Showing posts with label health departments. Show all posts
Showing posts with label health departments. Show all posts

Wednesday, July 24, 2024

Drug to reverse opioid overdoses is more available than it used to be; health official says stigma still exist around carrying it

By Shepherd Snyder, WEKU

The annual Kentucky Drug Overdose Fatality Report says overdose deaths in 2023 dropped by 9.8 percent from the year prior; 2022’s report showed a 5 percent decrease compared to 2021.

Photo from Wikimedia Commons
That comes as access to naloxone has improved, in part because of state and federal programs that support local health departments and emergency services.
Holly Buchenroth, an assistant professor in Eastern Kentucky University’s Emergency Medical Care Program, says requesting access to naloxone has become an easy process.

“Any first-responder agency can get access to this naloxone if they qualify and are in a rural county that's eligible, and all they have to do is complete a training, make a request and document the usage or distribution,” Buchenroth said.

Naloxone is a nasal spray medicine that reverses opioid overdoses with no negative side effects. It’s also sold under the brand names Narcan and Evzio.

Kentucky got $800,000 last year from the federal government to dispense Narcan to first responders in rural counties. Last year, more than 160,000 units of the medicine were distributed across the state.

Scott Lockard, public health director of the Kentucky River District Health Department, says the added resources have been a big help. The health department serves Knott, Lee, Leslie, Letcher, Owsley, Perry and Wolfe Counties. 

“A couple years ago, Narcan was much harder to access, and we've seen much more awareness around harm reduction and the importance of getting Narcan, naloxone out there,” Lockard said. “So pretty much there's no excuse now.”

Other agencies, like the Pike County Health Department have fared similarly. Director Tammy Riley says in 2021, the agency wasn’t able to distribute any naloxone kits to individual community members, with just 82 Narcan kits distributed to the county in total.

They’ve since been able to turn that around.

“Compare that to our 2023 data, 3,500 Naloxone kits were distributed through the harm reduction program, 25 Naloxone kits through first responder and community organizations and 240 Naloxone kits to individual community members,” Riley said.

Riley says they’ve also focused on education. For every box of Narcan they give out, they inform its receiver on how to use it.

“When you see those numbers of distribution, every box that's distributed to an individual is provided with about a five to 10 minute education session,” Riley said. “We don't just hand naloxone to an individual and say, ‘Good luck.’”

The life-saving drug is also getting cheaper. Buchenroth says that’s in part because of its availability over-the-counter at chain pharmacies.

“You can pick up a generic two pack now for about $35, so the price has come down,” Buchenroth said.

But access in rural areas could still improve. Riley says in places like Pike County, where the health department covers a large area, it’s harder to follow up with those in recovery compared to urban areas like Lexington or Louisville.

“We need a Quick Response Team in Pike County, so when those individuals do refuse those 911, first responder services, we could deploy a Quick Response Team to find that individual in the throes of reversal when they're most likely to seek treatment,” Riley said.

Other officials, like Lockard, say getting rid of the stigma that carrying Narcan involves is also an issue.

“Although the resource of the service may be here, they're still reluctant to make themselves available to the resources that they can access,” Lockard said. “So how do we reduce the stigma? How do we do more training in the communities?”

Maria Slone is a social worker with Lexington’s community paramedicine program and works with a quick-response team. She says there’s a simple way to bridge that gap: community involvement.

“They're not going to have as many resources as we have, but how much buy-in is in their community members and their law enforcement and their courts and EMS providers?” Slone asked. “What does that look like for them to have that buy-in?”

Most recently, the state has launched a website that shows a map of all the locations naloxone is available, both for free and for purchase. It’s available at findnaloxone.ky.gov.

Thursday, July 11, 2024

Breathitt, Lee, Jessamine and Nelson counties are certified as Recovery Ready Communities, totaling 14 in effort's 14 months

Kentucky Health News map
Gov. Andy Beshear presents Recovery Ready Community
certificate for Lee County to Scott Lockard and Jo Ann Fraley
of the Kentucky River District Health Department. (Photo by Al Cross) 
By Al Cross
Kentucky Health News

Four more Kentucky counties have been certified as Recovery Ready Communities, signaling that they have the services needed to help their residents recover from addiction. That brings the total to 14 out of 120; the program began 14 monhs ago. "We've got 106 to go," Gov. Andy Beshear said.

Breathitt, Jessamine, Lee and Nelson counties earned cetification by showing they are able to provide addiction treatment to their 123,000 residents, according to Beshear, who presented Lee County's certificate at a wide-ranging press conference Thursday.

Scott Lockard, public-health director for the seven-county Kentucky River Disrrict Health Department, accepted Lee County's certificate with Jo Ann Fraley, who runs the department's harm-reduction program, which includes a syringe exchange to prevent disease among intravenous drug users and steer them into treatment.

"The substance-use-disorder problem is the largest public-health issue that we are facing today in Eastern Kentucky and many parts of our commonwealth," Lockard said.

Noting another major topic of Beshear's press briefing, Lockard said, "These great economic-development announcements are fabulous, but each one of those factories need people to work in them. Second-chance employment is huge, and we have so many people who are being impacted by substance-use disorder, especially in our part of the state, in Eastern Kentucky."

Lee County's recovery program is based in The Hub, in the health department's annex. "Our motto at the Hub is 'We meet people where they are, but we do not leave them there,' because it's key that everyone who comes through our door is treated with respect and dignity."

Lockard said the program has gotten more 230 people into treatment, including three that morning. They were immediately transported to a treatment facility, Lockard said: "When they're ready, we need to get them in there right then."

When people leave residential treatment, The Hub offers them 11 support groups, links to second-chance employment and "a ministry that fills the soul," Lockard said. "You know, this emptiness left by drugs, we need to fill it with somethng else, and if we can get individuals back and show them that they have worth, that they have dignity, then we have the possibility to really help them to be gainful members of our society and fill some of these many jobs and just have a higher quality of life."
 
Lockard said substance use must be approached as a disease. "We cannot incarcerate our way out of this problem." He said The Hub includes a court diversion program for low-level drug offenders.

Immediately before the recovery discussion, Beshear and State Police Commissioner P.J. Burnett announced a statewide drug roundup of 206 suspects, mostly on trafficking charges. Burnett said another 50 suspects are still being sought.

