Repeat Covid-19 shots help ward off variants, even other viruses

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Kentucky Health News

The virus that caused the Covid-19 pandemic is still here, sending thousands of Americans to hospitals each week and regularly spinning off new variants that can evade immune defenses, so public-health agencies recommend annual updates of vaccinations.

Some scientists have worried that the success of the first vaccines may undermine the utility of annual updates, much as the annual flu shot can interfere with immune responses in subsequent years, but a new study shows that Covid-19 vaccines don't do that, and actually "promote the development of broadly inhibitory antibodies," says a news release from Washington University School of Medicine in St. Louis, where the study was conducted.

Everyone who is 65 and over, or has medical conditions that make them more vulnerable, is advised to get a Covid-19 booster this spring.

The study, available online in the peer-reviewed scientific journal Nature, shows that people repeatedly vaccinated for Covid-19 — initially getting shots aimed at the original SARS-CoV-2 variant, followed by boosters and updated vaccines targeting variants — generated antibodies capable of neutralizing a wide range of virus variants and even some distantly related coronaviruses.

"The findings suggest that periodic re-vaccination for Covid-19, far from hindering the body’s ability to recognize and respond to new variants, may instead cause people to gradually build up a stock of broadly neutralizing antibodies that protect them from emerging SARS-CoV-2 variants and some other coronavirus species as well, even ones that have not yet emerged to infect humans," the release says.

“The first vaccine an individual receives induces a strong primary immune response that shapes responses to subsequent infection and vaccination, an effect known as imprinting,” said Dr. Michael S. Diamond, senior author of the study. “In principle, imprinting can be positive, negative or neutral. In this case, we see strong imprinting that is positive, because it’s coupled to the development of cross-reactive neutralizing antibodies with remarkable breadth of activity.”

Imprinting is the natural result of how immune-system memory works. A first vaccination triggers the development of memory immune cells. When people receive a second vaccination quite similar to the first, it reactivates memory cells elicited by the first vaccine. These memory cells dominate and shape the immune response to the subsequent vaccine.

The study suggests that regular re-vaccination with updated Covid-19 vaccines against variants might give people the tools to fight off not only the variants represented in the vaccines, but also other variants and related coronaviruses, possibly including ones that have not yet emerged.

“At the start of the Covid-19 pandemic, the world population was immunologically naïve, which is part of the reason the virus was able to spread so fast and do so much damage,” said Diamond, a professor of molecular microbiology, pathology and immunology. “We do not know for certain whether getting an updated Covid-19 vaccine every year would protect people against emerging coronaviruses, but it’s plausible. These data suggest that if these cross-reactive antibodies do not rapidly wane — we would need to follow their levels over time to know for certain — they may confer some or even substantial protection against a pandemic caused by a related coronavirus.”

Bird flu is bad for livestock; it's not a dire threat to most of us - yet

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By Amy Maxmen
KFF Health News

Headlines are flying after the U.S. Department of Agriculture confirmed that the H5N1 bird flu virus has infected dairy cows around the country. Tests have detected the virus among cattle in nine states, mainly in Texas and New Mexico, and most recently in Colorado, said Nirav Shah, principal deputy director at the Centers for Disease Control and Prevention, at a May 1 event held by the Council on Foreign Relations.

A menagerie of other animals have been infected by H5N1, and at least one person in Texas. But what scientists fear most is if the virus were to spread efficiently from person to person. That hasn’t happened and might not. Shah said the CDC considers the H5N1 outbreak “a low risk to the general public at this time.”

Viruses evolve and outbreaks can shift quickly. “As with any major outbreak, this is moving at the speed of a bullet train,” Shah said. “What we’ll be talking about is a snapshot of that fast-moving train.” What he means is that what’s known about the H5N1 bird flu today will undoubtedly change.

With that in mind, KFF Health News explains what you need to know now.

Who gets the bird flu? Mainly birds. Over the past few years, however, the H5N1 bird flu virus has increasingly jumped from birds into mammals around the world. The growing list of more than 50 species includes seals, goats, skunks, cats, and wild bush dogs at a zoo in the United Kingdom. At least 24,000 sea lions died in outbreaks of H5N1 bird flu in South America last year.

What makes the current outbreak in cattle unusual is that it’s spreading rapidly from cow to cow, whereas the other cases — except for the sea-lion infections — appear limited. Researchers know this because genetic sequences of the H5N1 viruses drawn from cattle this year were nearly identical to one another.

The cattle outbreak is also concerning because the country has been caught off guard. Researchers examining the virus’s genomes suggest it originally spilled over from birds into cows late last year in Texas, and has since spread among many more cows than have been tested. “Our analyses show this has been circulating in cows for four months or so, under our noses,” said Michael Worobey, an evolutionary biologist at the University of Arizona in Tucson.

Is this the start of the next pandemic? Not yet. But it’s a thought worth considering because a bird flu pandemic would be a nightmare. More than half of people infected by older strains of H5N1 bird flu viruses from 2003 to 2016 died. Even if death rates turn out to be less severe for the H5N1 strain currently circulating in cattle, repercussions could involve loads of sick people and hospitals too overwhelmed to handle other medical emergencies.

Although at least one person has been infected with H5N1 this year, the virus can’t lead to a pandemic in its current state. To achieve that horrible status, a pathogen needs to sicken many people on multiple continents. And to do that, the H5N1 virus would need to infect a ton of people. That won’t happen through occasional spillovers of the virus from farm animals into people. Rather, the virus must acquire mutations for it to spread from person to person, like the seasonal flu, as a respiratory infection transmitted largely through the air as people cough, sneeze, and breathe. As we learned in the depths of covid-19, airborne viruses are hard to stop.

That hasn’t happened yet. However, H5N1 viruses now have plenty of chances to evolve as they replicate within thousands of cows. Like all viruses, they mutate as they replicate, and mutations that improve the virus’s survival are passed to the next generation. And because cows are mammals, the viruses could be getting better at thriving within cells that are closer to ours than birds’.

The evolution of a pandemic-ready bird flu virus could be aided by a sort of superpower possessed by many viruses. Namely, they sometimes swap their genes with other strains in a process called reassortment. In a study published in 2009, Worobey and other researchers traced the origin of the H1N1 “swine flu” pandemic to events in which different viruses causing the swine flu, bird flu, and human flu mixed and matched their genes within pigs that they were simultaneously infecting. Pigs need not be involved this time around, Worobey warned.

Will a pandemic start if a person drinks virus-contaminated milk? Not yet. Cow’s milk, as well as powdered milk and infant formula, sold in stores is considered safe because the law requires all milk sold commercially to be pasteurized. That process of heating milk at high temperatures kills bacteria, viruses, and other teeny organisms. Tests have identified fragments of H5N1 viruses in milk from grocery stores but confirm that the virus bits are dead and, therefore, harmless.

