State judge dismisses constitutional challenge to anti-vaping law

Kentucky State Capitol Building

By Sarah Ladd
Kentucky Lantern

Franklin Circuit Judge Thomas Wingate has dismissed a lawsuit challenging the constitutionality of a 2024 law banning the sale of some vaping products.

Wingate sided with the lawsuit’s defendants — Allyson Taylor, commissioner of the state Department of Alcoholic Beverage Control, and Secretary of State Michael Adams — who filed a motion to dismiss. The law designates the ABC as its enforcement agency.

The Kentucky Smoke Free Association, which represents vape retailers, had argued that the law was too broad and arbitrary to be constitutional because it is titled “An act relating to nicotine products” but also mentions “other substances.” The state constitution says a law cannot relate to more than one subject.

In his opinion, Wingate said the law doesn’t violate the state constitution.

The law’s title “more than furnishes a clue to its contents and provides a general idea of the bill’s contents,” he wrote.

The law’s “reference to ‘other substances’ is not used in a manner outside of the context of the bill, but rather to logically indicate what is unauthorized,” Wingate wrote.

The lawsuit centers on House Bill 11, which passed during the 2024 legislative session and is scheduled to take effect Jan. 1. Its backers said it will curb underage vaping by limiting sales to “authorized products” or those that have “a safe harbor certification” based on their status with the U.S. Food and Drug Administration.

Opponents have said it will hurt small businesses and favor big companies, and could drive youth to traditional cigarettes.

Altria, the parent company of tobacco giant Philip Morris, lobbied for the bill and is pushing similar bills in other states. Altria, which has moved aggressively into e-cigarette sales, markets multiple vaping products that have FDA approval.

“The sale of nicotine and vapor products are highly regulated in every state, and the court will not question the specific reasons for the General Assembly’s decision to regulate and limit the sale of nicotine and vapor products to only products approved by the FDA or granted a safe-harbor certification by the FDA,” Wingate wrote in a Monday opinion. “The regulation of these products directly relates to the health and safety of the commonwealth’s citizens, the power of which is vested by the Kentucky Constitution in the General Assembly.”

Half of rural hospitals lose money; firm says 418 could close; Ky. not a standout except in Medicare Advantage, which is a threat

Map by Chartis Center for Rural Health, labeled by Kentucky Health News

Kentucky Health News

Rural hospitals are in more trouble than ever, and 418 of them are “vulnerable to closure,” according to a study of their finances by Chartis, a Chicago-based health-care consultancy that specializes in tracking the business of rural health.

The Chartis Center for Rural Health says rural hospitals are entering "a startling new phase of this crisis as rural hospitals fall deeper into the red, 'care deserts' widen throughout rural communities, and the increasing penetration of Medicare Advantage could further disrupt rural hospital revenue."

The top warning signal cited in the study is that half of rural hospitals are losing money, up from 43 percent a year ago. That news is especially bad for independent rural hospitals, 55% of which are in the red, while only 42% of rural hospitals affiliated with groups are operating at a loss. "Nearly 60% of rural hospitals are now affiliated with a health system," Chartis reports.

Most people on Medicare now have Medicare Advantage, private insurance plans that get lump sums from Medicare to cover members and look for ways to attract customers while limiting claims. "Medicare Advantage now accounts for 35% of all Medicare-eligible patients in rural communities," Chartis reports, saying Advantage plans' share of rural residents has risen 48% since 2019. 

Chartis map, labeled by Ky. Health News; click on it to enlarge

That's a problem for rural hospitals designated as "critical access" because Medicare Advantage plans' net reimbursement to such hospitals "is often lower for similar services than that of traditional Medicare because Medicare Advantage does not follow cost-based reimbursement" as traditional Medicare does for such hospitals, Chartis reports. Insurance companies negotiate those rates with hospitals, and in many rural areas, hospitals are at a negotiating disadvantage because few insurers operate in their service areas.

Also, "Medicare Advantage may not cover all the services traditional Medicare does, including swing beds, which provide skilled nursing care for patients and are often a strong source of revenue stability for rural hospitals," Chartis notes. "Rural providers may not be equipped to efficiently navigate administrative requirements for payment introduced by Medicare Advantage, such as prior authorizations, which can lead to increased denials."

Since 2010, "167 rural hospitals have either closed or converted to a model that excludes inpatient care," Chartis says. The firm says its estimate that 418 are “vulnerable to closure” is based on "a new, expanded statistical analysis" of their finances, gleaned from cost reports they file with Medicare.

The report does not give details for each state, but places each one in certain ranges. It deems fewer than 10% of Kentucky rural hospitals "vulnerable to closure" but places the state in the highest range of rural Medicare Advantage growth. As for being in the red or the black, it puts Kentucky among the states where 41% to 60% of the rural hospitals are losing money.

Eastern Ky. towns fight to recover from opioid epidemic, with help from newcomers and recovering addicts, national author reports

An event in downtown Hazard: “When somebody gets clean, they want to change the world,” Stephanie Callahan, a former addict and current business owner in Hazard, said of the town’s new can-do spirit. “You do something just to prove you can do it.” (Photos by Stacy Kranitz for The Free Press)

By Sam Quinones
Republished from The Free Press

In early 2020, Mandi Fugate Sheffel, 42, opened a tiny bookstore in her hometown of Hazard. Everyone thought she was crazy.

Downtown Hazard was a forbidding place to start any business, much less a bookstore. Most coal mines that once supported the area had closed. Many brick buildings from Hazard’s heyday were gone, bequeathing a gap-toothed look to Main Street.

What’s more, Fugate Sheffel couldn’t afford a website or employees. She had never run a business before. And she had a complicated personal history to wrestle with.

But she loved to read—particularly contemporary Appalachian authors like Silas House, James Still and Gurney Norman, who told stories that felt real to her. She figured others in town were tired, like her, of driving two hours to Lexington to buy books.

So, on January 30, she opened Read Spotted Newt in a 250-square-foot space—the size of a small bedroom.

 
I met Fugate Sheffel last spring when I visited Hazard for the first time. I came to speak about my book, The Least of Us, about America’s drug-addiction epidemic. I had heard about the town, and had formed an image of it as the buckle on Eastern Kentucky’s opioid belt.

Mandi Fugate Sheffel poses outside her bookstore in Hazard.

From Fugate Sheffel, though, I heard another story—one that I heard elsewhere in the Appalachian coalfield.

“When you don’t have industry, you’re having ecological disaster and a drug epidemic—you would think all those things would get us to a place where the town would be uninhabitable,” Fugate Sheffel told me. “But that’s not what I’m seeing at all. I’m seeing a lot of people rally.”

The loping hills of Eastern Kentucky are studded with scores of towns like Hazard—and nearby Prestonsburg and Pineville and Corbin—that, over the centuries, emerged in the valleys and along its rivers. By the early 20th century, coal dominated the region, with roughly 700,000 men and boys toiling in the mines of Kentucky and neighboring West Virginia.

