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

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

By Al Cross

Kentucky Health News

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

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

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

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

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

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

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

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

Ky. Dept. for Public Health graph, relabeled by Ky. Health News; for a larger version, click on it.

Beshear spoke as the state's coronavirus case numbers remained on a rough plateau but the number of deaths kept trending upward and getting younger.

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

He said Saturday was the worst day yet for staffing at Kentucky hospitals, with 74 of the 96 acute-care hospitals reporting critical staff shortages. That dropped to 63 by Monday.

 

The state reported 88 deaths Saturday, Sunday and Monday; the seven-day average was 40 per day on Sunday and 38 on Monday. The average over the last 14 days is 31 per day. The pandemic death toll is now 8,339.

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

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

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

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

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

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

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

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

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

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

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

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

Beshear calls special session on pandemic; extent of his authority to issue mask mandates is likely most critical, contentious issue

State Dept. for Public Health map, adapted by Kentucky Health News; for a larger version, click on it.

By Al Cross

Kentucky Health News

The Kentucky General Assembly will meet in special session at 10 a.m. Tuesday, under a call issued Saturday afternoon by Gov. Andy Beshear, to set state policy for the pandemic as it continues its record surge.

Beshear has issued many edicts under a state of emergency that he declared almost 18 months ago, but the legislature passed laws last winter to limit his emergency powers, and two weeks ago the state Supreme Court upheld them.

"In previous surges the governor, me, was empowered to act, to do what was necessary … to save lives," Beshear said at a news conference, "Now that burden will fall in large part on the General Assembly."

Beshear said he and legislative leaders have agreed on how to approach many issues, but not on the one that may be the most critical and divisive: power to require face coverings to prevent spread of the coronavirus.

"I believe this authority is absolutely necessary, as we would not have been able to stop the previous surges without using it. We would not have been able to flatten the curve without the ability to require masking," he said. "That kept our emergency rooms and hospitals from overflowing . . . We're already to that stage now, so I think that it's necessary."

The governor said he doesn't expect legislators to give him general authority to require masking, but hopes they will let him impose mask mandates in counties with a certain level of infection, as shown on the state's color-coded map.

"If a local government can keep the infection levels low, in the green or even in the yellow, then maybe they would make that determination," he said. "But when it gets to orange or especially red, you know, sometimes it's easier to make the call here than what some other people might face."

He explained later, "I certainly think a red county . . . if a local government will not require indoor masking when you're out of your house … it's something the state should be allowed to do, at least during the Delta variant," which has caused the current surge.

The orange zone is for counties where the seven-day average of daily new cases is more than 1 per 10,000 residents. Only two counties, Carlisle and Woodford, are now in orange; the rest are in red, signifying rates of 2.5 per 10,000, which state health officials consider a high rate of virus transmission.

"Right now, we need it everywhere," Beshear said. "We have more cases per week than we ever seen,” and more Covid-19 patients in hospitals and intensive-care units than ever. "My worry is that we will have more deaths, in a short period of time, than we've ever seen."

The first big debates on the issue are likely to be in private, in the party caucuses of the House and Senate. "I know this is one that will be a contentious issue within the caucus or within in the General Assembly itself," the Democratic governor said, referring to the Republican majorities that control the legislature.

Governors set limits for special sessions when they call them. Beshear's call for the session allows the legislature to extend the state of emergency he declared March until Jan. 15, when the legislature will be in regular session; and to "set forth the criteria pursuant to which the governor may exercise authority to require facial coverings in indoor settings" during the emergency.

"I hope we can have a constructive, if we can, a low-drama experience," Beshear said, thanking legislative leaders and the staffs for the work they have already done. He said they have shared drafts of legislation.

The call also includes approving executive-branch orders issued under the emergency declaration, providing flexibility for school districts to use "alternatives to in-person instruction," give employees additional sick-leave days, "provide funding stability" to schools and use of $69.2 million in federal pandemic relief money. Those uses do not include support for extra staffing for hospitals and nursing homes, for which they asked a legislative committee, some members of which endorsed the request.

Beshear said he does not expect the session to last longer than five days, ending Saturday. He said his understanding of the Supreme Court ruling is that it becomes final at midnight Friday night. "I think they will come to consensus pretty early on what they want to do," he said.

