As blood runs short in Ky. and the U.S., Red Cross seeks donors

Gov. Andy Beshear and first lady Britainy Beshear listen to Steve Cunanan, regional CEO of the American Red Cross, as they prepared to donate blood in the state Capitol rotunda. (Photo by Al Cross)

By Al Cross

Kentucky Health News

Responding to a potentially dangerous shortage of blood, Gov. Andy Beshear and his wife set an example Monday by donating blood in the state Capitol and hosting a blood drive in the Capitol Education Center.

First lady Britainy Beshear said before they donated that the number of blood donors in the U.S. is at a 20-year low. Steve Cunanan, regional director for the American Red Cross, said that means the organization is getting 40 percent less blood than usual. It declared a national emergency last month.

Cunanan noted that blood is a perishable product, and is needed an average of every two seconds in the U.S., and only 3 percent of Americans donate blood.

The governor said the shortage could lead to delays in surgeries in Kentucky and would become even more dire in the event of a disaster. He said he and his wife have become regular donors in recent years.

The Red Cross is coordinating with the Kentucky Blood Center, the largest blood bank in the state. Its website has a page where you can enter your ZIP code to find drives in Eastern and Central Kentucky, including Louisville. The Red Cross has a site where you can find blood drives anywhere in Kentucky or the U.S.

Kentucky gets $2.25 million to expand, restructure reserve corps of medical and non-medical workers who help in times of need

Kentucky Health News map from iStock base map

By Melissa Patrick

Kentucky Health News

With a $2.25 million grant, Kentucky will expand and restructure its Medical Reserve Corps to cover every county in the state.  

The corps comprises medical and non-medical personnel who volunteer their time and expertise to supplement public-health resources during emergencies and other times of community need.

Kentucky's corps supported emergency-shelter operations following storms in December 2021 in Western Kentucky; the flooding, mudslides and landslides in Eastern Kentucky last July; and during extreme weather events, such as the temperature plunge last December. Volunteers helped with testing and vaccine distribution during the pandemic, and typically provide medical support and first aid at large public gatherings such as the Kentucky Derby. 

“These volunteers have been crucial in aiding with disaster responses, and their invaluable impact has especially been felt during recent years,” Gov. Andy Beshear said in a news release. “We have faced unimaginable challenges such as natural disasters, a once-in-a-century global pandemic and so much more. With this funding, the administration will be able to provide direct financial support, technical assistance, resources and training to help our regional units and strengthen communities.”

The Medical Reserve Corps has 29 locally housed units with volunteers in 78 counties. The 42 counties not covered by the Medical Reserve Corps are Adair, Allen, Barren, Bath, Bracken, Breathitt, Butler, Calloway, Casey, Clay, Clinton, Cumberland, Edmonson, Estill, Green, Hardin, Hart, Jackson, LaRue, Laurel, Lewis, Logan, McCreary, Madison, Marion, Marshall, Meade, Menifee, Metcalfe, Monroe, Morgan, Nelson, Powell, Pulaski, Rockcastle, Rowan, Russell, Simpson, Taylor, Warren, Washington and Wayne. 

The state plans to use the grant money to restructure and consolidate the units into eight regionalized units that will cover all 120 counties. The corps will be housed under "Kentucky’s Healthcare Coalitions" in the preparedness branch of the state Department for Public Health.

“The regionalization of the Medical Reserve Corps program will provide a more robust and equitable coverage of volunteers across our commonwealth and will enhance the quantity and quality of partnerships with key stakeholders we already partner with, such as hospitals, universities and local health departments,” Cabinet for Health and Family Services Secretary Eric Friedlander said in the release. 

Of the 33 states and jurisdictions recently granted awards through the American Rescue Plan Act to strengthen the Medical Reserve Corps network across the country, Kentucky received the fourth largest. 

Deputy Health Commissioner Connie White told the legislature's Interim Joint Health Services Committee June 21 that the money will provide the funding needed to strengthen the program. 

"We're really going to work hard with our local providers to be sure that they know in case of emergency, that's not when you have a training. In case of emergency, that's when you call and say, 'Remember those desktop trainings that we did? Well, it's time to kick that into gear, because we need you.'"

UK environmental-health scientist Erin Haynes leads study to track health impact of train derailment in East Palestine, Ohio

Erin Haynes (University of Kentucky photo)

A University of Kentucky environmental scientist is taking steps to learn more about the health symptoms and exposures faced by the residents of East Palestine, Ohio, following a train derailment through an online health tracking survey.

On Feb. 3, a train carrying hazardous materials derailed near East Palestine, raising concerns about both short- and long-term impacts on the health of the area’s residents.

Erin Haynes, chair of the Department of Epidemiology and Environmental Health at the College of Public Health, is leading the research for this project. 

“It’s important that we characterize the health symptoms and exposure concerns from residents in East Palestine and in the surrounding area,” Haynes said in a UK news release. “We do not know exactly how far the chemicals have spread, so we want to include all surrounding counties in this survey.”

The survey is open to anyone aged 18 or older who lives in Columbiana, Mahoning, Stark, Carroll and Jefferson Counties in Ohio and residents of Beaver and Lawrence Counties in Pennsylvania and Hancock County, West Virginia. The survey asks questions about their experiences during the evacuation, concerns about exposures and health symptoms, including stress. 

Residents’ responses will give the research team insight on the experiences and health symptoms they have been facing since the incident. 

The release notes that this survey is the first part of a long-term research study to assess the potential lingering health effects from the toxic chemicals released and formed from the derailment and the subsequent controlled burn of chemicals.

“I have worked with Dr. Haynes for over 10 years on several environmental health projects,” Amanda Kiger, resident of East Palestine, said in the release. “We are excited to see this much-needed health survey launch. The community needs this long-term follow up to assess their health over time.”

Haynes is also the Kurt W. Deuschle Professor of Preventive Medicine and Environmental Health, director of the UK Center for the Environment and deputy director of the UK Center for Appalachian Research in Environmental Sciences (UK-CARES). 

As Dec. 10 anniversary of tornado disasters looms, and holidays also draw near, Kentucky's mental-health experts are on alert

Tornado damage in Mayfield reminded Brian Bowen of Iraq. (Photo by Brett Carlsen, Getty Images)

This story discusses suicide. Anyone who is having suicidal thoughts or sees a friend who they think needs help can call or text the Suicide and Crisis Lifeline at 9-8-8 for help and support.

