The Covid-19 pandemic devastated many nurses' mental health, and workplace racism made it worse, two recent studies find

Shannon Simonovich and Kashica Webber-Ritchey and
other faculty and students at DePaul interviewed nurses.

Nurses from all backgrounds have felt immense stress during the Covid-19 pandemic, but for nurses of color, pandemic-related stress was compounded by stress from workplace racism.

That news comes from two studies looking at the emotional well-being of nurses in 2020. The first was done by researchers at DePaul University in Chicago. The researchers conducted interviews with a diverse group of 100 nurses from May to September 2020 to assess their emotions. Nurses reported moral distress related to knowing how to treat patients and protect themselves, but not having the staff, equipment or information they needed. As a result, they reported feeling fear, frustration, powerlessness and guilt. The research is published in the journal SAGE Open Nursing.

According to Shannon Simonovich, the study's principal researcher, many news stories about health-care heroes featured white female nurses, but nurses from many different backgrounds with varying education levels cared for Covid-19 patients. Simonovich recruited a diverse group of DePaul researchers for the study, which in turn helped recruit a diverse group of nurses to be interviewed, according to coauthor Kashica Webber-Ritchey. “We captured the voices of diverse nurses caring for a diverse patient population ... proportionately impacted by Covid-19,” Webber-Ritchey said. In the DePaul sample, 65% of the nurses identified as a member of a racial, ethnic, or gender minority group.

The study's findings are supported by another study from Rutgers University, which found that nurses of color were suffering from a "dual pandemic" because of the emotional distress caused by Covid-19 and workplace racism.

In September 2020, during a lull in the pandemic, the researchers surveyed nearly 800 nurses working in acute-care hospitals in New Jersey. Participants completed online questionnaires that asked about indicators of emotional distress, Covid-19 worry and concerns, workplace racial climate, workplace racial microaggression experiences, and demographic information. The study, published in Behavioral Medicine, concluded the following:

• Nonwhite nurses reported significantly higher levels of emotional distress and overall worry about Covid-19.
• A higher percentage of nonwhite nurses (61%) were very worried about Covid compared with the percentage of white nurses (41%) who were very worried.
• Nonwhite nurses perceived more negative racial climates, with Black nurses reporting the most negative climates.
• Nonwhite nurses experienced more racial microaggression experiences, and Black nurses experienced the highest number of racial microaggressions compared with all other racial groups.

Both study authors expressed how important nurses' psychological needs are. “Taking time to speak to nurses to understand their needs and provide support would help with addressing moral distress,” Webber-Ritchey said.

CDC says certain people in Bourbon, Henderson, Nicholas and Union counties should mask up in indoor public spaces

CDC map shows Union, Henderson, Bourbon and Nicholas counties with a medium level of Covid-19.

By Al Cross

Kentucky Health News

Four Kentucky counties are back in yellow on the national Covid-19 risk map, meaning certain people there are advised to wear masks in indoor public spaces, says the Centers for Disease Control and Prevention.

The latest weekly CDC map shows a medium level of the coronavirus in Union and Henderson counties in northwestern Kentucky and in Bourbon and Nicholas counties in the eastern Bluegrass region.

The CDC says people in those counties who are immunocompromised, or at high risk for severe illness from the virus, should talk to a health-care provider about whether they need to wear a mask or take other precautions.

The weekly ratings are based on new virus cases, Covid-19 hospitalizations and the percentage of staffed inpatient beds occupied by Covid-19 patients.

The report accompanying the map shows that the percentage of Kentuckians testing positive for the virus continues to increase, approaching 8 percent. It says the positive-test rate for the last week was 5% to 7.9%, with an average of 350 cases per day.

The state's latest weekly report, which was issued Monday, said the positive-test rate for the week ended Sunday was 4.35%, with an average of 428 new cases per day. Thursday's CDC report said the latest seven-day total was 2,450 cases, an average of 350 cases per day.

The CDC report shows several Kentucky counties have high levels of virus transmission, but low or moderate levels of Covid-19, perhaps indicating local effectiveness of preventive measures such as vaccinations, social distancing and masking.

Centers for Disease Control and Prevention map

OPINION: Insurers say killing bill hospitals, pharmacists backed against pharmacy benefit managers saved Kentuckians money

By Tom Stephens
Executive Director, Kentucky Association of Health Care Plans

Pocketbook issues were front and center in this most recent session of the Kentucky General Assembly as runaway inflation at the national level continues to outpace wage gains. Lawmakers and the governor worked to ease inflationary burdens for working families by offering relief on hefty vehicle property tax increases caused by a pandemic surge in used car values. The General Assembly also moved to lower the personal income tax to keep more dollars in taxpayer wallets.

Tom Stephens

There were encouraging policy moves in health care as well. One driver of cost increases are government health-benefit mandates, which can add as much as 5 percent to coverage premiums. Kentucky has more healthcare mandates than the national average, but with a few exceptions, legislators largely resisted pressure from powerful lobbying groups to add more in 2022. This was a big win for Kentucky businesses and employees.

One group, the Kentucky Pharmacists Association, worked with an independent pharmacist in the General Assembly to introduce HB 203, a lengthy mandate bill that would have added a minimum $10.64 dispensing fee (5 times the current rate) to Kentuckians’ prescription drugs. The legislation also would have ended quality-driven, pay-for-performance contracts, significantly limiting the ability of companies and health plans to negotiate better pharmacy prices for their employees and members. This would have created a guaranteed payday for high-cost pharmacists. To further tip the scales in their favor, a pharmacist-controlled board would have been established to set future policies on prescription drugs.

As part of their legislative strategy, the pharmacists worked to broaden support for HB 203 and ratchet up pressure by allowing lobbyists for certain hospital systems to insert monopolistic provisions on specialty drugs (medications administered by a provider through injection or infusion typically, in a hospital outpatient setting or a provider’s office). This measure effectively banned a successful innovation known as “white bagging” or “alternate sourcing,” whereby health plans and businesses fight hospital price gouging by using specialty pharmacies to safely distribute these drugs.

