As Covid-19 sets hospital records, Beshear calls out National Guard to help, meets with legislators empowered by high court

State Department for Public Health graph

By Melissa Patrick and Al Cross
Kentucky Health News

As Gov. Andy Beshear shifts to a new role of executing and not making pandemic policy, at a time when coronavirus cases are surging and hospitals fear they will run out of beds, he has mobilized the Kentucky National Guard for help and is still talking about a statewide indoor mask mandate. 

"It appears that we are moving from alarming to a critical stage, and the future next couple of weeks to couple months looks like they're going to be very, very rough," Beshear said at his Monday pandemic news briefing. He said he has begun discussing next steps with legislative leaders, in the wake of Saturday's Supreme Court decision upholding new laws that limit governors' emergency powers.

Beshear said starting Sept. 1, the National Guard will provide support to hospitals, health departments and food banks, with the initial deployment to include 75 guardsmen, in five teams of 15 people. The teams will initially go to Pikeville Medical Center, The Medical Center at Bowling Green and St. Claire Regional Medical Center in Morehead.

One of the slides Gov. Andy Beshear showed at his press conference

Beshear said he has asked the Federal Emergency Management Agency for support for understaffed hospitals and emergency medical services. If approved, the help would go to Baptist Health Hardin in Elizabethtown, Saint Joseph London, Pikeville, Bowling Green and St. Claire, whose dire straits were highlighted in a live video.

Dr. William Melahn, chief medical officer at St. Claire, said the Morehead hospital is working under a "code yellow" disaster plan and has a critical nursing staff shortage. He said its Covid-19 patient count recently rose form 17 to 32, and another 32 patients who would typically have been hospitalized are being cared for by the hospital's home-health team.

Melahn estimated that 85% of the hospital's Covid-19 patients are unvaccinated, and that the vaccinated ones are not as sick, while all the critical-care patients are unvaccinated. He said more vaccinations would alleviate some of the strain.

"There’s two reasons to be vaccinated. One is to protect you, and the other is to protect people around you," he said. "Let me just point out a little bit of reality here: If we had another disaster happen  now – even a small one – we don’t have any reserve left. So if we had a bus accident . . . or whatever, I’m not sure what we would do. So, vaccination is clearly what is going to get us out of this." 

Steve Haines, critical-care nursing director at Danville's Ephraim McDowell Regional Medical Center, called the latest surge "pretty horrific." He said his hospital had eight Covid-19 deaths in 24 hours over the weekend, and only has three holding rooms in its morgue.

"We wouldn't have to work so hard to help our community if more people were vaccinated," he said. "And right now it just looks like there is no end. And I think the only chance we have is vaccination, and that's it." At that point, he broke down and spoke no more.

Beshear said between 21 and 25 regional hospitals have a critical staffing shortage and up to 11 have a nursing shortage.

Every county but Robertson is in the red zone. The top 10 infection rates
are in Clay, Magoffin, Whitley, Bell, Jackson, Laurel, Owsley, Union and
Floyd counties. All but Union are in Eastern Kentucky. (Click to enlarge)

Daily numbers: The state broke its previous record for Covid-19 hospitalizations Saturday, and the numbers kept rising Sunday and Monday, when hospitals reported 1,893 Covid-19 patients, 523 of them in intensive care and 301 of those on mechanical ventilation.

Beshear said hospitalizations are doubling every two weeks and the state is getting close to all its beds being full. He said many hospitals are already converting space to accommodate a surge in Covid-19 patients, are not doing procedures that require an overnight stay and some have moved into a modified disaster mode. One is already in full disaster mode. 

The state reported 2,596 new cases of the coronavirus Monday, 695 of them in Kentuckians 18 and younger. Beshear noted that in August 2020, 10-to-19-year-olds made up 11.8% of the cases, but so far this month, it has been 20.6%. 

He said the weekly case numbers are showing exponential growth and that the weekly increases are "faster and steeper than anything that we have seen to date. And it does not look like it is slowing down." He said this is the third highest week for cases since the pandemic began. 