Unpasteurized “raw” milk, however, has been shown to contain living H5N1 viruses, which is why the FDA and other health authorities strongly advise people not to drink it. Doing so could cause a person to become seriously ill or worse. But even then, a pandemic is unlikely to be sparked because the virus — in its current form — does not spread efficiently from person to person, as the seasonal flu does.

What should be done? A lot! Because of a lack of surveillance, the U.S. Department of Agriculture and other agencies have allowed the H5N1 bird flu to spread under the radar in cattle. To get a handle on the situation, the USDA recently ordered all lactating dairy cattle to be tested before farmers move them to other states, and the outcomes of the tests to be reported.

But just as restricting covid tests to international travelers in early 2020 allowed the coronavirus to spread undetected, testing only cows that move across state lines would miss plenty of cases.

Such limited testing won’t reveal how the virus is spreading among cattle — information desperately needed so farmers can stop it. A leading hypothesis is that viruses are being transferred from one cow to the next through the machines used to milk them.

To boost testing, Fred Gingrich, executive director of a nonprofit organization for farm veterinarians, the American Association of Bovine Practitioners, said the government should offer funds to cattle farmers who report cases so that they have an incentive to test. Barring that, he said, reporting just adds reputational damage atop financial loss.

“Outbreaks have a significant economic impact,” Gingrich said. “Farmers lose about 20% of their milk production in an outbreak because animals quit eating, produce less milk, and some of that milk is abnormal and then can’t be sold.”

The government has made H5N1 tests free for farmers, Gingrich added, but hasn’t budgeted money for veterinarians who must sample the cows, transport samples, and file paperwork. “Tests are the least expensive part,” he said.

If testing on farms remains elusive, evolutionary virologists can still learn a lot by analyzing genomic sequences from H5N1 viruses sampled from cattle. The differences between sequences tell a story about where and when the current outbreak began, the path it travels, and whether the viruses are acquiring mutations that pose a threat to people. The research has been hampered by the USDA’s slow and incomplete posting of genetic data, Worobey said.

The government should also help poultry farmers prevent H5N1 outbreaks since those kill many birds and pose a constant threat of spillover, said Maurice Pitesky, an avian disease specialist at the University of California-Davis.

Waterfowl like ducks and geese are the usual sources of outbreaks on poultry farms, and researchers can detect their proximity using remote sensing and other technologies. By zeroing in on zones of potential spillover, farmers can target their attention. That can mean routine surveillance to detect early signs of infections in poultry, using water cannons to shoo away migrating flocks, relocating farm animals, or temporarily ushering them into barns. “We should be spending on prevention,” Pitesky said.

OK, it’s not a pandemic, but what could happen to people who get this year’s H5N1 bird flu? No one really knows. Only one person in Texas has been diagnosed with the disease this year, in April. This person worked closely with dairy cows, and had a mild case with an eye infection. The CDC found out about them because of its surveillance process.

Clinics are supposed to alert state health departments when they diagnose farmworkers with the flu, using tests that detect influenza viruses, broadly. State health departments then confirm the test, and if it’s positive, they send a person’s sample to a CDC laboratory, where it is checked for the H5N1 virus, specifically. “Thus far we have received 23,” Shah said. “All but one of those was negative.”

State health departments are also monitoring around 150 people, he said, who have spent time around cattle. They’re checking in with these farmworkers via phone calls, text messages, or in-person visits to see if they develop symptoms. And if that happens, they’ll be tested.

Another way to assess farmworkers would be to check their blood for antibodies against the H5N1 bird flu virus; a positive result would indicate they might have been unknowingly infected. But Shah said health officials are not yet doing this.

“The fact that we’re four months in and haven’t done this isn’t a good sign,” Worobey said. “I’m not super worried about a pandemic at the moment, but we should start acting like we don’t want it to happen.”

Respiratory-virus activity ticks up a bit, but hospital admissions fall; flu remains driver for respiratory admissions, ER visits in Ky.

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

The state Department for Public Health says respiratory virus activity ticked up a bit in Kentucky in the last week of March, but remained at a relatively low level, while hospitalizations for respiratory disease declined but remained at a level that the department considers moderate. 

In the week ended March 30, emergency-room visits for influenza, Covid-19 and respiratory syncytial virus (RSV) increased almost 5% to 1,796. Of those, 1,508 were for the flu. 

But in that same week, hospital admissions for the diseases dropped 19%, to 233.  Of those, 135 were for flu, 85 were for Covid-19 and 13 were for RSV. 

In the week ended March 30, every Kentucky county had a low rate of Covid-19 hospital admissions, considered to be less than 10 admissions per 100,000 people by the Centers for Disease Control and Prevention. 

The state reported 1,431 laboratory-confirmed cases of the flu in the week ended March 30, showing the first uptick in confirmed flu cases since mid-February. The state reported 857 lab-confirmed cases of Covid-19, which have declined for seven weeks in a row.  

The Kentucky Respiratory Disease Dashboard is now reporting Kentucky monthly death information for all Kentuckians since October 2023 as well as a separate category for those 65 and older during the 2023-24 respiratory season. 

The dashboard shows that since the flu season began in October,  there have been a total of 524 deaths attributed to Covid-19, with 447 of them in people 65 and older. One Covid-19 victim and one flu victim were children. There have been 121 flu-related deaths, with 74 in people 65 and older. Ten deaths have been attributed to co-infection, with two of in people 65 and older.

Emergency-department visits and hospitalizations for respiratory illness keep dropping; at 'moderate' level for first time since fall

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

For the first time since December, the state Department for Public Health says both respiratory-virus activity and hospital admissions related to respiratory disease are moderate and declining in Kentucky. 

In the week ended March 16, emergency-department visits for influenza, Covid-19 and respiratory syncytial virus (RSV) dropped 30%, to 1,936. Of those visits, 1,555 were for flu. 

Hospital admissions for the diseases dropped 38%, to 272. Of those, 141 hospital admissions were for flu, 111 for Covid-19 and 20 were for RSV. 

In that same week, eight Kentucky counties had Covid-19 hospital admission rates between 10 and 19.9 admissions per 100,000 population, which the the Centers for Disease Control and Prevention considers to be a "medium" rate. Those counties were Clay, Elliott, Knox, Laurel, Menifee, Morgan, Rowan and Whitley. 

The state reported 1,761 laboratory-confirmed cases of the flu in the week ended March 16 and 1,121 lab-confirmed cases of Covid-19. These numbers have dropped for five weeks in a row. 

Since the flu season began in October, the state has recorded 439 Covid-19 deaths, 110 flu deaths and two co-infection deaths. One Covid-19 victim and one flu victim were children. 

ED visits, hospitalizations for respiratory disease decline in state

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

Kentucky's influenza levels remain elevated, but are declining, and hospitalizations for overall respiratory illness are moderate and declining, according to the state Department for Public Health.

In the week ended March 9, emergency-department visits for the three main respiratory diseases showed a 16% drop in visits for Covid-19, flu and RSV, to 2,734. Of those, 79% of the visits were attributed to the flu. 

