliminary federal data shows drug-overdose deaths in Kentucky rose 50% in 2020, the third highest rate of increase in the nation.

More than 100 Kentucky counties and some Kentucky cities have brought litigation against opioid manufacturers and distributors, as has the state, Bentley said in presenting the bill to a committee in February. 

Bentley's bill lays out the details of the plan. It passed without opposition in the last legislative session and had an emergency clause, so it took effect when Gov. Andy Beshear signed it March 24. 

Attorney General Daniel Cameron said the deal, “speaks volumes about what can happen when we put egos aside, when we put our party affiliation aside and say, ‘How we can we best, or how can we be a good neighbor in the midst of these challenges to make sure that we get the dollars and the help that's necessary to ease this affliction and pain that has plagued our people for too long?’”

Cameron mentioned the bill to Salena Zito of the Washington Examiner in a long interview that touched on many topics. He said it was the result of a collaboration between his office, Senate President Robert Stivers, House Speaker David Osborne, prosecutors, county judge-executives, mayors, and others. "It took some work for us to get together and organize," he said. 

Cameron's spokesperson said the attorney general's office started working with stakeholders on the concept for this legislation soon after Cameron took office in mid-December 2019. 

The bill places management of any Kentucky settlement in a new Kentucky Opioid Abatement Advisory Commission, comprised of nine volunteer members representing, among others, victims of the opioid crisis, representatives from the treatment and prevention community, and law enforcement.

The bill includes a list of 29 ways the money can be spent, all of them related to either opioid use disorders, a co-occurring substance-use disorder, or mental-health issues related to substance-use disorder.  

Cameron told Zito that the state plans to maximize any money it gets from the settlement with other federal avenues that exist.

Recipients of the money will be required to submit an annual report that certifies the funds were used consistently with the established criteria, as a way to minimize fraud and abuse, said Bentley

The companies involved in the settlement negotiations are Johnson & Johnson, McKesson Corp., AmerisourceBergen Drug Corp. and Cardinal Health Inc, and possible affiliates or subsidiaries.

The companies are proposing a $26 billion settlement of all opioid suits against them. The deal, which is yet to be finalized, would also give each of the companies about $1 billion each in tax breaks, The Wall Street Journal reported in February.

Cameron told Zito that a requirement of the settlement would be that states, counties and cities that have filed specific lawsuits against the opioid distributors and manufacturers will be asked to give up those claims in exchange for settlement money. 

Some states and localities in West Virginia have chosen to opt out of the tentative settlement, including Huntington and Cabell County in West Virginia, where a federal-court trial of the city's and county's suit against McKesson, Cardinal Health and AmerisourceBergen began May 3.

"Cabell County’s lawyer, Paul Farrell, has said West Virginia’s portion of the “global” settlement wasn’t nearly enough. The Mountain State’s potential share has yet to be disclosed to the public," Eric Eyre and Lauren Peace report for Mountain State Spotlight.

Saturday, May 8, 2021

Eula Hall, one of the best friends the poor in Eastern Kentucky ever had, dies at 93; one of the region's saints, Rep. Rogers says

Hall is the subject of this 2013 book. In the cover photo,
she stands in her clinic's ruins after a fire destroyed it.
Eula Hall, who founded a clinic to serve the poor in one of the poorest parts of the nation, the heart of Central Appalachia, died Saturday. She was 93.

An anti-poverty worker in the 1960s, Hall founded the Mud Creek Clinic, Kentucky's first rural clinic for low-income families, with $1,400 in donated money in 1973. It is now named for her.

“Nothing comes easy up on Mud Creek,” Hall’s longtime friend and ally, former Kentucky House Speaker Greg Stumbo, told the Lexington Herald-Leader. “It was always a fight.”