In the 1990s, “as one declined and things got worse, the other increased and things got worse,” Les Stapleton, the mayor of Prestonsburg, pop. 4,000, 35 miles northeast of Hazard, told me about the correlation between jobs and drugs.

Larger forces over which locals had little or no control exacerbated things: the rise of natural gas for power plants, new environmental standards, our shifting political and cultural landscape.

By the early 2000s, the region had become the epicenter of the new opioid epidemic, which had its epicenter in Eastern Kentucky, West Virginia, and southwest Virginia.

Downtowns emptied out. Buildings were abandoned. Business startups seemed dominated by “pill mills”—clinics that prescribed huge quantities of prescription painkillers. In the little evangelical churches, they prayed for an end to “hillbilly heroin.”

The state cracked down on the pill mills, but by 2017, Perry County was the worst-hit county in the United States when it came to hospitalization for opiate addiction.

But then, weirdly and unexpectedly, at the same time that everything was falling apart, things started to get better—and that old world started, very tentatively, to build itself back up.

In the past few years, some 43 businesses have opened in Hazard, creating 171 new jobs, said Bailey Richards, the town’s coordinator of downtown development. That includes a toy store, a café, a women’s boutique, a quilt and apparel place, and a smoothie shop. A longtime restaurant just moved downtown.

The population, which declined for most of the latter half of the 20th century, now appears to be inching up. The growth was driven mostly by outsiders—new families, mostly from cities in Kentucky, in search of a better future, and immigrants, including health-care workers a nascent Latino community.

Shane Barton, the downtown-development coordinator at the University of Kentucky’s Community and Economic Development Initiative, went so far as to call Hazard “a hip destination for young people.”

It was hard to say why this was happening. Gradually, people were becoming more aware of the crisis of Appalachia and were doing things trying to help. Covid-19 pushed people to move out of the cities. And there were the recovering addicts; they weren’t expensive to hire if you needed a barista or someone to stock your shelves or paint your walls, and they were eager to work, to live.

In Hazard, about a quarter of the new jobs are held by recovering addicts. In Pineville, an hour and a half southwest of Hazard, one-third of new jobs are filled by people in recovery, said Jacob Roan, who oversees economic development in the Bell County seat.

“When somebody gets clean, they want to change the world, and have ideas of how to change the world,” Stephanie Callahan, a former addict and current business owner in Hazard, told me. “You do something just to prove you can do it.”

Joey Jones poses in his Ready Set Play toy store in Hazard.

That’s what inspired Joey Jones—the can-do spirit.

Jones and his wife, Nikki, grew up in Hazard, went to the University of Louisville, and in 2019, returned home after ten years away, now with two kids.

Though a trained social worker, Joey Jones opened a toy store. This was last year. He called it Ready Set Play, and it’s on Main Street. Jones advertises on social media and, despite selling toys that are available online, he is expanding.

“The small business community here feels like family,” Jones said. Mandi Fugate Sheffel, who knew something about hard times and people coming together, agreed.

She had been in high school in the 1990s, as the mines were closing and pain pills were invading. “One day, we were drinking beer in the back of a truck,” she said. “Then, all of a sudden, these pills were everywhere.” By 1997, she was an OxyContin addict.

The addicts dubbed a local park “Pillville,” and Fugate Sheffel got out. She moved to western Kentucky, came home in 2002, got sober, married, had a son. She survived.

So did her bookstore, against all odds.

A few days after she opened it, in 2020, it was flooded. Then Covid hit and Kentucky’s governor banned in-store shopping, and Fugate Sheffel thought this might really be it for Read Spotted Newt.

But after news media reported on Read Spotted Newt’s woes, Fugate Sheffel started getting orders from all over. Soon, she said, “I was shipping books everywhere—Boston, Florida, Texas, L.A.  Anybody who had any tie to Eastern Kentucky who knew this was going on were like, ‘We gotta make sure she makes this work.’”

By late 2020, she had moved to a larger space—a triangular building on a corner that once housed Hazard’s tourist welcome center. The city renovated it for her.

There are other pockets of hope scattered across the region.

In Prestonsburg, an hour north of Hazard, there are five locally owned restaurants, all but one of which opened in the last five years. An Indian restaurant is coming soon. The two-block historic downtown once had eleven abandoned buildings. Now, all are occupied.

In Pineville, pop. 1,600, the downtown was similarly decimated. Now there are boutiques, a hair salon, a furniture store, and several restaurants. Importantly, noted Roan, the economic-development director, “Those businesses are still in business six, seven years after opening.”

In Corbin, pop. 8,000), just up the Cumberland Gap Parkway from Pineville, several old buildings have been redone. They now house restaurants, a clothing boutique, a print shop, a café, an ice cream parlor, a record store, and a pinball museum.

“Everybody is like, ‘What can I start? What’s missing around here?’ ” Corbin Mayor Suzie Razmus told me.

Something else locals are starting to see in these places: people. On the street, outside their favorite coffee shop, chatting with a friend through an open car window.

In the past, a town grew from a big factory that employed hundreds or more people. But no one’s waiting any longer for factories or big-box stores—to say nothing of the mines or unions—to save them.

Prestonsburg Mayor Les Stapleton: “If a deer gets killed on the

highway, I pull over and put it in the truck and get rid of it . . .

I don’t want people seeing that the first time they drive into town.”

“Too many have come in to try to save us, and they don’t,” said Stapleton, the Prestonsburg mayor. “We got to do it ourselves.”

Now, he’s facing a problem he could never have anticipated: a shortage of affordable housing. This has been driven, he added, by outsiders who, since Covid, have been moving to Prestonsburg and other towns across the region.

Jeff Siegler, whose firm Revitalize, or Die advises small towns on rebuilding, said the area’s success “has to be about small, incremental victories—one business at a time.”

The new generation of mayors, town councilors, and city planners across much of Appalachia, who had come through the disaster of the last three decades and seemed inspired by recovering addicts in their own communities, understood what Siegler was saying: small is good; local is good; people are good.

Instead of trying to lure massive out-of-state companies with tax incentives, they were thinking about beautification projects and homeowners and places where people could congregate.

“That’s the shift,” said UK's Shane Barton. “How can we make our communities people-ready as opposed to industry- or investment-ready?”

Still, progress is uneven, and many small-town economies are frail. Self-reliance may take them only so far.

The drug problem rages on. Fentanyl seems to be mixed into everything on the street, creating staggering numbers of overdoses. On top of all this, a form of perverse gentrification has taken hold that’s peculiar to this birthplace of the opioid epidemic. Legions of national drug treatment centers catering to the addicts have moved to the region—sopping up cheap real estate and pricing lower-income buyers and start-ups out of the market.

But at this point, that seems like a minor, mostly surmountable hurdle, at least to the people here who have stopped waiting for outsiders—coal companies, big-box retailers, Frankfort, Washington—to save them.

That is definitely the way Stephanie Callahan, in Hazard, sees things.

Now in her early forties, Callahan, like Mandi Fugate Sheffel, was part of the generation consumed by Oxycontin. She got clean when she had a baby—this was 15 years ago—and built a career as a showroom saleswoman at a local furniture company. But she yearned to do something on her own.

