How to keep your family safe in pools, lakes, streams and oceans

Photo by Marina Kuzminykh, iStock/Getty Images Plus

By Sherri Hannan
Safe Kids Fayette County

Ask any child about the best part of summer, and chances are many will say it’s going to the pool or beach. And even though parents are aware of the risk of drowning, it remains the number one cause of death in children ages 1-4, as well as a leading cause of death among teens. Nearly 1,000 children drown each year, and more than 8,700 children were hospitalized for a near-drowning event. It’s quick and silent, and it can happen to any family.

The American Academy of Pediatrics recommends swimming lessons as a layer of protection against drowning; that can begin for many children starting at age 1. Even if your child has had lessons, they should never be unsupervised in water. Toddlers are the highest risk for drowning; their curious nature will lead them to explore areas that are dangerous for them but seem innocuous to adults. A good rule is “touch supervision,” meaning young children should always be close enough to touch when around water.

Other tips include:

• Choose a safe place to swim. Ensure that swimming pools are enclosed by a fence on all sides. In oceans, be aware of strong currents and waves.
• Instead of “floaties,” have your child wear a Coast Guard-approved life jacket in and around water.
• Watch kids when they are in or around water without being distracted. Young children can drown in as little as one inch of water, so it’s important to keep them within an arm’s reach of an adult. Assign a “water watcher,” an adult who will pay constant attention to children in the water. Switch off with another adult for breaks.
• Children should wear brightly colored swimsuits that contrast against the water, such as yellow, orange and pink.
• Empty small kiddie pools immediately after use. Store them upside down and out of children’s reach.

Kentucky’s numerous lakes are a fun summer getaway. However, teens and adolescents have a greater risk of death or injury in natural bodies of water because they overestimate their abilities and underestimate dangerous situations. They may feel pressure from their friends even if they don’t have strong swim skills or experience. They may also seek out unsafe areas such as waterfalls and rivers. Encourage them to only swim where lifeguards are present.

Familiarize yourself with the signs of drowning. It’s not the dramatic splashing you see in movies but is actually subtle and silent. If you see someone vertical in the water with their mouths near the surface, and they appear to be “climbing an invisible ladder,” get them out of the water as soon as possible.

One of the best ways to prepare for summer safety is to learn CPR. Contact your local community center or the Red Cross to find certification courses near you.

This is the latest weekly health column provided by the University of Kentucky Office of Public Relations and Strategic Communications.

Tips to prevent drowning, No. 1 cause of unintentional injury-related death among children under 5; swim lessons reduce risk

By Melissa Patrick

Kentucky Health News

As summer approaches and people begin to head to pools, lakes, ponds and streams, it's important to remember that drownings can happen to anyone in a matter of seconds – and that they are often preventable. 

CDC photo

Drowning is the leading cause of unintentional injury-related death among children under the age of 5, with most of the drownings happening in swimming pools, according to the Centers for Disease Control and Prevention. It is the second leading cause of unintentional injury death for children between the ages of 5 and 14, behind motor-vehicle crashes. 

In 2022, 15 Kentucky children died from drowning and three experienced "near fatalities," according to the state's 2023 Child Fatality and Near Fatality External Review Panel annual report.

Here are some suggestions from the CDC to prevent drowning, which can happen in seconds and is often silent. 

• Learn and teach children basic swimming skills.
• Build fences that fully enclose pools, with self-closing gates. 
• Designate a responsible adult to supervise children closely and constantly when they are near water – including bathtubs. 
• Children should wear life jackets for all activities around natural water, and weaker swimmers of all ages should also wear them around swimming pools. Do not rely on air-filled or foam toys; they are not safety devices. It's also important to make sure a life jacket fits properly. Click here to learn how to choose the right life jacket. 
• Learn CPR, which could save a person's life in the time it takes paramedics to arrive. Many organizations such as American Red Cross and American Heart Association offer CPR classes.

Swimming lessons reduce risk

From 2016 to 2021, 329 Kentuckians unintentionally drowned, with most of these deaths happening among people 45-54 and 65 and older. There were also 543 visits to the emergency departments related to unintentional drowning injuries and most of these were children under the age of 5, according to the Kentucky Injury Prevention and Research Center.

Nationwide, about 4,000 people a year in the U.S. unintentionally drown, and those deaths disproportionately affect age, racial and ethnic groups, according to a recent CDC report. 

That same study found that the number of unintentional drownings were "significantly higher" during the pandemic (2020-22), than those in the pre-pandemic (2019).  And, it said, the drowning rates during the pandemic included "increases among populations that were already at elevated risk, such as children, older adults and Black persons." 

The report notes that data on drowning-risk factors are limited, but suggests that increased drownings in the pandemic could have been related to infrastructure disruptions, including limited access to supervised swimming settings. 

The report stresses that basic swimming and water-safety skills training can reduce the risk for drowning, but social and structural barriers to accessing this training persist – especially among groups at the highest risk. 

To that point, the study found that just over one half of U.S. adults have never taken a swimming lesson and that this rate was highest among Hispanics (72%), Blacks (63%) and other races or ethnicities (53%). Further, it found that 15% of adults reported not knowing how to swim. 

"Recent increases in drowning rates, including those among populations already at high risk, have increased the urgency of implementing prevention strategies," says the report.  "Basic swimming and water safety skills training can reduce the risk for drowning." 

State doctors' group calls for more gun control, repeal of Second Amendment 'sanctuary' law; passes resolutions on many topics

By Melissa Patrick

Kentucky Health News

The Kentucky Medical Association called mass shooting and gun violence "a public-health crisis" and called for more gun control in one of nine resolutions on the topic at its annual convention.

Voting delegates representing the state's doctors also adopted resolutions addressing sex education, abortion care and more at their meeting Aug. 25-27 in Louisville.

Kentucky has the “14th-highest rate of gun deaths” in the nation, according to one of the resolutions.

 

KMA joined several other groups in declaring the public-health crisis, in a resolution that supports "A ban of assault (semi-automatic) weapons and killing-enhancement features, including high-capacity magazines, rapid-fire increases ('bump stocks'), silencers, and guns without serial numbers ('ghost' and 3-D printed guns)."

The resolution also calls for background checks without loopholes, waiting periods and safety training on all firearm transfers (retail, internet, gun-show purchases, lending and gifts); and extreme-risk protective orders ('red flag' laws) "to disarm persons who pose risks of gun violence to self or others."