Hall was also president of the Kentucky Black Lung Association and "fought for better water service and free lunches for schoolchildren," reports the Herald-Leader's Karla Ward. "Funeral services will be held at 10 a.m. Tuesday at Hall Funeral Home in Martin. Visitation will begin after 6 p.m. Sunday will continue all day Monday at the funeral home."
Read more here: https://www.kentucky.com/news/state/kentucky/article251262069.html#storylink=cpy

Senate Republican Leader Mitch McConnell called Hall a "one-of-a-kind Kentuckian . . . She was among the toughest women I’ve ever met, overcoming one challenge after another to serve those who had nowhere else to turn. Even after a fire burned down the clinic, her team didn’t miss a single day. Slowing down was simply never an option. When we spoke on the phone just a couple of weeks ago, Eula’s entire focus remained on those she could help.”

Hall's congressman, U.S. Rep. Hal Rogers, said in a release, “Eula Hall was one of Eastern Kentucky’s greatest saints. . . . Driven by her own experience with poverty, Eula dedicated her life to ensuring every person had access to medical care, regardless of their ability to pay for services or prescriptions. She pioneered hope on Mud Creek and far beyond the borders of Floyd County. When I called Eula on her 90th birthday, she was doing what she loved most: working at the clinic that she transformed from a home-grown operation into a modern facility with state-of-the-art equipment. She will always be a legend in Kentucky’s Appalachian region and an inspiration to never stop serving those around us.”

Pandemic metrics tick slightly down, but 19 deaths added; CDC acknowledges virus can go aerosol and spread farther than 6 feet

Screenshot from state website, adapted; Campbell has replaced Jefferson as the No. 5 county.
By Al Cross
Kentucky Health News

Most of Kentucky's pandemic numbers took slight turns for the better Saturday.

The share of Kentuckians testing positive for the coronavirus in the last seven days fell by 0.18 percentage points, to 3.32%, the lowest in a week. It has been below 4 percent since March 9 and hit a low of 2.8% March 26-27.

The state reported 544 new cases of the virus, lowering the seven-day rolling average by 15, to 572. That's almost exactly where it was April 30. It has been below 700 since March 19 and hit a low of 525 April 10.

The statewide rate of new cases over the last seven days is 10.95 per 100,000 residents, 0.29 lower than Friday. This is the first time it has been under 11 since April 29; it has been below 12 since March 19.

Counties with rates more than double the statewide rate were Powell, 55.5; Montgomery, 50.7; Lewis, 30.1; Robertson, 27.1; Hickman, 26.1; Bath, 25.1; Simpson, 23.1; Estill, 22.3; Grayson, 22.2; and Wolfe, 22.

The worst datum in the state's daily report was the 19 additional Covid-19 deaths, one from the ongoing audit of death certificates and the rest from regular health-department reports. That was much more than the 14-day average of 7.7 per day, which has been relatively stable; a month ago, it was 7.9. The state's Covid-19 death toll is 6,578.

As usual on a weekend, the state did not issue an itemized list of the additional fatalities by county, sex, age and date of death.

The Centers for Disease Control and Prevention has changed its guidance to say, in boldface type on its website, to emphasize that the virus is transmitted by "inhalation of very fine respiratory droplets and aerosol particles," which float through the air and "can remain suspended in the air for minutes to hours." That means the particles can spread more than six feet from an infected person, though the risk is greatest at three to six feet. The guidance no longer mentions "close contact."

The CDC reiterated that the virus can also spread through "direct splashes and sprays," and touching the mouth, nose or eyes with contaminated hands, and the risk of infection depends on the amount of viral exposure. It says there have been cases of infected people exhaling indoors for more than 15 minutes leading to "virus concentrations in the air space sufficient to transmit infections to people more than six feet away, and in some cases to people who have passed through that space soon after the infectious person left."

A year ago, infectious-disease experts said the CDC and the World Health Organization "were overlooking research that strongly suggested the coronavirus traveled aloft in small, airborne particles," The New York Times reports. "Several scientists on Friday welcomed the agency’s scrapping of the term 'close contact,' which they criticized as vague and said did not necessarily capture the nuances of aerosol transmission."

