Thursday, September 30, 2021

October is Audiology Awareness Month, and hundreds of thousands of Kentuckians could benefit from hearing aids

October is National Audiology Awareness Month, and the state Commission on the Deaf and Hard of Hearing is urging the public to be aware of the importance of good hearing health and checkups.

The National Institute on Deafness and Other Communication Disorders says approximately 28.8 million Americans could benefit from the use of hearing aids. Age is a bug factor, but there are growing numbers of younger people reporting hearing difficulties, the commission says.

Gov. Andy Beshear said in a news release, “As a parent, I know how important it is to pay attention to the hearing health of your children and teens. Noise-induced hearing loss is preventable with proper protection and awareness about the dangers of loud sounds. If you suspect your child is experiencing a hearing loss, go see an audiologist.”

A study says untreated hearing loss during midlife is one of 12 risk factors for dementia, which typically begins many years before it is recognized. There is also a link between untreated hearing loss and falls.

One way to keep your hearing healthy is to be aware of the degree and amount of exposure to loud noises, which can damage the inner ear. Such damage is permanent, so people who can’t avoid loud sounds should wear hearing protection, the commission says: "An audiologist can help you identify the right hearing protection for you including custom hearing protection that can provide a comfortable fit and good sound quality."

How loud is too loud? The American Academy of Audiology says lengthy or repeated exposure to noise above 85 decibels can damage hearing. "An amplified music concert and an MP3 player with the volume turned all the way up can be as high (or higher) as 120 decibels," the release says. "Movie action scenes in the theater have been known to reach 100 decibels. Outdoor sounds can pose a risk too. Lawn mowers are around 85 decibels and chain saws can be 115-120 decibels."

The commission uses an "EARS" meme to help people remember the four main ways to protect your hearing:
Avoid loud sounds
Reduce the level of sounds
Shorten time in loud environments

“Anyone suspecting that his or her hearing has diminished should see an audiologist and get tested as soon as possible,” said Virginia Moore, executive director of the commission.

As hospital numbers keep falling, Senate again calls for special session on staffing shortages; Beshear says more work needed

Ky. Dept. for Public Health graph shows relative risk of coronavirus infection. To enlarge, click on it. 
By Melissa Patrick
Kentucky Health News

State Senate President Robert Stivers sent Gov. Andy Beshear a letter today, asking him to call a special session to address health-care staffing shortages that continue even as the pandemic slowly wanes. Beshear said more work needs to be done before a session, which only he can call.

"I think I was pretty clear that if we're gonna call a special session, they need to come meet with me, and I got a letter," Beshear said at his weekly news conference. "Also, no indication there has been any discussions whatsoever with the House. Again, the serious work that's required for a special session doesn't appear to have really been started in earnest, much less done. And we need to see a lot more." 

Sen. Robert Stivers
Stivers' letter opened with a response to comments Beshear made Sept. 20 that no plan had been put in front of him to address the issue and no one had asked to meet with him about it. "In fact," Stivers wrote, Senate Bill 8 of the recent special session laid out a plan to use $81 million of American Rescue Plan Act money, and there had been staff-to-staff discussion on whether Beshear could amend the special-session all to allow it. 

Beshear has said that all the ARPA money had been appropriated. Stivers' letter walks through several possible funding scenarios, including use of coronavirus relief money that will arrive during the current fiscal year and using the state's Budget Reserve Trust Fund, usually called the "rainy day fund."

"In short, the funding is there," Stivers wrote, closing with a statement that the Senate is "ready to work with you on this issue." The Senate and House are controlled by Republicans; Beshear is a Democrat.

Beshear said he has been talking to hospital groups about the staffing issue and remains unconvinced that funding from the state would solve the problem as opposed to escalating an "arms race with these different private nursing and other services." 

Hospital officials have said traveling-nurse staffing companies are paying their nurses upwards of $200 an hour, a rate they can't compete with.

Beshear said 63 of Kentucky's 96 acute-care hospitals report critical staffing shortages. He listed some of the many ways the state has helped hospitals throughout the pandemic, including an additional $1.8 million in Medicaid reimbursements, and said it would continue direct calls with them. 

Beshear responds to Stivers' letter
"But you know, there's policymaking and there's politics in Frankfort," he said. "I've shown that I can sit down and work with anyone and I'm willing to, but they have to be willing to sit down too. I'm still told that the written plan is the bill that was previously filed. Again, that doesn't show where the money is coming from, which is really, really important."

The proposal to use federal money to boost staffing in health-care facilities would be a short-term fix for a nagging problem that has been exacerbated by the pandemic.

Hospital leaders called for a long-term approach to the problem in a meeting with White House Vaccinations Coordinator Bechara Choucair during his visit with the Kentucky Hospital Association. 

"The shortage has been an issue in health care for many years before the pandemic, and although the current climate has highlighted these problems, a short-term solution will not solve the overall staffing shortage," the Kentucky Hospital Association said in a news release.

Covid-19 numbers in Kentucky hospitals dropped again Thursday. They reported 1,976 patients with the disease, down 19 from Wednesday; 566 in intensive care, down seven; and 381on mechanical ventilation, down three.

Seven of the state's hospital regions are using more than 90% of their intensive care unit beds, with Northern Kentucky at 100%. 

The governor called the declining numbers "generally good news," but cautioned that there are still a lot of Kentuckians dying from this virus. Kentucky reported 53 more Covid-19 deaths on Thursday, bringing the death toll to 8,770 and the average for the last seven days to 43.4 per day.

"This thing is deadlier than ever," Beshear said. "If you are unvaccinated it is incredibly deadly. And it's taken so many people.  Please don't make it take a family member before you're willing to get vaccinated. Because if you're willing to get vaccinated, it is still incredible protection against illness, against hospitalization and against death." 

From March 1 through Wednesday, 86.2% of coronavirus cases, 92.4% of Covid-19 hospital cases and 84.5% of Covid-19 deaths have been in unvaccinated or partially vaccinated Kentuckians.

Daily numbers: The state reported 2,510 new coronavirus cases Thursday, bringing the seven-day average down 227 to 3,051, the lowest since Aug. 18.

The percentage of Kentuckians testing positive for the virus in the last week increased a but, to 10.08%. This is the first day this rate's gone up in 22 days. The rate can be affected by the number of tests; today's daily report showed fewer tests than Wednesday's. 

Kentucky's infection rate over the last seven days dropped to sixth among the states, according to The New York Times

The state reported an infection rate of 60.34 daily cases per 100,000 residents. Counties with rates more than double that rate are Whitley, 141.4; McCreary, 131.8; Harlan, 129.1; and Owsley, 123.0.

Dept. for Public Health map, relabeled by Ky. Health News; colors
denote area development districts; each must have at least one center.
Treatment: Public Health Commissioner Steven Stack announced that the state launched a new webpage today that provides information about monoclonal antibody treatments and includes a map of 51 monoclonal-antibody treatment-administration centers across the state. 

Stack cautioned that supplies of the treatment are limited, while Covid-19 vaccinations are more readily available. 

“So when you contact a site, they’re going to use the current Food and Drug Administration criteria for who are the highest risk and the most in need, and they’re going to use that coupled with their supply to determine prioritization and who can get the treatment at that time," he said. "Obviously, the hope is the disease will go down, we’ll need less of this and everybody who needs it will have access. That's the hope. At the moment, that's not the reality." 

Beshear spoke more bluntly about the limited supply, saying, "Let me just say this, you cannot count on them to save your life if you are unvaccinated. . . . So please get vaccinated." 

Choucair, the White House vaccination coordinator, shared a similar sentiment as he urged Kentuckians "to focus on prevention of the Covid-19 virus by getting vaccinated instead of waiting to be treated after getting sick."

