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Thursday, July 22, 2021

As surge continues, Beshear won't rule out new measures, makes red-zone recommendations, says schools face 'difficult questions'

State Dept. for Public Health graph, with ratios added by Ky. Health News, shows how the infection rate declined as the vaccination rate increased, and while the Delta variant has broken through in some vaccinated people, the infection rate among unvaccinated people is still five times higher.
By Al Cross
Kentucky Health News

With Kentucky averaging almost 1,000 new cases of the coronavirus a day, Gov. Andy Beshear said Thursday that he is willing to re-impose restrictions to thwart the resurgence of the pandemic, and issued new cautions for counties than have reach what the state calls a critical level of virus spread.

"We're not gonna be afraid to make the tough decision if it's merited," he said, adding later, "If I think we have to take steps to save lives, we're gonna do it."

He disputed claims that he lacks power to issue emergency mandates, but pointed out that "Our world's entirely different" than it was when he imposed a mask mandate and other restrictions last summer because "people can now protect themselves" with a vaccine, "so our decision calculus will be very different."

Beshear displayed statistics showing that since March 1, unvaccinated Kentuckians have accounted for 95 percent of new cases in the state, 92% of hospitalizations and 89% of deaths.

He said his decisions on restrictions would be based on the number of hospitalizations, "what the outcomes are and how sick individuals are. We will also be looking at the breakthrough rate," the percentage of new cases among vaccinated people. "We're going to see how this goes pretty quickly."

He said vaccines provide "some pretty significant protection for you" against the more contagious Delta variant, but "If you are unvaccinated, it is the deadliest form of Covid we have seen." He noted that Dr. Scott Gottlieb, head of the Food and Drug Administration under Donald Trump, said unvaccinated people should expect to catch the virus and have the worst illness they have ever had.

Asked what he would tell vaccinated people about the variant, Beshear said the vaccines "provide very serious protection" against getting it, and even if you get it, "They provide you significant protection form getting really sick or dying." He said vaccinated people should "Take the steps you feel like you need," such as wearing a mask when grocery shopping.

Health Commissioner Steven Stack, a physician, said medically vulnerable people "should try to avoid gathering with unvaccinated folks. Even if you’re vaccinated, if you are around a lot of unvaccinated folks, you’re increasing your risk of being around someone with a very high viral load . . . and being one of those unlucky few who does get hurt even though you’re vaccinated."

Stack said, "There's no debate among anyone who looks at science and fact seriously: The vaccines work, they protect you, and if you couple that with some other simple steps if you're vulnerable, like wear a mask, wash your hands and keep some distance, you can go out in the world and enjoy your life again, not like we were last year."

Hotspots: The state reported 933 new cases of the virus Thursday, making a three-day average of 983 and a seven-day average of 649, which was a 9% jump from Wednesday. Beshear said he expects the state to have more cases in the current Monday-through-Sunday reporting week than last week.

State Department for Public Health
Thirteen of the 120 counties are now in red on the state's infection map, meaning they have seven-day new-case rates above 25 per 100,000, which the map labels "critical." Beshear issued several recommendations for such counties, including postponement of large public events.

Asked if that includes athletic contests or religious gatherings, the governor said those in charge should consider the size of the event, precautions such as distancing and masking, and the ability to move the event outside and reduce capacity. "Our goal here is to highlight the concern about what large events can do, 'cause we've had . . . more clusters [of cases] than at any time since the vaccine was introduced."

He said most of the recent clusters have been among people under 50, and displayed an updated table of vaccinations by age.

DPH chart, adapted by KHN
Because of low vaccination rates among younger people, the Delta variant's greater impact on them (24 percent of Thursday's new cases were 18 and younger) and the inability of children under 12 to be vaccinated, school districts face some tough decisions as they prepare to resume classes. The state and the Centers for Disease Control and Prevention have recommended masks for the unvaccinated in schools, but at this point any mandates are up to school districts.

Kentucky Health News asked Beshear if he is considering doing what a fellow Democrat, North Carolina Gov. Roy Cooper did this week: require students in grades K-8 to wear masks. "We will have to look at and answer that question," in cooperation with the Kentucky Department of Education, he said.

"We're gonna be talking with KDE later this week," Beshear said. "I think there are some difficult questions we have to address. . . . I see a whole lot of people gearing up because they want to have some fight about this, but the basic facts are, if you want your kids to be in school every day of the next year, the only way to make sure that happens is to get them vaccinated or to make sure that there are other protections in place."

Education Commissioner Jason Glass told Lexington's WKYT-TV that he is encouraging districts to follow the CDC guidance, and notes that they might incur legal liability for Covid-19 cases if they don't.

Vaccination persuasion: Though school is fast approaching, vaccinations in Kentucky have been at a low level for weeks, and over the past week are averaging about 6,000 per day.

Asked what can be done to get more people vaccinated, Beshear said, "I know you're not going to take it from me at this point. . . . We're at a point where those who are unvaccinated aren't listening to any public official." 

He said vaccination persuasion has to come from local leaders and friends of the unvaccinated: "We need every individual to make a few more efforts to talk to their friends and family."

Stack said that when making those efforts, "You can't be judgmental" or "try to tell them you know better."

Also, Beshear said, there needs to be more communication between doctors and patients. "People aren't actually calling their doctors and talking to them about it," he said.

To encourage vaccination, the state is holding three lottery-style drawings at which one adult wins $1 million and 10 children win full scholarships for post-secondary education. The first was held July 2. 

Beshear said almost 700,000 vaccinated adults and almost 40,000 vaccinated children have signed up, about a third of the vaccinated population. "We do believe that this drawing working, at least to some degree," he said. The second and third drawings will be July 29 and Aug. 26.

Employees of nursing homes, which house people who are most vulnerable to the virus, have about the same vaccination rate as the entire population. Few nursing homes have required employees to be vaccinated, saying they are afraid to lose employees when they are short of help. The American Hospital Association said Thursday that it stands behind members who require vaccinations.

Beshear has said he would not mandate vaccination of anyone. Kentucky Health News asked him if incentives to the employees might get more of them vaccinated. "That's an interesting question," he said. "Let us think about that." He said he supports any employer who requires vaccinations.

Daily numbers: The share of Kentuckians testing positive for the virus in the last seven days rose for the 28th day in a row, to 6.63%. Stack said the increase is concerning.

The seven-day infection rate rose for the 16th consecutive day, to 13.87 per 100,000 residents. Counties with rates more than double that rate are all in the red zone: Washington, 41.3; Muhlenberg, 40.1; Webster, 39.7; Clay, 38.8; Laurel, 35.7; Hart, 34.5; Hopkins, 32.9; Hancock, 31.1; Whitley, 29.2; Jackson, 28.9; Floyd, 28.9; and Barren, 27.8. Letcher, at 27.2, is also in the red zone.

Hospitalizations also continued to increase. Kentucky hospitals reported 423 Covid-19 patients, the most since May 12; 124 of them are in intensive care and 50 are on a ventilator.

The state reported two more Covid-19 deaths, raising the pandemic toll to 7,308.

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