Hospital admissions for the diseases dropped 28% in the week ended March 9, to 387. Of those admissions, 216 were for the flu, 154 were for Covid-19 and 17 were for RSV (respiratory syncitial virus).

In the week ended March 9, 10 Kentucky counties had a Covid-19 hospital admission rate between 10 and 19.9 admissions per 100,000 people, a rate that is considered "medium" by the Centers for Disease Control and Prevention. 

Those counties were McCracken, Marshall, Lyon, Livingston, Hickman, Graves, Crittenden, Carlisle and Ballard, in West Kentucky, and Letcher, on Kentucky's southeastern border.

The state reported 2,762 laboratory-confirmed cases of the flu in the week ended March 9 and 1,605 lab-confirmed cases of Covid-19. Both of these numbers have dropped for four weeks in a row. 

Since the flu season began in October, the state has recorded 439 Covid-19 deaths, 110 flu deaths and two co-infection deaths, both reported in recent weeks. One Covid-19 victim and one flu victim were children.

Emergency-room visits for respiratory illness keep declining, but flu activity remains elevated, and hospital admissions for it are up

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

Kentucky's influenza levels remain elevated and hospitalizations for respiratory illness remain high, even though emergency-department visits for respiratory illness have stayed on a rough plateau since mid-January, according to the state Department for Public Health.

In the week ended March 2, Kentucky saw a 13% drop in emergency-department visits for respiratory illness, to 3,175. Flu continues to be the driver for this high number.

Hospitalizations for flu increased slightly, but overall admissions for the three respiratory diseases tracked by the state dropped 7%, to 491. In addition to flu, the state tracks Covid-19 respiratory syncytial virus (RSV).

Letcher County is the only Kentucky county to have a high rate of Covid-19 hospital admissions in the week ended March 2, with 23.2 admissions per 100,000 people, according to the Centers for Disease Control and Prevention. 

Sixteen Kentucky counties had a hospital-admission rate between 10 and 19.9 per 100,000 people, considered "medium" by the CDC. That included Pike County, just north of Letcher. The others are in Western Kentucky: Union, Ohio, McLean, McCracken, Marshall, Lyon, Livingston, Hickman, Henderson, Hancock, Graves, Daviess, Crittenden, Carlisle and Ballard counties. 

For two weeks in a row, ED visits for respiratory illness have declined in children aged 5 to 17, dropping to 723 in the week ended March 2. Like adults, these visits have been driven by the flu. This age group had 14 hospital admissions in the week, 12 for flu and two for Covid-19. 

The state reported 3,603 laboratory-confirmed cases of the flu in the week ended March 2 and 1,983 lab-confirmed cases of Covid-19. Both of these numbers have dropped for three weeks in a row. 

Since the flu season began in October, the state has recorded 414 Covid-19 deaths and 97 flu deaths, 75 of the latter since the first week of January. One Covid-19 victim and one flu victim have been children.

Flu shots limit infection rates, which are still elevated in Kentucky

State health department graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

The Kentucky Department for Public Health still considers hospitalizations for respiratory illnesses high and says flu activity remains elevated. 

Health officials say the best way to protect yourself from these viruses is to stay up to date with your vaccines. 

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu vaccine and updated Covid-19 vaccines, especially children younger than 5 or anyone at high risk for complications.

Vaccines for respiratory syncitial virus are recommended for some infants and young children, pregnant women and adults 60 and older. At some places and times, there has been a shortage of these vaccines. 

This year's "flu vaccines have worked, substantially reducing the risk of flu-related medical visits and hospitalizations across all age groups, with some estimates higher than have been previously observed, even during well-matched seasons," said a CDC report released on Feb. 29.

"Specifically, flu vaccination has reduced the risk of flu medical visits by about two-thirds and flu-related hospitalization by about half for vaccinated children and flu medical visits by half and hospitalization by about 40% for vaccinated adults."

Even though flu season usually peaks around January, it lasts until May. Health experts say that if there is any flu activity occurring, it's not too late to get vaccinated.

What the numbers say

Emergency-department visits for respiratory illness in Kentucky have stayed about the same for the last two weeks, with 3,607 visits reported in the week ended Feb. 24.

Hospitalizations for respiratory disease in that week stayed about the same as the week prior, with 491 530 hospitalizations reported in the week ended Feb. 24. 

Kentucky had 20 counties with Covid-19 hospitalizations between 10 and 19.9 hospitalizations per 100,000 people, a rate that the  CDC considers "medium." 

Those counties are Adair, Green, Russell, Taylor, Clinton, Cumberland, Lewis, Elliott, Menifee, Morgan, Rowan, Barren, Hart, Metcalfe, Monroe, Bath, Montgomery, Floyd, Johnson and Magoffin. 

Overall, there was little change in the three respiratory viruses tracked by the state health department: Covid-19, influenza and RSV, with flu continuing to drive ED visits and hospital admissions. 

The state reported 3,857 laboratory confirmed cases of the flu in the week ended Feb. 24 and 2,246 laboratory confirmed cases of Covid-19. This reflected a slight drop in flu cases and a nearly 9% drop in Covid cases.

Among children, ED visits for respiratory disease increased 12% in children four and younger, to 671, compared to the prior week, and hospitalizations for children 5 to 17 increased 50%, to 18. The increase in ED visits for younger children was driven by the flu, and hospitalizations for the older children were driven by an increase in  both flu and Covid-19.

Since the respiratory-illness season began the first week in October, 384 Kentuckians have died from Covid-19, and 51 from flu, according to the health department. One Covid-19 victim and one flu victim have been children. 

Emergency-department visits and hospitalizations for respiratory illness in Kentucky were down slightly from last week's uptick

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

While still considered high, Kentucky hospitalizations for respiratory disease dropped 15% in the week ending Feb. 17 after increasing in the previous week. 

The state Department for Public Health's weekly respiratory-illness report says 454 Kentuckians were hospitalized during the week, with big drops in all three respiratory viruses the state tracks -- flu, Covid-19 and respiratory syncytial virus (RSV). 

However, even with an 11% drop in Covid-19 hospitalizations, 15 Kentucky counties had a Covid-19 hospitalization rate between 10 and 10.9 per 100,000 people, considered an elevated or medium rate by the Centers for Disease Control and Prevention, and four Kentucky counties continued to have high rates of Covid-19 hospitalizations: Elliott, Menifee, Morgan and Rowan, all with rates of 21.2 per 100,000. 

The counties with medium rates of Covid-19 hospital admissions were Pike and Letcher, in far eastern Kentucky; Daviess, McLean, Ohio and Hancock, in western Kentucky; and Ballard, Carlisle, Crittenden, Graves, Hickman, Livingston, Lyon, Marshall and McCracken, in far west Kentucky.

