Tuesday, August 31, 2021

The worse your case of Covid-19, the worse the 'brain fog' you are likely to suffer; disease has effect even in mild cases

Chart by The Economist shows levels of "brain fog" at different levels of Covid-19 seriousness.
Covid-19 is a new disease that is not fully understood, but new research by American and British scientists shows it causes problems with memory and concentration, often known as “brain fog,” even in mild cases.

The researchers teamed up with the BBC on the "Great British Intelligence Test," an online assessment billed to the public as a way to “test your cognitive strengths.” About 80,000 people "were asked to remember lists of numbers or locations on a chessboard to test their recall," The Economist reports. Other tests measured planning ability, verbal skills, problem-solving and the ability to manipulate information. "Questions about the virus, as well as about demographic factors such as age, ethnicity and socioeconomic status, were asked only after the test had ended."

The test showed that the more serious the disease, the greater the cognitive effect. "People ventilated for different respiratory diseases often face similar cognitive issues, but the performance of those with mild covid-19 symptoms suffered more than would be expected in the event of mild illness," The Economist reports. "Scientists are still unsure how exactly covid-19 is linked to cognitive impairment. . . . It remains unclear how long brain fog takes to clear, or if it does at all. That makes it difficult to estimate the lasting economic and social impact. And it reinforces worries that the health effects of Covid-19 will linger long after the pandemic is tamed."

Covid-19 hospital, intensive-care and ventilator cases keep setting new records; positive-test rate also jumps to new high

State Dept. for Public Health map, adapted by Kentucky Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

The metrics to measure the coronavirus pandemic continue to worsen, with Covid-19 hospitalizations and use of intensive-care units and ventilators at all-time highs. 

"The Delta variant continues to spread like wildfire," Gov. Andy Beshear said in a Facebook post. Kentucky still has the fourth highest infection rate over the last seven days, according to The New York Times.

Beshear added, "Two weapons can win this war. Number one, everybody's got to get vaccinated. This is still primarily unvaccinated folks either in the hospital or who spread it to someone who is vaccinated and is now in the hospital.

"The second one is masking; universal masking in our schools is a must, or we will get even worse from here. Everybody needs to be wearing a mask when they are outside of their home and indoors."

The state reported 4,548 new virus cases on Tuesday, the 10th largest daily total of the pandemic. The seven-day average went down 13, to 4,219, because last Tuesday had 90 more cases than today.

But the share of Kentuckians testing positive for the coronavirus in the past seven days increased 0.21 percentage points Tuesday, to 13.66%. That one-day increase equaled the total increase of the previous four days. 

The younger the age group, the greater the increase in cases during August. Among Tuesday's cases, 1,407, or 31%, were in Kentuckians 18 and under. 

Hospitals reported 2,274 Covid-19 patients, up 76 from Monday; 617 are in intensive care, up 2; and 406 are on mechanical ventilation, up 22. This is the first time the number of ventilated patients has gone above 400.

If all ventilated patients are in intensive care, 65.8 percent of Covid-19 ICU patients were ventilated on Tuesday, an indicator of how sick the Delta variant is making people. That is far above the average for the month, 50.6%, which is also about the average since Nov. 1.

Ventilator use forecasts deaths, the  lagging indicator of the pandemic. The state reported 23 more Covid-19 deaths Tuesday, bringing the death toll to 7,764. The daily average for the last week is 25.

The daily new-case rate for the last seven days is 89.42 per 100,000 people. Counties with rates more than double that rate are Owsley, 317.1; Clay, 264.9; Bell, 249.1; Whitley, 243.1; Perry, 214.6; Wolfe, 193.6; Leslie, 190.9; LaRue, 181.6; and Powell, 180.3.

Wolfe County schools will close next week due to a high number of cases, making the district at least the 20th to pause instruction in the academic year that recently began.

Again, the only county not in the state's red zone, for counties with 25 cases per 100,000, is Woodford County, the county with the highest vaccination rate.

The seven-day average of vaccinations in Kentucky is 13,902 doses per day, according to The Washington Post. That is 30 fewer than Monday. Only 48.5% of Kentuckians are fully vaccinated, 28th among the states.

"This is the worst the pandemic has been," Beshear said. "Please, at least take the same precautions you did earlier in Covid. Come on, folks. We've got to do this. Do the right thing. Love your neighbor as yourself. Protect one another."

The Kentucky General Assembly will make major decisions on dealing with the pandemic, since the state Supreme Court upheld several new laws it passed to limit the governor's emergency powers. 

Legislators have scheduled committee meetings this week to begin deciding what measures to take, anticipating a special session to enact such laws as early as next week.

Only Beshear can call a special session. He said Monday that he would like to do so before his declared state of emergency for the pandemic expires, which will happen when the court ruling becomes final Sept. 10.

If you know someone who's taking, or thinking about taking, horse de-wormer to fight Covid-19, please pass this along to them

Cartoon by Nick Anderson
Demand is surging nationwide for ivermectin, an anti-parasitic drug typically used for livestock, based on unsubstantiated claims that it can help Covid-19 patients. How bad is it? A Las Vegas-area feed store is requiring customers to show a picture of themselves with their horse before they can buy it, and the Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institutes of Health have warned against using it to treat Covid-19.

This didn't start with ivermectin. It's largely a function of trust, or lack of it: in government, in science, and in the "elites" believed to control both. When Donald Trump, whom supporters saw as an outsider, cast doubt on top scientists from the beginning of the pandemic, it set the stage for supporters to doubt them when vaccines were released. Trump also advocated for untested Covid therapeutics such as hydroxychloroquine and publicly floated the notion of injecting disinfectants into the body to "clean" the lungs. Some followers listened; hydroxychloroquine prescriptions shot up 900% in 2020, leading to shortages for patients with autoimmune disease. And the day after Trump retweeted a viral video from America's Frontline Doctors claiming hydroxychloroquine cured Covid-19, poison-control centers in many states saw a significant rise in calls from people who had ingested bleach, Lysol and other household cleaners.

Part of the drugs' appeal is that both are FDA-approved to fight other human diseases. Ivermectin is used to treat parasites in animals and humans, but has a long history of being promoted as a panacea for everything from AIDS to autism. Last summer it became popular in Latin America and India for Covid treatment, mostly because doctors didn't have access to a vaccine and believed an experimental treatment was better than nothing.

But the science is inconclusive at best, and leading scientific bodies have said so. The studies ivermectin fans often cite are either far too limited in scale to draw conclusions (which the studies' authors acknowledged), or say ivermectin only shows a therapeutic effect at toxic doses, or are ethically suspect. One study was yanked from a peer-reviewed journal almost immediately because the paper contained unsubstantiated claims and promoted the authors' own ivermectin treatment.

In some cases, courts have forced hospitals to allow Covid-19 patients receive ivermectin. Why not just let them take it? It's not necessarily safe, for one thing: Some people are experiencing violent diarrhea and other side effects from taking it, especially those using the over-the-counter version meant for animals. And putting one's faith in ivermectin may dissuade people from seeking other experimental but approved treatments for Covid-19, such as monoclonal antibodies.

UPDATE: Greg Sargent of The Washington Post explains "How right-wing media and social isolation lead people to eat horse paste."