To be certified as recovery-ready, a county must have peer-support services, mental-health treatment, addiction treatment, employment services and a stigma-free environment to encourage recovery. The program "encourages communities to provide transportation to and from employment services and job interviews, allowing Kentuckians to make positive changes in their lives while filling much-needed jobs and contributing to the commonwealth’s record-breaking economic growth," a news release from Beshear's office said. 

The release included statements from representatives of the other counties.

“This is a huge step in continuing to move Breathitt County forward in applying for grants that will improve the lives of every person in our county,” said Breathitt County Circuit Court Clerk James Elliot Turner II. “We need to provide every opportunity for each person in Breathitt County to fulfill their potential. This is a win for our people.”

Shauna O’Nan, Jessamine County Health Department harm reduction director, said “There is no set path of recovery, but after going through this certification process, we are confident, as a community, that we will be able to meet people where they are on that path.”

In Nelson County, "Collaboration and community involvement underlie Nelson County’s efforts to provide recovery resources to its citizens," the release said. Jessica Bickett, safe-communities specialist with the Lincoln Trail District Health Department, said “Nelson County has a strong network of community partners who are committed to supporting the recovery community.”

"These communities are stepping up to help fellow Kentuckians who are struggling with addiction," Beshear said. "We are grateful for, and we applaud, their good work."

To learn more about the program and to apply for certification as a Recovery Ready Community, click here.

Paths to treatment

If you or a loved one are struggling with addiction, connect to treatment by calling 833-8KY-HELP (833-859-4357). Information about treatment programs all across the commonwealth is available at FindHelpNowKy.org.

Information on how to obtain the life-saving drug naloxone, which is used to reverse an opioid overdose, can be found at that website as well as at FindNaloxoneNowKy.org and FindMentalHealthNowKy.org.

Visit the State Police website to find a post where those suffering from addiction can be paired with a local officer who will assist with locating an appropriate treatment program through KSP’s Angel Initiative.

To find recovery housing, go to FindRecoveryHousingNowKY.org.

Tuesday, June 25, 2024

Health department director says she has work to do, to educate Attorney General Coleman about syringe exchanges

Dr. Crystal Miller with state
Health Commissioner Stack
Kentucky Health News

The director of a district health department with a syringe exchange has voiced disappointment to her local newspaper over Attorney General Russell Coleman's opposition to the exchanges.

Dr. Crystal Miller, director of the Wedco Health District, which serves Scott, Harrison and Nicholas counties, told the Georgetown News-Graphic that syringe-exchange programs are misunderstood.

“It is unfortunate that our attorney general doesn’t support syringe service programs,” Miller told the newspaper. “We have work to do to educate him on grasping a full understanding of what this program entails.”

Noting Coleman's statements to Kentucky Health News, Miller said, “This program is designed around the very things he’s supportive of, prevention and treatment. We work closely with community partners to create a system that no matter where someone enters, we know how to link them to an agency that can assist. Substance abuse is a problem in our society that we will never enforce our way out of, and successful mitigation requires all hands-on deck. Syringe service programs are a framework for that in our community.”

The News-Graphic notes, "Approval for such a program, here, was difficult and strongly opposed by the Scott County Fiscal Court several times until a magistrate who once opposed such a program became aware of a situation involving someone he knew and reversed his opposition."

Miller said, “At surface level, syringe service programs can be misconceived. This program provides an entry point to many resources for people who use drugs and allows us to promote recovery. Through this program alone, we have referred people to treatment for drug use, linked them to care and resources within the community to help them make better, healthier choices.

"We have success stories of people recovering in every SSP program across Kentucky. However, one of the biggest successes within this program is the amount of hepatitis C and HIV that we have been able to detect and treat within our communities. Without this program, we would not have identified communicable diseases that are killing people and costing taxpayers large amount of money. Just within the Wedco District, through our SSP program, we have saved taxpayers $1.3 million in early identification/treatment of Hepatitis C. We are effective at prevention and treatment and the data proves it."

As for Coleman's concern that syringe exchanges promote drug use, Miller said, “I can assure you that not one participant has ever reached our doors and decided to start using drugs because we are providing clean syringes. We prevent the spread of disease, focus on reducing as many barriers as possible and being a resource to helping people make better decisions and recover, all while saving taxpayers money. I hope that we can work more closely with our AG to help him understand and support the impact that this program has in communities.”

More than half of Kentucky's counties have syringe exchanges.

Sunday, July 2, 2023

Kentucky has 84 syringe-service programs in 65 counties; the pandemic slowed their growth, but two have opened this year

State Department for Public Health map, adapted by Kentucky Health News; click on it to enlarge.
By Melissa Patrick
Kentucky Health News

Kentucky has added two new syringe-service programs for intravenous drug users this year, bringing the total to 84 SSPs, in 65 of the state's 120 counties. Hart County opened its program in January and Estill County reopened its program in April.

SSPs are part of what health departments call “harm reduction programs,” which offer a host of strategies to minimize the negative physical and social impacts of drug use. They are also called syringe-exchange programs or needle exchanges, for the best-known element of the prorgams.

Estill County's program reopened after being shut down in 2020 because the Irvine City Council took away its approval, required by state law in a city where a program is based. The Estill County Health Department's program is now in a mobile clinic that goes to multiple locations in the east-central Kentucky county. 

Hart County is in south-central Kentucky, which is served by the Barren River District Health Department. Charity Crowe, a UK Healthcare health-education coordinator embedded in the department's harm-reduction program, told Kentucky Health News that adding more SSPs to decrease overdose deaths is one goal of the Barren River Initiative to Get Healthy Together (BRIGHT) Coalition.

Only three of the eight counties in the district have SSPs. Warren County opened its program in 2016, Barren County in 2018, and Hart County in January. 

Crowe said one of the first steps they took as they worked to get local approvals in Hart County was a survey of local jail inmates, asking f they would use an SSP if it was available. She said 63 inmates, or 64% of the survey respondents, said they would use it.  

"That kind of helped us with getting everything passed through the Board of Health, Fiscal Court and City Council," Crowe said. She praised the efforts of County Judge Executive Joe Choate: "He was a huge supporter of the program and us getting it started, so that helped get everything moving along a lot quicker."

Asked if she had any advice for people in the 55 Kentucky counties that still don't have an SSP, but want one, she said it's important to keep educating people about what they are and why they are important. 

"Just to try to educate people on why we do what we do," Crowe said. "There's so much stigma surrounding the things that we do with harm reduction. . . . We are trying to make our communities a safer place, not just for people that use drugs, but for our kids, our first responders, everybody." 

