Supply finally exceeds demand: Beshear lets any Kentuckian 16 and older get a coronavirus shot starting Monday, April 5

Gov. Andy Beshear displayed this slide listing vaccination
sites with the most open appointments. To enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Kentucky will open up coronavirus vaccinations to residents 16 and older Monday, after thousands of appointments across the state have gone unused, showing the state's challenge has shifted from supply to demand. 

"This is a good day," Gov. Andy Beshear said at his final news conference of Easter Week. "It means that we will beat the president's request by a month to have it opened up to  everyone."

The governor and his lieutenants have lamented for months that the main challenge in getting Kentuckians vaccinated has been "supply, supply, supply."

But last week, Beshear started providing a list of vaccine sites across the state with hundreds and sometimes thousands of appointments available. Now the Department for Public Health has a daily "Where Can I Get Vaccinated?" report on the its vaccine website, listing places with open slots and how to register for them. 

Today, Beshear mentioned the four sites with the most slots available: Norton Healthcare in Louisville, the Northern Kentucky Convention Center in Covington, the Kentucky Dam Village State Resort Park Convention Center in Gilbertsville and Baptist Health Madisonville.

"Let's get this done. Let's get vaccinated. Let's reach herd immunity. Let's defeat Covid-19 for good," the governor said. "To do that, we've got to make sure that everywhere across the state, we are filling up our vaccination openings." 

Asked if vaccine doses are going unused, Beshear said only that the state knows of no wasted doses, but "What we are seeing is areas where they believe the demand is waning," and some have asked to decrease their supply, allowing it to be redirected to other parts of the state where it is being used. 

One of those waning-demand regions appears to be Western Kentucky, where Beshear said more than 1,000 appointments are available. 

He said there may be some who will never choose to get a vaccine, and "It's going to take some time to convince those who are hesitant, and there may be some that'll never get it, but we also need to see strong local leadership, which we're seeing in places.

"It makes it harder, in places where leaders may have downplayed the virus. I hope now they spend twice as much effort in pushing people to get vaccinated. . . .  You will see us continuing to ramp up our communications, That's paid communications, that's radio ads, billboards, more use of local leadership as we move forward. So our campaign on that side ramps up as we start seeing the hesitancy, trying to use the dollars at the time that they are most effective."

Beshear said he was opening vaccines up to all residents 16 and older because there has been a rise in cases and hospitalizations in other states, primarily in younger people; getting more people vaccinated will limit mutation of the virus into more aggressive variants; and empty vaccine slots need to be filled. 

Only the two-dose Pfizer vaccine is approved for 16- and 17-year-olds. The two-dose Moderna and one-dose Johnson & Johnson vaccines are available to those 18 and up. 

The state's daily vaccine report shows that 1.4 million Kentuckians have received at least one dose of a vaccine, more than any bordering state, but Beshear called on people to remain enthusiastic about getting vaccinated and asked the news media to help him spread the word that vaccines are available statewide. 

"I believe people want to go and get the vaccine, that demand is still strong," he said. "But we may be working with harder to communicate with populations, and we can use your help." 

The numbers: Beshear announced 815 new cases of the virus, raising the seven-day rolling average by 18, to 607 cases per day. For the last week the average has fluctuated between 589 and 614, making a rough plateau.

Likewise, the share of Kentuckians testing positive for the coronavirus in the last seven days rose slightly, to 2.96%. In the previous seven days it ranged from 2.85% to 2.92%. 

All Covid-19 numbers in Kentucky hospitals rose Wednesday, and Beshear said they are being watched. There are 413 Covid-19 patients, up 14 from Tuesday; 110 of them are in intensive care, up 4; and 48 of those are on ventilators, an increase of 11. 

The rate of new coronavirus cases in Kentucky over the last seven days is 10.96 per 100,000 residents. The New York Times says Kentucky's rate is 34th among the states. Counties with rates double the state rate are Owsley, 38.8 cases per 100,000; Powell, 37; Harlan, 36.2; McCreary, 34.0; Simpson, 33.1; Lee, 30.9; Lyon, 26.1; Whitley, 26; Martin, 23; and Knox, 22.9.

The state added 25 more deaths to its list of Covid-19 fatalities, bringing the toll to 6,090. Three were from the ongoing audit of death certificates and 22 were from the regular health-department reporting system.

The 22 were a Barren County man, 83; a Boyle County man, 79; a Caldwell County man, 75; a Crittenden County woman, 77; three Hardin County women, 65, 66, 79; a Hardin County man, 89; a Harlan County woman, 83; two Jefferson County women, 66, 70; a Jefferson County man, 66; a Larue County women, 80; a Laurel County woman, 66; a Laurel County man, 92; a Letcher County woman, 81; a Logan County man, 68; a McCracken County woman, 72; a Nicholas County woman, 96; a Simpson County man, 62; a Warren County man, 80; and a Whitley County man, 78.  

Variants: Beshear said the state has detected 66 total cases of the B.1.1.7 variant first identified in the United Kingdom, and that there are 10 in Allen County; 10 in Jefferson County; and up to 13 in Kenton County.

Kentucky Health News asked the governor's office how many cases have been tested for the variants, but has not heard back. 

According to a Centers for Disease Control and Prevention report that draws only from publicly available data and is updated on Sundays, Kentucky has genomic sequenced only 757 coronavirus test samples. That is one of the lower rates in the nation, 0.179%. 

Among the seven border states, Tennessee's .089% is one of the lowest rates in the nation, and Virginia's .686% is the best border state, at .686 %, but that is far below Wyoming, which ranks highest at 5.82%.  

Experts have been sounding the alarm that the U.S. is not doing enough genomic testing to have a real picture of how the virus has mutated, but states are beginning to reopen and abandon their mitigation strategies. Only 16% of Americans have been fully vaccinated and 29% have had at least one shot, The New York Times reports. 

Just as there was not enough testing for the virus in the early days of the pandemic, there is now not enough gene sequencing to monitor how the virus is evolving and moving through population, says an article on The Conversation, a site for journalistic writing by academics. The authors say the nation needs to set up a "genomic surveillance system" to detect variants of concern and develop responses to them.

Prisons and vaccines: Beshear said that the state's prisons will be provided enough one-dose Johnson & Johnson vaccines by April 5 for every inmate who wants to be vaccinated. He said the two Lyon County facilities recovering from recent outbreaks, the Kentucky State Penitentiary and the Western Kentucky Correctional Complex, will have to wait until health officials deem it safe for them to get it.

After Beshear's briefing, The New York Times reported that a factory mixup had led to a halt in shipments of the Johnson & Johnson vaccine, which could delay the prison vaccinations.