In other pandemic news Saturday:
  • Counties with 10 or more new cases were Jefferson, 73; Fayette, 34; Scott, 25; Pulaski, 24; Campbell, 21; Montgomery, 18; Russell, 18; Boone, 15; McCracken, 14; Graves, Kenton and Laurel, 11; and Daviess, Hopkins and Warren, 10.
  • Kentucky hospitals reported 417 Covid-19 patients, five more than Friday, with 107 of them in intensive care (up 1) and 49 on ventilators (down 3). All the number were near the average for the past month.
  • As usual, the Lake Cumberland hospital region was the only one with more than 80% of its intensive-care beds occupied, at 87%.

Friday, May 7, 2021

Beshear defends his re-opening plans, saying, 'We are doing it right'; state ordered 10% less vaccine this week than it could have

Agric. Comm. Quarles, Gov. Beshear (WLWT image)
By Melissa Patrick
Kentucky Health News

Under pressure from some Republicans to lift all pandemic restrictions or to set a date to do so, Democratic Gov. Andy Beshear issued an op-ed Friday laying out why he's sticking to his plan, and he continued that theme in his regular weekday press release about the coronavirus.

“Our economy is heating up. We are doing it right – safely and sustainably,” Beshear said in both missives. Noting the state's improved credit rating and other good news, he said in the op-ed, "These successes would stand out at any time, but they’re particularly notable as some partisan politicians claim I need to 'reopen Kentucky'."

In the release, he added, “We cannot give up now. We are picking up economic momentum while putting the health and safety of our people first. We are lifting more restrictions each month as we get more folks vaccinated, open our schools and protect our neighbors from this virus that has already killed more than 6,500 Kentuckians.”

Meanwhile, U.S. Sen. Mitch McConnell declined to join the calls of some fellow Republicans, such as Agriculture Commissioner Ryan Quarles, for Beshear to lift all pandemic restrictions or set a date for doing so.

McConnell in Scottsville (BG Daily News photo)
The Bowling Green Daily News reports from Scottsville, "When asked for his opinion on when Covid-19 restrictions should be lifted in Kentucky, McConnell said the decision is up to Gov. Andy Beshear and that he has made a habit of not second-guessing the governor."

Beshear has often praised McConnell's efforts to encourage Kentuckians to get vaccinated as he tours the state, even calling out people in his own party to do so. He did so Thursday in Allen County, where infections have been higher than average and vaccinations lower than average in the last month.

“There are a lot of people who still believe there are still some safety problem with [vaccines], which there isn’t,” McConnell said, according to the Daily News. “I think it’s important to continue to encourage people to get vaccinated, and let’s try to get this disease all the way totally into the end zone.”

Vaccination rates continue to slow across the state, resulting in the state ordering less vaccine from the federal government than it could have. Cabinet for Health and Family Services data show that vaccine demand has declined since mid-April, and that on May 5, the state ordered 10% less than its allocation. 

Daily numbers: The percentage of Kentuckians testing positive for the virus in the past seven days is 3.5%, virtually the same as Thursday's 3.51%.

Beshear reported 638 new cases of the virus Friday, 158 under the age of 19. That lowered the state's seven-day rolling average of new cases by 12, to 587 per day. 

The statewide rate of daily new cases over the last seven days is 11.24 cases per 100,000 residents, down .17 from yesterday. Kentucky's rate is 23rd among the states, according to The New York Times. 

Counties with rates more than double the statewide rate were Powell, 63.6; Montgomery, 41.6; Hickman, 35.9; Robertson, 33.9; Lewis, 32.3; Bath, 29.7; Menifee, 26.4; Wolfe, 25.9; Shelby, 25.9; and Simpson, 24.6.

Kentucky hospitals reported 412 Covid-19 patients, four more than Thursday, with 106 of them in intensive care (down 7) and 52 of those on a ventilator (up 3). 