Emergency-department visits for respiratory illness in Kentucky dropped 4% in the week ended Feb. 17, to 3,481. The biggest drop was among patients with RSV (down 27%), followed by a drop in Covid-19 visits (down 12%). 

ED visits by 5- to 17-year-olds leveled off, largely because flu visits, while still high, leveled off. During the week, 880 children in this group visited EDs for flu. 

Both flu and Covid-19 saw slight drops in laboratory-confirmed cases in the week ended Feb. 17. Lab-confirmed flu cases dropped to 3,860 and lab-confirmed Covid-19 cases dropped to 2,430. 

Since the respiratory-illness season began the first week in October, 361 Kentuckians have died from Covid-19, and 51 from the flu, according to the health department. One Covid-19 victim and one flu victim have been children. 

It's important to remember that flu and Covid-19 related deaths are reported in the week they happened, which can create an uptick in these numbers on any given week even though the deaths did not happen in that week. 

For example, this week's report shows an increase of 34 Covid-19 deaths and an increase of 23 flu deaths over the last report even though no new deaths were reported in the week ended Feb. 17.

Respiratory illness in Ky. resurged in the week ended Feb. 10, with 5-to-17-year-olds having an 84% jump in ED visits for the flu

State Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

After weeks of overall decline, three major respiratory illnesses increased in Kentucky during the week ended Feb. 10, with children between the ages of 5 and 17 getting hit hard by influenza.  

The Kentucky Department for Public Health's weekly report says flu and Covid-19 activity is elevated and increasing and hospitalizations for respiratory illnesses are considered high.  

Emergency-department visits for the three respiratory viruses tracked by the state -- flu, Covid-19 and respiratory syncytial virus (RSV) -- increased nearly 16% in the week ended Feb. 10, to 3,583.  

This increase was driven by a 16% increase in visits for flu, to 2,745, and a 26% increase in Covid-19 visits, to 740. RSV visits dropped 26%, to 98. 

In the same week, Kentucky hospital admissions for the respiratory diseases increased 6% from the previous week, to 509. Flu was the only one of the tracked viruses to see an increase in hospital admissions in the week ended Feb. 10, with a 17% increase to 288. Covid-19 and RSV admissions had slight drops.  

Four northeastern Kentucky counties had high rates of Covid-19 hospital admissions in the week, according to the Centers for Disease Control and Prevention, which considers high to be 20 or more admissions per 100,000 residents. Rowan, Morgan, Menifee and Elliott counties had 27 Covid-19 admissions per 100,000. 

Ten Kentucky counties had admission rates between 10 and 19.9 Covid-19 admissions per 100,000, a rate the CDC considers "medium." They were Pike County, in far Eastern Kentucky, and McCracken, Marshall, Lyon, Livingston, Hickman, Graves, Crittenden, Carlisle, and Ballard counties, in far Western Kentucky. 

Children between the ages of 5-17 saw an 84% jump in emergency-department visits for respiratory illness in the week ended Feb. 10, to 970. This was driven by flu-related visits, which were up 82% over the previous week, to 876. Hospital visits for this age group dropped to 15 in that week, down from 22 the prior week. 

In the week ended Feb. 10, the state reported 3,912 laboratory-confirmed cases of the flu, up 17% from the prior week. It reported 2,459 laboratory-confirmed cases of Covid-19, up 16% from the week prior. 

Since the respiratory-illness season began the first week in October, 327 Kentuckians have died from Covid-19, and 28 from the flu, the health department says. One Covid-19 victim and one flu victim have been children.

Respiratory illness in Ky. keeps declining, but slowly, and is still elevated; more kids are in hospitals; not too late to get vaccinated

Ky. Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

While emergency-department visits and hospital admissions related to respiratory illness were again less numerous in the week ended Feb. 4, the state Department for Public Health still considers them elevated. 

ED visits for respiratory-associated illness in Kentucky in the week saw a 6.7% drop, to 3,005 visits, according to the health department's weekly respiratory report.

Kentucky hospital admissions for the diseases in Kentucky dropped 25% from the previous week, to 428 in the week ended Feb. 3. 

Admissions for all three respiratory viruses monitored by the state saw big drops. Flu admissions dropped 25%, to 222; Covid-19 admissions dropped 19.6%, to 168; and RSV admissions dropped 59%, to 28. 

Again, none of the state's counties had high rates of Covid-19 hospital admissions in the week ended Feb. 3, but 13 had admission rates between 10 and 19.9 admissions per 100,000 people, a rate the Centers for Disease Control and Prevention considers "medium."

The counties are bunched in Southern Kentucky (Barren, Hart, Metcalfe and Monroe), Central Kentucky (Boyle, Casey, Lincoln, Garrard and Mercer) and northeastern Kentucky (Elliott, Morgan, Menifee and Rowan). 

Children 4 and younger saw a slight uptick in hospital admissions for respiratory illness in the week ending Feb. 4, largely driven by nine Covid-19 admissions, eight more than the week prior. 

Children 5 to 17 saw a 40% increase in respiratory-related ED visits, to 737, and a 100% increase in hospital admissions (18), both driven by increases in flu. 

In the week ended Feb. 3, the state reported 3,415 laboratory-confirmed cases of the flu, less than a 1% decrease from the previous week It reported 2,173 lab-confirmed cases of Covid-19, up 4% from the week prior.

Since the first week in October, 296 Kentuckians have died from Covid-19, and 28 from the flu, the health department says. One Covid-19 victim and one flu victim were children. 

It's not too late to get vaccinated. Flu season in Kentucky runs through mid-May, RSV outbreaks tend to occur through the end of spring, and the CDC warns that the virus that causes Covid-19 is constantly changing and has not yet established a regular season. 

Health officials recommend that everyone 6 months old and older get the annual flu vaccine and updated Covid-19 vaccines, especially children younger than 5 or anyone at high risk for complications.

Vaccines for RSV are recommended for some infants and young children, pregnant women and adults 60 and older, although a shortage of the vaccine has been reported.

Earlier this week, WKYT-TV reported there have been six flu-related deaths in Lexington since October, and that the most recent deaths were a person in their 40s and another in their 60s. The health department told WKYT that 84% of the 2,030 people with lab-confirmed influenza in Fayette County since October had not received a seasonal flu shot.

Update 2/11/24: This story has been updated to reflect the correct number of children 4 and younger hospitalized for Covid-19 (nine) and the correct increase from the week prior (eight) when the state had only one Covid-19 hospitalization in this age group.  

Up to 75% of people say they've hidden illnesses, raising risks

Newswise graphic

Kentucky Health News

A startling number of people conceal an infectious illness to avoid missing work, travel, or social events, the University of Michigan says in reporting on research conducted there.

The findings were published in Psychological Science, a journal of the Association for Psychological Science, and announced in a university news release.

Reserachers did a series of studies involving healthy and sick adults and found that 75% of the 4,110 participants said they had either hidden an infectious illness from others at least once or might do so in the future. Many of them reported boarding flights, going on dates, and making other social interactions while secretly sick.

