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Friday, April 30, 2021

As case numbers and positive-test rate rise, and Derby looms, Beshear cautions, 'Mask up when you're inside or in large groups'

State Dept. for Public Health map, relabeled by Ky. Health News; to enlarge, click on it.
By Al Cross
Kentucky Health News

Heading into Kentucky Derby weekend, a time for gatherings, the state is seeing more new cases of the coronavirus and a higher positive-test rate.

“I hope all Kentuckians enjoy Oaks today and the Derby tomorrow,” Gov. Andy Beshear said in a press release. “I know we’re so excited to get back to a more normal celebration of such a special tradition. It’s important to keep yourselves and others safe. Mask up when you’re inside or in large groups, and most important, get vaccinated if you haven’t yet.”

The state reported 723 new cases of the virus, raising its seven-day rolling average to 573, the highest in nine days. The percentage of Kentuckians testing positive for the virus in the last seven days is 3.22%, the highest in eight days.

The statewide rate of daily new cases over the last seven days is 11.1 per 100,000 residents, the highest in nine days. The New York Times says the state's rate ranks 29th among the states, the highest since March 24.

Counties with rates more than double the statewide rate were Powell. 47.4 per 100,000; Lewis, 36.6; Bath, 33.1; Todd, 29.1; Robertson, 27.1; Montgomery, 25.4; Simpson, 23.8; and Monroe, 22.8.

As case numbers rose, vaccinations remained slow. The state's daily vaccination report said 28,071 first doses were given Tuesday through Thursday, an average of 9,357 per day. Thursday's total was 9,392. This reflects a national trend; the rate of vaccinations in the U.S. has dropped 25% in the last week. Ten states are not ordering additional doses for next week.

Beshear's release said 1,760,933 Kentuckians had received at least their first dose of a coronavirus vaccine. That leaves the state 739,067 first shots short of 2.5 million, the level at which Beshear has said he will relax all capacity restrictions on businesses and venues. He lifted the outdoor mask mandate Monday, the day before the Centers for Disease Control and Prevention issued similar guidance.

Kentuckians can visit vaccinemap.ky.gov to find a vaccination site.

The bright spot, relatively speaking, in Friday's report was the low number of deaths: four, all from regular health-department reports. That brought the state's Covid-19 death toll to 6,501 and the 14-day average of deaths dropped to seven per day, the lowest in more than six months.

In other pandemic news Friday:
  • Counties with more than 10 new cases were Jefferson, 140; Bullitt, 47; Fayette, 46; Boone, 40; Daviess, 26; Warren, 26; Kenton, 18; Hardin, 17; McCracken, 17; Mason, 14; Pulaski, 13; and Christian and Clark, 11.
  • Kentucky hospitals reported 439 Covid-19 patients, 17 more than Thursday; 101 of them (up 4) were in intensive care; and 44 (down 1) were on a ventilator.
  • Hospitals in the Lake Cumberland hospital-readiness region reported 93% of their intensive0care beds occupied; the next highest region was Barren River, at 75%.
  • The newly listed fatalities were a Knox County man, 84, who died March 30; a Laurel County woman, 78, who died Jan. 19; a Pike County man, 65, who died April 16; and a Spencer County woman, 51, who died April 22.

Thursday, April 29, 2021

FDA announces plan to ban menthol-flavored cigarettes and all flavored cigars within the next year; likely to be a long process

Menthol cigarettes (New England Public Media photo)

By Melissa Patrick
Kentucky Health News

The Food and Drug Administration announced a plan Thursday to ban menthol-flavored cigarettes and all flavored cigars within the next year. The proposed ban is likely the beginning of a long process that could take years to implement, CNBC reports.

The agency says the goal is to "reduce tobacco addiction" and curb deaths. "Banning menthol — the last allowable flavor — in cigarettes and banning all flavors in cigars will help save lives, particularly among those disproportionately affected by these deadly products," acting FDA Commissioner Janet Woodcock said in a news release. "With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and address health disparities experienced by communities of color, low-income populations, and LGBTQ+ individuals, all of whom are far more likely to use these tobacco products.”

The ban is not expected to take effect within a year, because it will take years to produce sufficient evidence to support it, and it is likely to face legal challenges from the cigarette industry. The Centers for Disease Control and Prevention reports that as of 2018, sales of menthol cigarettes made up 36% of all cigarette sales in the U.S.

Richmond, Virginia-based Altria Group, which controls about 17% of the menthol market, told CNBC, “We share the common goal of moving adult smokers from cigarettes to potentially less harmful alternatives, but prohibition does not work. Criminalizing menthol will lead to serious unintended consequences," such as illegal sales. 

Imperial Tobacco's ITG Brands, which has about 8% of the market, told CNBC that the FDA’s decision was “disappointing” but expected: “We believe the rulemaking process will reveal that there is no clear scientific evidence to support a federal menthol and flavor ban. We are hopeful that FDA will follow the law and prioritize sound policy and science over political pressure.”

The proposal does not set an effective date. Its next step will be publication of the proposed rules and an opportunity for public comment.

Anti-smoking groups have long called for this ban, supported by research that shows Big Tobacco has deliberately targeted Black communities, especially youth, with marketing menthol cigarettes, cigars and other tobacco products.

Menthol products also have a strong appeal for youth, since menthol numbs the throat and reduces irritation from smoking and makes it easier for them to start smoking.

If implemented, one study suggests that within the first 13 to 17 months of a ban, an additional 923,000 American smokers would quit, including 230,000 African Americans. Another study projected a ban would prevent about 633,000 American deaths, including nearly a quarter million African Americans.

“This ban is a crucial step in preventing youth initiation and addiction to nicotine and will help mitigate some of the health outcome disparities for African Americans,” Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a press release. “The foundation applauds the FDA for taking this step to improve Americans’ health, save lives and reduce health care costs.”

The proposal also gained the support of Dr. Richard E. Besser, president and chief of the Robert Wood Johnson Foundation, in a op-ed in The Hill: "Together, these actions would provide a monumental victory for public health, a generational advancement in our nation’s efforts to achieve health equity, and a significant step forward to protect ourselves against future pandemics."

About 20 million Americans smoke menthol cigarettes, including nearly 85% of Black smokers and 30% of white smokers, says the release. Tobacco use is the number one cause of preventable death among African Americans. Some 45,000 African Americans die annually from tobacco-related diseases.

If implemented, the regulations would only apply to manufacturers, distributors, wholesalers, importers and retailers to ensure the products do not make their way onto the market. It would not be enforced against individual consumer possession of the products, says the release.

The FDA made the decision to ban menthol products after facing an April 29 court-ordered deadline to respond to a citizen petition sent to the agency in 2013 to ban menthol as a flavor in cigarettes, Reuters reports.

As coronavirus vaccines keep falling short of goals in Kentucky, businesses step up with incentives to nudge Kentuckians along

By Melissa Patrick
Kentucky Health News

Coronavirus vaccination rates in Kentucky remain slow, with only 9,504 shots given yesterday, and only 12% of the state's available shots given in the vaccine-reporting week that began Tuesday.  