Wednesday, September 29, 2021

'I have never seen anything like it' in 40 years of hospital work, says administrator of Morehead hospital, still overrrun

St. Claire Regional Medical Center in Morehead (YouTube image via Daily Yonder)
Kentucky hospitals have seen fewer cases of Covid-19 lately, but the number who are in intensive care, with the majority of those on mechanical ventilation, still pose major challenges for hospitals, especially those that remain understaffed.

That is made clear by a chilling story in The Daily Yonder by Kentucky writer Liz Carey, about St. Claire Regional Medical Center in Morehead. CEO Don Lloyd told her that it's just an example of many hospitals facing their most difficult challenge ever.

“This fourth surge here in this region has been the worst of all the surges since the beginning of the pandemic,” Lloyd said. “It’s not only for St. Claire but for all the institutions throughout Kentucky, whether you’re in Western or Eastern or Central, it doesn’t make a difference; it’s just horrendous.”

In this surge, a much greater share of Covid-19 patients are critically ill. About half those at Morehead have used some sort of breathing apparatus, about half of those will be put on mechanical ventilation, and about 75 percent of those will die, Lloyd said. And keeping them alive is a big job, Carey writes:
Patients with Covid are often treated through what is called “proning,” he said. In this treatment, patients lay on their stomachs for a period of time before being turned over. But turning a patient isn’t as simple as flipping them onto their back.

“It requires six people to turn those patients because they’re still hooked to a ventilator, and they have all sorts of lines and drains in them,” he said. “You need to be very judicious and careful. At the very best, that is a 15- to 20-minute process. … When you have 22 people on ventilators, that’s a massive undertaking and utilization of clinical resources.”

To augment the clinical staff, the hospital has trained non-clinical staff to help with turning patients. Additionally, 30 nursing students are volunteering their time to help. But still, he said, there’s not enough nurses to care for the volume of patients the hospital is seeing.
Lloyd told Carey, “I’ve been doing this for 40 years,” he said. “I’ve been through, maybe 15 or so hurricanes up to a category 5 on a couple of occasions. I’ve been through man-made disasters, and terrible, terrible multi-vehicle accidents, but the death and carnage that I have witnessed and my teams have witnessed for almost two months now… I have never seen anything like it.

“I’ve had nurses that have just fallen apart after holding up an iPad so a family could say goodbye or holding the hand of somebody in ICU as they pass,” he said. “You know, it’s worth it. When you sign up for this business, you know, you have to do those things occasionally, but you don’t expect to do it five times in one shift.”

Covid-19 deaths in Kentucky are at record levels, as new coronavirus cases remain on a plateau and positive-test rate falls

Kentucky Health News graph, based on daily state reports
By Melissa Patrick
Kentucky Health News

Kentucky reported 82 more deaths from Covid-19 Wednesday, the most in a single day. The state's death toll from the coronavirus disease is now 8,717.

In the last week, the state has averaged reporting 42 deaths per day. The average was higher for more than two weeks in late January and early February, at one point reaching 47.3 deaths per day.

Gov. Andy Beshear said in a Facebook post that all the deaths reported Wednesday happened in August and September, and that they are hitting certain regions really hard, with 10 of them in Hardin County, six of them in Mercer County, and five in Pulaski County -- and in people who are "far too young" to lose.  

"So this is why we need everybody to get vaccinated. And this is why you should be masking up when you are indoors, in public, and outside of your home," the governor said.

New York Times chart; for a larger version, click on it.
The New York Times notes a correlation between high death rates and votes for Donald Trump in the last election. Kentucky lies exactly on the trendline of the scatterplot of states' death rates and their 2020 election results.

Deaths are considered a lagging indicator of the virus, so as cases drop the hope would be that deaths from the virus will eventually go down as well.

The good news is that the state's coronavirus case numbers continue to plateau and the positive-test rate continues to decline incrementally, although Beshear reiterated that it is still too high. Earlier in the pandemic, health officials said the positive-test rate needed to be under 5% for at least two weeks to slow the spread of the virus. 

The state reported 3,893 new coronavirus cases, with 32% of them in people 18 and younger. The seven-day average for cases is 3,278 per day. That's 65 less than Tuesday, when the average jumped by 166 after 12 days of decline.

The share of Kentuckians testing positive for the virus in the last seven days dropped for the 21st consecutive day, to 10.05%.

Hospital numbers also dropped again Wednesday. Kentucky hospitals reported 1,995 Covid-19 patients, down 11 from Wednesday; 573 intensive-care patients, down 15, and 384 patients on mechanical ventilation, down 11. 

Seven of the state's 10 hospital regions are using at least 80% of their intensive-care beds, and four are using more than 90%: Barren River, Bluegrass, Northern, and Southeast. 

Kentucky's infection rate over the last seven days remained fifth among the states, where it has hovered for several weeks, The New York Times reports. Alaska, West Virginia, Wyoming and Montana have higher rates than Kentucky. 

The state reported an infection rate of 64.84 daily cases per 100,000 residents. Counties with double that rate are Whitley, 144.2; Letcher, 142.5; McCreary, 132.7; and Magoffin, 130.4.

New York Times chart; for a larger version, click on it.
The Times notes, "The political divide over vaccinations is so large that almost every reliably blue state now has a higher vaccination rate than almost every reliably red state."

In the last seven days, a daily average of 11,984 doses of coronavirus vaccine were given in Kentucky, a 2% decrease over the previous seven, The Washington Post reports. 

Kentucky has administered at least one dose of a vaccine to 2.7 million people, covering 71% of the eligible population, 12 and older, and 60.5% of the state's entire population, according to the Post. At least 2.3 million Kentuckians have been fully vaccinated. 

One of the challenges in getting more people vaccinated is the rampant spread of misinformation about them. To address this, YouTube will remove videos spreading misinformation about any approved vaccine, not just those that target the Covid-19 vaccine, Clare Duffy reports for CNN. 

Duffy writes, "Users who post misinformation about any 'currently administered vaccines that are approved and confirmed to be safe and effective by local health authorities and the WHO' will have their videos taken down, and will be subject to YouTube's strike policy and could face removal, the company said in the blog post."

Primary Care Assn. launches targeted campaign of short videos to persuade high-school athletes to get coronavirus vaccine

The Kentucky Primary Care Association is launching a new digital advertising campaign to encourage high school student-athletes to get a coronavirus vaccination so high school sports events can go on as scheduled.

“Stay in the Game” uses geofencing digital technology to pinpoint sporting events and geographic areas. Videos lasting 15 seconds and 30 seconds will also appear on YouTube and other social media channels. "Digital news outlets across Kentucky are encouraged to use the ads on their social media and online news and information websites," said a press release from KPCA, which comprises community health centers, rural health clinics, primary care centers and other organizations.

“Fully vaccinated teenagers are much more likely to stay in the game, regardless of what sport they play,” KPCA Chief Operating Officer Molly Lewis said in the release. “Everyone wants the games, matches, meets, and other events to go on uninterrupted. If the players are vaccinated then they have a much better chance of getting in a full season. The vaccines provide the best shot for our high school student-athletes to safely play the games they love with their teammates, coaches, and family members by their side.”

The campaign is scheduled to last through Memorial Day 2022. It directs viewers to log on to to find a nearby vaccination site.

Tuesday, September 28, 2021

Ky. coronavirus cases and deaths are up, but so are vaccinations

Washington Post map, adapted by Kentucky Health News, shows vaccination rates in Kentucky and nearby states. For the state's interactive map showing vaccinations in Kentucky counties, click here
By Melissa Patrick
Kentucky Health News

Coronavirus case numbers and Covid-19 deaths surged in Kentucky Tuesday, but the percentage of Kentuckians testing positive for the virus in the last seven days and the state's hospital numbers dropped. 