Before the convention, Alex Acquisto of the Lexington Herald-Leader talked to KMA Executive Vice President Patrick Padgett about how KMA passes resolutions and what it means. 

Padgett said the association, by definition, is an advocacy organization to promote the well-being of patients, doctors and the community at large, and the resolutions represent the consensus of an organization that represents thousands of doctors statewide. Padgett said KMA members regularly conduct grassroots advocacy with legislators about health-related bills.

The group's rules say any KMA member can propose a policy change, which is then reviewed by a group of more than 100 doctors in KMA’s House of Delegates, which votes on resolutions in deliberations that are closed to the public. KMA is a private organization, not a public agency coveregd by the state Open Meetings Act.  

Acquisto notes that the KMA's suggested firearm legislation goes against the long-prevailing views in the General Assembly. 

Other resolutions support creation of a statewide gun-safety office to reduce firearm-related deaths;  eliminating ghost-gun loopholes; supporting legislation that promotes the implementation of "domestic violence prohibition laws;" screening during medical visits for presence of guns in the home; and research and educational campaigns about firearms, including safe storage.

"Gov. Andy Beshear, a Democrat, has called for the legislature to pass  to this end multiple times since he became governor — as far back as 2019 after two mass shootings in El Paso, Texas, and Dayton, Ohio, left dozens of people dead, and again this year, after a gunman in downtown Louisville killed five people," Acquisto reports.

Such laws are not popular "in a state that has historically championed the proliferation of and freedom to possess firearms," she adds. "Beshear’s predecessor, Republican Gov. Matt Bevin, said in 2019 that red flag laws are an 'erosion of our constitutional rights' and signed" into a law a bill repealing the requirement for a separate permit or training to carry a concealed deadly weapon.

"In 2020, a bipartisan bill to enact a red-flag law in Kentucky failed to get traction," Acquisto notes. "Earlier this year, legislators enacted a law making Kentucky a 'Second Amendment Sanctuary' state."

The legislation, which Beshear allowed to become law without his signature, says local and state officials and their employees shall not "enforce, assist in the enforcement of, or otherwise cooperate in the enforcement of a federal ban on firearms, ammunition, or firearm accessories."

One of the KMA resolutions calls for Kentucky to repeal the law, saying it and one to ban local gun laws "substantially weaken protection of our schoolchildren, citizens and police officers from mass shootings and gun violence." 

Abortion resolutions

Last year's KMA meeting, two months after the U.S. Supreme Court overturned federal abortion protections, allowing Kentucky's trigger law banning abortion except to save the life of the mother to become law, "could not reach consensus to take a bold stance in opposition to state laws restricting it," Acquisto reports. 

Five abortion-related resolutions were proposed at that meeting, and most were not adopted. This year, the KMA House of Delegates passed two of three abortion-related proposals. 

The first one "supports the protection of OB/GYN residents in Kentucky to have comprehensive education and training in obstetrics and gynecology," stating that without such training, "residents will compromise the future of OB/GYN health care and failure to incorporate abortion training in the resident curriculum will lead to a generation of physicians ill-equipped to fulfill their duty to care for patients." 

The other resolution calls for "revisions to relevant state statutes that restrict access to abortion-inducing medications for women who experience underlying medical conditions concurrently with life-threatening pregnancies."

That is aimed at 2022 House Bill 3, which "prohibits doctors from providing abortion-inducing medication to patients with certain medical histories, including if they have a history of ectopic pregnancies, are taking steroid hormones for rheumatoid arthritis, or are on a blood thinner medication for a heart condition, for example," Acquisto writes.  

The resolution says “The unintended consequences of HB 3 could adversely impact women and risk their lives during a life-threatening pregnancy.” 

A resolution to support comprehensive reproductive health care for women, including the opportunity to choose a medical or surgical abortion, was not adopted. 

Transgender health care and sex education 

Acquisto reports that last year, before most Republican-controlled states "began outlawing gender-affirming care for transgender youth, KMA adopted a policy supporting access to hormones and puberty blockers, and the preservation of the doctor-patient relationship in such settings, devoid of political tampering. According to the current policy handbook, KMA 'advocates against any prohibition of physicians or other health care providers (from) socially affirming gender identity or discussing evidence-based therapies for management of gender dysphoria with their patients and their parents.' The association also supports behavioral-health options and "non-surgical treatment provided to youth by appropriately trained and experienced health-care providers."

This year, the General Assembly passed Senate Bill 150, outlawing all forms of gender-affirming medical care for trans youth, contradicting the advice of the KMA and all oyther major U.S. medical associations.

None of this year's KMA resolutions addressed gender-affirming care, but two dealt with sex and health education in direct response to SB 150. One says "KMA supports legislation to remove age limits for health education in schools."

The other says "SB 150 . . . has raised the question of whether teaching students human health-related curriculum, including puberty and menstrual health education, is permitted in Kentucky before 6th grade." It amended KMA policy to say the group opposes the sole use of "abstinence-only education by providing information about condoms, birth control, and other means of preventing pregnancy and sexually transmitted diseases," and "supports age-appropriate anticipatory education related to menstruation and puberty for elementary school students," as well as "age-appropriate sexual education in schools to include information on sexual assault, consent communication, and dating violence prevention" and "age-appropriate sexual education in schools to include reference to non-traditional (LGBTQIA) practices for safe sex, in the interests of equality and prevention of sexually transmitted disease."

The resolution says KMA "will work with appropriate agencies, including but not limited to the public-school system, to ensure that sex education is age-appropriate, evidence-based, led by well- trained individuals, and subject to periodic evaluation and improvement." 