Monday, August 30, 2021

Every metric to measure the pandemic in Kentucky is worse, and cases in children are rising; vaccination is up, but less than cases

State Dept. for Public Health graph, adapted by Ky. Health News; for a larger version, click on it.
By Melissa Patrick
Kentucky Health News

Kentucky reported more Covid-19 cases last week than in any other week during the pandemic, 29,456, and Gov. Andy Beshear said at this point the state is in "exponential growth," with no real end in sight.  

"We don't know where the peak is going to be yet and we ought to be concerned about that," he said at his weekly pandemic news conference. He said the peak will come when "we force it" with more masking and vaccinations.

Beshear said 27,505 vaccinations were given in the last three days, fewer than the number of new cases in that period.

Chart by The Washington Post based on Centers for Disease Control and Prevention data

The governor pleaded again for vaccination and concluded his hour-long news conference by saying, "All we have to do is care about each other . . . to put selflessness above selfishness." He called for "the vast majority of people who want to do the right thing" to talk with unvaccinated friends and family members.

"I need you to have that uncomfortable conversation, and I'm hearing from all over Kentucky from people who have done it," he said. "And it's really that risk of losing the friendship that oftentimes convinces that other person of how genuine you are."

The state also set records for Covid-19 hospitalizations, intensive-care-unit use and ventilators Monday, and Beshear said 58 of the state's 96 acute-care hospitals have critical staffing shortages, up from 50 on Friday.

State Department for Public Health graph
He said more Kentucky children than ever are getting Covid-19, with cases among youth eight times higher than they were last August, going from 2,352 a year ago to more than 18,900 this month. Percentagewise, last August, 11.8% of Covid-19 cases in Kentucky were under 18; this month, it's 24.5%. 

"More kids are getting Covid right now than we ever thought imaginable," Beshear said. 

He said for months, youth and young adults between 10-19 have been getting Covid at a higher rate than other age groups. "These are our school-aged children," he emphasized.

Beshear spoke at length about the need for universal masking in Kentucky's schools, a question the legislature will now decide since the state Supreme Court upheld several laws that limit the governor's emergency powers. 

Senate President Robert Stivers said in an interview broadcast Sunday that he expects the legislature to let local school officials decide mask policy, perhaps within some guidelines.

Asked by Kentucky Health News what parameters would be acceptable to him, Beshear again stressed that universal masking is the "one right answer" but said "If they won't do universal masking, but they say we will establish a metric by which if you hit a certain point, you have to and if you're under that you still can. If that's the best we can get,  I'll take it and we'll do the very best that we can from there to try to continue to educate."

Nineteen Kentucky school districts have paused normal instruction this month due to coronavirus cases. Heather Antle, an instructional aide at Lee County Elementary School, died Sunday from Covid-19 and three other employees have been hospitalized from it, the Lexington Herald-Leader reports.

Daily numbers: Beshear reported 4,050 new cases on Saturday, 3,249 Sunday and 2,619 on Monday, with 752 of Monday's cases in people 18 and younger. That raised the seven-day rolling average to new records, but the rise from to Sunday to Monday was only four cases; the average is now 4,232 per day.

The percentage of Kentuckians testing positive for the virus in the past seven days is 13.45%, again the highest since testing became widely available in soring 2020. Beshear said everyone should be tested regularly, since the virus is so widespread and can be spread by people without symptoms.

Hospitals also continue to report record numbers, with 2,198 Covid-19 patients, 615 of them in intensive care and 361 of those on mechanical ventilation.

State Department for Public Health graph; for a larger version, click on it.

Beshear said 21 children are hospitalized with Covid-19, seven of them in intensive care and three on mechanical ventilation.      

Since Saturday, 56 more Covid-19 deaths have been recorded, with 25 reported on Monday and four of those being people in their 30s. The death toll is now 7,741.

Again, Beshear invited health-care professionals to tell the real stories of how Covid-19 is overwhelming their hospitals, with all of them asking Kentuckians to get vaccinated. 

"That’s the one thing you can do for our community," said Sherrie Mays, vice president and chief nursing officer for Baptist Health Corbin. "The other thing you can do for our community is pray for our patients, and pray for our staff and our physicians that they can be resilient during this pandemic and that we can get through it as quickly as possible."

He said the state has 115 intensive-care beds available and has had to provide ventilators to Advent Health in Manchester, after having done the same last week to TJ Samson Community Hospital in Glasgow.

The statewide new-case rate over the last seven days is 87.53 daily cases per 100,000 residents. Counties with rates more than double that rate are Owsley, 284.7; Clay, 246.9; Bell, 245.9; Whitley, 233.2; Perry, 200.8; Powell, 183.8; and Wolfe, 183.6.

The only county not in the state's red zone, for counties with 25 cases per 100,000, is Woodford County, the county with the highest vaccination rate.

State Department for Public Health graph, adapted and added to by Kentucky Health News

McConnell keeps urging shots, but avoids comment on others' work and won't repeat that he has 'total' confidence in Fauci

McConnell spoke at the University of Kentucky as
Dr. Mark Newman, head of the hospital, listened.
By Melissa Patrick and Al Cross
Kentucky Health News

At an event to announce a renewed four-year grant for the Center for Clinical and Translational Sciences at the University of Kentucky, U.S. Sen. Mitch McConnell first congratulated the center, noting that this award is "extremely difficult to get" and then spent the rest of his time talking about the need for more people to take the Covid-19 vaccine. 

"Honestly, my friends, it never occurred to me that we'd have a challenge getting people to take the vaccine, but that's where we are. Ninety percent of the people in the hospital are unvaccinated, we have a crisis of the unvaccinated. And so we're all I think perplexed as to how we tackle this problem. But clearly getting more and more Americans vaccinated is the only way to end it." 

He then went on to encourage people to collectively talk to their friends and relatives and encourage them to get vaccinated. 

Asked why he hasn't pushed back on some in his own party who have helped fuel skepticism about masks and vaccines, McConnell said it "wouldn't serve any purpose to start criticizing others" and said that he has been clear in letting people know what he thinks is the right thing to do, which is to get vaccinated.

McConnell said decisions about requiring employees to get vaccinated need to be left up to employers and school boards. "They can weigh the evidence, look at the effectiveness and make a decision," he said. 

Asked if he had had direct conversations with his fellow Republican lawmakers to nudge them to publicly support vaccinations, McConnell didn't answer directly but said he has been "quite vocal" about his opinions on this matter, so he thinks everybody knows how he feels about it.

In a later press conference at Millersburg, McConnell declined to repeat what he said on July 15, 2020, that he had "total" confidence in Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci has come under fresh attack by Sen. Rand Paul and others in recent months.

Asked the same question, his level of confidence in Fauci, McConnell replied, "Oh, look. I've said, Al, the same thing over and over and over for months. We know the vaccine works, we know this is largely a rising epidemic among the unvaccinated, and without getting into an argument about who's the best health-care adviser out there, it doesn't make any difference. We know the vaccine works, we know the people who are not vaccinated are the ones who are in the hospitals."

At UK, McConnell told reporters that "money is not the problem" when it comes to dealing with the pandemic, including the most recent surge in hospitalizations, pointing to the most recent $1.9 trillion rescue plan passed earlier this year. Instead, he said, "The reluctance of people to get vaccinated is the problem." 

This is the third time the UK center has received federal support for its research, now totaling $65.4 million since 2011. 

With a focus on Appalachia, the center provides support for all types of health research, including pilot funding, training and career development for the next generation of translational researchers, a full spectrum of research support services, community engagement resources, multidisciplinary mentors and connections to local and national research networks, a UK news release said. 