Kentucky reported 4,551 new cases Tuesday, raising the seven-day average to 3,553. That was 166, or 5.2 percent, higher than Monday. Thirty-two percent of the cases, or 1,465, were in people 18 and younger. 

However, the percentage of Kentuckians testing positive for the virus in the last week dropped for the 20th straight day, to 10.40%.

The state reported 56 more Covid-19 deaths, making Tuesday the seventh deadliest day of the pandemic. The Louisville Courier Journal tells the story of Johnson Central High School's football head coach, Jim Matney, who died Tuesday after a month-long battle with the disease. The state's death toll is 8,635. In the last seven days the state has averaged 38 deaths per day.

Hospital numbers dropped again Tuesday. Kentucky hospitals reported 2,006 Covid-19 patients, down 39 from Monday; 588 in intensive care, down 29; and 395 on mechanical ventilation, down four. 

Six of the state's 10 hospital regions are using more than 80% of their intensive-care beds, with two of them at 100%: Northern Kentucky and Barren River, which includes Bowling Green and Glasgow.

Kentucky's infection rate over the last seven days dropped a slot in national rankings, to sixth among the states and territories, just behind Guam and just ahead of Idaho, The New York Times reports.

The state reported an infection rate of 65.95 daily cases per 100,000 residents. Counties with more than double that rate are Whitley, 154; Letcher, 152.4; Magoffin, 151.5; McCreary, 140.1; and Harlan, 129.1.

Kentucky's daily vaccination average rose 37% last week, ranking it second in the nation, behind Ohio, which saw a 55% increase after starting a new sweepstakes drawing for people aged 12 to 25 who get a shot. Gov. Andy Beshear expressed doubt Monday that such incentives would persuade unvaccinated Kentuckians.

Sixty percent of the state's total population has received at least one dose of a Covid-19 vaccine, which is 24th among the states. That includes 73% of Kentuckians18 and older and 47% aged 12 to 17. Over 2.7 million Kentuckians have received at least one shot. Kentucky's fully-vaccinated share, 52%, is 26th among the states.

Monday, September 27, 2021

Beshear asks Kentuckians not to unmask just because case numbers are dropping, warning that they are still way too high

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

New-case numbers and the percentage of Kentuckians testing positive for the coronavirus declined last week, which Gov. Andy Beshear called a "good sign" while stressing cases are "way too high" and need to start decreasing faster. He also urged Kentuckians to not let down their guard. 

"We've got to wear masks. Don't starting taking it off because you see cases starting to trail," Beshear said, noting that he can only encourage since the legislature took away his ability to impose a statewide mask mandate. 

Kentucky reported 6,463 coronavirus cases in the last three days. The seven-day average is 3,187, which is 302 lower than Friday and the lowest since Aug. 20.

The state reported 87 more Covid-19 deaths since Saturday, with 19 of them reported on Monday. The death toll is now 8,579. Over the last week, the state has averaged 34 Covid-19 deaths per day. 

After listing at least eight fatalities in their 30s and 40s over the weekend, Beshear said,  "If you’re in your 30s or in your 40s or in your 20s or below, you do need to get vaccinated as quickly as possible." 

Hospitals are reporting a decline in Covid-19 patients, although numbers in the intensive-care units aren't dropping as fast. Kentucky hospitals reported 2,045 Covid-19 patients on Monday, 617 in intensive care and 399 on mechanical ventilation. 

The hospital-cases number was 166 fewer than Friday. It went down 49 Saturday, fell by 117 Sunday, then stayed the same Monday. ICU numbers dropped to 608 Saturday, but rose to 609 Sunday and to 617 Monday. Patients on mechanical ventilation were 30 fewer on Monday than on Friday. 

Also, fewer hospital regions are reporting using more than 80% of their ICU beds, although two of them are reporting 100% capacity: Northern Kentucky and Lake Cumberland. 

Beshear said the state has 104 ICU beds available and 68 of the state's 96 acute-care hospitals are reporting critical staffing shortages. 

The share of Kentuckians testing positive for the virus in the past seven days dropped for the 19th straight day, to 10.55% 

Despite the declines, Kentucky's infection rate over the last seven days remains fifth among the states, The New York Times reports. The state reported an infection rate of 62.2 daily cases per 100,000 residents. Counties with rates more than double that rate are Magoffin, 168; Whitley, 165.5; Letcher, 155.1; McCreary, 142.6; Owsley, 132.7; and Harlan, 130.7. All are in Appalachia.
NYT graphs adapted by Ky. Health News shows Whitley County's new-case rate rose while the state's fell, and Magoffin County, which the state says has a slightly higher rate, has had an even worse trend.

Covid-19 vaccinations:
 From March 1 to Sept. 22, 86.7% of coronavirus cases, 92.1% of Covid-19 hospitalizations and 84.6% of Covid-19 deaths in Kentucky have been among the unvaccinated or partially vaccinated, according to a news release.

Sixty percent of the state's population has received at least one dose of a vaccine, as have 73% of those 18 and older and 71% of those 12 and older -- an increase of one percentage point. So far, 2.7 million Kentuckians have received at least one shot of a vaccine. 

Beshear cautioned that because the Delta variant is so much more contagious than earlier strains of the virus, we will need more than 70% of the population vaccinated to reach herd immunity.

At the Howard L. Bost Memorial Health Policy Forum last week, state Public Health Commissioner Steven Stack said the number of people needed to get vaccinated to reach "community immunity" is closer to 90%. 

Bottom line, Beshear said, a lot more people need to get vaccinated, especially those between the ages of 12-29 since at this time about half of this age group remains unvaccinated. 

The Washington Post reports that in the last week, an average of 14,577 doses per day of vaccine were given in Kentucky, a 37% increase over the week before that. That's the highest this number has been since June 20. 

Boosters: Beshear reviewed the federal guidance for those who are eligible for Pfizer-BioNTech booster shot six months after their second shot. They are individuals 65 and older; those living in long-term care facilities; people 19 to 64 with a medical condition that increases their risk of Covid-19 infection; and people 18 to 64 who are likely to get exposed at their place of work. 

"If you are eligible, go get them," he said. "There are plenty of vaccine doses out there." 

In addition, the governor said a third shot of the Pfizer or Moderna vaccine is available and recommended at least 28 days after the second shot for people who are immunocompromised.

At this time, there is no booster recommendations for those who have received the one-dose Johnson & Johnson vaccine. 

It is also important to know that you should not mix the vaccines, said Beshear. 

U.S. Senate Republican Leader Mitch McConnell has already received his Covid-19 booster, calling it an easy decision because he follows the best advice from experts and his own health care providers. 

“I am a survivor of childhood polio from before vaccines eradicated that disease here in our country and around the world. So I have been a lifelong champion of vaccinations," McConell said in a news release. “Mountains of evidence tell us these shots are safe, effective, and dramatically shrink the odds of severe disease or death from Covid. Like I’ve been saying for months: These safe and effective vaccines are the way to defend ourselves and our families from this terrible virus. They’re also how we stay on offense against Covid as a country. All Americans should speak with their doctors and get vaccinated.”

Treatment: Beshear announced that the federal government was sending five monoclonal antibody injection teams to help provide these treatments to Kentuckians with severe Covid-19.  

Today, a team arrived at Baptist Health Corbin; on Sept. 29, teams will arrive at Highlands ARH Regional Medical Center in Floyd County and Primary Care Centers of Eastern Kentucky; and on Oct 1, teams will arrive at Taylor Regional Hospital in Campbellsville and ARH Middlesboro. Each team will include two to four nurses and/or paramedics to assist with injections.

Beshear said the state will launch a webpage Thursday to show the 50-plus locations where treatments can be found, meeting the legislature's mandate that they be offered in each of the state's 15 area development districts. 