The Lake Cumberland hospital-readiness region remains the only one out of 10 that is using 80% of its intensive-care-unit beds, at 87%, but only 16% of the ICU beds are occupied by Covid-19 patients. 

The state reported 11 more Covid-19 deaths, 10 from regular health department reports and one from the ongoing audit of death certificates. The death toll is now 6,559. 

The regularly reported  fatalities were a Breathitt County woman, 55; a Fayette County woman, 89; a Floyd County woman, 89; a Jefferson County woman, 74; a Jefferson County man, 69; a Kenton County woman, 84; a Laurel County man, 77; a Pulaski County man, 69; a Scott County man, 71; and a Wayne County woman, 76. The audit death was a Jefferson County woman, 86 ,who died in December. 

In other pandemic news Friday: 
  • Counties with 10 or more new cases are Jefferson, 124; Pulaski, 25; Fayette, 24; Montgomery, 23; Warren, 19; Daviess, Jessamine, Oldham and Taylor, 14; Hardin, 13; Fleming, Kenton, Powell and Scott, 12; Bath, Bullitt, Pike and Shelby, 11; and Greenup, 10. 
  • The global death toll from Covid-19 is twice as high as official estimates, and the U.S. figure is 38 percent higher, says an analysis from the Institute for Health Metrics and Evaluation at the University of Washington. It estimates that 905,000 Americans have died due to the disease. Experts believe the unreported cases and deaths are largely due to overwhelmed health care systems and insufficient testing, reports Helen Branswell of Stat.
  • Real-world data show the Pfizer BioNTech vaccine is highly effective against two variants of concern. Based on 385,000 vaccine recipients in Qatar, it's 90% percent effective at preventing infections from the B.1.1.7 variant first identified in the U.K. and 75% effective against B.1.351, first identified in South Africa. B.1.1.7 is rapidly becoming the dominant strain around the world, but B.1.351 is thought to be the most threatening variant for vaccine protection, The Washington Post reports. Even so, the vaccine is still highly effective, especially at preventing severe cases or death. The study also emphasized the importance of getting both doses of the vaccine; one dose was only 30% effective against B.1.1.7 and 17% effective against B.1.351.

Medicare-Medicaid agency rated 74 Kentucky hospitals this year; 20 got one of the top two grades, 28 got one of the bottom two

By Melissa Patrick
Kentucky Health News

The Centers for Medicare and Medicaid Services has released its Hospital Quality Star Ratings for 2021, with new methodology that includes fewer Kentucky hospitals.

Of the 74 Kentucky hospitals that CMS rated in its most recent report, only five got the highest rating, five stars: Clark Regional Medical Center in Winchester; Meadowview Regional Medical Center in Maysville; Owensboro Health Muhlenberg Community Hospital in Greenville; Saint Joseph Berea; and Saint Joseph Mount Sterling.

Five hospitals got the minimum rating of one star: Hazard ARH Regional Medical Center; Monroe County Medical Center; Rockcastle County Hospital in Mount Vernon; The Medical Center at Bowling Green; and University of Louisville Hospital. 

Most hospitals fell in the middle, with 23 getting two stars, 26 getting three and 15 getting four. By that measure, Kentucky hospitals did not compare well with those in adjoining states.

Unlike Kentucky, every state adjoining it had more hospitals in the top two categories than in the bottom two. Among other neighboring states, Arkansas looked most like Kentucky, with 15 in the top two and 20 in the bottom two. Georgia had 23 in the top two and 32 in the bottom two.

Individual hospital ratings can be found on the CMS Hospital Compare page. They are based on 51 quality measures in five categories: mortality, safety of care, readmissions, patient experience, and timely and effective care. Prior ratings had seven categories. CMS also changed how it calculates scores and compares hospitals, now grouping them into one of three peer groups for comparison. 

CMS said it did not do its originally scheduled ratings in January, to allow time to review comments about and finalize the new methodology.