In other pandemic news Wednesday:

• Counties with 10 or more new cases were Jefferson, 112; Fayette, 63; Warren, 41; Scott, 31; Boone, 28; Daviess, 27; Kenton, 24; Clinton, 21; Pulaski, 19; Laurel, 18; Oldham, 15; Bullitt and Hopkins, 14; Whitley, 13; Perry, 12; Knox, 11; and Hardin, Harlan, Marshall and Simpson, 10.
• Kentucky will open its largest vaccination site Monday, April 12, at Cardinal Stadium, through a partnership with U of L Health. It will have 24 lanes for drive-thru vaccinations, with a goal of doing 4,000 shots a day. Kentuckians can sign up at 502-681-1435. The hope is that nearly 200,000 people will get vaccinated in the seven weeks that the site will be operational. 
• No new cases were reported among long-term care residents, and only three were reported among staff. Today's report shows 50 active resident cases and 74 active staff cases. Also, no new deaths were reported in long-term care facilities, which got priority for vaccinations.
• A Texas doctor claimed that the vaccines are not only ineffective, but are "experimental gene therapy." Dr. Steven Hotze made the claim in a video that has been shared thousands of times. That is false, writes Donald Forthal, a professor of molecular biology at the University of California. He notes that the RNA in the vaccines is not incorporated into genes, and rapidly degrades after doing its work, and multiple tests have shown the vaccines to be around 95% effective at preventing severe disease.
• Pfizer reported that its coronavirus vaccine was 100% effective in protecting children 12 and older against the virus in a small study of 2,200 children. The company will need emergency authorization from the Food and Drug Administration to be able to offer the vaccine to the younger group. Last week, Pfizer started testing its vaccine in children aged 6 months to 11 years. Moderna announced that it had begun a clinical trial among children.
• Click here for the governor's press release that includes information on the eviction moratorium being extended and an unemployment insurance update. 

Vaccinations may come to Kentucky state prisons next week, after an increasing number of questions about why it took so long

By Bruce Maples and Al Cross
Kentucky Health News

As the state's coronavirus vaccination program has gradually expanded, so have questions about the very limited vaccinations of inmates in the state's prisons. Questions have been raised recently by families of inmates, their advocates, the news media and state legislators.

During his press briefing Wednesday, Gov. Andy Beshear noted the questions and announced that the state was expecting to offer the vaccine to all state inmates next week, a week earlier than first suggested, with the only exceptions being two facilities still recovering from Covid-19 outbreaks.

Beshear credited that to an earlier-than-expected shipment of the Johnson & Johnson one-shot vaccine, to come Friday or Monday, April 2 or 5. The state is using the one-dose vaccine for inmates so they don't have to follow up with those who might have been released to get their second shot.

After Beshear's briefing, The New York Times reported that a factory mixup had led to a halt in shipments of the Johnson & Johnson vaccine, which could delay the prison vaccinations.

Kentucky has one of the nation's highest incarceration rates, so many of its jails and prisons are overcrowded, many jails extremely so. Add that to normal confinement, in which people are often in close contact for meals and other activities, and you have an almost ideal setting for a virus to spread.

The state has the third-highest death rate among state prisoners from Covid-19, and the third highest rate of coronavirus cases, according to The Marshall Project, a nonprofit news organization that deals with criminal-justice issues and has tracked prison cases and deaths during the pandemic.

State Sen. Robin Webb

A longtime state legislator and criminal-defense lawyer said Tuesday the state needs to vaccinate inmates in prisons and jails as soon as possible.

As she voted to spend millions of dollars in federal relief, including $30 million for county jails, Sen. Robin Webb, D-Grayson, told other members of the Senate Appropriations and Revenue Committee, "The best thing we can do for the jails and people in them are to get vaccinations to the inmates; I don’t understand why that’s not been mandated."

Told afterward that helping people behind bars is not politically popular among some voters, Webb said, "This is Holy Week. I don't think that’s the way Jesus would look at it, or the way we’re supposed to be looking at it."

She's taking it personally: "I'm not getting a vaccination until the inmates are vaccinated. . . . People who don’t have a choice where they're going should have been a priority."

Webb said vaccinations are critical in prisons and jails because inmates are more likely to have underlying health issues. Among prisoners, "We have grave health problems with the use of needles, blood-borne disease, people needing dialysis," she said.

"If you're not into the humanitarian side, let's look at the fiscal side," she said. Long-term, "We’re gonna be spending a lot more money on these populations than the vaccine costs."

Also, she said the situation makes it even more difficult to recruit corrections workers: "How are we gonna recruit officers? They were busing 'em to LaGrange last year from my area" in northeastern Kentucky.

Asked if she had discussed the issue with the Beshear administration, she said Justice Secretary Mary Noble "was very responsive. … I know her heart's in the right place when it comes to these issues." Noble appeared at some of Beshear's early pandemic briefings to discuss prison cases, but hat task has since been handled by J. Michael Brown, secretary of the Executive Cabinet and a former justice secretary.

Early in the pandemic, Beshear tried to reduce risk in state prisons by releasing almost 1,900 older, nonviolent offenders who were nearing the end of their sentences. 

The state has prioritized vaccination of employees in prisons, but only last week did it say it would start vaccinating inmates, starting this week with those over 70. Many employees have been unwilling to be vaccinated; on Monday, the Corrections Department said 1,845 employees and contractors have received a shot, and another 338 were pending, for total of 2,193. That is barely half of the agency's 4,288 employees and contractors.

Several prisons have had serious Covid-19 outbreaks, most recently at the Kentucky State Penitentiary and the Western Kentucky Correctional Complex, both in Lyon County. Those two prisons will not be included in next week's vaccinations, and will join in when it is medically safe, Beshear said.

The infection rate at individual prisons is hard to pin down. Inmates come and go from facilities, so the total number who have been incarcerated during the pandemic is greater than the current population.

Some reported case numbers are striking. In some cases, as much as 70% of the population in a state prison has tested positive for the coronavirus.

The Northpoint Training Center near Burgin had an average daily population in 2019 of 1,252 inmates and 337 staff, for a total population of 1,589. The latest Corrections Department report shows it has reported 1,040 cases.

Or take the Correctional Institute for Women near Pewee Valley. Its average daily population was 215 inmates and 174 staff in the 2019 annual report, for a total average population of 399. In the latest DOC report, 470 cases have been reported since the pandemic started.

In correctional facilities run by the state, with a population of 11,674 inmates and 3,100 staff as of 2019, there have been 9,275 cases, according to the Corrections Department: Bell County Forestry Camp, 217; Blackburn Correctional Complex, Lexington, 266; Eastern Kentucky Correctional Complex, West Liberty, 1,343; Green River Correctional Complex, Central City, 440; Kentucky Correctional Institute for Women, 470; Kentucky State Penitentiary, 1,082; Kentucky State Reformatory, LaGrange, 620; Lee Adjustment Center, 764; Little Sandy Correctional Complex, 635; Luther Luckett Correctional Complex, LaGrange, 1,089; Northpoint Training Center, 1040; Roederer Correctional Complex, LaGrange, 778; Southeast State Correctional Complex, Wheelwright, 95; and Western Kentucky Correctional Complex, 436.

The New York Times reports that in federal prisons in Kentucky, which have 6,123 beds, there have been 2,586 cases of Covid-19, led by the Federal Medical Center in Lexington, with 843. Others: Federal Correctional Institution Manchester, 765; FCI Ashland, 434; United States Penitentiary McCreary, Pine Knot, 282; and USP Big Sandy, Inez, 262.

In local jails, there have been 3,678 cases among those with more than 50 cases, according to the Times: Lexington, 708; Louisville, 547; Warren County, 351; Boyd County, 276; Marion County, 213; Daviess County, 192; Boyle County, 134; Barren County, 132; Hart County, 115; Franklin County, 113; LaRue County, 111; Kenton County, 110; Bourbon County, 101; Powell County, 88; Butler County, 80; Clay County, 80; Wayne County, 75; Madison County, 72; Nelson County, 70; Carroll County, 57; and Simpson County, 53.