Sensing a growing concern over the costs and complexity of the bill, proponents quickly pulled HB 203 before an official Kentucky Department of Insurance cost assessment could be posted. A Pharmaceutical Care Management Association analysis estimated that HB 203 would have increased prescription drug costs by a staggering $5 billion over the next decade. (Editor's note: PCMA lobbies for pharmacy benefit managers, firms that are middlemen between insurance and drug companies, determining what drugs are offered, at what price, and how much pharmacists are paid.)

Immediately upon withdrawing HB 203, a slightly revised bill, HB 457, was introduced. It also drew heavy opposition from multiple Kentucky employers, including the Kentucky Association of Manufacturers, General Electric, Mercer and dozens of other Kentucky employers. The Kentucky Association of Health Underwriters rang the alarm: “This bill does nothing to address the cost of prescription drugs, it’s going to do the opposite.” The Kentucky Association of Health Plans pointed to the negative impacts by reminding legislators that the Department of Insurance statement showed a family of four would have paid up to $167 more a year for health coverage.

Fortunately for Kentucky businesses and individuals, HB 457 was not enacted into law. Senate President Robert Stivers illuminated HB 457’s potential effects in an end-of-session press conference when he said, “we started getting, from the business sector and the provider sector, comments and questions about what the overall cost would be to various plans because it would have cost impact on various health insurance plans, including potential fiscal impact to the state employees’ health plan.”

Kentucky businesses would be wise to stay vigilant and continue to raise their voices against expensive health care mandates and disruptions in the healthcare marketplace through legislation that does not have broad support from all stakeholders.

KAHP Executive Director Tom Stephens can be reached at tom@kahp.org.

USA Today reports on its analysis of Covid-19 deaths in nursing homes last winter, with a focus on Trilogy Health Services

Some Trilogy Health Services residents who died of Covid-19 (Photos contributed to USA Today)

USA Today recently published its findings from an in-depth analysis that looked at Covid-19 nursing home deaths during the 2020-21 winter surge, with a focus on one company that had twice the national average of deaths for nursing homes and has as many as 20 facilities in Kentucky. 

The year-long analysis was done by Letitia Stein, Jayme Fraser, Nick Penzenstadler and freelancer Jeff Kelly Lowenstein. It was published mid-March as a series of  stories, titled "Dying for Care."  

USA Today says, "In a first-of-its-kind analysis, they identified nursing-home ownership webs invisible to consumers. They scored the performance of every nursing home in America to probe questions of corporate responsibility left unanswered by government regulators and dozens of research papers on the pandemic's 140,000-plus nursing home deaths."

The series opens with pictures of people who died in nursing homes of Trilogy Health Services, found to have the "highest death rates reported by any large nursing home chain at the height of the pandemic."  

The analysis found that residents in Trilogy's 115 homes died of Covid-19 last winter at twice the national average for nursing homes, based on figures facilities must file weekly with the federal government. 

After being presented with USA Today's findings, the company told the newspaper that it had mistakenly reported hundreds of deaths during the surge and offered a revised tally that reduced the count by more than 40 percent, but it declined to provide documentation of those claims. It has since "filed new numbers with the federal government and hired a consultant to help it review its death count," the newspaper reports. 

But even with those lower numbers, the paper found Trilogy's Covid-19 death rates were "well above the national average" during the winter surge. 

The paper's analysis found that the deaths were not driven by residents who were older or more fragile, and could not be explained solely by the company's presence in states hard-hit by the virus. An unusual distinction was that Trilogy had been acquired by a company specializing in real estate in a test of a business model new to large nursing-home chains. 

The analysis found that "millions of dollars continued to flow from Trilogy to a California-based real estate venture busy preparing its next investment pitch – a stock listing expected to launch this year." 

The story digs into the business model behind these nursing homes and their efforts to increase profits, including staff cuts. It says Trilogy "went further than any other major chain in shrinking care hours delivered to residents before the pandemic," that "half of its facilities were cited by health inspectors for violating Covid-19 safety rules in 2020" and that "Trilogy's poor Covid outcomes stood out by measure after measure." 

The company divided its facilities "into red, yellow and green zones to limit exposure to the virus," the story says, but "Eyewitness interviews and the reports filed by health inspectors indicate this safety regimen was often a charade." The story also includes interviews with families of those who died. 

The series also includes short stories about some of the Trilogy residents who died and another includes a video of families reflecting on their loss. In addition, there is a link to share the story of how you lost a loved one in a nursing home due to Covid-19. 

Also in the USA Today "Dying for Care" series: 

The reporters break down their findings into four key things to know about their investigation into nursing home failures during Covid-19, including why Trilogy stood out, impact of staffing on care, impact of ignoring safety lapses pointed out in inspections, and impacts from the real-estate business model. 

In response to the story, federal nursing home regulators have said they need to collect better information about real estate ownership model's like Trilogy's, they report. Further, President Joe Biden  proposed reforms in February that would track problem owners across states  and shed light on Wall Street profits from nursing homes. 

The analysis revealed ownership webs invisible to consumers and said "problems across chains eluded federal officials overseeing nursing homes, who were focused on individual facilities during the pandemic." 

A story by Fraser walks through the details of how they did the analysis. She writes that USA Today took a closer look at nursing-home performance in the winter surge from October 2020 to February 2021 because half the nation's 140,000 Covid-19 deaths in nursing homes happened during that period, "months after best practices were established and federal aid issued for coping with the coronavirus." 

Another story, written by Penzenstadler, offers a guide to choosing the right nursing home for a loved on in three steps. 

Penzenstadler also explores the question, "When does a nursing home Covid-19 death count?" 

There is also a section that allows you to look up nursing-home ratings from the analysis and see how they fared during the pandemic's winter surge, 2021-21. 