After the pandemic hit, the center established a Covid-19 biobank, launched pilot funding to address issues related to the virus and launched a "hugely successful" Johnson & Johnson vaccination trial that became the top enrolling site in the world for the final trial that led to the emergency-use authorization for the vaccine and paved the way for more Covid vaccine trials.  

Coronavirus burning through low-vaccinated Breathitt County; 'It's like they're blind ... I don't understand,' local health official says

A sign in Jackson (Photos by Jamie Lucke)
By Jamie Lucke
Kentucky Health News

JACKSON, Ky. – William Sizemore fights Covid-19 from the front lines in Breathitt County; he worries that “like the drug epidemic,” no family there will escape the coronavirus – unless more of his neighbors get vaccinated.

In recent weeks, the virus has burned through the county’s population of 13,000 at a faster pace, fueled by the more contagious Delta variant, and is infecting younger people.

“Unfortunately, we are seeing an increase in the number of children testing positive for Covid-19 that are presenting with severe symptoms in our emergency department,” said Susie Robinette, chief nursing officer at the Kentucky River Medical Center in Jackson.

Like hospitals across Kentucky, Robinette said the 55-bed hospital is under stress from the Delta surge.

The hospital reports 12 Covid-19 patients were hospitalized at the beginning of this week and none had been fully vaccinated.

“We are asking our community to get vaccinated to help slow the spread of the virus,” Robinette said.  “This effort will allow our hospital to maintain proper capacity to continue caring for our families, friends and neighbors.”

She also recommends: “Wear your mask, wash your hands and maintain physical distancing when possible.”

Children under 12 are not yet eligible for the vaccine, and only 36 percent of Breathitt residents have been fully vaccinated, compared with 48% statewide and 52% nationally, according to the Centers for Disease Control and Prevention. Among eligible residents, 12 and older, 42% are fully vaccinated compared with 61% nationally.

“When it got politicized, that hurt public health. I don’t care if you’re a Democrat or a Republican,” Sizemore said, because the virus doesn’t care, either.

As the Breathitt County Health Department’s environmentalist, Sizemore is responsible for preparedness. He has been urging people to protect themselves and each other by taking the free shots available at the health department, pharmacies and Juniper Health.

In response to the Delta surge, there has been an uptick in people coming to the health department to receive the free vaccines, including more children 12 and older, said Sizemore. “We’re chipping away, just not hard enough.”

On Aug. 23, the Pfizer vaccine became the first of the three vaccines to advance from emergency authorization to full approval by the Food and Drug Administration.

Derrick Hamilton, D.O.
FDA approval removes one objection raised by the unvaccinated. Ever since the immunizations became available last winter, Dr. Derrick Hamilton has been assuring patients they could trust the process and the vaccines.

“Just because it was done at such speed does not mean it did not go through the same level of scrutiny,” Hamilton said. “It has been rigorously studied. Hundreds of millions of doses have been administered. The science speaks for itself.” 

Hamilton is chief executive officer and chief medical officer of Juniper Health, a Jackson-based nonprofit that provides primary medical and dental care and other health services in Breathitt, Elliott, Lee, Morgan and Wolfe counties.

Hamilton calls the Trump administration’s Operation Warp Speed, which helped speed the vaccines to the public, “a testament to American greatness, on par with the Apollo program” that sent humans to the moon. Vaccination, in his opinion, is “the patriotic thing to do.”

What does he say to patients who have misgivings about the vaccine? “I tell them I’ve taken it. My family has taken it. Other family members of mine have taken it. Then I go through reasons that they are reluctant to take it and try to counter that with facts and open up the conversation to try to combat disinformation.”

In the five counties served by Juniper Health, vaccination rates vary from 26% in Elliott to 40% in Wolfe.

“Covid is an ongoing threat to the health and well-being of the patients of our service area,” said Hamilton. “The most effective tool we have medically to get this forest fire under control is widespread vaccination. I’ve had the vaccine. My family has had it. I advocate for it. It’s safe. It’s very effective at preventing death and severe illness.”

After Covid forced cancellation of a Breathitt County High School Bobcats football scrimmage against Bell County, the health department’s Sizemore warned in the Jackson-Breathitt County Times-Voice, “For those not vaccinated, get ready. It’s coming for you.” 

A sign in Jackson advertises testing.
Recent statistics bear out his fears. The county’s incidence of new cases for the week ending Aug. 29 was 136 per 100,000 residents, 38 percent more than the statewide rate of 92 per 100,000 population. The CDC reports Kentucky’s highest rates were in Clay, Bell and Perry counties, where the rates per 100,000 were 270, 235 and 212, respectively.

(All three counties together don’t have close to 100,000 people, but the standard measure allows comparisons across a wide range of populations.)

The state reports 1,333 cases in Breathitt County during the 18 months of the Covid-19 pandemic. The state’s numbers slightly lag those of the local health department. Either way, about one in 10 residents has been identified as infected.

Two recent deaths, yet to be confirmed in state data, will likely bring the county’s Covid death toll to 14, said Sizemore, who has been surprised at how many people resist taking a potentially life-saving shot.

“They see people dying. These are hard numbers. … It’s like they’re blind. I don’t understand.”

Sunday, August 29, 2021

Eastern Kentucky couple's deeply held resistance to coronavirus vaccines illustrate difficulty of getting enough people immunized

Kentucky Health News

One reason many Kentuckians are resistant to coronavirus vaccination is people like Josh Stacy.

“I feel there is more to it than just getting a shot,” Stacy told Brandon Roberts of Spectrum News. “The government doesn’t do anything with your best benefit in mind.”

Stacy's feelings about government are common in Kentucky. In a national poll, the state ranked second only to Minnesota in the percentage of people who said they weren't vaccinated or planning to be because they distrust government.

Tomi and Josh Stacy (Photo provided to Spectrum News)
Stacy also has reservations based on religion.

“I’m a Christian, and I also think that this is going to lead to other things,” he said. “I’m not saying this vaccine is the Mark of the Beast, but it can lead to that. It says in the Bible [the Mark of the Beast] will be placed in your right hand or forehead. We haven’t gotten that far yet, but it is leaning that way. You won’t be able to buy or sell anything without the mark.”

Roberts interviewed Stacy, a fellow Pike County native, to localize a story about another national survey that showed rural parents have more reservations about the vaccines than those in cities and suburbs. Stacy, 43, asked that his exact address and occupation not be reported, Roberts told Kentucky Health News.

Stacy "has lived and worked in the mountains of rural Eastern Kentucky his entire life," Roberts reports. "He and his wife, Tomi, are the parents of two daughters, ages 13 and 5. He said none of them have gotten or will get the vaccine. . . . Stacy’s doubts about the vaccine have only intensified recently, as his vaccinated mother and stepfather are currently battling Covid-19."

Stacy told Roberts, “There is not a 100 percent guarantee you will not contract the virus even with the vaccine.” That is true, but unvaccinated people are about four times more likely to catch the virus, and about 10 times as likely to be hospitalized with Covid-19.

Stacy also said, “It’s not like chickenpox, tuberculosis, or anything like that. This virus is man-made, and I feel that the government and certain elites in this country are about population control.” U.S. intelligence agencies have ruled out the possibility that China developed the virus as a bioweapon, "but the agencies failed to reach consensus on the virus origin, according to key takeaways from a classified report delivered to President Biden," The Washington Post reports.

