State opens priority vaccinations to ages 50-59, aims for all 16 and up by April 12; audit found 604 missing deaths from Covid-19

Sen. Rand Paul and Dr. Anthony Fauci argued about
masks at a Senate hearing. See below. (NBC image)

By Bruce Maples and Al Cross
Kentucky Health News

Gov. Andy Beshear announced expansions of the state's Covid-19 vaccination program, both in age priorities and availability, and said bars and restaurants could stay open an hour later because the share of Kentuckians testing positive for the novel coronavirus has fallen sharply, especially Thursday.

He also announced that an audit of deaths had found that the state had missed 604 Covid-19 fatalities during the biggest surge of the pandemic, from mid-November to late January, and said the state would keep looking.

Vaccination expansion: As Kentucky pushes vaccines to thwart more contagious strains of the virus, Beshear said the priority vaccination group would be expanded Monday to anyone 50 or older. People can sign up now, and if sites have slots available this weekend, they can sign up for those as well.

“Kentuckians deemed most vulnerable should still get priority, and they will, but we can’t have these vaccines sitting in a freezer,” Beshear said. “We are in a race against the Covid-19 variants and we’ve got to get it out fast.”

Beshear said that his goal is to have the vaccine program fully open to everyone 16 and older by April 12. That depends on supply, but he said that he is confident the state will not only meet that goal, but beat it.

Asked about anecdotal reports that some vaccination sites are taking adults of any age, and whether that indicates a problem with vaccine hesitancy, Beshear said, "We don't think it's happening on a huge scale." But he also said, "As more people get vaccinated, we'll reach people that want more information. I think as we open up new categories, we'll see more of that hesitancy."

The state will open three big vaccination sites over the next few weeks. The largest, a partnership with U of L Health, will be at Cardinal Stadium. It will have 24 lanes for drive-through vaccinations, with a goal of 4,000 shots a day. Appointments can be made starting March 31, for shots beginning April 12. 

In a push to care for an under-served community, a regional site will open at Whitney Young Elementary School in west Louisville. It will be able to deliver 400 to 500 doses per day, and will have evening hours. 

A regional site will open Wednesday, March 24 at Kentucky Dam Village State Resort Park, in partnership with the University of Kentucky, Wild Health, and the Marshall County Health Department. It will include testing as well as vaccinations and be open 8 a.m.to 7 p.m. seven days a week.

Details on these sites, as well as the other 563 sites across the state, are available at vaccine.ky.gov.

Bars, restaurants and numbers: Due to the continuing decline in the pandemic statistics in the state, Beshear said, bars and restaurants will be able to serve until midnight beginning this Friday, with closing extended to 1 a.m. The capacity limit is still at 60%, and masks and social distancing are still required.

The percentage of Kentuckians testing positive for the virus in the last seven days fell to 3.23%, 0.5 point lower than the day before and the lowest percentage since July 2. It has declined steadily since late January.

The state reported 785 new cases, lowering the seven-day rolling average by 61, to 721. That's the lowest average since Sept. 24.

Audit of deaths: As Beshear explained in an earlier update, the normal death reporting process broke down to some extent during the surge around the holidays. He ordered an audit of death records, which several other states have done, and reported Thursday that 604 more deaths had been found.

The governor said the deaths will be itemized over the next few days. Today's death report included 417 of them, including 200 who lived long-term-care facilities. The average age of the 417 fatalities was 79.9.

Of the 417, Jefferson County had 103, or 24.7% of the total; its share of all deaths has been 17.9%. McCracken County had 16 (3.8%, of the audit total and more than double its overall share of 1.8%); Boyle and Bullitt counties each had 12 (2.9% of the audit total and well above their overall shares of 1% and 1.2%, respectively); Knox and Whitley each had 10 (2.4% of the audit total, far above their overall respective shares of 0.4% and 0.7%).

Other counties with more than five deaths among the 417 were Boyd, Kenton and Madison, 9 each; Fayette and Greenup, 8 each; Barren, Estill, Floyd and Hardin, 7 each; Campbell, Christian, Laurel, Pike and Warren, 6 each. Seventy other counties had five or fewer, for a total of 90 counties with at least one death found through the audit and reported Thursday, with 187 left to be itemized.

Beshear noted that audits in Ohio and Indiana found about 4,000 and 1,500 missing deaths, respectively.

The audit, and 31 deaths added to the list through the normal review process, brought the state's death toll to 5,504, 4,987 of them confirmed and 517 probable.

Asked why the Centers for Disease Control and Prevention reports 6,483 Covid-19 deaths in Kentucky, based on death certificates, Beshear said his administration follows a more rigorous process. He said a certificate might list Covid-19 as a cause of death, but the state's review process may find no positive test to prove it; and even if does, the test may not be close enough to the date of death to be listed as a cause. He noted that death certificates can list multiple causes.