The state reported 17 more Covid-19 deaths, seven in people younger than 60, bringing the death toll to 7,558. The average for the last week is 10.4 deaths per day, the first time it has been in double figures since April 4.

The share of Kentuckians testing positive for the virus in the past seven days fell to 12.87% Monday after hitting 13.01% Sunday, the highest since testing became widely available 15 months ago. 

"So here we are, at a time when we have vaccines, when we know that masks work, with our third highest week of cases ever and the highest positivity. That means Covid is burning through our population here in Kentucky," said Beshear.

A new role: Beshear said the state is “reaching the point where a statewide mask mandate is absolutely necessary because we’ve gotta have hospital beds,” but said that will be up to the legislature because of Saturday's Supreme Court decision limiting his emergency orders to 30 days unless adopted by the legislature.

“What we can do is gonna be more limited, depending on what the legislature decides,” he said. “Up to now I’ve carried the football. I've been able to make the tough, unpopular decisions. . . . I foresee the legislature needing to make a lot of calls from here forward.”

Beshear, a Democrat, said he met with Senate leaders Monday and has had phone conversations with members in both chambers, which Republicans control, but did not seek any reaction to the idea of a mask mandate because he wants to provide information and give them time to consider it.

Asked why he rescinded the broader school mask mandate he issued before the state school board issued one for public schools, Beshear noted that legislators had opposed it, and “Hopefully it was a good step to try to be able to take some time and have some conversations and hopefully come to the best place we can about moving forward.”

He said the mandate issued by the state school board, limited to public schools, should not be affected by the Supreme Court ruling, but that appears to be a likely point of legal argument in Franklin Circuit Court and the appellate courts. Earlier, Beshear pointed to several Kentucky schools that have postponed classes due to Covid-19, including most recently Leslie County, saying “We fail when we don't require universal masking.”

He said his talks with legislators “have primarily been on stuff we hope to find agreement on. . . . There are some kind of no-brainers that hopefully everybody will agree to,” such as his emergency certification out-of-state doctors and nurses and special workers' compensation rules for front-line health workers.

“Our talks have been constructive; it has been a good dialogue,” he said. “From what I’ve seen in the last couple of days it’s being taken seriously. . . . I think in the very least, we've hopefully come to an agreement on some basic tools we're using to fight this, and then maybe it’ll take deeper conversation for the others.”

Asked if he would require state workers to be vaccinated now that the Pfizer vaccine has received full approval, he said "Anything having to do with mandates on vaccines would now have to be decided by the state legislature; I think that’s a really big policy decision," one he hasn't broached with legislators.

Beshear said he expects to call a special legislative session because the state of emergency he declared will expire in 20 days, when the Supreme Court decision becomes final.

The governor said he was surprised by the decision because the court upheld his emergency orders last year. “I think at least part of the court had a change of heart.”

Vaccinations: The Food and Drug Administration gave final approval to the Pfizer BioNTech vaccine Monday. Beshear said that will prompt more national companies to require employees to get it, and "some" Kentuckians will now take the vaccine because of this final approval.

A Kaiser Family Foundation survey found that three in 10 unvaccinated adults said they would be more likely to get vaccinated after they move to final approval. Beyond that, Beshear said, "There's just a group, and we don’t know how big it is, that is fully politically opposed to vaccinations for whatever reason, and it doesn’t look science is gonna help there.

"For them it’s someone they love and care about that is being willing to have a conversation that might end their friendship . . . At the stage we are at, that’s the most effective thing people can do; if they don’t I’m not sure there’s any other way to reach certain folks."

Beshear said 31,847 vaccine doses were given in Kentucky over the weekend and through reporting time today. In all, 56% of the state's total population has received at least one dose of a vaccine and 67% of those 18 and older.

State Department for Public Health chart shows "breakthrough" cases in vaccinated people increased in July, when the Delta variant of the coronavirus became dominant in Kentucky.