Stacy's concern about the Antichrist ("the beast" in the Book of Revelation) is common in many fundamentalist churches that regard the book as prophetic about modern times, and Kentucky is more religious than most states. "Stacy's faith . . . plays a significant role in his decision not to get the vaccine. Strong adherence to one’s religion is prevalent in rural America, but was not a factor the study considered," Roberts reports for Spectrum News, a service of cable-TV firm Charter Communications.

The study found that rural parents shared the same concerns as parents in cities and suburbs, but to greater degrees. They were 10 percentage points more likely than urban parents to say they were concerned that the vaccines have been tested enough (58% to 48%), nine points more likely to wonder whether the vaccines actually work (51% vs. 42%) and what long-term health effects they might cause (56% vs. 47%), and eight points more likely say they were concerned about how new the vaccine is (52% to 44%).

The survey was conducted online by researchers at Northeastern University, Harvard University, Rutgers University and Northwestern University June 9 through July 7 among 20,669 people, using quotas to reflect race, ethnicity, age, and gender in each state. The data were weighted using data for race, ethnicity, age, gender, education, and residency in urban, suburban or rural areas. It was funded by the National Science Foundation.

Stivers sees legislature returning mask policy to school districts, maybe with guidelines; Beshear says universal masking needed

Sen. Robert Stivers (Image from WKYT-TV)

By Al Cross
Kentucky Health News

The Kentucky General Assembly may well let local school officials decide mask policy, rather than follow a state school-board regulation, Senate President Robert Stivers said in an interview broadcast Sunday.

Asked if the legislature would shift the authority for school mandates back to locals, Stivers said, "I can see that very seriously happening, because we've had certain school systems where you have had very successful responses without a mask mandate."

Local school officials "understand what needs to be done, whatever that may be, in their district . . . and do it in a responsible fashion," Stivers said on "Kentucky Newsmakers" on Lexington's WKYT-TV. But he said the legislature might require certain measures depending on the local status of the pandemic.

"You might see protocols that say, as long as you're at this stage, it is a local level, but if it gets above a certain area you have certain guidances that you have to follow," he said. 

Asked for a response, Gov. Andy Beshear told Kentucky Health News in an email, "Every public health agency from the CDC to every local health department in Kentucky, as well as the Kentucky Chamber of Commerce, and education organizations across the country know the science is clear. Universal masking is the only safe, responsible way to have in-person learning at this time. This will be a major test of the General Assembly but there is only one right answer. If school districts are not required to or choose not to mask, we will see thousands of quarantines, more sickness amongst kids, and a depleted workforce that doesn't show up to work because their child has to stay home."

The legislature has power to kill the emergency regulation that the Kentucky Board of Education issued Aug. 12, requiring all students and staff in public schools to wear face coverings for the rest of the school year.

On Aug. 10, Beshear, who appointed all members of the board, issued a broader mandate for all schools, saying so few districts had required masks that the threat of contagion and ability to maintain in-person instruction was in danger. He withdrew it after the state Supreme Court upheld laws limiting his emergency powers.

Now the Democratic governor and leaders of the Republican-controlled legislature are discussing a new legal framework for dealing with the pandemic, to be passed in a special legislative session Beshear would call.

"My hope is they have the courage to do the hard things," Beshear said in a separate interview with WKYT, adding later, "Certainly, we're going to collaborate with them. . . . The first thing we need the people of Kentucky to do is to care about each other."

When the state recorded 65 deaths Wednesday, the second most of the pandemic, Beshear said that if not for the court ruling, he would have reinstated the statewide mask mandate that he ended in June. Stivers quickly said there is little legislative support for such a broad mandate, and said likewise in the interview.

"If you're gonna do mandates of that nature, they really should be targeted, based on the positivity rate, other things of that nature," he said. "I think at this point in time we ought to be focusing on shots, behavior modification for those individuals who don't want to take the shots."

Only 48 percent of Kentuckians are fully vaccinated against the coronavirus, and resistance to vaccination is strongest in rural areas like Stivers' district: Whitley, Knox, Clay, Owsley, Lee and Wolfe counties.

Stivers has announced a campaign in his home Clay County with 30 local "influencers" urging people to get vaccinated, vaccination clinics at 13 public schools, drawings for cash prizes to be used for sports equipment in the schools with the highest vaccination rates, wrist bands that say "I took the shot" and coupons for free pizza. Stivers has suggested that the campaign could be used in other areas.

Some of Stivers' fellow Republicans have been openly skeptical of vaccinations and masking, and interviewer Bill Bryant told him some people have said politicians need to work as hard to inform people about vaccination as they do at getting elected.

Stivers replied, "Politicians have been somewhat tainted because they've seen this as more of a national political battle than as a local political battle." He said the state needs a vaccination campaign "that removes politicians" and uses more trusted messengers. 

"It would be better for leaders in their communities, be it doctors, be it religious leaders, educators, to step forward with the message," he said, adding later, "There's been a lot of misinformation."

Bryant noted that a pre-filed bill would ban employee vaccine mandates, but Stivers indicated little if any support for that, and implicitly endorsed the vaccine mandates issued recently by hospital chains. He said patients or their families could sue hospitals for "not requiring their people to have shots, knowing that they're dealing with a fragile population," and "Each business needs to look at their policy and set their policy based on what's prudent and reasonable."

Stivers said he expects a special session "at the appropriate time with a measured response," but said it should follow a quick session to redraw legislative districts to conform to the 2020 census, "so we can get that off the board and focus on covid policies and budgets."

The timing and agenda of special sessions is up to the governor, but with their partisan divide, Beshear and legislative leaders are expected to agree on much in advance, such as emergency certifications of health personnel.

The law upheld by the Supreme Court limits governors' emergency orders to 30 days, but Stivers said the legislature could "tier" that authority, allowing certain measures for 30 days, others for 45 days and allowing others to continue until January, when the regular legislative session will begin.

Stivers acknowledged that the public is "extremely divided" on how to tackle the pandemic, but he and Beshear agree on "We need to get shots. how we deal with things after the shots, there may be disagreement."

He said the 10-day limit on non-traditional instruction, which the legislature passed this year, "will have to be revisited" because school districts are already closing temporarily and shifting to NTI because of high case numbers.

Bryant said in introducing the interview that Stivers, "usually careful and deliberate, has handled things in that same cautious way" since the court ruling. House Speaker David Osborne used a similar tone in an email to Kentucky Health News on Wednesday.

"Moving forward, our caucus is going to continue to be deliberate and intentional in how we approach this pandemic," Osborne said, noting that House Joint Resolution 77 in the last session was passed after legislators "evaluated each executive order and emergency regulation issued by the administration to address the pandemic. Ultimately, we ratified the ones that evidence supported were necessary and good. It is our intent to work closely with the administration, hear their recommendations, and work with them as well as other stakeholders to set the policies."

Massie leads 'Freedom Rally' that includes man who says his wife, a UK hospital worker, will quit her job rather than get a shot

U.S. Rep. Thomas Massie, left, and state Rep. Josh Calloway
spoke at the rally. (Courier Journal photo by Scott Utterback)
Opponents of restrictions to fight the coronavirus pandemic, led by Fourth District U.S. Rep. Thomas Massie, rallied at the state Capitol Saturday. The "Freedom Rally" crowd included one man who said his wife, a nurse, is refusing her employer's requirement to get vaccinated and they may leave the state as a result.