Other resolutions 

The House of Delegates also adopted resolutions to :

• Encourage swimming lessons for children, promotion of fences around swimming pools and direct supervision of children around water by a responsible individual, amid increased focus on an increased drowning risk of children with autism.
• Encourage caution in pediatric melatonin consumption and to promote physician-led education to caregivers regarding pediatric use of melatonin. 
• Increase skin cancer prevention, noting that "from 2016 to 2020, Kentucky was in the top 10 states with incidence rates of melanoma." 
• Support efforts to educate health care professionals and the public about the frequency and severity of eating disorders and weight stigma, and stated that it supports evidence-based treatment for eating disorders and the removal of insurance barriers designed to deny or restrict such treatment. 
• Promote efforts to decrease the rate of physicians' moral injury in Kentucky, defined as “the challenge of simultaneously knowing what care patients need but being unable to provide it due to a variety of constraints that are beyond a physician’s control.”
• Support improvements in mental health care services for the postpartum period to improve maternal and infant health outcomes; and supports advocating for funding of programs that aid postpartum depression research.
• Support use of anti-obesity medications if they are safe, effective and have a sustained impact with lifestyle modifications; and to advocate for better access to anti-obesity medications for all patients appropriately prescribed those medications.
• Urge an increase research on the safety and efficacy of Kratom and to support increased regulation on the sale and purchase of Kratom. The resolution states that while Kratom is legal to buy, sell and own in Kentucky, "The opioid and stimulant properties of Kratom make it an option for treating opioid withdrawal, but subsequently comes with risk for abuse, addiction, and overdose." It also supported a resolution to ban over-the-counter sales of Kratom in Kentucky and that it supports increased education regarding its misuse and negative health effects.
• Encourages and support expanding representation of darker skin tones in medical education, especially in printed texts and textbooks. 

Click here for a list of the adopted resolutions and for the "Kentucky Medical Association Gun Violence and Firearm Safety Work Group Report to the 2023 KMA House of Delegates."

Tips for keeping children safe in the 'deadliest days of summer'

Yobro10, iStock / Getty Images Plus

By Sherri Hannan
University of Kentucky

The season from Memorial Day weekend to Labor Day is known as the "100 deadliest days of summer." The summer months, while a highlight for kids, can also expose them to greater injury risk. Kids spend time in the water, walking or riding bikes in their neighborhood and just enjoying their summer break from school. All that can change quickly without the use of safety devices or following safe practices.

Here are some tips and trips to keep kids safe while they have fun in the sun.

Outdoors:

• Apply sunscreen when kids will be outdoors, even on cloudy day. Reapply every two hours and after your child has been swimming.
• Kids are at a higher risk for dehydration. Combined with the summer heat, the lack of water can lead to muscle cramps, heat exhaustion or heatstroke. Have them drink water before, during and after physical activity.
• Fireworks are a fun way to celebrate, but every year, more than 3,000 children under the age of 15 visit the emergency department because of fireworks. Give children glowsticks instead of sparklers, and always keep fireworks away from children. If possible, attend a public fireworks display instead, and leave the firepower to the professionals.
• Keep a first aid kit handy, and give your children a few first aid basics such as when to use a bandage, what a tick might look like and how to spot poison ivy.

In the water or on a boat:

• Actively supervise children in and around water, giving them your undivided attention.
• Teach children to swim with an adult. Older, more experienced swimmers should still swim with a partner every time. From the first time your kids swim, teach children to never go near or in water without an adult present.
• Swimming aids such as water wings or noodles are fun toys for kids, but they should never be used in place of a U.S. Coast Guard-approved life jacket.
• A large portion of boating accidents each year involve alcohol consumption by both boat operators and passengers. To keep you and your loved ones safe, it is strongly recommended not to drink alcoholic beverages while boating.

Bicycling:

• Wear a properly fitted helmet. It is the best way to prevent head injuries and death. Learn how to properly fit a helmet for your children in seconds.
• Ride on the sidewalk when you can. If not, ride in the same direction as traffic as far on the right-hand side as possible.
• Use hand signals and follow the rules of the road. Be predictable by making sure you ride in a straight line and don’t swerve between cars.
• Wear bright colors and use lights, especially when riding at night and in the morning. Reflectors on your clothes and bike will help you be seen.
• Ride with your children. Stick together until you are comfortable that your kids are ready to ride on their own.

State health chief tells Kentuckians who've been to Myrtle Beach to self-quarantine; some long-term-care visitation to resume Mon.

By Al Cross and Melissa Patrick
Kentucky Health News

As it reported 280 more coronavirus cases in Kentucky, the state Department for Public Health issued an advisory to Kentuckians who had traveled in the last two weeks to Myrtle Beach, S.C., which has turned into a hotspot.

“DPH advises Kentucky residents who have traveled to Myrtle Beach in the past two weeks to self-quarantine for 14 days and monitor themselves for covid-19 symptoms,” the advisory says, then adds a message from Dr. Steven Stack, commissioner of the agency:

“If you or someone to whom you are close has been to Myrtle Beach in the past two weeks, please be aware that you have a good probability of having been exposed to the novel coronavirus. Please avoid contact with those who are vulnerable, such as the elderly and anyone with significant medical conditions, including diabetes, obesity and heart disease.”

Some other South Carolina beach counties are also hotspots, and the advisory warned, “Exposure to covid-19 is not limited to Myrtle Beach. Multiple states have reported a rise in covid-19 cases, and the guidance should be applied more broadly, including social situations where people gathered in numbers of 10 or greater and in situations where people are not observing recommended precautions, including practicing social distancing and wearing a cloth mask when in public or in groups. Kentuckians should also practice thorough and frequent hand-washing."

Kentucky Health News chart

Gov. Andy Beshear announced the 280 new cases in a press release, bringing the state's total to 14,617. That pushed the seven-day rolling average to 211, from 204 the day before. The average has risen for five days in a row. Fayette County again led the new-case list with 57; Jefferson had 42, Warren 32, Kenton 18, Shelby 15 and Boone 10.

Beshear also reported eight additional deaths, making the state's toll 546. The fatalities were an 81-year-old woman from Warren County, a 69-year-old man from Christian County; a 63-year-old man from Fayette County; an 89-year-old woman and an 86-year-old man from Jefferson County; and three women from Shelby County, 84, 90 and 93.

The state's daily report said 377 Kentuckians were hospitalized with covid-19, and 79 of them were in intensive care.

Cabinet for Health and Family Services Secretary Eric Friedlander announced in the release that on Monday, June 29, the state allow visitation at assisted-living and personal-care homes, group activities with 10 or fewer people in facilities, communal dining, and off-site appointments. Visitation in nursing homes and intermediate-care facilities for individuals with intellectual disabilities will resume July 15.