By Sarah Ladd
Kentucky Lantern

Army veteran and crisis counselor Brian Bowen fought in an Iraq war zone.

But even the devastation he saw in combat didn’t compare to the leveling of Mayfield after an EF4 tornado going upwards of 200 miles an hour tore through Kentucky, destroying homes and killing dozens in December 2021.

Bowen, who lost his job at the Graves County Jail when the twister destroyed it, now runs a small support group in Marshall County through Project Recovery for those impacted by the storms.

Mental-health experts like Bowen expressed concern over the coming disaster anniversary, which they said could trigger mental health issues. As the Dec. 10 first anniversary approaches, it’s important for survivors to be aware of their moods and take care of their mental health.

In addition to his law enforcement background, Bowen has a degree in psychology and quickly saw the need for more mental-health services in the area. So, he joined Project Recovery, an organization that aims to help people recover from disasters. “I like helping people. I like counseling people,” he reasoned. “So, you know, why not?”

Bowen at work (Photo provided to Kentucky Lantern)

He quickly saw the mental health fallout was worse than he’d realized among his neighbors. He wasn’t immune, either.

“I’ve seen buildings burned out and blown up. I’d seen vehicles turned upside down and on fire,” he said. “I’ve seen all that stuff. And I remember, to this day, when I started driving around Mayfield the next day (after the tornadoes), I was like: ‘I have never seen anything like this before.’ It was totally worse than any war zone I’ve ever seen.”

Seeing the devastation all around him “affected me very heavily and mentally and cognitively,” he said.

Some of Bowen’s clients have already noted the changing weather to him, the cycles of warm and cold.

“That’s the exact same kind of environment that we had last year, so a lot of them are pretty scared,” he told the Kentucky Lantern. “First thing they tell me is: ‘Is it going to happen again?’ All I can say is, ‘I don’t know.’”

Bowen can’t control the weather, but he’s focused on getting his clients to meditate, practice mindfulness or listen to calming music or sounds like the chirp of crickets or a running creek.

Leah Fondaw is a licensed clinical social worker and the vice president of clinical services at Four Rivers Behavioral Health, a nonprofit that serves West Kentucky. She said there is concern as Dec. 10 approaches despite the healing that has happened over the last months.

“Anniversaries can be a triggering event,” she said. She’s prepared postcards for distribution on the anniversary that offer advice for coping with trauma such as focusing on deep breathing, practicing mindfulness and finding someone to talk to — whether it’s a therapist, friend or even a stranger.

“Some people might not feel comfortable talking to a therapist, but they might feel comfortable talking to friends or family,” Fondaw said. “And then other people might not feel comfortable sharing with their family but they might feel more comfortable sharing with a stranger. I know that sounds funny, but sometimes that person like a therapist is kind of on the outside, (and) it’s easier to talk to for some people.”

Dr. Eric Russ

Dr. Eric Russ, executive director of the Kentucky Psychological Association and a clinician with the Louisville Psychotherapy Group, said there isn’t a ton of research into disaster anniversary reactions, but “what we know is that folks who struggle with reactions to a traumatic event, so whether that’s PTSD, or depression or anxiety or substance use, tend to have kind of a surge in their symptoms.”

A 2012 study at Princeton University found that even five years after the deadly Hurricane Katrina that killed almost 2,000 people, survivors still experienced mental-health challenges. Study author Christina Paxson said at the time, “I think the lesson for treatment of mental health conditions is don’t think it’s over after a year. It isn’t.”

In her study of 532 low-income mothers, she found that after four years, 33% experienced post-traumatic stress symptoms and 30% still experienced psychological distress.

Marcie Timmerman, executive director for Kentucky’s chapter of Mental Health of America, said there is an “upward trend of interpersonal domestic violence, murder-suicides and suicides” in the aftermath of disasters like last December’s tornadoes, particularly in the first three years.

“The emotional blowback takes a while,” Timmerman said. “You’re kind of in that emergency mode for a while … until the basic needs are met. And for some people, unfortunately, that emergency mode doesn’t cease at the end of the year. So that adds a lot of extra stress.”

As the tornado anniversary and the holiday season approach, it’s important to surround yourself with community, these experts say.

“If you’re somebody who has been struggling with suicidality as part of your recovery, it would be a time where you want to do some extra planning for yourself about how to take care of yourself,” Russ said, “about how you want to spend the day or the week and what resources you can draw on to get yourself some extra support.”

Fondaw, who has also worked as a grief counselor and compared the tornado recovery to the grieving process, agreed. Pay attention to the day, she said, and don’t ignore it.

“I always felt like for . . . anniversaries of a loved one’s death, it was so important to plan something positive for that day,” she said, “plan something that was meaningful, something that would help you with the emotions of that day.”

Tornado survivors — and their friends — can be on the lookout for these suicide warning signs, Timmerman said:

• Any change in mood or attitude, either positive or negative.
• Giving away prized possessions or discussing giving away belongings or pets.
• Discussing where their children would live if they were gone.
• Discussing death by suicide.

Be careful not to assume someone who reached out for help before will do it again, Timmerman said, adding, “Our largest rate of loss of folks by suicide is in, like, three to six months after they’ve seen a provider. So we want to make sure we’re continuing that follow-up support as friends and family members.”

And, she said, asking someone specifically if they’re having thoughts of ending their life is not a harmful question. In fact, if someone is feeling suicidal, they will likely feel relief that someone is seeing and acknowledging their pain.

Anyone who is having suicidal thoughts or sees a friend who they think needs help can call or text the Suicide and Crisis Lifeline at 9-8-8 for help and support.

The lifeline is also a good resource even if thoughts haven’t progressed as far as suicidal ideation, Russ said: “In general, people wait too long to reach out for help.”

Loved ones say actor killed himself after losing all in flood, showing need for mental-health services for region's homeless

Tony Calhoun (Showhouse Productions)

A Kentucky actor and screenwriter killed himself after losing everything he owned in last month's flash floods, his fiancée said, and "His friends and family hope the incident emphasizes the need for mental health services as part of Eastern Kentucky’s recovery," reports Valarie Honeycutt Spears of the Lexington Herald-Leader.

