Sunday, December 31, 2023

Legislature, convening Tuesday, is being asked to strengthen laws on sales of cigarettes and vapes to minors, including licensing

Map by Jeremy Chisenhall, Lexington Herald-Leader
"When the General Assembly returns to Frankfort on Jan. 2, one of the many problems it’s been asked to address is youth smoking — particularly vaping, which studies suggest has become more far common for Kentucky high school students than cigarette smoking," reports John Cheves of the Lexington Herald-Leader. "State regulators, public health experts and others are urging lawmakers to strengthen the laws against the sale of smoking products to minors."

From November 2021 through August 2023, the state Department of Alcoholic Beverage Control cited stores 883 times for sales to minors during the 21 months between, Cheves reports: "At least 114 retailers were cited two or more times . . . Penalties ranged from warning letters — the most common response — to civil fines of $100 and $1,000 for state offenses, going as high as $6,397 for federal offenses in a handful of cases involving five or more violations within a 36-month period."

The U.S. Food and Drug Administration can ban sales by "the most serious repeat offenders, but it seldom does," Cheves reports. "The FDA has issued one such no-sale order in Kentucky since 2015." It lasted only 24 days.

The Kentucky ABC enforces the FDA regulations. Forty states require tobacco or vape dealers to be licensed, but Kentucky does not, so there are no state licenses for the state to revoke to punish repeat offenders. ABC officials refused Cheves's request for an interview but gave him a written statement saying that an alcohol retailer with repeated tobacco sales violations could be charged with operating “disorderly premises,” which could lead to suspension or revocation of their alcohol license, but the ABC has never done that.

The ABC, part of Democratic Gov. Andy Beshear's administration, wants the Republican-controlled legislature to pass a licensing law, but acknowledged the difficulty of regulation in its latest annual report on the topic: “Kentucky’s history and culture is tied to the cultivation and processing of tobacco. The role of tobacco in Kentucky’s economy, coupled with the fact that tobacco was the livelihood of many Kentucky families, has created strong norms of acceptance around tobacco that pose a significant challenge to prevention efforts.”

The number of tobacco farmers in Kentucky has declined to fewer than 3,000, but tobacco remains an significant cash crop and the state has the nation's second-highest adult smoking rate, behiund only West Virginia. Among Kentucky minors, vaping is twice as popular as smoking, Cheves notes.

Terry Brooks, executive director of Kentucky Youth Advocates, told Cheves, “All the evidence we’re seeing — and this includes anecdotal evidence that I hear from my two grandchildren — leads me to believe that kids don’t have any problems getting their hands on these things. And I think it’s a much more widespread phenomena than most of us realize.”

Cheves notes, "Attempts in the General Assembly to increase the civil fines on retailers caught selling smoking products to minors have gone nowhere."

While state officials debate the licensing issue, Louisville has had a local law requiring it for two years, "even if it isn’t being fully enforced yet," Cheves reports. "The licensing law and a related zoning law also give the city tools to prevent new stand-alone smoking retail stores from opening within 600 feet of another such store or 1,000 feet of facilities that serve children, such as schools, parks, public playgrounds, day-care centers, outdoor recreation areas, athletic facilities or community centers."

Cheves adds, "Health officials said in a recent interview that they’ve just begun working on the enforcement part of the law. Louisville’s health department was assigned its new duties on tobacco retail licensing around the same time the Covid-19 pandemic hit three years ago, with Covid understandably dominating the agenda for many months, said Nick Hart, director of the city’s Division of Environmental Health. Funding provided by the relatively small licensing fee has not provided enough money for the city to hire more staff at the health department, Hart added."

Saturday, December 30, 2023

Rising flu cases drive continued increases in emergency-room visits and hospital admissions for respiratory illnesses in Kentucky

State graphs, adapted by Kentucky Health News
By Al Cross
Kentucky Health News

A big jump in influenza cases more than outweighed small declines in Covid-19 and respiratory syncitial virus as Kentuckians headed into the holidays, according to the state's latest respiratory-illness update.

The report for the week ended Dec. 23 shows the three illnesses accounted for 4,431 Kentucky emergency-department visits, an increase of 10.3 percent from the week before. That was driven entirely by a 30 percent increase in flu cases, from 2,109 to 2,737.

Covid-19 cases declined from 1,107 to 1,080 during the week, and RSV cases dropped from 802 to 614, a decline of 31 percent, accoridng to the report from the state Department for Public Health.

Kentucky hospital admissions for the three diseases rose only 3.3 percent, from 670 to 692, while admissions for the flu rose 36 percent, from 144 to 196.

Covid-19 admissions declined from 339 to 329, and RSV admissions declined from 187 to 167 during the week ended Dec. 23.

CDC map, adapted by Ky. Health News; click on any image to enlarge it.
The week saw the development of a new hotspot for Covid-19 hospital admissions, in far western Kentucky and two nearby Illinois counties. The rate of Covid-19 hospital admissions was 23.1 per 100,000 residents in Ballard, Carlisle, Hickman, Graves, Livingston, Lyon, McCracken and Marshall counties.

That list incudes all the counties in the Jackson Purchase except Calloway, which had a very low Covid-19 hospital-admission rate of 0.9 per 100,000, according to the Centers for Disease Control and Prevention, which considers rates above 20 to be high and below 10 to be low.

Parts of Kentucky's notheastern quadrant remained hotspots for Covid-19 hospital admissions. Greenup, Boyd, Carter and Martin counties had rates of 23.4 per 100,000. Pike County's rate was 20.3, and the rate in Fleming, Mason and Bracken counties was 20, according to the CDC.

Doctors say the best way to prevent hospitalization for Covid-19, the flu and RSV is immunization. Vaccines are readily available for the flu and Covid-19. The RSV vaccines for infants and people over 60 are in shorter supply, so experts advise you to check with your doctor or nurse practitioner.

Tuesday, December 26, 2023

2023 was a tough year in many ways, but saw significant positive developments in science and medicine, Washington Post reports

2023 saw new understanding and the start of a treatment
for dementia, as clinical trials cotinue at the University
of Kentucky and other sites. (iStock photo via Washington Post)
Kentucky Health News

Despite wars, the most mass killings since 2006 and the hottest average temperatures in human history, "2023 also was a year with significant positive developments, including in scientific research and medicine," The Washington Post reports, with a motive: "Research has indicated that uplifting news can provide an emotional buffer against distressing news and feelings of hopelessness — and even encourage optimism or action." Here are some things the Post listed:

The World Health Organization approved a new malaria vaccine that has been shown to be much more effective than the only previous vaccine against the potentially deadly disease. "The WHO said it expects the vaccine, which costs $2 to $4 per dose and has been shown to reduce symptomatic cases by 75 percent after three doses within a year, to be available by the middle of 2024," the Post reports. The U.S. has about 2,000 cases of malaria each year, most of them contracted in other nations.

The Food and Drug Administration approved the first pill to treat postpartum depression, which affects up to one in five womenand can cause "experience intense hopelessness and, in rare cases, psychosis — and it can last for years," the Post notes. "The new drug is taken once a day for two weeks and, unlike the existing treatment of an IV injection that may take as long as 60 hours to administer in a health-care setting, it can be taken at home."