In other covid-19 news Thursday:

• Deborah Yetter of the Courier Journal tells the story of 106-year-old Sherman Guthrie Price, who had covid-19 but really died of complications from pneumonia, which he had before he tested positive for the virus, his family says. A grandson said that "profoundly affected his final days by keeping him isolated from family and friends except for video visits."
• Churchill Downs said the Sept. 5 Kentucky Derby will be run with fans in the stands and still-to-be-specified capacity reductions. "The plan approved by Gov. Andy Beshear’s office will restrict holders of general admission tickets to the track’s 26-acre infield and impose density limits on reserved seating and suites," the CJ reports.
• Beshear's office said he would hold one coronavirus briefing a week, on Tuesdays.
• "State health departments reported 38,115 new infections on Wednesday," the most ever, and “Our best estimate right now is that for every case that’s reported, there actually are 10 other infections,” The Washington Post reports. "The new spike was caused by a rush to reopen without proper safety measures in place, infectious-disease experts say, and the push to do so, even as cases climb, sends a dangerous and inaccurate message."
• The University of Kentucky is adding extract from the medicinal plant Artemisia annua, also known as sweet wormwood, to its innovative clinical trial of covid-19 therapies to test its effectiveness against the coronavirus, following studies in Germany that showed it to be effective, the university reports. The trial will also test artesunate, "a derivative of the plant that is a standard treatment for malaria in many parts of the world," UK's Elizabeth Chapin writes.
  
• UK President Eli Capilouto has made a public service announcement to encourage everyone to follow the suggested guidelines to decrease the spread of the coronavirus, with a focus on why it is important to wear masks. 
• A federal judge ruled that Beshear went “too far” in limiting in-person protests at the Capitol during the pandemic, Jack Brammer reports for the Lexington Herald-Leader. District Judge Greg Van Tatenhove said Wednesday that Beshear must amend his mass-gatherings order to allow for in-person protests. Despite the order, several large gatherings have been held outside the Capitol in recent months, at least one of which Beshear attended himself, Brammer notes.
• The annual political speaking will not be held at the Aug. 1 Fancy Farm Picnic in far Western Kentucky due to the pandemic. The priest at St. Jerome Catholic Church overruled the picnic committee, which had announced the event would be held with a limited audience in a school gym, the Mayfield Messenger and the Herald-Leader report.
• An updated model by the University of Washington's Institute for Health Metrics and Evaluation released Wednesday projects that 33,000 American lives would be saved between now and Oct. 1 by near-universal wearing of masks.
• Eleven Kentucky hospitals received $151.8 million to respond to the coronavirus pandemic "because of their focus on providing medical care to all patients regardless of ability to pay," Senate Majority Leader Mitch McConnell said. They are UofL Health (Jewish Hospital and Shelbyville Hospital), St. Claire HealthCare in Morehead, Pikeville Medical Center, CHI St. Joseph (Mount Sterling and London), Methodist Health in Henderson, St. Elizabeth Healthcare in Northern Kentucky, Hardin Memorial Health in Elizabethtown, Murray-Calloway County Hospital and Baptist Health Richmond.
• West Virginia Gov. Jim Justice forced out his top public-health official "hours after he publicly questioned the accuracy of the state’s coronavirus data and detailed growing outbreaks in about a dozen counties" and "vented during a news conference," The Associated Press reports. Dr. Cathy Slemp "was a regular feature of the governor’s daily virus news conferences, at which he "showered Slemp with praise." West Virginia's estimated virus transmission rate has been rising slowly and was at 1.06 Thursday morning, meaning that every 100 infected people in the state would infect 106 others, and so on. Kentucky's was 0.99.

With less than half the year gone, Kentucky has already had more drownings than it had all last year; top cause of death, ages 1-4

Photo from The Indianapolis Star 

With public swimming pools closed due to the pandemic, and some families having more free time from work, the number of drownings in Kentucky this year, 33, has already surpassed the number for all of last year, 32, according to the state Department of Fish and Wildlife Resources.

The causes aren't clear, but "With pools now scheduled to open at the end of June, parents and guardians need to keep an eye on their children to ensure their safety in any body of water," Norton Healthcare says in a news release, citing the state figures.

The fish-and-wildlife agency says there have been 14 drownings in lakes, reservoirs and streams in Kentucky since May 23, the start of the Memorial Day weekend.

“It’s concerning that we’ve seen a rise in drownings even before many pools are open,” said Brit L. Anderson, pediatric emergency medicine physician at Norton Children’s Hospital in Louisville. “While many people are aware of the risks of swimming pools, it’s important to remember that other bodies of water can be dangerous, including ponds, rivers, drainage ditches and even bathtubs or backyard wading pools.” 

Drowning is top cause of accidental death in children ages 1 to 4 in the U.S., according to SafeKids.org. Two-thirds of toddlers' drownings occur from May to August, so the summer is the time to safeguard children, the Norton release says. And the safeguarding need to be vigilant; the National Drowning Prevention Alliance says nearly 90 percent of child drownings happen when at least one adult is present.

“Children require constant, attentive supervision when they are in water,” Anderson said. “If there are multiple adults, they need to communicate to make sure someone is watching the water without distraction. Drowning is often silent and can happen quickly.”

Here are safe swimming reminders from Norton:

• Don’t swim alone, especially children. Use the buddy system so there’s always someone looking out for you and loved ones.
• At least one adult should supervise children around water at all times. Don’t let yourself get distracted by talking with friends, reading, drinking alcohol or using your phone when it’s your turn to supervise. Adult supervisors should be trained in CPR.
• If you own a pool, make sure it has a fence completely surrounding it, separating it from the house.
• Teach children lifesaving skills, such as how to float on their back, tread water and move to the side of the pool to climb out.
• Don’t rely on inflatable toys and water wings to keep a child safe. Children can easily fall off of toys or slide out of wings and slip under the water. If the child is using inflatables, you should be right there with a child, especially if he or she cannot swim.
• Kentucky law requires each occupant of a boat to have ready access to a U.S. Coast Guard-approved life jacket. Children younger than 12 must wear a life jacket while in the open portion of a boat that is underway.
• Most boating accidents, particularly among teens, are related to alcohol. Be sure teens know about the dangers of alcohol, on and off the water.

Child-care reopenings set; tentative date announced for larger gatherings and bars; Beshear says 'We may be in true reduction'

Kentucky Health News chart shows two-week trendline slightly down, more than Wednesday.