Tony Calhoun, 39, "killed himself Monday morning, said Calhoun’s fiancée, Edith Heather Lisk. . . . Gov. Andy Beshear is counting Calhoun as the 39th death in the state flood toll. Calhoun’s parents, Betty and Lowell Thomas Calhoun, said that if even one person could be helped by talking about Calhoun’s death, it will be worth them telling his story."

Calhoun's mother said he lost first-edition comic books and "memorabilia that he had collected since he was 5 years old, but he was proud that he had not broken down in tears," the Herald-Leader reports. "What happened on Monday, she said, 'was his way of breaking down'."

Mental-health professionals are needed to tell hundreds of people made homeless by the flooding “that they don’t need to give up on life, that they can start over,” Betty Calhoun said. Breathitt County Coroner Hargis Epperson said Calhoun’s death is being investigated as a suicide.

Flooding and recovery cause concerns about health and safety

WEKU-FM photo by Stu Johnson

"Maintaining good physical and mental health is top of mind for health officials in flood-devastated Eastern Kentucky," reports Samantha Morrill of WEKU-FM. "Tetanus and hepatitis are major concerns after a flooding event."

So says Scott Lockard, public health director at the Kentucky River District Health Department. He told Morrill that the agency has been administering vaccinations in the community and going door to door.

“We have partners, and we've done this ourselves, to get on ATVs and side by sides and go up hollers in our communities and people who have not been able to get out and get the care, they need to make sure that they're getting vaccinations and getting, you know, the services that they need right there at their homes,” Lockard said.

He added that volunteers need to take care of their general health. Part of that includes properly treating cuts and scrapes: “They're in the water or the mud, you know, there's just a coating of mud on everything. We have to make sure that individuals are very mindful of treating wounds effectively, don't let these places become infected.”

The mud that coats nearly everything the flooding touched carries contaminants that can cause illness, Lockard said. The mud and debris are hazards for falls, and people should use protective equipment like rubber boots and gloves.

Lockard also said maintaining good mental health is also a concern. "A social worker by training, Lockard said setting boundaries and knowing when to ask for help are important tools," Morrill reports.

Eastern Kentucky health-care workers and patients face more threats: heat, mold, mental-health and substance-abuse issues

The rescues and initial cleanup are over, but health-care workers in areas of Eastern Kentucky that were hit by flooding now face other threats, reports Linda Blackford of the Lexington Herald-Leader: "dangerous heat for many without power, mold that can cause Legionnaires' disease in compromised lungs, and mental-health issues with people still in shock and grief from their trauma. Substance-use disorder has also been a huge problem in Eastern Kentucky."

Dr. Van Breeding (Photo: Ryan C. Hermens, Herald-Leader)

Dr. Van Breeding of the Whitesburg Mountain Comprehensive Medical Clinic said he had to cancel a long-planned festival set for Thursday to celebrate those in recovery and highlight resources, because rain is forecast.

"Many have lost suboxone and other medications, and Breeding is worried about another flood-related problem: drug overdoses," Blackford reports. "They need more Narcan and clean needles for exchange. People, including healthcare workers themselves, need homes and money and clothes, and it’s not at all clear when they will get them.

"UK HealthCare and other organizations are sending vaccines and supplies. People are sending aid through various organizations. But the medical needs for Eastern Kentucky, already serious, are going to get much more dire in the short and long term."

“We need all the help we can get,” Breeding said.

Flooding devastated many health clinics in Eastern Kentucky

The flood wrecked the Mountain Comprehensive Care Corp. warehouse in Whitesburg. (MCCC photo)

The flooding in Eastern Kentucky has disrupted much of life, and health care is no exception.

"The floods dealt a devastating blow to the 'safety net' system of federally-designated community health clinics throughout Eastern Kentucky which focus on medically underserved areas and low-income patients," reports Deborah Yetter of The Courier Journal. "In addition to primary health care, the clinics provide behavioral health, dental care, and social services. . . . Now clinic operators are scrambling to try to clean up and reopen or find alternate sites. They also must replace equipment, supplies, medication, and other goods lost in the flood. Some remain without power, water or phone service."

Yetter cites a Facebook post from Dr. Van Breeding of the Whitesburg Mountain Comprehensive Medical Clinic: "We will be open but are literally using paper charts, stethoscopes and cell phones to try to take care of people. Please, if you are in the medical field and can help us, send help, we lost our lab, X-ray, dental equipment and most clinical supplies but we are still helping our patients who lost everything. . . . The horrific tales of loss are extreme. We and the people we take care of are in shock and near exhaustion. Please help in any way you can."

Linda Blackford of the Lexington Herald-Leader reports on the response of Breeding and staff: "They evacuated a nursing home, they rescued people from their homes with kayaks, boats and jetskis, they helped set up a shelter at the CANE Kitchen in the old high school, and by Friday, they turned their attention to the flood clinic on Medical Plaza Lane. It wasn’t as bad as some places — just a few inches of mud as opposed to total immersion — but patients were already starting to trickle in. By Friday, the clinic was back open. On Monday, the clean waiting rooms were filled, as nurses and aides cleaned others."

“It’s a miracle; we worked around the clock and reopened,” Breeding told Blackford. “You don’t have time to think about it, you just do it.”

Also in Whitesburg, the headquarters of Mountain Comprehensive Care Corp., which operates 13 clinics, "is unusable from floodwaters that swept through and destroyed records and equipment. A supply warehouse was also wrecked," Yetter reports, citing CEO Mike Caudill.

"MCHC is now servicing patients out of the old Whitesburg High School located at 58 Walnut Street and limited operations utilizing a mobile clinic at the Isom location, the Kentucky Primary Care Association, the trade group for the clinics, said in an update Tuesday.

KPCA is trying to locate and ship needed supplies to its members in Eastern Kentucky, interim CEO Molly Lewis told Yetter, who reports, "It also is looking for volunteer medical workers from other parts of the state to assist at the clinics and will help with their costs of lodging."