Contrary to the national trend, pandemic numbers in Kentucky stay on a rough plateau or decline slightly

By Bruce Maples
Kentucky Health News

As the rest of the country is seeing increasing numbers of new coronavirus cases, Kentucky continues at a rough plateau or even a slight a decline in its numbers, such as its seven-day average of new cases.

The Washington Post reports that new cases across the country have increased by 13% in the past week, with the seven-day average topping 63,000 new cases a day for the first time in a month.

Kentucky seems to be bucking the national trend, or at least not joining it. On Tuesday, the state announced 751 new cases of the coronavirus, bringing its seven-day average of new cases 589. That was a drop of 21 from the day before, after two days in which it increased by nine.

The percentage of Kentuckians testing positive for the virus in the last seven days stayed virtually the same: 2.9%, after two days at 2.89%.

Kentucky's seven-day average of daily new cases per 100,000 residents fell to 10.83, from 11.07 on Monday. It moved down to 35th among all the states on the New York Times national Covid-19 tracking site; the ranking has improved as other states' rates have increased.

“We are on a positive trajectory – we are leading all of our seven border states in administering at least one dose of the vaccine and our positivity rate continues to decline –  but we need to keep working hard and not give up,” Gov. Andy Beshear said in a press release. “We need every eligible Kentuckian to join the team and get the first vaccine available them.”

The state has delivered at least one dose of a coronavirus vaccine to about 40% of all adults in the state. There are over 570 vaccination sites across the state, and many have openings. Vaccinations are available to people over 40, and some sites vaccinate younger people in order to use available vaccine.

Beshear reported 13 new deaths, bringing the state's total to 6,065. He also reported 10 new deaths found through the state's audit of death certificates. The 14-day average of deaths reported fell to 18.8, from 19.6 the day before. 

Today's reported fatalities include an Anderson County man, 75; a Breckinridge County man, 89; a Carroll County woman, 65; a Fayette County woman, 82; a Garrard County man, 90; two Hopkins County women, 52 and 61; two Jefferson County men, both 78; a Laurel County woman, 72; a McCracken County woman, 77; a Trigg County man, 69; and a Trimble County man, 91.

Of the deaths found through audit, one was from October, seven were from December and two were from January. The daily lists of deaths are at https://governor.ky.gov/attachments/20210330_COVID-19_Deaths.pdf.

In other pandemic news Tuesday:

• Counties in the state with daily new-case rates more than double the state rate of 10.83 cases per 100,000 residents over the last seven days were: Owsley, 45.3; Simpson, 34.6; McCreary, 34; Harlan and Powell, 32.4; Lee, 28.9; Whitley, 28; Lyon, 26.1; and Martin, 21.7.
• Counties with more than 10 new cases in today's report were Jefferson, 130; Fayette, 55; Christian, 26; Scott, 25; Whitley, 23; Daviess, 22; Warren 21; Adair and Boone, 19; Hardin, 18; Pike, 17; Kenton and Laurel, 16; Knox and Madison, 13; and Campbell, Harlan, and Pulaski, 11.
• Kentucky's hospitals reported 378 persons hospitalized with Covid-19, up 14 from Monday. Of those, 91 were in the ICU, up 4 from Monday, and 37 were on ventilators, down 4 from Monday.
• A New York judge has ordered the state to vaccinate all prisoners in the state's prisons, jails, and other detention facilities. In issuing the order, Alison Y. Tuitt said “There is no acceptable excuse for this deliberate exclusion.” New York thus becomes one of the few states to make public its plan for vaccinating their incarcerated population. In many states, prisoners are already eligible due to age or health conditions, but have still not been vaccinated, as the focus has been on vaccinating the general population.
• U.S. Sen. Mitch McConnell, on stops around the state during a Senate recess, urged his listeners to get vaccinated. “I’m here today because it’s time to start emphasizing the importance of getting the vaccine,” he said in Bowling Green. “I read the other day that one of the segments of our population that was reluctant to get the vaccine was Republican men. I’m a Republican man, and I took my vaccine as soon as I was eligible. And I certainly encourage everybody to do it. It’s been extraordinarily successful.”
• Signs are pointing to travel being on the rebound in America, even as health officials are warning about "getting back to normal" too soon. Multiple airline companies, including American, Delta, and Southwest, are reporting surges bookings. Gasoline demand is up, too; those not flying are traveling by car. “What we’re seeing now is more travel than we saw throughout the pandemic, including the Christmas and New Year’s holidays,” which were followed by surges in new cases, CDC Director Dr. Rochelle Walensky said at a White House briefing. “I would just sort of reiterate the recommendations from CDC, saying please limit travel to essential travel for the time being.”

Nurses shouldn't have to pick between integrity and compliance, one writes, calling for a standard national work system

The writer is a nurse in Central City. She wrote this for The Leader-News.

By Dara Bratcher

Integrity is one of the most important qualities a nurse should possess. We must perform our duties completely and accurately. We should be talking to our residents with the intention of hearing what they have to say, treating the person, not just the wound or illness.

We must take the time to ensure our residents have the sense of security they long for, treat our elderly with dignity, and work to improve their quality of life.

Sometimes these goals come into conflict with another important part of nursing – compliance, which is the option nurses are conditioned to choose in the workplace these days. It is implied that we should make sure everything is signed off on, and then if there is time, go back and do the work. We are expected to comply with state and federal regulations within the nursing budget set for the facility, or face disciplinary action.

State and federal regulations implemented to protect residents of long-term-care facilities have created so much redundancy in the workload, nurses find themselves being pushed away from nursing and into clerical roles. It may not seem time-consuming to type in a set of vital signs or write a progress note, but the ratio of nurses to residents adds up when one nurse has dozens of patients under their care.

We are left to make a decision, the ultimate dilemma nurses face: Do we maintain our integrity and face reprimand, or remain compliant and leave the work of caregiving undone? With little money for overtime in most nursing-home budgets and paperwork necessary to remain in compliance, corporate officers encourage us to fill in the blanks first, then do whatever tasks time allows before the end of our shift.

The majority of nurses care as much as I do, but choose to comply. Can you blame them? People choose job security over fighting a losing battle. I don't believe we have a shortage of nurses who care; I believe there is a problem with the system.

I have always been strong willed, but the spark I have in me when it comes to the type of care I give is now a flame.

My dad, also known as Grandad to my children, was usually my babysitter. He complained daily about me coming home from work late. After my 12-hour shift was over I should “pass it on to the next shift” and come home, he would tell me. I would try to explain to him why my 12-hour shifts often turned into 14, 15, 16 hour shifts.

It wasn’t until my dad became a resident of a nursing home that he was able to truly understand what I had been trying to tell him all along. On one of the last days he was able to communicate before he passed away, in his own way of apologizing, he told me he could finally see the difference in how I talk about the way I do my job, and how other nurses do theirs.

He said, “Dara, I see now what you mean about not only treating your patients, but also treating them like human beings.” His words were, “Do not let the world change you, you fight to change the world!” After six years of hearing how much he hated the career I chose because it took me away from my family, it had turned to respect in just a few short weeks.

I know these regulations and their enforcers are meant to serve as advocates for residents, to ensure they receive the level of care they deserve, but at some point we lost sight of who the Number One patient advocate should be: the nurse.