More than 61% of health-care workers in the studies said they had concealed an infectious illness.

The research report is titled “When and why people conceal infectious disease.” The basic answer is they want to avoid "social exclusion," writes the lead author, Wilson N. Merrell, a Ph.D. candidate at Michigan.

"But just because concealment is common does not mean it is costless: Masking signs of illness can facilitate interpersonal disease transmission," Merrell writes, citing a 2014 survey in the United Kingdom found that that 82% of workers there believed they had become sick because a coworker came in not feeling well.

The researchers found a difference between how people believe they would act when ill and how they actually behave, Merrell said in the news release: “Healthy people forecasted that they would be unlikely to hide harmful illnesses—those that spread easily and have severe symptoms—but actively sick people reported high levels of concealment regardless of how harmful their illness was to others.”

In the first study, Merrell and his colleagues recruited 399 university health-care employees and 505 students who reported the number of days they felt symptoms of an infectious illness, starting in March 2020, when the Covid-19 pandemic began. They then reported how often they actively concealed symptoms, came to campus or work without telling anyone they were feeling ill, or falsified mandatory symptom screeners that the university had required for anyone using campus facilities.

More than 70% of the participants reported concealing their symptoms. Many said they hid their illness because it would conflict with social plans, while a small percentage cited pressure from institutional policies such as lack of paid leave. Only five participants reported hiding a Covid-19 infection.

In a second study, the researchers recruited 946 participants online and randomly assigned them to one of nine conditions in which they imagined being either moderately or severely sick while in a social situation. In each condition, the risk of spreading the illness was designated as low, medium, or high. To control for the special stigma associated with Covid-19 at the time, the researchers asked participants not to imagine being sick with that disease. Participants were most likely to envision themselves hiding their sickness when symptom severity was low, and least likely to conceal when symptoms were severe and highly communicable.

In another study, Merrell and colleagues used an online research tool to recruit 900 people—including some who were actively sick—and asked them to rate the transmissibility of their real or imagined illness. The participants were also asked to rate their likelihood of covering up an illness in a hypothetical meeting with another person. The actively ill were more likely to conceal their illness than those who just imagined being sick, regardless of the illness's transmissibility.

“This suggests that sick people and healthy people evaluate the consequences of concealment in different ways, with sick people being relatively insensitive to how spreadable and severe their illness may be for others,” Merrell said.

The Covid-19 crisis may have shaped the way the participants thought about concealing an illness, Merrell said, adding that future research could explore how ecological factors such as pandemics and medical advances such as vaccines influence people’s disease-related behavior.

Merrell said, “People tend to react negatively to, find less attractive, and steer clear of, people who are sick with infectious illness. It therefore makes sense that we may take steps to cover up our sickness in social situations. This suggests that solutions to the problem of disease concealment may need to rely on more than just individual good will.”

Seasonal respiratory illness in Kentucky has declined for three weeks, but the numbers are still considered elevated

Ky. Dept. for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

Emergency-department visits and hospital admissions for respiratory disease in Kentucky have dropped for three weeks in a row, but the Kentucky Department for Public Health still considers the rate of respiratory virus activity to be elevated and the number of hospitalizations to be high. 

Respiratory illness-related ED visits have dropped 47% since the last week of 2023, when the health department showed the highest number of ED visits during this respiratory-illness season, 6,147. 

In the three weeks since, there has been a steady decline in such visits, dropping to 3,243 visits in the week ended Jan. 20.

Of those, 2,379 were for flu, down 15% from the week prior; 663 were for Covid-19, down 30% from the week prior; and 201 were for respiratory syncytial virus (RSV), down 38% from the week prior.

Hospital admissions associated with respiratory disease have also dropped steadily for three weeks in a row, to 530. That's down 47% from the season's high of 1,002 in the week ended Dec. 30. 

In the latest report, 236 admissions were for Covid-19, down 33% from the week prior; 216 were for flu, down 22% from the week prior; and 78 were for RSV, down 27% from the week prior.

Kentucky has no counties with high Covid-19 hospital admission rates in the week ended Jan. 20, according to the Centers for Disease Control and Prevention. However, it does have 24 counties with between 10 and 20 Covid-19 hospitalizations per 100,000 people, a rate the CDC considers "medium." These are largely in the easternmost part of the state and in a strip down the middle of the state. 

In the week ended Jan. 20, the state reported 2,042 laboratory-confirmed cases of Covid-19, down 32% from the prior week. It reported 2,745 lab-confirmed cases of the flu, down 16% from the week prior. 

Among children 4 and younger, the number of respiratory-illnessemergency-department visits also dropped for the last three weeks, to 697 in the week ended Jan. 20. That's down 53% from a season-high of 1,489 on Dec. 30. 

In the latest report, 471 vists of those 4 and younger were for flu, down 11% from the week prior; 125 were for RSV, down 33% from the prior week; and 101 were for Covid-19, down 30%.

Respiratory-related hospitalizations for children 4 and younger have dropped for six weeks in a row, down to 38 in the week ended Jan. 20 from a season-high of 134 in the week ended Dec. 16, a drop of 72%

In the latest report, 18 of the hospitalizations were for RSV, down 44% from the week prior; 12 were for flu, down 48% from the week prior;  and 8 were for Covid-19, 2 more than the week prior. 

Hospital visits also dropped among children 5 through 17, with 633 respiratory-related ED visits reported in the week ended Jan. 20, down 18% from the week prior. 

In the latest report, 565 of the yoith visits were for flu, a drop of nearly 19%; 54 were for Covid-19; and 14 were for RSV. The Covid-19 and RSV numbers have fluctuated little for several weeks.

The number of ED visits in this age group has declined from a high of 1,000 in the week ended Dec. 23, but it has not been a steady decline; there were nine hospitalizations in the week ended Jan. 20 among children aged 5-17, the same as the week before.

Of those, seven were for flu, up one from the prior week; one was for Covid-19, down from three the week prior; and one was for RSV, up from none the prior week. 

Since the first week in October, 236 Kentuckians have died from Covid-19 and eight have died from the flu. One of the Covid-19 deaths and one of the flu deaths have been children. 

In the week ended Jan. 6, there were two Covid-19 deaths and one flu death reported in Kentucky. These numbers follow two weeks where the state saw 23 Covid-19 deaths during each week.

State reports two Kentucky children have died, one from flu and one from Covid-19, but hospital visits show first decline in months

By Melissa Patrick

Kentucky Health News

As the state reported the first two deaths of children from Covid-19 and influenza, Kentucky saw the first drops in emergency-room visits and hospital admissions for the diseases in more than three months.

State health department graphs, adapted by Kentucky Health News

The weekly respiratory-illness update from the state Department for Public Health showed a 21% drop in emergency-department visits for the flu, Covid and respiritory syncitial virus (RSV), and a 13% drop in related hospitalizations the week ended Jan. 6. 