She loved fashion. For two years, she had been running a side hustle out of her bedroom, selling plus-size clothes. She hated that she had to go to Lexington every time she needed a new top or skirt.

So, in the summer of 2021, Callahan quit her full-time job and rented a space in downtown Hazard that had once been a gym. Her father said she’d lost her mind, opening a women’s clothing store during Covid. She did it anyway, calling it Hot Mess Express, which is what her mother and friends often called her.

She showed them: in her first two years, Callahan had 2,000 repeat customers. She now has nine part-time employees and will soon open a men’s store.

It wasn’t just about the clothes. It was about people in Hazard, like so many towns, trying to find their way back to each other.

“When I was growing up, we had arcades, movie theaters, mom-and-pop restaurants,” Callahan said. Now, “there’s no place for people to go talk to each other.”

So, she put a brown leather couch, almost as an afterthought, in the middle of the store, intending it for men accompanying their wives and girlfriends to sit and scroll through their phones or read a magazine—kill time. Instead, it became the focal point of the store, and it made Hot Mess Express a community hangout as well as a women’s boutique. A little place, or nook, where people would say hi, catch up, laugh, hug, gossip.

“It’s comfortable,” Callahan told me, referring to the couch. “I have a photo of the mayor asleep on it.”

Sam Quinones is the author of four books, including his latest, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. You can follow him on X at @samquinones7.

Norton Healthcare expands its footprint in Bowling Green with primary care; also adds a multi-purpose facility in Frankfort

Norton's new Frankfort facility (WLKY image)

Kentucky Health News

Norton Healthcare of Louisville is buying Bowling Green Internal Medicine and Pediatric Associates as its latest interest in the state's third largest city.

"It's about taking our specialized services out into the state," Dr. Steve Hester, Norton's senior vice president and chief clinical and strategy officer, told Don Sergent of the Bowling Green Daily News. "We appreciate the relationships we already have with providers in Bowling Green. Now we want to look at what things we can bring that aren't already there."

Norton spokesman Joe Hall todl Sergent that the company already has "significant investments" in Bowling Green through such Norton Children's Hospital specialty practices as heart, neurology and maternal-fetal medicine, and the new group will "bring primary care into the fold."

Sergent notes, "Norton is also expanding to other locales outside of Louisville. Earlier this month, it announced a new $12 million multi-practice location in Frankfort that will provide pediatrics, adult services and urgent care under one roof."

Big health-insurance company and major health-care foundation among lead investors in Invest Appalachia venture-capital fund

Kentucky Health News

Two big players in health care are the major financiers of a venture-capital firm that calls itself "a regional social investment platform" for Eastern Kentucky and most of Appalachia. Invest Appalachia says it "has secured $19 million of new investment" and is already investing in projects.

ARC.gov map, adapted by Kentucky Health News

The fund's press release says 90% of the money is "new capital from outside the region," which it defines as as the Appalachian counties of Kentucky, West Virginia, Virginia, Tennessee, North Carolina and Ohio, and it has a target of $40 million by November. The lead investors are UnitedHealth Group, a big insurance company, which has put in $10 million; the Robert Wood Johnson Foundation, a major funder of health research and projects; and the Appalachian Regional Commission, a federal-state agency that serves 54 of Kentucky's 120 counties. The release did not list ARC's and RWJF's amounts.

Andy McMahon, a vice president of UnitedHealth, said, “Advancing health equity and addressing social needs like housing and access to health care in rural and underserved areas is an integral part of making the health-care system better for everyone. We are fortunate to work with partners like Invest Appalachia, who really understand the rich culture of Appalachia and are creating new ways to address community needs to improve quality of life and health.”

Zoila Jennings, impact investment lead with the foundation, said “Invest Appalachia is pioneering regionally controlled creative capital solutions in Appalachia that support inclusive economic growth for the region and offer new opportunities for national investors. We see the Invest Appalachia Fund as an innovative model for foundations and other impact investors who want to get capital to the people and places that need it most.”

CEO Andrew Crosson told The Rural Blog that his fund has invested in real estate for downtown revitalization, "support for consumer and business lending for flood-impacted communities" in Eastern Kentucky, "solar and energy efficient equipment for a rural grocery store, and expansion of rural eye care clinics." He said in an email that he couldn't give specifics because "these deals aren't public yet" but said his priorities are "downtown revitalization/community-focused real estate, solar and energy efficiency for rural businesses and institutions, and community health facilities and social enterprises."

Pandemic state of emergency would end March 7 under a resolution the state Senate sent to the House on a party-line vote

Sen. Donald Douglas (Legislative photo) 

By Melissa Patrick
Kentucky Health News

The Senate has sent the House a resolution to end the Covid-19 state of emergency in Kentucky on March 7.

Senate Joint Resolution 150, sponsored by Republican Sen. Donald Douglas of Nicholasville, would end the state of emergency that Democratic Gov. Andy Beshear declared on March 6, 2020. In January, the legislature set it to expire on April 15. 

The resolution would end "all subsequent executive orders, emergency administrative regulations, suspensions of statutes, and other directives which rely upon the declaration of emergency."  

And it says the governor "shall not" declare a new Covid-19 state of emergency "based upon the same or substantially similar facts and circumstances as the original declaration" without the prior approval of the General Assembly. 

The resolution passed the Senate Thursday, Feb. 24. on a party-line vote of 28-8. Including Douglas, the resolution has 18 sponsors. 

While presenting the bill on the Senate floor, Daniels acknowledged that when the virus was first announced, there were many unknowns that drove decision-making, but he said it quickly turned political. 

"Instead of proceeding down a purely medical path, it seems that politics took a major role and  sometimes even the lead," said Douglas, a physician. "The emergency seemed to be more about emotion and feeling and a lot less about objectivity and facts."  

He said the focus has been on cases and deaths, without an understanding that "many more people recovered without issue," causing our citizens to be "terrified." As of Feb. 25, there have been 1.3 million Covid-19 cases in Kentucky and 13,758 deaths attributed to it, most in people over 60. However, as many as a third of people with Covid-19 have reported lingering effects.

Douglas noted that the state of emergency led to cancellation of elective medical procedures, business shutdowns, loss of jobs, mask mandates and travel restrictions, and said "the Kentucky State Police were directed to target church attendees."

When Douglas presented the bill in committee, he said Beshear ordered police "to pull the attendees of the church out of the church.” That is not true. Beshear ordered police to go to parking lots of churches that held in-person services on Easter 2020 and place notice on cars saying that attendees were in violation of his order against mass gatherings and should quarantine themselves for 14 days.

Douglass also cited a Johns Hopkins University meta-analysis of 24 studies that looked at the effects of lockdowns on Covid-19 deaths. The researchers found lockdowns in the U.S. and Europe reduced Covid-19 mortality by an average of 0.2 percent; that shelter-in-place orders reduced mortality by 2.9%; and that there was no broad-based evidence of noticeable effects from non-pharmaceutical interventions. 