The last time Kentucky Health News reported on the ratings in 2019, the agency rated 94 Kentucky hospitals. The number fell by 20 because the new methodology "excludes those with too few data points to create a reasonable rating," Deborah Campbell, vice president of quality and health professions for the Kentucky Hospital Association, said in an email.

"KHA conducted an informal survey of Kentucky’s hospitals, and from the responses we received, some improved by one star, a small number went down by one star, but most stayed the same. The CMS list of ratings confirms the data from that survey."

In addition to the Hospital Compare website, consumers can also check ratings by U.S. News & World Report, which were released in July; and the recently released safety ratings by the Leapfrog Group. Another resource is Kaiser Health News' list of hospitals that are penalized by Medicare for high rates of readmissions and hospital-acquired conditions.

Advertising agencies' national campaign for Covid-19 vaccination is like no other one they have ever done, and it's still evolving

The two keys: missing moments, and independence.
The business of persuading Americans to get a coronavirus vaccine is one of the most complex and challenging parts of the pandemic. A big part of that effort is the campaign by The Advertising Council, a nonprofit that has conceived Smokey Bear and a host of other campaigns. David Montgomery tells the story in The Washington Post Magazine:

"The question of whether to vaccinate sits at the center of America’s deepest sources of discontent: political hatred, racial injustice, institutional mistrust. And unlike a political campaign, which needs to persuade 50.1 percent of the voters, or a car commercial, which would be a smashing success if it captured 25 percent of consumers, this marketing blitz had to convince upward of 70 percent of the public — enough to reach herd immunity," to protect those unwilling or unable to be vaccinated.

"Against this absurdly challenging backdrop, the Ad Council and its partners embarked on a search for a message — a phrase, really — that a fractured nation could somehow agree on," Montgomery reports. "That search would eventually lead them towards a surprising strategy — one that broke with almost everything the Ad Council had learned in its history of creating public service campaigns."

Ad Council research chief Charysse Nunez’s research "pointed to four main reasons for hesitancy: fear of dangerous side effects; concern about how fast the drugs were developed; mistrust of the political motives of elected leaders and the economic motives of the drug companies; and conspiracy theories. Those four clusters of concern, in turn, splintered further, depending on the subgroup, with Republican, Democratic, conservative, liberal, religious, nonreligious, informed, underinformed, rural and urban people having distinct takes on the issue. Unlike past causes the Ad Council has taken up, “this is a unique situation because ... America is divided in many ways,” Nunez told me. “We have to meet [people] where they are, in a very empathetic manner.”

The key challenge, Montgomery reports, was "how to connect the seemingly unrelated concerns that factored into different populations’ vaccination decisions. Where was the unifying thread? The experts on the call were stumped." Then marketing strategist Nikki Crumpton asked, “Why don’t we get comfortable with the fact that they’re uncomfortable?”

"It was a key epiphany," Montgomery wrote. Doubt itself must be given space; fears must be acknowledged. Crumpton told him, “You’re not going to get over this hump of vaccine hesitancy until you face into the real problem, which is there are more questions than answers around this right now. And to not lean into the fact that people have questions will make people feel like you’re hiding something. Or that they’re not smart enough, clever enough or worthy enough to be heard.”

Montgomery observes, "The sensation of not being heard had roiled the nation throughout the pandemic and during the preceding years — not being heard about political grievances, racial injustices, public health mandates. Vaccine production was ramping up as more than half the country thought Trump was trying to steal an election he lost, while a large minority baselessly thought it was being stolen from him. Facts and truth itself were constantly being challenged."

In such an environment, the group soon found what didn't work: "Appeals to civic duty or community spirit" or casting vaccinations as the way to get back to normal, Montgomery reports. "What might work, Nunez found, was invoking 'missed moments': getting back to activities people yearn for," but "The hesitaters didn’t want to be talked down to or told what to do. They wanted their doubts respectfully acknowledged and their questions answered."