The children's deaths, one from Covid and one from flu, are the first pediatric deaths from respiratory illness reported this season. Neither child was vaccinated against the viruses that killed them, the department said. The report did not include any other information about the children. 

“Influenza and Covid-19 are serious illnesses that unfortunately can be deadly for some people, including young children,” said Dr. Steven Stack, the state's public health commissioner. “It is important for people who have not been vaccinated to get their updated influenza and Covid-19 vaccines this season, along with other recommended immunizations, to protect themselves.”

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu and Covid vaccines, especially children younger than 5 or anyone at high risk for complications.

While hospital cases of the flu, Covid and RSV declined for the first time in many weeks, they continue to be widespread across Kentucky, says the release. 

Deaths are a lagging indicator of disease. Since Oct. 1, 165 Kentuckians have died from Covid-19 and seven have died from the flu, according to the health department's weekly respiratory report. 

In the week ended Jan. 6, Kentucky reported 3,173 laboratory confirmed cases of flu, down 19% from the week prior. The state reported 3,316 laboratory-confirmed cases of Covid, down nearly 14% from the prior week. 

Covid, the flu and RSV all saw a drop in emergency department visits and hospitalizations in the week ended Jan. 6. Flu has led in emergency-department visits for weeks, but Covid-19 has been the leading cause for hospitalizations since the state starting its reporting in October. 

Among children 4 and younger, the number of respiratory-related emergency-department visits and hospitalizations also dropped in the week ended Jan. 6. Emergency visits for this age group dropped 23% from the prior week, to 1,137, and hospitalizations dropped 18%, to 102. 

They also dropped among children 5-17, with 589 respiratory-related emergency department visits reported in the week ended Jan. 6, down nearly 40% from the prior week. However, respiratory-related hospitalizations in this age group increased to 19, up from 17 the week prior. 

A CDC report for the week ended Jan. 6 showed 11 Kentucky counties with hospitalization rates above 20 hospitalizations per 100,000 people, a rate the CDC considers high. 

Boyd, Carter, Greenup, Lawrence and Martin counties had a rate of 26.6 admissions per 100,000; Pike County had 22.9; Lewis County 21.8; and Daviess, Hancock, McLean and Ohio counties had 20.3.

Flu, up 33% in year's final week, continues to drive big jumps in respiratory illness in Kentucky; it's not too late to get a flu shot

Kentucky is in the CDC's third highest category of flu activity. (Chart adapted by Ky. Health News)

By Melissa Patrick

Kentucky Health News

Like the rest of the nation, Kentucky saw another big jump in influenza cases in the week ended Dec. 30, with visits to emergency departments for flu up 33% over the prior week and flu-related hospitalizations up nearly 48%.

"The influenza virus is the thing that's really skyrocketing right now," Dr. Steven Stack, Kentucky public-health commissioner and president of the Association of State and Territorial Health Officials, told NPR. "Influenza is sharply escalating and driving more hospitalizations."

The Centers for Disease Control and Prevention considers flu activity in Kentucky to be "very high." 

State health department graphs, adapted by Ky. Health News

The state's weekly report for the week ended Dec. 30 shows that the three respiratory that it tracks – flu, Covid-19 and respiratory syncytial virus – accounted for 5,662 vistis to Kentucky hospital emergency departments. That was an increase of 20% from the prior week, when the state recorded 4,703 such visits.  

For the third week in a row, flu cases accounted for a majority of the respiratory-illness cases seen by emergency departments. The latest report shows 3,802 of the visits were for flu, up from 2,854 in the prior week. 

Covid-19 cases increased 15% during the week, to 1,365, up from 1,183 the prior week. RSV cases dropped 25.6%, to 495 from 666 the prior week. 

Kentucky children four and younger saw an 8% increase in respiratory-related emergency-department visits, increasing to 1,378 from 1,271 the prior week. This increase was also driven by a 32% increase in flu cases, to 854, up from 646 the prior week. 

RSV cases among children under four dropped to 328 during the week, down from 453 the week prior, and 196 of the cases were for Covid-19, up from 172 the week prior. 

Kentucky children between the ages of 5 and 17 saw a slight drop in emergency department visits for respiratory illness, down to 928 from 994 the prior week.  Of those, 823 were for flu, down slightly from 861 the week prior; 75 for Covid-19, down from 77 the week prior; and 30 for RSV, down from 56 the week prior. 

The state considers all of these respiratory viruses to be at an elevated level, with hospitalizations for the flu increasing. 

Hospitalizations for respiratory illness increased to 857, up from 757 the week prior, an increase of 13%. Of those 404 were for Covid-19, up from 364 the week prior, an increase of nearly 11%; 306 were for flu, up from 207 the week prior, an increase of 47.8%; and 147 were for RSV, down from 186 the week prior, a decrease of nearly 21%.

Among children four an younger,  there were 122 hospitalizations related to respiratory illness, down slightly from 125 the week prior. Of those, 76 were for RSV, down from 97 the week prior; 28 were for flu, up from 16 the week prior, an increase of 75%; and 18 were for Covid-19, up from 12 the week prior. 

Among children 5-17, hospitalizations for respiratory illness dropped to 16, down from 25 the week prior. Of those, 13 were for flu, down from 19 the week prior; two were for RSV, down from five the week prior; and one was for Covid-19, the same as the week prior.

According to the CDC, 20 Kentucky counties had a high rate of Covid-19 hospitalizations in the week ended Dec. 30, with most of them in the far eastern and western parts of the state. Since last week's report, Clinton and Cumberland counites were added to this list. 

The CDC considers 20 or more hospitalizations per 100,000 people a high rate. 

Those counties were led by Pike, at 37.1 hospitalizations per 100,000 people; McCracken (23.6); Martin (20.2); Marshall (23.6); Magoffin (21.4); Lyon (23.6); Livingston (23.6); Lawrence (20.2); Johnson (21.4); Hickman (23.6); Greenup (20.2); Graves (23.6); Floyd (21.4); Cumberland (23.8); Crittenden (23.6); Clinton (23.8); Carter (20.2); Carlisle (23.6); Boyd (20.2); and Ballard (23.6). 

Since Oct. 7, Kentucky health officials have attributed 159 deaths to Covid-19, an average of about 12 per week. There have been seven flu-related deaths.

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

Stack "encourages seasonal preventive shots for everyone 6 months and older," NPR reports, but "says it's particularly important for 'everybody who is elderly — and not even old elderly — like young elderly, 60 and older,' since they are more likely to get very sick from these viruses." 

Experts say the best ways to not spread respiratory illness is to stay home if you are sick, to cover your coughs and sneezes with a tissue or your shirt sleeve, not your hands, and to keep your hands washed with soap and water.