KPCA issued this report on some of its other members in the region, including:

• Kentucky Mountain Health Alliance (Little Flower Clinic), Hazard: Needs drinking and distilled water, tetanus and Hepatitis A immunizations, portable oxygen tanks, home oxygen concentrators, insulin, medical supplies, sleeping bags, personal care supplies, nonperishable food, cleaning supplies, shower truck, laundry truck.
• Primary Care Centers of Eastern Kentucky in Hazard: No water; staff have lost homes, cars; needs for supplies.
• Dr. Clemente Zulueta, Jackson: clinic destroyed.
• East Kentucky Health Services, Hindman: All needs for patients and staff.
• North Fork Valley Community Health Center: June Buchanan Medical Clinic damaged; requesting supplies.
• Juniper Health, Jackson: Facilities okay but needs water, supplies for homeless and medical needs.
• Quantum Healthcare, Hazard: same.

In flood cleanup, here's how to stay safe and healthy

Disaster cleanup workers take breaks and keep hydrated
when temperatures are high, as is forecast this week.

Floods can kill, but so can the cleanup, if you aren't careful, says Anna Goodman Hoover, an assistant professor in the University of Kentucky College of Public Health.

"As people try to re-enter flood-damaged properties, the risk of serious injury and even death is high," Hoover told Kentucky Health News. She shares a package of "vetted materials from various agencies and environmental/disaster organizations that provide safety information for re-entering, cleaning up, etc."

The college's Department of Epidemiology and Environmental Health has created a web page with a wide range of resources for people to stay safe and healthy in flooding. Here are selected examples from Hoover's package of how to protect yourself.

• Wash your hands often to avoid exposure to harmful substances.

• Use hand sanitizers frequently.

• Exercise good housekeeping.

• Only drink from proven potable water sources.

• Be careful walking over and handling debris that is covered with water, to avoid risk of slips, trips and falls.

• Remain current with tetanus vaccination (within the past 10 years).

• If exposed to stagnant water, wash and sanitize immediately.
• If injured by sharp or jagged materials, immediately clean out all open wounds with soap and clean water. If a wound gets red, swells, or oozes, seek immediate medical attention.

• Consider steel toe/shank footwear if available and use durable gloves for handling debris.

• Watch for exposed power lines.

• Use hearing protection for noisy environments.

• Use appropriate breathing apparatus to avoid inhaling dust containing asbestos, silica and other lung-damaging substances.

• Avoid sunburn by limiting exposure, using protective eyewear and using sunscreen and lip balm.

To avoid heat stress:

• Drink plenty of fluids, sports drinks if available.

• Monitor yourself and coworkers, use the buddy system.

• Block out direct sun or other heat sources.

• Use cooling fans and/or air conditioning, and rest regularly.

• Wear lightweight, light-colored, loose-fitting clothes.

• Avoid alcohol, caffeinated drinks, or heavy meals.

• Seek medical attention for symptoms of: extremely high body temperature (above 103°F); red, hot, and dry skin (without sweating); rapid, strong pulse; throbbing headache, dizziness or nausea.

• Take shelter in shaded areas and loosen or remove excess protective clothing if feasible.

To avoid traumatic stress:

• Pace yourself and take frequent rest breaks.

• Watch out for each other and identify nearby hazards.

• Be conscious of those around you. Exhausted responders or stressed responders may put themselves and others at risk.

• Maintain as normal a schedule as possible; regular eating and sleeping are crucial.

• Whenever possible, take breaks away from the work area.

• Recognize and accept what you cannot change—the chain of command, organizational structure, waiting, equipment failures, etc.

To avoid eye injury:

• Use safety glasses with side shields; a retainer strap is suggested.

• Consider safety goggles for protection from fine dust particles; can be used over regular prescription glasses.

• Any worker using a welding torch for cutting must have special eye wear to protect against welding flash, which causes severe burns to the eyes and surrounding tissue.

• Use only protective eyewear that has an ANSI Z87 mark on the lenses or frames.

Avoid the hazards of floodwaters:

• There are usually elevated levels of contamination associated with raw sewage and other hazardous substances in floodwaters.

• Minimize human contact with flood water.

• Wear waders and waterproof gloves.

• If skin comes into contact with floodwater, wash thoroughly with soap and water.

• Keep all open cuts or sores as clean as possible.

• Use antibiotic ointment such as Neosporin.

• Stay alert for flash flooding.

• Floodwater may contain chemicals, diesel fuel, gasoline, motor oil, chlorine, liquid oxygen, medical waste, corrosives and industrial and household products in all sizes and quantities.

Watch your work environment:

• Do not enter a structure that shows indication of being unsafe such as walls with large cracks, shifting, or partial collapse.

• Determine if any hazardous substances have been anywhere on the property including pipes and tanks.

• Don’t walk on surfaces you aren’t sure are stable.

• Use other ways to get to work surfaces, such as bucket trucks.

• Erect scaffolding on stable surfaces and anchor it to stable structures.

• Wear protective equipment provided, including safety shoes with slip resistant soles.

• Use fall protection with lifelines tied off to suitable anchorage points, including bucket trucks, whenever possible.

• After flooding, the water creates the perfect environment for mold to grow in homes and other buildings. Exposure to mold can cause wheezing and severe nasal, eye and skin irritation.

• Floods chase animals from their burrows, increasing the risk of snakebite.

At home:

• Reconnect with family, spiritual, and community supports.

• Do not make any big life decisions.

• Spend time with others or alone doing the things you enjoy to refresh and recharge yourself.

• Be aware that you may feel particularly fearful for your family. This is normal and will pass in time.

• Remember that “getting back to normal” takes time.

 • Be aware that recovery is not a straight path but a matter of two steps forward and one back. You will make progress.

• You need to support your family and recognize that you are not going through this along.

• Avoid overuse of drugs or alcohol. 
• Identify and throw away food that may not be safe to eat: Food that may have come in contact with flood or storm water; food that has an unusual odor, color, or texture; meat, poultry, fish, eggs and leftovers that have been above 40 degrees F for two hours or more; food containers with screw-caps, snap-lids, crimped caps (soda pop bottles), twist caps, flip tops, snap-open, and home canned items; these cannot be disinfected if they have been in contact with floodwater

• If power is out, keep the refrigerator and freezer doors closed as much as possible
• Add block ice or dry ice to your refrigerator if the electricity is expected to be off longer than four hours.

• Wear heavy gloves when handling ice
Employers: Federal law "requires employers to provide a safe and healthful workplace free of recognized hazards and to follow Occupational Safety and Health Act standards. Employers' responsibilities also include providing training, medical examinations and record keeping. For more information, go to www.osha.govor call 1-800-321-OSHA(6742).