"I want to get the masks off the kids," Joseph Mattingly of Lebanon told Munashe Kwangwari of Louisville's WLKY-TV.

Mattingly said his wife works at the University of Kentucky hospital, one of many that recently said employees would have to be vaccinated against the virus. "She's gonna be forced out with these mandates, but she's not going to take the shot. There's no reason she should have to take the shot. . . . If we have to, we'll move out of the state. I don't want to move. That's why we're here. We're willing to fight."

Morgan Watkins of the Courier Journal reports that Massie, a Republican, referred to masks as "face diapers" but acknowledged, "Covid is a serious disease," saying he has known people who died from it. "But there's another disease, another virus, in the state of Kentucky . . . the Beshear virus."

Massie said the original version was Steve Beshear, the governor's father and governor in 2007-2015, but the state caught the "Andy variant," symptoms of which include "loss of balance in your bank account" and confusion.

Andy Beshear, a Democrat, is seeking re-election in 2023, and one Republican, state Auditor Mike Harmon, has already declared for the nomination to face him. The auditor joined other officials in criticizing pandemic restrictions, Watkins reports: "Harmon specifically criticized so-called 'vaccine passports,' a buzzword that basically references some form of verification that a person has gotten vaccinated against Covid-19 and potentially might be required to work or enter restaurants in some places."

Watkins reports that Massie's statements were similar to those he has made: "In recent months, Massie has inaccurately claimed masks are ineffective and has questioned the Covid-19 vaccines' efficacy and necessity, despite medical and public-health professionals' consensus that the vaccines remain safe and effective, especially at preventing hospitalization and death."

Republican state Reps. Josh Calloway of Irvington, Savannah Maddox of Dry Ridge and Felicia Rabourn of Campbellsburg also spoke to "the crowd of at least 300," Watkins reports. Kwangwari's crowd estimate was 600.

Beshear said in an interview broadcast Sunday on Lexington's WKYT-TV, "We don't have a tool other than vaccinations and masking that can stop this virus. . . . It doesn't impact anybody's liberty. . . . What we don't have is the liberty to spread a deadly virus to other people if we can prevent it."

Saturday, August 28, 2021

Most Kentucky faith communities still meet in person, many without requiring masks, and vaccination is a touchy subject

Rev. Carol Harston leads communion at Louisville's Highland Baptist Church. (Bill Campbell photos)
By Bruce Maples and Melissa Patrick
Kentucky Health News

As the state and nation endure another surge of coronavirus cases, how are Kentucky houses of worship dealing with the pandemic? Has their approach changed from the spring to now? And what are they doing to encourage vaccination? Kentucky Health News reached out to a wide range of them to find out.

In our sampling of faith communities, and parent organizations if they have one, nearly all said the pandemic had taken them through stages, from a full shut-down that lasted months, with all worship services done virtually, to more recently offering in-person services that include a range of social distancing and masking requirements. 

The return to in-person services was prompted by a drop in case numbers and the arrival of vaccines, with all of the faith communities looking forward to the day when they could resume most of their normal activities.

But as the highly contagious Delta variant of the virus caused a spike in new cases, many of these same faith communities are moving back to the more cautionary stages that were seen early in the pandemic, with some again going fully masked. A few are moving back to a full shutdown.

"We were just beginning to get back and now we're going backwards again. . . . It's tightening back up," said Gwenda Bizzle, church secretary at First United Methodist Church in Clinton, near the Mississippi River. 

Commonalities across communities

We were struck by the similarity of responses to the pandemic among leaders of churches, synagogues and mosques, including looking to the Centers for Disease Control and Prevention and the governor's office for guidance, including virtual options for worship. 

They also adapted services to ensure the safety of their members by not passing offering plates, discouraging touch during "passing of the peace," limiting singing, and doing temperature checks. 

Some may be guided by the Kentucky Council of Churches, which meets regularly with the governor's office. It has issued a guide for healthy worship including many of these suggestions.

"We highly recommend that all of our membership listen to and speak to their congregations in accord with recommendations that are put out by the CDC and the doctors who are speaking as far as the help of the state, and and we highly recommended that all peoples be vaccinated that are eligible for it," said Melissa Holland, interim executive director at the council, which comprises 21 denominational organizations, primarily but not exclusively on the more moderate and liberal side of the Christian faith.

Highland music associate Austin Echols leads choir in an
anthem he wrote for returning to worship in the sanctuary.
Only one church in our sample had moved back to virtual-only services: Beaumont Presbyterian Church in Lexington, largely driven by the surge of the Delta variant and a positive-test rate that is the highest it's been since the state started widespread testing.  

"We're going to keep doing this until this surge starts heading in the right direction," said the pastor, the Rev. Stephen Fearing. He added, "Some people might say that we're being overly cautious right now. But we're trying to set the example. I think the church should be a moral example to folks and we really want to set the tone that way." 

Most churches said they provide masks, strongly encourage people to wear them and encourage social distancing, but said they had removed systems that placed six feet of distance between families and now say masks are optional, calling them a personal choice. 

"We are encouraging masks, but we are also saying it is your choice; you are grownups, you are adults," said Senior Minister Larry Wilson at Woodlawn Christian Church in Campbellsville. 

Pastor Vince Farrell at Journey Church of Hopkinsville said mask wearing "is your prerogative. You are welcome here with a mask. You are welcome here without a mask." 

Most of faith communities said such decisions were made by their elders, deacons or church councils, and some had boards or committees that included medical professionals from their membership to offer input.  

Innovative measures 

Some communities have found innovative ways to deal with the pandemic. 

Journey Church uses colored arm bands to indicate a person's level of social comfort. Farrell said 85% of his members use green bands, indicating they are comfortable with fist bumps and hand shakes; 12% use yellow, inviting talking but no touching; and 3% use red, which indicate they would rather not socialize. 

Woodlawn Christian is not enforcing social distancing in the same way it did at the beginning of the pandemic, Wilson said the Campbellsville church is keeping track of where its members are sitting, to help contact tracing if someone gets the virus. 

Pastor Mike Caudill of Hindman First Baptist Church said they recorded more than 20 choir songs while their choir members stood 10 to -12 feet apart and now use those recording during both virtual and regular services.

The Louisville-based Mid-Kentucky Presbytery offered $2,000 grants to churches to help them adapt to virtual worship.

The Chabad House congregation in Louisville made special booths for members so they could pray without risking their health. The prayer booths are transparent (from the waist up) so congregants can see others and feel a sense of community, yet still be protected. Another synagogue is doing funerals in person, but only at gravesides. 

Rev. Jim and Mary Helen England at Highland.
What about vaccinations?

Parent organizations, who do not oversee most of the congregations in Kentucky, offered a list of ways they encouraged people to get vaccinated.

They have encouraged congregations to sponsor vaccine clinics and several have done so, and pastors have been encouraged to mention "God's gift of the vaccines" in sermons.  

Others reported that pastors have made pastoral calls on individual families to inquire about vaccine status and encourage getting vaccinated, with one church in the Mid-Kentucky Presbytery achieving a 100% vaccination rate among its regular attendees.

Another congregation is providing rides or money for Uber or Lyft for members to reach vaccination sites. And one faith community said getting vaccinated is mentioned every week in announcements, and information posted on their web site.

But among the sampling of churches interviewed, few of them are preaching about vaccines from the pulpit. 