FDA leaders say thousands of Americans are likely to die this winter because too many of them no longer believe in vaccines

By Dr. Peter Marks and Dr. Robert Califf
Republished from the Journal of the American Medical Association

Vaccination is one of the most highly effective public-health interventions, responsible for saving millions of lives each year. In the U.S., authorized or approved preventive vaccines must be manufactured with high quality, and the effectiveness and favorable safety profile of vaccines must be demonstrated. Their safety over time is also closely and continuously monitored through multiple overlapping passive and active safety surveillance systems.

Despite the care taken in the development and deployment of vaccines and their clear and compelling benefit of saving individual lives and improving population health outcomes, an increasing number of people in the U.S. are now declining vaccination for a variety of reasons, ranging from safety concerns to religious beliefs. Setting aside for now the controversial issue of vaccine mandates at the federal, state, or local level in the U.S., which are not within the purview of the Food and Drug Administration, the situation has now deteriorated to the point that population immunity against some vaccine-preventable infectious diseases is at risk, and thousands of excess deaths are likely to occur this season due to illnesses amenable to prevention or reduction in severity of illness with vaccines.

To counter the current trend, we urge the clinical and biomedical community to redouble its efforts to provide accurate plain-language information regarding the individual and collective benefits and risks of vaccination. Such information is now needed because vaccines have been so successful in achieving their intended effects that many people no longer see the disturbing morbidity and mortality from infections amenable to vaccines. For example, smallpox has been eradicated, and polio has been eliminated from the U.S., through effective vaccination campaigns.

Measles was similarly eliminated, but imported cases remain a threat to those who are unvaccinated as well as to those who are immunocompromised. Regrettably, pediatric vaccine hesitancy now has been responsible for several measles outbreaks in the U.S., including a recent one in central Ohio involving locally acquired cases in 85 children, 36 of whom (42%) had to be hospitalized for complications. It is sobering to note that vaccine hesitancy to childhood vaccines, such as the measles, mumps, and rubella vaccine, has been found to cluster in middle- to high-income areas among parents with at least a college degree who preferred social-media narratives over evidence-based vaccine information delivered by clinicians. Anyone doubting the benefits of vaccination need only look to low-income parts of the world where measles vaccination is inaccessible, and many thousands of children continue to die each year due to preventable disease. Unfortunately, with the success of pediatric vaccination campaigns to date, increasing numbers of people have become complacent and underestimate the actual risk of forgoing vaccination.

In addition to making a difference regarding childhood immunization, communication regarding the potential benefits of vaccination can hopefully also improve the number of individuals accepting vaccination to protect against Covid-19, influenza, and respiratory syncytial virus disease (RSV). Vaccination rates against these respiratory pathogens are inadequate, and this is most distressing in older individuals in whom the benefits of vaccination in reducing hospitalization and death are eminently clear. In fact, uptake of the updated Covid-19 vaccine in the U.S. is only about 35% in those older than 65 years, which is about half the rate in this age group in the U.K.

Clinicians who provide care are most trusted information sources

What can we do to start tipping the scales in the direction of evidence-informed vaccine acceptance to reduce the risk of death and illness from diseases in which vaccines are effective? Evidence indicates that the most trusted source of information about health decisions remains clinicians who provide care. Broadly interpreted, this also includes retail pharmacists, who may serve as the only source of medical advice for the many individuals in the U.S. who lack a primary-care clinician or who are uninsured. All those working in health care, while being straightforward about the risks, need to better educate people regarding the benefits of vaccination, so that individuals can make well-informed choices based on accurate scientific evidence.

For example, contrary to a wealth of misinformation available on social media and the internet, data from various studies indicate that since the beginning of the Covid-19 pandemic tens of millions of lives were saved by vaccination. The benefits of these vaccines in prevention were largest in older individuals. However, studies show that people of all ages who are up to date on vaccination benefit and have a lower risk of developing long Covid.

FDA graph from CDC data, adapted by Kentucky Health News; click image to enlarge it.

During the Covid-19 pandemic, vaccine effectiveness appeared to be higher against the original strain of SARS-CoV-2 than against later variants. Nonetheless, since the introduction of the Covid-19 vaccines, in absolute terms vaccination has been associated with notably fewer deaths across the age range. A similar trend was seen in 2021 and 2023, even though the total number of deaths from Covid-19 have decreased more recently (note the order of magnitude difference on the scale). Those up to date on Covid-19 vaccination had notably lower numbers of deaths per million individuals than those who were unvaccinated. The benefits were apparent across the entire age range early on, and more recently following the exposure of a larger number of individuals to natural infection with one of the SARS-CoV-2 variants, with 16.5-fold and 3.6-fold reductions in death, respectively. 

And although the argument is sometimes made that Covid-19 is not a serious illness in younger individuals, those who received at least one dose of any Covid-19 vaccine had a notably reduced risk of dying from this disease compared with those who had never been vaccinated. Comparing 11.71 million unvaccinated individuals with 9.9 million individuals who had received at least one dose of a Covid-19 vaccine, the risk of death was 2.46 times higher in the unvaccinated group. And this finding is not an outlier; other studies report equal or greater benefit. The message from the data on vaccination status and serious illness, subsequent hospitalization, and death is clear, and this can be communicated in verbal or visual terms to individuals contemplating vaccination.

It is often difficult for a person to take action when the individual risk of an outcome is relatively low, even when the consequences of complications are high, and the population effects are substantial. In situations such as with seat belts, however, the discussion ultimately has led to almost uniform use, and vaccination use had similarly been almost uniformly accepted. The current reversal of vaccine acceptance has already resulted in hundreds of thousands of excess deaths from Covid-19 and concern about the re-emergence of previously conquered infectious diseases.

We believe that the best way to counter the current large volume of vaccine misinformation is to dilute it with large amounts of truthful, accessible scientific evidence. To reduce deaths, hospitalization, and the burden on families and the health care system, all those directly interacting with individuals in a health care setting, ranging from front office staff to retail pharmacists to primary-care physicians, need to focus at every appropriate opportunity on helping to ensure that individuals have the necessary information to make informed choices regarding vaccination, considering the benefits and risks. By doing so, we can both help prevent pediatric infectious diseases and dramatically reduce the harm from pathogens such as Covid-19, influenza, and respiratory syncytial virus disease before we have another large wave of any of these vaccine-preventable illnesses.

Peter Marks is director of the Center for Biologics Evaluation and Research at the U.S. Food and Drug Administration; Robert Califf is FDA commissioner.

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

State Department for Public Health graphs, adapted by Ky. Health News

By Melissa Patrick
Kentucky Health News

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Emergency-room visits for respiratory illness went up 10% in latest weekly report; hospitalizations for flu and RSV inched up

State graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

The state Department for Public Health's latest weekly respiratory report shows Covid-19 virus activity is moderate, influenza and respiratory syncytial virus (RSV) activity is increasing, and hospitalizations for RSV and the flu have inched up.