Beshear said the state is getting more of this treatment than was originally allocated, but it's important to know that "there is not going to be enough" for everyone who needs it.

Sunday, September 26, 2021

Appalachian Kentucky, especially the southeastern part of the state, is being devastated by the coronavirus

New York Times map, adapted by Ky. Health News, shows southeast Kentucky has been a hot spot.
Knox County, site of the photo, is the central county in the state's main hot spot. (Click map to enlarge)
Sisters Billie Mitchell, Anita Hudson and Teresa Davenport with
a photo of their father, Willie Hudson, who died of Covid-19.
They have since changed their minds about getting vaccinated.
(Photo by Alton Strupp, Louisville Courier Journal)
The Delta variant of the coronavirus "is cutting a devastating swath through Appalachian Kentucky," the Louisville Courier Journal reports.

Reporter Chris Kenning cites experts who blame experts "some of the nation’s highest poverty rates, less access to health care and a longstanding reluctance to seek care early, and pervasive smoking and chronic illness such as diabetes and lung disease that worsen Covid outcomes. All this mixes with a toxic brew of pandemic misinformation and politics."

Kenning's object example is Willie Hudson of Heidrick, near Barbourville, who had a cough and got tested on Aug. 15. "One of his daughters had Covid-19, but the family had spurned vaccinations," because they thought the vaccines were unproven or "might cause a stroke, they believed, and could be a government plot to track people," Kenning reports. "The virus, they heard, was being exaggerated for Democratic political gain. Ten days later, on Aug. 25, after gasping and thrashing, Willie Hudson died in a Kentucky hospital — leaving his daughters stunned, grieving and scrambling to get vaccinated."

Others have done likewise, but "so far vaccine rates are ticking up slowly and remain too low in many areas to provide a sufficient bulwark," Kenning reports. He cites a Corbin funeral director who has had the disease and held several funerals for victims but is skeptical of the vaccines: “If this shot is so good, why have they tried to bribe us to take it, to make us take it?”

Scott Lockard, public-health director of the Kentucky River District Health Department, told Kenning that misinformation isn't the only problem: “Somebody who doesn't engage in social media, doesn’t watch the news, primarily farms and comes to town a couple of times a month, they’re like, 'Well, I guess this Covid’s a pretty big deal, isn’t it?'”

Saturday, September 25, 2021

Crowd at Rupp Arena's biggest concert during the pandemic was almost entirely unmasked, making music writer feel unsafe on job

The crowd gathers for the Eric Church concert. (Herald-Leader photo by Estill Robinson)
“Masks are encouraged at today’s event,” read signs at the biggest concert at Rupp Arena since the start of the pandemic, a three-hour performance for 15,000 by country rocker Eric Church on Friday, Sept. 17. But Lexington Herald-Leader music writer Walter Tunis reports, "The 'suggestion' for the night was largely being shrugged off. To my eyes, the number of masked patrons was, at best, miniscule. Rupp employees were masked up. The bulk of the audience, however, seemed to view this concert event as business – or rather, pleasure – as usual. If there is one certainty to how any of us live our lives in a COVID-19 world, it’s that the term “as usual” no longer applies."

"In addition to no mask mandate, the Church concert did not have a vaccination/negative test requirement in place for admission. Being an indoor event simply added to the Covid queasiness. It did to mine, anyway. . . . I’m of a somewhat advanced age with a health issue or two, so mask wearing on my part was a done deal," Tunis wrote for the Herald-Leader Sept. 21. He said he felt safer at the Railbird festival at Keeneland Race Course, which drew 30,000 people but was outdoor sand required proof of a vaccination or a recent negative test. 

"I want events like Church’s concert to play out as much as anyone. I’ve been writing about live music events at Rupp and elsewhere for over four decades. It’s something I am immovably passionate about. But we live in an altered world where we have to become more selfless if this kind of art and entertainment can truly be considered safe. All of us have to do more – from artists to promoters to venues to, especially, patrons. We all deserve to feel safe. Last weekend at Rupp, I simply didn’t."

Tunis concluded, "What we have to wrap our heads around is the fact we aren’t back to normal in dealing with Covid. We’re not even close. . . . We have to do more to protect ourselves and especially others. Otherwise, the normalcy our country is literally dying for will slip further out of reach."

Friday, September 24, 2021

Rural news media need to promote vaccination, not just by delivering facts to quash misinformation, but by example

By Al Cross
Director, Institute for Rural Journalism and Community Issues, University of Ky.

Millions of Americans say they have decided not to get vaccinated to protect themselves, their families and their neighbors from the coronavirus, but polling and anecdotal evidence show that some will change their minds. News media have a role to play in that, especially in rural America, where vaccination rates are lower than the rest of the nation, sometimes dangerously lower.

Few vaccine-hesitant or -resistant people are likely to be persuaded by a news story or editorial urging vaccination, but it's important to keep delivering facts about the vaccines, because social media are awash with misinformation about them. And there's another way to promote the shots: lead by example.

That's what Alan Gibson, editor and publisher of the Clinton County News in Albany, did this week. On the back page of the newspaper is a "house ad" telling readers that the paper's entire staff of five is vaccinated and urging readers to do likewise.

Gibson told me he got the idea from the Kentucky Chamber of Commerce's "Covid Stops Here" campaign, which provides signs that businesses can download and print to display their level of vaccination, and lets them post their logos to do likewise.

Gibson knew his staff was fully vaccinated. "I thought, we should promote this," he said. Why? "We're one of the hardest-hit counties in the nation but we're one of the slowest to get vaccinated." And he thought it would be better to persuade by example than to lecture: "Do as I do, you know? I'm tired of arguing with people, because the arguments aren’t valid." He said it's worth the effort "if just one or two people look at it and say, 'I need to go ahead and do this.'"

Clinton County (Wikipedia map)
Gibson could be called a beacon in a wilderness. Only two other newspapers have their logos posted on the Kentucky Chamber site, and they're in the state's most highly vaccinated counties: The State Journal of Frankfort, in Franklin County, and The Woodford Sun, in Versailles; 79% and 77% of the adjoining Bluegrass counties' vaccine-eligible residents, respectively, are fully vaccinated. In Clinton County, where I grew up, it's only 38%.

As editor and publisher of Kentucky Health News, I send a weekly update to Kentucky editors. A few weeks ago, I told them, "There is no more immediately pressing public interest in this country than persuading people to get vaccinated, and local medical professionals and news media are more trusted than those at state and national levels. Please do your part. It's a slog, but if the heroes of public health can do it, so can we."

Even with Kentucky's anxiety and depression rates dropping since January, the state still ranks ninth for this measure in the U.S.


By Melissa Patrick
Kentucky Health News

While rates of anxiety and depression in Kentucky are among the top 10 states in the nation, the good news is that since January, those rates have dropped. Those findings are consistent with what is going on across the nation, according to an analysis of Centers for Disease Control and Prevention data. 

"Our team of analysts found that while anxiety and depression levels increased during the first year of the pandemic, they have decreased dramatically throughout 2021," says the Quote Wizard report. "We found that nationwide, the number of people dealing with anxiety or depression increased by 6.3% in 2020 and has decreased by 23% throughout 2021." 

In Kentucky, that rate dropped 19% throughout 2021, with 34% of people in Kentucky reporting symptoms of anxiety or depression -- the ninth highest rate in the nation.

Marie Timmerman, executive director of Mental Health America of Kentucky, said she wasn't surprised by these results, pointing to all of the uncertainty that Kentuckians experienced at the height of the pandemic as the likely cause for the increase in symptoms of depression and anxiety. 

"The coronavirus pandemic exacerbated the mental-health and substance-use-disorder pandemic in Kentucky," Timmerman said in an e-mail. "I'm not surprised that anxiety and depression symptoms were going down as vaccines were becoming more widely available over the spring and summer months." 