She also encouraged them to not give up. "Pretty much anywhere that you go, you will get a little bit of pushback," she said. "But in order for us to break that stigma, we just have to keep educating people."

Looking to other counties in the district, Crowe said they have held an educational meeting in Edmonson County and are working to have one in Logan County. She said Logan County's health board of health and Russellville City Council have approved an exchange, but the Fiscal Court has not.

Kentucky Health News graph from state data; click on it to enlarge.
The steady growth of SSPs in Kentucky took a heavy hit from the pandemic, with only eight counties opening a new SSP since 2020. The legislature authorized the programs in 2015.

Syringe-service programs not only exchange clean needles for dirty ones, to decrease the spread of blood-borne diseases like hepatitis C and HIV, but provide education on the safe use and distribution of wound-care kits and Naloxone, which blocks a drug overdose. Other services are infectious-disease screening, vaccinations, and linking people to housing, food access, insurance, medical care, substance-use treatment and behavioral-health services.

Crowe said the SSPs in Hart and Warren counties also use a peer-support specialist who has "been a phenomenal resource for our clients." 

On June 29, a new law kicked in that decriminalized fentanyl test strips in Kentucky, meaning they will no longer be considered drug paraphernalia in the state. Because of this, Kentucky's SSPs can offer them to their clients . Fentanyl was involved in 72.5% of the state's 2,135 overdose deaths in 2022. 

Fentanyl test strips are paper strips that can detect the presence of the powerful opioid in pills and other drugs within minutes. They are considered a low-cost method of helping prevent drug overdoses and reducing harm, according to the Centers for Drug Control and Prevention.

Friday, June 30, 2023

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.'"

Sunday, October 30, 2022

Health officials in counties with high and low Covid-19 death rates point to vaccination rates, residents' underlying health status

Kentucky Health News map via Datawrapper, highlighting high-death-rate counties of Metcalfe, Monroe, Harlan, Perry, Lee and Robertson, and low-death-rate counties of Jefferson, Fayette, Scott and Woodford. For an earlier story with an interactive map with all counties' rates and data, click here.

By Melissa Patrick
Kentucky Health News

Health officials from Kentucky counties with some of the state's highest and lowest Covid-19 death rates both cited vaccination rates as a contributor, but the health official in the county with one of the highest death rates said the relatively low health status of the population must also be considered. 

A breakdown of Covid-19 deaths per 1,000 people in each county found that the highest county death rate is five times the lowest one. To explore that discrepancy, Kentucky Health News talked with a health official in a county with one of the highest rates, and one in a county with one of the lowest rates. 

In Woodford County, which had the fourth lowest rate, 2.09 Covid-related deaths per 1,000 residents, Public Health Director Cassie Prather said she attributed the low rate to its high Covid-19 vaccination rates, especially among residents 65 and older, who are among the most vulnerable.

"I would love to see a map overlay of the death rates and the vaccine rates," she said. Later adding, "I think the correlation is there." 

Woodford County has had one of the highest vaccination rates in the state throughout the pandemic. According to the Centers for Disease Control and Prevention Data Tracker, 78.3% of Woodford County's population has received at least one dose of the Covid-19 vaccine. Among residents 65 and older, 93.3% are fully vaccinated; 73.3% of those who are fully vaccinated have received one booster shot; and 54.6% of  those who have had the first booster have also received the second. 

Cassie Prather
Prather said getting people in Woodford County vaccinated has been a community effort that includes weekly clinics that are still running, community members volunteering to drive people to the clinics, a partnership with the emergency medical service to do home visits, and a mobile clinic that goes out twice a week to farms and people they normally wouldn't see at the health department. 

She added that city and county governments have worked diligently to keep their citizens informed, and that she and Judge-Executive James Kay still do weekly Covid-19 updates on the county government's Facebook page. "We knew how important communication would be . . . because we wanted people to be aware and to be able to make the best decisions for their family and friends," she said. 

Kay, who as judge-executive chairs the county health board, said his pandemic role has been to unite the community in an effort to fight the virus, while allowing the health department to lead the response. 

"We did a full county and community response," Kay said. "And we brought the cities and the county and the schools together to all be on the same page every day for nearly two years."

Expanding on the importance of giving the public direct, real-time information to combat misinformation, he said, "We created a level of trust. When we told them information; they knew it was true."  

Adjoining Scott County's Covid-19 death rate was just .007 per 1,000 higher than Woodford's. Crystal Miller, public health director of the regional health department that serves the county, told Mike Scogin of the Georgetown News-Graphic that the community's response to the pandemic was critical to keeping Covid-19 under control. 

“It was all hands on deck,” Miller told Scogin. “All our community partners bought in and everyone contributed. From elected leaders to businesses and industries, the hospital, schools and the newspaper, everyone wanted to do the right thing. A big portion was community support. The calls we received at the health department were, ‘How can we keep people safe?’”

Miller also said Scott County has one of the state's highest vaccination, which saved lives. The CDC says 65.2% of the county's population has received at least one dose of Covid-19 vaccine. 

“We did not get a lot of pushback," Miller said. "I know that was not the case in other communities, where people refused to even wear masks."

Metcalfe County, in south-central Kentucky, had the sixth highest Covid-19 death rate, 7.348 per 1,000 residents. It is served by the Barren River District Health Department, where Public Health Director Matt Jones said he thinks the rate stems from multiple factors.

Jones cited the county's poor health outcomes, gauged by life expectancy and measures of quality of life; and health factors, such as access to physicians, tobacco use, children living in poverty, and other environmental factors that contribute to or detract from the local population's health. 

"Those health outcomes, those health factors, they were already at play," he said. "And I think that is one of the leading reasons why we had higher mortality rates in Metcalfe County and the other six counties that you listed."

Counties with death rates higher than Metcalfe were Lee, 7.565; Perry, 7.803; Monroe, 8.075; Harlan, 8.574; and Robertson, the state's smallest county, 10.436 deaths per 1,000 residents.

Comparing just Metcalfe and Woodford counties' 2022 County Health Rankings, Metcalfe ranked 71st for health outcomes and 89th for health factors and Woodford County ranked eighth for health outcomes and third for health factors. 

Eight of the top 10 counties with the lowest Covid-19 death rates in Kentucky ranked in the top 11 counties for health outcomes, and included the top six counties for health factors.

"ZIP code matters," Jones said. 

Among the seven counties with the highest Covid-19 death rates, all ranked 69th or lower for health outcomes, and four ranked in the bottom 11. All seven ranked 64th or lower in health factors, with three in the bottom six. 