The FDA also approved two gene-therapy treatments for sickle-cell disease, "a rare and debilitating condition that affects around 100,000 Americans, most of them Black. The disease causes extreme, constant pain and can drastically cut the life span of those affected," the Post notes. "Both are intensive, expensive procedures — and require chemotherapy, which has significant side effects. But patients who have received the treatments have spoken of its profoundly beneficial impact on their lives."

Scientists made progress in understanding dementia, the Post reports. One study "suggested that lifestyle habits, including regular mental and physical activity, eating a healthful diet, and regular social contact were linked with a slower rate of memory decline," the Post reports. "Another found that living in areas with more natural green spaces was associated with lower rates of hospital admissions for diseases including dementia, while separate research indicated that the use of hearing aids could cut the risk of cognitive decline by nearly half."

Meanwhile, the FDA approved, for the first time, to a drug that modestly slows Alzheimer’s disease. While difficult questions about safety, effectiveness and cost remain, many neurologists say that having a drug that slows Alzheimer’s is nonetheless a milestone after years of failed trials. The University of Kentucky is one of the sites of the clinical trials, and at last report was still seeking participants.

Friday, December 22, 2023

CDC keeps urging health-care providers to recommend and offer vaccines; flu, Covid-19 and RSV rates are elevated in Kentucky

State Department for Public Health graphs, adapted by Ky. Health News
By Melissa Patrick
Kentucky Health News

The Centers for Disease Control and Prevention continues to encourage health-care providers to get their patients immunized against flu, Covid-19 and respiratory syncitial virus, noting that a recent poll shows that many Americans who have not yet been immunized report being open to vaccination.

"Strong provider recommendations for, and offers of, vaccination could increase influenza, Covid-19 and RSV vaccination coverage," says the CDC's Dec. 22 Morbidity and Mortality Weekly Report

The survey sample was drawn from a random-digit-dialed cellular telephone survey that included adults in every state.

It found that between Sept. 24 and Dec. 9, an estimated 40% of Kentucky adults reported they had gotten a flu shot; 15% had received an updated 2023-24 Covid-19 vaccine, and 23% of adults 60 and older had received a vaccine for RSV, which poses the greatest risk for seniors and infants. 

Kentucky's flu and updated Covid-19 vaccination rates are lower than the estimated national rates of 42% for flu and 18% for Covid-19, but higher than the national seniors rate for RSV, 17%. 

The state Department for Public Health's latest weekly respiratory-illness report shows that Covid-19, RSV and flu activity is elevated, and hospitalizations for RSV and flu are increasing. 

In the week ended Dec. 16, emergency-department visits for respiratory illness increased for yet another week, to 3,921, up from 3,670 the week prior. 

Of the latest week's cases, 2,072 were for flu, up from 1,720 the week prior; 1,073 were for Covid-19, down from 1,134; and 776 for RSV, down from 816. 

Among children 4 and younger, emergency-department visits due to respiratory illness increased slightly, to 1,303, up from 1,265 the week prior. Of those, 604 were for flu, up from 507; 570 were for RSV, down from 594; and 129 were for Covid-19, down from 164. 

Among children 5 to 17, emergency-department visits due to respiratory illness increased to 810, up from 653 the week before. Of those, 653 were for flu, up from 498. Covid-19 and RSV numbers stayed about the same as the week before, at 86 and 71, respectively. 

In that same week, hospital admissions for respiratory illness dropped a bit, to 617, down from 639 in the prior week. Of those, 310 were for Covid-19, down from 345; 171 were for RSV, down from 191; and 136 were for flu, up from 103. 

Among children 4 and under, hospitalizations for respiratory illness increased to 130, up from 105 the week prior. Of those, 101 were for RSV, up from 94; 19 were for flu, up from 7; and 10 were for Covid-19, up from 7. 

Among children 5 to 17, hospitalizations due to respiratory illness increased to 17, up from 10 the week prior. Of those, 13 were for flu, up from 4; 3 were for RSV, down from 4; and 1 was for Covid-19, the same as the week prior. 

A CDC report for the week ended Dec. 16 showed that Covid-19 hospitalization rates in 11 Kentucky counties were above 2 hospitalizations per 10,000 residents, which the CDC considers high. 

The leading county remains Letcher, with a rate of 2.3 hospitalizations per 100. The other high counties, with rates of 2.05 to 2.12, were all in northeastern Kentucky: Lewis, Greenup, Boyd, Carter, Rowan, Menifee, Morgan, Elliott, Lawrence and Martin. 

Deaths: Since Oct. 1, the state health department has attributed 118 deaths to Covid-19 and six to flu. One Covid-19 death was reported during the week ended Dec. 9.

Respiratory-related deaths for flu and Covid-19 on the state's weekly dashboard are reported according to when they occur, which sometimes leads to a delay between the actual date of death and the submission to the department.

Beshear wants lawmakers to be empathetic on controversial issues like abortion; sees better health for Ky. as possible legacy

Gov. Andy Beshear during his interview with Kentucky
Health News in the Capitol's State Reception Room
By Melissa Patrick
Kentucky Health News

In an interview Wednesday with Kentucky Health News, Gov. Andy Beshear said he would be pleased if one of his legacies as governor was improving the health of Kentuckians, and looked forward to the upcoming legislative session.

Beshear acknowledged that if Kentucky has clearly improved its health status when his term ends in 2027, he would have to share that legacy with his father, Steve Beshear, who expanded Medicaid coverage in Kentucky to 600,000 people when he was governor from 2007 through 2015.

"I'd love for both Beshears to be remembered for that," he said. 

Beshear's comments came after he was asked why he thought Kentucky showed a slight upward trend in the latest America's Health Rankings by the United Health Foundation.

The foundation ranks Kentucky 41st for overall health, up from 43rd in the last two rankings (2022 and 2019; the rankings were not made in 2020 and 2021 due to the pandemic). The state was 45th in 2018, 42nd in 2017, 45th in 2016, 44th in 2015 and 47th in 2014.

Beshear said increasing access to health care has been key to improving the health of Kentuckians, not only as a way to improve the quality of their lives, but  as a way to improve the state's workforce. 

"I believe that we are doing better, and that we will do better for a couple of reasons," he said. "First, especially coming out of the pandemic, we are seeing expansion of health-care access all over Kentucky." 

As examples, he pointed to the first hospital being built in West Louisville in 150 years, the expansion of the Bullitt County hospital and the new clinic that  Morehead-based St. Claire HealthCare is building in Morgan County. He said health-care systems are "recognizing that the overall health of our people is a shared responsibility." 

Other examples, "especially over the last four years," he said, are "the leaps we have made in treating addiction, especially the number of treatment beds." He said Kentucky has the most treatment beds per person in the country, and that has improved the overall health of Kentuckians. 

"That's a big start towards getting people healthy," he said. 

Beshear agreed that his father's 2014 expansion of Medicaid to people who earn up to 138 percent of the federal poverty level, under the 2010 Patient Protection and Affordable Care Act, has played a key role in improving access to care. He noted that his administration has extended post-birth Medicaid coverage from 60 days to 12 months, and expanded dental, vision and hearing benefits.

Outcome-based payments? Looking forward, Beshear said it will be important to find a way to use "significant dollars" to incentivize and reimburse Medicaid providers who have good patient outcomes, as opposed to the current model of reimbursing them only for the care they provide. 