There are no Kentucky data in the spreadsheet; USA Today reports there are 13 Trilogy Health Services facilities in Kentucky, but its website lists 20: Cooper Trail Senior Living in Bardstown; Cedar Ridge Health Campus in Cynthiana; Walker's Trail Senior Living in Danville; The Willows at Harrodsburg; The Springs at Oldham Reserve in La Grange; The Willows at Citation in Lexington; The Willows at Fritz Farm in Lexington; The Willows at Hamburg in Lexington; Forest Springs Health Campus in Louisville; Franciscan Health Care Center in Louisville; Glen River Health Campus in Louisville; Park Terrace Health Campus in Louisville; The Legacy at English Station in Louisville; The Springs at Stony Brook in Louisville; The Willows at Springhurst in Louisville; Westport Place Health Campus in Louisville; Sanders Ridge Health Campus in Mt. Washington; Calumet Trace Senior Living in Owensboro; Shelby Farms Senior Living in Shelbyville; and Boonesboro Trail Senior Living in Winchester. 

Coronavirus positive-test rate in Ky. rose from 3.12% to 4.35% last week, even as cases and Covid-19 hospital numbers dropped

Kentucky Health News map with Dept. for Public Health data on GISGeography base map

By Melissa Patrick
Kentucky Health News

The share of Kentuckians testing positive for the coronavirus went up for the third week in a row last week, but coronavirus cases and hospitalizations for Covid-19 dropped. 

The state's report for the last Monday-to-Sunday reporting period showed the percentage of Kentuckians testing positive in the past seven days is 4.35 percent, a significant increase from 3.12% the week before and up from a low of 1.97% three weeks ago. Public-health experts say a level of 5% or more is concerning.

The figures do not include results of at-home tests.

The state reported 2,997 new cases of the virus in the reporting week, an average of 428 per day, down almost 8% from 465 a day the week before. 

Of this week's new cases, nearly 21% were in people 18 and younger. 

The statewide seven-day infection rate is 6.49 daily cases per 100,000 residents, up from 5.63 in the prior week's report. Counties with rates more than double the state rate were Jefferson, 14.7; Mason, 14.2; Bath, 13.7; and Robertson, 13.6.

The New York Times ranks Kentucky's infection rate 15th among the states and Washington, D.C., with a 7% decrease in cases over the last 14 days. 

The state attributed 116 more deaths to Covid-19 last week, an average of 16.6 per day. The week before, it was 13.9 per day; the week after it was 24.6 per day. The state's pandemic death toll is now 15,413. 

Kentucky hospitals reported 166 patients with Covid-19, with only 24 in intensive care and eight on mechanical ventilation, all fewer than the previous week, though the declines are less than the week before.

Again, very few intensive-care beds in Kentucky are being used for Covid-19 patients, but five of the state's 10 hospital regions are using at least 80% of their intensive-care beds. Statewide, 77% of the beds are in use. 

Kentuckians are still encouraged to get a Covid-19 vaccination or boosted. 

The Washington Post reports that a daily average of 3,885 doses of Covid-19 vaccine were given in Kentucky last week, an 18% drop from the week before. The Post reports that 61% of Kentucky's eligible population, 5 and older, are fully vaccinated and 44% of fully vaccinated people have received a booster shot.

First phase of $87 million HEALing Communities Study to address opioid epidemic has touched thousands of Kentuckians

UK's Sharon Walsh, Carrie Oser and Amanda Fallin-Bennett, along with

the Clark County Health Department's Jennifer Gulley (second from left)

presented an update on community engagement in UK's HEALing grant

at the 2022 Rx and Illicit Drug Summit. (University of Kentucky photo)

Thousands of Kentuckians in eight counties have benefited from a variety of evidence based practices to address the opioid epidemic in the first phase of the $87 million University of Kentucky HEALing Communities Study . The second phase of the study will begin in July.

"As the study continues, their work will help us better understand what’s needed in each community and where to focus and ramp up efforts to best support patients to reduce opioid overdose deaths,”  Sharon Walsh, the principal investigator, told Elizabeth Chapin of UKNow. “Our goal is that the changes implemented in these communities develop into sustainable solutions for the opioid epidemic in the commonwealth and throughout the nation.”

Walsh is a professor in UK’s colleges of Medicine and Pharmacy and directs the Center on Drug and Alcohol Research. 

Evidence-based practices the study team implemented with behavioral-health and criminal-justice agencies include effective delivery of medications for opioid-use disorder, overdose-prevention education and distribution of naloxone, a life-saving medication that reverses the effects of opioids. The team has also been working with various pharmacies and health care providers to implement safer opioid prescribing and dispensing, says a news release. 

Kentucky Health News map

The study includes 16 Kentucky counties and is broken down into two waves of eight counties each. Community coalitions in each county determined what interventions to implement based on individual community need. The first wave is Boyd, Boyle, Clark, Fayette, Floyd, Franklin, Kenton and Madison counties.

Working with 146 agencies in the eight counties in the first wave, the study has:

• Dispensed 55,147 units of naloxone to 166 locations that have so far distributed 40,243 units to individuals in high-risk populations;
• Gave financial support for staff and transportation to 38 facilities that use medication for opioid-use disorder (MOUD);
• Expanded capacity for MOUD treatment, as well as linkage and retention programs in criminal justice venues including sheriff's departments, pretrial services, home incarceration, drug courts, jails and probation and parole programs;
• Helped 38 agencies with implementation of peer-support programs and 28 agencies with care-navigation programs;
• Gave 206 individuals with opioid-use disorder financial support to overcome barriers to medication treatment, including transportation, vehicle repairs, jail communication-service fees and utility bills;
• Provided 16 people with housing assistance including rent and emergency housing;
• Provided transportation assistance to link individuals to treatment and keep them in it. Through March 10, 1,531 rides to treatment programs and recovery-related appointments had been provided to 121 unique individuals for a total of 80,007 miles;
• Installed medication receptacles at 35 pharmacies, with more than 1,400 pounds of medication incinerated to date; and
• Led educational sessions on safer opioid prescribing and dispensing for more than 150 health-care professionals including dentists, primary-care providers and pharmacists.

The intervention also includes community engagement to assist key stakeholders in applying evidence-based practices and a communications campaign to build demand for treatment and reduce stigma toward people with opioid use disorder.

The first-wave intervention ends this summer, with the sustainability phase beginning in July. This phase is intended to build capacity to help community coalitions and partner organizations,  sustain the evidence-based practices after the study ends, efforts around community staffing and budget planning, and efforts to sustain naloxone distribution. 