The study concluded, "While this meta-analysis concludes that lockdowns have had little to no public-health effects, they have imposed enormous economic and social costs where they have been adopted. In consequence, lockdown policies are ill-founded and should be rejected as a pandemic policy instrument."

Douglas said, "It is time to move to normalcy." He said the March 7 date would give Beshear time to file any administrative regulations that are needed and ensure that the lawmakers are still in session when the emergency ends.

He added that it is not his intent to decrease or interfere with any federal funding, but Sen. Morgan McGarvey, D-Louisville, said it remains unknown if the resolution would affect federal funding such as the additional nutrition benefits that have been made available to children and families.

Sen. Karen Berg, D-Louisville, also spoke against the resolution, saying it is premature because the percentage of Kentuckians testing positive for the virus remains too high and only 60% of eligible Kentuckians have received even a single dose of a Covid-19 vaccine.

When Berg spoke, the positive-test rate was around 10%, after being above 30% for much of January. Early in the pandemic, public-health officials said caution is required when the rate is above 5%. 

Vaccination rates are also slowing. Over the last seven days, the average number of Covid-19 vaccinations in Kentucky was 2,508 per day, the lowest since the Centers for Disease Control and Prevention began gathering reliable data in January 2020. Most of the shots were boosters. State and CDC data show that 64% of the total population have received at least one dose of a vaccine, 56% are fully vaccinated and 43% of the eligible population is boosted.

Sen. David Yates, D-Louisville, asked his colleagues, “Why are we doing it? This doesn’t change anything. . . . I actually cannot wait until I can join in support of it, but what is the rush? I vote no.”

Gov. Andy Beshear said on Feb. 21, "We don't have any state restrictions left . . . and we haven't in a long time."

Douglas, who won a special election in November, is running in the May 17 primary election against Andrew Cooperrider of Lexington, who flouted Beshear's restrictions and led protests against them.

Senate Republicans want to end Covid-19 state of emergency March 7, more than a month earlier than they voted last month

Most of the Republicans in the GOP-controlled state Senate are supporting a resolution that would end the state of emergency that Gov. Andy Beshear declared last March 6 to deal with the Covid-19 pandemic.

The legislation would undo a bill the General Assembly already passed to extend the state of emergency until April 15, with the limitations that the legislature imposed on it in September's special session.

Senate Joint Resolution 150 would end the state of emergency on March 7. It has 17 sponsors.

Sen. Donald Douglas, R-Nicholasville

Its lead sponsor, new Sen. Donald Douglas, a Nicholasville physician, Douglas said that date would give Beshear and legislators time to negotiate it and make changes.

“This is what our people want,” Douglas said in a Senate floor speech Friday. “This is what our constituents need. Dare I say; this is what they demand.”

Douglas said the state of emergency, which allowed Beshear to exercise special powers, including closure and limitation of businesses, "caused great harm."

“Some will say that this emergency certainly saved lives,” he said. “Well, others will say that the changes that were forced by this emergency caused great harm not only to our economy, but also to our workforce, and to our supply chain.”

The Lexington Herald-Leader's Austin Horn reports, "The only senator who spoke up against the joint resolution was Sen. Karen Berg, D-Louisville, who pointed out that Kentucky’s Covid-19 positivity rate is still about 15% and that legislators should be focusing more on getting more people vaccinated than ending the state of emergency." Berg is a physician.

Responding to Senate President Robert Stivers' point that California and other states that have imposed stronger restrictions than Kentucky are relaxing them, Berg said California has a 5% positive-tesr rate and 70% of its population is fully vaccinated, while Kentucky’s corresponding rates are 15% and 56%.

Beshear Communications Director Crystal Staley issued a statement saying Kentucky is still using the state of emergency to activate 300 National Guard members to help overwhelmed hospitals, and noted that the state reported 700 Covid-19 deaths last month.

“The state of emergency helps Kentucky receive federal dollars to fight the pandemic and provide relief,” Staley added, concluding, “Gov. Beshear is focused on beating the pandemic and not playing politics. He hopes others will follow that example.”

Douglass came to the Senate in November through a special election to fill the term of Republican Tom Buford, who had died. He is seeking re-election this year, and has an opponent in the May 17 primary election: Andrew Cooperrider, a Lexington coffee-shop owner who defied some of Beshear's orders and helped lead protests against them.

All Ky. adults can get booster; new-case rate and hospitalizations up over 2%; cases in unmasked Warren County schools jump

New York Times map, adapted by Ky. Health News, shows cases increasing with colder weather.
To enlarge any image, click on it; for the interactive version of this map, with local data, click here.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear has signed an executive order to allow all Kentucky adults to get a Covid-19 booster shot, citing the recent upticks in coronavirus cases and Covid-19 hospitalizations as the reason for this change. 

“Folks, you really need to get vaccinated and get this booster, and now it should be fairly easy. It’s going to make you much safer over the next several months,” Beshear said in a news release. 

Previously, boosters were officially available only to people 65 and older, adults at high risk of severe Covid-19, and those with high exposure to the virus through their jobs or living situation.

At least five other states (Arkansas, California, Colorado, New Mexico and West Virginia) have expanded eligibility, the release says. So has New York City. The U.S. Food and Drug Administration is expected to authorize Pfizer-BioNTech Covid-19 booster shots for all adults this week, The New York Times reports.

Under Beshear's order, all adults in Kentucky may get a Covid-19 booster six months after their second Moderna or Pfizer shot, or two months after the single-dose Johnson & Johnson vaccine. 

As of Wednesday, more than 437,000 Kentuckians had received a booster and 2.6 million, or 59% of the total population, had received at least one shot. 

 The state reported 2,195 new coronavirus cases Wednesday, raising the seven-day average by 31 (2.2 percent), to 1,431. Of Wednesday's new cases, 29% are in people 18 and younger. 

The share of Kentuckians testing positive for the virus jumped more than half a percentage point, to 6.24% from 5.73% on Tuesday. The rate is the highest since Oct. 21. Beshear has cautioned that the rate is not the best measurement of the pandemic because it tends to rose when there is an increase in disease in communities because more people get tested.

A more reliable metric, the seven-day infection rate, is 27.94 daily cases per 100,000 residents. That's a noticeable jump from Tuesday's 27.08. Counties with rates more than double that rate are Magoffin, 98.7; Breckinridge, 82.3; Robertson, 81.3; Bourbon, 72.2; Monroe, 61.7; Powell, 61.3; and Harrison, 58.2.

Seventy-three of the state's 120 counties have rates over 25, considered a high level of transmission and represented by red on the state infection map. That's six more than Tuesday. 

The New York Times ranks Kentucky's infection rate 25th among the states and says it has increased 16% in the last 14 days.

Kentucky hospitals reported 757 Covid-19 patients, 18 more than Tuesday (up 2.4%); 200 of them in intensive care (down 4); and 100 on mechanical ventilation (down 15).  Eight of the state's 10 hospital regions are using at least 80% of their intensive-care beds, five of them more than 90%. 