The Quote Wizard analysis did not address substance-use disorders, but the state's latest overdose report found that drug-overdose deaths in Kentucky rose 49% in 2020.

The analysis also looked at rates of anxiety and rates of depression in each state separately. In Kentucky 30% of people surveyed in August reported experiencing anxiety, a drop of 19% since the beginning of the year. The highest this rate has been in Kentucky during the pandemic is 38%, the report says. 

Twenty-four percent of Kentuckians reported being depressed in August 2021, a drop of 22% since January. During the pandemic, the highest this rate got was 31%. 

Nationwide, women reported having higher anxiety and depression levels than men, while older and more educated Americans have some of the lowest levels, says the report. 

The researchers note that the decline in the number of people experiencing symptoms of anxiety and depression coincides with a decline in the number of coronavirus cases and the easing of lockdown restrictions. 

However, with the current surge in cases and subsequent restrictions -- whether required or suggested -- they also note that only time will tell if this new round of cases and restrictions will lead to an increase in anxiety and depression levels. 

Timmerman encouraged Kentuckians to take a free Mental Health America of Kentucky mental health screening if they are concerned about their mental health. Click here for the link. For more resources or information, reach out to or call 859-684-7778. 

"It's okay to have bad days," she said. "It's a real concern, though, when bad days become bad weeks that interfere with your ability to work or to attend to the activities of daily living. If you're not sure if your mental health symptoms are a result of the day-to-day stress or are something more, a mental health screening is a great way to find out." 

New virus cases keep slowing, but patients in ICUs and on ventilation rise slightly as ICU beds remain in short supply

Ky. Dept. for Public Health map, adapted by Ky. Health News; for the interactive version, click here.
By Al Cross
Kentucky Health News

The pace of the pandemic in Kentucky continued to slow slightly on Friday, but the number of very sick and critically sick patients went up, intensive-care beds continued to run short, and Lexington mourned a 15-year-old dead of Covid-19.

The state reported 3,941 new cases of the coronavirus, lowering the seven-day rolling average by 80, to 3,489, the lowest in a month. The New York Times ranks the state's infection rate fifth among the states, behind Alaska, West Virginia, Wyoming and Montana. Kentucky is the only state in the top five with a declining rate (8 percent) over the last two weeks.

However, six counties in Kentucky were in the top 12 in the nation, and 14 of the top 25, according to the Times analysis of Centers for Disease Control and Prevention data. Russell was second (behind Andrews County, Texas), Whitley was third, Magoffin seventh, Perry eighth, Taylor 11th, Harlan 12th, McCreary 15th, Knox 16th, Barren 18th, Letcher 20th, Monroe 21st, Metcalfe 23rd, Rockcastle 24th and Wayne 25th. All are in Appalachia except Barren and Taylor, which border the region.

The state Department for Public Health, which uses different reporting methodologies, reported a seven-day infection rate of 68.45 daily cases per 100,000 residents, down for the ninth straight day. Counties with rate more than double that rate on the state report were Magoffin, 180.9; Whitley, 171.4; Owsley, 161.8; Leslie, 157.7; Harlan, 157.6; Monroe, 156.9; Letcher, 145.8; Barren, 143.3; Metcalfe, 137.6; and Rockcastle, 132.6.

The Barren River hospital region (Allen, Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Monroe, Simpson and Warren counties) reported all of its intensive-care-unit beds in use, and only one of the 10 regions, the northeast, reported fewer than 90% of its ICU beds occupied. The western region (Christian, Daviess, Hancock, Henderson, Hopkins, McLean, Muhlenberg, Ohio, Todd, Union and Webster counties) reported 65% of its ICU capacity being used by Covid-19 patients; others ranged from 34% to 56%.

Overall, 93% of ICU beds were in use, and only 107 were available.

Hospitals reported 2,211 Covid-19 patients, 12 fewer than Thursday, but the number in intensive care and on mechanical ventilation went up; the ICU census rose to 632, from 625; and those on ventilators rose to 429 from 424.

The state reported 26 more Covid-19 deaths, for a total of 8,492. Two fatalities were in their 20s, and a 15-year-old boy in Lexington died of the disease Thursday, WKYT-TV reports. Gov. Andy Beshear ordered flags to be flown at half-staff in memory of student C.J. Gordon Jr. and all Covid victims.
Daily coronavirus vaccinations in Kentucky continued a slow decline, according to CDC data analyzed by The Washington Post. The latest daily number was 11,600 doses, lowering the seven-day average to 11,242. That was 11% lower than the previous seven-day period.

CDC Director Rochelle Walensky slightly expanded her advisers' recommendation of who should qualify for a booster shot of the Pfizer-BioNTech vaccine, adding "front-line workers like nurses, teachers and grocery-store employees, in addition to Americans 65 and older and "many adults with underlying health conditions," The Wall Street Journal reports.

Thursday, September 23, 2021

Covid-19 metrics all fall Thur., but Beshear sees 'very dangerous situation' that could worsen; hospitals seek state funds for staffing

Ky. Health News graph; daily new cases are from initial, unadjusted reports; click image to enlarge.
By Melissa Patrick
Kentucky Health News

With every metric used to measure the coronavirus in Kentucky down Thursday, Gov. Andy Beshear said it's too early to celebrate, largely because all the numbers are still too high. 

"It's overall good news, but we're still in a very dangerous situation, is how I would describe it," Beshear said at his regular Thursday news conference. "You've gotta stop growing before you can start shrinking. But we really need to start shrinking a whole lot faster." 

The state reported 4,099 new cases of the coronavirus Thursday, lowering the seven-day average to 3,569 per day, the lowest in a month and a drop of more than 200 from Wednesday's seven-day average.

The percentage of Kentuckians testing positive for the virus in the last seven days dropped for the 15th day in a row, to 11.33%. 

And all of Thursday's hospital numbers dropped. Kentucky hospitals reported 2,223 Covid-19 patients, 34 fewer than Wednesday; 625 patients in intensive care, down 26; and 424 on mechanical ventilation, down 29.

Beshear cautioned that many of the hospitals are at a breaking point, so it is imperative that the state continue on its downward trajectory, noting that other states have seen resurgences after declines, and if hospitalizations returned to an exponential increase, "every single hospital will be overrun." He said 64 of the state's 96 acute-care hospitals are reporting critical staff shortages.

On Thursday, only two of the state's 10 hospital readiness regions reported using fewer than 80% of their intensive-care beds, the northeast and easternmost regions. Beshear said the state had 130 intensive beds available; a week ago, it had fewer than 100.

On Wednesday, Nancy Galvagni, president of the Kentucky Hospital Association, told the Interim Joint Committee on Health, Welfare, and Family Services that Kentucky hospitals had added nearly 200 more intensive-care beds in the last three weeks to meet demand, and even with that, fewer are available than in August. 

Galvagni told the committee about the struggles hospitals are having with staffing and asked the lawmakers to "support an appropriation to help hospitals retain our current staff and recruit additional staff," noting that other states, like Arkansas, have already done so. 

Sen. Ralph Alvarado, R-Winchester, said some American Rescue Plan Act funds could be moved from other programs, and reiterated his plea for Beshear to call a special session to help hospitals recruit and retain staff.

Asked about that, Beshear said, "First, let me say that we all run for these jobs and in any of those elections, you know, folks win  and folks lose, and it's hard either way. I mean, I've certainly been with my family through the losses. I've been fortunate to have some wins too. What's difficult and strains relationships and abilities to work together. And sometimes the things that you'll hear and say is when it can kind of grab us and it's hard to let go of and it can, it can make working relationships difficult." 