Wilson, of Campbellsville's Woodlawn, said he has been forthcoming with people about being fully vaccinated, but said that as a church body, "We have not encouraged nor discouraged anyone from being vaccinated."

"We do not speak about current culture issues that don't reflect biblical things," said Hopkinsville's Farrell. "So we focus on preaching Jesus and love for one another. And things [like] vaccinations unfortunately have been so politically charged that we don't bring that into our pulpit."

Some others approach the touchy subject very differently. 

"From the get-go I have been advocating, vocally, for the congregation to get vaccinated," said Fearing of Beaumont Presbyterian. "I've been encouraging them to encourage their co-workers and friends and families to get vaccinated. . . . And our leadership has also been very vocal about that. So it's not something we're afraid to bring up. We see it as a theological issue. Getting vaccinated is how we protect our neighbors. So that's what Jesus calls us to do. So for us, it's a no brainer."

Some take a gentler approach.

Caudill, of Hindman First Baptist, said he encourages his congregation to get vaccinated by telling them that he and many people that they know have gotten vaccinated, "So without telling people you've got to go get vaccinated, they receive encouragement."

Some said they encourage people one-on-one to get vaccinated, but not from the pulpit. 

"I personally have been very up-front with my recommendation for [the] vaccine," said Pastor David Grout of Florence United Methodist Church. "I have had a lot of private conversations with people, encouraging them to get them. I've tried to counter some of the misinformation that I think is out there about vaccines, but we have not had any kind of official stance or anything." 

The Rev. Alex Lockridge of First Baptist Church in Corbin said, “I do believe churches should be more supportive of the local experts and health-care professionals, and taking what they have taught us and sending it out to our people, using our platform to encourage people to do the right thing."

Some have poor compliance

Some churches that Kentucky Health News contacted did not return multiple calls for comment on their practices. But, in the videos of recent worship services from three Baptist churches that are posted online, none of the performers on stage wore masks as they sang for the first 20 minutes of the service. And, in the few shots of the congregations, only one person was seen wearing a mask, even as the congregations also sang and greeted one another with hugs and handshakes while standing close together.

Some churches around the state have been the sources of Covid-19 outbreaks. One organizational leader said they have provided guidance to churches, but have no way to make them comply, even though they have felt the deadly effects of the virus.

Another leader, Rev. John Odom of Mid-Kentucky Presbytery, shared this personal observation: “One of our congregations … chose to ignore our guidance, ignore the CDC guidelines. They kept worshipping in person, without masks, without social distancing, they kept singing. And last December, when infections spiked here in Kentucky, the church service became a super-spreader event for that congregation, and the pastor and several members ended up in the ICU, and the pastor actually died as a result of Covid infection. Which is a great sadness, but at the same time, God always tells us our actions have implications. We reap what we sow, right?”

Isolation, closures and lethal drug supply likely contributed to the big increase in drug overdose deaths in Kentucky last year

The 49% increase in drug-overdose deaths in Kentucky in 2020 included a big jump among young people, Jasmine Demers reports for the Kentucky Center for Investigative Reporting

Her object example is Isabell Slusher, 24, who came close to being one of those overdoses. She said she started using heroin when she was 18. Last year, she was forced into isolation during the Covid-19 pandemic, and isolation is a dangerous place to be for someone with a substance-use disorder.

“As addicts, you already isolate yourself. And then when the pandemic hit, you’re then being forced to not be around your loved ones,” Slusher told Demers. “You do start to get lonely. What better thing to do than just lay around and get as high as you can get?”

Slusher said she became depressed and felt hopeless, adding, “Who would even know I was gone? Who would miss me?”

Slusher entered treatment last November, and hasn’t used drugs since, reports Demers, but she adds that that wasn't the case for everyone. 

"Young Kentuckians experienced the highest increase in drug overdose deaths last year, according to the state’s overdose fatality report released this month. The report showed increases in mortality across all age groups, and overdose deaths grew overall by 49%. But the jump for young people was much higher: 127 people aged 15-24, 90% more overdose deaths than the previous year," Demers reports. 

The exact cause for this increase in drug overdose deaths is not clear, but many have blamed the isolation of the pandemic.

“They’re already dealing with a lot of uncertainty and just figuring out life,” Julie Duvall, CEO of Adult and Teen Challenge of Kentucky, told Demers. “Their peer groups are so important to them and all of that has kind of been disrupted.”

Duvall added that drug use among young people can be misinterpreted as rebellion or behavioral issues instead of a deeper problem, and that people tell them that they start experimenting with drugs as a way to cope with life.

State records show that over the last five years, increases or decreases in overdose deaths have correlated with the number of people seeking emergency care, but in 2020 there were more deaths than emergency room visits, Demers reports. 

"In 2020, emergency department visits for nonfatal drug overdoses increased statewide by just 13%, compared to the 49% increase in total overdose deaths, according to the Kentucky Injury Prevention and Research Center. For young people, the discrepancy is even wider — emergency room visits increased by 10.5% while overdose deaths jumped by 90%," Demers writes. 

Duvall told Demers that her treatment program hasn’t seen an increase in admissions. “So, what that tells me is they’re suffering in isolation at home or wherever they are and not reaching out for help," she said. 

Another challenge has been restrictions and closures during the pandemic that have made finding recovery options even harder. 

Slusher told Demers she came into treatment through a court order after being arrested for violating her federal probation. The judge sent her to Adult and Teen Challenge of Kentucky.

“I think maybe if I didn’t get locked up that day, I know that I probably wouldn’t be here,” she said.

Courtney Duerksen, 24, who is in treatment with Slusher, told Demers that she also felt the impact of that isolation. But five months into recovery, Duerksen offered this advice for people with substance use disorders. 

“Make sure that you’re reaching out if you need help. Make sure you’re talking to someone,” she said. “Because that’s one thing that I didn’t do. I isolated to the fullest. And if I needed help, I didn’t call anyone.”

Another contributor to the increase in overdose deaths during the pandemic was the lethality of the drug supply, with fentanyl detected in 71% of the overdose deaths, Demers reports. 

Last year, 1,964 people died of a drug overdose in Kentucky, and about 29% of them were 35 to 44 years old. Kentucky had the third-highest increase of overdose deaths in the nation in 2020, according to the Centers for Disease Control and Prevention.

And it seems to be getting even worse this year, according to Dana Quesinberry, public health policy and program evaluator for the Kentucky Injury Prevention Research Center.

“There had been a hope … that once vaccines became available and we’re reintegrating our society that we would see a decline in overdose deaths, and we are not seeing that," she said. 

And while the data is important, Quesinberry told Demers that it's about more than just numbers.

“Every person who has died, every person who has had a non-fatal overdose, every person who has suffered with substance use disorder is somebody’s parent, somebody’s child, somebody’s brother, sister, coworker, neighbor,” she said. “That’s why prevention and harm reduction services and support for them are very important.”

Kentuckians can call 1-833-8KY-HELP (1-833-859-4357) to speak with a specialist about substance use treatment options and available resources. To find openings at addiction treatment facilities, you can also visit www.FindHelpNowKY.org.

Friday, August 27, 2021

More than half of state's acute-care hospitals report critical staff shortages; 7-day average of new coronavirus cases sets a record

Ky. Health News graph; daily cases from initial, unadjusted reports. For a larger version, click on it.
By Melissa Patrick and Al Cross
Kentucky Health News

Before celebrating the third and final batch of winners of the state's lottery for the vaccinated, Gov. Andy Beshear gave yet another grim pandemic report, saying 50 of the state's 96 acute-care hospitals report critical staff shortages.