Jones also pointed to the discrepancies in health-care access between rural and urban counties as a possible reason for Metcalfe County's higher Covid-19 death rate.

He noted that Warren County, which has a population of nearly 133,000, and Metcalfe, with around 10,000, have very similar vaccination rates, 45.7% and 45.3%, respectively, with at least one dose, but Warren's death rate was less than half Metcalfe's, 3.02 deaths per 1,000 residents. 

Warren, with its fast-growing county seat of Bowling Green, has many more health resources than Metcalfe County, including two hospitals, while Metcalfe County has no hospital and a shortage medical providers, Jones noted.  

Asked about the county's lower vaccination rates, he said, "I think vaccinations did play a role, especially as it relates to moderate and severe cases. But I do think those health outcomes and the other indices played a major role in the overall outcomes of Covid." 

Among Metcalfe County seniors, 62.7% are fully vaccinated; 67.8% of those have received one booster shot; and 36% of that group have taken the second shot, according to the CDC.  

Jones said the eight counties in his health district have taken a multifaceted approach to the pandemic that has evolved as their needs have evolved. Beyond providing testing and Covid-19 vaccination clinics, the local departments participated in work groups with community leaders to keep them informed and used social media, local newspapers and radio stations to keep the public informed.

Saturday, June 4, 2022

Mothers on WIC program who need formula should call health department; others should call pediatrician, health secretary says

Photo from nbcnews.com
By Melissa Patrick
Kentucky Health News

As Kentucky families struggle to find baby formula for their infants and no immediate end in sight, Kentucky lawmakers discussed ways to improve the situation at the June 2 meeting of the Interim Joint Committee on Health, Welfare and Family Services. 

The shortage is largely the result of a U.S. Food and Drug Administration investigation of Abbott Nutrition's Michigan factory that resulted in it shutting down in February. The investigation was prompted by four bacterial infections in infants who had consumed formula from the company's Michigan plant. Abbot makes up to 40% of the formula market in the United States.  

Abbott announced Saturday that it had resumed production at the factory after meeting initial requirements agreed to with the FDA as part of a consent decree the company entered into on May 16. 

But that doesn't mean an immediate end to the shortage. Abbott says its priority is production of EleCare, a special formula for children with multiple allergies, before it ramps up production of its other products. The initial EleCare product is expected to be released "on or about June 20," Abbott's release said. 

Last week, FDA Administrator Robert Califf  told lawmakers that the baby formula shortage in the U.S. will likely not be resolved until late July. 

On June 2, Datasembly, a retail data firm, reported that the nationwide out-of-stock rate for formula in the week ending May 28 was 74%, up from 70% the week before and 45% the week before, according to Bloomberg. Kentucky's latest out-of-stock rate is 76.7%, a slight increase from 75% the week before. 

President Joe Biden has done several things to increase access to formula, including invoking the Defense Production Act to mandate increased production and importing formula manufactured overseas. 

Legislators and Beshear

The day before the health committee meeting, Rep. Kim Moser, R-Taylor Mill, a co-chair, published an opinion article that urged Democratic Gov. Andy Beshear to issue a plan for how to deal with the shortage, saying "We have heard nothing from Gov. Beshear on what families are to do." 

Moser took several jabs at Beshear's handling of the shortage and said he should issue executive orders to increase the production of formula and address price gouging, as governors in other states have done. 

"I am calling on him to make a statement and do what he can to address this shortage because Kentucky families struggle every day to find the necessary supplies for their children," Moser wrote.

At the committee meeting, Eric Friedlander, secretary of the Cabinet for Health and Family Services, said there are already anti-price gouging statutes on the books that should continue to be enforced. 

Moser said the state attorney general's office told her that any anti-price gouging policies specific to formula need to be tailored specifically to this food product. "I think it's worth looking into, just to provide some protections," she said. 

She also noted that Agriculture Commissioner Ryan Quarles (whom she is supporting for governor) is calling for donations of formula through his Kentucky Hunger Initiative. 

Beshear answered several questions on the topic at his regular weekly news conference, in Frankfort just after the committee meeting in Northern Kentucky. "It's certainly something that I'm concerned about," he said, adding that the FDA should have seen the ramifications of shutting down the Abbott plant. 

"I'm going to push to ensure that every time the FDA makes one of these decisions, and I get they're making it in terms of immediate health, but they need to be providing a long-term analysis of the ramifications, how this impacts our economy, and different supply chains so in the very least, the president, governors, Congress is made immediately aware of what could happen," Beshear said. 

Beshear was not asked about price gouging or ways to increase formula production or price gouging, He encouraged people on Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, to call their local health department or their community WIC agency and all others to reach out to their pediatrician. 

Friedlander did likewise at the committee meeting, adding that those who are not part of the WIC program should reach out to their pediatrician.

He said the state is looking at ways to take back formula from families who have excess supplies and redistribute it, but the rules governing that are pretty stringent. He also encouraged families to check out online resources to locate formula such as the U.S. Department of Health and Human Services website at hhs.gov/formula.

Health departments, WIC and retailers

Kentucky has taken advantage of federal waivers that allow the WIC program to cover more types and sizes of formula since February. Click here to see the list of approved formulas available to WIC participants.

"We're doing pretty much everything we can to try to help families find the formula they need," Cathy Winston, nutrition manager at the Northern Kentucky Health Department, told the committee. "And it's been a real challenge." 

Moser commended the department for its efforts, but suggested more needs to be done for families not on WIC, by providing information to them about what substitutes are acceptable if they can't find the baby formula they normally use. "We have some desperate families out there," she said.

Shannon Stiglitz, a lobbyist for the Kentucky Retail Federation, walked the legislators through challenges that retailers face in the formula shortage, including supply-chain issues that started during the pandemic, the need to limit on purchases to minimize panic buying, and efforts to minimize theft. 

Stiglitz said four baby-formula manufacturers in the country is "too few," and said Abbott has contracts with 30 of the 31 states that use a single provider, exacerbating the shortage for WIC families.  

Breastfeeding as an option

Sen. Ralph Alvarado, R-Winchester, encouraged new and expectant mothers to consider breastfeeding and consult their doctors about it. 

"You won't have to worry about any of this., and you can provide your child with the nutrition that it needs, probably the best nutrition that your baby could have," said Alvarado, a physician. "So I would encourage moms to think about that. That's really the the answer for this moving forward."