"How do we create the best platform and structure to make this happen?" he pondered. "And that's going to be what we're looking at, really closely. . . .  Again, if we can move towards a model where we reward outcomes, I think we can do significantly better." 

Beshear also spoke about the importance of preventive screenings as a way to improve health outcomes, pointing to Lt. Gov. Jacqueline Coleman's experience as an example of their importance. Coleman recently underwent a double mastectomy after concerns were raised during a routine physical examination. 

"That shows just how critical and important that is," he said. 

Legislative issues: When it comes to controversial health issues, like "red-flag" laws or abortion, Beshear said it's important to approach these topics from a place of "basic human empathy" where people can find common ground.  

Beshear said he supports a red-flag law, which allows temporary confiscation of an individual's firearms if a judge finds that person is a risk to themselves or to others. A bipartisan bill to enact a version of the law is planned for introduction in the General Assembly session that begins Tuesday, Jan. 2.

But first, the governor said, he would like to stop the auctioning of murder weapons to the highest bidder. He said his support for such laws has grown stronger since the loss of a close friend, Tommy Elliott, in a mass shooting at the Old National Bank in downtown Louisville. 

"I know what it's like to lose a very close friend in a mass shooting," he said. "I know what it feels like to have someone who you love and care about murdered and taken from you." 

Beshear said it is imperative for the legislatuire to add rape and incest exceptions to the state's near-abortion ban, along with an exception for non-viable pregnancies. 

"There are kids right now that have been raped and impregnated by family members that don't have any options," he said. "Hadley said it right, she wasn't the first and she wasn't the last. There are Hadleys out there right now and they deserve better." 

Hadley Duvall, who was sexually abused by her stepfather for years and became pregnant at age 12 and eventually miscarried, appeared in an ad for Besehear's re-election campaign where she said, “To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Beshear's Republican opponent, Attorney General Daniel Cameron, responded to that attack by asking Beshear in a debate and afterward how far into a pregnancy a woman should be allowed to get an abortion.

In his campaign and in the interview, Beshear wouldn't say, and turned the tables: "I believe in access, but that's not what we're going to see from this General Assembly," he told Kentucky Health News. "I believe in access with reasonable restrictions. That's not where we are. We are at zero access." 

In the interview and several others this month, the Democratic governor said he thinks he and Republicans who run the legislature can have a more cooperative relationship because he can't seek re-election in 2027.  

"This is the period of time when we can get these things done and not to be seen as a benefit or a detriment, politically," he said. "And I'm already seeing a little difference in tone, and that's everyone. . . . I think we're seeing just a different tone and willingness to talk or to . . . talk differently."

Fact-checkers at Politifact say RFK Jr.'s presidential campaign of conspiracy theories, mainly about health topics, is 'Lie of the Year'

Robert F. Kennedy Jr. is an independent candidate
for president. (Associated Press photo by Meg Kinnard)
Politifact is a fact-checking service of The Poynter Institute, a foundation for journalism that says it is "an instructor, innovator, convener and resource for anyone who aspires to engage and inform citizens."

By Madison Czopek and Katie Sanders, Politifact

As pundits and politicos spar over whether Robert F. Kennedy Jr.’s presidential campaign will factor into the outcome of the 2024 election, one thing is clear: Kennedy’s political following is built on a movement that seeks to legitimize conspiracy theories.

His claims decrying vaccines have roiled scientists and medical experts and stoked anger over whether his work harms children. He has made suggestions about the cause of Covid-19 that he acknowledges sound racist and antisemitic.

Bolstered by his famous name and family’s legacy, his campaign of conspiracy theories has gained an electoral and financial foothold. He is running as an independent — having abandoned his pursuit of the Democratic nomination — and raised more than $15 million. A political action committee pledged to spend between $10 million and $15 million to get his name on the ballot in 10 states.

Even though he spent the past two decades as a prominent leader of the anti-vaccine movement, Kennedy rejects a blanket “anti-vax” label that he told Fox News in July makes him “look crazy, like a conspiracy theorist.”

But Kennedy draws bogus conclusions from scientific work. He employs “circumstantial evidence” as if it is proof. In TV, podcast and political appearances for his campaign in 2023, Kennedy steadfastly maintained that:
  • Vaccines cause autism.
  • No childhood vaccines “have ever been tested in a safety study pre-licensing.”
  • There is “tremendous circumstantial evidence” that psychiatric drugs cause mass shootings, and the National Institutes of Health refuses to research the link out of deference to pharmaceutical companies.
  • Ivermectin and hydroxychloroquine were discredited as Covid-19 treatments so Covid-19 vaccines could be granted emergency use authorization, a win for Big Pharma.
  • Exposure to the pesticide atrazine contributes to gender dysphoria in children.
  • Covid-19 is “targeted to attack Caucasians and black people. The people who are most immune are Ashkenazi Jews and Chinese.”
For Kennedy, conspiracies aren’t limited to public health. He claims “members of the CIA” were involved in the assassination of his uncle, John F. Kennedy. He doesn’t “believe that (Sirhan) Sirhan’s bullets ever hit my father,” Sen. Robert F. Kennedy. He insists the 2004 presidential election was stolen from Democrat John Kerry.

News organizations, including PolitiFact, have documented why those claims and many others are false, speculative or conspiracy-minded. PolitiFact did not receive a response from Kennedy’s campaign for this story. Kennedy has sat for numerous interviews and dismissed the critics, not with the grievance and bluster of former President Donald Trump, but with a calm demeanor. He amplifies the alleged plot and repeats dubious scientific evidence and historical detail.

Four of Kennedy’s siblings called Kennedy’s decision to run as an independent “dangerous” and “perilous” to the country. “Bobby might share the same name as our father, but he does not share the same values, vision or judgment,” the group wrote in a joint statement.

Kennedy brushes it off, saying he has a large family, and some members support him.

On her “Honestly” podcast in June, Bari Weiss asked whether Kennedy worried his position on autism and vaccines would cloud his other positions and cost him votes. His answer ignored his history: “Show me where I got it wrong,” he said, “and I’ll change.” In a campaign constructed by lies, that might be the biggest one. (Read more)

Wednesday, December 20, 2023

Ky. gambling problem help-line calls have tripled since legislature legalized sports betting; state has only seven certified counselors

Mike Stone, executive diredctor of the Kentucky Council on Problem Gambling, talks with a potential recruit at a conference in his effort to train more problem-gambling counselors. (Image from KET)
Kentucky Health News

Since sports betting became legal in Kentucky on Sept. 7, calls to the state problem-gambling hotline have nearly tripled, one of the state's few problem-gambling counselors told June Leffler for KET's "Kentucky Edition" Wednesday.

"Since December of '22 to '23, we've seen almost a three-fold increase" in calls, said Lionel Phelps of River Valley Behavioral Health in Owensboro.

Owensboro has two certified gambling counselors, but the state as a whole has only seven.

"There are none in Lexington, there's none in Northern Kentucky, there's none in Bowling Green, and there's none in Paducah, but there's gambling all over the state," Kentucky Council on Problem Gambling Executive Director Mike Stone told Leffer. "It is as much a geographic concern as it is a numerical concern. There's one counselor in Eastern Kentucky."