We should build a nationwide operating system that eliminates redundant work and improves communication. This should include features such as linking data to appropriate assessments, evaluations, notes, etc. and standardizing forms and protocols. All nursing homes and long-term-care units should follow the same protocols, with the same required forms in the same format, whether documenting a new admission or a patient discharge, and everything in between.

This would not only reduce time spent at a computer, but reduce the margin of error in documentation. It would make for easier transitions when a resident transfers from one facility to another. It would also make it easier for nurses when changing employers, cutting down on orientation time, by bringing their career-long knowledge of documentation along with them.

Doing this, I believe we can ensure better patient outcomes, improve resident satisfaction with nursing-home care, and improve overall satisfaction with the nurse’s role in the workplace. I also believe when we are given the opportunity to actually perform the work of nursing, the shortage of nurses we are experiencing will eventually fade away, as the perception of nursing changes along with us.

Kentucky's one-dose vaccination rate is above adjoining states', but its positive-test and new-case averages have hit plateaus

Kentucky Health News graph, based on initial, unadjusted daily reports of cases

By Bruce Maples and Al Cross
Kentucky Health News

As the pandemic in Kentucky hit a plateau, Gov. Andy Beshear announced that 40 percent of adult Kentuckians had been vaccinated – but he and his health commissioner redoubled their pleas for people to sign up for openings that are going unfilled as more contagious coronavirus strains keep spreading.

Beshear said four major centers had hundreds of openings: Kroger Field in Lexington, Norton Healthcare in Louisville, the Kroger Regional Clinic in Frankfort, and King's Daughters Pavilion in Russell. "If you are 40 and up and you haven't gotten vaccinated yet, I will bet that if you try, you can get an appointment in the next week and a half. Just think about that."

The state reported 310 new cases of the virus, 16 more than last Monday of last week. That raised the seven-day average of new cases for the second day in a row, to 610. The last time that happened was Feb. 23-25, when the average was about double what it is now.

The daily new-case average per 100,000 residents over the last seven days rose to 11.07, from 10.95 on Sunday and a recent low of 10.8 on Saturday. The state's rate is 30th among the states, according to The New York Times; the rank has improved lately because the pandemic has worsened in other states.

The state has also seen a slight increase or a plateau in the percentage of residents testing positive for the virus. The rate reported on Monday was 2.89%, .01 percent higher than Sunday. It was 2.8% on Friday and Saturday, after falling pretty steadily for two and a half months from a high of 12.45%.

Beshear called the positive-test rate "virtually flat" and, as usual, didn't mention the seven-day average of new cases. But he repeated a data point that he had already noted in a Facebook post Sunday.

"Congratulations, Kentucky," he said a news briefing. "You have just had your eleventh straight week of declining cases," he said That is amazing. It's down roughly 400 cases of Covid from the week before."

He added, "That is wonderful for us – but a word of caution: Many other states are seeing their numbers increase." Noting that the national new-case rate is increasing, he said, "That's what happens if we give up too early. . . . We have to get enough people vaccinated before this thing mutates further."

Health experts say new cases are increasing partly because of mutant, more contagious strains of the virus, and the nation must keep up the vaccination pace to thwart the variants. Health Commissioner Steven Stack said variants have been found at least 15 counties in Kentucky, including the more contagious strains first identified in the United Kingdom and South Africa. 

"The vaccines are our exit strategy," Stack said. "The vaccines are the shot of hope that gets us out of this and back to our lives." He said that was shown by the differences in vaccinated and unvaccinated people at a Kentucky nursing home where there was an outbreak of a variant, and encouraged everyone to get whatever vaccine they can get as soon as they can get it.

Following up on Stack's comments, Beshear listed the counties where 41 cases of variants have been found: 11 in Kenton County, eight in Jefferson County, five in Boone County, four in Campbell County, two each in Fayette and Garrard counties, and one each in Allen, Bullitt, Calloway, Christian, LaRue, Madison, Marshall, Russell and Warren counties.

Beshear noted a Centers for Disease Control and Prevention study that found the Moderna and Pfizer vaccines were highly effective in preventing infection in front-line workers, with a protection rate of 80% after the first dose and 90% after the second. "Everything from the studies before we started doing the injections is now proven amongst those that are exposed the most," he said.

Ky. Health News table; CDC data

Beshear reported that 1,319,323 doses of coronavirus vaccines had been administered in Kentucky, and that about 40% of adults have received at least one dose of vaccine. That is 30.6% of the total population, better than any adjoining state, according to the CDC. West Virginia has a higher rate of fully vaccinated persons.

Beshear noted that he joined pastors representing more than 50 congregations, and leaders with UofL Health, for a one-day, twelve-hour event that vaccinated close to 2,500 people in western Louisville.

A person receives the vaccine at Saturday's event. (State photo)

"Our health-care providers throughout the commonwealth, including UofL Health, have been great partners as we take vaccinations into the community, making sure every Kentuckian gets their opportunity at a shot of hope," he said. "Our health-care heroes and volunteers spent their Saturday ensuring those who were willing could get vaccinated."

The state added 11 new deaths to its list of Covid-19 victims, bringing Kentucky's total to 6,042. Over the last 14 days the state has added an average of 19.6 deaths per day. This is the first time it has been below 20 since Dec. 5.

The fatalities included a 38-year-old Jefferson County man who was listed as dying Aug. 9, one in November and two in December, but Beshear said no deaths were added from the audit of death certificates. He said the audit will continue, going back farther than November, its initial starting point.

He said the state has pending "at least a couple hundred cases without enough documentation" or that have to go through the committee that designates confirmed and probable Covid-19 deaths.

Tim Jackson

Reflecting on the pain of over 6,000 deaths in Kentucky from the disease, Beshear honored the life of Tim Jackson, 74, of Prospect, who died March 1. Jackson was a coach, teacher, principal, and superintendent, before becoming secretary of the Cabinet for Families and Children (since consolidated into the Cabinet for Health and Family Services). One friend called Jackson "the ultimate role model."

Beshear remind people of the Team Kentucky Covid Memorial Fund, which will be used to pay for a memorial on the grounds of the state capitol. This memorial will honor the lives of all those lost to the virus in Kentucky. The state plans on doing an artist call soon, for persons interested in envisioning and creating the memorial itself. Anyone wishing to donate to the fund can do so at TeamKYCovidMemorial.ky.gov.