"It's worse from a hospitalization standpoint and a hospital capacity standpoint than it's ever been for any reason," Beshear said at an event held to announce the lottery winners. "You are at more risk now if you are in a car accident or have a heart attack of not getting all the services you need than ever before."

The state continued to report record numbers of Covid-19 patients in hospitals and intensive care, and on mechanical ventilation, though the daily gains were mostly the lowest of the week. But 4,815 new cases of the coronavirus raised the seven-day average above 4,000 per day. It is 4,045, breaking the record of 4,002 set Jan. 12.

Kentucky hospitals reported 2,129 Covid-19 patients, 592 in intensive care and 349 on ventilation. Beshear noted the latter record a sign of the seriousness of the pandemic, noting the state had delivered two ventilators to T.J. Samson Community Hospital in Glasgow because it had run out.

"People should rightfully be very scared of the Delta variant. . . . It is that serious. It is that aggressive," he said.

The seven-day infection rate set a new record Thursday and did again Friday, rising to 84.49 daily cases per 100,000 residents. Counties with rates more than double the statewide rate are Clay, 259.9; Bell, 226.1; Whitley, 215.1; Owsley, 197.4; LaRue, 175.6; and Perry, 171.9. The next six are Laurel, 166.6; Wolfe, 163.7; Jackson, 161.8; Grayson, 153.5; Breckinridge, 153.5; and Allen, 148.1.

The lowest rate, 25.1, is in Woodford County, which has the highest percentage of residents who have received at least one dose of vaccine, 72%.

Kentucky's infection rate ranks fifth in the nation, trailing Mississippi, Florida, Louisiana and Tennessee. Indiana and West Virginia are 15th and 16th; Missouri is 23rd, Virginia is 30th, Ohio is 34th and Illinois is 36th.

The percentage of Kentuckians testing positive for the virus was again the highest since testing became widely available last spring: 13.33%.

The state reported 18 more Covid-19 deaths, raising the seven-day average to 24 per day. One month ago, it was four per day.

Beshear reiterated several of the state's most recent efforts to provide relief to its hardest-hit hospitals, including use of the Kentucky National Guard in ways that free up hospital staff; Federal Emergency Management Agency emergency-medical strike teams arriving in Louisville, Prestonsburg and Somerset; a request to FEMA for nurse strike teams; and using money from the 2020 federal pandemic relief bill to set up four testing sites.

Beshear again called on Kentuckians to get vaccinated, and reiterated that it's time for a statewide mask mandate, a measure that would have to be imposed by the legislature because of last Saturday's state Supreme Court ruling upholding laws that limit the governor's emergency powers. 

"If we truly want to stop the surge and save lives . . . the legislature is going to need to do a statewide mask order," Beshear said, noting national projections of 100,000 more deaths, "half of which could be saved by universal masking That's 50,000 people across the United States; that's a pretty good reason to do it."

The winner of the third $1 million prize, Mary Mattingly of Louisville, Mattingly urged vaccination and expressed her appreciation and via video because she was traveling. 

"I want to use this opportunity to encourage each of you to get the shot of hope," Mattingly said. "The vaccines cannot stop every case, but they can greatly reduce your chances of acquiring a serious, long term or fatal case of Covid-19."

The five Kentucky youth selected for full postsecondary-education scholarships are Marissa Herron of Mount Washington, Lillie Nielsen of Nicholasville, Jordan Ballard of Crestwood, Grider Burch of Lexington and Jaden Wattley of Louisville.

"The response we've had for this sweepstakes has been great," Beshear said, saying it generated hundreds of thousands of dollars worth of favorable publicity for the vaccines, which are the targets of misinformation. "I do think we're at the point where incentives can probably only do so much."

Beshear said 762,174 adults entered to win the three $1 million prizes and 47,544 youth entered to win the 15 scholarships. Since announcing the sweepstakes, 419,566 Kentuckians received a Covid-19 vaccine.

Daily vaccinations continued to increase. Today's report, reflecting yesterday's shots, says 16,410 doses were given, raising the seven-day average to 13,389 per day, the most in more than two months.
Chart by The Washington Post, adapted by Kentucky Health News; to enlarge, click on it.
In other pandemic news Friday:

  • Franklin County Schools said they would close next week due to a rising number of virus cases, and will offer students non-traditional instruction and work.
  • The Grayson County school board adjourned without finishing its business Thursday night "as tensions escalated and more audience members began speaking out of turn" about masks and other controversial subjects and "additional Leitchfield Police Department personnel responded," the Grayson County News-Gazette reports.
  • Senate President Robert Stivers did a "Kentucky Newsmakers" interview about the newly powerful legislature's approach to the pandemic. It will air Sunday at 6 a.m. on WKYT-27 and 10 a.m. on The CW Lexington, WKYT's digital channel 27.2.
  • The University of Kentucky says it's not taken vaccine mandates off the table, even as it expands incentives for vaccination, WKYT reports. Starting next week, unvaccinated students and employees must be tested weekly.

Thursday, August 26, 2021

State has second highest number of new cases; 1/3 of hospitals critically short of staff; Beshear says Ky. in 'uncharted territory'

Screenshot of KHN-adapted New York Times map; for interactive version, with local data, click here.
By Melissa Patrick and Al Cross
Kentucky Health News

As Kentucky hospitals struggle with enough beds and staff to care for Covid-19 patients, and the state recorded its second most coronavirus cases in one day, Gov. Andy Beshear said the state is in "uncharted territory." 

Beshear said Thursday that 32 of 96 of the state's hospitals, exactly one-third, are reporting critical staffing shortages. He said hospitalizations have increased for 42 consecutive days, setting daily records the last five days. 

"As horrible as last year’s surge was, and it was awful, we were never in a position where doctors worried they [would] need to choose between treating a patient who can't breath because of Covid or treat a patient who’s bleeding out because of a car accident. That’s the strain our hospitals are under," Beshear said at his weekly news conference. 

The state reported 5,401 new cases of the coronavirus Thursday, 1,759, or 32.56 percent, among Kentuckians 18 and younger. Even before that report, the state's 14-day infection rate was fourth in the nation, trailing Mississippi, Florida and Louisiana, according to The New York Times.

The percentage of Kentuckians testing positive for the virus in the last seven days set another record, 13.24%, and the state reported 27 more Covid-19 deaths, raising the seven-day average to 22 per day.

The state saw a similar surge last December and January. The difference between now and then, Beshear said, is that we know how to prevent it, how to make sure those hospital beds remain available for emergencies and routine care: "The difference between now in uncharted dangerous territory and before is we have the answer, they are the safe and effective vaccines."

Kentucky hospitals reported 2,115 Covid-19 patients, 41 more than Wednesday, with 590 of them in intensive-care units and 345 of those on mechanical ventilation. All set new records. The share of ICU patients being ventilated has increased; in the first week of August, it averaged 40%; Thursday, it was 58%. The Lake Cumberland hospital region became the first to report that all its ICU beds are full; 40% are occupied by Covid patients.

Beshear played a video from Dr. Mohan Rao, a Baptist Health Madisonville surgeon, who encouraged Kentuckians to get vaccinated, reporting that 19 of the hospital's 20 intensive-care beds are full, many of the beds are occupied by young people, and most of the patients on ventilators. 