By Al Cross
Kentucky Health News

Small child-care centers in Kentucky will be allowed to reopen June 8, and larger ones with limited capacities June 15, removing much of a major obstacle to getting unemployed Kentuckians back to work in the covid-19 pandemic.

Gov. Andy Beshear announced several other openings at his Thursday briefing, including a tentative date of June 29 for bars and gatherings of 50 or fewer. Gatherings of 10 or fewer will be allowed starting Friday.

Beshear announced 135 new cases of the coronavirus, tipping further down the two-week trendline that is a key federal metric for reopening state economies. "We may be more than just plateaued," he said. "We may be in true reduction."

Cabinet for Health and Family Services Secretary Eric Friedlander said the child-care move made Thursday "a day of really good news for many people. . . . Child care is one of the areas that we know is critical to opening the economy."

Beshear has allowed people who are receiving unemployment benefits to keep getting them and not return to their jobs if they cannot find child care. He acknowledged that the limits on larger facilities will limit their capacity, but said that until a coronavirus vaccine is developed "our world . . . has to be based on reduced contacts."

The child-care centers allowed to open June 8 are those in homes, serving 10 or fewer children, "more in a family style atmosphere," Friedlander said.

The larger providers opening June 15 will have limited capacity because they must have 10 or fewer children in a room, and those groups must stay together all day, along with staff members. The groups must have staggered play times, and the centers must do temperature and wellness checks on everyone, and have centralized pickup and drop-off points with social distancing.

Friedlander said family events will not be allowed "for now," and there will be no field trips. Adults at the centers will be required to wear masks, and children under 5 will not be required to do so. "It’s a judgment call, [based] on a child’s developmental ability," he said. The state's guidelines say centers "may recommend to the parents of children over 5 that their child wear a mask, and provide information about the benefits of masking."

The state has continued to pay child-care providers, almost $62 million in the last two months, based on previous payments, to keep them in business, Friedlander said: "We can't afford to lose them."

Friedlander also announced additional food benefits for children who will no longer get meals at school this summer, using $163 million in federal relief funds. He said $313.50 per month will go to families on the Supplemental Nutrition Assistance Program (once called food stamps), Temporary Assistance to Needy Families and Medicaid.

He urged people who qualify for the programs, but are not enrolled in them, to apply beginning June 23 at benefind.ky.gov or at 855-306-8959. "Don’t feel like this is selfish, or something you shouldn’t do," he said, noting that the money will help grocers, farmers and "the rest of the food system."

Other openings: Beshear announced that auctions will be allowed starting June 1, and horse shows on June 8. On June 29, he plans to allow opening of bars, with social distancing, and gatherings of 50 or fewer people. But he said that isn't certain.

"It all depends on how good we do at being healthy at work," his catchphrase for the current phase of reopenings. He said he made the announcement because "We want to give those people dates to see and work toward. It relieves a lot of anxiety." He said his top priority is to "make healthy-at-work successful; my number-two goal is to get kids back in school this fall."

Health Commissioner Steven Stack, who said last week that he was worried that Kentuckians don't appreciate the danger posed by the virus, again alluded to the possibility that reopenings will be delayed or scaled back if cases start going up: "If we take our eye off the ball, we’re gonna find we have the problem in June and July that we have avoided."

Beshear said gatherings of up to 50 will facilitate weddings, which should still keep "groups of family units" together and practice social distancing. "The six feet’s gonna be really important," he said. "It's gonna require some creativity." He said the five weeks between now and then will allow Kentucky to learn best practices from other states.

Beshear said the 50-or-fewer rule could also provide "an opportunity to do something" with swimming pools. He said he hasn't allowed them to open because of the likelihood that social-distancing rules would be violated "outside the pool."

He said June 29 might also provide an opportunity to reopen indoor recreation facilities, which are "taking us a little longer" to figure out, due to capacity questions, differences among facilities, and the number of things that can be touched.

Asked about reopening gyms, he indicated that will take longer. "We can't go back right now to everything the way we used to do it," he said. Then he complimented retailers "for being really thoughtful" with their reopenings this week and said he thought restaurants would do likewise when they are allowed to open at one-third capacity plus outside seating on Friday.

And what about more personal activities, such as hug between friends this weekend? "We’re realistic," he said. "We know that people have missed each other . . . Limit your contact as much as you can."

In other covid-19 news Thursday:

• The new-case number of 135, which brought the adjusted total to 8,286, was "one of the smallest in a while," Beshear said. He reported 122 new cases on Sunday, but Sundays and Mondays tend to be low due to limited lab activity on weekends; aside from that, Thursday's number was the lowest since the 105 reported on Monday, May 11.
• Counties with more than five new cases were Jefferson, 23; Kenton, 18; Warren, 15; Boone and Grayson, nine each; and Fayette and Logan, seven each.
• Beshear reported 10 more deaths, bringing the three-day total to 40 and the overall total to 386. Death numbers have gone up lately as new-case numbers have trended down; Stack said the average length of a fatal case of covid-19, from onset of symptoms to death, is 13 days.
• The new fatalities were two Warren County women, both 56; an Adair County woman, 73; a Grayson County man, 62; a Jackson County woman, 93; a Jefferson County woman, 69; a Jefferson County man, 78; an Oldham County man, 81; and Oldham County woman, 86; and a Simpson County man, 72.
• Six of the deaths were in long-term-care facilities, bringing their death toll to 207, including two staff members. State testing found cases in 39 more residents and 27 more employees, for respective totals of 1061 and 488. "All across the country we’re finding out there’s a lot of asymptomatic staff members," who can spread the virus without knowing it, Beshear said.
• Asked if his administration had done enough, early enough, for nursing homes, which account for most covid-19 deaths, Beshear said "I believe we did everything in our power with the resources we had. We did done of the first visitor bans in the country," and other steps. He said there are things he would have done differently, having learned from experience, but said he had made "made the very best decisions based on the data in front of us and what we’ve known at the time."
• The governor said he plans to issue guidance for youth sports Friday, so organizers and parents will have time to plan for the June 15 opening.
• Asked if hospitals are falsely identifying patients as covid-19 so they can get more money from Medicare and Medicaid, Stack said "I have no sense that's occurring" and Friedlander said he was "very confident" that it is not, partly because such records are subject to federal audits.
• Beshear, asked about Senate Majority Leader Mitch McConnell's opposition to continuing extra unemployment benefits, which some conservatives think discourage returns to work, Beshear said "I think we’re gonna have plenty of people ready to go back to work. What I want to make sure is that people who need help are getting help. … I am not for cutting the benefits at this time."