Gov. Andy Beshear's daily press release reported 1,751,541 Kentuckians had received at least one dose of a vaccine, which leaves the state 748,459 short of the governor's 2.5 million goal -- the benchmark set by the governor to lift capacity and curfew restrictions on most businesses. 

“Every day, thousands more Kentuckians get their shot of hope, but we need to accelerate our progress,” Beshear said in the release. “The sooner more Kentuckians get vaccinated, the faster we can lift more restrictions.” He has indicated that he would do more incremental relaxations of restrictions.

Retail businesses and employers eager for Beshear to lift these restrictions are offering incentives to people who decide to get vaccinated, Jack Brammer reports for the Lexington Herald-Leader. 

"Freebies for those vaccinated include dessert-on-a-stick from White Castle, glazed doughnuts from Krispy Kreme and lamination of vaccination cards from Staples and Office Depot," Brammer writes.

The Cincinnati Reds are offering discounted tickets, and some businesses, including Kroger and Tractor Supply, are offering employees paid leave and bonuses to get a shot; and Appalachian Regional Healthcare has set up a bonus competition among its facilities based on vaccine rates, Brammer reports. 

Amazon announced it is launching 20 sites to provide vaccinations for more than 18,000 front-line employees in Kentucky, and has been offering an incentive to employees vaccinated off-site, Brammer reports. Meanwhile, some independent pharmacies are taking the vaccine out into their communities.

“The governor has successfully called on community and business leaders to offer vaccine incentives,” Beshear spokesman Sebastian Kitchen told Brammer. “They have responded with time-off and direct and competitive bonuses for employees who get vaccinated. More incentive announcements will be coming soon from the Commonwealth as well as from several major companies and organizations."

To find a vaccination site near you, go to vaccinemap.ky.gov. Thousands of appointments are available across the state, and many sites take walk-ins.

Daily numbers: Beshear's release was abbreviated again; its statistics omitted hospital numbers and were limited to the number of vaccinations and new cases and the percentage of Kentuckians testing positive for the virus in the last seven days. That was 3.12%, .01 percentage points higher than yesterday.

The state reported 796 new cases of the coronavirus, bringing the seven-day rolling average up to 556, and increase of 24 from yesterday and the highest in eight days. 

Likewise, the rate of daily new cases over the last seven days is 10.87 cases per 100,000 residents. That was the highest in a week, but The New York Times still ranks Kentucky's rate 38th among the states. 

Counties with rates more than twice the statewide rate are Powell, 50.9 cases per 100,000;  Lewis, 49.5;  Bath, 36.6;  Robertson, 33.9;  Montgomery, 30.4;  Monroe, 28.2;  Morgan, 24.7;  Todd, 24.4; and Hickman, 22.8.

Hospital numbers, which appear on the daily report from the Department for Public Health, dropped after a slight surge on Wednesday. Kentucky hospitals reported 422 Covid-19 patients (down 12 from Wednesday) ; 97 of them in intensive care (down 22); and 45 of those on a ventilator (down 14). 

The Lake Cumberland hospital readiness region is the only region using at least 80% of its intensive care unit beds, at 84% .

The state reported 12 more Covid-19 deaths, 10 from the regular health-department reports and two from an ongoing audit of the state's death certificates. That brings the death toll to 6,497. 

The regularly reported deaths, all but three of which were in April, were an Allen County man, 82; an Anderson County woman, 59; a Barren County man, 64; a Boone County man, 82; a Clark County man, 69; a Clay County man, 73; a Monroe County woman, 69; a Muhlenberg County woman, 92; a Muhlenberg County man, 69; and a Warren County man, 80. 

The two audit deaths, in October and November, were a Boone County man, 87, and a Whitley County man, 95. 

In other pandemic news Thursday:
  • Counties with at least 10 new cases were Jefferson, 235; Fayette, 42; Warren, 28; Daviess, 23; Hardin, 20; Kenton, 16; Madison and Powell, 15; Graves and McCracken, 14; Boone, Bullitt and Lewis, 12; Hopkins, 11; and Clark, Floyd, Laurel and Pulaski, 10.
  • Vaccines appear to be curbing new coronavirus infections in the U.S., according to data from Johns Hopkins University that shows the seven-day average for new cases in the U.S. has fallen below the 14-day average for more than a week, which health experts says is a strong indication that cases are on the decline, The Wall Street Journal reports. As of April 27, 37.3% of U.S. adults were fully vaccinated against Covid-19, with about 2.7 million shots given each day.  “When you get to somewhere between 40 and 50%, I believe you’re going to start seeing real change, the start of a precipitous drop in cases,” Dr. Anthony Fauci, the top U.S. infectious-disease expert, told the Journal in an interview.
  • Moderna said its vaccine can be refrigerated at standard temperatures for three months, not just one, and can be frozen for up to seven months. "The extended shelf life for refrigerated Moderna doses could help simplify distribution, especially in smaller settings and hard-to-reach populations," The Hill reports.

Wednesday, April 28, 2021

Coronavirus vaccinations and cases continue to slow in Kentucky

Dept. for Public Health map, relabeled by Kentucky Health News; for a larger version, click on it.
By Al Cross
Kentucky Health News

Vaccinations for the coronavirus in Kentucky continue to slow, with the state reporting only 9,246 additional Kentuckians getting their first dose of vaccine since yesterday's report.

That number is in the state's daily vaccination report but not in Gov. Andy Beshear's daily press release, which merely reported the latest total: 1,742,037. That leaves the state 757,963 first doses short of 2.5 million – the level at which Beshear said, two weeks ago, that he would lift most capacity restrictions.

As vaccinations have slowed, Beshear has said his moves would be more incremental, and his goal isn't mentioned in today's press release. Instead, it quotes him as mentioning his visits to a variety of vaccination sites, "from a mobile clinic run out of an emergency management van that can meet people where they are, to a pop-up clinic at a professional soccer game. No matter where you are, there’s a convenient, and sometimes even fun, place where you can get your shot of hope, protect yourself and save lives."

The pandemic remained on a slightly downward plateau Wednesday. The percentage of Kentuckians testing positive for the virus in the last seven days was 3.11%. That was the lowest since April 11, which was the end of a three-week stretch when the mean of the daily averages was 2.91%.

The state reported 747 new cases of the virus, lowering the seven-day rolling average to 532, about where it has been for six days. The statewide rate of daily new cases over the last seven days is 10.41 per 100,000 residents. The New York Times says Kentucky's rate is 37th among the states.

Counties with rates more than twice the statewide rate are Lewis, 45.2; Powell, 37; Bath, 35.4; Monroe, 32.2; Montgomery, 30.9; Robertson, 27.1; Morgan, 26.8; and Todd, 26.7.

Hospital numbers went up. Kentucky hospitals reported 434 Covid-19 patients, 37 more than Tuesday; 119 of them in intensive care, up 16; and 59 of those on a ventilator, up 18. Hospital-readiness regions in Southern Kentucky reported more than 80% of their intensive-care beds occupied: 91% in Lake Cumberland and 81% in Barren River.