In other pandemic news Monday:

• CDC Director Rochelle Walensky made an impassioned plea to Americans Monday to not let their guard down in the fight against the virus after reporting that nationwide, cases are up about 10% from the last week, with both hospitalizations and deaths ticking up as well.
• The 11 fatalities added to the list were a Bourbon County woman, 58; 01/27/21 a Bullitt County woman, 92; a Garrard County man, 90; a Jackson County man, 78; two Jefferson County men, 38 and 86; a Johnson County woman, 73; a McCreary County woman, 78; a Muhlenberg County man, 72; a Shelby County man, 80; and a Spencer County man, 59.
• Counties with daily new-case rates more than twice the statewide rate of 11.07 per 100,000 residents over the last seven days were Owsley, 42.1; Simpson, 40.8; Powell, 37; Lyon, 29.6; Harlan, 27.5; Whitley, 27.2; McCreary, 25.7; and Lee, 25.1. Coincidentally, the state's "red zone" is for counties with a daily average of more than 25.
• Counties with 10 or more new cases were Jefferson, 60; Kenton, 16; Carter and Harlan, 15; Bullitt, 14; and Boone, 12.
• Kentucky hospitals reported 364 Covid-19 patients, 17 fewer than Sunday. Of those, 87 were in intensive care, nine fewer than the day before, and 41 were on a ventilator, an increase of two. Beshear noted that the declined, but said the curve "may be flattening a bit."
• A long-awaited joint study by the World Health Organization and China on the origins of the coronavirus is set to be released on Tuesday, but it is already drawing questions on both its findings and its methodology, The Washington Post reports. The study says the virus most probably jumped from animals to humans via an intermediate host, but also leaves open the possibility of other paths, including leaking from a lab or coming through frozen food. "The findings are far from conclusive and will be overshadowed by questions about China’s lack of transparency — and the WHO’s apparent inability to press for more," the Post reports.
• The Lexington-Fayette County Health Department has about 400 vaccine appointment slots available for Wednesday, March 31 for anyone ages 18 and older. Appointments can be made at lfchd.org/vaccine/ or call 859-899-2222 between 8 a.m. and 5 p.m. 
• A study in the American Journal of Obstetrics and Gynecology found pregnant women pass coronavirus antibodies from the vaccine to their unborn children, Katie Camero reports for McClatchy. "The finding offers encouraging news for pregnant and breastfeeding women, who face increased risks for severe Covid-19, including intensive care unit admission, mechanical ventilation and death, as well as dangerous pregnancy outcomes such as preterm birth." 
• "A new study suggests the messenger RNA vaccines produced by Moderna and the Pfizer-BioNTech partnership appeared to be 90% effective in preventing Covid-19 infection in a real-world setting," Stat reports. The CDC released the study Monday.

People gave up on influenza pandemic measures a century ago when they tired of prevention – and many of them paid a price

Armistice Day celebrations of the end of World War I on Nov. 11, 1918, worried public-health experts as people crowded together in cities across the United States. (Photo by The Associated Press)

By J. Alexander Navarro, University of Michigan

Picture the United States struggling to deal with a deadly pandemic.

State and local officials enact a slate of social-distancing measures, gathering bans, closure orders and mask mandates in an effort to stem the tide of cases and deaths.

The public responds with widespread compliance mixed with more than a hint of grumbling, pushback and even outright defiance. As the days turn into weeks turn into months, the strictures become harder to tolerate.

Theater and dance hall owners complain about their financial losses.

Clergy bemoan church closures while offices, factories and in some cases even saloons are allowed to remain open.

Officials argue whether children are safer in classrooms or at home.

Many citizens refuse to don face masks while in public, some complaining that they’re uncomfortable and others arguing that the government has no right to infringe on their civil liberties.

As familiar as it all may sound in 2021, these are real descriptions of the U.S. during the deadly 1918 influenza pandemic. In my research as a historian of medicine, I’ve seen again and again the many ways our current pandemic has mirrored the one experienced by our forebears a century ago.

As the Covid-19 pandemic enters its second year, many people want to know when life will go back to how it was before the coronavirus. History, of course, isn’t an exact template for what the future holds. But the way Americans emerged from the earlier pandemic could suggest what post-pandemic life will be like this time around.

Sick and tired, ready for pandemic’s end

Like Covid-19, the 1918 influenza pandemic hit hard and fast, going from a handful of reported cases in a few cities to a nationwide outbreak within a few weeks. Many communities issued several rounds of various closure orders – corresponding to the ebbs and flows of their epidemics – in an attempt to keep the disease in check.

These social-distancing orders worked to reduce cases and deaths. Just as today, however, they often proved difficult to maintain. By the late autumn, just weeks after the social-distancing orders went into effect, the pandemic seemed to be coming to an end as the number of new infections declined.

People clamored to return to their normal lives. Businesses pressed officials to be allowed to reopen. Believing the pandemic was over, state and local authorities began rescinding public health edicts. The nation turned its efforts to addressing the devastation influenza had wrought.

For the friends, families and co-workers of the hundreds of thousands of Americans who had died, post-pandemic life was filled with sadness and grief. Many of those still recovering from their bouts with the malady required support and care as they recuperated.

At a time when there was no federal or state safety net, charitable organizations sprang into action to provide resources for families who had lost their breadwinners, or to take in the countless children left orphaned by the disease.

For the vast majority of Americans, though, life after the pandemic seemed to be a headlong rush to normalcy. Starved for weeks of their nights on the town, sporting events, religious services, classroom interactions and family gatherings, many were eager to return to their old lives.

Taking their cues from officials who had – somewhat prematurely – declared an end to the pandemic, Americans overwhelmingly hurried to return to their pre-pandemic routines. They packed into movie theaters and dance halls, crowded in stores and shops, and gathered with friends and family.

Officials had warned the nation that cases and deaths likely would continue for months to come. The burden of public health, however, now rested not on policy but rather on individual responsibility.

Predictably, the pandemic wore on, stretching into a third deadly wave that lasted through the spring of 1919, with a fourth wave hitting in the winter of 1920. Some officials blamed the resurgence on careless Americans. Others downplayed the new cases or turned their attention to more routine public health matters, including other diseases, restaurant inspections and sanitation.

Despite the persistence of the pandemic, influenza quickly became old news. Once a regular feature of front pages, reportage rapidly dwindled to small, sporadic clippings buried in the backs of the nation’s newspapers. The nation carried on, inured to the toll the pandemic had taken and the deaths yet to come. 

It's hard to hang in there

Our predecessors might be forgiven for not staying the course longer. First, the nation was eager to celebrate the recent end of World War I, an event that perhaps loomed larger in the lives of Americans than even the pandemic.

Second, death from disease was a much larger part of life in the early 20th century, and scourges such as diphtheria, measles, tuberculosis, typhoid, whooping cough, scarlet fever and pneumonia each routinely killed tens of thousands of Americans every year. Moreover, neither the cause nor the epidemiology of influenza was well understood, and many experts remained unconvinced that social distancing measures had any measurable impact.

Finally, there were no effective flu vaccines to rescue the world from the ravages of the disease. In fact, the influenza virus would not be discovered for another 15 years, and a safe and effective vaccine was not available for the general population until 1945. Given the limited information they had and the tools at their disposal, Americans perhaps endured the public health restrictions for as long as they reasonably could.

A century later, and a year into the Covid-19 pandemic, it is understandable that people now are all too eager to return to their old lives. The end of this pandemic inevitably will come, as it has with every previous one humankind has experienced.

If we have anything to learn from the history of the 1918 influenza pandemic, as well as our experience thus far with Covid-19, however, it is that a premature return to pre-pandemic life risks more cases and more deaths.

And today’s Americans have significant advantages over those of a century ago. We have a much better understanding of virology and epidemiology. We know that social distancing and masking work to help save lives. Most critically, we have multiple safe and effective vaccines that are being deployed, with the pace of vaccinations increasingly weekly.

Sticking with all these coronavirus-fighting factors or easing off on them could mean the difference between a new disease surge and a quicker end to the pandemic. Covid-19 is much more transmissible than influenza, and several troubling variants are already spreading around the globe. The deadly third wave of influenza in 1919 shows what can happen when people prematurely relax their guard.

J. Alexander Navarro is assistant director of the Center for the History of Medicine at the University of Michigan. This was originally published on The Conversation, a site for journalistic reporting by academics.