When the General Assembly approved sports betting, it set up the state's first problem-gambling fund, supplied by 2.5% of the state's revenue from sports betting. That is projected to be about $1.2 million a year, but the money won't be available "until well into 2024," said Stone.

Meanwhile, Stone said he is using gaming-industry contributions to recruit and train more counselors "because we anticipate a wave of problem gambling surfacing in 2024, with the advent of the sports betting in the state."

Sports betting is available online, and that aspect "is likely expanding how people bet," Leffler reports. At the Super Bowl, the betting will start with the coin toss, said Ronsolyn Clark, a counselor at Boulware Mission, an Owensboro residential program for men with drug and alcohol problems.

Clark said addiction to gambling is similar to drug addiction, in which people with the disorder get a high from the brain's release of dopamine, a neurotransmitter that acts like a hormone. "The brain doesn't see it really much differently" than drugs, "as far as the dopamine it releases" into the bloodstream, she said.
She said gambling disorder has the highest rate of suicide among all mental illnesses: "One in five individuals with a gambling problem will attempt or complete suicide."

The National Council on Problem Gambling estimates that 1% of U.S. adults have a gambling disorder, and 2-3% have a gambling problem, Leffler reports: "The consequences of problem gambling are arguably as devastating as those from a substance-use disorder."

The state's problem-gambling hotline is 1-800-GAMBLER, answered by people in Kentucky around the clock, Leffler reports.

Tuesday, December 19, 2023

Incoming attorney general replaces leading advocate of funding research aimed at legalizing psychedelic for addiction treatment

By Al Cross
Kentucky Health News

The main proponent of using state opioid-settlement money to fund research into a psychdelic drug as a treatment for addiction will soon be out of a job.

Bryan Hubbard, the chair and executive director of the state Opioid Abatement Advisory Commission under outgoing Attorney General Daniel Cameron, will be replaced when Russsell Coleman becomes attorney general Jan. 1. Coleman was elected in November, as his fellow Republican was losing the race for governor.

D. Christopher Evans
The commission's new chair and executive director will be Christoper Evans, a former Drug Enforcement Administration agent and leader who was acting administrator of the agency for more than five months in 2021, while President Biden's nominee, Anne Milgram, was being chosen and confirmed.

When Coleman announced his executive team in the state Senate chamber Tuesday, Kentucky Health News asked for his opinion and Evans's opinion of funding research on ibogaine, the African psychedelic that can suppress opioid-withdrawal symptoms but poses risks to the heart and is illegal everywhere but Mexico and New Zealand.

Coleman didn't give Evans an opportunity to respond, but said "We're gonna take a look at ibogaine," and would "make sure we look at that objectively." He said earlier that "Personnel is policy" and the change signals his belief that the "three-legged stool" of prevention, enforcement and treatment needs to focus more on prevention of drug use.

"We do not have a statewide prevention effort in the commonwealth," he said, adding later, "There's some great ideas out there on the prevention side. I want to see if we can scale those up. . .  I understand there's been a lot of ink spilled on ibogaine. My concern is we are not as focused as intently as we should be on the prevention piece of this."

The commission handles the state's half of the $900 million or so that the state will get in lawsuit settlements from opioid manufacturers and distributors. As chair and executive director, Hubbard promoted the idea of spending $42 million, about 5 percent of the money, on research aimed at getting Food and Drug Administration approval for use of ibogaine in addiction treatment.

At the commission's Nov. 14 meeting, Hubbard read several endorsements of ibogaine by experts, foundations and the American Legion. One foundation is supporting ibogaine research at Stanford University, which is awaiting publication, presumably in a peer-reviewed journal. Hubbard said the researcher had agreed to discuss his findings with the commission after they are published.

Bryan Hubbard
Hubbard noted that on Oct. 31 the National Institutes of Health and the Department of Health and Human Services issued a notice of funding opportunity for research on psychedelics including ibogaine as treatment for substance-use disorder. The notice says "There is an urgent need to develop novel treatments for SUD in light of the escalating rates of substance use, addiction, and overdose."

Several commission members spoke favorably of funding ibogaine research, but a non-voting member, state Rep. Danny Bentley, R-Russell (Greenup County), a pharmacist, called it "false hope," saying "It will take $2 billion and 10 years to get that product on the market."

Bentley said the drug's effect on the heart will put it in a "black box," meaning it will have one of the highest safety-related warnings assigned by the U.S. Food and Drug Administration. Other critics have said the heart effects would mean that treatment would be limited to hospitals, and thus expensive.

Bentley cautioned the commission to be aware of who is funding ibogaine research. Citing his education as a pharmacist and one of the earlier witnesses at the commission, he said he was taught that "If the people paying for the research own the company and the drug, it was invalid from the get-go."

Gov. Andy Beshear was also critical of the idea and the way it was promoted by Hubbard. His initial promotion of it was countenanced by Cameron, whom Beshear defeated for re-election.

Around the time Cameron implicitly endorsed the idea, a firm owned by a major national political contributor increased its investment in such research and gave Cameron a political boost, the Daily Beast reported.

Unlike Hubbard, Evans will have a deputy: Jessie Halladay, now a senior policy specialist with the Criminal Justice Institute. She has been special adviser to the Louisville Metro Police Department, senior policy adviser to the Kentucky Justice and Public Safety Cabinet, communications director for Jefferson County attorney and a public-safety and social-services reporter for the Louisville Courier Journal.

Evans, who will head the commission starting next month, was the first special agent in charge of the DEA's Louisville Field Division. In that job, he partnered with Coleman, then U.S. attorney for Western Kentucky, to create a DEA office in Paducah, a Coleman news release said.

Coleman said Evans rose to become chief of operations for DEA, which led to his stint as acting administrator. The release said he is a director of Christopher 2X Game Changers in Louisville and the Kentucky State Police Foundation.

Monday, December 18, 2023

Lt. Gov. Coleman has twin mastectomy, citing exam, family history; says early detection and prevention made the difference

Lt. Gov. Jacqueline Coleman (January 2022 photo)
Kentucky Health News

UPDATE, Dec. 26: Coleman issued a statement saying in part, “My post-surgery reports came back clean! While I am grateful for my amazing health-care heroes, and the relief I feel for having answers, please hear me when I say, if I had put this off, skipped appointments, or not taken it seriously, it is likely the news I’d be sharing eventually wouldn’t be great. Early detection and prevention were the difference makers for me. And they are for you, too. Go schedule that appointment that’s been in the back of your mind.”

Lt. Gov. Jacqueline Coleman underwent a double mastectomy Monday, then issued a statement saying the surgery was prompted by an examination and her family history.

“Concerns were raised to me during a recent routine physical exam,” she said. “With a significant family history of cancer, I made the decision to have a double mastectomy. I am happy to report that a successful surgery was performed today, and I expect to make a full recovery.”

Coleman, 41, was re-elected in November and is considered a likely Democratic candidate to succeed Gov. Andy Beshear in 2027, when he would not be eligible for a third term. He and Coleman said her case was a good example of the need for regular screening exams and other preventive measures.