Some new mothers don't want to breastfeed, or have to rely on formula for several reasons; they may have an illness, incompatibility with work schedules, or issues with lactation or their baby's latching to a breast.

Saturday, May 28, 2022

FDA chief says baby formula supply is expected to remain short through late July; meanwhile, shortage gets worse in Kentucky

Photo from The Associated Press
By Melissa Patrick
Kentucky Health News

The baby formula shortage continues to worsen in Kentucky, with the state's out-of-stock rate increasing by 20 percentage points since May 8, according to the retail data firm Datasembly

Datasembly reports that in the week starting May 15,  the latest data available, Kentucky's out-of-stock rate for baby formula increased to 75%, up from 55% the prior week. That placed Kentucky 26th among the states, with out-of-stock rates ranging from a high of nearly 89% in Utah to a low of 45% in Illinois. The nationwide out-of-stock rate is 70%. 

Gov. Andy Beshear said at his May 26 news conference that he could not confirm the data, but said, "Certainly there is a nationwide shortage, which is real concerning." 

Kelly Potts, a spokeswoman for Datasembly, said in an e-mail that their data comes from more than 230 retailers with over 130,000 stores across the U.S., Canada and Mexico, and the out-of-stock (OOS) index only includes U.S. stores. 

"Datasembly’s proprietary data collection platform collects OOS information for each designated product based on OOS indicators . . . We collect the in-stock and out-of-stock information at the product level for each of the stores," Potts said. "For example, if a retailer offers 10 unique formula products on the shelf and the indicators point to 5 of the 10 products being out of stock, this would generate a 50% out-of-stock status." 

Beshear encouraged Kentuckians who are part of the Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, to reach out to their WIC provider, which is usually the local health department, if they are struggling to get enough formula. He said those who are not part of the WIC program should reach out to their pediatrician.

WIC is available to Kentucky residents who are pregnant, breastfeeding or have a child 5 or younger and have household income of no more than 185% of the federal poverty level, with rules governing what counts as income. Anyone who receives Medicaid or is part of the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) automatically meets the income requirements for WIC. Click here for a WIC PreScreening Tool to see if you are eligible for WIC benefits. 

According to the state Department for Public Health, Kentucky has about 19,500 infants on WIC who are fully formula-fed in any given month. 

The health department said it connects WIC participants with about 350,000 containers of formula per month, accounting for about $2.2 million in WIC benefits per month, just over a third of the total benefits. 

The department said redemption of formula since the February recall by major manufacturer Abbott Laboratories has declined by about one-third, from an average utilization rate of about 82% six months before the recall to about 69% in the first quarter of the year.

The agency said it took several actions in response to the recall. 

"The Kentucky WIC Program quickly requested and began to execute all waivers available to the states as soon as the U.S. Department of Agriculture provided for them," Susan Dunlap, spokeswoman for the department, said in an e-mail. "However, that has only been a small part of their response." 

Louisville's WFPL reports that Kentucky made its first policy change to expand the types of formula covered by WIC in February, and has since updated this policy several times to add more types of formula to the list. Click here to see the list of approved formulas available to WIC participants. 

Dunlap said the state has worked to keep local health departments updated as the situation has unfolded; is pushing important updates to WIC families via the WIC Shopper smartphone app; and are in "constant contact" with Abbott about reports of regional supply deficiencies. 

In a story about the baby formula shortage that opened with the state's May 8 out-of-stock rate, Norge Garcia told the Louisville Courier Journal about his struggles to find the specific formula for 4-month-old, who was born premature and can only have one type of formula, Nutramigen, because of his weight.
"I walked the day before yesterday more than six hours looking for milk, and of the 10 cans that WIC gives us . . . we only got one," Garcia told the newspaper in Spanish.

"I went to seven Walmarts — all the Walmarts that are here in Louisville, I went to all of them," he said. "I went to Target and none of them have any. There is only milk for babies 9 months and older."

Abbott and the U.S. Food and Drug Administration recently agreed how to reopen the Michigan plant where formula is made, but it will take several weeks to affect supplies. Beshear said Thursday, "We believe that we're going to see a significant boost in the coming weeks, but we've got to get to that point." 

The baby formula shortage in the U.S. will likely not be resolved until late July, FDA Administrator Robert Califf said Thursday at a Senate Health Committee hearing, The Hill reports.

"My expectation is that within two months we should be beyond normal, and with a plethora,” Califf said. “It’s going to be gradual improvement up to probably somewhere around two months until the shelves are replete again.”

Tuesday, May 24, 2022

Dr. Douglas Scutchfield, an international leader in public health and a mentor to many in Kentucky, died Monday night

UPDATE, June 12: Scutchfield's memorial service will be at 4 p.m. June 22 at UK's Lewis Honors College. In lieu of flowers the family suggests donations to the Scutchfield Endowment Scholarship Fund at Eastern Kentucky University, the UK College of Public Health, or the UK opera program.

F. Douglas Scutchfield, M.D.
Dr. F. Douglas Scutchfield, a public-health leader for the world, the nation and his native Kentucky, died Monday night after being hospitalized for several weeks with pneumonia.

Scutchfield recently served as chair of the accreditation committee of the Public Health Accreditation Board, which accredits local and state health departments, and spurred Kentucky to be a leader in getting its departments accredited. It was one of his latest accomplishments in a life devoted to public health.

A native of Wheelwright in Floyd County and a graduate of Hazard High School and Eastern Kentucky University, Scutchfield earned his M.D. at the University of Kentucky, where he held an endowed professorship in the College of Public Health, of which he was founding director when it was the School of Public Health. He was also a professor in the Department of Family and Community Medicine and the Martin School of Public Policy and Administration, founding director of the Center for Health Services Research and Management, and associate dean of the College of Medicine, where he chaired the Department of Preventive and Environmental Medicine. He founded the Graduate School of Public Health at San Diego State University, was a founder of the College of Community Health Science at the University of Alabama and also taught at the University of California-Irvine.

Scutchfield was an editor of many academic health journals, founding co-editor of the Journal of Appalachian Health and an editor of a new book, Appalachian Health: Culture, Challenges, and Capacity. Here's a discussion of it with the other editor, Randy Wykoff of East Tennessee State University.

Julia Costich, who succeeded Scutchfield as the UK College of Public Health's Peter P. Bosomworth Professor of Health Services Research, told Kentucky Health News, "Public health is about doing things for populations, but Scutch’s gift was relating to individuals—students, colleagues, prominent leaders—as individuals. His generous nature was tempered by a deep need for reciprocation. I think this was part of what drew him to the work of Thomas Merton, who articulated the need for human contact to bridge the spiritual gulf."