Developing the sales pitch was up to the ad agency Pereira O’Dell, "which was working pro bono for the Ad Council," Montgomery writes. Principal PJ Pereira recalled his thinking: “We need to find a way to tap into this American instinct and this energy towards, ‘It’s our decision’.” Creative Director Simon Friedlander, on a Zoom call from Australia, coined the catchphrase: “It’s up to you.”

In other words, Montgomery translates, "No one is telling you to get a vaccine the way they were telling you to wear a mask. At the same time, the phrase carries a subtext of implied responsibility: It’s up to you to ask questions and get answers. It’s up to you to get back to the moments you miss," such as "hugging a grandmother, watching a ballgame, lunching with friends, traveling. The phrase seemed infinitely adaptable." In Spanish, it's "De ti depende."

The campaign, targeting the hesitant and reluctant, appeared to work, but polling showed conservatives and evangelical Christians were a tougher sell. "The Ad Council joined the National Association of Evangelicals and others to support a new website, ChristiansAndTheVaccine.com, which has videos with biblical perspectives on questions such as, 'Should pro-lifers be pro-vaccine?' and 'How can Christians spot fake news on the vaccine?' There’s also an interview with Francis Collins, head of the National Institutes of Health and a devout Christian," Montgomery notes.

Nunez analyzed polling of those target groups and told the team, “This audience wants to be educated, not indoctrinated. Their personal physician is the most trusted source that they’re seeking.” Montgomery reports, "They also want to hear personal stories and endorsements from 'credible influencers' and their family and friends, she said. To begin mobilizing those trusted voices, however, would require a more-tailored conservative ground game — a work in progress." And so is the entire campaign, which is "constantly being modified and expanded to keep up with twists and turns" like more contagious variants and the pause in Johnson & Johnson vaccinations. But as vaccination numbers rise, they are displayed on the campaign's GetVaccineAnswers.org website — "a shrewd exercise of what marketing professor Jonah Berger calls 'social proof,' or subtly enticing people to do something because so many others are."

The Ad Council's campaign isn't the only one. There are state campaigns, and a federal campaign, which has a more traditional slogan: “We Can Do This.” It channels "public-spirited campaigns of the past, counting on an all-for-one spirit to get us out of the pandemic," Montgomery writes. "It presumes that this crisis and today’s America are not really so different from those shattering moments and scary challenges of the past. President Biden’s slogan seemed naive to me. Then again, perhaps the nation’s chief executive has little choice but to invoke unity."

“If you’re president, how to rally a nation?” asks John Bridgeland of the Covid Collaborative. “You’ve got to do that. You’ve got to take a stance that we’ve got to get back to a sense of ‘we’.” That could work to those who still think that way, "but what chance did a Democratic administration have of persuading vaccine hesitaters who distrust government and Democrats?" Montgomery asked Bridgeland, who replied, “Our campaign [with the Ad Council] is reaching a population that’s more difficult for the government campaign to reach.”

Thursday, May 6, 2021

Beshear lifts more capacity limits starting May 28, touts his handling of the pandemic and the state's economic recovery

State Department for Public Health table shows vaccination numbers by age group.
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced he will lift both indoor and outdoor capacity limits to 75 percent for businesses and events with fewer than 1,000 people starting May 28, the start of Memorial Day weekend, and said he expects all restrictions to be lifted by July and "certainly . . . this summer."

"If you can just give me a little patience, we're coming up to a time when we're going to be able to fully get out of this," Beshear said at his second and last press conference of the week. “The CDC is now projecting a sharp decline in Covid cases in the U.S. by July. I’m hoping we’ll be fully done with any capacity restrictions by July. That is actually my expectation." 

The governor also increased capacity limits on outdoor businesses and venues serving more than 1,000 people from 50% to 60%, also effective May 28. He said a main reason he chose that date is to give schools time to finish the school year, noting that schools in Boyd County and Flemingsburg have had to move back to virtual learning because of the virus.