"Coleman’s office did not immediately clarify if she’d received a cancer diagnosis" or if the surgery was preventive, reports Tessa Duvall of the Lexington Herald-Leader, noting that "Such surgeries can reduce the risk of breast cancer by 90% or more," according to the American Cancer Society. "Certain genetic mutations — such as the BRCA1 or BRCA2 — carry with them a “greatly increased risk of breast cancer,” according to the Susan G. Komen Breast Cancer Foundation."

Coleman said, “As Kentucky’s highest elected teacher, it is only fitting that I leave you with a little homework: Schedule those preventive exams you’ve put off, hug your people a little tighter and be kind, because everyone is fighting a battle you may know nothing about.”

She also said, “I want to thank the health-care heroes for the compassionate care I continue to receive. I am more appreciative than I can articulate for your expertise and your kindness through this process. . . . I am eternally grateful for my loving and supportive family who makes that possible, a compassionate friend in Gov. Beshear and a top-notch staff.”

Businesses are pitching local governments to give them money from the national opioid settlement; Ky. advisers say to go slow

Information for this story was also gathered by Kentucky Health News.
By Aneri Pattani
KFF Health News

The pitches are bold and arriving fast: Invest opioid settlement dollars in a lasso-like device to help police detain people without Tasers or pepper spray. Pour money into psychedelics, electrical stimulation devices, and other experimental treatments for addiction.

Opioid manufacturers and distributors are paying more than $54 billion in restitution to settle lawsuits about their role in the overdose epidemic, with little oversight on how the money is spent. KFF Health News and Kentucky Health News are tracking how state and local governments use or misuse the cash.

The marketing pitches land daily in the inboxes of state and local officials in charge of distributing money from the settlements in opioid lawsuits over the next two decades or more. Kentucky is getting $900 million, split evenly between the state and local governments.

The money is coming from an array of companies that made, sold, or distributed prescription painkillers, including Johnson & Johnson, AmerisourceBergen and Walgreens. Thousands of state and local governments sued the companies for aggressively promoting and distributing opioid medications, fueling an epidemic that progressed to heroin and fentanyl and has killed more than half a million Americans. The settlement money, arriving over nearly two decades, is meant to remediate the effects of that corporate behavior.

But as the dollars land in government coffers — more than $4.3 billion as of early November — a swarm of private, public, nonprofit, and for-profit entities are eyeing the gold rush. Some people fear that corporations, in particular — with their flashy products, robust marketing budgets, and hunger for profits — will now gobble up the windfall meant to rectify it.

“They see a cash cow,” said JK Costello, director of behavioral health consulting for the Steadman Group, a firm that is being paid to help local governments administer the settlements in Colorado, Kansas, Oregon, and Virginia. “Everyone is interested.”

Officials of the Kentucky Association of Counties and the Kentucky League of Cities told Kentucky Health News that they are advising cities and counties to not rush to spend the funds, because they don't expire and might be used more effectively if they are allowed to accumulate.

Morgain Patterson, the cities league's law director, said it is encouraging the state's 149 elibigle cities to form partnerships "to build more of an infrastructure" for things like job training for people in recovery. She noted that Ashland, which is getting about $100,000 a year from settlements, issued a request for propopals from people and groups interested in the funds.

Tim Sturgill, general counsel for the counties association, said it has hired a new employee, starting Jan. 4, who will help county officials understand both what they can and should do with the money.

The key to deciding how to spend the settlement money, public-health and policy experts told KFF Health News, is to critically evaluate products or services to see if they are necessary, evidence-based, and sustainable, instead of flocking to companies with the best marketing. Otherwise, “you end up with lots of shiny objects,” Costello said. And, ultimately, failure to do due diligence could leave some jurisdictions holding an empty bag.

Van Ingram
Van Ingram, executive director of Kentucky's Office of Drug Control Policy and former police chief in Maysville, told League of Cities writer Jeff Moreland that local governments need to be cautious.

“I think they need to put the brakes on, and I think you can’t get too much stakeholder input,” Ingram said. “We need to be hearing from our public health departments; we need to be hearing from any treatment providers we have in the area. We need to hear from people who are in recovery now and find out what barriers they are facing. It’s time to do a community inventory of recovery capital and look at the things you have in place, but more importantly, the things you don’t have in place.”

Ingram added, “I’m encouraging community leaders to develop a five- to 10-year plan. This money is spread out over 18 years, and you’ve got to have a direction you want to go in and a plan you want to meet. We’ve got one shot at this, and then it’s gone. I think it’s incumbent upon the state and communities to spend these dollars wisely.”

KFF Health News obtained emails in eight states that show health departments, sheriffs’ offices, and councils overseeing settlement funds are receiving a similar deluge of messages. In the emails, marketing specialists offer phone calls, informational presentations, and meetings with their companies.

In 2022, North Carolina lawmakers allotted $1.85 million of settlement funds for a pilot project using the first FDA-approved app for opioid use disorder, developed by Pear Therapeutics. There were high hopes the app would help people stay in treatment longer. But less than a year later, Pear filed for bankruptcy.

The state hadn’t paid the company yet, so the money isn’t lost, according to the North Carolina Department of Health and Human Services. But the department and lawmakers have not decided what to do with those dollars next.

$1 million for drug-disposal pouches

Jason Sundby, CEO of Verde Environmental Technologies, said the Deterra pouches his company sells are a low-cost way to prevent expensive addictions.

Customers place their unused medications in a Deterra pouch and add water, deactivating the drugs before tossing them, ensuring they cannot be used even if fished out of the trash. A medium Deterra pouch costs $3.89 and holds 45 pills.

The goal is to “get these drugs out of people’s homes before they can be misused, diverted, and people start down the path of needing treatment or naloxone or emergency room visits,” Sundby said.

Sundby’s company ran an ad about spending settlement dollars on its product in a National Association of Counties newsletter and featured similar information online.The Deterra website prominently features opioid settlement funds as a potential funding stream to purchase drug disposal pouches. Several other companies have taken similar approaches, urging consumers to consider applying opioid settlement funds to their products.

It may be paying off. Deterra is set to receive $1 million in settlement funds from the health department in Delaware County, Pennsylvania, and $12,000 from the sheriff in Henry County, Iowa. The company also has partnerships with St. Croix and Milwaukee counties in Wisconsin, and is working on a deal in Connecticut.

Several other companies with similar products have also used their product sites to urge jurisdictions to consider the settlements as a funding stream — and they’re seeing early success.

DisposeRx makes a drug-deactivation product — its version costs about a dollar each — and received $144,000 in South Carolina for mailing 134,000 disposal packets to a program that educated high school football players, coaches, and parents about addiction.

SafeRx makes $3 pill bottles with a locking code to store medications and was awarded $189,000 by South Carolina’s opioid settlement council to work with the Greenville County Sheriff’s Office and local prevention groups. It also won smaller awards from Weld and Custer counties in Colorado.

None of the companies said they are dependent on opioid settlements to sustain their business long-term. But the funds provide a temporary boost. In a 2022 presentation to prospective investors, SafeRx called the opioid settlements a “growth catalyst.”

Critics of such investments say the products are not worthwhile. Today’s crisis of fatal overdoses is largely driven by illicit fentanyl. Even if studies suggest the companies’ products make people more likely to safely store and dispose of medications, that’s unlikely to stem the record levels of deaths seen in recent years.