Scutchfield and Paul Evans Holbrook Jr. wrote The Letters of Thomas Merton and Victor and Carolyn Hammer: Ad Majorem Dei Gloriam (the Jesuit motto, "For the greater glory of God"), published by the University Press of Kentucky in 2015. The book helped Scutchfield earn the 2017 UK Libraries Medallion for Intellectual Achievement in 2017, which he called "a coda to my academic career." In accepting it, he said his interest in Merton and the humanities reflected a part of his philosophy of being a physician: "I am a firm believer in the importance of humanity to those of us in the health professions. We do not treat a disease; we treat a person, thus we must know the humanness of the individual in front of us, as well as the diagnosis and treatment of their disease."

Two years later, he won the top award from the American Public Health Association, the Sedgwick Memorial Medal for Distinguished Service in Public Health. He was a charter diplomat of the American Board of Family Practice, a fellow of the American College of Preventive Medicine, which he served as a regent and president. He was secretary-treasurer of the Association of Schools of Public Health and a board member of the Public Health Foundation, which presented him with the Theodore R. Ervin Award. He In 2004, he received the Balderson Lifetime Achievement Award of the National Public Health Leadership Network.

Scutchfield was a member of the American Medical Association House of Delegates and served as chair of the AMA Section Council of Preventive Medicine on several occasions. He was vice chair of the AMA’s Council on Medical Education, and represented the AMA as a member of the Accreditation Council on Graduate Medical Education, the Liaison Committee on Specialty Boards, the American Board of Medical Specialties and the Committee on Allied Health Education and Accreditation. He received AMA’s Dr. William Beaumont Award as its outstanding young physician in 1985 and its Distinguished Service Award, the highest recognition of a physician, in 2003.

Scutchfield had an international reputation and was a consultant to government and non-governmental organizations in Panama, China, Saudi Arabia, Israel and Germany, as well as the U.S. But he never forgot Wheelwright, which was one of Kentucky's biggest coal towns when he was growing up, then-Libraries Dean Terry Birdwhistell said in 2017: “As a scholar, teacher, mentor, administrator and public health advocate, he has never forgotten his Floyd County roots even as he became internationally recognized and honored.”

During the pandemic, Scutchfield worried about the damage done to his profession, said Al Cross, director of UK's Institute for Rural Journalism and Community Issues and publisher of Kentucky Health News: "At our last lunch, he and I talked about writing a 'where we go from here' essay as a bookend to the one we published on March 1, 2020: Is our political system properly serving our public-health system? The answer was no, and it got worse, and it hasn’t gotten any better. May Doug Scutchfield’s life inspire us to stand up to officials of all stripes who damage the discipline of public health and thus the health of the public."

Scutchfield is survived by his wife, Phyllis; his son, Alex; and his brother, Scott. Funeral arrangements are pending.

Sunday, May 8, 2022

Former state public-health commissioner Jeff Howard is interim director of Metro Louisville Department of Health and Wellness

Dr. Jeffrey Howard
Dr. Jeffrey Howard, the longest-serving of three public-health commissioners in the previous state administration, has been named acting director of the Louisville Metro Department of Health and Wellness.

Howard succeeds Dr. Sarah Moyer, who will become chief medical officer for Humana Healthy Horizons, the new name for the health-insurance company's Medicaid plan in Kentucky. She will remain an adviser until June 30, the end of the the fiscal year, and start her new job on July 5.

Howard's "commitment to equitable health outcomes, paired with his experience at the state and federal levels makes him the right person to lead our health department at this critical time," Mayor Greg Fischer said.

Howard has been the department's contracted medical director since October. He told Kentucky Health News he still plans to leave to become a general surgeon at Louisville's Norton Healthcare in August.

Howard, a native of Harlan County, was health commissioner in 2017-19, during the term of Republican Gov. Matt Bevin. He left to become a White House fellow for a year, then returned to complete his residency at the University of Louisville.

Wednesday, January 26, 2022

Virus infection rate stalls, but new-case average hits a new high and Covid-19 hospitalizations jump 4% in one day, nearing record

Regions in red are using over 80% of ICU beds. (State table, adapted by Ky. Health News; click to enlarge)
By Al Cross
Kentucky Health News

Covid-19 hospitalizations in Kentucky jumped 4 percent from Tuesday to Wednesday, to nearly 2,500, as the state seemed likely to set a new record this week for residents hospitalized with the disease.

The seven-day average of new coronavirus cases reached a new high, 12,462, as the state reported 12,827 new cases Wednesday. However, the state's infection rate dropped slightly, and now ranks 11th in the nation, rather than second, as it did Tuesday, according to The New York Times.

The percentage of Kentuckians testing positive for the virus in the last seven days also fell slightly; it is 32.44%, based on 185,522 laboratory tests. The figures do not include at-home tests.

Kentucky hospitals reported 2,497 patients with Covid-19 as of midnight. That was 96 more than 24 hours earlier, one of the biggest jumps ever, and just 44 short of the record 2,541 Covid-19 patients reported on Sept. 10.

However, a smaller share of patients with Covid-19 are in intensive-care units than during the late-summer surge. ICUs reported 474 Covid-19 patients, with 271 on mechanical ventilation; at the high point in September, ICU cases numbered 698, with 448 ventilated.

Hospitals have said they are discovering Covid-19 cases in some people who have been admitted for other reasons, but several hospitals are limiting or suspending elective surgeries that require an overnight stay, perhaps due more to staffing shortages than the increase in Covid-19 patients.

The state's daily report showed more ICU capacity than on most recent days, with only three of the 10 hospital readiness regions using more than 90% of their ICU beds. Another six were between 80% and 90%.

The state's seven-day coronavirus infection rate is 234.7 daily cases per 100,000 residents, slightly less than Tuesday's 235.9 but still not far from the record 237 set last Friday.

Counties with rates above 300 per 100,000 are Hopkins, 415.3; Muhlenberg, 404.5; McCracken, 396.1; Daviess, 363.5; Powell, 350.2; Henderson, 339.4; Harrison, 329.8; Boyd, 327.5; Whitley, 323.4; Hardin, 322.5; Harlan, 318.6; Spencer, 317.4; McLean, 311.9; Ohio, 311.4; Shelby, 308.9; and Henry, 308.3.