The second-wave intervention begins July 1 in Bourbon, Campbell, Carter, Greenup, Jefferson, Jessamine, Knox and Mason counties.  So far, the study team has had 134 meetings with 174 stakeholders and has identified 85 potential coalition members for the second wave.

Launched in 2019, the four-year study includes a multidisciplinary team of more than 25 researchers spanning seven colleges across UK, and partners with communities to implement strategies to reduce opioid deaths.

Tick season nears. 10% of ticks carry debilitating diseases; quick action can prevent them. And UK wants you to send in your ticks!

Lucie Conchou works in UK entomologist

Zainulabeuddin Syed’s lab. (Photo by Matt Barton)

Kentucky Health News

Ticks are a threat in Kentucky year-round, but especially in the summer months. The next time one bites you, stop and think before flushing it down the toilet. You could help other people by mailing it to the University of Kentucky entomology department to see if it carries disease or not. 

Here's how: If you find a tick on yourself or your pet, remove it with tweezers, place it in alcohol in a sealed container or bag, and mail it to the university's entomology department. Those are the instructions Professor Reddy Palli, who chairs the department and serves as state entomologist, told Aaron Mudd of the Lexington Herald-Leader.

A university spokesperson told Mudd to check with your local UK Extension office to see exactly where to mail a specimen for study. 

“We will contact the person who submits the specimen if we detect pathogens in the tick and encourage them to contact their physician,” Palli told the Herald-Leader in an email.

Mudd reports, "As a leader in his field, Palli is overseeing several researchers who are studying tick populations in Kentucky, monitoring the diseases they spread and potentially engineering ways to repel them or even stop them from searching for blood in the first place."

Katie Pratt of the UK College of Agriculture, Food and Environment also wrote about the work of Palli and his colleagues. 

She reports that one of the Palli's graduate students is Anna Pasternak, who leads the Kentucky Tick Surveillance Program. She collects ticks analyze their genetic material and any disease-causing pathogens hiding within them. The program has been collecting information on ticks in the state since January 2019. 

“Preliminary results show that the greatest number of ticks exist in wooded areas of the state and at Land Between the Lakes, and 10 percent of them carry a pathogen that cause diseases like Lyme disease, Rocky Mountain spotted fever, alpha-gal and others,” Palli said. The last disease he mentioned can cause an allergy to red meat.

“We really did not expect pathogen presences in these ticks to be that high,” Palli said.

“Our goal is to take Anna’s data and educate farmers, loggers, physicians and health care workers about the ticks in the state and ways to minimize their effects. For example, if someone gets bitten by a tick carrying the Lyme disease pathogen and they get an antibiotic within 72 hours, it is likely the antibiotic will kill the bacteria that causes Lyme disease. Not many people know that, and by the time symptoms appear, it’s often too late.”

University of Kentucky graphic; for a larger version, click on it.

Blacklegged ticks, tiny bugs otherwise known as deer ticks, are the main transmitter of Lyme disease, the top insect vector-borne disease in America. And as these ticks expand their region from New England to the eastern half of the United States, cases of Lyme disease are growing too, Pratt reports. 

Signs and symptoms of Lyme disease include fever, chills, headache, fatigue, muscle and joint aches and swollen lymph glands. Upwards of 80% of infected persons have a distinctive "bull's eye" rash that appears at the site of the bite three to 30 days after infection.

The American dog tick and the brown dog tick can carry and transmit the bacteria that causes Rocky Mountain spotted fever.

Signs and symptoms of RMSF are fever, headache, nausea, vomiting, stomach pain, muscle pain, lack of appetite and a spotted rash. The rash usually develops several days after the onset of a fever and can vary between splotches and smaller pinpoint dots.

The Lone Star tick caries the bacteria that causes ehrilichiosis. Signs and symptoms of ehrilichiosis are fever, headache, chills, cough, malaise, muscle pain, nausea, vomiting, diarrhea, confusion and red eyes. A rash is common in children, but less so in adults.

The Lone Star tick is also a vector for alpha-gal syndrome, known as the red-meat allergy, which is becoming increasingly more common.

Ways to protect yourself from ticks are:

• Avoid grassy, wooded and leaf-covered areas
• Keep grass and shrubs trimmed and cleared away
• Walk in the center of walking trails
• Wear light-colored clothes, which make it easier to spot ticks
• Wear long pants tucked into boots and tuck in your shirts
• Use tick repellent that has the repellent DEET or picaridin
• Treat your clothes with permethrin, which repels and kills ticks
• Do a body check along the way and at the end of each day
• Check your pets and equipment for ticks
• Shower within two hours of potential exposure, if possible

To kill ticks on clothing, tumble dry for 10 minutes or wash them in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

Albert B. Chandler Hospital at UK opened 60 years ago today

The latest Chandler Hospital is on Limestone Street.

By Kristi Willett

University of Kentucky

Sixty years ago today, the Albert B. Chandler Hospital at the University of Kentucky opened its doors and welcomed its first patients. The hospital has evolved into the UK HealthCare system, operating three hospitals – UK Chandler, UK Good Samaritan and UK Kentucky Children’s Hospital – serving more than 40,000 patients a year.

UK HealthCare also includes more than 60 outpatient clinics, conducting more than 2.2 million outpatient visits every year, and employs more than 10,000 physicians, nurses, pharmacists and other health-care providers.

“This team is dedicated to providing the most advanced, high-quality patient care to Kentucky and beyond,” said Dr. Mark F. Newman, UK's executive vice president for health affairs.

Chandler Hospital has been rated the No. 1 hospital in Kentucky by U.S. News & World Report for six years.

Access to quality health care in the Bluegrass region is something that is often taken for granted, but that hasn’t always been the case. In the early 20th century, one of every three Kentuckians examined for military service during World War II was deemed medically unfit for duty. In 1949, there were more than 5,000 unattended births in Kentucky and the state ranked near the bottom in physician-to-patient ratio, with an estimated 1,400 additional doctors needed.