“The plausible mechanism by which they would even be able to reduce overdose is a mystery because prescription medications are not driving overdose,” said Tricia Christensen, policy director with the nonprofit Community Education Group, which is tracking settlement spending across Appalachia.

Safe storage and disposal can be accomplished with a locking cabinet and toilet, she said. The FDA lists opioids on its flush list for disposal and says there is no evidence that low levels of the medicines that end up in rivers harm human health.

Milton Cohen, CEO of SafeRx’s parent company, Caring Closures International, said keeping prescription medicines secure addresses the root of the epidemic. Fentanyl kills, but often where people start, “where water is coming into the boat still, is the medicine cabinet,” he said. “We can bail all we want, but the right thing to do is to plug the hole first.”

SafeRx has been awarded $189,000 in opioid settlement funds in South Carolina to work with the Greenville County sheriff and local prevention groups.

Products to secure and dispose of drugs also provide an opportunity for education and destigmatization, said Melissa Lyon, director of Pennsylvania's Delaware County Health Department. The county plans to mail Deterra pouches and postcards about preventing addiction to three-quarters of its residents.

“The Deterra pouch is to me a direct correlation” to the overprescribing that came from pharmaceutical companies’ aggressive marketing, Lyon said. Since the settlement money is to compensate for that, “this is a good use of the funds.”

Law-enforcement that the Justice League would envy

Other businesses making pitches for settlement funds have a less clear relationship to opioids.

Wrap Technologies creates tools for law enforcement to reduce lethal uses of force. Its chief product, the BolaWrap, shoots a 7½-foot Kevlar tether more than a dozen feet through the air until it wraps around a person’s limbs or torso — almost like Wonder Woman’s Lasso of Truth.

Terry Nichols, director of business development for the company, said the BolaWrap can be used as an alternative to Tasers or pepper spray when officers need to detain someone experiencing a mental-health crisis or committing crimes related to their addiction, like burglary.

“If you want to be more humane in the way you treat people in substance use disorder and crisis, this is an option,” he said.

The company posts body camera footage of officers using BolaWrap on YouTube and says that out of 192 field reports of its use, about 75% of situations were resolved without additional use of force.

When officers de-escalate situations, people are less likely to end up in jail, Nichols said. And diverting people from the criminal justice system is among the suggested investments in opioid settlement agreements.

That argument convinced the city of Brownwood, Texas, where Nichols was police chief until 2019. It has spent about $15,000 of opioid settlement funds to buy nine BolaWrap devices.

After Brownwood’s purchase, Wrap Technologies issued a press release that did not mention Nichols but quoted Kevin Mullins encouraging more law-enforcement agencies to “take the opportunity afforded by the opioid-settlement funds to empower their officers.” The company has also sent a two-page document to police departments explaining how settlement funds can be used to buy BolaWraps.

Language from that document appeared nearly word-for-word in a briefing sheet given to Brownwood City Council before the BolaWrap purchase, listing "Chief Terry Nichols (Ret.)" as the companyu contact. The council voted unanimously for the buy.

BolaWrap's process hasn’t been as smooth elsewhere. In Hawthorne, California, the police department planned to buy 80 BolaWraps using opioid-settlement funds. After it paid its first installment of about $25,000 in June, the state Department of Health Care Services informed it that the BolaWrap is not an allowable use of these dollars.

Sturgill said he hasn't heard of any Kentucky counties buying BolaWraps.

Patterson said some local governments have spent money to increase local addiction treatment and recovery programs, and the league is advising its cities that they sign a memorandum of understanding with such providers to fully document how the funds are being used.

She said that if a local government spends settlement money on things not mentioned in the settlement agreements or state law, it is required to report that to the state attorney general, who oversees settlement spending in Kentucky.

How are your local governments spending their settlement money, or planning to spend it?

Some decongestants spike blood pressure; alternatives available

Photo by September 15, iStock/Getty Images Plus
By Dr. Vincent Sorrell

It’s the season for respiratory viruses and the cough, congestion and sore throats they bring. There are many options for over-the-counter (OTC) remedies and relief, but if you have high blood pressure, you may want to take a closer look at the label. Some may contain warnings that advise against taking if you have high blood pressure. Others contain high levels of sodium, which can also increase blood pressure.

Some OTC decongestants contain pseudoephedrine, a drug that works by constricting the blood vessels to reduce nasal swelling. But with those blood vessels narrowed, blood pressure increases. For the 122 million Americans with hypertension, decongestants can raise an already elevated blood pressure to dangerous levels and increase the chance of heart attack and stroke.

Many OTC cold and flu medicines now have a version formulated specifically for those with high blood pressure. Allergy medicines can also relieve stuffy or runny noses without adverse side effects, just as cough medicines and expectorants to help clear mucus.

If you need relief from cold and sinus congestion without medication, try these at-home remedies:
  • Use a saline rinse to move saltwater through the nasal passages to clear out mucus.
  • Drink extra fluids to help thin the mucus.
  • Use a humidifier to moisten the air in your home and help clear your sinuses.
  • Get plenty of rest.
If your symptoms persist, and you’re concerned about which decongestant is the best for you, talk to your doctor.

Vincent Sorrell, M.D., is chief of cardiology at UK HealthCare’s Gill Heart & Vascular Institute.

Sunday, December 17, 2023

American Cancer Society wants state to spend $10 million a year on smoking cessation and prevention; current budget is $2 million

Graph from Broken Promises to Our Children: A State-by-State Look
at the 1998 Tobacco Settlement 24 Years Later; click on it to enlarge.
By Melissa Patrick
Kentucky Health News

The American Cancer Society Cancer Action Network will ask legislators in the upcoming General Assembly session to spend a lot more on tobacco prevention and cessation, with a focus on how decreasing smoking and vaping rates would improve Kentucky's economy and its workforce.  

Doug Hogan, the group's government-relations director for Kentucky and West Virginia, told Kentucky Health News that Kentucky's high smoking rates come with great cost to people's health, health-care systems and the economy. 

"From a business perspective, businesses are losing thousands of dollars each month because of lost productivity and also on increased health-care costs for their employees who smoke," Hogan said. "This is a huge cost factor for our businesses and it's also a healthy-workforce issue." 

In a news release, Hogan said "Smoking is estimated to cost Kentucky $2.23 billion in direct health-care costs, including $634 million in Medicaid costs annually. Additionally, smoking costs the state an estimated $6.3 billion in productivity costs annually." 

Doug Hogan (LinkedIn photo)
Hogan praised state officials for creating in the last several years environments that are conducive to expanding businesses and creating more jobs, but he told KHN, "If there's not a healthy workforce to fill in those jobs, then a lot of that is for naught. And so we want to take a look at the economics of this and say, we need to focus on a healthy workforce." 

The cancer society's ask of $10 million a year for tobacco cessation and prevention is $8 million more than the state is spending now. 

This increase would prevent 2,400 Kentucky teenagers from growing into adults addicted to deadly nicotine products, Hogan said in an email. 

"We want to use the additional funding for prevention so that our next generation of young people don't grow into adults who are addicted to deadly nicotine products," he said. "And then the other part of that is to provide the tools and the resources that adults need, who want to quit, to be able to be successful and move toward a smoke-free lifestyle." 

In Kentucky, the release said, “22.5% of high school students currently use tobacco products, including e-cigarettes, and 17.4% of adults in Kentucky smoke, which is over 40% higher than the national average.”