Pike, Woodford, Perry, Fayette and Floyd counties lead Kentucky in full vaccination, Washington Post reports, using CDC data

Screenshot of Washington Post interactive map; click it to enlarge. Click here for interactive version.

By Al Cross

Kentucky Health News

Two pairs of very different Kentucky counties – Pike, Woodford, Perry and Fayette – have the highest percentages of their populations fully vaccinated against the novel coronavirus, according to Centers for Disease Control and Prevention data published Sunday by The Washington Post.

The CDC data show that 23.3% of Pike County's population has been fully vaccinated, well above the state average of 15.3% and the national average of 14.7%. Woodford County ranks second, at 21.6%, followed by Perry County at 21.4% and Fayette County at 21.2%.

Pike and Perry counties are deep in Appalachian Kentucky, while Fayette and Woodford are in the heart of the much more well-to-do Bluegrass, but the first three are all home to major health-care facilities, and most of Woodford County's population has easy access to Fayette, so that could be a factor.

Floyd County, which borders Pike, has a fully-vaccinated rate of 20.1%. It is the only other Kentucky county with more than 20%, according to the Post map produced with the CDC data. It is the first public report of county-by-county vaccination rates, and doesn't include all states because of limited reporting.

The report's interactive map also lists the percentages of adult and senior population that have been fully vaccinated, either one-shot Johnson & Johnson vaccine or both doses of the Moderna or Pfizer vaccines. Pike leads in adult vaccinations with 29.3% and Fayette is tops for 65 and up with 54.6%.

Twenty counties have less than 10% of their populations fully vaccinated, according to the Post map: Adair, Ballard, Calloway, Casey, Christian, Clay, Clinton, Elliott, Graves, Hart, Jackson, Lee, Lewis, McCreary, Meade, Rockcastle, Spencer, Taylor, Todd and Wayne, which has the lowest rate, 6.6%. Other low counties are Spencer, 6.7%; Casey, 6.9%; and Christian, 7.2%.

Jefferson, the state's most populous county, had 15.8% fully vaccinated, half a percentage point above the statewide average. It and Christian County both have large Black populations, and Gov. Andy Beshear has said more than once that the vaccination rate among Kentucky Blacks lags that of whites.

The Post story reports the CDC data show "notably lower rates in predominantly Black areas and counties that voted most heavily for President Donald Trump in 2020." President Biden carried only Fayette and Jefferson counties, but the data suggest that counties where Trump got over 80% have lower vaccination rates.

The Post says it included only counties for which at least 85% of vaccination records included a person’s county of residence: "For the states with usable information, 45 percent of people age 65 and older, 18.2 percent of all adults 18 or older, and 14.3 percent of the entire population are fully vaccinated."

State records 11th consecutive week of fewer new cases, but its positive-test and new-case averages went up a little on Sunday

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

By Al Cross
Kentucky Health News

Two key measures of the pandemic took a turn upward Sunday, even as Gov. Andy Beshear pointed out in a Facebook post that the Monday-to-Sunday reporting week was the 11th in a row with a smaller number of new cases.

The percentage of Kentuckians testing positive for the novel coronavirus. It rose to 2.88% after staying at 2.8% for two days. The rate has been below 3% since last Sunday.

The other major metric going up was new cases of the virus. The state reported 361 new cases, 45 more than last Sunday. That brought the seven-day rolling average to 607, six higher than it was Saturday.

For the week, the initial, unadjusted daily reports of new cases totaled 4,252. The previous week's corresponding total was 4,654.

Kentucky hospitals reported 381 Covid-19 patients, 20 fewer than the week's average. Intensive care had 96, four more than Saturday, but the number on ventilators fell by seven to 39, a historically low share.

Kentucky's statewide rate of new cases last week ranked 31st among the states, according to The New York Times coronavirus data tracker. The state's daily report said the rate today was 10.95 per 100,000 residents over the last seven days, up 0.15 from Saturday's rate of 10.8.

Counties with rates more than double the statewide rate were Owsley, 42.1; Simpson, 41.5; Powell, 33.5; Whitley, 27.6; Lyon, 26.1; Lee, 25.1; McCreary, 24.9; and Knox, 24.8.

Counties with more than five new cases Sunday were Jefferson, 84; Fayette, 34; Kenton, 13; Warren, 12; Harlan and Laurel, 11; Bullitt, 10; McCracken, Madison and Oldham, 9; Lyon, 8; Caldwell and Logan, 7; and Boone, Daviess, Henderson and Scott, 6.

The state list eight more Covid-19 deaths, five confirmed and three probable, raising the death toll to 6,031. It was the first single-digit addition to the list since Monday, Feb. 15. On weekends, the state does not itemize deaths or add to the list of those found in its ongoing audit of death certificates.

Vaccination: Two health experts said on CBS's "Face the Nation" that keeping up the current pace of vaccination is the key to preventing a fourth surge of coronavirus cases and Covid-19 deaths.

"If we could just get two or three more weeks" at the current national rate, that would be "a pretty good backstop against a fourth surge," said Dr. Scott Gottlieb, a commissioner of the Food and Drug Administration in the Trump administration. He said vaccine supplies should be boosted in areas with outbreaks.

Dr. Anthony Fauci, President Biden's chief medical adviser and director of the National Institute of Allergy and Infectious Diseases, said those outbreaks are being driven both by more contagious variants and by "pulling back on the mitigation," as some states are doing. "I believe it's premature."

After weeks of decline, the U.S. has hit a plateau in cases. "Once you stay at that plateau you're really in danger of a surge coming up, and unfortunately that's what we're starting to see," even more so in Europe, Fauci said. He said travel remains risky because "you get congregation of people" in lines.

Asked how to overcome resistance to vaccination, especially among younger Republicans, Gottlieb suggested getting more vaccine into doctor's offices and pharmacies would produce better results than messages featuring celebrities.

Dr. Sanjay Gupta said on CNN's "Reliable Sources" that vaccine hesitancy or resistance are being fed by "very provocative" social-media posts. The show referred to a report by NPR that said "Articles connecting vaccines and death have been among the most highly engaged with content online this year, going viral in a way that could hinder people's ability to judge the true risk in getting a shot."

For example, no vaccine-related deaths have been reported, but "On almost half of all the days so far in 2021, a story about someone dying after receiving a vaccine shot has been among the most popular vaccine-related articles on social media, according to data from the media-intelligence company NewsWhip," NPR reporter Miles Parks notes.

Social-media platforms are "making more of an effort to take down patently false health claims," Parks reports, so "bad actors are turning to cherry-picked truths to drive misleading narratives. Experts say these storylines are much harder for companies to moderate, though they can have the same net effect of creating a distorted and false view of the world."

Ky. missed over 700 Covid-19 deaths because one state worker stopped double-checking reports in an antiquated system

State table, adapted by Ky. Health News,
lists deaths from audit added on Friday.

Kentucky missed more than 700 Covid-19 deaths from October to January for the same reason Ohio missed 4,000: One state employee stopped reconciling death certificates with reports from health departments using an antiquated system, reports Deborah Yetter of the Louisville Courier Journal.

"Two separate streams of information about deaths — one from health departments and the other from death certificates — must be reviewed and reconciled. The task is time-consuming and currently is performed by a human, not a computer," Yetter reports.