Jefferson County's rate is 240 per 100,000, just above the state average and Fayette County's rate is 248.8, but the Lexington-Fayette County Health Department reported 1,040 new cases Wednesday, the first time above 1,000. (The department's and state's numbers differ, due to reporting methodologies.)

The state attributed 31 more deaths to Covid-19, raising Kentucky's pandemic toll to 12,817.

In other pandemic news:
  • The Richmond city commission voted 3-2 Tuesday night to offer a $500 vaccination incentive to employees, using federal pandemic relief funds. The city is following the local examples of the Madison County school board and Eastern Kentucky University, reports Taylor Six of the Richmond Register.
  • Mercer County schools are again requiring masks, for at least a week, due to an increase in coronavirus cases, Lexington's WKYT-TV reports. The county's seven-day infection rate is 279.4 per 100,000 residents.

Wednesday, January 19, 2022

Low Covid-19 vaccination rates are associated with high death rates; map shows your county's rate of deaths from Covid-19

Graph by University of Kentucky College of Public Health has one dot for each Kentucky county, except the six counties that have had fewer than 20 deaths, which were omitted for statistical stability.

By Al Cross
Kentucky Health News

If you live in a Kentucky county where a low percentage of the population has been fully vaccinated for Covid-19, more of your neighbors are likely to have died from the disease. And if you live in a county with a high full-vaccination rate, it is likely to have a low death rate.

That is proven by a comparison of Kentucky counties' Covid-19 death and vaccination rates as compiled by the state Department for Public Health. The department provided the previously unreleased death rates, as of Jan. 11, to Kentucky Health News at its request.

The statistics were compared by the College of Public Health at the University of Kentucky. Donna Arnett, dean of the college, said the comparison showed that "non-vaccination rates were statistically associated (at the county level) with increasing death rates," and that the association was significant.

The correlation is moderate, not strong, said Bruce Maples of the online publication Forward Kentucky, who has previously performed research and statistical analysis for Kentucky Health News. He found a slightly lower, but still moderate, correlation with partial vaccination rates.

Many factors enter into death rates, including the extent of other preventive measures such as mask wearing and social distancing, the effectiveness of local health agencies, the underlying health status of the population and the presence of nursing homes that have had deadly Covid-19 outbreaks.

Most Kentucky counties with low death rates are in the state's metropolitan areas, which have high health status; and most with high rates are rural, but there are exceptions.

For example, tiny Gallatin County is part of the Cincinnati metro area but has one of the highest death rates, 496 per 100,000 residents. (It has had 44 Covid-19 deaths and its 2020 census population was 8,690.) But it has low vaccination rates, 43% with one dose and 40% fully vaccinated.

Perry County, in southeastern Kentucky, has one of the state's higher vaccination rates but also one of the higher death rates, 520 per 100,000 residents. (It has had 138 Covid-19 deaths and its 2020 census population is 28,473. Its county seat is Hazard.)

Only three counties in the East Kentucky Coalfield  Elliott, Morgan and Wolfe – have full-vaccination rates in the top one-fifth of the state.

Spencer County, part of the Louisville metro area, has the lowest vaccination rate reported by the state, 33%, but one of the lower death rates. Local officials have questioned the state's data gathering and methodology, saying that many Spencer County vaccinations are credited to adjoining counties.

Generally, though, urban counties tend to have high vaccination rates and low death rates, and rural counties tend to have higher death rates and lower vaccination rates.

The biggest cluster of counties with high death rates is in Southern Kentucky. It includes Monroe County, which has the state's second-highest death rate, 648 per 100,000. Other counties in the cluster are Barren, Hart, Metcalfe and Adair.

The county with the highest death rate, Robertson, also has Kentucky's smallest population, 2,108, so its rate can be significantly affected by a small number of deaths. The county has had 19 deaths attributed to Covid-19, according to the state health department's latest daily report.

Kentucky Health News map, from Jan. 11 state Department for Public Health data; click it to enlarge.
For clarity, rates above 415 deaths per 100,000 residents are rounded to the nearest whole number.
The state average is in the second-lowest group due to many small counties having high death rates. 

Thursday, December 30, 2021

Frankfort paper names local health agency Newsmaker of Year

Franklin County Health Department staff pose for a photo taken by Deputy Director Brittany Parker.
The pandemic has been very hard on local health departments, which in many if not most cases haven't received the respect and recognition they deserve for bearing the extra workload and putting up with coronavirus skeptics who harass or abuse them. At least one got very prominent recognition at year's end, as The State Journal of Frankfort named the Franklin County Health Department its Newsmaker of the Year.

"It is because of their tireless efforts to keep the community healthy, while dealing with an increasingly hostile environment and constant threat of possible contamination," Harrison Wagner writes. "From organizing a way to administer tests and multiple doses of the vaccines, to creating informational materials about virus prevention, all while attempting to keep a healthy work-life balance and still perform their normal duties, the Franklin County Health Department has managed to weather the storm of the pandemic."

Health departments also enforce rules at workplaces, and "there were instances of hostility towards health environmentalists, or health inspectors, while they were enforcing safety guidelines at businesses," Wagner reports, quoting Director Judy Mattingly: “There were quite a few scary situations where their strict instructions from me were that if any business owner is hostile with you in any way, shape or form, that you are to leave immediately. There were situations at that time where our environmentalists were able to call our police partners or sheriff partners and be accompanied on those inspections.”

On the bright side, the pandemic has raised the profile of the department "and its other healthy-living initiatives," Wagner writes. "The staff has become closer as a result of working together at the testing and vaccination drive-thrus. Mattingly said this has led to Secret Santa gift exchanges and Friendsgivings, which has made the department more tightly knit."

Wednesday, October 27, 2021

Foundation gives $20,000 to spur vaccination in low-vax counties

State Department for Public Health vaccination-rate map, adapted by Kentucky Health News
The Foundation for a Healthy Kentucky has awarded grants totaling $20,000 to increase uptake of the Covid-19 vaccines in counties with the lowest vaccination rates. They are "intended for rapid deployment" for new or expanded vaccination efforts, the foundation said in a news release.

Two grants are aimed at Christian County, which has the state's second-lowest percentage of residents who have received at least one dose of vaccine, 34.2%. The rate may be depressed by the presence of Fort Campbell, but the county also has a big population of African Americans, who nationally have a low vaccination rate. The money will go to the the Hopkinsville-Christian County Branch, NAACP, and the Christian County Health Department.