Kentucky reported 36 more Covid-19 deaths Wednesday, raising the pandemic death toll to 10,354. 

Other pandemic news Wednesday: "Active Covid-19 cases among Warren County Public Schools students have more than tripled since the district dispensed with its universal masking policy Nov. 1," the Bowling Green Daily News reports. The district has 73 cases; Bowling Green Independent Schools, "which has chosen to keep its universal masking requirement for at least one more month – reported 17 active student cases on its district dashboard Tuesday morning."

To increase immunization among young adults, "Some public health experts are turning to ad campaigns that feature 20-somethings talking about their struggles with fatigue, memory loss and other symptoms associated with long Covid," the term used to describe lingering effects after basic recovery from the disease, reports Derek Hawkins of The Washington Post. "The testimonials are devastating. One 20-year-old chokes up as she describes how she can't remember first dates with her boyfriend, even after looking at photos."

U.S. Sen. Rand Paul of Bowling Green issued a report on the economic cost of President Biden's vaccine-or-test mandates in Kentucky, saying 677,458 Kentucky workers, or 34% of the state's workforce, are at risk of losing their jobs if they do not comply with the mandates for employers of more than 100. It says 35% of retail workers risk losing their job if they resist the mandate. A report for all 50 states will be released tomorrow, said the release from the Republican senator, who is seeking re-election.

The Occupational Safety and Health Administration has suspended enforcement of the mandate for businesses with more than 100 employees after a federal appeals court upheld a stay of it last week, The Hill reports.

Kentucky program, first of its kind in the nation, makes it less risky for employers to hire people with substance-use disorder

By Melissa Patrick

Kentucky Health News

Kentucky has launched a new program that will lessen the risk of liability to employers who hire or retain people with substance-use disorder -- if employees sign up for treatment and complete it. 

"This program is the bridge between recovery and employment," LaKisha Miller, executive director of the Kentucky Chamber of Commerce's Workforce Center, told Kentucky Health News. She said the Kentucky Transformational Employment Program could be a model for the rest of the nation. "This has never been done before."

The program "ultimately provides a pathway for businesses and employers to help more Kentuckians reach long term recovery, while supporting fair-chance employment," Miller said.

"Fair chance" or what some call "second-chance" hiring is an important and necessary tool to address the staffing shortages across Kentucky, Miller said in a news release: "Kentucky currently ranks 48th nationwide for workforce participation, and the Covid-19 pandemic has only exacerbated this problem. Research shows that when the nation’s unemployment rate increases by just 1 percent, the opioid overdose death rate rises by 3.6%." 

In the interview, Miller spoke about the importance of employment for those in recovery. She acknowledged that employment is not the "silver bullet" to solve the addiction crisis, but "It is a big piece of the puzzle." 

The program is made possible by Senate Bill 191 of the 2020 legislative session, which, among other things, established a framework for employers to retain and hire people who are in addiction recovery and provides legal-liability protections for those employers that adhere to the established framework.

The liability protections are key, Miller said, adding that strong legislation allows for strong programs like KTEP. 

For example, she said a company that is enrolled in KTEP, and has enrolled eligible employees in it, is protected against legal action if the employee with a substance-use disorder "is using" and has a mishap.

"So that's the power of Senate Bill 191," MIller said. "It's removing that legal liability from you; whereas, before you would have been open to that." 

She said the program also lets employers "pause the employment process" to allow applicants time to enter treatment, and is also meant to decrease stigma in the workplace related to addiction, treatment and recovery.

Once an employer has signed up for KTEP, Miller said, a dedicated staff person helps with the process, including resources, guidelines, training videos and for review and revision of the firm's drug and alcohol policies. 

"We want to make sure that that businesses aren't just focused on giving somebody a fair chance, but are truly committed to creating an a transformative workplace," Miller said. To ensure the program is working as intended, data will be collected regularly from participating employers.

KTEP is sponsored by the Chamber's foundation, the state Cabinet for Health and Family Services, the Kentucky Office of Drug Control Policy, the Kentuckiana Health Collaborative and Kentucky Opioid Response Effort.

KODP Director Van Ingram said in the news release, “We see a real opportunity for this program to do some good, and we encourage employers across Kentucky to make a positive impact in their communities. Stable employment is a critical component of long-term recovery and can provide Kentuckians with the purpose and motivation they might need to stay in remission and get their lives back.”

Miller said the state was already leading the way in fair-chance employment through the Kentucky Chamber of Commerce Foundation's "Who's Hiring" campaign, which has recruited 19,000 fair-chance positions in the last year and a half. More information, including training resources for employers and a form for businesses to sign up for the program, can be found online at kentuckycomeback.com/KTEP.

Legislature moves to leave mask mandates up to local officials and businesses as state's positive-test rate reaches a new high

State Department for Public Health graph; for a larger version, click on it. 

By Al Cross and Melissa Patrick
Kentucky Health News

The Kentucky General Assembly is quickly moving to leave all decisions about masking to fight the surging pandemic at the local level, where most school officials were reluctant to impose them when they had the chance.

In the first day of a special session that may only last three, legislative committees approved bills to keep Gov. Andy Beshear from re-imposing the mask mandate he issued last summer and abolish the school-mask mandate that was imposed last month by the state school board he appointed.

Beshear and his Democratic allies in the Republican-controlled legislature asked that the governor at least be able to impose mask mandates in counties with certain rates of infection. The week ending Sunday had the most coronavirus cases yet, and the share of Kentuckians testing positive for the virus in the last seven days is a record 13.74%.

House Democratic Leader Joni Jenkins, D-Shively, tried to offer an amendment to give state officials power to issue mandates in counties with high levels of virus transmission, but she was ruled out of order.

Senate Minority Leader Morgan McGarvey of Louisville told Kentucky Health News that he offered to let Republicans pick the infection level at which the governor could have mask-mandate power, but they declined.

Republicans said they are putting the power where it belongs, at the local level. "The people are speaking through their duly elected 138 legislators," said Majority Floor Leader Damon Thayer, R-Georgetown.

Senate Education Committee Chair Max Wise of Campbellsville, sponsor of Senate Bill 1, which abolishes mask mandates in schools and daycare centers, was asked if this sets up such decisions to be made based on politics and not public health policy.

Wise acknowledged that many of those making such decisions don't have a public-health background, but "We're hoping that many of those local health professionals will be talking to school board members, the same thing as parents who were pushing for what they want will be talking to local elected officials too," he said. "Local people, local elected officials, know their people."

The bill passed Wise's committee 8 to 5. Sen. Reggie Thomas, D-Lexington, called it "completely irresponsible."

Most legislators don't pass through the Capitol rotunda, but those
who did saw this new display. (Photo by Al Cross; click to enlarge)

After lamenting the political nature of the issue, Sen. Alice Forgy Kerr, R-Lexington, asked for assurances that the had been fully vetted. Senate President Robert Stivers, R-Manchester, said while Beshear was part of the discussion, that didn't mean he would get what he wants.