"I thought last year that we had seen the worst of it, especially with the introduction of vaccines," Rao said. "And once we all got vaccinated, I thought that a lot of this would go away. Unfortunately, it's come back and it's come back pretty ugly, it's come back with a vengeance." 

Thanks to an extension in federal funding, the Kentucky National Guard will provide a variety of services across the state to help combat the virus between Sept. 1 and Dec. 30, including helping hospitals in ways that will free up staff. 

Also, the Federal Emergency Management Agency has approved the state's request for additional emergency medical personnel and will provide 30 additional staff and 15 ambulances. The state still awaits approval for a "nurse strike team," he said.

In addition, using money from the 2020 federal pandemic relief bill, the state is setting up four new sites to help the hardest-hit hospitals with testing. They will be in Danville, Corbin, Morehead and Pikeville.

The University of Kentucky has more Covid-19 patients than ever, 118. "This is more patients in the hospital than we had even last winter before we had a vaccine," she said. "We're just seeing more infections and more sick folks, and more young people as well," Dr. Ashley Montgomery-Yates, UK HealthCare's chief medical officer for inpatient and emergency services, said at a separate news conference. She also said they are seeing "a significant increase" in pregnant women with Covid.

Montgomery-Yates said this surge in patients has caused them to shift resources and to delay some elective surgeries, all while dealing with a nursing shortage that started long before Covid-19 ever hit and has only been exacerbated because of it. "And so now we are all existing in a world where we actually need more nurses, and we have less, and it's hard. It's hard on everybody," she said.

UK also announced that beginning Sept. 1, it will require weekly Covid-19 testing for all faculty, staff and students on campus who are unvaccinated.

Legislature faces questions 

Beshear's ability to deal with the pandemic has been limited by the state Supreme Court decision that upheld, for now, the 30-day limit on governors' emergency orders enacted by the 2021 General Assembly.

He said that if he still had the authority to do so, the 65 Covid-19 deaths reported yesterday, along with case numbers approaching 5,000 in one day, would have prompted him to impose another statewide mask mandate: “That would’ve been the trigger for me, if it was in my authority to put in a masking order for indoors across the state,” as the governor of Illinois did Thursday.

“Every other time we've been this high, we've done that and it's worked,” Beshear said. “I can’t do that now, and I get that. I’ll provide all the information I can to the General Assembly and hopefully, they will make the best choice that they can. . . . But I’m begging you out there, put on that mask.”

Beshear and Republican leaders are negotiating how to dissolve that court ruling, which means Kentucky's state of emergency related to the coronavirus will need to remain in effect until they tell Franklin Court Judge Phillip Shepherd how they want to proceed. Shepherd has asked them to come up with an agreed order within 10 days, Ryland Barton reports for Louisville's WFPL.  

Beshear said after an earlier event at Midway that he has now met with almost all Republican legislative leaders. He also said that the state school board's emergency regulation requiring masks to be worn in school is not in legal jeopardy from the newly effective laws or the Supreme Court's ruling.

Asked at his news conference why he wasn't able to simply issue a 30-day order for a statewide mask mandate, the governor explained that the state of emergency needed to declare such a mandate would expire sometime before that. The Supreme Court's decision will become final Sept. 10.

Being more careful

Beshear cancelled his appearance at the annual Kentucky Farm Bureau Country Ham Breakfast at the state fair, saying that he did so to model what needs to be done, especially after yesterday's high case and death numbers.

In a video for the audience, he said, "I know this event was pre-planned, I know you're doing your very best to stick by all of the safety protocols; folks, after today, please be as careful as you can. Our hospitals are overrun. And right now, the last thing we need to do is do things that make it more likely that we end up taking up a bed that somebody else may need."

At his news conference, Beshear again made the case for the state school board's mask rule, pointing to a North Carolina State University modeling study that showed without masks or regular testing, up to 90% of susceptible students may become infected by the end of this semester. The study demonstrated that, when used in combination, masks and testing can prevent 80% of new infections. 

With the death of Jamie Kennedy, an assistant football coach and health teacher at Greenup County High School, who reportedly died from complications of Covid-19 on Wednesday, schools in the county have been shut down for the rest of the week with no virtual learning, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. 

“The number of students and staff who are positive and or quarantined has greatly impacted our ability to operate buses, kitchens and maintain classroom staffing,” Greenup County Schools Superintendent Traysea Moresea said in a message to families.

At least six other school districts in Kentucky have closed for various time periods this school year, several with no virtual learning, Honeycutt Spears reports.

Most of them are in Eastern Kentucky, which continues to have most of the counties with the highest infection rates over the last seven days. The statewide rate is 81.73 per 100,000 residents; counties with rates more than double that are Clay, 256.3; Bell, 205.2; Whitley, 205.2; Owsley, 194.1; LaRue, 175.6; and Jackson, 165.1.

Morehead hospital is so desperate for staff that it may put coronavirus-positive nurses back to work, in its Covid-19 units

Drs. Adam Howard and William Melahn (St. Claire photo)
St. Claire Regional Medical Center in Morehead is so desperate for staff that it may bring back to work nurses who have tested positive for the coronavirus, and assign them to care for patients with Covid-19, Dr. William Melahn, the hospital's chief medical officer, said in a radio interview.

"If things get much worse, Melahn says St. Claire's will have to bring back nurses who have tested positive for Covid just to keep things running," Sheena Goodyear reports for the Canadian Broadcasting Corp.

"Yes, we have a plan for that, actually," and it's approved by the state Department for Public Health, Melahn told CBC's Peter Armstrong. "If we have Covid-positive staff who are … feeling well, that we can use them in Covid-only units. We have two Covid-only units that we can do that with, and that's certainly on the table already. I don't think we're doing it today, but it's on the table."

"We've hired two nurses in six weeks," Melahn said. "And nobody can find [nurses]. There's a really big hospital up the road about 100 miles from us. They are short 200 nurses." Cincinnati is 100 miles from Morehead.

Asked if there are nurses or doctors or hospital staff that could come from other parts of the U.S. to help, Melahn said, "What we're finding is everyone around is going through the same thing. That doesn't mean that all hope is lost. This week we declared, actually, an official disaster, and that allows us to make some flexible changes. We're a health system, so we have a system of rural clinics around us. We've already pulled all those nurses and some of those doctors in."

Sperling's Best Places map
Melahn noted that the hospital will be one of five in Kentucky to get help from the National Guard, a step Gov. Andy Beshear announced Monday. He said Thursday that the hospital "is in disaster mode."

The hospital's Covid-19 patient count has exploded. "Thirty-one days ago, we had one in-patient with Covid," Melahn said. "We usually take care of a total of 75 in-patients per day, all told. This afternoon, I have 67 Covid inpatients."

He said that's due to low vaccination rates in the area, which are driven by bad information. "We are not upset at our patients," he said. "We're upset about the disinformation or misinformation that's out there that really fills them with fear. What we have observed is this is a pandemic driven by fear. I mean, these people are afraid of being vaccinated."

Armstrong asked Melahn, "Do you have hope? Do you have a sense how to get to a brighter, better day?" Melahn replied, "Usually, in an infectious-disease pandemic, the more rapidly it rolls out, the more rapidly it falls off. So … if you want to call that a positive, that's something that we're looking forward to."