In other pandemic news Wednesday:

  • Counties with 10 or more new cases were: Jefferson, 118; Fayette, 60; Boone, 35; Bullitt, 32; Warren, 32; Hardin, 26; Kenton, 19; Oldham, 19; Christian, 13; Lewis, 13; Campbell, Daviess, Knox and Muhlenberg, 11; and Whitley, 10.
  • The state reported nine more Covid-19 deaths, all from regular health-department reports and all of them women. The fatalities' counties and ages were Carter, 56; Crittenden, 57; Fayette, 54; Fleming, 69; Jefferson, 59; Kenton, 73; Laurel, 65; Lewis, 73; and Whitley, 72. The state's death toll is 6,485.
  • Alicia Diaz, an intern for Stat, the medicine-and-science publication of The Boston Globe, wonders why more communities aren't using door knocking and personal appeals from neighbors to promote vaccination. "Door knocking has several key advantages over print fliers and social media posts," she writes. "Most directly: It’s far better at building trust where there might not be much."
  • Conflicts over use of emergency powers in the pandemic are not all partisan. The Republican governor of Indiana sued the Republican-controlled Legislature to block a new law giving it more authority to call itself into session when the governor declares an emergency. "Republican legislators pushed the bill after criticism from many conservatives over the mask mandate and other Covid-19 restrictions that Holcomb imposed by executive order with the General Assembly not meeting for about nine months after its 2020 session ended," The Associated Press reports.

New federal guidelines will let almost all providers prescribe buprenorphine for opioid-use disorder, a boon to rural Kentucky

The U.S. Department of Health and Human Services said Tuesday that it will allow most medical providers to prescribe buprenorphine for opioid-use disorder without being trained and getting a waiver. "For years, many addiction physicians and public health advocates have argued that the 'X-waiver,' as the special buprenorphine license is known, poses a barrier to basic care for patients with opioid addiction," Lev Facher reports for Stat. "Many have argued that if a doctor can prescribe potentially addictive prescription pain drugs, they should also be able to prescribe the medicine used to treat the addiction."

Assistant Secretary for Health Rachel Levine said in the press release that increasing overdose deaths, especially during the pandemic, show the need for more access to medication-assisted treatments. Rural patients seeking such therapy can have a hard time accessing it because of transportation issues and the relative lack of qualified prescribers. But buprenorphine can be prescribed for a month at a time and taken at home, meaning rural patients don't have to travel so much, and can easily get it even at mobile clinics. About 40 percent of U.S. counties don't have a health-care who is approved to prescribe buprenorphine, an active ingredient in Suboxone, the preferred drug in medication-assisted treatment for substance-use disorder, according to a federal report.

"The move comes amid a worse-than-ever drug overdose crisis, which has taken a dire turn amid the Covid-19 pandemic," Facher reports. "More than 87,000 Americans died of overdoses during the 12-month period that ended in September 2020, according to estimates from the Centers for Disease Control. Data for the full 2020 calendar year isn’t available yet, but most addiction policy officials expect the death toll will climb even higher."

Tuesday, April 27, 2021

Vaccination demand plummets for second week in a row; state used only 39% of the vaccine doses it received last week

Kentucky Health News chart from state Dept. for Public Health data; dates are beginning of weeks.
By Al Cross
Kentucky Health News

Kentucky used less than 40 percent of the coronavirus vaccine doses it received in the last week, and the number of vaccinations declined for the second week in a row.

Those numbers stood out more than those on the daily pandemic report, which showed slight increases in new cases and the positive-test rate.

Gov. Andy Beshear's daily press release emphasized vaccination, announcing that 1,732,791 Kentuckians had received at least their first dose of a vaccine.

“Every day, we get a step closer to reaching the 2.5 million-vaccine Team Kentucky Vaccination Challenge and ending this pandemic once and for all,” Beshear said.

The governor has said he would lift all capacity restrictions once 2.5 million Kentuckians have gotten at least one dose of vaccine. On Monday, when he largely lifted his mask mandate for vaccinated people who are outdoors, he noted that vaccinations are slowing and "We will probably do things more incrementally."

The state's daily vaccine report showed that in the reporting week that ended Monday, about 59,000 Kentuckians got a first dose. That was 31 percent less than the approximately 85,000 the previous week, and less than half the 125,000-plus in each of the two weeks before that.

The previous week, the state used 54% of the doses it received. Last week, it used only 39%, though supplies were slightly lower because of the pause in shipments of the Johnson & Johnson one-dose vaccine.

Because the other two vaccines require two doses, the J & J vaccine has been the most popular, but now experts and officials fear it will be in less demand because of the very rare blood clots that led to the pause. The vaccine now carries a warning label for women of childbearing age.

The decline in vaccine demand has prompted many vaccination sites to take walk-in patients, not just those with appointments.

“There are now more options than ever for you to sign up for your shot of hope,” Beshear said. “It’s fast, it’s easy and it will help us save lives and get back to more of the activities we’ve missed over the past year.”

The Centers for Disease Control and Prevention issued masking guidance similar to Beshear's. President Biden touted it, saying "If you're vaccinated, you can do more things more safely, outdoors as well as indoors. . . . This is another great reason to go get vaccinated now. Now!"

Daily numbers: The state reported 716 new cases of the virus, raising the seven-day rolling average by 16, to 538. The percentage of Kentuckians testing positive for the virus rose .02 percentage points, to 3.17%.

The state's daily rate of new cases over the last seven days is 10.47 per 100,000 residents, up .32. The national rate is 17, and Kentucky's rate remains 38th among the states, according to The New York Times.

Counties with rates more than double the statewide rate are in the northeast or along the Tennessee border: Lewis, 39.8; Bath, 37.7; Powell, 33.5, Morgan, 33.3; Montgomery, 32.5; Robertson, 27.1; Monroe, 25.5; Mason, 24.3; and Todd, 20.9.

The state added 17 more fatalities to its Covid-19 death toll, bringing it to 6,476. Ten were from regular health-department reports and seven were from the ongoing audit of death certificates.

The regularly reported deaths, all in April or March, were a Casey County woman, 73; a Clay County woman, 68; a Hopkins County woman, 50; a Hopkins County man, 84; a Jefferson County woman, 69; a Jefferson County man, 60; a Jessamine County woman, 75; a Kenton County woman, 77; a Pike County man, 76; and a Wayne County woman, 69.

The audit deaths, which ranged from August through January, were a Grayson County woman, 89; a Jefferson County woman, 86; a Jefferson County man, 75; a McCracken County man, 85; a Rockcastle County woman, 88; and two Whitley County women, 89 and 96.

In other pandemic news Tuesday: 

  • Counties with more than 10 new cases were Jefferson, 94; Fayette, 59; Boone, 30; Warren, 30; McCracken, 24; Daviess, 23; Hardin, 21; Oldham, 21; Madison, 20; Christian, 18; Bullitt, 15; Barren, Harlan and Montgomery, 13; and Pike, 12.
  • Beshear visited the main UPS global air hub in Louisville "to highlight the role Kentuckians are playing in distributing coronavirus vaccines throughout the nation to save lives and end the pandemic," a release from his office said. It quoted Beshear: “In a week when a lot of the world has their eyes on Kentucky and one of our signature industries – Thoroughbred racing – and on our culture, sports and hospitality, this seemed a perfect time to visit a major employer in the commonwealth that is doing so much to help this country win the war against Covid.”
  • The Washington Post reported on its poll with ABC News: "While 10 percent of Democratic respondents said they’re unlikely to get the shot, 40% of Republicans gave that response. But Republicans' age appears to play a big role in how they view vaccines: 20% of Republican seniors said they won’t get the shots; that rises to 40 percent of Republicans ages 40 to 64, and 55% of Republicans ages 18 to 39. Age is a less salient factor among Democrats who are hesitant. Three percent of seniors are hesitant, compared with 14 percent of those under age 40."