Algal bloom warning issued for Ohio River above Louisville

The state Division of Water and Department for Public Health are warning people not to swim, wade or ski in the Ohio River from the McAlpine Dam at Louisville upstream to the Greenup Dam because several sections of the river have toxic algal blooms.

"Water ingested during recreational activities in this area may increase the risk of gastrointestinal symptoms such as stomach pain, nausea, vomiting and diarrhea," the warning says. "Skin, eye, and throat irritation and/or breathing difficulties, skin rashes, as well as numbness or tingling of limbs may also occur after contact."

The state said toxins in the Cincinnati area "were well above the advisory threshold. Toxin-producing blooms that exceeded the advisory threshold were also identified on the Ohio River near Dover, and near Towhead Island in Louisville -- and additionally at Briggs Lake in Logan County," which was also included in the warning.

"Bloom conditions can change rapidly," the state advises, giving tips to avoid exposure to harmful algal blooms (HABs):
• Avoid direct contact, including swimming, wading, paddling, diving, and water skiing, with affected water that has a visible bloom, unusual color, or algal scum.
• People who are prone to respiratory allergies or asthma should avoid areas with HABs. Children may be particularly at risk.
• If contact has been made with water containing blue-green algae, wash off with fresh water. In some cases, skin irritation will appear after prolonged exposure. If symptoms persist, consult your health care provider.
• If fishing in affected waters, fish fillets (not internal organs) may be consumed after the fillets have been rinsed in clean, potable water.
• Prevent pets and livestock from coming into contact with water where HABs are apparent.

If you are concerned that you have symptoms that are a result of exposure to HABs, please see your doctor and call your local health department. For additional information about harmful algal blooms in Kentucky, visit the Division of Water’s HAB webage.

"Blue-green algae occur naturally in the environment and are a vital part of the ecosystem," the state says. "Harmful algal blooms arise when there are excess nutrients (phosphorus and nitrogen), sunny conditions, warm temperatures, and low-flow or low-water conditions. The more typical green algae, which do not produce toxins, come in many forms.

"Harmful algal blooms, on the other hand, appear as slicks of opaque, bright-green paint, but closer inspection often reveals the grainy, sawdust-like appearance of individual colonies. The color of the algae may also appear red or brown."

Swimmer's ear can be very painful; here are tips to prevent it

photo: CDC

One of the best parts of summer is swimming, but it can cause a condition called swimmer's ear that can be extremely painful.

Acute otitis externa, or swimmer's ear, happens when water stays in the ear too long, which creates a perfect environment for bacteria to grow.

"Swimming is a significant risk factor, especially in fresh water," Kara Jones-Schubart, a clinical assistant professor at the Texas A&M College of Nursing, told HealthDay News. "For most people, swimmer's ear is a one-time occurrence, but for others, it can take a more chronic form."

Symptoms of swimmer's usually begin with itching in the outer ear, but this can progress to redness in the outer ear along with some warmness and pain and pain when the infected ear is tugged on or moved.

Treatment for the condition varies depending on the severity of the case, but often includes antibiotic ear drops.

The Centers for Disease Control and Prevention offers these prevention tips for swimmer's ear: wear earplugs, custom fit ear-molds or a swim cap while swimming; use a towel to dry your ears after swimming; tilt and shake your head to drain water from your ears after swimming; and to use a hair dryer on a very low setting while holding it at least a foot away from the affected ear to dry it out after swimming.

The Mayo Clinic suggests an at-home preventive treatment for swimmer's ear "if you know you don't have a punctured eardrum." A solution of one part white vinegar to one part rubbing alcohol is poured by one-teaspoon amounts into each ear and then allowed to drain out. This will help prevent the growth of bacteria and fungi that can cause swimmer's ear, Mayo says. Similar over-the-counter products are available.

More cautiously, the CDC says it is important to consult a health-care provider before using any kind of ear drops for swimmer's ear. Like Mayo, it cautions that ear drops should not be used by people with damaged ear drums, but also adds that people with ear tubes, outer ear infections, and ear drainage should not use ear drops.

In addition, the CDC points out that it's important to not place any object in the ear canal, like cotton swabs or cotton balls, as they can push material deeper into the ear canal. It also suggest that you should also ask the pool operator if the disinfectant and pH levels are checked at least twice per day, noting that properly disinfected pools with correct pH levels are less likely to spread germs.

Swimmer's ear is not the same as the common childhood ear infection, otitis media,which is an infection of the middle ear. The CDC says that if you can wiggle the outer ear without pain, it is probably not swimmer's ear.

Electric-shock drowning happens most often around marinas and docks; here are tips on how to avoid it

A sign warns boaters and swimmers at the
marina at Lake Barkley State Resort Park.

By Melissa Patrick
Kentucky Health News

Electric shock in water can't be seen or heard, but it can be deadly.

Electric-shock drowning occurs when electricity from faulty wiring, equipment or damaged cords on a boat or dock seeps into water where people are swimming. The electricity can paralyze muscles, causing drowning, and in some cases is strong enough to electrocute, says a Kentucky State Parks news release.

The Electric Shock Drowning Prevention Association notes that while shock drowning can happen anywhere electricity is provided near water, most deaths occur near marinas and docks. Shock drowning is called a "silent killer" because there are no visible warning signs to indicate when water has electricity.

The association was created by Kevin Ritz, whose son Lucas was electrocuted while swimming near a dock in 1999.

Electric Shock Drowning Prevention Association

The association explains that water may be safe when a swimmer enters the water, but electricity on a dock or boat can trigger an electric fault, causing the swimmer to become paralyzed and drown. And unless a witness is nearby to experience and report the sensation of electric shock in the water, the death is usually judged to be a common drowning.

More than 3,000 people drown each year from non-boating related drownings, according to the federal Centers for Disease Control and Prevention. It is unclear how many of those drownings are caused by electric shock.