Employees should "follow the employer's safety and health rules and wear or use all required gear and equipment, and follow safe work practices for your job, as directed by your employer." Report hazardous conditions to a supervisor, and to the state OSHA agency, if employers do not eliminate them.

The above information originated with the Federal Emergency Management Agency, the National Institute of Environmental Health Sciences, the National Institute of Occupational Safety and Health, the Occupational Safety and Health Administration, the Centers for Disease Control and Prevention and the U.S. Army Corps of Engineers.

Remote Area Medical and health insurers serve more than 180 people at free clinic in tornado-devastated town of Mayfield

Remote Area Medical workers do a vision exam.
(Photo from Kentucky Association of Health Plans)

More than 180 people received free medical treatment or vision exams and glasses this weekend at a two-day clinic in Mayfield, the West Kentucky town devastated by the massive December tornado.

The clinic was sponsored by Remote Area Medical, which specializes in such clinics, and the Kentucky Association of Health Plans, the trade association representing all commercial insurers and Medicaid managed-care organizations in the state.

Free glasses were made on-site at Mayfield Middle School. Attendees also received free, take-home colon-cancer screening tests. Children received free coats and shoes from Operation Warmth, and snow cones.

“Probably half of our patients have brought children with them and some families,” Nicole Yates of Passport Health Plan told Paducah's WPSD-TV. Most patients didn't have primary-care health providers.

Yates says told the station that vision issues are often forgotten about in disasters. “During the disaster, everybody thought, bring water to Mayfield, right? But no one thought about if they were going to be able to get their prescription filled. What if they lost their glasses in the tornado?”

Yates says many patients came in with problems they didn't know they had: “Cataracts, other vision issues, diabetes. We had someone here who . . . were having chest pains.” She said many requested dental services, and "They hope to be able to bring a free dental clinic to Mayfield later this year," WPSD reports.

KAHP Executive Director Tom Stephens said in a news release, “We said back in December we wanted to help through all stages of the recovery and that is exactly what we are doing. There is still a great need for support.”

Tornadoes caused unseen damage to residents' mental health; in such cases, ramifications are often delayed, but help is available

Toskia Adamson at her mother's trailer site Feb. 11, two months after a tornado destroyed it and sucked her son and mother out of it and into the air. (Photo by Ryan C. Hermens, Herald-Leader)

Almost three months on, the devastating tornadoes of December are receding from the day-to-day memory of most Kentuckians, but thousands of people in the western half of the state "who’ve lost loved ones, homes and their livelihoods . . . are still battling with the toll on their mental health," reports Aaron Mudd of the Lexington Herald-Leader.

Mudd's story accompanies a long one by Alex Acquisto about one Dawson Springs family's struggle to recover from the damage, injuries and near death caused by the EF-4 twister that largely flattened the town of 2,500, sucked two of them out of one's trailer and threw them through the air. One thinks he has post-traumatic stress disorder, and there are many like him in the region, not all diagnosed. A study of the aftermath of the EF-5 tornado in Joplin, Mo., "found that emotional ramifications were often delayed, and that it may have correlated directly with a lack of mental health support services," Acquisto reports.

"In the first round of surveys six months out, close to 13% of participants showed signs of probable PTSD. At two-and-a-half years post-disaster, that amount more than doubled to nearly 27%. . . . Children, especially of parents who developed PTSD or depression, were more likely to exhibit borderline or abnormal behavior, the study found."

Mudd notes the 24-hour regional crisis hotlines in Western Kentucky:

• Four Rivers Behavioral Health in Paducah: 800-592-3980
• Pennyroyal Center, with clinics in Hopkinsville, Madisonville, Greenville, Princeton and Central City: 877-473-7766
• Adanta Group Behavioral Health: 800-954-4782
• LifeSkills in Bowling Green: 800-223-8913
• RiverValley Behavioral Health in Owensboro: 800-433-7291
• National Alliance on Mental Illness Lexington: 800-928‑8000

"These clinics are also offering support groups, one-on-one therapy sessions, and treatment for substance-use disorder," Mudd reports.

For mental health counseling, the Kentucky Counseling Center says it has more than 100 providers and accepts all major insurers, Mudd reports. If you don't have insurance or don't want to use it, “Kentucky Counseling Center offers some of the most affordable prices for mental health treatment in Kentucky,” its website says. Mudd reports, "According to a representative at the center, its therapy sessions are $100 per session. Medication appointments are $100 for the first visit and $75 for medication follow-ups, as needed."

Also, Open Counseling has a list of community mental health centers, which have income-based fees for patients without insurance.

Tornado cleanup is more than physical; loss and suffering take emotional and psychological tolls that can be harder to deal with

Downtown Mayfield is pictured on Feb. 2. (Photo by William Widmer for The New York Times)

About 40 percent of the debris from the gigantic tornado that plowed through 200 miles of Western Kentucky Dec. 10 has been picked up, but Rick Rojas of The New York Times reports, "Communities along that path are now confronting another form of devastation that is less tangible but just as staggering: the emotional and psychological toll that comes from enduring so much loss and suffering."

Rojas adds, "The long and unforgiving reach of the storm is evident in nights that are sleepless or disrupted by harrowing dreams, unexpected bursts of tears, flashes of anger, fuzzy memories, a diminished appetite — the multitude of ways that trauma can manifest itself after a disaster. Now, more than a month after the storm, some — because of resources or simple luck — have been able to emerge from the shock of the storm. On the other side of a growing gulf, though, are the many others whose lives were upended and are still being whirled by turbulence. For them, mental health experts warn, the sense of security and calm integral to recovery remains elusive."

The focus of Rojas's story is Mayfield, a town of 10,000 "walloped by the initial shock of seeing entire stretches pulverized by the worst of the storm. Downtown remains mangled," he writes. "People point to piles of debris and refer to them by what they used to be: a church, a shop, a family home."

Steven Elder, the president of the Mayfield Community Foundation, which is raising money to help residents recover, told Rojas that it has been hardest for people who were already disadvantaged: “People were hurting long before Dec. 10. That’s the disaster that’s going to set these people back a lifetime. They’ve fallen into a hole they’ll never get out of.”