Monday, April 26, 2021

Beshear lifts outdoor mask mandate, says 'We will probably do things more incrementally;' Johnson & Johnson vaccine returns

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

With all of the coronavirus metrics on a plateau in Kentucky, Gov. Andy Beshear announced that starting Tuesday, the state will no longer require masks at outdoor events or venues with fewer than 1,000 people. 

“It means if you are at a backyard barbecue, if you are at your community pool, if you are at an outdoor wedding, especially if you are vaccinated, you are not required to wear a mask,” Beshear said at a news conference. Louisville television stations cited Kentucky Derby parties as the main example.

Beshear encouraged anyone who was not vaccinated to continue wearing a mask, and to get vaccinated. The mandate under his emergency powers is still in effect at indoor events, and outdoor ones with more than 1,000 people, like the Derby, to be held at Churchill Downs in Louisville Saturday, May 1. 

Beshear said he was relaxing the rule because a growing number of Kentuckians have been vaccinated and new data supports the change. President Joe Biden is reportedly planning to issue similar guidance from the Centers for Disease Control and Prevention Tuesday; Beshear said he had only seen news reports of that possibility.

Beshear has said he would remove all restrictions on business capacity once 2.5 million Kentuckians have received a dose of vaccine, but vaccination rates have slowed each week lately. Beshear noted that, adding later in response to a question, "we probably will do things more incrementally."

The state said 1,726,346 million Kentuckians have received at least one dose of a coronavirus vaccine, which is about 734,000 short of the governor's goal. Kentuckians can find an appointment near them at vaccinemap.ky.gov

The state's daily vaccine report added only 2,533 vaccinations yesterday, presumably a reflection of shots administered on Sunday. 

Beshear continues to plead with Kentuckians to get what he calls "a shot of hope" -- not only to reach herd immunity, which will provide some protection for people unwilling or unable to get a vaccine and can be reached when 70% to 85% of people are vaccinated, but to also slow the spread of the more contagious variants of the virus. 

Beshear said Kentucky has confirmed 276 virus cases with variants of concern, and 256 are the highly contagious B.1.1.7 variant, which originated in the United Kingdom and is now dominant in the U.S.

In particular, he is asking Kentuckians between the ages of 20 and 49 to get vaccinated, since they have some of the state's lowest vaccination rates.

Beshear said 75% of Kentuckians 70 and older have been vaccinated; 65% between 60-69 have been vaccinated; 48%  between 50-59 have been vaccinated; 39% between 40-49 have been vaccinated; 34%  between 30-39 have been vaccinated; and 25% between 20-29 have been vaccinated. 

Beshear said he talked Friday with the Kentucky Chamber of Commerce to more than 100 businesses, representing "hundreds of thousands" of employees. 

"My message was, we need your help. We need your leadership. We need you to be creative, we need you to incentivize, we need you to do everything you can to get not just your employees vaccinated, but to encourage others out there in the community," he said. 

He added that he has already seen "some incredible response," including a hospital system that has created a bonus competition among facilities based on vaccination levels and a pop-up vaccine clinic being hosted by Racing Louisville FC, a National Women's Soccer League expansion team. 

He added that he also had a call with mayors and county judge-executives last week. 

"I think we've got a lot of people out there who want to be creative, who have bought in and certainly our business community knows about the disruption that a Covid outbreak could cause in their workplace. and that if we truly want to get back to a normal, not just in our personal lives, but in a steady workforce, that vaccinations are the key," he said. 

A vaccine returns: Health Commissioner Steven Stack announced that the state has resumed using the single-dose Johnson & Johnson vaccine immediately, for anyone 18 and older. 

Stack said some vaccination sites may choose to wait for more federal guidance, which will be released on Tuesday, to help them around their "informed consent" guidelines. He said new shipments of the vaccine will resume next week. 

Stack noted that the federal investigation of the J&J vaccine found 15 cases of women who received it and developed a rare blood clotting condition that also involved low platelet counts, called "thrombosis with thrombocytopenia syndrome," or TTS. He said all were between 18 and 59, and all but two were under 50. 

"There was no association found with birth-control pills or any other sort of medications," Stack said. "There was not a clear pattern, other than the gender association and relative youth of the individuals."

He said they found that among around 8 million people immunized with the J&J vaccine, it has been 85% effective in preventing severe Covid-19 and 93% effective in preventing hospitalizations. "That is incredibly effective," he said. 

Further, he said a J&J analysis found that for every 1 million persons vaccinated with the J&J vaccine, there would be two cases of the TTS syndrome, but those vaccinations would prevent 2,000 deaths from Covid-19 and prevent 6,000 hospitalizations. 

The CDC Advisory Committee on Immunization Practices analysis showed that for every 9.8 million people vaccinated, there would be 26 cases of TTS in women who are 18 and older, but it would prevent 1,434 deaths and prevent 2,236 admissions to the hospital ICU. 

"Nothing in life is without risk," Stack said. "But there is no doubt that the relative balancing of the risks and the benefits show this vaccine to be incredibly effective and incredibly safe." 
 
And for women under 50 who are concerned about the J&J vaccine, Stack said, "There are two other exceptional vaccines out there. Get Moderna. Get Pfizer. For all other persons, at the moment, there is no significant indication that you're undertaking any meaningful risk by getting vaccinated, but there is an enormous mountain of evidence that you are keeping yourself much safer." 

Beshear said the use of the J&J vaccine will resume in prisons, although the state will make the Moderna and Pfizer-BioNTech vaccine available to inmates with concerns. He said the two remaining prisons that have not been vaccinated are men's facilities.  At this time, only 70% of the inmates have been vaccinated. Beshear has said in-person visitation can resume when they reach the 80% mark.

Daily numbers: Beshear announced 213 new cases Monday, lowering the state's seven day average by three, to 522. 

The percentage of Kentuckians testing positive for the virus in the past seven days dropped again, to 3.15%. This rate has hovered in the 3% range since April 11. Health officials like to see this number below 5% as an indicator of lower community spread of the virus.

The weekly averages for both of these measure were lower than the prior week, Beshear said the state continues on a plateau. 

"Remember, every single person who gets vaccinated helps make sure this happens or gets us on the decline," he said. "While I'd like to see more people vaccinated, every week, every person that gets vaccinated makes a big difference." 

The statewide average of new cases over the past seven days was 10.15 per 100,000 residents, down .09 from yesterday. The New York Times ranks Kentucky 38th among the states.

Counties with double the statewide rate were Lewis, 38.7 per 100,000;  Bath, 36.6; Powell, 34.7; Montgomery, 27.4; Robertson, 27.1; Mason, 26.8; and Morgan, 24.7.

Kentucky hospitals have 414 Covid-19 patients (down 33 from Sunday); 108 in intensive care (down 20); and 47 of those on a ventilator (up 2). Beshear said these numbers have largely plateaued as well. 

