Tuesday, August 17, 2021

Ky. risks running out of hospital and ICU beds, governor warns

State Dept. for Public Health graph, relabeled by Ky. Health News; to enlarge, click on it.

By Melissa Patrick

Kentucky Health News

As the surge of Covid-19 cases continues to escalate in Kentucky, from a strain of the coronavirus that is making people sicker than before, Kentucky is at risk of running out of intensive-care beds in its hospitals.

"The situation is serious and alarming, and we are rapidly approaching critical," Gov. Andy Beshear said at a press conference about the pandemic.

And the prospect for the near future is not good, since the percentage of Kentuckians testing positive for the virus is higher than ever, 12.47%, and has risen 52 out of the last 53 days.

Use of intensive-care units and ventilators are expected to reach an all time high in another day or two, because they show a "vertical climb," with "no sign that is abating," Health Commissioner Steven Stack said.

"What we're finding across the states is this disease, this version of Covid, the Delta variant, is hitting people harder, they are getting sicker and they are younger," so more people are ending up in ICUs than in a regular hospital bed, and "We could find ourselves in trouble real fast," Stack warned. "This will cascade and it will get worse."

Beshear said, "By the end of this week, we expect to have more Kentuckians in the hospital battling Covid than at any point in this pandemic." 

Stack also noted that the state has a record 17 young people hospitalized with Covid-19, breaking the previous record of 12 in December. Beshear said, "Your kids are at a greater risk than they have been."

Kentucky Health News graph; click on it to enlarge.
Hospitals are worried about having enough staff to handle the load. Beshear said the state is working on being able to count staffed beds across the state, but at this time the best measure of that metric is anecdotal reporting by individual hospitals. 

He said hospitals in Western Kentucky are either at or near capacity, with Jennie Stuart Health Center in Hopkinsville reporting a 500% increase in Covid-19 patients in the last two weeks; Baptist Health hospitals in Paducah and Madisonville near capacity; and The Medical Center at Bowling Green reporting that its ICU is full. 

In northeastern Kentucky, St. Clair Healthcare in Morehead had to create a Covid-19 ICU surge unit to handle its overflow of Covid-19 patients, Beshear said.

Beshear said there is no need for a field hospital at this time, largely because each hospital has individual plans for how to handle a surge of Covid-19 patients. He said the equipment to open such a hospital is ready, but it would be a challenge to find enough health-care workers to man it. 

"We are going to hit that point where we need more help," said Beshear.

Asked if he is considering emergency orders to fight the virus, Beshear again said that at this time there will not be "any form of shutdown" or "any type of capacity restriction,"  although a statewide mask mandate is "under active consideration."

"That's where we are, that at least has to be a part of the conversation because if we run out of beds for people, if we run out of beds for people who are injured or sick or have a heart attack, don't we have to do something? Don't we have to do something to make sure we've got that capacity for everybody. And so that's under active consideration," said Beshear. 

School mask regulations

While Beshear was providing the Covid update, the legislature's Administrative Regulation Review Subcommittee was hearing testimony on two emergency regulations, one from the Kentucky Department of Education and the other from the state Department for Public Health, to require masks in schools.

After several hours of testimony, the committee voted on party lines, 5-2, that both measures were deficient, a finding that would make the regulations expire at the end of the 2022 General Assembly. It also send the regulations back to Beshear for his review. "He determined within an hour that the mask regulation would remain in effect," Olivia Krauth and Joe Sonka report for the Louisville Courier-Journal. 

KDE spokeswoman Toni Konz Tatman told the paper, "We hold that the board’s emergency regulation was appropriate, within the board’s legal authority, and that the process followed to put it in place was sound. We all look forward to the day when these mitigation efforts become unnecessary."

One arguments against the regulations was that masks don't work. Asked about this, Stack said there is "countless different types of evidence" that show they do, pointing to how cases of other respiratory illnesses have plummeted in the last year as people have worn masks to thwart the coronavirus.

Stack also pointed to federal reports that show how the transmission of the virus is reduced when masks are worn. "People who are going out there and saying false and demonstrably inaccurate information about the utility and value of masks about the safety and importance of vaccinations to prevent this disease are killing people," he said.

Beshear said of the committee meeting, "This is what happens when politics runs over public health or common sense." He later added, "We've got to separate those that are going to challenge direct truth and facts simply because they wish the reality was different."

Beshear added that the Centers for Disease Control and Prevention, the Kentucky Department of Public Health, every health department director in the state and the American Academy of Pediatrics and the Kentucky Chamber of Commerce recommends universal masking for students. 

Daily numbers: Again, every metric to measure the coronavirus in Kentucky is on the rise. 

The state reported 3,276 new cases of the virus Tuesday, with 849 of them in Kentuckians 18 and younger. That brings the seven-day rolling average to 2,820 per day, almost double what it was two weeks ago. 

Eight more Covid-19 deaths were reported Tuesday, bringing the death toll to 7,459. The daily death average rose again, to 9.3.

Hospitals reported 1,603 Covid-19 patients, 441 of them in intensive care and 238 of those on  mechanical ventilation. 

Two of the state's 10 hospital-readiness regions are using at least 80% of their ICU beds: the easternmost region, from Pike to Lee counties, at 87%, and Lake Cumberland, at 91%. 

The new-case rate is 60.23 per 100,000 residents. Counties with rates more than double the state rate are Clay, 221; Union, 146; Laurel, 133; and Floyd, 130.

Vaccinations: All of this is preventable if enough people get vaccinated, Stack said. 

Beshear said vaccinations are on the uptick in Kentucky, with 2.4 million Kentuckians having received at least one dose of a vaccine. Sixty-six percent of Kentuckians 18 and older have received at least one dose of a vaccine. 

Stack said a booster is recommended for anyone who is considered immunosuppressed and that includes anyone living in a long-term care facility.

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