Effective immediately, Beshear lifted the mask mandate for small, private gatherings and businesses if everyone is fully vaccinated, which means they are at least two weeks beyond their second shot of Moderna or Pfizer-BioNTech vaccine or two weeks after the single-dose Johnson & Johnson jab. 

Beshear has said since mid-April that he would lift all restrictions on businesses and venues with capacities of fewer than 1,000 people when 2.5 million Kentuckians got at least one dose of a coronavirus vaccine. He has also said "for seven straight press conferences" that he would be willing to ease restrictions along the way as the state moves toward that goal, and offered a long list of ways he had already done that. 

His announcement follows publication of an article by Agriculture Commissioner Ryan Quarles, a Republican who is a leading prospect to face Beshear in the fall 2023 election, asking the governor to set a firm date to open the economy instead of using a vaccine goal as the marker. He said that by not fully opening the economy,  Beshear "is holding Kentucky's economic engine hostage."

Asked if he had any specific response to Quarles, Beshear said, "I'm not playing politics," but then repeated earlier points about how well the state is doing economically and thwarting the virus.

Beshear said Kentucky has had fewer Covid-19 deaths per capita "than just about any state" and ticked off a long list of Kentucky's pandemic and economic performance. Two new items were that Fitch Ratings had improved the state's credit outlook to stable and the state's sales-tax revenue set an all-time record for an April, which he said refutes any notion that the state's economy isn't open.

"One of the things that's gotten us here is we've been measured" and have eased into and out of restrictions, Beshear said. "We have adjusted based on what's going on with the virus, listening to the best science available. And so that's what we are going to continue to do."

After the governor spoke, Quarles' Department of Agriculture issued a statement in which he said "Beshear continues to ignore the bipartisan consensus emerging across the nation, in which far-left leaders like California’s Gavin Newsom, self-avowed socialists like New York Mayor Bill de Blasio, and strong conservatives like Florida’s Ron DeSantis have either set reopening dates for their states or have already fully reopened them. . .. We must send a clear signal of confidence towards our small businesses across the state by joining our neighbors and fully reopening Kentucky’s economy."

Dept. for Public Health graph shows shots by age group.
Vaccine report: 
Beshear said 1,855,111 Kentuckians have received at least one dose of a vaccine, a number that also includes Kentuckians who have been vaccinated out of state. He said that amounts to 52% of Kentuckians 16 and older who have received at least one dose of a vaccine, and gave an age-group report (graph at right).

Beshear said the federal government is expected to authorize the Pfizer vaccine for 12- to 15-year-olds next week, and that's another reason he was willing to increase capacities.

Health Commissioner Steven Stack said the state will move to the Centers for Disease Control and Prevention's vaccine finder next week at vaccines.gov, on which you can enter your ZIP code and get three choices of where you can go to get a vaccine. It also allows you to search for the vaccine you want, he said. 

Daily numbers: The percentage of people testing positive for the virus over the last seven days was 3.51%, down .06 points from Wednesday's average, which was the highest since March 17. 

The state reported 655 new cases of the virus, 147 in people 18 and younger. That lowered the seven-day rolling average by 20, to 599. Since March 17, the average has ranged from 721 to 518 per day.

The statewide rate of daily new cases over the last seven days is 11.41 per 100,000 residents. Kentucky's rate is 23rd among the states, according to The New York Times. Counties with rates more than double the statewide rate were Powell, 59; Hickman. 35.9; Montgomery, 31.5; Lewis, 31.2; Menifee, 30.8; Simpson, 29.2; Robertson, 27.1; Bath, 26.3; and Shelby, 24.8.

The state reported six more Covid-19 deaths, five from regular health-department reports and one from the ongoing audit of death certificates. The fatalities were a Breckinridge County man, 79, April 22; a Lawrence County man, 50, May 4; a McCreary County woman, 75, April 1; a Marion County woman, 49, April 16; an Ohio County woman, 88, Nov. 12; and a Jefferson County man, 86, Dec. 1 (found by audit). The state's death toll is 6,548.