The Lake Cumberland hospital readiness region is the only region using at least 80% of the beds in its intensive care units, at exactly 80%. Only 13.3% of the ICU beds have Covid-19 patients. 

Eleven more Kentuckians were added to the list of Covid-19 fatalities, four of them from regular health-department reports and seven from an ongoing audit of death certificates. The death toll is 6,459. 

The regularly reported fatalities were in April, March and January. They were a Hart County woman, 67; a Henry County man, 92; and two Jefferson County women, 55 and 73.

The audit fatalities were all from November and December. They were a Garrard County man, 82; a Greenup County woman, 71; a Henderson County woman, 80; two Jefferson County men, 71 and 84; a Nelson County woman, 95; and a Spencer County man, 96. 

In other pandemic news Monday:

  • Counties with five or more new cases were Jefferson, 56; Daviess, 15; Fayette, 14; Bullitt, 9; Graves and Montgomery, 6; and Christian, Hardin, Jessamine, Kenton, Knox and Laurel, 5. Sixty-six of the state's 120 counties reported no new cases. 
  • In long-term care, there were five new resident cases and nine new staff cases, bringing the total number of active cases to 57 residents and 90 staff. Beshear reported three Covid-19 deaths in the facilities, one of them considered new and two from the ongoing audit of death certificates. The death toll from Covid-19 in long-term care is 2,286. 
  • Fayette County Public Schools will offer the Pfizer-BioNTech coronavirus vaccine for students, families and staff at its six main high schools Tuesday. All Fayette County students 16 and older are eligible, reports the Lexington Herald-Leader . Students who are fully vaccinated two weeks past the second shot may not need to quarantine, Valarie Honeycutt Spears reports. 
  • The Lexington-Fayette County Health Department announced that it would start vaccine that would accept walk-in patients without appointments, to reach more people who are casual about getting a shot. The department noted that half of the county's people adults are fully vaccinated.
  • The J&J vaccine was paused for 10 days after TTS occurred in six women, among more than 7 million people who had received the vaccine. Later, there were nine more confirmed cases, and a handful of other possible cases are under review, according to Dr. Tom Shimabukuro, a member of the CDC's Covid-19 Vaccine Task Force, NBC reported April 23. Among the confirmed cases, three patients died and seven others remain hospitalized. All cases were in women, and all but two were in women ages 18-49. Seven were among women in their 30s, among whom the rate was 11.8 cases per million doses of the J&J vaccine administered.

Sunday, April 25, 2021

More than ever, numbers show a pandemic plateau, tilting down

Ky. Health News graph shows state-reported data for the last seven months.
By Al Cross
Kentucky Health News

Is this the definition of a pandemic plateau, one with a slight downward tilt?

The state reported 325 new cases of the coronavirus Sunday. That was 50 more than last Sunday, but also exactly the average of the past four Sundays.

The seven-day rolling average of new cases rose by 7, to 525, exactly where it was 15 days ago; since then, it has been no higher than 623. Saturday's average was the lowest since July.

Much the same is seen in the other key leading indicator, the percentage of Kentuckians testing positive for the virus in the last seven days. It is 3.18%, and has gone down seven11 days in a row. It is now virtually the same as it was 12 to 13 days ago. Thirty days ago, it hit a recent low of 2.8%; nine days ago, it hit an April high of 3.51%. (See graph.)

After declining for a week, the statewide average of new cases over the past seven days rose a bit, to 10.24 per 100,000 people. On that metric, the state continues to compare well; The New York Times says Kentucky's rate is 37th among the states.

Only seven counties have rates more than double the statewide rate: Bath, 43.4; Lewis, 38.7; Powell, 35.8; Morgan, 30.1; Mason, 27.6; Robertson, 27.1; Montgomery, 25.9.

Counties with more than five new cases Sunday were Jefferson, 71; Fayette, 28; Kenton, 23; Boone, 22; Trigg, 15; Scott, 12; Campbell, 10; Floyd, 9; Daviess, 8; and Warren, 6.

In a rarity, none of the state's hospital-readiness regions reported 80% or more of their intensive-care-unit beds in use. The closest was Lake Cumberland, at 78%; 13% of its ICU beds were occupied by Covid-19 patients.

Kentucky hospitals reported 381 Covid-19 patients, 23 fewer than Saturday; 88 were in ICU, down 14; and 45 of those were on a ventilator, the same as Saturday.

The state added 13 more Covid-19 deaths to its list of pandemic fatalities, four from regular health-department reports and nine from the ongoing audit of death certificates. The death toll is 6,449. In the last two weeks, Kentucky has averaged eight regularly reported Covid-19 deaths per day.

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

Vaccinations for the virus slowed over the weekend, according to the state's daily vaccination report. It showed a total of 49,926 first-dose vaccinations in the vaccination-reporting week that began Tuesday, April 20. In the previous week, the state averaged 12,138 vaccinations per day; so far this week it is only 8,321 per day.

The state is expected to resume administering the popular, one-dose Johnson & Johnson vaccine this week, after federal officials lifted their recommendation that it be paused because a few women who received it developed a rare type of blood clot. Women under 50 will be advised of the risk, which is small: less than that of being hit by lightning, National Institutes of Health Director Dr. Francis Collins said on NBC's "Meet the Press."

Asked how vaccine advocates can persuade the reluctant, Collins said, "Try to emphasize the positives that people go through when they experience vaccination." He said he and his wife recently had their first dinner with friends since the pandemic began, and "That was so liberating."

Ky. is a regional leader in vaccinations, but some rural counties lag far behind, and public-health officials blame misinformation

Photos by Liam Niemeyer, Ohio Valley Resource
Kentucky is a regional leader in immunization for the coronavirus, but vaccinations are slowing and many of Kentucky's counties lag behind the national rate, not just the state rate.

Reporters from Ohio Valley Resource, a consortium of public radio stations in Kentucky and West Virginia, fanned out across the three states to dig into why some people got vaccinated, or not. 

Public-health officials told OVR that the challenge is misinformation. "It’s those falsehoods and rumors about the Covid-19 vaccines, spread readily on various online forums, that officials say are becoming a significant barrier to reaching herd immunity," OVR reports. 

Some people say it's just too early. In Grand Rivers, between Kentucky Lake and Lake Barkley, OVR talked with tourist Jill Baty of Georgetown, who told them, "It’s an experimental shot, and I am not planning on taking it until we have more information." 

Phyllis Gibbs of Ballard County said she got a shot
because of how sick her son got from Covid-19.

Phyllis Gibbs of Ballard County, one of the places with a low vaccination rate, told OVR that she struggled with her decision, and finally decided to get a shot in part because of her son's experience with the virus. 

“He was so sick,” she said. “He called me. He was at the emergency room. Of course, I couldn’t have gone and seen him. He was afraid he was going to lay there and die.” She added, wiping tears form her eyes, “So if it prevents me from being that way, yeah, I’d recommend anybody getting it.” 

Gibbs also had an opinion about which vaccine she wanted. She told the reporters that she only wanted the Pfizer vaccine, because the Johnson & Johnson vaccine was under suspension and she had heard bad stories about side effects from the second Moderna shot. 