The Democratic governor reiterated that no one has come to him personally and asked for a special session, and no one has presented him with a spending plan, which would need to be agreed on before having such a session. "Is it real, or are people pushing different things for different reasons?" he asked, without explaning.

Beshear said he would also needs more information from hospitals about how much money they need, what it would be used for and whether it would be effective.

Asked if he would consider using the state's unappropriated "rainy day" surplus to boost hospital staffing, which Sen. Robert Stivers told the Louisville Courier Journal could be an option, Beshear didn't answer directly, but noted several times that the legislature has limited his ability to make emergency use of such funds.

Beshear spoke at length about what he has done to help hospitals, including an additional $1.8 million in Medicaid reimbursements. He noted several state and federal initiatives to ease staff shortages, including deployment of 505 National Guard members to 29 hospitals; getting Federal Emergency Management Agency strike teams to help with emergency medical services, health care, and testing; allowing nursing students to provide care; and, most recently, the addition of AmeriCorps volunteers. 

He said the best way to help with hospital staffing issues is to decrease the number of patients, which could be done if more people would get vaccinated and everyone would wear a mask when indoors and away from your home. 

From March 1 to Sept. 22 in Kentucky, 86.7% of coronavirus cases, 92.1% of Covid-19 hospitalizations and 84.5% of Covid deaths in Kentucky are in people who are unvaccinated or partially vaccinated, Beshear said. He showed new graphs that showed with few exceptions, since July, most of the people who have died under the age of 49 were not vaccinated.

Washington Post chart adapted by Ky. Health News; click to enlarge
Beshear announced that 60% of Kentucky's total population has now received at least one dose of a coronavirus vaccine. Among those eligible to be vaccinated, 12 and older, 70% have received at least one dose; among those 18 and older, it's 72%. 

The governor urged those 12 to 29 to get vaccinated, noting that their vaccination rates are among the lowest and they are getting infected the most; 51% of those aged 18 to 29 have received at least one dose of a vaccine, and 47% of those 12 to 17 have. 

"We need more people to get vaccinated," Beshear said. "Remember, you can choose to get a shot that protects you, it's really safe, over half the country has already taken it. Or you can rely on infusions and potentially a machine just to help you breathe, hoping that they can keep you alive. The shot is a lot more effective, and a lot less intrusive."

Beshear said 90 acute-care hospitals in Kentucky have administered 4,385 infusions of monoclonal  antibodies, from a federal allocation of 4,950. "There’s not going to be enough," he warned. "Don’t put yourself in the position where you show up hoping to get these and we’ve run out."

More daily numbers: Kentucky has the fourth highest infection rate among the states over the last seven days, according to The New York Times. It trails Alaska, West Virginia and Wyoming. (The territory of Guam is third.)

The state reported an infection rate of 71.45 daily cases per 100,000 residents, the eighth straight day of decline. Counties with rates more than double that rate are Magoffin, 183.3; Whitley, 174.9; Harlan, 174.1; Leslie, 167.8; Rockcastle, 164.3; Barren, 160.1; Monroe, 154.3; Metcalfe, 153.2; and Owsley, 145.6.

Kentucky reported 44 more Covid-19 deaths, for a total of 8,466. Over the last seven days, the average is 37 deaths per day.

Wednesday, September 22, 2021

Covid-19 is killing 40 Kentuckians a day; 453 are on ventilators; state's seven-day infection rate still ranks third in the nation

National Guard members work in the UK HealthCare
warehouse. (Photo by Marcus Dorsey, Herald-Leader)
By Al Cross
Kentucky Health News

Most measures of the pandemic in Kentucky inched down Wednesday, except the most serious: deaths and Covid-19 patients on mechanical ventilation.

The state reported 52 Covid-19 deaths, raising the total to 8,422 and the average over the last seven days to 40 per day. The dead included a 34-year-old from McCreary County, a 36-year-old from LaRue County, a 38-year-old from Johnson County and a 39-year-old from Kenton County.

"This is hitting people far younger than we ever saw previously in the pandemic," Gov. Andy Beshear said in a Facebook video in which he read the ages and counties of several victims younger than 60.

Hospitals reported 2,257 Covid-19 patients, 30 fewer than Tuesday, and 651 on intensive care, down 13, but the number on ventilation rose by eight, to 453. The record of 463 was set six days earlier.

Though "Kentucky hospitals have added nearly 200 more staffed intensive care unit beds in the last month," fewer were available Tuesday than in late August, the president of the Kentucky Hospital Association told a legislative committee, reports Alex Acquisto of the Lexington Herald-Leader. National Guard members are at 25 hospitals to free up clinical staff.

The state reported 4,418 new coronavirus cases, cutting the seven-day rolling average by 140, to 3,772, the lowest in almost a month. And the percentage of Kentuckians testing positive for the virus fell to 11.66%. The figure has fallen daily for two weeks, but "That's still far too high," Beshear said. he has said that the decline could be partly due to more testing, prompted by more cases.

Kentucky still has the nation's third-highest infection rate over the last seven days, according to The New York Times, trailing Alaska and West Virginia.

The state reported a seven-day infection rate of 73.89 daily cases per 100,000 residents. Counties with rates more than double that rate were Rockcastle, 190.8; Harlan, 189.5; Whitley, 189.5; Leslie, 173.6; Magoffin, 163.3; Powell, 163; Metcalfe, 156; Barren, 155; Monroe, 151.6; Knox, 151.4; and Wolfe, 149.7. 

"Please get vaccinated," Beshear said. "It gives you the best protection out of anything out there."

The Food and Drug Administration authorized booster shots of the Pfizer-BioNTech vaccine for people 65 and older, adults at risk of severe illness form Covid-19 and people “whose frequent institutional or occupational exposure” puts them at high risk of serious complications from the disease.

"The FDA "took an approach similar to what was recommended Friday by the agency’s outside panel of vaccine experts, but the agency interpreted the advisory panel’s guidance broadly to cover a larger swath of people," The Washington Post reports. "The FDA action is not the final step before the booster is made available. The Centers for Disease Control and Prevention and its advisers still must recommend in detail who should receive the shots."

Dr. Peter Hotez, a Baylor University vaccine specialist, told NBC News that he always expected the vaccine to require three doses, but that wasn't well explained to the public. He also said he thought people in their 40s and 50s should be allowed to get booster shots.

Tuesday, September 21, 2021

Just 20% of Ky. adults say a health-care provider has contacted them about a Covid-19 shot; only 14% say their health insurer has

By Al Cross and Melissa Patrick
Kentucky Health News

Only one in five Kentuckians say they have been contacted by a health professional about getting a Covid-19 vaccine, and just one in seven say have been contacted for that reason by their health-insurance provider, according to a statewide poll taken Aug. 4 through Sept. 4.

Twenty percent of adults said a doctor, nurse or other health professional had contacted them about vaccination, and only 14% said their health-insurance provider had, the poll for the Foundation for a Healthy Kentucky discovered.

Foundation President and CEO Ben Chandler announced the poll results during the foundation's annual Howard L. Bost Memorial Health Policy Forum. He said the results for health-care professionals were "a little bit surprising" and those for health-insurance providers were "a real shocker." 

"What this tells us, I think, is that we have a lot of work to do," Chandler said. "Would doctors and health insurance providers reaching out have made a difference in where we are today? Well, I don't know the answer to that. But I do think . . . it's certainly worth a try in the future to think about seeing if we could figure out a way to get doctors and to get insurance companies to reach out more effectively and, and in a systematic way to the people who have not gotten vaccinated." 

The poll also found that Kentucky adults said they would take recommendations on vaccines from their health-care providers, but for reasons unknown the providers have not reached out to them much, Chandler said.