In the early 1950s, a group of UK professors and the Legislative Research Commission recommended that an academic medical center be built at UK to improve health-care access for Kentuckians. The state's only medical school was at the University of Louisville.

In 1954, UK trustees committed to fulfilling the university's original charter to create a medical college and associated medical center once funds became available. During his 1955 campaign for a second, nonconsecutive term as governor, Albert B. "Happy" Chandler promised that he would get it done, and the university named it for him.

The hospital immediately became a cornerstone for educating top physicians, providing outstanding health care, and conducting breakthrough medical research. It and the rest of UK HealthCare have become a statewide hub for advanced care. Chandler Hospital is a Level 1 trauma center and has one of the largest intensive-care units in Kentucky. During the Covid-19 pandemic, the hospital and UK HealthCare played a critical role, caring for more than 4,400 patients.

“During our anniversary celebration of the opening of UK Chandler Hospital, it is vital that we honor those who came before us and worked diligently on what was merely a vision of health-care access in the 1950s and '60s,” Newman said. “We are forever grateful for those who provided the support needed to build the foundation that has led to our world-class medical facilities. It is our hope that through our work, we honor the legacy of these visionaries and leaders each and every day.”

Latest CDC map shows all of Kentucky has low level of Covid-19

CDC map shows all of Kentucky in green, for low levels of Covid-19 transmission. 

By Melissa Patrick
Kentucky Health News

Every county in Kentucky has a low level of coronavirus transmission, according to the latest weekly analysis of risk based on cases and hospital capacity by the Centers for Disease Control and Prevention. 

The CDC ratings are based on new coronavirus cases, Covid-19 hospitalizations and the percentage of staffed inpatient beds occupied by Covid-19 patients. Its color-coded map uses green for counties with low risk of transmission, yellow for counties with medium risk and red for counties with high risk. 

The latest map shows that the whole state is in the green, a level that comes with recommendations to stay up to date with your Covid-19 vaccines and to get tested if you have symptoms. 

The CDC reports that 91.7% of counties and county equivalents in the U.S. have a low level of Covid-19. 

The latest ratings came as Kentucky's Covid-19 cases and the share of Kentuckians testing positive for the virus in the previous week  ticked up a bit, while hospital numbers continued to decline.

"So we're gonna keep taking a look at at where the numbers of cases and positivity are, but [we're] not concerned because of where these [hospital] graphs are, which is in such a good place," Gov. Andy Beshear said at his weekly news conference on Thursday, before the new CDC map was released. 

The slight uptick also comes as Kentucky gears up for what Beshear said would be record crowds at this year's Kentucky Derby on Saturday, May 7, which he said he plans on attending. 

"We are in the best shape that we have been since the start of the pandemic, with all factors considered to host the Kentucky Derby," he said. "And how exciting is that?"

Appalachian Food for Health Diabetes Prevention virtual event is Tuesday, April 26; it's free, but registration is required

The fourth Appalachian Food for Health Diabetes Prevention event will take place Tuesday, April 26 from 10 a.m. to 12 p.m. ET.

The virtual event will focus on food and nutrition policy that impact diabetes. It will also include a discussion about diabetes prevention and how better access to fresh, healthy foods can play a role in deterring this disease. The event is free, but registration is required. Click here to register. 

The agenda for the event includes presentations from Tyler Offerman, food justice organizer for the Kentucky Equal Justice Center, who will give an overview of 2022 Kentucky legislation related to food and nutrition; Martin Richards and Kimberly Ishmael of the Community Farm Alliance, who will discuss the healthy farm and food fund; and Pamela Spradling, director of planning and grant management at Big Sandy Health Care, who will discuss community health workers and diabetes prevention. 

The Appalachian Food for Health Diabetes Prevention Convening series is a collaboration between the Community Farm Alliance, the Foundation for a Healthy Kentucky and Shaping Our Appalachian Region, the regional economic-development group for Kentucky's 54 Appalachian counties. 

Beshear says he is looking at ways to bring medical marijuana to Ky. by executive action, while seeking public's opinion on topic

Business Insider map provided by Beshear's office, adapted by Ky. Health News

By Melissa Patrick
Kentucky Health News

After a bill to legalize medical marijuana in Kentucky failed again in the legislature, Gov. Andy Beshear announced a plan to ask Kentuckians how he might address the issue through executive action. 

"This session, like the last one and many before, the General Assembly did not get the job done, despite broad support from the public," Beshear said at his regular weekly news conference. A medical cannabis bill again passed the House this year but couldn't even get a committee hearing in the Senate.

The Democratic governor, who is seeking re-election next year, said his move isn't political.

"This issue's time has come," he said. "I think it's pretty clear where everybody falls on it. I believe if it had been given a committee vote, depending on the committee, it would have passed. If it would have been brought to the floor, it would have passed. You know, it's time that a couple of individuals that are out of touch with the vast majority of Kentuckians on this issue. Stop obstructing it, and we're able to move forward."

Senate President Robert Stivers has long said that he believes more research is needed before such a bill should pass. The Republican-controlled legislature passed a bill to create a cannabis research center, but the medical cannabis bill went nowhere in the Senate after passing the House 59-34.

Stivers issued a statement saying, “The public should be concerned with a governor who thinks he can change statute by executive order. He simply can’t legalize medical marijuana by executive order; you can’t supersede a statue by executive order because it’s a constitutional separation-of-powers violation.”

Beshear said, "We're looking through our legal options right now. If someone has just told you carte blanche, it's, it's against the law, then they haven't done the full analysis as we are looking at what different options there are out there."

He said he did not have an example of another state that had done this by executive action, and offered no details on what legalizing medical cannabis that way would look like, but outlined a plan to explore how it could be accomplished that would seek input from Kentuckians.

First, his lawyers will analyze options under the law regarding executive action on medical cannabis; then a Governor's Medical Cannabis Advisory Team will travel the state to hear from Kentuckians; and they will have an e-mail address to communicate with him about it: GovMedicalCannabisAdvisoryTeam@ky.gov. 