Also, "She said some of her family is totally against the vaccines — “they’re kind of hard-headed,” she laughs — and some in her part of conservative Ballard County trust “homeopathic” treatments rather than traditional medicine," OVR reports.

Gibbs got her vaccine at the convention center at Kentucky Dam Village State Resort Park, a regional vaccination site. She is one of 1.7 million Kentuckians who have gotten their first dose of a vaccine.

As of April 16, "Kentucky is leading the vaccination efforts in the Ohio Valley, as 38 percent of its residents have received at least one dose of the vaccine," 1.1 percentage points ahead of Ohio and 3.7 points ahead of West Virginia, OVR reports. A week later, Kentucky led in full vaccination among Southern states and was second only to Virginia in percentage of residents with a first dose.

The Centers for Disease Control and Prevention reports that 15 of Kentucky's 120 counties had fewer than 20% of their residents fully vaccinated through Saturday. Spencer is lowest, at 12.5%; then come Christian at 14.4% and Ballard and Lewis at 16.2%. Up from there, to 19.9%, are Casey, Todd, Jackson, Hart, Carlisle, Hickman, Rockcastle, Knox, Clay, Union and Elliott. Woodford and Franklin counties lead with around 43%.

Polling has shown that Republicans and white, evangelical Christians are the most likely to say they will not take the vaccine, OVR reports.

Baty told OVR that that finding did not surprise her. “All my Republican conservative friends are not going to be taking the vaccine, especially if they have any intelligence and do any reading for their own, go to the actual studies,” Baty said. “I can figure this out for myself. So give me the information, give me the data, and I will figure it out.”

OVR notes, "Numerous studies show that the COVID-19 vaccines approved for emergency use are safe and effective." Scott County, where Baty lives, ranks sixth in full vaccinations in Kentucky, at 33.6%.

Army veteran Robert Martin of southeastern Missouri, who was also visiting Grand Rivers, told the reporters at OVR that the vaccines have been given "bad publicity" and that people have fallen for false rumors on social media. 

“There’s too many false rumors going around about it. People who, they say they’re experts, but they’re really not,” Martin said behind a camouflage-themed mask. “People have gotten paranoid over it.”

OVR notes that public health officials have to regularly work to build trust about the vaccines, while battling falsehoods and misinformation. And the J&J pause has added another layer to the already existent vaccine hesitancy.

Mendy Blair, chief nursing officer at Baptist Health Richmond, said she respects people’s choices, but if someone is still unsure about the Covid-19 vaccines’ safety, she said it’s an opportunity for education.

“Once you have educated an individual and let them make that informed decision," she said, "probably a good percentage of them do end up changing their mind once they understand what the vaccine is, what it does and how it can help."

Study in West Virginia finds rural users of electronic cigarettes are older, and often sicker, than their urban counterparts

E-cigarettes are called "vapes," for vapor, but make aerosols. (Centers for Disease Control and Prevention graphic)
A new study out of West Virginia University says rural users of electronic cigarettes are older, and often get sicker, than their urban counterparts.

The study, published in Hospital Practice, looked at patients with lung injuries associated with e-cigarettes and vaping-associated lung injury, or EVALI, who were admitted to WVU hospitals from August 2019 to March 2020. It found that EVALI in rural Appalachia resulted in severe respiratory failure. 

"One of the real lessons we learned is we can't take data from urban centers and apply them to rural. We could be different, and we physicians need to treat the way that the science is showing in our areas." Sunil Sharma, lead author of the study, said in a WVU press release.

The researchers "recorded demographics, baseline characteristics, health conditions and vaping behavior for 17 patients admitted to WVU hospitals with EVALI. They also evaluated lung specimens for signs of inflammation and analyzed patient-volunteered e-liquid materials using mass spectrometry to determine chemical composition," says the release. 

The study found that compared to EVALI studies done in urban centers, the rural patients in the study were older, had a higher amount of illicit drug use and were much sicker.

"The median age of patients in this study was 33, compared to 23 in a large national study. Thirteen patients had a history of cigarette smoking, while four were never smokers. Urine testing determined that nine patients were also consuming THC and another nine were positive for other illicit drugs. Seven of the patients consuming THC required critical care, and four of the 17 had secondary infection of the lungs. Ten patients required mechanical or noninvasive ventilation while two required treatment with an extracorporeal membrane oxygenation machine, which pumps someone's blood outside of their body, oxygenates it and returns it to the body," says the release. 

The researchers also found higher levels of "volatile organic compounds" in the e-liquids provided by the three most severely ill patients, which includes things like formaldehyde, acetaldehyde, acetone, propylene glycol and cyclohexane. 

"We were the first ones to show that there was high correlation of volatile organic compounds, specifically in patients who were really sick," said Sharma, who is section chief of pulmonary/critical care and sleep medicine in the WVU School of Medicine. "Inhaling all these volatile organic compounds into your lungs at high temperatures, producing these really toxic gaseous compounds, can cause chemical burns in your lungs."

Despite the strong correlation between lung injury and volatile organic compounds, Sharma said there are many other factors that also determine how much e-cigs harm the lungs, like "the type of device or technique used to vape, the ratio of propylene glycol and vegetable glycol used as the e-liquid base, what flavors were added, the age of the patient and if the patient uses other drugs."

The study indicates it may be time to target messages about the dangers of vaping to older people in rural areas, the release says, quoting Sharma: "All the effort has been directed toward high schoolers and young people, but maybe in rural areas, we should be having awareness campaigns for older populations."

Saturday, April 24, 2021

State reports 33 more Covid-19 deaths, 22 from regular reports; Beshear urges Kentuckians to get vaccinated in their honor

Gov. Andy Beshear looking at the flags on the state Capitol grounds  
that represent Kentuckians lost to Covid-19. (Facebook photo)
By Melissa Patrick
Kentucky Health News

As the key metrics used to measure the coronavirus in Kentucky continue to plateau, Gov. Andy Beshear reminded Kentuckians that people are still dying from the virus, and asked them to get vaccinated in their honor.   

"Every day, I look out across the flags that represent Kentuckians lost to this virus and say a prayer for all those mourning each and every loss," Gov. Andy Beshear said in a Facebook post. "Let's get vaccinated in their honor. Let us fight to protect the lives of our people." 

The state added 33 deaths to its list of Covid-19 deaths on Saturday, 22 from regular health department reporting and 11 from the ongoing audit of death certificates. As usual for a weekend, the state did not provide an itemized list of the victims by age, sex, county and date of death. The death toll is 6,436. 

The state's vaccine report shows that about 1.7 million people have been vaccinated with at least one dose of a vaccine, which means about 784,000 more Kentuckians need to get a vaccination to meet Gov. Andy Beshear's 2.5 million goal. 

Beshear has said he will open businesses and activities with fewer than 1,000 people to full capacity when 2.5 million Kentuckians have received their first dose of a coronavirus vaccine. 

As coronavirus vaccinations have slowed down, Beshear has called on local leaders and businesses to encourage their communities to get vaccinated and several of them have stepped up to the plate. 

In Lexington, the University of Kentucky, local faith leaders and SHARE Lexington hosted a Covid-19 Vaccine Community Town Hall today to answer questions about safety, efficacy and long-term effects of coronavirus vaccines, an offered attendees the opportunity to register to get one. 