Other recipients, targeted counties and vaccination rates are:
  • The school district in Clinton County, which has an at-least-one-dose vaccination rate of 40.9%. 
  • The Lake Cumberland Community Action Agency and the Lake Cumberland District Health Department, for Clinton, Casey (36.8%), Cumberland (42.1%), McCreary (42.7%) counties.
  • Pennyrile Area Development District, for Crittenden County, 40.9%.
  • Barren River District Health Department, for Edmonson (37.4%), Hart (36%) and Metcalfe (39.3%) counties.
  • Grace Community Health Center, for Knox County, 36.3%.
  • Lewis County Health Department, 37.6%.
  • Buffalo Trace District Health Department, for Robertson County, 37.3%.
  • Todd County Health Department, 41.8%.
  • Green River District Health Department, for Union County, 40.5%. The statewide rate is 62%. 
“These organizations are on the front line of the effort to get more Kentuckians vaccinated against Covid-19,” foundation President and CEO Ben Chandler said. “We are proud to support their hard work to protect our citizens against serious injury or death from the virus.”

"The organizations will employ various efforts such as videos and graphics to be posted on social media, as well as radio, television and print advertisements, school-based outreach, a 24-hour information hotline, bilingual efforts, and other outreach, especially to vulnerable populations," the news release said. "The foundation also has a number of resources on its website to assist organizations, health care providers, family and friends in sharing the truth about COVID-19 and the vaccines. This includes public service announcement videos, a fact sheet, and links to the CDC and Kentucky Covid-19 dashboard."

Monday, August 30, 2021

Coronavirus burning through low-vaccinated Breathitt County; 'It's like they're blind ... I don't understand,' local health official says

A sign in Jackson (Photos by Jamie Lucke)
By Jamie Lucke
Kentucky Health News

JACKSON, Ky. – William Sizemore fights Covid-19 from the front lines in Breathitt County; he worries that “like the drug epidemic,” no family there will escape the coronavirus – unless more of his neighbors get vaccinated.

In recent weeks, the virus has burned through the county’s population of 13,000 at a faster pace, fueled by the more contagious Delta variant, and is infecting younger people.

“Unfortunately, we are seeing an increase in the number of children testing positive for Covid-19 that are presenting with severe symptoms in our emergency department,” said Susie Robinette, chief nursing officer at the Kentucky River Medical Center in Jackson.

Like hospitals across Kentucky, Robinette said the 55-bed hospital is under stress from the Delta surge.

The hospital reports 12 Covid-19 patients were hospitalized at the beginning of this week and none had been fully vaccinated.

“We are asking our community to get vaccinated to help slow the spread of the virus,” Robinette said.  “This effort will allow our hospital to maintain proper capacity to continue caring for our families, friends and neighbors.”

She also recommends: “Wear your mask, wash your hands and maintain physical distancing when possible.”

Children under 12 are not yet eligible for the vaccine, and only 36 percent of Breathitt residents have been fully vaccinated, compared with 48% statewide and 52% nationally, according to the Centers for Disease Control and Prevention. Among eligible residents, 12 and older, 42% are fully vaccinated compared with 61% nationally.

“When it got politicized, that hurt public health. I don’t care if you’re a Democrat or a Republican,” Sizemore said, because the virus doesn’t care, either.

As the Breathitt County Health Department’s environmentalist, Sizemore is responsible for preparedness. He has been urging people to protect themselves and each other by taking the free shots available at the health department, pharmacies and Juniper Health.

In response to the Delta surge, there has been an uptick in people coming to the health department to receive the free vaccines, including more children 12 and older, said Sizemore. “We’re chipping away, just not hard enough.”

On Aug. 23, the Pfizer vaccine became the first of the three vaccines to advance from emergency authorization to full approval by the Food and Drug Administration.

Derrick Hamilton, D.O.
FDA approval removes one objection raised by the unvaccinated. Ever since the immunizations became available last winter, Dr. Derrick Hamilton has been assuring patients they could trust the process and the vaccines.

“Just because it was done at such speed does not mean it did not go through the same level of scrutiny,” Hamilton said. “It has been rigorously studied. Hundreds of millions of doses have been administered. The science speaks for itself.” 

Hamilton is chief executive officer and chief medical officer of Juniper Health, a Jackson-based nonprofit that provides primary medical and dental care and other health services in Breathitt, Elliott, Lee, Morgan and Wolfe counties.

Hamilton calls the Trump administration’s Operation Warp Speed, which helped speed the vaccines to the public, “a testament to American greatness, on par with the Apollo program” that sent humans to the moon. Vaccination, in his opinion, is “the patriotic thing to do.”

What does he say to patients who have misgivings about the vaccine? “I tell them I’ve taken it. My family has taken it. Other family members of mine have taken it. Then I go through reasons that they are reluctant to take it and try to counter that with facts and open up the conversation to try to combat disinformation.”

In the five counties served by Juniper Health, vaccination rates vary from 26% in Elliott to 40% in Wolfe.

“Covid is an ongoing threat to the health and well-being of the patients of our service area,” said Hamilton. “The most effective tool we have medically to get this forest fire under control is widespread vaccination. I’ve had the vaccine. My family has had it. I advocate for it. It’s safe. It’s very effective at preventing death and severe illness.”

After Covid forced cancellation of a Breathitt County High School Bobcats football scrimmage against Bell County, the health department’s Sizemore warned in the Jackson-Breathitt County Times-Voice, “For those not vaccinated, get ready. It’s coming for you.” 

A sign in Jackson advertises testing.
Recent statistics bear out his fears. The county’s incidence of new cases for the week ending Aug. 29 was 136 per 100,000 residents, 38 percent more than the statewide rate of 92 per 100,000 population. The CDC reports Kentucky’s highest rates were in Clay, Bell and Perry counties, where the rates per 100,000 were 270, 235 and 212, respectively.

(All three counties together don’t have close to 100,000 people, but the standard measure allows comparisons across a wide range of populations.)

The state reports 1,333 cases in Breathitt County during the 18 months of the Covid-19 pandemic. The state’s numbers slightly lag those of the local health department. Either way, about one in 10 residents has been identified as infected.

Two recent deaths, yet to be confirmed in state data, will likely bring the county’s Covid death toll to 14, said Sizemore, who has been surprised at how many people resist taking a potentially life-saving shot.

“They see people dying. These are hard numbers. … It’s like they’re blind. I don’t understand.”