Beshear noted a long list of medical conditions that can be treated by cannabis, and stressed that 37 states, plus Puerto Rico, the U.S. Virgin Islands, Guam and Washington, D.C., already allow it for medical use and said it's time for Kentucky to do the same. 

"We are actually behind Mississippi," he said. "This time, we can't make that joke. Mississippi was actually the latest state to permit the use, and their legislature had the courage that ours did not." 

The bill that would create the research center and do several other things, HB 604, passed on the last day of the session. It would create the Kentucky Center for Cannabis Research at the University of Kentucky, which would get $2 million in the fiscal year that begins July 1. Stivers noted that Beshear has had the bill for a week and still hasn't signed it.

One stable at Keeneland focuses on addiction recovery while offering instruction on the basics of horsemanship

Will Walden and Tyler Maxwell of Ready Made Racing at Keeneland
on April 2. (Photo by Silas Walker, Lexington Herald-Leader)

Jacalyn Carfagno, a contributing writer for the Lexington Herald-Leader, tells a story about a group of men training horses at Ready Made Racing, a stable where all of the staff are in addiction recovery. 

The idea came to fruition last summer when Will Walden, a fourth-generation horseman and the son of Elliott Walden, president and CEO of WinStar Farm, went to Frank Taylor, vice president of sales at his family's Taylor Made Farm and pitched the idea, Carfagno reports. 

Taylor, also in recovery,  proceeded to buy 10 yearlings, found a group of investors and convinced his brothers to try a pilot project they called the Taylor Made School of Horsemanship to train people in recovery from substance use addiction the basics of horsemanship, she writes. 

Taylor told Carfagno that the horse industry is rife with addiction and "It's a lot safer to hire the ones that are in treatment."  

A year later, she writes that 20 have graduated from the 90-day program, 11 still work for Taylor Made, and others have gone on to other farms or industries. 

At the core of Ready Made Stables are Walden, Michael Lowry and Tyler Maxwell, who had gotten to know each other in the Shepherd's House recovery program. Carfagno reports that these three men took the 10 yearlings to Florida to train over the winter, even after a friend told Taylor that he was "a complete idiot" for trusting "three addicted guys that are in recovery" with that responsibility. 

Walden agreed it was a leap of faith, telling her, “You wouldn’t trust any one of us with five dollars to go to the store just a year ago, let alone hundreds of thousands of dollars worth of horses.” 

"But the three supported and encouraged each other, stayed sober and came back with race-ready two-year-olds," she writes. And by the time the Ready Made team arrived at Keeneland the third week of March,  she writes that Walden, 31, had been sober for 16 months, the longest period since he finished high school. 

On Wednesday, April 20, Sergeant Countzler, a two-year-old Bolt D'Oro colt and one of the 10 yearlings purchased for the program, came in third in his first race.

Walden told Carfagno that it was fitting that the horse is named for Christian Countzler, who helped him, Lowry and Maxwell climb out of addiction through his work at Shepherd's House. "I don't think we'd be here without that guy," he said. 

Lowry told Carfagno that caring for the horses entrusted to them is more than just a job.

"They do something to you, they bring peace, they really do, they bring peace," he said. 

Taylor shares even more about the mission and benefits of this program in a video with Blood Horse Magazine. 

Judge blocks state's new anti-abortion law, pending study of it

Kentucky Health News

A federal judge has blocked Kentucky's broad, new anti-abortion law, saying it has so many restrictions that she needs time to evaluate the ability of the state's two abortion clinics to follow them.

District Judge Rebecca Grady Jennings issued a temporary restraining order, saying “The Court restrains enforcement of the entirety of HB 3 at this time, as it lacks information to specifically determine which individual provisions and subsections are capable of compliance.”

The law was passed as House Bill 3 of the recently completed session of the Republican-controlled General Assembly, over the veto of Democratic Gov. Andy Beshear, who said it was unconstitutional and lacked an exception for cases of rape or incest. The bill had an emergency clause that made it take effect immediately, which the clinics said made compliance even more difficult.

U.S. District Judge Rebecca Grady Jennings

Jennings ruled in a lawsuit filed by a unit of Planned Parenthood, which has an abortion clinic in Louisville and called the law "tantamount to a ban on abortion." A similar suit was filed by the American Civil Liberties Union of Kentucky on behalf of EMW Women's Surgical Center of Louisville, the state's only other abortion clinic.

Both clinics stopped providing abortions when the law took effect April 13, saying it was impossible for them to comply with it immediately. "The law has put Kentucky in the national spotlight for becoming the first state to eliminate access to all abortion services," notes Deborah Yetter of the Courier Journal, adding that they are resuming services.

Jennings ruled that the law makes any abortion unlawful until the state Cabinet for Health and Family Services creates a system and forms for compliance. “Because [Planned Parenthood] cannot comply with HB 3 and thus cannot legally perform abortion services, its patients face a substantial obstacle to exercising their rights to a pre-viability abortion,” and that us an “undue burden,” making it constitutionally questionable, she wrote.

Jennings made her restraining order effective for two weeks, during which she will hold a hearing on the plaintiffs' motions for a preliminary injunction to keep the law from taking effect.

The law strengthens parental-consent rules, increases reporting rules, requires aborted fetuses to be cremated or buried through pre-arrangement with funeral homes, which the clinics said will be reluctant to make for fear of retribution.

It also prohibits abortion after the 15th week of pregnancy, mimicking a Mississippi law that is awaiting a decision from the U.S. Supreme Court, and bans mailing medications that have become the most common way to end a pregnancy in Kentucky, a means recently approved by the U.S. Food and Drug Administration. "It requires the state Cabinet for Health and Family Services to create a new, extensive system to certify, register and monitor anyone who produces, ships or dispenses the medication," Yetter notes. Beshear noted that the legislature provided no money for the system.

Planned Parenthood Great Northwest CEO Rebecca Gibron said in a press release that her group was “grateful” for Jennings' order: “This is a win, but it is only the first step. We’re prepared to fight for our patients’ right to basic health in court and continue doing everything in our power to ensure abortion access is permanently secured in Kentucky.”

Attorney General Daniel Cameron, a Republican who may run for governor against Beshear in 2023, said he was disappointed in the ruling. He had argued against a restraining order, notes Alex Acquisto of the Lexington Herald-Leader.