Five days is the minimum length of a session that enacts laws, unless the legislature suspends the state constitution's rule that bills be read in each chamber three times on separate days.

Beshear closed his press conference with a warning about the Delta variant: “If you are unvaccinated you’ll get it, and unfortunately, you're likely to get very sick.”

In other pandemic news Saturday:

The Roman Catholic Diocese of Covington, citing rising case levels, has changed policy and will require masks in its 37 schools starting Tuesday. Some parents of children in the system got a federal judge to stop enforcement of Beshear's school-mask order, which Beshear withdrew after the Supreme Court ruling. A mask rule issued by the state school board still applies to public schools.

Linda Blackford of the Lexington Herald-Leader explains why Woodford County is the most-vaccinated county in Kentucky.

As Covid-19 sets hospital records, Beshear calls out National Guard to help, meets with legislators empowered by high court

State Department for Public Health graph

By Melissa Patrick and Al Cross
Kentucky Health News

As Gov. Andy Beshear shifts to a new role of executing and not making pandemic policy, at a time when coronavirus cases are surging and hospitals fear they will run out of beds, he has mobilized the Kentucky National Guard for help and is still talking about a statewide indoor mask mandate. 

"It appears that we are moving from alarming to a critical stage, and the future next couple of weeks to couple months looks like they're going to be very, very rough," Beshear said at his Monday pandemic news briefing. He said he has begun discussing next steps with legislative leaders, in the wake of Saturday's Supreme Court decision upholding new laws that limit governors' emergency powers.

Beshear said starting Sept. 1, the National Guard will provide support to hospitals, health departments and food banks, with the initial deployment to include 75 guardsmen, in five teams of 15 people. The teams will initially go to Pikeville Medical Center, The Medical Center at Bowling Green and St. Claire Regional Medical Center in Morehead.

One of the slides Gov. Andy Beshear showed at his press conference

Beshear said he has asked the Federal Emergency Management Agency for support for understaffed hospitals and emergency medical services. If approved, the help would go to Baptist Health Hardin in Elizabethtown, Saint Joseph London, Pikeville, Bowling Green and St. Claire, whose dire straits were highlighted in a live video.

Dr. William Melahn, chief medical officer at St. Claire, said the Morehead hospital is working under a "code yellow" disaster plan and has a critical nursing staff shortage. He said its Covid-19 patient count recently rose form 17 to 32, and another 32 patients who would typically have been hospitalized are being cared for by the hospital's home-health team.

Melahn estimated that 85% of the hospital's Covid-19 patients are unvaccinated, and that the vaccinated ones are not as sick, while all the critical-care patients are unvaccinated. He said more vaccinations would alleviate some of the strain.

"There’s two reasons to be vaccinated. One is to protect you, and the other is to protect people around you," he said. "Let me just point out a little bit of reality here: If we had another disaster happen  now – even a small one – we don’t have any reserve left. So if we had a bus accident . . . or whatever, I’m not sure what we would do. So, vaccination is clearly what is going to get us out of this." 

Steve Haines, critical-care nursing director at Danville's Ephraim McDowell Regional Medical Center, called the latest surge "pretty horrific." He said his hospital had eight Covid-19 deaths in 24 hours over the weekend, and only has three holding rooms in its morgue.

"We wouldn't have to work so hard to help our community if more people were vaccinated," he said. "And right now it just looks like there is no end. And I think the only chance we have is vaccination, and that's it." At that point, he broke down and spoke no more.

Beshear said between 21 and 25 regional hospitals have a critical staffing shortage and up to 11 have a nursing shortage.

Every county but Robertson is in the red zone. The top 10 infection rates
are in Clay, Magoffin, Whitley, Bell, Jackson, Laurel, Owsley, Union and
Floyd counties. All but Union are in Eastern Kentucky. (Click to enlarge)

Daily numbers: The state broke its previous record for Covid-19 hospitalizations Saturday, and the numbers kept rising Sunday and Monday, when hospitals reported 1,893 Covid-19 patients, 523 of them in intensive care and 301 of those on mechanical ventilation.

Beshear said hospitalizations are doubling every two weeks and the state is getting close to all its beds being full. He said many hospitals are already converting space to accommodate a surge in Covid-19 patients, are not doing procedures that require an overnight stay and some have moved into a modified disaster mode. One is already in full disaster mode. 