Beshear's office said it gave legislators a long list of scientific references on usefulness of masks, and he said at his weekly Covid-19 press conference, "Universal masking is absolutely necessary if we want our kids in school."

Education Commissioner Jason Glass said after the meeting that the bill “does not go far enough in providing the flexibility in different school models that [our districts] need to support continued school operations given the disruptions you are currently experiencing due to Covid-19 outbreaks and quarantining. Further, the politically motivated effort to remove masking requirements in public schools flies in the face of virus mitigation efforts at the very time they are needed most.”

At least 38 Kentucky school districts have paused instruction during the new school year due to high levels of infection. The bill gives the state Department for Public Health 14 days to develop a optional "test-to-stay" model to avoid quarantines for students who have been exposed to the virus but test negative and have no symptoms. They would be tested for a period of days to see if they can remain in the classroom or be quarantined.

The bill also gives school districts more flexibility for in-home learning and replaces the requirement for a minimum number of school days, instead setting a minimum number of hours and allowing schools to have school days as long as seven hours, while prohibiting instruction on Saturdays.

The ban on a statewide mask mandate is in House Bill 2, which was approved by the House Health and Family Services Committee. "These orders will be decided upon at the local level," by local officials and businesses, said Rep. Kim Moser, R-Taylor Mill, chair of the committee and a nurse by trade.

Rep. Lisa Willner, D-Louisville, said she was hearing from business owners that the issue has become so politicized that they appreciated "the executive branch kind of taking the heat for them."

Moser replied, "It is not really the job of the government to come in and give cover to private businesses. . . . even when it comes to the health of their patrons. They are able to decide what's best for their business."

The bill includes provisions to boost the use of monoclonal antibodies, an experimental Covid-19 treatment that has proven effective under a federal emergency-use authorization; allow paramedics to work in hospitals and nursing homes; and allow families of nursing-home patients to name an "essential caregiver" who would have the right to visit the patient.

The bill also tells the the state health cabinet to partner with universities and health-care organizations to produce public-service announcements about the severe effects of Covid-19 and "talk with their doctor about the benefits of receiving a Covid-19 vaccination;" and to implement a plan to improve access to Covid-19 vaccinations in doctor's offices.

Both chambers passed and sent to Beshear a House resolution to confirm most of the other orders that he and state agencies have issued until Jan. 15, when a regular legislative session will have begun. 

Sen. Ralph Alvarado, R-Winchester, voted for the resolution, but expressed concern over a section that he said would allow nurse practitioners to write more prescriptions for narcotics. “Prescribing more controlled substances does nothing to help us treat Covid more rapidly or effectively,” he said, adding that opioid prescriptions by NPs had risen recently while those by physicians and dentists had declined. Alvarado is a physician. 

Objections from other Republican senators to certain features of the bills got little traction, indicating that the Senate leaders had worked out differences and lined up votes. "This has been a true compromise," said Senate State and Local Government Committee Chair Robby Mills, R-Henderson. 

McGarvey said after the committee meeting that Republicans "are bending over backward to ensure anything rational stays, while taking care of their political base," which is strongly opposed to masks.

Thayer told the Senate that "a large portion of Kentuckians were not pleased with the governor's unilateral actions," taken under a state of emergency that he declared March 6, 2020, when the state reported its first case of Covid-19.

The legislature passed laws limiting the governor's emergency powers, and the state Supreme Court upheld those laws Aug. 21, prompting Beshear to call the session. The court's order will become final at midnight Friday, and the legislature will have its business done by then, under parliamentary maneuvers the House and Senate took to suspend or avoid the constitutionally required three readings of bills in each chamber on separate days.

Daily numbers: These decisions are being made as coronavirus cases continue to surge across the state. Beshear said that Kentucky saw 30,680 cases in the reporting week that ended Sunday, setting a record, and that between Saturday and Tuesday, he there were more than 13,000 new cases and 60 deaths attributed to Covid-19, eight of them under 50. 

The state reported 2,356 new cases of the virus, low among recent Tuesdays, almost surely due to the Labor Day holiday on Monday. The three-day weekend brought the seven-day average of new cases to 4,073 per day, down from the record average of 4,398 posted on Sunday. 

“We continue to see more cases than is safe by any means,” Beshear said at his weekly Covid-19 news conference. “The bad news is we had the worst week ever last week. Our hospitals continue to be pushed to the brink. If we have one bad week, we can very quickly run out of ICU beds.”

And while the state is still seeing record numbers of cases each week, Beshear said the escalation seems to be slowing, although he cautioned that it is too soon to be sure.

Hospitals reported 2,353 Covid-19 patients; 661 patients in the intensive care units; and 433 on mechanical ventilators.

All but two of the state's hospital-readiness regions are using more than 89% of their intensive-care beds. The two are the far-west region and the northeast region.

Kentucky's infection rate over the last seven days is 84.73 daily cases per 100,000 residents. Counties with rates more than double that rate are Perry, 223; Clay, 206.7; Leslie, 203.9; Rockcastle, 198.5; Bell, 188.2; Russell, 184.1; Whitley, 178.5; and Breathitt, 176.5. All are in Appalachia.

The state reported five more deaths from the virus, bringing Kentucky's pandemic death toll to 7,905.

Local businesses can play a big role in getting rural customers and neighbors vaccinated for Covid-19; organizations offer help

Map by The Daily Yonder, adapted by Kentucky Health News

"A return to regular, small-town living will require a continuous effort to get residents vaccinated for Covid-19, according to the head of the Rural America Chamber of Commerce," Adilia Watson reports for The Daily Yonder. But do employers know how crucial they are to making that happen?

“A lot of business leaders, small business owners . .. see this as a critical issue,” Sherri Powell, the Rural Chamber’s executive director, said during the recent online National Rural Business Summit, which "explored outreach tools that business leaders, public health officials, and elected officials can use to share information in rural communities about Covid-19 vaccination," Watson reports.

Employers are important sources of information for their employees, and they can cut through medical and public-health terminology to “describe what science says in an accessible way,” said Maria Elena Castro, a health equity program analyst with the Oregon Health Authority. 

"As part of the online summit, the National Rural Health Association released a toolkit for communicating about vaccination in rural areas," Watson notes. The Health Action Alliance, which sponsored the event, has a checklist for rural employers who want to do more to educate workers and community members about coronavirus vaccination.

Without herd immunity, estimated at 70 to 80 percent of a population, “We will never get back to normal, even as small towns,” Powell said. “We can’t gather at the local baseball team’s games, or we can’t head into summer camp. These things are just not going to happen in a safe way until we take this seriously and get the shots.”

Free webinar at 1 p.m. ET Thursday, June 3, will show how rural employers can strengthen local vaccination rates

A National Rural Business Summit webinar on Thursday, June 3, will discuss how major rural employers and small businesses can engage with employees and residents to play a meaningful role in increasing the rural coronavirus vaccination rate. Strategies include sharing fact-based information, sharing personal vaccination stories, and supporting community vaccination efforts.