The poll asked Kentucky adults if they agreed with this statement: "Generally, I do what my doctor or health-care provider recommends about vaccines for me." Sixty percent strongly agreed, 22% agreed somewhat, 1% leaned toward agreeing, 9% disagreed somewhat, 6% strongly disagreed and 2% said they didn't know. The older and better educated the respondent, the more likely they were to agree.

The poll, which had an error margin of plus or minus 4.3 percentage points, found that 27% of adults who had not taken a Covid-19 vaccine said they strongly agreed that they would take their vaccine recommendations from their doctor. Chandler said that suggests that one-third of Kentuckians might be persuaded by their doctor or other health-care provider to get a Covid-19 shot. Just over half have received one dose of a vaccine so far.

"We may be able to figure out a way to create a system where this could happen," Chandler said. "I think we could maybe make up some ground if we did that."

Cory Meadows of the Kentucky Medical Association, the lobby for physicians, was asked during a forum panel discussion about vaccine messaging why more providers aren't reaching out to their patients. He said it could be due partly to their a heavier-than-usual workload after pandemic slowdowns last year.

"I do think there's a practical side to it," Meadows said. "Given the workload and the patient load that they have . . . the real side of it right now is catching up on a lot of stuff. But I do think that many of them are starting to have those conversations, especially during this Delta surge."

Dr. Brent Wright of Glasgow while moderating a panel on the first day of the forum said it's difficult to have 15-minute conversations to explain vaccines and when you are running 30 minutes behind already.

Meadows acknowledged that some health-care providers may be reluctant to bring up the controversial topic of Covid-19 vaccination for fear of losing patients, but said that while they may be careful to soften their tone, he did not think that was a significant factor. 

"There may be a certain element to that," he said. "I think physicians try to be sensitive to patients' concerns. However, I think given the severity of this virus, especially with the Delta surge, I don't sense, at least in my conversations with physicians, that that's holding a lot of them back. . . . I think given the severity of the situation, that barrier is not there, maybe it would be in normal times so as not to offend their patient."

The poll found little statistical difference among various groups of Kentuckians, but the results suggested differences among educational levels. College graduates appeared least likely to say they had been contacted by a health professional, but appeared most likely to be contacted by their health insurer.

Conversely, those with a high-school diploma or less education seemed most likely to say they had been contacted by a health professional, and among the least likely to say they had been contacted by their health insurer. 

More than a third of Kentuckians get free health care through Medicaid, a federal-state program for the low-income and disabled. State government uses insurance-company subsidiaries to manage relations with Medicaid beneficiaries, who have a low vaccination rate.

Any possibility that the beneficiaries may not think of managed-care firms as a "health-insurance provider," the wording used in the poll question, did not arise when the poll was field-tested before it was conducted, pollster Eric Rademacher of the University of Cincinnati told Kentucky Health News.

The Kentucky Association of Health Plans, the lobby for insurance companies in the state, said it had engaged in "unprecedented outreach campaigns" with community partners, using "calls, texts, emails, letters, social media, events, giveaways, and promotions to encourage commercial and Medicaid plan members to receive the Covid-19 vaccine."

KAHP's latest gambit is a sweepstakes for Medicaid beneficiaries, with 20 Disney World trips as the prizes. At least some All managed-care organizations are offering Medicaid beneficiaries cash bonuses for getting vaccinated, KAHP spokesman Tyler Glick said.

Some pandemic metrics inch down in Ky.; hospital numbers up

Ky. Health News graph; new daily cases are initial, unadjusted numbers; to enlarge, click on it.
By Melissa Patrick
Kentucky Health News

The state reported 3,391 new coronavirus cases Tuesday, lowering the seven-day average by 91, to 3,912, almost to the level that it was eight days ago when it was lowered by the post-Labor Day lull.

But Kentucky hospitals reported 2,287 Covid-19 patients, 33 more than Monday; 664 were in intensive care, up 10; and 445 were on mechanical ventilation, down seven. Seven of the state's 10 hospital-readiness regions are using more than 92% of their intensive-care beds. 

The New York Times data shows Kentucky's seven-day infection rate ranks third, behind Alaska and West Virginia, and says Russell and McCreary counties have the nation's highest infection rates. National and state reporting differ due to methodology; the state eliminates duplicate tests.

The state reported a daily new-case rate over the last seven days of 75.74 per 100,000 residents. Counties with rates more than double that rate are Rockcastle, 196.8; Whitley, 190.7; Powell, 187.3; Harlan, 174.1; Monroe, 173.0; Metcalfe, 160.3; Barren, 159.2; Leslie, 156.2; Perry, 155.8; and Magoffin, 152.7.

The percentage of Kentuckians testing positive in the past seven days dropped for the 13th straight day, to 11.95%. Gov. Andy Beshear said last week that could be due to more testing, but Monday he said it could be a good sign.

The Kentucky Army National Guard has been deployed to University of Kentucky hospitals to give "non-clinical logistical and administrative support," Alex Acquisto reports for the Lexington Herald-Leader. 

Chris Kenning of the Louisville Courier Journal offers a snapshot of how a clinic in Perry County is handling the pandemic in a county that has had some of the highest rates of in the nation.  

“It never stops. We’re open 13 hours most days, and it never ends,” nurse Katie Cornett told Kenning, adding that patients tend to show up sicker with the Delta variant. “We have to send a lot to the hospital, unfortunately.”

The state reported 31 more Covid-19 deaths on Tuesday, bringing the death toll to 8,370. The seven-day average is 39 per day.

A third employee at Lee County Elementary School, counselor Rhonda Estes, has died from Covid-19. So did Matt Cockrell, a Shelby County High School teacher, Valarie Honeycutt Spears of the Herald-Leader reports, noting that a teacher union reported last week "that at least 33 Kentucky school employees had died of Covid-19. The latest two deaths raises that toll to at least 35."

Getting more Kentuckians vaccinated would bring all of these numbers down. Kentucky is behind national vaccination rates, with 51.2% of its population fully vaccinated, and 59.8% with at least one dose. The national rates are 54.8% and 63.9%. Among the state's vaccine-eligible population, those 12 and older, 70.2% have had at least one dose. In the last seven days, an average of 12,513 doses per day were administered, a 11% increase over the week before, according to The Washington Post.

Monday, September 20, 2021

Poll and falling vaccination rates spark concern that Covid-19 conflicts make Kentuckians skeptical of long-accepted vaccines

Poll found that 27.3% of Kentucky adults said not all CDC-recommended vaccines are beneficial.
By Melissa Patrick
Kentucky Health News

The first day of the Foundation for a Healthy Kentucky's annual health policy forum addressed vaccine hesitancy, which the foundation's latest poll and other information show may be spreading to affect public attitudes toward all vaccines, not just those developed to fight the coronavirus.

The day also included a dire warning from the state's top doctor that it's time for vaccines to be seen like other public safety measures that lower the risk for serious harm -- like requiring the use of seat belts -- because he hasn't seen hospitals under so much distress in his 25 years in health care. 

"I've never seen all of health care across whole states on the brink of collapse in the hospitals. And yet, that's where we are right now," Health Commissioner Steven Stack said, after being asked how the unvaccinated should be persuaded that they have an obligation to society to become immunized.

"As far as societal obligation, I really think that these vaccines for Covid have now reached the point where it's essential," Stack said. "Everybody should get these vaccines, because the consequences being worn by all of society are so adverse, that it no longer becomes reasonable for society to accept those consequences." 

Stack said 90% of new coronavirus cases in Kentucky are among the unvaccinated, as are 91% of Covid-19 hospital patients and 85% of those who have died from it recently, "so here we have yet another example of the incredible power of vaccination and immunization to prevent horrible, horrible adverse harm."