The Centers for Disease Control and Prevention issued a reminder that immunizations are available this fall and winter that can help protect against all three of these major respiratory diseases, saying, "Immunization against these viruses remains the best protection for reducing the risk of serious illness, hospitalizations, long-term health impacts, and death." 

In the week ended Nov. 19, emergency department visits for respiratory illnesses in Kentucky increased again, to 3,582, an increasse of 10 percent from 3,247 the prior week. 

The breakdown of cases was 1,492 for flu, up from 1,345 the prior week; 1,306 for Covid-19, up from 1,200; and 784 for RSV, up from 702. 

Among Kentucky children, ED visits for respiratory illnesses also increased again, to 1,726.  Of those, 867 were for flu, up from 771; 662 were for RSV, up from 598; and 197 were for Covid-19, down from 201. 

Hospitalizations for respiratory illnesses in Kentucky decreased a bit, but have largely stayed the same for the last three weeks.  In the week ended Nov. 19, the state reported  471 such hospitalizations, down from 476 the prior week. Hospitalizations for Covid-19 decreased for the second week in a row, to 263; RSV hospitalizations increased to 129, up from 116 the prior week; and flu also went up slightly to 79, from 72 the prior week. 

Among children, hospitalizations for respiratory disease dropped slightly after rising for six weeks in a row, to 111. That's down from 115 the prior week. RSV hospitalizations among children dropped to 84, down from 90 the week prior; flu hospitalizations increased to 20, up from 14 the week prior; and Covid-19 dropped to seven, down from 11. 

Covid-19 hospitalization rates for week ended Nov. 25
(CDC data and map adapted by Kentucky Health News)

A more recent report, from the federal Centers for Disease Control and Prevention, shows that Covid-19 hospitalization rates in Kentucky in the week ended Nov. 25 were highest along the state's eastern border, from Lewis County to Letcher County. 

In the week ended Nov. 19, the state reported 2,990 laboratory-confirmed Covid-19 tests, down from 3,116 the week prior. The state reported 570 laboratory-confirmed flu tests, up from 428 the week prior. It was the third straight increase in weekly flu numbers. 

Emergency-room visits for respiratory illness in Kentucky went up for the sixth week in a row, as hospitalizations saw a slight dip

By Melissa Patrick
Kentucky Health News

As we head into the full swing of the holiday season and people start to gather indoors to celebrate while taking fewer precautions to protect themselves, respiratory viruses such as influenza, respiratory syncytial virus (RSV) and Covid-19 are expected to surge. 

The state Department for Public Health's weekly respiratory illness report shows that in the week ended Nov. 12, emergency-department visits for respiratory illnesses in Kentucky increased again, to 3,160. The weekly rise was the sixth in a row.

The breakdown of cases was 1,336 influenza, up from 1,209 the prior week; 669 were for RSV, up from 534; and 1,155 for Covid-19, down from 1,209.

Among Kentucky children, ED visits for respiratory illness also increased again, to 1,534, and Covid-19 cases rose to 194 from 172 the week before. Flu cases in children totaled 765, up from 694 the prior week, and 575 were for RSV, up from 475..

Hospitalizations for respiratory illness in Kentucky dropped a bit in the week ended Nov. 12, to 447, down from 458. Of those, 261 were for Covid-19, down from 306 the prior week; 113 were for RSV, up from 89; and 73 were for flu, up from 63.

Among children, hospitalizations for respiratory illness also increased in the week ended Nov. 12, to 115. That's up from 88 the week prior. Of those, 90 were for RSV, up from 67 the week before; 14 were for flu and 11 were for Covid-19, both about the same as the week prior.

In the week ended Nov. 12, Kentucky reported 3,053 laboratory-confirmed tests for Covid-19 and 424 laboratory-confirmed tests for the flu.

Axios reports that nationwide, vaccinations against all three respiratory viruses are lagging and that health experts worry hospitals could be slammed again this winter. 

"The concern here with this vaccination gap is: Could this get worse as the number of transmissions increases from November, December, into January?" Marc Watkins, chief medical officer for Kroger Health, told Axios.

The latest Kaiser Family Foundation Covid-19 Vaccine Monitor survey shows that about half of adults say they do not plan to get the latest Covid-19 vaccine, which became publicly available nearly two months ago. This includes three in 10 of those who were previously vaccinated, says KFF. However, a quarter of the public said that while they have not gotten the latest vaccine, they intend to do so. 

While experts are hoping that the new RSV vaccination will protect older adults and infants from the virus, and keep them out of the hospital, Axios reports, supplies have been limited and some patients have struggled to get insurers to pay for them. 

 
Covid-19 and the flu continue to kill. In the week ended Nov. 5, the state attributed four deaths to Covid-19 deaths and one to the flu.

Louisville wastewater shows a surge of flu virus, signaling Ky. flu season is here; shots recommended for all six months and older

By Melissa Patrick

Kentucky Health News

The state Department for Public Health's weekly respiratory virus update, released Thursday, Nov. 9, shows that Covid-19 activity is moderate and influenza activity is low, but increasing. And while hospitalizations for Covid-19 and flu remain low, respiratory syncytial virus (RSV) hospitalizations in children continue to increase. 

This report comes as Louisville public-health officials are urging residents to get their flu shots, saying that the city's wastewater surveillance system has detected a surge in influenza virus – which means that flu season is right around the corner, reports Jess Clark of Louisville Public Media.

Researchers at the University of Louisville told Clark that their wastewater monitoring system has detected a redoubling of influenza virus concentration in recent weeks.

“That’s a sign that flu season is almost here,” Dr. Kris Bryant, associate medical director of the Louisville Metro Department of Public Health and Wellness, told Clark. “And if people have not yet had their flu shot, now is the time. Make an appointment today to get a flu shot before flu really starts circulating in our community.”

The Centers for Disease Control and Prevention recommends that everyone 6 months and older get an annual flu vaccine. 

The state report shows that emergency department visits for respiratory illness in Kentucky have increased weekly since early October, reaching a high of 2,115 in the week ended Oct. 29. Of those, 891 visits were for Covid-19, 885 were for flu and 339 were for RSV. 

Hospitalizations for respiratory illness in Kentucky stayed about the same as the previous week, increasing by three to 296 in the week ended Oct. 29. Of those, 192 were for Covid-19, 53 were for flu and 53 were for RSV. 

Among children, emergency-department visits increased to 965 in the week ended Oct. 29, up from 748 the week prior. Of those, 513 were related to flu, up from 414 the prior week; 302 were related to RSV, up from 185 the prior week; and 150 were related to Covid-19, up one from the prior week. 

Hospitalizations for respiratory illness among children increased slightly from the prior week, to 60. Of those, 45 were for RSV, 13 for flu and two for Covid-19. 

In the week ended Oct. 29, Kentucky reported 2,414 laboratory-confirmed tests for Covid-19, up from 2,312 in the prior report; and 169 positive laboratory tests for the flu, the same as the week prior. 

No additional deaths were reported in this week's report.