Free academy at Pikeville June 12-25 will introduce rising high-school seniors and juniors in Appalachian Kentucky to nursing

The regional development group Shaping our Appalachian Region and the state Department for Public Health’s Office of Health Equity are hosting the first Appalachian Nursing Academy June 12-25 at the University of Pikeville for rising juniors and seniors at high schools in Kentucky's 54 Appalachian counties. The free two-week academy offers:
· Interactive programming with workshops, presentation, shadowing, mentorship, tours, etc.
· Housing at the university
· Three meals a day
· $1,500 scholarship to further your education
· Trips to see and experience regional attractions and activities

You do not have to have any prior experience related to nursing to apply. Your interest is all that matters. If you are interested, click here to apply or here to download a flyer.

Kentucky highway fatalities rose again in 2021, by 3%; once more, most of those killed were not wearing their seat belt

Ky. Health News graph from state data shows fatalities not using a seat belt, and in which alcohol, speeding or aggressive driving, and distracted driving were involved, and the total number of fatalities.

Deaths from highway accidents in Kentucky rose 3.3 percent last year, according to the State Police and the Transportation Cabinet. But so far this year, fatality numbers are running below last year. 

Again last year, most of those killed were not wearing a seat belt.

"Of the 806 highway fatalities last year in Kentucky, 54.7 percent were not wearing a seat belt and 15 percent involved alcohol," the agencies said in a press release. "Approximately 26 percent involved speeding or aggressive drivers and 15 percent involved driver distraction."

Those percentages were about the same as in 2020, and those two years showed declines in fatal speeding or aggressive driving and driver distraction from 2019. About 32 percent of deaths in 2019 involved speeding or aggressive driving, and 21 percent involved driver distraction.

Unlike the last two years, 2021 saw deaths of motorcyclists outnumber those of pedestrians and  bicyclists. In 2021, pedestrians and bicyclists accounted for 85 deaths and motorcyclists accounted for 88 deaths. In 2020, pedestrians and bicyclists accounted for 97 deaths and motorcyclists accounted for 74 deaths. In 2019, pedestrians and bicyclists accounted for 79 deaths and motorcyclists accounted for 77 deaths.

“While we pledge to increase our awareness efforts, we need the public’s help,” Transportation Secretary Jim Gray said in the press release. “We’re asking motorists to commit to save driving behaviors when behind the wheel, and everyone – both drivers and passengers – pledge to always buckle up.”

According to the National Highway Traffic Safety Administration, wearing a seat belt gives motorists the best chance of preventing injury or death if involved in a crash. Properly fastened seat belts contact the strongest parts of the body, such as the chest, hips and shoulders. A seat belt spreads the force of a crash over a wide area of the body, putting less stress on any one part, and allows the body to slow down with the crash, extending the time when the crash forces are felt by the occupant.

Kentucky gets $4.19 million to expand AmeriCorps work in public health, with the hope it will funnel more people into such work

Kentucky has received nearly $4.2 million to expand the public-health role of the AmeriCorps program in the state. The grant comes from the American Rescue Plan Act, last year's pandemic relief bill.

"This funding will support the recruitment, training and development of a new generation of public health leaders,” Gov. Andy Beshear said in a news release. “The funding will support the addition of community health workers with coordination from Serve Kentucky, the agency committed to engaging Kentuckians in volunteerism and service to positively impact our communities.”

This new public health initiative is the result of a partnership between AmeriCorps and the Centers for Disease Control and Prevention. Nationwide, the initiative will fund up to 5,000 public-health positions over the next five years. 

Public Health AmeriCorps will help meet public-health needs of local communities by providing surge capacity and support while also creating pathways to public health-related careers, says the release. 

Health Commissioner Steven Stack pointed to the many public-health challenges caused by the pandemic, noting that it has been "neither easy nor without loss" to get to our current low rates of transmission. 

"This grant allows us to plan for future public health emergency responses," he said. "Creating a standing corps of public health personnel to manage surge capacity and respond to crises will enable Team Kentucky to stand ready to support Kentuckians when emergencies arise." 

Funding from the grant will  to the Kentucky Health Departments Association and Family Scholar House. 

The KHDA will get $1,367,986 to add 75 AmeriCorps members as community health workers in local health departments. They will work in programs such as the Health Access Nurturing Development Services, (HANDS), the Women, Infant and Children (WIC) program, and harm-reduction programs.

AmeriCorps members will not replace any existing health-department staffers, Susan Dunlap, spokeswoman for the Cabinet for Health and Family Services, told Kentucky Health News in an e-mail. 

"AmeriCorps members will be used to bolster the local public health workforce in Kentucky to expand the number of services delivered at local health departments currently available," Dunlap said. "Additionally, AmeriCorps members will receive training to become certified as community health workers, which are in short supply at local health departments throughout Kentucky."

Family Scholar House, which oversees the annual grant competition that awards funding to AmeriCorps State and other community service programs, says it works to provide a comprehensive, holistic continuum of care for low-income families and youth to help them reach their educational, career and family goals. It will get $2,825,124 to offer additional services.

Dunlap said, "FSH applied for the grant due to their familiarity with AmeriCorps, and because the grant will enable participants to receive training and support to enter the public-health field (in addition to the living allowance and education award) – which aligns with FSH’s priorities of health, educational support, and career pathways."

FSH's grant will allow it to leverage 200 AmeriCorps members who will provide health-care support to seniors and disabled individuals in health care facilities across Kentucky, says the news release. 

"FSH AmeriCorps member activities will include support with basic clinical assistance, activities for socialization, infection control, and dietary and patient services," said Dunlap. "FSH AmeriCorps members will develop their healthcare knowledge and complete credentialing coursework—enabling them to work in memory care, skilled nursing, assisted living, and other healthcare related environments." 

Eric Friedlander, secretary of the cabinet, which administers and oversees Serve Kentucky, said this initiative will serve as a steppingstone to get more people into the public-health field.