While 59% of the state's total population and 72% of those 18 and older have received at least one dose of a coronavirus vaccine, Stack cautioned that there are still counties that have vaccinated less than 34% of their populations with one dose, which puts them "in incredible danger from Covid."

Further, he said the Delta variant is so contagious that for herd immunity to protect the unvaccinated, "We probably now have to have a vaccination rate over 90%," not the previously assumed 75 to 80%. 

That is a tall order, since a fifth of Kentuckians in the foundation's poll said they would probably not or definitely not get vaccinated. That was an improvement from 29% in the previous poll, taken in late winter, but Ben Chandler, president and CEO of the foundation, voiced concern that unfounded controversies about the Covid-19 vaccines are undermining confidence in other vaccines.

In the most recent poll, taken Aug. 4-Sept. 4, seven in 10 Kentucky adults agreed that all recommended, routine vaccines are beneficial; four out of five agreed that being vaccinated is important to the health of a community; and 90% said they believe vaccination is a good way to protect themselves from disease.

But when asked if all routine vaccines recommended by the Centers for Disease Control and Prevention are beneficial, 27% said they disagreed. And only three in five said all children should be required to be vaccinated, and three out of seven said parents should be able to block vaccination of their children.

Stack pointed out that rates of vaccination for many childhood diseases declined 20% last year, mainly when the state and nation were in the initial pandemic lockdown, and have not recovered to previous levels.

Chandler said, "We believe the issue of declining public confidence in vaccines is a burgeoning crisis," and noted that the World Health Organization calls vaccine hesitancy one of the top 10 threats to global health.

"Any decline in these numbers is cause for concern," he said. "Decisions made by parents today and actions taken by our legislators today will lead to results that we may not see for years. We cannot take our vaccine policies for granted. History has shown us lapses in protection can cause future pandemics, impacting people's health, our economy, and the future of our civilization." 

Most recently, Kentucky passed a law during the 2020 legislative session that added a "conscientiously held belief" exemption for any child or adult in Kentucky who doesn't want to receive a vaccine that the state mandates during an epidemic or a pandemic. 

The poll also took a look at hesitancy about the influenza vaccine, finding that almost two-thirds of Kentucky adults said they are very or somewhat likely to get the vaccine by the end of the year; 28.4% said they were very unlikely to get the flu vaccine and 5.9% said they were somewhat unlikely to get it.  

The most recent poll, conducted by the Institute for Policy Research at the University of Cincinnati, included more than 500 adults who were contacted by both landline and cell phones. Its margin of error is plus or minus 4.3 percentage points. Read the briefs here.

The annual Howard L. Bost Memorial Health Policy Forum, being held Monday and Tuesday, is sponsored by the foundation and Aetna Better Health of Kentucky.

Beshear says he's glad to see so many districts masking up, but predicts some will abandon mandates when county goes orange

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

Gov. Andy Beshear, who was skeptical that local school officials would keep the mask mandate the legislature stopped him from imposing, said Monday that he was cheered to see 166 of the 171 school districts still requiring masks.

But he predicted that more will go mask-optional as their counties' infection rates move from red to orange on the state's infection map.

"I am heartened by the fact that this many school districts are currently masking, but my concern is . . . orange is dangerous too. If a county moved down to orange, they still need universal masking. But we know, the way the pressures will work, is that we will lose districts that are there when we desperately need them to keep the masking."

Kentucky Health News had asked Beshear if he was surprised at the number of districts with mask mandates, in light of Senate President Robert Stivers' statement Friday that Beshear should have more faith in local officials. Beshear, a Democrat, began his answer with what amounted to a reply to Stivers, a Republican.

"To say the General Assembly was successful because most school districts aren't requiring universal masking is like saying they'd be successful if most kids weren't neglected," he said. "So what we've got is at least six school districts where the kids are in huge amounts of danger."

Beshear apparently based his number of the Kentucky School Boards Association's masking map, which shows Gallatin County as mask-optional though it just started a temporary two-week mask mandate. The mask-optional districts are Burgin, Mercer County, Lyon County, Science Hill and Clinton County, which is one of three counties in orange on the map.

"The districts don't have the courage to do the very basic to protect them from a very aggressive disease," Beshear said. "When I had the ability, 100 percent of school districts were doing universal masking, because it's the right call and I had the courage to make it, and not simply hand it over to others that are exposed to significantly more pressure," including "attempted bullying."

Beshear complimented the state House for derailing legislation that would have kept schools and businesses from requiring masks. "The pressure of leading in the midst of a pandemic is significant," he said.

Ky. Dept. for Public Health graph, relabeled by Ky. Health News; for a larger version, click on it.
Beshear spoke as the state's coronavirus case numbers remained on a rough plateau but the number of deaths kept trending upward and getting younger.

"We cannot sustain a plateau at this level, with the number of people it would put in the hospital," the governor said.

He said Saturday was the worst day yet for staffing at Kentucky hospitals, with 74 of the 96 acute-care hospitals reporting critical staff shortages. That dropped to 63 by Monday.
The state reported 88 deaths Saturday, Sunday and Monday; the seven-day average was 40 per day on Sunday and 38 on Monday. The average over the last 14 days is 31 per day. The pandemic death toll is now 8,339.

Beshear read the age, sex and county of several young victims, including three men from Bell County, 23, 37 and 41; two women from adjoining Whitley County, 36 and 39; a 22-year-old man from Carter County; and two 36-year-old women, from Bullitt and Lewis counties. He also noted relatively high numbers of deaths in small counties, including four in Nicholas, census population 7,343.

The Monday-to-Sunday reporting week had the third highest number of cases in the pandemic, up slightly from the week before; Beshear said that confirmed a slight lull caused by the Labor Day holiday. The state's seven-day average of new cases is 4,003 per day, 395 less than the record 4,398 on Sept 5.

"I want to make sure we don't view this as good news, because a plateau will continue to push our hospitals over capacity," Beshear said. He played a video from Sherrie May, nursing supervisor at Baptist Health Corbin, who said her staff is suffering post-traumatic stress disorder "just as a soldier would in a time of war. . . . This is like a war zone to us." Mays said.

Her voice choking, she said, "My heart breaks for my staff. They've put this hospital and their patients ahead of their families."

Beshear said three more Kentucky hospitals that are already being getting logistical and administrative assistance from the National Guard have applied for FEMA nurse "strike teams."

In response to a question, the governor said he had not heard of any deaths related to lack of care at a too-busy hospital, but "It's absolutely going to happen. . . . I worry about that bus accident."

Kentucky hospitals' Covid-19 patient counts have declined for six straight days, but the number in intensive care and on mechanical ventilation haven't slacked much. Hospitals reported 2,254 Covid patients Monday, 654 of them in intensive care and 452 on mechanical ventilation.

Hospitals will be getting fewer monoclonal antibodies, a treatment that can be effective early in a Covid case, because the federal government has begun rationing them. Beshear said the state gave more than 5,000 infusions last week but would get only 4,960 this week, and the number will drop in later weeks.

Because whole families are now being infected by the more contagious Delta variant, Beshear said, hospitals may have to decide which members of a family will get the treatment. He said that's another reason to get vaccinated, which is much less invasive than the infusions.

The share of Kentuckians testing positive for the virus in the last seven days dropped for the 12th straight day, to 12.18%, but the governor said that is still much too high. "We would hope it's the start of a decline," he said, "but it's way too early to suggest that."

He said 70 percent of eligible Kentuckians, those 12 and older, have now received at least one dose of a vaccine, but that is not enough to thwart the Delta variant. He displayed a graph showing that unvaccinated or partially vaccinated people are 4.5 times more likely to test positive than those who are vaccinated.

"It's really important, as we move forward, that we get back to trusting those who have studied something for decades, more than what we read that day on the internet," he said. "We've got to reclaim reason, and science, and push out the craziness."