Rojas focuses on several victims, primarily Isaiah Holt, who "sustained nerve damage while trapped in the rubble of the candle factory where he worked and fears it will be permanent. His skin is etched with cuts and chemical burns. A strong gust of wind or an exploding building in an action movie can unleash in him a rush of terror. Lately he has spent $400 on DoorDash deliveries, as the pain — physical but also psychological — makes it difficult to venture outside."

“I felt good today,” Holt told Rojas after making phone calls and taking a shower, but "He confessed that it was only the second one he had taken in 2022."

“That’s what ‘feeling good’ means, just be feeling normal,” Holt said. “What makes it hard is I have nothing to do right now. I’m single with no kids, and I have no job.” So, Rojas writes, "He sits and he stews."

Holt was "pinned under the rubble for hours," Rojas reports. "He drained the battery on his cellphone posting videos on Snapchat, desperate to tell his family and friends he loved them. He feared he would not make it out. He feared for his brother, who worked there too and was similarly trapped. Weeks later, Mr. Holt is grateful to be alive and for the company of his brother, who spent several days in a coma but is now recovering at home. But he is also depressed and saddled with new fears."

Holt "lost 20 pounds in the hospital and feels out of shape. He is even more concerned about his mental health," Rojas writes, quoting him: “An able mind is 10 times better than an able body.” Holt has already had post-traumatic stress, after serving in the Army as a door gunner on a helicopter.

"Before he started at the candle factory about three months ago, Mr. Holt was working with young people, coaching them in sports and taking them on college tours," Rojas reports. "In a way, he is still coaching. He is often on the phone with his candle factory co-workers, trying to help them deal with the trauma. “Instead of sugarcoating,” he said, “I’m just letting them know: There are going to be bad days.”

Family members of the injured are affected, too: "Darryl Johnson, whose sister was killed at the factory, has checked in just about every day with his nieces and nephew — her grown children. He was trying to give his brother-in-law some space. He could tell he needed the room to grieve," Rojas reports.

“Eventually, it got to me,” Johnson told him. “I’m a fisherman. I was at the lake one day. I turned into the lake — that’s how hard I cried. You cry so hard your throat gets sore and you can’t speak, and finally, it was over. I just put my feet on the ground and said, ‘Get back to work. You’ve got a job to do.’”

Kentucky farmers, often beset by circumstances, can take advantage of a new program to support their mental health

The following story is from The Goldenrod, which normally covers rural Eastern and Central Kentucky. Editor Sarah Baird writes, "If you live in a farming community—or are part of a farming family—I’d ask you to share Michelle’s piece with a friend or loved one this week. It could help save a life."

By Michelle Eigenheer

As dawn broke in the early morning hours of Dec. 11, 2021, residents and aid workers began to get a clearer view of the damage caused by a late-night tornado that left nearly 200 miles of wreckage across 11 counties in Western Kentucky. The EF-4 tornado—one in an outbreak of over 60 that caused $5 billion in estimated damage across six states—killed at least 77 people and sent more than double that number to emergency rooms.

Logo of the program, which began in 2020

Among the neighbors and rescue workers who poured into communities like Mayfield to help pull people from the rubble and offer hot meals in the December cold were Dr. Cheryl Witt and Dale Dobson, who met with farmers to take stock of their unique needs. Witt and Dobson are members of a campaign called Raising Hope, a coalition including the Kentucky Department of Agriculture and Cabinet for Health and Family Services, the Southeast Center for Agricultural Health and Injury Prevention and a number of state universities that formed in 2020 to offer critical resources and education to support the mental health of Kentucky farmers and their families.

Along the tornado’s path, farmers found their buildings demolished, equipment missing or damaged, and livestock killed by the destruction, debris and devastating winds. An estimated 30 poultry barns were leveled in the night; a hatchery and the 8 million eggs inside were destroyed; grain mills and silos were toppled or torn apart, exposing the livestock feed inside to the storm’s rain and rendering it unsafe for consumption. Hundreds of cattle and other livestock were injured and killed, sometimes even carried away by the 190-mph winds. Total estimates for damages and losses are still being assessed, over a month after the supercell storm.

“We’ve had two tornadoes come through . . . and laid flat [farmers’] whole livelihood, just laying there on the ground to pick up and rebuild, and then the snowstorm…you have tragedies,” says Dobson, a KDA farm safety officer and Hodgenville-area farmer who has taught farm safety for 20 years. He joined Witt—a sixth-generation farmer and nurse who teaches at the University of Louisville in addition to serving as the Raising Hope project manager—with the intention of expanding ideas of farm safety to include mental health and physical wellness.

The devastating storms are the latest in a series of acute struggles that farmers across Kentucky and the nation have faced since the start of the pandemic, adding to a growing list of stressors that have negatively impacted the mental health of farmers and their families for decades.

Farmers and agricultural workers have among the highest reported rates of suicide across all occupational groups, according to studies from the CDC. With this in mind, Raising Hope formed and outlined immediate goals: reducing the stigma of mental healthcare among farming communities; increasing education and awareness around mental health; showing farmers appreciation from their communities; and using data collection methods to get a better view of the issue.

State Rep. Brandon Reed's Twitter post about the program

Support from state Rep. Brandon Reed, a Hodgenville Republican, secured funding from the legislature, providing $500,000 for 2020 and again in 2021. The group worked quickly, enacting programs to improve existing infrastructure and build a network of crisis and risk assessment training access throughout the 56 Kentucky counties that showed the highest number of indicators for crisis.

They began QPR training—a method of crisis response that follows a directive of Question, Persuade, Refer, to identify and interrupt a mental health crisis so that the subject can be directed to care—and educated 57 QPR trainers across the state who, in turn, trained 450 key community members on how to recognize and aid those who may be considering self harm or ending their own life.

They invited doctors and nurses to the annual Farm Machinery Show and offered health checkups for attendees. Partnering with Western Kentucky University, they developed a rural suicide prevention training that focuses on “response measures for farmers in crisis and the application of cultural sensitivity and humility.” CRUSHing Farmer Suicide—Cultural Respect, Understanding, Sensitivity, and Humility—is currently available for healthcare professionals in the form of a free, one-hour continuing education program.

They then turned to the state’s crisis hotline. Backup call centers were located in Miami and New York at the time, creating unneeded confusion and complications during critical conversations with rural populations.