The free webinar will begin at 1 p.m. ET and is presented by the Rural Assembly in partnership with the Health Action Alliance, The Daily Yonder, the National Rural Health Association, The Rural America Chamber of Commerce, and other organizations. Click here to register.

In related news, a new episode of the Rural Assembly's Everywhere Radio show is all about how to overcome vaccine hesitancy in rural America. Host Whitney Kimball Coe, director of the Rural Assembly, talks with Jeff Eastman, CEO of Remote Area Medical, a nonprofit that provides free health care to those in need. Listen to the episode here.

Pandemic roundup: Ky. ranks 29th in full vaccination; U of L Health to require staff shots; daily new-case average below 400

Kentucky ranks 29th among the states in percentage of population fully vaccinated for the coronavirus and 28th in the share of residents who have received at least one dose of vaccine, according to The Washington Post.

Chart of Centers for Disease Control and Prevention data by The Washington Post

Post graph from CDC data shows national figures

The Centers for Disease Control and Prevention says 38 percent of Kentucky's population is fully vaccinated and 46 percent of state residents have received at least one does of a vaccine. Two of the three available vaccines require two doses.

State officials emphasize the one-dose percentage. The state Department for Public Health says that among the Kentuckians who are eligible to get a vaccine, those age 12 and older, 54 percent have had a shot.

Screenshot of state Dept. for Public Health interactive map, labeled by Kentucky Health News

The University of Louisville's health system will be the first major one in Kentucky to require employees to get a coronavirus vaccine. The rule will take effect Sept. 1, when it U of L Health expects at least one of the three vaccines currently approved for emergency use will have final federal approval. It estimates more than 70% of its 12,000 workers in five hospitals, four medical centers and over 200 physician practices have been vaccinated. "Atria Senior Living, an assisted-living company based in Louisville, requires the Covid-19 vaccines for its 10,000 member workforce nationwide, as do two other senior living companies with sites in Louisville, the Courier Journal reports.

Kroger Co. is offering customers, employees and other people who get a vaccination the chance to win $1 million or free groceries for a year, the Courier Journal reports: "The sweepstakes are being offered in collaboration with the Biden administration as part of the president’s bid to get the U.S. toward the threshold of herd immunity, where so many Americans are protected against the new coronavirus that it can’t spread."

Alexandra Ellerbeck writes for The Washington Post: "The vaccination rate in the United States has fallen sharply from an average of more than 3 million shots a day in early April to around 1.62 million shots. And although the administration only needs to average about half a million shots a day to reach the July 4 deadline, the number of people who say they want a vaccine but haven’t gotten one is quickly shrinking. Only 4 percent of adults fall in the category of unvaccinated people who say they want a shot 'as soon as possible.' A similar proportion of people have an appointment scheduled for a vaccine or plan to make one in the next three months, even though they say they want to “wait and see” before getting a shot," according to a Kaiser Family Foundation poll. "If both those groups follow through, it may be just enough to reach Biden’s goal."

Daily numbers: The state reported 415 new cases of the virus, lowering the 7-day rolling average by 19, to 394 per day. This is the first time it has been below 400 since July 14, 2020. The new-case rate fell again, to 5.98 per 100,000 residents. Counties with rates more than double the statewide rate were Webster, 39.7 per 100,000; Owen, 21; Union, 20.9; Robertson, 20.3; Bath, 17.1; Harlan, 15.9; Rowan, 15.8; Laurel, 14.8; Rockcastle, 13.7; Montgomery, 13.2; Taylor, 12.8; Adair, 12.6; and Casey, 12.4.

The percentage of Kentuckians testing positive for the virus over the last seven days fell 0.08 percentage points, to 2.43%. It has been below 3% since May 15.

Kentucky hospitals reported 338 Covid-19 patients, 103 of them in intensive care and 64 of those on a ventilator.

On Friday, the state lifted capacity restrictions on businesses and venues with capacities of 1,000 or less; restaurants and bars can fill to 75%. Memorial Day weekend travel will be a test of resistance to the virus, USA Today reports.

The Kentucky Chamber of Commerce has gently joined calls for Gov. Andy Beshear to end extra unemployment benefits, as Republican governors have done but he and other Democrats have not. The chamber wrote Beshear Friday, "asking that the administration consider phasing out" the $300 weekly benefit by July instead of the federal program's Sept. 30 ending date, Jacqueline Pitts writes for the chamber's Bottom Line.

The business lobby told Beshear that a phase-out would "help address a serious workforce shortage faced by employers." It said that wouldn't be "a cure-all," and "Steps must also be taken to increase access to high-quality child care, retrain and reskill workers, and increase vaccination rates. We also believe that return-to-work incentives, which other states have implemented, are worth exploring, particularly incentives that assist working parents to afford and have access to child care."

Now that the governor is giving pandemic news briefings just once a week, and has resumed a travel schedule that looks to be aimed in part at getting re-elected in 2023, "Politicos are busy jostling over what voters should think of Beshear’s handling of the crisis," writes Lexington Herald-Leader political reporter Daniel Desrochers. "Was he the steady leader who took decisive action to save the lives of thousands of Kentuckians during an unforeseen emergency or the power-hungry executive who overstepped his authority to control the daily lives of Kentuckians?" Kentucky's infection rate was 29th among the states and territories, and its death rate was 32nd, Desrochers reports.

Beshear lifts more capacity limits starting May 28, touts his handling of the pandemic and the state's economic recovery

State Department for Public Health table shows vaccination numbers by age group.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced he will lift both indoor and outdoor capacity limits to 75 percent for businesses and events with fewer than 1,000 people starting May 28, the start of Memorial Day weekend, and said he expects all restrictions to be lifted by July and "certainly . . . this summer."

"If you can just give me a little patience, we're coming up to a time when we're going to be able to fully get out of this," Beshear said at his second and last press conference of the week. “The CDC is now projecting a sharp decline in Covid cases in the U.S. by July. I’m hoping we’ll be fully done with any capacity restrictions by July. That is actually my expectation." 

The governor also increased capacity limits on outdoor businesses and venues serving more than 1,000 people from 50% to 60%, also effective May 28. He said a main reason he chose that date is to give schools time to finish the school year, noting that schools in Boyd County and Flemingsburg have had to move back to virtual learning because of the virus.

Effective immediately, Beshear lifted the mask mandate for small, private gatherings and businesses if everyone is fully vaccinated, which means they are at least two weeks beyond their second shot of Moderna or Pfizer-BioNTech vaccine or two weeks after the single-dose Johnson & Johnson jab. 

Beshear has said since mid-April that he would lift all restrictions on businesses and venues with capacities of fewer than 1,000 people when 2.5 million Kentuckians got at least one dose of a coronavirus vaccine. He has also said "for seven straight press conferences" that he would be willing to ease restrictions along the way as the state moves toward that goal, and offered a long list of ways he had already done that. 

His announcement follows publication of an article by Agriculture Commissioner Ryan Quarles, a Republican who is a leading prospect to face Beshear in the fall 2023 election, asking the governor to set a firm date to open the economy instead of using a vaccine goal as the marker. He said that by not fully opening the economy,  Beshear "is holding Kentucky's economic engine hostage."