"Reports of Covid-19 cases already often delayed. On Monday, Beshear announced 11 new deaths and 50 more from the audit, though none were from March. . . . Timely reports are important if health officials hope to convince a sometimes-skeptical public of the need for precautions to reduce infection, such as requirements to wear masks and limit sizes of gatherings, said Dr. Kraig Humbaugh, commissioner of the Lexington-Fayette County Health Department."

"We want to be as accurate as possible," Humbaugh told Yetter. "We want to count those that are Covid deaths, and not count those that are not."

Kentucky and Ohio officials said the problem arose late last year as coronavirus cases and Covid-19 deaths "began to pile up and workers became overwhelmed," Yetter reports. "Some death reports lag behind simply because it takes time to compile, review and forward the information to public health officials in Frankfort."

They get the data in two ways, Yetter notes: "Health departments rely on epidemiologists — specialists in identifying diseases — to review information from individual cases and reach a conclusion about whether a death resulted from Covid-19," and many health departments have lagged behind. "Death certificates are filed separately with the state Vital Statistics Branch by sources including local coroners, hospitals, doctors or nursing homes. Sometimes a death certificate reports an individual had Covid-19, though it may it may not have been reported by the health department."

Sometimes, causes of death are difficult to determine "in a state with high levels of disease, such as heart and lung ailments, diabetes, cancer and other conditions which can also prove fatal and likely are complicated by Covid-19," Yetter writes. "At the state Department of Public Health, a committee of experts reviews individual cases in question in order to decide whether they should be listed as deaths from Covid-19." That's one reason deaths are often listed weeks or even months after they occur.

New-case and positive-test averages stable as U.S. numbers rise

Kentucky Health News graph, based on initial, unadjusted case numbers announced daily

By Al Cross

Kentucky Health News

As national numbers suggested the pandemic is expanding again, Kentucky's numbers of new coronavirus cases keep falling, but just barely.

The state reported 637 new cases Saturday, making its seven-day rolling average 601, just one less than Friday. The statewide rate of new cases over the last week fell to 10.8 per 100,000 population, and Kentucky's rate fell to 30th among the states, according to The New York Times data tracker.

Kentucky ranked in the top 10 a few weeks ago, but as its new-case numbers have fallen, those in most other states have picked up. The Times's national two-week average is 8 percent higher than it was two weeks ago.

The percentage of Kentuckians testing positive for the virus remained at 2.8%, the same as Friday and a little more than half of what it was a month ago.

Counties with seven-day new-case rate that were more than double the statewide rate were Simpson, 46.9 per 100,000; Owsley, 42.1; Powell, 31.2; Whitley, 27.6; Lee, 27; Knox, 24.3; McCreary, 24; and Lyon, 22.6.

Counties with 10 or more new cases Saturday were Jefferson, 86; Fayette, 53; Adair, 32; Warren, 24; Scott, 22; Christian, 20; Hardin, 19; Boone, 17; Daviess, 17; Lee, 14; Kenton, 13; Whitley, 12; Barren, Hopkins and McCracken, 11; and Pulaski, 10.

The state added 15 more deaths to its official Covid-19 toll, 13 confirmed and two probable, for a total of 6,023. As usual for a Saturday, it did not itemize the deaths by county, age and sex, and did not add any deaths from its ongoing audit of death certificates.

Over the last two weeks, the state has added a daily average of 21 regularly reported deaths to the list. In the previous two weeks, the average was 24.4 per day; in the two weeks before that, it was 25.4 a day.

The share of Covid-19 deaths in long-term care facilities has dropped to 39.4%. It was as high as 60%, but residents and staffers of the facilities were given top priority for vaccinations.

Kentucky hospitals reported 400 Covid-19 patients, 17 more than Friday but still 38 fewer than the average for the last two weeks; 92 of them were in intensive care and 46 of those were being mechanically ventilated.

Only one of the 10 hospital readiness regions reported more than 80% of its intensive-care beds in use: Lake Cumberland, at 89%.

Special open enrollment period for government-subsidized health insurance extended to Aug. 15; new rules expand who qualifies

By Melissa Patrick

Kentucky Health News

The special open enrollment period for people to buy government-subsidized  health insurance on the federal marketplace has been extended by three months to Aug. 15. 

Kaiser Family Foundation graphs; for a larger version of any image, click on it.

President Joe Biden announced the extension March 23, the 11th anniversary of the Patient Protection and Affordable Care Act becoming law. The special enrollment period was set to end May 15. 

The special enrollment period includes enhanced premium subsidies, also known as tax credits, to help offset the cost of the marketplace's health insurance plans. It also makes more people eligible for the subsidies and eliminates repayments that may be required when people reconcile their tax return with the tax credit they received.

The enhanced subsidies, along with several other health-related provisions, were authorized under the  $1.9 trillion relief-and-stimulus law and are aimed at making coverage more affordable for people who already have marketplace coverage, who are uninsured or have lost their employer coverage.

Open enrollment is usually open for only six weeks at the end of a year, except for those who experience a "qualifying life event," like getting married or losing a job. 

Under the American Rescue Plan, subsidized premiums will drop an average of $50 per person per month, according to a federal fact sheet. It also says four out of five enrollees will be able to find a plan for $10 or less per month after the tax credit, and most will be able to find a "silver" plan for $10 or less. Silver plans have the the second-lowest costs and are the benchmarks used to calculate the tax credits. 

Under the ACA, only people with incomes between 100% and 400% of the federal poverty level  were eligible for a tax credit to reduce their premiums for marketplace coverage. 

The American Rescue Plan removes that cap for two years and allow people with incomes above 400% of the poverty level ($51,040 for an individual) to be eligible for the enhanced subsides. 

It also limits the amount a person would pay for a plan to 8.5% of household income, down from 9.83%. The federal government picks up the slack.

For example, Kaiser Health News reports that a typical single person who makes $30,000 a year will pay $85 per month for a silver plan instead of $195, according to an analysis by the Center on Budget and Policy Priorities. A family of four making $75,000 will pay $340 rather than $588 per month for similar coverage, the analysis found.

The Kentucky Center for Economic Policy reports that the American Rescue Plan's provisions mean that many who earn between 139% of the poverty level ($17,900 for an individual) and 150% of the federal poverty level ($19,320 for an individual) can find plans with zero premiums.

In Kentucky, anyone earning up to 138% of the federal poverty line qualifies for Medicaid, which is free of charge. 

The savings are available to both new and existing enrollees and will start on April 1. They will be available for two years. They will help the 77,800 Kentuckians who are already covered by marketplace plans, and open enrollment to more Kentuckians.

Kaiser Health News has a list of things to do to determine whether you qualify for an enhanced subsidy:

• People with marketplace coverage through healthcare.gov should update their applications and reselect their current plan to get details about their subsidies that will start on April 1. 
• The more generous premium tax credits may mean that a person can switch to better coverage with lower cost sharing for the same contribution, although Kaiser Health News cautions that switching plans may mean any money paid toward a deductible under the current plan could be lost -- so check with your insurer before making a switch. 
• People who have already bought a 2021 plan on the marketplace that didn't qualify for a premium tax credit under the ACA will need to enroll again to get the new premium tax credit.
• Recipients of unemployment insurance benefits in 2021 are urged to enroll in a marketplace plan now. Under the new law, unemployed workers can get a zero-premium plans in 2021. 