In other pandemic news Thursday:
  • Counties with 10 or more new cases were Jefferson, 127; Fayette, 52; Boone, 26; Daviess, 23; Warren, 21; Kenton, 20; Montgomery, 17; Clark, 14; Shelby, 13; McCracken, 12; Scott, 12; Madison, Rockcastle and Pulaski, 11; and Boyd and Laurel, 10.
  • Kentucky hospitals reported 408 Covid-19 patients, 12 fewer than Wednesday; 113 of them, 2 more, were in intensive care; and 49 of those, up 3, were on a ventilator. The Lake Cumberland hospital-readiness region was the only one of 10 using more than 80% of its intensive-care beds, at 84%.
  • The national infection rate hit a seven-month low, but new vaccinations are down 25% from last week, CBS News reported.
  • A new Kaiser Family Foundation poll taken April 15-29 found that 9% of unvaccinated adults said the pause made them less likely to want the Johnson & Johnson vaccine. Seven percent said it made them less likely to want any of the vaccines. And 4% said it changed their thoughts about the vaccines in some other way.
  • The KFF poll also found that the share of Republicans who say they will “definitely not” get vaccinated decreased from 29% in March to 20% in April, but remains substantially larger than the share among Democrats (4%) or independents (13%). It also found that 55% of Republicans say they have received a vaccine or will as soon as possible, up from 46% in March.
  • A single dose of Moderna’s original Covid-19 vaccine and a booster shot that targets key virus variants both show promising signals that they can protect previously vaccinated people against problematic strains, the company announced Wednesday, Politico reports. In a trial that began in March, volunteers were given either a booster shot of the original formula or a modified vaccine aimed at the South Africa and the Brazil variants, which are less susceptible to the existing vaccines. The study found that a booster dose of the variant-targeting formula was more effective than a booster of the original vaccine, but both raised antibody levels, Moderna said in a press release. The research is not yet peer-reviewed.
  • A Politico Pro article reports that state and federal officials fear low vaccination rates throughout the South and parts of the mountainous West will prolong the pandemic and increase the risk of a new strain developing that can sicken vaccinated people. The authors write that several states have struggled to vaccinate even one-third of their populations. In Tennessee, 34% of its population have received at least one dose of a vaccine and 24.5% have been fully vaccinated, according to its Covid-19 State Profile Report.
  • “With herd immunity against Covid-19 now looking harder to reach, [Sen. Mitch] McConnell reiterated his support for the vaccines — while stopping short of calling out fellow Republicans for fueling skepticism about the shots,” Josh James reports for WUKY. “Acknowledging the slowdown in vaccination rates and the increasingly complicated task of convincing opponents to agree to the shot, McConnell had a football analogy.” He said, "This last 20 yards, it looks to me, are going to be kind of difficult," he said, partly because a recent Gallup poll found a fourth of Americans still resistant to the vaccination. “Asked whether he lays any blame at the feet of fellow GOP lawmakers who have sown mistrust about the vaccines, McConnell stuck to his own message.” He said, "I can only speak for myself. I'm a big proponent of wearing masks, getting vaccinated, and I've tried, at least for myself, to say the things that I think the American people need to hear.”
  • Based on four different scenarios of vaccination rates and state re-openings, the CDC is projecting a surge in Covid-19 cases that will peak in May before sharply declining by July, as more people get vaccinated, CNBC reports. Hospitalizations and deaths from the virus are expected to remain low.
  • Kentucky received a $21.6 million grant from the U.S. Department of Labor to help newly injured and ill employees to return to work, including those who have dealt with the enduring implications  of Covid-19 on their physical and mental health and are working to get back into the workforce. The Retaining Employment and Talent after injury/illness Network (RETAIN) program is expected to reach over 3,000 employees. Kentucky is one of five states to receive this a grant for the program's second phase. Go to kyretain.org or follow on Twitter @KYRETAIN to learn more.