Asked if he had any specific response to Quarles, Beshear said, "I'm not playing politics," but then repeated earlier points about how well the state is doing economically and thwarting the virus.

Beshear said Kentucky has had fewer Covid-19 deaths per capita "than just about any state" and ticked off a long list of Kentucky's pandemic and economic performance. Two new items were that Fitch Ratings had improved the state's credit outlook to stable and the state's sales-tax revenue set an all-time record for an April, which he said refutes any notion that the state's economy isn't open.

"One of the things that's gotten us here is we've been measured" and have eased into and out of restrictions, Beshear said. "We have adjusted based on what's going on with the virus, listening to the best science available. And so that's what we are going to continue to do."

After the governor spoke, Quarles' Department of Agriculture issued a statement in which he said "Beshear continues to ignore the bipartisan consensus emerging across the nation, in which far-left leaders like California’s Gavin Newsom, self-avowed socialists like New York Mayor Bill de Blasio, and strong conservatives like Florida’s Ron DeSantis have either set reopening dates for their states or have already fully reopened them. . .. We must send a clear signal of confidence towards our small businesses across the state by joining our neighbors and fully reopening Kentucky’s economy."

Dept. for Public Health graph shows shots by age group.

Vaccine report: Beshear said 1,855,111 Kentuckians have received at least one dose of a vaccine, a number that also includes Kentuckians who have been vaccinated out of state. He said that amounts to 52% of Kentuckians 16 and older who have received at least one dose of a vaccine, and gave an age-group report (graph at right).

Beshear said the federal government is expected to authorize the Pfizer vaccine for 12- to 15-year-olds next week, and that's another reason he was willing to increase capacities.

Health Commissioner Steven Stack said the state will move to the Centers for Disease Control and Prevention's vaccine finder next week at vaccines.gov, on which you can enter your ZIP code and get three choices of where you can go to get a vaccine. It also allows you to search for the vaccine you want, he said. 

Daily numbers: The percentage of people testing positive for the virus over the last seven days was 3.51%, down .06 points from Wednesday's average, which was the highest since March 17. 

The state reported 655 new cases of the virus, 147 in people 18 and younger. That lowered the seven-day rolling average by 20, to 599. Since March 17, the average has ranged from 721 to 518 per day.

The statewide rate of daily new cases over the last seven days is 11.41 per 100,000 residents. Kentucky's rate is 23rd among the states, according to The New York Times. Counties with rates more than double the statewide rate were Powell, 59; Hickman. 35.9; Montgomery, 31.5; Lewis, 31.2; Menifee, 30.8; Simpson, 29.2; Robertson, 27.1; Bath, 26.3; and Shelby, 24.8.

The state reported six more Covid-19 deaths, five from regular health-department reports and one from the ongoing audit of death certificates. The fatalities were a Breckinridge County man, 79, April 22; a Lawrence County man, 50, May 4; a McCreary County woman, 75, April 1; a Marion County woman, 49, April 16; an Ohio County woman, 88, Nov. 12; and a Jefferson County man, 86, Dec. 1 (found by audit). The state's death toll is 6,548.

In other pandemic news Thursday:

• Counties with 10 or more new cases were Jefferson, 127; Fayette, 52; Boone, 26; Daviess, 23; Warren, 21; Kenton, 20; Montgomery, 17; Clark, 14; Shelby, 13; McCracken, 12; Scott, 12; Madison, Rockcastle and Pulaski, 11; and Boyd and Laurel, 10.
• Kentucky hospitals reported 408 Covid-19 patients, 12 fewer than Wednesday; 113 of them, 2 more, were in intensive care; and 49 of those, up 3, were on a ventilator. The Lake Cumberland hospital-readiness region was the only one of 10 using more than 80% of its intensive-care beds, at 84%.
• The national infection rate hit a seven-month low, but new vaccinations are down 25% from last week, CBS News reported.
• A new Kaiser Family Foundation poll taken April 15-29 found that 9% of unvaccinated adults said the pause made them less likely to want the Johnson & Johnson vaccine. Seven percent said it made them less likely to want any of the vaccines. And 4% said it changed their thoughts about the vaccines in some other way.
• The KFF poll also found that the share of Republicans who say they will “definitely not” get vaccinated decreased from 29% in March to 20% in April, but remains substantially larger than the share among Democrats (4%) or independents (13%). It also found that 55% of Republicans say they have received a vaccine or will as soon as possible, up from 46% in March.
• A single dose of Moderna’s original Covid-19 vaccine and a booster shot that targets key virus variants both show promising signals that they can protect previously vaccinated people against problematic strains, the company announced Wednesday, Politico reports. In a trial that began in March, volunteers were given either a booster shot of the original formula or a modified vaccine aimed at the South Africa and the Brazil variants, which are less susceptible to the existing vaccines. The study found that a booster dose of the variant-targeting formula was more effective than a booster of the original vaccine, but both raised antibody levels, Moderna said in a press release. The research is not yet peer-reviewed.
• A Politico Pro article reports that state and federal officials fear low vaccination rates throughout the South and parts of the mountainous West will prolong the pandemic and increase the risk of a new strain developing that can sicken vaccinated people. The authors write that several states have struggled to vaccinate even one-third of their populations. In Tennessee, 34% of its population have received at least one dose of a vaccine and 24.5% have been fully vaccinated, according to its Covid-19 State Profile Report.
• “With herd immunity against Covid-19 now looking harder to reach, [Sen. Mitch] McConnell reiterated his support for the vaccines — while stopping short of calling out fellow Republicans for fueling skepticism about the shots,” Josh James reports for WUKY. “Acknowledging the slowdown in vaccination rates and the increasingly complicated task of convincing opponents to agree to the shot, McConnell had a football analogy.” He said, "This last 20 yards, it looks to me, are going to be kind of difficult," he said, partly because a recent Gallup poll found a fourth of Americans still resistant to the vaccination. “Asked whether he lays any blame at the feet of fellow GOP lawmakers who have sown mistrust about the vaccines, McConnell stuck to his own message.” He said, "I can only speak for myself. I'm a big proponent of wearing masks, getting vaccinated, and I've tried, at least for myself, to say the things that I think the American people need to hear.”
• Based on four different scenarios of vaccination rates and state re-openings, the CDC is projecting a surge in Covid-19 cases that will peak in May before sharply declining by July, as more people get vaccinated, CNBC reports. Hospitalizations and deaths from the virus are expected to remain low.
• Kentucky received a $21.6 million grant from the U.S. Department of Labor to help newly injured and ill employees to return to work, including those who have dealt with the enduring implications  of Covid-19 on their physical and mental health and are working to get back into the workforce. The Retaining Employment and Talent after injury/illness Network (RETAIN) program is expected to reach over 3,000 employees. Kentucky is one of five states to receive this a grant for the program's second phase. Go to kyretain.org or follow on Twitter @KYRETAIN to learn more.