“During that time, you want to be able to talk to somebody who understands and can connect and relate to you,” Witt explains, giving examples of how different accents and lack of knowledge about stressors, like those specific to rural or farm life, can be obstacles between the person in crisis and the one who answers the call. “You don’t need a communication barrier at that time.”

Now, at least 95 percent of all in-state calls to the National Suicide Prevention Lifeline (1-800–273-8255) are answered by someone within one of the commonwealth’s own call centers. Callers are now also asked, as part of the existing call intake process, if they’re a farmer or member of a farming family. This was added as part of a data gathering effort to better understand the mental health crisis.

“Because we used our original money to build and expand our projects, that really gave us a lot of ammunition, if you will, to put in for federal funds and be awarded them,” Witt explains. In December 2021, the federal government issued a $500,000 grant to the Department of Agriculture to further expand Raising Hope’s projects and partnerships.

The additional funding has allowed Raising Hope and partners to implement a farmer appreciation grant program. It is also funding the development of a mental health curriculum specifically for rural youth aged 9-12, as well as a peer-to-peer mobile app similar to those used in veterans groups that will center “mental health and wellbeing-focused online interventions” and include access to just-in-time telehealth services. The curriculum is slated to pilot in fall 2022, while the app is entering user testing in the coming weeks.

This grant is part of a nearly $25 million investment by USDA’s National Institute of Food and Agriculture to 50 state-level projects in an effort to expand or create mental health and stress management resources for farmers and ranchers across the country.

The list of stressors and potential crisis factors for farmers is long: they are isolated within the acres of land that they farm; their income is greatly affected by fluctuating commodities pricing and supply chain failures; their crops and livestock are subject to damage or ruination from factors out of their control like climate change and natural disaster; even exposure to insecticides has been linked to higher rates of depression. Farmers are also more likely to suffer chronic pain from a lifetime of manual labor, and have increased access to lethal means, such as firearms and heavy machinery. A number of studies on farmer mental health note that reported rates of suicide are likely low because deaths can easily be misreported or mistaken as farming accidents.

The pandemic compounded many of these stressors. Ongoing tariffs in the trade war with China hit U.S. agriculture hard. And 2020 payments to compensate for those financial losses largely missed small producers and family farms: CNBC reports that two-thirds of the $28 billion Market Facilitation Program went to the top 10 percent of recipients. The report outlines the disparity: companies at the top received an average of $164,814 per payment, while the bottom half of recipients received, on average, less than $2,500 per payment. Meanwhile, bankruptcy rates for farms in the Midwest, including Kentucky, rose 23 percent from June 2019 to June 2020.

In financial turmoil, many small-scale and family farm operations are not facing just a loss of income: losing the farm can also mean losing the house, losing an identity, or failing a family tradition.

Dr. Cheryl Witt on her farm (Photo from Ky. Dept. of Agriculture)

Witt explains: “I farm—six generations now. You talk about something you’re passionate about, it’s all those internalized feelings and attachment to the land. That’s me. I live it every day. Because farming is such an identity, as farmers age and are unable to [continue working], that also mentally affects a lot of farmers. Farmers will define good health by their ability to get up and work. So when they can’t do that, it absolutely does a number on their psyche.”

Dobson’s explanation is more succinct: “Everything is tied into one thing: If I lost my job [at KDA] today, I’ve still got my home and my farm to go to and work. [If] I lose my farm, I lose my home. My living. My identity. My everything.”

When Dobson began mental health outreach with farmers in the communities where he teaches farm safety, he used challenge coins as a prop to turn everyday conversations toward oft-stigmatized mental health subjects. Turning the coin in his hands gave him an opening to incite a promise from those he works with, he explained.

“When you shake my hand and take my coin, you take my challenge,” he tells them. “You give me your word that if you feel down, you’ll call somebody. You call me, you call the 800-number on the back, anytime. You find somebody.”

Breaking through the barrier to a discussion about mental health opens a door for stories and disclosures that may otherwise be withheld for years, even decades. He tells them, “I’m not saying anyone is suicidal, I’m saying some of us have good and bad days.”

“I had one farmer, we’ve been friends for 30 years. We shook hands, he held my hand and says, ‘You been involved in suicide?’” Dobson recounts.

Dobson, who has encountered a number of cases of self harm, including the loss of his best friend, says that the farmer then shared that his first wife had taken her own life in front of their young son—and for 35 years had never said a word about it to Dobson or most others.

He points to this disclosure as a sign that things are changing for the better.

“Raising Hope is going to change the world,” Dobson declared on a phone call from Atlanta, where he was attending a farm safety training. “We ain’t never had a program before that dealt with rural mental health, or mental health, period, out here. There’s a stigma about it, there’ve been no conversations about it. And farmers, some of them, are starting to talk about the bad days and the gloom and doom.”

Dobson continued, “Everyone’s had to go pick up a friend or neighbor and know somebody that took their lives. The world’s changing on that part for the good, because we’re communicating.”

If you’re in crisis, there are options available to help you cope. You can call the National Suicide Prevention Lifeline at any time to speak to someone and get support. For confidential support available 24/7 call 1-800-273-8255 or visit https://go.usa.gov/xftYC.

Virus cases still lag, but Beshear says a surge is coming, and its size will depend on how many people get booster shots

Times of India illustration

By Al Cross

Kentucky Health News

As the fast-spreading Omicron variant of the coronavirus takes hold in some areas of the country, Gov. Andy Beshear says he expects it to cause a surge in cases in Kentucky over the holidays, and urged more vaccination to fight it.

Beshear said Thursday that the big factor in the coming surge “is how many people get their booster” shot of a Covid-19 vaccine. He also urged initial vaccinations, saying any natural immunity from having Covid-19 may not protect as well against the Omicron variant, which is still being researched.

With a booster shot, “You’re pretty well protected. You’ll free up that hospital capacity, if it comes in a crunch, that others will need,” he said. “So please, for the holiday season, if you haven’t gotten vaccinated, go get vaccinated. Even if it’s your first shot, go ahead and get it; it’ll help. If you've been fully vaccinated and it's time for your booster, go get it; don’t wait until after the holidays; go get it as quickly as you can.”

Beshear also asked Kentuckians to think about how they hold holiday gatherings, keeping in mind the vaccination status of the attendees, using masks and perhaps having smaller gatherings than planned.