And in Louisville, through a partnership with U of L Health, Central High School students led an outreach effort to inform their community, classmates and their classmates' families with factual information about the coronavirus vaccine that culminated in a one-day vaccine clinic in West Louisville. Lt. Gov. Jacqueline Coleman visited the high school to celebrate the clinic. 

“This vaccine clinic is just one example of the successes that can occur when we value the voices and talents of young people,” said Coleman in the news release. “Our students have been impacted by this pandemic as much as anyone. They know how serious this is, and they’re eager to help protect their community from this virus.”

The share of Kentuckians testing positive for the virus in the past seven days dropped for the sixth day in a row, to 3.21%. That's about where it was 11 days ago, four days after hitting a recent low of 2.79%.

The state reported 489 new cases of the virus Saturday, bringing the seven-day average down by 16, to 517.  Its seven-day average of daily new cases dropped for the seventh day in a row,  to 10.15 cases per 100,000 residents. The New York Times ranks Kentucky's rate 36th among the states. 

Counties with rates more than double the statewide rate were Lewis, 43; Bath, 41.1; Powell, 35.8;  Mason, 32.6; Morgan, 32.2; Robertson, 27.1; Montgomery, 25.4; Simpson, 20.8; and Bracken , 20.6.

Counties with 10 or more new cases were Jefferson, 72; Fayette, 43; Warren, 21; Montgomery, 16; Daviess, Kenton and Trigg, 12; Hardin and Scott, 11; and Henderson, 10. 

Kentucky hospitals reported 404 Covid-19 patients, 102 of them in intensive care, and 45 of those on a ventilator.

The Lake Cumberland hospital readiness region is the only using 80% or more of its intensive care unit beds, at 84.44%, with only 17.8% of those patients having Covid-19. Click here for the state's daily report.

Ex-Gov. Beshear 1 of 7 on Opioid Crisis Task Force formed by Bipartisan Policy Center, a Washington, D.C., think tank

Steve Beshear
Photo from Bipartisan Policy Center
By Melissa Patrick
Kentucky Health News

Former Gov. Steve Beshear is one of seven members of the Bipartisan Policy Center's new Opioid Crisis Task Force, tasked by the Washington, D.C. think tank with finding evidence-based recommendations to drive down drug-overdose deaths, which have skyrocketed during the pandemic.

"The Bipartisan Policy Center felt it was time, and I agreed with them, to try to develop some bipartisan policy solutions at the federal level to recommend to Congress on how to reduce overdose death rates in the near term, and to increase the efficacy of the longer-term federal response to the opioid crisis," Beshear told Kentucky Health News.

The Democrat said he has long had a working relationship with the center, serving for several years on its Governors' Council. He said the bipartisan members of the task force offer "significant expertise" around the issue. 

The other members are Dr. Jerome Adams, a former surgeon general; Mary Bono, a former U.S. representative from California;  Richard G. Frank, endowed professor of health economics at Harvard University; Dr. Patrice Harris, CEO of eMed and former president of the  American Medical Association; Susanna Martinez, former governor of New Mexico; and Donna E. Shalala, a former secretary of health and human services and U.S. representative from Florida.

"The task force will examine drug-overdose trends in the past two years and the main drivers behind the surge, track fiscal year 2020 federal opioid funding and investments from the four Covid-19 emergency relief packages, and analyze the types of treatment services that are being supported across the country and the gaps that exist," the center said in a news release. Its report, due in early 2022, will "examine treatment disparities in states that expanded Medicaid compared to non-expansion states."

Beshear, who expanded Medicaid under the Patient Protection and Affordable Care Act when he was governor, noted that the expansion allowed Medicaid to cover treatment for substance-use disorder "for the first time. That's not to say we had enough of it, or that it was all effective, but certainly to have it available through the expanded Medicaid program proved very beneficial to us."   

Opioid dependence was one of the top five diagnoses made for Kentucky adults and seniors on Medicaid in the federal fiscal year that ended Sept. 30, and buprenorphine-naloxone which is used to treat opioid use disorders, was one of the top five prescribed drugs. About 570,000 Kentuckians gained access to health care in Kentucky through Medicaid expansion in that fiscal year. 

Beshear said the task force is timely, given the latest Centers for Disease Control and Prevention study that shows more than 90,000 Americans died from drug overdoses in fiscal 2020, a 29 percent increase from the previous year. In Kentucky, overdose deaths increased 50 percent, the nation's third highest rate of increase.

The former governor, who is father of the current governor, said the nation has made "tremendous strides" in prevention and treatment of addiction, but not enough: "Our national response is still inadequate, and it's obvious that it's inadequate. This may be an opportune time for Congress and a new administration to renew and strengthen the efforts to get ahold of this epidemic and wrestle it to the ground."

Beshear stressed that more focus needs to be on treatment.

"We have spent quite a bit of time and effort and money on prevention, which is obviously the right thing to do, but from a treatment standpoint, we have fallen short in reaching those who need it," he said. "We as a country have to finally step up and recognize that this problem will never be resolved without a tremendous effort in the area of  treatment."

He also pointed to the need for additional support for people in recovery.

"You can't work with a person who wants to overcome their addiction, and then just turn around and put them right back in the same environment that helped to cause that addiction in the first place," he said. "You have to provide additional support in various ways and we've got to figure out how better to do that."

Beshear said measures to fight the opioid epidemic have found bipartisan support, and "With these new numbers from the CDC, there's an urgency here to attack this problem more effectively. I think there is a window of opportunity for some bipartisan efforts out of Congress that will help in that regard." 

The Bipartisan Policy Center was founded by former Senate majority leaders Howard Baker and Bob Dole, Republicans, and Tom Daschle and George Mitchell, Democrats.

Friday, April 23, 2021

Vaccinations in Ky. keep slowing; FEMA to open sites in London, Henderson next week; one-dose vaccine likely to return soon

The Johnson & Johnson vaccine carries the Janssen
brand name. (New York Times photo by Bryan Anselm)
By Al Cross
Kentucky Health News

Kentucky continued to make slow progress against the coronavirus Friday, as most measures of the pandemic declined slightly and the number of Kentuckians who have received at least one dose of vaccine passed 1.7 million.

But only 11,088 vaccinations were added to the total, less than last week's daily average of 12,138, which includes weekends. The state announced that the Federal Emergency Management Agency will open vaccination sites in Henderson and London that can each vaccinate 1,000 people per day.

“It is getting easier and easier for Kentuckians to get their shot of hope,” Gov. Andy Beshear said in a press release. “With this extra help from the federal government, the opportunities are even greater. Now is the time for us all to step up to end this battle with the coronavirus once and for all. Talk to people you trust to get the information you need about the vaccines, find a location near you and get vaccinated. We can do this, Kentucky.”

Vaccination sites are listed at vaccinemap.ky.gov.

In another release, Beshear announced that 1,708,318 Kentuckians had received at least their first dose of a vaccine. “Now, fewer than 800,000 Kentuckians 16 and older need to sign up to receive their shot of hope in order for us to reach our goal and lift a lot more restrictions.” Beshear has said that when 2.5 million people have been vaccinated, he will remove capacity limits on businesses and events of fewer than 1,000 people.