Hogan said in the release, "Kentucky has the opportunity to turn these numbers around with the 2024 budget. For every $1 spent on comprehensive prevention and cessation programs, states receive up to $55 in savings from averted tobacco-related health-care costs. So, a $10 million investment would be a great step toward a healthier workforce and could save up to $550 million." 

The University of Kentucky's Markey Cancer Center will evaluate the program to ensure the state is getting the maximum return on its investment, Hogan said.

He added, "We know that kids who experiment with electronic cigarettes are much more likely to experiment with other tobacco products and more likely to become addicted to deadly nicotine products."

A document presented to the legislature's Tobacco Settlement Agreement Fund Oversight Committee in September showed the estimated monthly and annual costs to employers from cigarette smoking, by county. In Adair County, where 26% of the adult population smokes, the annual cost to the workforce for the estimated 1,138 adults in the workforfce who smoke is $7.9 million. 

The 2024 legislative session convenes Jan. 2 and must adjourn by April 15. The deadline for filing for legislative seats and other partisan offices in the 2024 primary elections is Jan. 5. 

Lawmaker on key committees supports an increase in funding

Sen. Amanda Mays Bledsoe
Sen. Amanda Mays Bledsoe, R-Lexington, vice-chair of the Senate Appropriations & Revenue Committee and co-chair of the House-Senate tobacco committee, said she agrees with the cancer society's argument that reducing the number of people who smoke will save money in the long run and would create a healthier workforce. 

"I think their plan is on the right track," she said. 

However, she added, that she'll have to wait and see what is in the House budget before before she can react to this request. The budget must start in the House. 

"I'm not really sure where that's gonna land," Mays Bledsoe said, "but I am supportive of their ask."

She added that it's important to recognize that the tobacco-settlement money touches several pieces of the budget, with half of it allocated for agriculture diversification. 

"I was really surprised over the years of where they've used program money," she said. "And my biggest surprise was how much of it was not used on specifically tobacco cessation." That was one of the big arguments for the states' 1998 settlement with cigarette manufacturers, but states have spent relatively little on it.

Kentucky 43rd in smoking cessation and prevention funding

While $10 million would be a huge jump from the current $2 million in tobacco prevention and cessation spending, it would still fall far short of the $56.4 million advised by the federal Centers for Disease Control and Prevention.

According to a report titled Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 24 Years Later,  Kentucky ranks 43rd among states in funding tobacco prevention and cessation programs, down five slots from 2020, when it spent $3.3 million.

Meanwhile, the tobacco industry spends $251 million for tobacco marketing in the state, says the report, issued by the cencer society, the Campaign for Tobacco-Free Kids, the American Heart Association, the American Lung Association, the Truth Initiative and Americans for Nonsmokers’ Rights.

Quit help for Kentucky smokers

Kentucky smokers have several tools to help them quit.

The state runs a 1-800-QUIT-NOW hotline that offers free tobacco-cessation services 24 hours a day, seven days a week. Coaching is available by phone or online chats. .

And while Quit Now Kentucky provides free services to people of all ages, middle- and high-school students may want to try "My Life, My Quit," a free, confidential quitline for Kentuckians 17 and younger to help them stop smoking or vaping. Teens can text "Start My Quit" to 36072, or click on the live chat button on the My Life, My Quit website to chat with a coach.

A 2017 law requires insurers, including Medicaid, to cover all seven tobacco-cessation medications approved by the U.S. Food and Drug Administration, and counseling services recommended by the U.S. Preventive Services Task Force. It also eliminated co-payments for medication and counseling, requirements tying medication coverage to counseling, and limits on the length of treatment.

The cancer society also offers a list of resources to help you quit using tobacco products.

Hogan said many Kentucky smokers still don't know what quitting resources are available to them, even though research shows that more than two-thirds of smokers say they want to quit.  

"But it's very difficult," he said. "If we increase the tobacco prevention, cessation programming, and the investment that we're making there, we can have more of an impact on the folks to get them the resources they need to quit."

Saturday, December 16, 2023

Flu, Covid-19 and RSV rates are so high that the CDC has issued a health advisory urging more Americans to get vaccinated

State graphs, adapted by Kentucky Health News
By Melissa Patrick

Kentucky Health News

As illness from the three respiratory viruses tracked by Kentucky health departments — influenza, Covid-19 and respiratory syncytial virus (RSV) — continue to pile up, the Centers for the Disease Control and Prevention has issued a health advisory urging more Americans to get vaccinated.  

"Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes Covid-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks," says the advisory, which also reported a rise in multisystem inflammatory syndrome in children following Covid-19 infection. 

The advisory says there is an urgent need to increase immunization for the flu, Covid-19, and RSV, along with the use of authorized and approved therapeutics this winter. 

The need for more people to get vaccinated holds true in Kentucky. 

As of Sept. 18, 58% of the state's total population was considered fully vaccinated for Covid-19, and 41% had received an additional dose, according to the state's Covid-19 dashboard

During the 2022-2023 flu season, 40.1% of Kentuckians got a flu vaccine. Among children, that rate was 47.1%, and among adults, it was 35.8%, according to the Kaiser Family Foundation.

And it appears there aren't enough of the recently approved RSV vaccines to go around, according to reporting by Louisville's WDRB on Dec. 6. 

Dr. Michael Kuduk, president of the Kentucky Medical Association, told Molly Jett of WDRB that the children's RSV antibody injection is "pretty much not available" and the vaccine for pregnant women is "really hard to find."

"Manufacturers can't keep up with the demand," Kuduk said. "It's not going to help anybody this year in the middle of RSV season."

The state Department for Public Health's latest weekly respiratory-illness report shows Covid-19 and RSV activity is high; flu activity is increasing; and hospitalizations for RSV are increasing. 

In the week ended Dec. 9, Kentucky reported 3,144 laboratory-confirmed cases of Covid-19, down from 3,907 the week prior. The state reported 1,109 laboratory-confirmed cases of the flu, up from 866 the prior week. 

In the week ended Dec. 9, emergency-department visits for the three respiratory illnesses in Kentucky remained high, but dropped a bit, to 3,383 visits, down from 3,631 the week prior. 

Of the week's cases, 1,661 were for flu, up from 1,650 the week prior; 1,070 were for Covid-19, down from 1,183 the week prior; and 753 were for RSV, down from 798 the week prior. 

This week's dashboard breaks children's cases into two age categories, 0 through 4 and 5 through 17. 

Among children 4 and younger, there were 1,201 emergency-department visits for respiratory illness. Of those, 548 were for RSV, down from 597 the week prior; 496 were for flu, down from 522 the week prior; and 157 were for Covid-19, down from 184 the week prior. 

Among children 5-17, there were 614 emergency-department visits for respiratory illness. Of those, 472 were for flu, up from 393 the week prior; 79 were for Covid-19, up from 54 the week prior; and 63 were for RSV, down from 72 the week prior. 

Overall hospitalizations for respiratory illness also dropped a bit, to 577, down from 584 the week prior. Of those, 310 were for Covid-19, down from 320 the week prior; 172 for RSV, up from 159; and 95 for flu, down from 105 the week prior. 