“Try to protect one another,” he said, relating the pandemic to the tornado disaster in the western half of the state. “We’ve seen horrific loss of life . . . I see the outpouring of love; take care of each other.”

Beshear said he had not been notified that the variant is in Kentucky, but “It’s unquestionably here” and is spreading faster than previous variants. Researchers still don’t know how strong it is, but Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said current vaccines will work on it. Fauci said he expects the variant to dominate cases in the U.S. by mid-January.

In response to a question at a press conference that focused on the disaster, Beshear said he is worried about spread of the virus as a result of it.

“That's one of reasons we’re trying to get people out of a shelter and into a state park,” he said. “We can create a little more distance.” After reporting that hundreds of victims are at park lodges, a reporter told him concern had been expressed about undocumented immigrants being housed at state facilities. Beshear said, “Anybody who lost their home, we want to have a place to stay.”

Daily report: New coronavirus cases continued on a slowly declining plateau Thursday, but the percentage of people testing positive for the virus in the last seven days went up 0.07 points, to 8.84%.

The state reported 2,507 new cases, lowering the seven-day rolling average by 32, to 2,163. The average has fallen for the last nine days, by 8.7% over that time. Of the new cases, 28% were in people 18 and younger.

The seven-day infection rate is 43.53 daily cases per 100,000 residents. Counties with rates more than double the statewide rate were Robertson, 176.2; Menifee, 151.9; Wolfe, 125.8; Lewis, 106.5; Union, 98.3; Hancock, 93.4; and Trimble, 92.8.

Kentucky's infection rate remains 21st among the states, according to The New York Times. The paper says that among the 3,100-plus counties in the nation, Lewis County has the 27th highest rate of new cases, with a 129% increase in the last 14 days. These figures, from the Centers for Disease Control and Prevention, differ from state figures due to methodological differences; for example, the state says it removes duplicate test results.

Kentucky hospitals reported 13 fewer Covid-19 cases and 12 fewer Covid patients in intensive care than Wednesday, but 14 more Covid patients were on mechanical ventilation; that number, 193, was the most since Oct. 20.

Intensive-care units have more patients in the winter, and they continue to fill up. In eight of the state's hospital regions, more than 90 percent of ICU beds were occupied, and Northern Kentucky remained at 100%.

The state reported 26 more Covid-19 deaths, raising the death toll to 11,719. Over the last seven days, 34.3 deaths per day have been reported; the 14-day average is 49.4 per day.

One good day: Beshear and others have expressed concern about the mental-health effects of the tornado disaster, but he said they got a boost Wednesday when President Biden visited two devastated towns.

Asked what surprises he had during the tour, other than Biden's announcement that the federal government would cover all cleanup costs for the first 30 days of recovery, Beshear said:

“There were really tough moments yesterday. I had not been able to get that far back into Dawson Springs, and it was even worse than I could tell, and it was painful, but to also the number of people who would say that they were blessed to be alive was pretty special . . . 

“Remember, eight blocks in any direction, nothing standing, everybody who is sporting through the rubble knows each other. I’ve said before, the trauma kind of seeps into your skin, but I will say that having the president there, and especially in Mayfield, created an energy, and you know what, I was just happy for one day – because it had been, what, five or six days? – for just one day since this happened, that there seemed to be this really positive energy, that the president of the United States was there.

“I’m not sure I expected to feel that, and you could see it on people’s faces . . . Whether or not you voted for him or you voted for me, we’re both trying to do our very best for you.”

National Preparedness Month's theme is 'Prepared, Not Scared. Be Ready for Disasters.' Here are tips to help you be prepared.

Because emergencies and disasters can happen without notice, the state Department for Public Health is offering tips on how to always be prepared in a campaign called "Prepared, Not Scared. Be Ready for Disasters" during National Preparedness Month, which falls in September.

“Emergencies and disasters can happen anytime and anywhere, often without notice and can leave us scared and confused,” Jim House, manager of the department's preparedness branch, said in a news release. “By taking the time to follow the ten steps outlined below, we all can better prepare ourselves and our communities should emergencies or disasters strike.” The state campaign encourages households, businesses and organizations to take the following 10 steps to prepare for a disaster:

• Assemble a "Go Bag" packed with essential items to have in the event of an emergency evacuation of your home. Go to ready.gov/build-a-kit for a list of what to put in a go-bag.
• Prepare digital forms of important documents for an emergency, including your ID and passport. You could also make copies of these documents and put them in a waterproof pouch or zip-lock bag.
• Have extra supplies in case of an emergency.
• Download the Federal Emergency Management Agency app (https://www.fema.gov/mobile-app) to provide emergency information about disaster resources, weather alerts and safety tips.
• Have an alternative power source for devices during emergencies.
• Set up an In Case of Emergency (ICE) emergency contact in your cell phone.
• Choose an emergency contact when out of town.
• Find a local, pet-friendly evacuation center.
• Update your social media to tell loved ones you are safe during an emergency.
• Text, don’t call, in an emergency. Phone lines will be clogged with calls reporting important information.

FEMA also offers a wealth of information to help people prepare for a disaster, including a "Family Emergency Communication Plan" form. FEMA suggests keeping some cash on hand in case of emergencies, since ATMs and credit card readers won't always be available; small bills are best.

Centers for Disease Control and Prevention graphic; click it to enlarge

The Centers for Disease Control and Prevention offers tips to address health needs during a disaster, including: gathering enough food, water and medical supplies to last at least 72 hours; preparing a seven- to 10-day supply of prescription medications; making copies of important documents and medical records, including an up-to-date list of all prescription drugs for each person in the household, with dosage and a list of each person's known allergies; and learning life-saving skills, such as cardiopulmonary resuscitation (CPR) to use until help arrives.

In addition, don't forget to prepare for pets' needs, including making sure they wear their collars and tags with up-to-date information or are microchipped to increase the chances that you will be reunited if you are separated.

And most importantly, make sure everyone, including children, knows what the disaster plan is since you might not be together when the disaster happens. The CDC offers "Ready Wrigley," a children's activity book series, to help parents talk to children about disasters.

"Remember that preparedness is a shared responsibility - it takes a whole community to prepare and respond to emergencies," said House.

National Preparedness Month was started after Sept. 11 and is organized by the U.S. Department of Homeland Security. For more information about preparing for and responding to emergencies, visit http://www.ready.gov.