The New York Times data tracker says 29 percent of Kentuckians are fully vaccinated, a rank that is 19th among the states. In the South, it is tops in full vaccination and second only to Virginia in one-dose vaccination, according to the Centers for Disease Control and Prevention.

Demand for vaccines was already exceeding supply before April 13, when use of the more recently released one-dose Johnson & Johnson vaccine was suspended after a rare type of blood clot was found in six women out of more than 7 million people who had received it. All were of child-bearing age.

Friday, a CDC advisory committee voted 10-4 to recommended that use of the vaccine be resumed, with a warning label for women under 50. The CDC and the Food and Drug Administration are likely to approve the recommendation, as early as this weekend.

Resuming use of the one-dose vaccine appears likely to boost vaccination efforts. Beshear and health officials have said many people want to get their immunity with one dose of vaccine.

The suspension has complicated outreach to "the homebound, the homeless, the hesitant and those who have trouble accessing vaccines," The Washington Post reports. "It is also forcing some health care providers to switch to the more cumbersome Moderna and Pfizer-BioNTech products, which require two doses, are harder to transport and need to be stored at ultracold temperatures."

Meanwhile, "Senior health officials frustrated by Johnson & Johnson’s repeated vaccine stumbles are no longer counting on the company to play a major role in the broader effort to inoculate the nation against coronavirus, Politico reports. "The flagging confidence comes in the wake of a series of setbacks that included a mix-up at one of J&J’s vaccine manufacturing contractors that ruined 15 million doses and revealed serious safety and hygiene lapses."

The state did not say which vaccine(s) will be offered at the Community Vaccination Centers that will open Wednesday at 200 County Extension Rd. in London and Thursday at 3341 Zion Rd. in Henderson. 

The sites will have their own vaccine supply in addition to the regular allocations the state gets. "These additional vaccine doses are made possible through an increase in production and availability," Beshear's release said. "FEMA and the commonwealth will continue reaching out to underserved communities in Kentucky to inform and build trust about the benefits of getting vaccinated."
 
The sites will vaccinate both registered and walk-up visitors. After getting their jab, the vaccinated will go to a post-vaccine waiting area for at least 15 minutes to be monitored for any adverse reactions.

Daily numbers: The state reported 607 new coronavirus cases, lowering the seven-day rolling average by 16, to 533. In the last eight months, only two days, April 8 and April 10, have had lower seven-day averages.

The seven-day statewide average of new cases declined for the sixth day in a row, to 10.57 per 100,000. The New York Times ranks Kentucky's rate 35th among the states.

Counties with rates more than double the statewide rate are Lewis, 48.4; Powell, 42.8; Bath, 42.3; Morgan, 37.6; Mason, 33.5; Robertson, 27.1; Wolfe, 25.9; Montgomery, 25.9; Bracken, 25.8; Simpson, 23.1; Hancock, 22.9; and Logan, 22.7.

The percentage of Kentuckians testing positive for the virus declined for the fifth day in a row, to 3.26%, about where it was 10 days earlier.

The state added 22 fatalities to its list of Covid-19 deaths, five from regular health-department reports and 17 from the ongoing audit of death certificates.

The regularly reported deaths were all in April of March, except a 77-year-old Johnson County man who died Nov. 14. The others were a Fayette County woman, 106; a Gallatin County woman, 74; a Jefferson County man, 81; and a Simpson County woman, 102.

The audit deaths, all from Nov. 15 to Jan. 19, were a Bell County man, 72; a Breckinridge County woman, 58; a Bullitt County man, 79; a Calloway County man, 80; a Garrard County man, 79; two Hardin County women, 69 and 70; two Jefferson County women, 87 and 90; two Jefferson County man, 73 and 88; a Jessamine County man, 77; a Kenton County woman, 80; an Owsley County woman, 80; an Owsley County man, 78; a Spencer County woman, 81; and a Warren County woman, 77.

In other pandemic news Friday:
  • Counties with more than 10 new cases were Jefferson, 110; Fayette, 54; Kenton, 28; Warren, 21; Boone, 19; Laurel, 13; Bath, Christian, Henderson, Mason and Pike, 12; Daviess, Lewis, Montgomery and Powell, 11; and Barren, Hardin and McCracken, 10.
  • Kentucky hospitals reported 420 Covid-19 patients, 20 fewer than Thursday; 113 of them in intensive care, down 7; and 50 on a ventilator, down 5. 

Reaching people where they are is the goal of a Lexington town hall meeting at 10 a.m. Saturday about coronavirus vaccines

Photo from Delaware.gov
By Melissa Patrick
Kentucky Health News

As coronavirus vaccinations have slowed recently, Gov. Andy Beshear has called on local leaders and  businesses to engage with their communities to encourage Kentuckians to get a shot, and a group of such influencers are doing just that in Lexington. 

At 10 a.m. Saturday, April 24, the University of Kentucky, local faith leaders and SHARE Lexington will host a Covid-19 Vaccine Community Town Hall to answer questions about the safety, efficacy and long-term effects of coronavirus vaccines, and offer attendees the opportunity to register to get one.

The hope is that this town hall will "meet people where they are" and open up a dialogue about the vaccines in a way that resonates with the attendees, Vincent Venditto, assistant professor in the UK College of Pharmacy, said in a Friday news conference.

"I hope that it becomes a dialogue tomorrow," said Venditto. "Because it's really in a dialogue, that we can actually make progress. Because if I'm telling you something and you don't understand or the community doesn't understand, then we're not actually making progress." 

Tukea Talbert, chief diversity officer for UK HealthCare, talked about the importance of health care providers being intentional about taking the time to answer all of their patient's questions about the vaccine, and also about the importance of individuals sharing their vaccine experience. 

"That goes a long way. I think that people do need to have those conversations. And that's exactly what we're hoping to achieve through this day tomorrow," she said. "We may get a handful of people, but if those people go out and have a conversation at the dinner table or with a spouse or with a child or a family member, then that may be the push that they need to get them over the hump and show up to register for a vaccination. So I think those conversations are very critical." 

Including Venditto, the panel includes Deshana Collett, associate professor in the College of Health Sciences; Trenika Mitchell, associate professor of pharmacy; and Dr. Sylvia Ofei, assistant professor in the College of Medicine. Talbert will moderate the panel. 

Each of the eight town hall locations will have a site coordinator who will facilitate the virtual viewing. Community members, especially those without Internet access, are encouraged to attend in person at one of the community town hall locations in Lexington:
  • Masjid Bilal Ibn Rabah, 1545 Russell Cave Road
  • Dunbar Community Center, 545 N. Upper St.
  • Kenwick Community Center, 313 Owsley Ave.
  • Castlewood Community Center, 201 Castlewood Drive
  • SHARE Center, 572 Georgetown St.
  • Central Christian Church, 205 E. Short St.
  • Quinn Chapel, 744 Charles Ave.
  • Charles Young Community Center, 540 E. Third St.
To view the event virtually, use this link https://uky.zoom.us/j/86710058846. The event will also be recorded and can be found at this link: https://www.youtube.com/watch?v=SRIYDQfebWw