Among children 0-4, there were 103 hospitalizations for respiratory illness, down from 127 the prior week. Of those, 93 were for RSV, up from 92; seven were for flu, down from 18; and three were for Covid-19, down from 17. 

Among children 5-17, there were nine hospitalizations for respiratory illness in the week ended Dec. 9, down from 11 the prior week. Of those, four were for flu, down from five; four were for RSV, up from three; and one was for Covid-19, down from three.

Ranges of Covid-19 hospitalization rates for the week ended Dec. 9
Red indicates a high rate; yellow, medium; and green, low. (CDC)
A CDC report for the week ended Dec. 9, showed that Covid-19 hospitalization rates in 10 Kentucky counties were above 20 hospitalizations per 100,000 people, which the CDC considers high. 

Letcher County continues to stand out with a rate of 41.8 Covid-19 hospitalizations per 100,000 residents. The previous week, that rate was 74.2. Other counties with the "high" designation were Pike, with a rate of 23.8 per 100,000; Martin (20.2); Magoffin (20); Lawrence (20.2); Johnson (20); Greenup (20.2); Floyd (20); Carter (20.2); and Boyd (20.2). 

Deaths: Since Oct. 1, the state health department has attributed 99 deaths to Covid-19, six to flu and none to RSV. No deaths were reported during the week ended Dec. 8. 

Respiratory-related deaths on the state's weekly dashboard are reported according to when they occur, which sometimes leads to a delay between the actual date of death and the submission to the department. 

Friday, December 15, 2023

Bipartisan bill would allow guns to be taken from people judged to be at risk of hurting themselves or others; opposition voiced

This story mentions suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988.

By Sarah Ladd
Kentucky Lantern

A Republican-backed draft bill aimed at temporarily removing firearms from Kentuckians at risk of harming themselves or others garnered mixed reactions from the Interim Joint Committee on Judiciary Friday morning.

State Sen. Whitney Westerfield (Legislative photo)
Republican Sen. Whitney Westerfield of Christian County said he will introduce t​he Crisis Aversion and Rights Retention Orders bill, or CARR, because of shootings that left children dead and people injured.

“The law has to allow us to protect people,” Westerfield told the House-Senate committee Friday. “I feel like it’s my obligation, and though I can’t speak for you, I believe it is your obligation, to not be afraid to have difficult conversations about the toughest issues that people of Kentucky face.”

Such laws have been enacted in 19 states, Louisville's WDRB reports. The nonprofit Whitney/Strong, formed by a Cincinnati woman to fight gun violence, says CARR generally works like this: 
  • A concerned community member brings evidence about potential harm to one’s self or others, and law enforcement can then file a legal petition to remove that person’s guns temporarily.
  • A judge will “approve or deny the temporary transfer petition after conducting a strict, independent judicial review.”
  • If the judge grants the petition, guns belonging to the person in question are handed over temporarily to law enforcement or “a trusted person outside of the owner’s household.”
  • A hearing is then held to determine next steps, which may include “identifying opportunities for important support services for the individual in crisis.”
  • Once the person is not in crisis, the guns are returned.
It’s unclear what Kentucky’s specific legislation would look like. Westerfield is working on two draft options, he said, which may “change a lot.”

One version of the bill includes the option for law enforcement to approach the person in question and tell them someone brought concerns forward about their safety or the safety of others.

“It gives the respondent the option,” Westerfield explained. “You can have a hearing within X number of hours, near immediate. Keep your guns until then, not keep your guns — that’s up in the air. Or, you can give us your guns now, and we’ll have a hearing in a week.”

“The respondent has the burden of defending that in that particular case,” he said. Timelines are adjustable, he added, since there may be practical problems getting a hearing so soon.

There are other potential problems, Westerfield said.

“If you tell someone that you fear has … a mental-health issue, or a trauma, something that you’re worried they’re about to break, and then you don’t act with some near immediacy, you might actually provoke the act,” he said. “That’s the concern. And you’re balancing that risk and that concern with the Second Amendment right that they have and no one disputes that they have.”

The second version of Westerfield's proposal includes an ex parte hearing, in which the judge would hold without the gun owner present.

This version “still has the law-enforcement steps,” Westerfield said. “So, it’s not just anybody on a whim asking for a judge to get your guns. There has to be some articulated, specific reasons” for the move.

Westerfield said whatever version of bill he files will be “meaningfully different in a couple of ways” from so-called “red flag” laws. “First of all, the timelines are shorter,” he said. “The burden of proof is going to be higher.”

State Rep. Savannah Maddox (Legislative photo)
Rep. Savannah Maddox, R-Dry Ridge, reiterated her “longstanding opposition to this proposal” and concern that it has the potential to violate constitutional rights such as due process and protection against government search and seizure.

“When law enforcement comes to seize the firearms, do they automatically know where to find them?” she asked. “Are they told where to find them? Do they dig through the entirety of the house?” She said this could lead to a registry of some kind.

Westerfield said he isn’t proposing any kind of “search” or “ransacking of a home,” and “I think it’s on the honor system.”

Maddox said, “We must fervently resist any effort to pass gun-control legislation. And we must be serious about analyzing the data and putting a stop to these ineffective policies that put innocent citizens in harm’s way. And we have to encourage privately held entities to do the same.”

Whitney Austin, who co-founded Whitney Strong after surviving a mass shooting in Cincinnati, told the panel that “we know that misuse of firearms is not tied to law-abiding, mentally well gun owners. CARR was not created for them. CARR was created to surgically identify the small subset of gun owners, including those in lawful possession of a firearm, who are on the brink of misusing their guns to harm themselves or others.”

Sheila Schuster, a licensed psychologist and executive director of the Kentucky Mental Health Coalition, told the Lantern that she supports CARR, but “The truth is that people with a mental illness are 10 times more likely to be a victim of violent crime than to be a perpetrator.”

She explained, “At the point that someone commits an act, particularly hurting someone else, it’s very likely that they are suffering with rage, with paranoia and in terms of feeling like somebody has done something to wrong them and they’re gonna (get) revenge.”

Schuster added that suicidal people taking their lives happen at an “astronomical percentage higher if there’s a gun within reach than if there’s not.”

In a written statement to the lawmakers, Schuster said: “As a psychologist and mental health advocate, I am painfully aware of the stigma of mental illness and the confusion in the minds of many people that mass shooters are undoubtedly mentally ill. This is not the case and the CARR legislation does a very good job of not adding to nor reinforcing that false narrative.”

Kentucky has a law that requires mental-health professionals to warn potential victims if a client makes a threat to someone’s safety. Kentuckians who are mentally ill and at risk of harming themselves or others and can benefit from treatment can be involuntarily hospitalized if that's the least restrictive mode of treatment available.

Support at the committee meeting came mainly from Jefferson County. Westerfield's intended co-sponsor is Sen. David Yates, D-Louisville. Rep. Pamela Stevenson of Louisville, this year's Democratic candidate for attormney general, endorsed CARR, saying “with every right there’s a responsibility. . . . We’ve got to be brave enough to not let people just die nilly-willy.”

Jeffersontown Police Chief Richard Sanders endorsed CARR, saying police are “faced with things today that I’ve never seen before. . . . One of the biggest problems we face in law enforcement is people suffering from mental illness.” Some people, he said, “shouldn’t have access to a weapon.”