The Kaiser Family Foundation offers a Health Insurance Marketplace Calculator to help people estimate how much their marketplace coverage would cost with the relief bill's changes.  

The ARP also requires the federal government to pay 100% of COBRA insurance premiums for eligible employees who lose their jobs (and for their covered relatives) through September, allowing them to stay on their company-sponsored health plans. This provision is especially important for people with medical conditions because it allows them to keep their coverage and existing providers.

Positive-test rate falls to 2.8%, about half of what it was 4 weeks ago; other pandemic metrics decline; death toll surpasses 6,000

Kentucky Health News graph; click on it to enlarge.

By Al Cross

Kentucky Health News

Every measure of the pandemic in Kentucky declined Friday, except death, and even that lagging indicator's averages kept declining, not counting deaths being found by an ongoing audit.

The percentage of Kentuckians testing positive for the novel coronavirus fell again, to 2.8%, about half of what it was a month ago (or four weeks, since last month was February).

The state reported 646 new virus cases, lowering the 7-day rolling average by 12, to 602, the lowest since Sept. 12.

The statewide rate of new cases over the last seven days fell to 11.38 per 100,000 residents. Counties with rates more than double the statewide rate were Lyon, 53.9; Simpson, 53.1; Owsley, 45.3; Whitley, 29.5; Powell, 27.7; Knox, 27.5; Lee, 25.1; and Mercer, 24.8.

Counties with 10 or more new cases were Jefferson, 110; Fayette, 52; Warren, 30; Scott, 24; Adair, 19; Madison, 16; Boone, 15; Clark, 13; Barren, Daviess, Mercer and Oldham, 12; Kenton, McCreary and Whitley, 11; and McCracken and Wayne, 10.

Kentucky hospitals reported 383 Covid-19 patients, 20 fewer than Thursday; 88 were in intensive care and 46 of those were on ventilators, down 18 and 3, respectively. Only the Lake Cumberland hospital region, at 82%, reported more than 80% of its intensive-care beds in use, and just 16% had Covid-19 patients.

The pandemic's death toll in Kentucky passed 6,000, as state officials added 27 more deaths to their official list of Covid-19 victims, plus 11 found by an ongoing audit of death certificates. That pushed the death toll to 6,008.

Unlike Thursday, there was no overlap in the two reports' dates of deaths. The dates of the regularly reported deaths ranged from Jan. 11 to March 24. The deaths found by audit were Dec. 8-27.

Not counting the deaths found by audit, the state's daily death average has been on a slow, general decline for the past month. Based on dates the deaths were officially listed after review, the 14-day rolling average declined from 25.2 on Feb. 27 to 21.1 on Friday. 

Gov. Andy Beshear did not comment on any daily numbers or averages in his press release, but continued to emphasize vaccination.

“More than one in three Kentucky adults have been vaccinated so far, which is a huge milestone,” he said. “If you haven’t been vaccinated, see where you can sign up. If you’ve got a family member or friend who wants their shot of hope, help them get registered and call our vaccine hotline, 855-598-2246 or TTY 855-326-4654 (for deaf or hard-of-hearing Kentuckians), if you need help. Together, we can defeat Covid-19 this year, but we have to keep up our momentum.”

A survey in Jefferson County found that 91% of residents would choose vaccination, with slightly lower rates among minorities.

"About 3% of white and 8% of minority participants indicated they would never choose vaccination," said a news release from the University of Louisville Christina Lee Brown Envirome Institute. "Minority participants reported they were more likely to choose vaccination with celebrity endorsement, offerings by faith organizations and vaccination requirements. White participants were more likely to choose vaccination if their family and friends or elected officials were vaccinated and with evidence of efficacy."

The survey was conducted as part of the Co-Immunity Project to understand the impact of Covid-19 in Jefferson County. Most of the 1,296 people who responded online to the mailed invitation were over 60 or over (44%), female (61%) and white (84%), and 90.2% reported being unvaccinated.

The state Department of Education updated its guidance on school distancing to match that of the Centers for Disease Control and Prevention: three feet, if all students are masked. Six feet is still required in common areas and during activities such as singing, band and sports, which should be moved outside.

In other pandemic news Friday:

• The state Corrections Department reported 196 active cases among prisoners, 171 at the state penitentiary; 12 employees at the prison were among the 19 staffers with active cases.
• "Outside of big cities, where office buildings remain vacant, people in America are becoming more active," The Washington Post reports after its analysis of cell-phone data showed that in parts of the Deep South and Mountain West, mobility is higher than it was before the pandemic. "This spring fever is palpable across much of the country," the Post reports, "and as people are on the move so is the virus: There is increasing evidence of a new bump in cases."
• Women are more likely than men to have gone without health care during the pandemic, and as a result women who had health and economic challenges beforehand have had worse health conditions, according to a survey by the Kaiser Family Foundation, which concluded, "These gaps in care could translate into higher numbers of women experiencing severe health issues after the health emergency from the pandemic resolves."
• Kaiser also reported, "The pandemic has had a significant effect on people’s mental health, with 51% of women and 34% of men saying that worry or stress related to the pandemic has affected their mental health. Most say that the impact has been moderate or minor, but almost one-fifth (21% women, 17% men) say the toll has taken a major impact on their mental health."

Four Ky. health groups mount campaign for vaccinations

To overcome hesitancy or resistance to vaccination against the novel coronavirus, four Kentucky health groups have started a campaign of public-service announcements online and in print.

"Take It From Me" is based on surveys that adults are more likely to get vaccinated if so advised by someone they know. The PSAs feature a diverse group of individuals reassuring others to “Take it from me” that the vaccines are safe and effective.

The campaign comes from the Kentucky Medical Association, the Kentucky Foundation for Medical Care, the Foundation for a Healthy Kentucky, the Kentucky Hospital Association and the Kentucky Primary Care Association.

“Our organizations have teamed up because we know that getting more Kentuckians vaccinated is the best way to get our state back to enjoying the things we all miss and protecting everyone’s loved ones,” Nancy Galvagni, president of the hospital association, said in a news release.

“Many people have questions about the Covid-19 vaccines, and that’s okay,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky. “This campaign features Kentuckians willing to share the answers they have found to the most frequently stated vaccine concerns. It’s our hope that the campaign spokespersons will give those who are vaccine hesitant a higher level of comfort about getting their Covid-19 shot of prevention.”

KMA President Dale Toney, who appears in the spots, said, “We encourage talking to your physician about the vaccine. But through the ‘Take It From Me’ campaign, we also hope Kentuckians will talk to their friends and neighbors who have received it to help ease any concerns. Millions of people have been safely vaccinated—myself included—and we need as many as possible to receive it to put this pandemic behind us.”

The campaign also features Michael Branch, the first Louisville firefighter to contract Covid-19, who is married to a physician; Dr. Leigh Doane of Winchester, a mother of two young children who specializes in women’s health; Camille Jordan, senior vice president of clinical operations and innovation for Signature HealthCare, the state's largest nursing-home operator; Edward L. Palmer Sr., pastor of The Sign Of The Dove Church in Radcliff and social justice advocate; and Jason “JP” Phillips, University of Kentucky extension agent for agriculture in Simpson County.

The PSAs range from 90 to 255 seconds and can be downloaded here:
“Take It From Me” 1:30
“Take It From Me” 2:30
"Take It From Me" 3:30
“Take It From Me” 4:15