Here are tips to prevent electric-shock drowning:

• Never swim around marinas, boats or docks that use AC electrical power for any purpose;
• Make sure all electrical devices on your boat are working properly, have problems repaired immediately. To locate a certified electrical inspector near you, see https://ky.joportal.com/License/Search;
• Have your boat and dock inspected annually by an electrician with a current American Boat and Yacht Council electrical certification;
• If you suspect an electric shock drowning is taking place, turn off the power, throw a life ring to the victim and call 911. Do not jump in the water! You could become a victim;
• Make sure there is a ground fault circuit interrupter at the dock;
• Know where the power cutoff is and make sure those not in the water also know where it is;
• Plastic or wooden ladders are preferable to metal or aluminum ones;
• Turn off the power to your dock when you are swimming;
• Wear a life jacket.

The ESDPA adds that it's important to share the dangers of electric shock drowning with marina operators and others, because most people have never heard of it.

Tips were gathered from a variety of sources including: the Kentucky State Parks, ESDPA , the U.S. Cost Guard Auxiliary and a University of Alabama news release.

With swim season upon us, here are water-safety tips; drowning is the top cause of accidental death among young children

Photo: cdc.gov

Summer fun often includes heading to the swimming pool or lake, but it's important to remember that all water activities come with a risk of drowning.

The federal Centers for Disease Control and Prevention reports that every day, about 10 people die from unintentional drowning. Of these, two are children under 15 and most are between 1 and 4.

That doesn't mean you shouldn't enjoy the water, it just means you need to take some safety precautions and stay vigilant, experts advise.

The American Academy of Pediatrics recommends swimming lessons for most children 4 and older because that is when they are developmentally ready to learn to swim. The academy once advised against swimming lessons before age 4, but has has relaxed that recommendation.

Why learn to swim? “Most children are around water in some form, whether it’s a pool, a river, a pond, a lake or the ocean, so learning to swim isn’t just for fun. It’s also important for safety,” says K.J. Hales, author of a book about children and swimming. “For some children, the idea of getting in the water and trying to swim can be a bit frightening,” Hales says. “But with the proper positive reinforcement, they can overcome their fears and discover just how much fun swimming can be.” 

The pediatricians' academy cautions that "swimming lessons will not provide 'drown-proofing' for children of any age" and notes that swimming lessons are just one part of a preventive strategy to keep children safe in or near the water.

The academy offers several water- and pool-safety tips for parents and caregivers, including:

• Never leave children alone or in or near the water, even for a moment. This includes bathtubs, pools, spas,wading pools, or near irrigation ditches or standing water.
• Less experienced swimmers and children under 5 should have an adult, preferably one who knows how to swim and perform CPR, within arm's reach of the child.
• Don't leave a child in or near the water under the care of another young child.
• Never swim alone. Always swim with a buddy, even at a public pool or a lifeguarded beach.
• Designate a "water watcher" when swimming.
• Because drowning can be quick and quiet, the water watcher should pay constant attention and be undistracted while supervising children, even if lifeguards are present.

Pool safety tips:

• If a child is missing, look for him or her in the pool or spa first.
• Install a fence at least 4 feet high around all four sides of the pool.
• Make sure pool gates open out from the pool, and self-close and self-latch at a height children can't reach. Consider alarms on the gate, or underwater alarms as an added layer of protection.
• If the house serves as the fourth side of the pool fence, install an alarm on the exit door to the yard and pool. As an added protection, install window guards on windows facing the pool.
• Remember, some drowning victims have used pet doors to gain access to the pool.
• Keep rescue equipment, a shepherd's hook, a life preserver, a first aid kit and a portable telephone, near the pool. Choose rescue equipment made of fiberglass or other materials that do not conduct electricity.
• "Floaties" and other inflatable swimming aids are not substitutes for approved life jackets and often offer parents a false sense of security.
• Do not use a pool or spa if there are missing drain covers, since drains cause suction that can trap a swimmer under water. Replace old drains with anti-entrapment drain covers or other similar systems.
• Large, inflatable above-ground pools can be dangerous and need to be surrounded by an appropriate fence. Also, remove access ladders and any structures that provide easy access to the pool when not in use. Children have also fallen in these pools simply by leaning on them.
• Share safety instructions with family, friends and neighbors.

CDC finds health problems are common at public pools; state requires local health departments to inspect each one twice a year

By Melissa Patrick
Kentucky Health News

Thousands of public pools, hot tubs and water playgrounds are forced to close every year for serious health and safety violations, according to a new study by the federal Centers for Disease Control and Prevention.

Kentucky requires local health departments to conduct two full inspections of each public swimming pool during the operating season, once every six months for its continuous-operation indoor facilities, and monthly water chemistry inspections, according to the state Department for Public Health.

"The local health department environmentalists are the ones who do these inspections and monitors, so the records for these inspections are kept with each local health department, Beth Fisher, spokesperson for the Cabinet for Health and Family Services, said in an e-mail.

But you might want to do your own inspection if you go on vacation out of state, because that's not the case everywhere.

"Almost one third of local health departments do not regulate, inspect, or license public pools, hot tubs, and water playgrounds,” Michele Hlavsa, chief of the CDC's Healthy Swimming Program, said in a news release. “We should all check for inspection results online or on site before using public pools, hot tubs, or water playgrounds and do our own inspection before getting into the water.”

And even if states are checking their pools, that doesn't mean they are always safe.

A 2013 CDC study of inspection data from the five large states containing 40 percent of the nation's public aquatic venues found that almost 80 percent of them had at least one violation. It found that one in eight inspections resulted in immediate closure because of serious health and safety violations and that one in five kiddie or wading pools were closed due to violations. Most of the violations were related to improper pH (15 percent), lack of proper safety equipment (13 percent) and inadequate disinfectant levels (12 percent).

"Young children who are still learning their toileting skills are more likely to contaminate the water. They're more likely to swallow the water. Both of which can lead to outbreaks of diarrheal illness," Michael Beach, the CDC's associate director for healthy water, told Dennis Thompson at HealthDay News. He said pH levels are "critical because it determines how effective the disinfectant is killing germs."

The CDC recommends that parents change their infants' diapers often and in the bathroom, not poolside, to take children to the bathroom every hour, and to teach children to spit out any pool water they get in their mouth.

Beach said most contamination of public pools and hot tubs are the result of people swimming while suffering from diarrhea. He said adults should not swim while recovering from diarrhea, and if they do, should shower before getting in the water.