The state reported 2,596 new cases of the coronavirus Monday, 695 of them in Kentuckians 18 and younger. Beshear noted that in August 2020, 10-to-19-year-olds made up 11.8% of the cases, but so far this month, it has been 20.6%. 

He said the weekly case numbers are showing exponential growth and that the weekly increases are "faster and steeper than anything that we have seen to date. And it does not look like it is slowing down." He said this is the third highest week for cases since the pandemic began. 

The state reported 17 more Covid-19 deaths, seven in people younger than 60, bringing the death toll to 7,558. The average for the last week is 10.4 deaths per day, the first time it has been in double figures since April 4.

The share of Kentuckians testing positive for the virus in the past seven days fell to 12.87% Monday after hitting 13.01% Sunday, the highest since testing became widely available 15 months ago. 

"So here we are, at a time when we have vaccines, when we know that masks work, with our third highest week of cases ever and the highest positivity. That means Covid is burning through our population here in Kentucky," said Beshear.

A new role: Beshear said the state is “reaching the point where a statewide mask mandate is absolutely necessary because we’ve gotta have hospital beds,” but said that will be up to the legislature because of Saturday's Supreme Court decision limiting his emergency orders to 30 days unless adopted by the legislature.

“What we can do is gonna be more limited, depending on what the legislature decides,” he said. “Up to now I’ve carried the football. I've been able to make the tough, unpopular decisions. . . . I foresee the legislature needing to make a lot of calls from here forward.”

Beshear, a Democrat, said he met with Senate leaders Monday and has had phone conversations with members in both chambers, which Republicans control, but did not seek any reaction to the idea of a mask mandate because he wants to provide information and give them time to consider it.

Asked why he rescinded the broader school mask mandate he issued before the state school board issued one for public schools, Beshear noted that legislators had opposed it, and “Hopefully it was a good step to try to be able to take some time and have some conversations and hopefully come to the best place we can about moving forward.”

He said the mandate issued by the state school board, limited to public schools, should not be affected by the Supreme Court ruling, but that appears to be a likely point of legal argument in Franklin Circuit Court and the appellate courts. Earlier, Beshear pointed to several Kentucky schools that have postponed classes due to Covid-19, including most recently Leslie County, saying “We fail when we don't require universal masking.”

He said his talks with legislators “have primarily been on stuff we hope to find agreement on. . . . There are some kind of no-brainers that hopefully everybody will agree to,” such as his emergency certification out-of-state doctors and nurses and special workers' compensation rules for front-line health workers.

“Our talks have been constructive; it has been a good dialogue,” he said. “From what I’ve seen in the last couple of days it’s being taken seriously. . . . I think in the very least, we've hopefully come to an agreement on some basic tools we're using to fight this, and then maybe it’ll take deeper conversation for the others.”

Asked if he would require state workers to be vaccinated now that the Pfizer vaccine has received full approval, he said "Anything having to do with mandates on vaccines would now have to be decided by the state legislature; I think that’s a really big policy decision," one he hasn't broached with legislators.

Beshear said he expects to call a special legislative session because the state of emergency he declared will expire in 20 days, when the Supreme Court decision becomes final.

The governor said he was surprised by the decision because the court upheld his emergency orders last year. “I think at least part of the court had a change of heart.”

Vaccinations: The Food and Drug Administration gave final approval to the Pfizer BioNTech vaccine Monday. Beshear said that will prompt more national companies to require employees to get it, and "some" Kentuckians will now take the vaccine because of this final approval.

A Kaiser Family Foundation survey found that three in 10 unvaccinated adults said they would be more likely to get vaccinated after they move to final approval. Beyond that, Beshear said, "There's just a group, and we don’t know how big it is, that is fully politically opposed to vaccinations for whatever reason, and it doesn’t look science is gonna help there.

"For them it’s someone they love and care about that is being willing to have a conversation that might end their friendship . . . At the stage we are at, that’s the most effective thing people can do; if they don’t I’m not sure there’s any other way to reach certain folks."

Beshear said 31,847 vaccine doses were given in Kentucky over the weekend and through reporting time today. In all, 56% of the state's total population has received at least one dose of a vaccine and 67% of those 18 and older.

State Department for Public Health chart shows "breakthrough" cases in vaccinated people increased in July, when the Delta variant of the coronavirus became dominant in Kentucky.