"We'll try to be as transparent about the process as we can," Beshear said. Earlier, he said:

"Our commitment is to know the full devastation of this virus. This won't be the last audit that we do; it won't be the last time that we discover additional people who have passed away. . . . We still have, from this audit, a number of records that we still need to get to determine whether additional Covid deaths occurred. What we will do is we will update when we get the information to make sure that everybody's loss is counted. And that as we move out of this, that we're able to process the total toll that it's taken, and the grief that is has created. No unknown soldiers; everybody counts."

Update on variant: Health Commissioner Steven Stack explained more about a new variant of the virus that had been found in a nursing home, apparently in Morehead. He said the genomic sequencing that found the variant was conducted because several residents had Covid-19 despite being vaccinated.

Whenever someone who has been vaccinated still contracts the virus, their infection is gene-sequenced to see if it is a "variant of concern" that is already known. If not, more the variant is compared with larger datasets to see if it is similar to other less-concerning variants around. He said that analysis is still ongoing, but it has not been identified as a variants of concern.

Mask debate: U.S. Sen. Rand Paul had another dust-up with Dr. Anthony Fauci, President Biden's chief medical adviser and director of the National Institute of Allergy and Infectious Diseases. At a Senate committee hearing, Paul accused Fauci of wearing a mask "for show" after being vaccinated, CNN and Fox News report. Fauci replied, "Here we go again with the theater. Let's get to the facts."

"Fauci stressed that vaccines and natural immunity did not protect against Covid-19 variants," Fox reports. "Fauci pointed to a South African study by Johnson & Johnson that found those who had been infected with the 'wild-type' Covid-19, meaning the original strain, had 'no protection' when exposed to variants." Paul, an ophthalmologist, said, "There is no evidence that there are significant reinfections after vaccine."

UPDATE, March 19, 2 p.m.: Aaron Blake's analysis of Paul's "amateur epidemiology" is the most-viewed story on The Washington Post site.

In other pandemic news Thursday:

• The 31 fatalities listed through the normal process today were nine Boone County women, aged 80, 81, 83, 90, 90, 91, 94, 94 and 103; three Boone County men, 80, 86 and 90; two Campbell County women, 84 and 90; a Harlan County woman, 73; a Henry County woman, 94; a Henry County woman, 77; a Hopkins County woman, 69; a Jefferson County woman, 97; a Kenton County woman, 98; a Kenton County man, 72; a LaRue County woman, 86; a Laurel County woman, 69; a McCracken County woman, 67; a McCreary County man, 80; a Marshall County woman, 93; an Ohio County man, 67; a Pike County man, 57; a Pulaski County man, 79; a Shelby County man, 79; and a Trimble County man, 75.
• Kentucky's rate of new cases ranks 17th, according to The New York Times, which shows that Lyon County, site of virus outbreaks at state prisons, still has by far the nation's highest rate. The state reports that rate to be 277 cases per 100,000 population. Other counties with rates more than double the statewide rate of 12.05 are Simpson, 63.1; Knox, 41.7; Clay, 34.5; Hopkins, 28.1; Carroll, 26.9; Laurel, 26.3; Butler, 25.5; and Estill, 24.3.
• Counties with 10 or more new cases were Jefferson, 150; Fayette, 48; Simpson, 37; Warren, 28; Boone, 27; Hardin, 25; Madison, 21; Kenton, 16; McCracken, 16; Clark, Daviess, Hopkins, Knox and Laurel, 14; Christian and Whitley, 13; Campbell and Oldham, 12; and Montgomery and Pulaski, 10.
• Kentucky hospitals reported 449 Covid-19 patients, eight more than Wednesday; 110 of those were in intensive care, up 1; and 57 of those were on ventilators, down 3.
• The new login screen and new home screen for the state's unemployment system goes live on Friday, as part of continuing improvement to the user experience. It will require every user to create a new login for their account, with stronger passwords. A tutorial for the new system will is available tonight.
• A new law allows the state to waive some of the overpayments made through federal relief programs. Persons who have been asked to pay back an overpayment must first file an appeal; if that appeal is denied, or the person never got a chance to appeal, they can then apply for a waiver, said Amy Cubbage, Beshear's general counsel.
• Dr. Anthony Fauci said on “Morning Joe” on MSNBC, “We’ve really got to be careful that we don’t claim victory and pull back on all the public-health measures that we know work in keeping the lid on these surging of infections. So although there is good news in the sense of the vaccine continues to get rolled out … if all of a sudden we declare victory, we can risk a surge.”
• Fauci also stressed the need to “get the overwhelming proportion of the population vaccinated.” Without that, he said, “You’re still going to have the virus have the capability of circulating in society because there are so many vulnerable people. So the approach we are taking is to try and reach out and explain to people and ask what are the issues that make them hesitant about getting vaccinated and try to address them with good, solid, scientific facts.”