The CDC recommends individuals do a self-inspection of all public pools before getting in them and offers this checklist that identifies some of the most common swimming pool health and safety problems:

• Use a test strip (available at most superstores or pool-supply stores) to determine if the pH and free chlorine or bromine concentration are correct.
• Make sure the drain at the bottom of the deep end is visible.
• Check that drain covers appear to be secured and in good repair.
• Confirm that a lifeguard is on duty at public venues. If not, check whether safety equipment like a rescue ring with rope or pole is available.

If you find problems, do not get into the water and tell the person in charge so the problems can be fixed, says the release.

Help prevent leading cause of child death: unintentional injury

Every day 2,000 children die from preventable injuries, making unintentional injuries the leading cause of death for children in the United States. More of these injuries occur during the summer than any other season.

"Kids are outside more, out of school and less supervised," said Greg Ozark, associate professor of pediatrics and internal medicine at Loyola University Chicago Stritch School of Medicine. "This leads to an increased risk of injuries, from drowning to head injuries to skin infections from bug bites and poison ivy.

Serious injuries and death can happen in an instant; most drownings occur when a parent hasn't been watching a child for only five minutes.

Ozark said the best method for injury prevention is adult supervision including not only watching the kids, but setting safety rules and leading by example. "Your children are watching you," Ozark said. "They are more likely to do what they see you doing than to do what they hear you saying."

Water safety:
1. An adult should be supervising children spending time around any source of water including pools and lakes; infants and toddlers should be supervised while they are in the bathtub.
2. Children 5 and older should take swim lessons.
3. Young children should always be in arm's reach of an adult.
4. Home pools have to have a four-foot fence surrounding them including a self-locking gate.
5. People of all ages should wear lifejackets while boating, and children should wear lifejackets even on docks and piers.

Wheeled activities like bike riding:
1. Each child needs to wear a helmet approved by the American National Standards Institute. The helmet should fit snugly, sit over the forehead and cover the back of the head. Helmets should be replaced if they get dented or cracked.
2. Children should wear knee and elbow pads and wrist guards while skateboarding.
3. Tell children to be particularly careful around driveways, and children younger than 10 should not be permitted to ride in the street.
4. Always be aware of wear your children are going and do not let them go too far from home.

Playground:
1. Supervise your children while they play on the playground.
2. Playground surfaces should be filled with wood chips or sand, not grass or cement.
3. Report broken equipment immediately, and don't let your children play on it.
4. Home swing sets can pose a strangulation hazard, so check them carefully before children use them.
5. Playground equipment should not be higher than six feet off the ground.

"Be wary, supervise and think about what are potential consequences that could occur by your child's activity," Ozark said. "Whether they are toddlers or teens, there is no age that doesn't need to be supervised."

Summer and water recreation offer fun and risk at the same time; prevention is the key to decrease the risk

One of the best parts of summer is splashing in a pool, playing in the back yard sprinkler or swimming in a lake or stream, but recreational water activity always comes with a risk of drowning.

It's important not to lose sight of this risk as you strive to keep your children and adolescents safe, writes Susan Pollack, director of the Pediatric and Adolescent Injury Prevention Program at the Kentucky Injury Prevention and Research Center at the University of Kentucky.

"Every year in Kentucky, an average of 14 children die by drowning. About half the drowning deaths occur among children ages 1 to 4," Pollack writes in the Lexington Herald-Leader. "From 2009-11, 80 percent of childhood drowning deaths occurred at the child’s residence or someone else’s home. A quarter of drowning deaths occurred among adolescents, mostly while swimming, boating or fishing on lakes and rivers."

Prevention requires constant supervision of toddlers and children around all types of water. This not only includes the obvious such as pools, swift-flowing creeks and large bodies of water, but also bath-tubs, car-washing buckets and ornamental ponds, Pollack says. Toddlers can fall in and drown even in just a few inches of standing water in a bucket. It is also important to empty baby pools immediately after use.

Drowning can happen "swiftly and silently," Pollack writes. This requires a responsible adult to supervise children at all times, even if lifeguards are present. And if a child can't swim, this adult should be within arms-reach. Supervision is needed even if the child is wearing an appropriately sized Coast Guard-approved life vest. Floaties and water-wings are not sufficient life-saving devices.

It is also important to create barriers to water sources. This can be accomplished by putting a four-sided, 4-foot-high fence with a self-closing gate around backyard pools or removing the ladder from above-ground pools that are not fenced.

While teaching children to swim does not replace supervision, it is an important life-saving skill children should learn, Pollack writes. The YMCA, Red Cross and university swim programs all offer lessons.

Adolescents should be reminded to never swim without a buddy and that alcohol and boating never mix, Pollack says. They should also be reminded of the dangers of swimming while fatigued and the importance of wearing a U.S. Coast Guard-approved life jacket when boating. (Read more)

Donor who helped Monroe schools take over, expand wellness center pledges more for improvements, upkeep, scholarships

The Monroe County Schools are getting a $1 million-plus donation for a family wellness center and scholarships for graduates of the county's only high school from businessman George Eagle Bushong of Bradenton, Fla., who grew up in a prominent Monroe County family.

George Bushong and daughter Isabelle

School Supt. Lewis Darrell Carter told Shelley Smith of the Glasgow Daily Times that Bushong had mentioned his intent to donate $50,000 a year for 10 years for the  Monroe County Family Wellness Center, and surprised him two weeks ago by adding an extra $55,000 for the next decade for various scholarships.

The schools took ownership in November 2011 of the center, "which was built on property owned by the school district," Smith reports. "Since then, Carter said the wellness center membership has gone up from 340 members to 1,200." The annual donations will pay for an indoor digital golf machine, a swimming scoreboard and maintenance of the George and Isabelle Bushong Foundation Aquatic Center, which Bushing helped build to hold swim meets and was named for his daughter.

Asst. Supt. Amy Thompson told Smith the wellness center is heavily used by student athletes for training, physical education classes and afterschool fitness classes. “It gives the kids something to do to include fitness in their lives,” she said. " Carter said he’s even seen families meet at the wellness center to work out together," Smith reports. "He said the funding to help support this facility will be great service to community. . . . To pay homage to Bushong’s generous donations, Carter said they will change the name of the wellness center to the George and Isabelle Bushong Foundation Monroe County Family Wellness Center."