2nd highest day for new cases; 2/3 of hospitals say staff critically short; Beshear says health system in state could be overwhelmed

Ky. Health News graph; new-case data from initial, unadjusted daily reports; click to enlarge.

By Al Cross

Kentucky Health News

Kentucky's health-care system is in danger of being overwhelmed by the pandemic, Gov. Andy Beshear warned Thursday, as the state reported the second largest number of coronavirus cases in one day and set another record for Covid-19 patients in hospitals.

The state reported 5,457 new cases, second only to the 5,742 reported Jan. 6, at the height of the pandemic.

"It's spreading like wildfire," Beshear said, and adding that two-thirds of Kentucky's acute-care hospitals are reporting "critical staff shortages."

"These numbers are growing every day," he said. "Our hospitals are already on the brink. . . . That precipitous climb can result in us running out of health-care capacity."

As an example, he cited Twin Lakes Regional Medical Center in Leitchfield, which blew a transformer and transferred patients whose care required electricity, but has been unable to bring any of them back because the hospital is "already full again."

Beshear said some hospitals are getting help from the Kentucky National Guard and three have been approved for nurses from the Federal Emergency Management Agency, starting with St. Claire Regional Medical Center in Morehead, but he said he wasn't sure when they would arrive.

Asked what constitutes a critical nursing shortage, Beshear said that is mostly defined by hospitals, but it means "You're terribly worried about the next day."

National Guard teams arrived at St. Claire and hospitals in Bowling Green, Pikeville and Hazard to handle non-clinical work so clinical staff can be freed to provide care. Beshear thanked Louisville's Galen College of Nursing for providing qualified nursing students to help out. 

Galen CEO Mark Vogt said, "I wish I had the magic words . . . We are imploring you to get vaccinated. . . . I want to ask you to have courageous conversations, to reach out to family members and ask them to consider getting vaccinated."

Beshear said, "I so wish that I had those magic words. It's breaking that Thanksgiving-dinner rule and having a difficult conversation with someone you love that is not vaccinated. The fact you're willing to put your relationship with them on the line speaks volumes to how serious this is and how much you care about them, and it may be the one thing that gets it done." 

In his effort to promote vaccination, Beshear played videos from doctors at hospitals in Glasgow and Somerset. Dr. Ted Qualls, emergency-medicine physician at Lake Cumberland Regional Hospital, said, "The hardest part of what we're facing right now is knowing that much of this is avoidable, but with your help we can turn the tide against Covid in Kentucky. . . . Vaccination is the primary way that we will avoid overwhelming our health-care system."

Washington Post chart, adapted by Kentucky Health News;
for a larger version, click on it; the interactive version is here.

Daily reports of vaccinations continued to increase, raising the seven-day average 14,489, the highest since June 20. Beshear said more that 200,000 vaccine doses were given in August.

The Delta variant of the virus is causing some infections in vaccinated people, but few of those cases result in hospitalization. Displaying the latest data, Beshear said the "breakthrough" rate of new virus cases in Kentucky was actually higher in April, before Delta arrived.

Beshear displayed a graph showing that in April, cases in unvaccinated people outnumbered those in vaccinated people by more that 4 to 1. In August, the ratio was more than 6 to 1.

Kentucky hospitals reported 2,315 Covid-19 patients Thursday, 620 of them in intensive care and 408 on mechanical ventilation. Beshear said some people on ventilators are not in intensive care, but are at hospitals without intensive-care units, an unusual situation.

 

He said the state asked the federal government for 40 more ventilators because some of the old ones it has haven't performed well, and warned that the state should prepare for shortages of oxygen.

The state's seven-day infection rate rose to a new high, 89.45 daily cases per 100,000 residents. Counties with rates more than double that rate were all in Kentucky's southeastern quadrant: Owsley, 265; Perry, 257; Leslie, 228.5; Bell, 221; Clay, 206; Wolfe, 200; Whitley, 193; Powell, 188; and Breathitt, 187.

The state's rate is the fourth highest in the nation, trailing Tennessee, Alabama and South Carolina, according to The New York Times.

The state's daily report said 1,774 of the new cases, or 32.5 percent, were in Kentuckians 18 and younger. Beshear said some are being ventilated, and "I can't imagine what it must feel like to look at your child needing a machine to help them breathe."

The state reported 45 more Covid-19 deaths, the 20th largest daily total of the 18-month pandemic.

The share of Kentuckians testing positive for the virus dipped for the second day in a row, to 13.29%, but Beshear said that was likely due to more testing.

Legislative matters: One big issue between Beshear and legislators he will soon call into a special session is likely to be his authority to require face coverings to thwart the spread of the virus.

"There are some tools that I believe we need that they are going to have to decide . . . whether we get," Beshear said. "That's certainly masking. General masking. Whether that is the power to do it when necessary, or the power to do it in high-transmission areas."

Every county is now a high-transmission area, under both state and federal definitions. Beshear added, "I think there is a big difference in the outcome in whether we have the authority on masking and whether we don't, and that's something they'll have to look at."

The governor said he has been "meeting around the clock with legislative leaders trying to come to common ground" and a session could begin as early as Tuesday.