“After their year of service, we expect more than 200 AmeriCorps members will pursue future engagement in the public-health sector,” Friedlander said in the release. "AmeriCorps and the CDC believe that Public Health AmeriCorps provides a unique way to expose those interested in learning more about public health and its various careers.”

Joe Bringardner, executive director of Serve Kentucky, said, "Adults of all ages and education backgrounds are eligible to serve in Public Health AmeriCorps."

Coronavirus cases and positive-test rate in Kentucky are rising, but deaths and hospital numbers are declining more

Kentucky Health News chart from state data

By Melissa Patrick
Kentucky Health News

Daily cases and the share of Kentuckians testing positive for the coronavirus are rising again, apparently reflecting a national trend.

The state's report for the last Monday-Sunday period showed 3,257 new cases of the virus, an average of 465 per day, up 4.5% from 445 a day the week before.  

The New York Times reports that cases are rising again in the U.S., going up 39% in the last two weeks. It notes that case numbers are likely higher than reported, because of the prevalence of home Covid-19 tests.

Kentucky Health News graph, from state data

The percentage of Kentuckians testing positive for the virus in the past seven days is 3.12%, up from 2.27%. 

The Times ranks Kentucky's infection rate 20th among the states and Washington, D.C. Of the week's new cases in Kentucky, 25% were in people 18 and younger. 

Kentucky's seven-day infection rate also showed an uptick, to to 5.63 cases per 100,000 residents from 4.09 the week before. Counties with rates more than double the latest statewide rate are Franklin, 23.5; Campbell, 11.9; and Jefferson, 11.6. Twenty of the 120 counties reported no cases last week.

While leading indicators showed more risk of infection, deaths related to Covid-19 dropped 43 percent and hospital numbers continued to decline. 

The state attributed 97 more deaths to Covid-19, an average of just under 13.9 per day. That's down from 24.6 per day the week before and 19.3 per day the week before that. All told, the state has attributed 15,297 deaths to the pandemic. 

Kentucky hospitals reported 176 patients with Covid-19, with 20 of them in intensive care and only nine on mechanical ventilation. All of these numbers are lower than last week's Monday report; hospitalizations were down 11%; intensive-care cases were down 31%.

Very few intensive-care beds in Kentucky are being used for Covid-19 patients, but six of the state's 10 hospital regions are using at least 80% of their intensive care beds. Statewide, 78.7% of the beds are in use. 

Kentuckians who are not vaccinated or boosted are still encouraged to do so. The Washington Post reports that an average of 4,753 Covid-19 vaccine doses per day were given in Kentucky last week, a 6% increase over the week before.

The numbers include second doses and booster shots. They have been increasing since late March, when a second booster shot was authorized for people 65 and older and other more vulnerable populations. But the rate of increase in Kentucky since then has not been as fast as nationwide. 

So far, 65% of the state's total population has received at least one dose of a vaccine; 57% of the total population is fully vaccinated; and 44% of those eligible have been boosted. The Post adds that nearly 61% of the state's eligible population, those 5 and older, have been fully vaccinated. 

"Let's keep going," Gov. Andy Beshear said at last week's press conference. "It's not enough." 

Travel masks out: On Monday, a federal judge in Florida struck down the federal mask mandate on airplanes and other modes of public transportation, saying it exceeds the statutory authority of the Centers for Disease Control and Prevention and violates administrative law. 

Last week, the CDC extended the public transportation mask mandate through May 3. The Biden administration has not decided on an appeal.

"White House spokesperson Jen Psaki said Monday afternoon that it was a 'disappointing' decision, and that the Department of Homeland Security and the CDC were reviewing the ruling" and that "the Justice Department will make any determinations about a legal response," CNN reports.

Cancer plagues Appalachia, so a UK program brings high-school and college students from the region into the study of it

The nation's highest cancer rates are in Appalachia, especially in Appalachian Kentucky. But the state is also home to an effort to get young people from the region involved in research to prevent and cure cancer.

It's at the University of Kentucky’s Markey Cancer Center, where college and high-school students from Appalachian Kentucky can explore research, clinical care and education "to help them learn more about pursuing careers in fighting cancer," Tom Martin of Richmond's WEKU-FM reports for The Daily Yonder.

The program is called ACTION, for Appalachian Career Training in Oncology, the study and treatment of cancer. It's directed by Nathan Vanderford, an associate professor of toxicology and cancer biology. He is editor of a book of student essays, Cancer Crisis in Appalachia: Kentucky Students Take ACTION , published by the University Press of Kentucky in 2020. A second edition, being edited by Vanderford and Chris Pritchard, is forthcoming.

Professor Nathan Vanderford with the students' book
and photographs (UK photo by Pete Comparoni)

Vanderford told Martin, "We truly do have a cancer crisis in Appalachian Kentucky. The state continues to rate number one in overall cancer incidence and mortality rates. And so it’s critically important that we bring awareness to this fact across the state, and particularly in Eastern Kentucky," which lacks oncology professionals and is distant from health-care centers.

"We are on a mission, and we think it’s really important to train the next generation of oncology professionals who are going to tackle the cancer problem in Appalachian Kentucky, and to have those be individuals who were born and raised and have a personal understanding of the issues that the area faces," Vanderford said. "And who best to do that than the youth of the region?"

Vanderford is from Appalachia, and lost his father to lung cancer in 2010. He told Martin that's when he "became really passionate about cancer and cancer disparities. . . . Just shortly thereafter, my mom was diagnosed with breast cancer, and luckily she was diagnosed early and went through some successful treatment and she’s OK today. So from a personal perspective . . . I’m deeply passionate about this work because of that. But in general, I just absolutely love working with students. It’s just so exciting to work with students, particularly students from Eastern Kentucky. We have amazing students in this state and they just need opportunities. In many of these rural areas, there’s fewer opportunities, outstanding students, and they can just excel when given opportunities like this to take the ball and run with it, so to speak."

Appalachian Kentucky students who are interested in applying to participate in ACTION may find information on the Markey Cancer Center website. The deadline for high-school students apply is May 13. The deadline for college-student applications has passed for this year. For more on the students' work, including photography that they used to illustrate their writings, click here.