Traveling with diabetes? Here are 10 tips for a safe, pleasant trip

By Tami Ross
University of Kentucky

Diabetes requires regular self-management and treatment, even on vacation. That’s why it is important to plan ahead to ensure that your next great adventure does not suspend your diabetes management.

Photo by Julia Amarai, iStock/ Getty Images Plus

Check in with your diabetes care provider: When in doubt, schedule an appointment with your diabetes care provider to discuss how your diabetes management may change while you are traveling. Your provider can let you know if your travels require any immunizations.

Ask your doctor for a letter detailing your diagnosis, how your diabetes is treated and what medication and equipment is required.

Notify the TSA agents about your medical devices: When flying, it is important to let TSA agents know beforehand that you have medical devices in your bag or on your person. This will help prevent any unnecessary hiccups, keep any diabetes devices safe, and speed you through security. It may be beneficial to bring a letter from your doctor stating your diagnosis and what supplies you are traveling with.

Take a TSA medical condition notification card: You may want to bring a TSA notification card to discreetly notify the agents of your diabetes. These cards should be printed and filled out ahead of time. This may be helpful if you have a child who is self-conscious about their diagnosis and does not want the extra attention that comes with notifying the agents.

Request a pat-down screening process: You can request a pat-down screening as an alternative to the airport full-body scanner. Some diabetes devices may be damaged by X-ray baggage machines or full-body scanners, so make sure to follow the device manufacturer’s recommendations.

Know that the 3.4 oz. rule doesn’t apply: Insulin and other liquid medications like glucagon are permitted through airport security even if they are greater than 3.4 ounces. You may travel with a juice box over 3.4 ounces to treat any potential low blood glucose, but it will receive additional screening. Lancets and syringes are also allowed through security but should be accompanied by insulin.

Keep medicines with you: Do not store insulin or other diabetes injectables in checked luggage or the trunk of the car. It could be affected by pressure and temperature changes. Keep any medication or blood testing supplies that you might need with you.

Make sure to have a pharmaceutical label for all your medication to show that it was prescribed by a physician when going through airport security. Try to pack twice as much medicine and diabetes supplies as you think you’ll need to be prepared for any travel delays or unforeseen circumstances.

Take frequent breaks: Since people with diabetes are at a higher risk of developing blood clots, which can lead to heart attack or stroke, try to take frequent breaks to stand up and walk around to help keep blood flowing.

Protect supplies from the sun: Make sure to keep your diabetes supplies out of the sun, and do not leave them in a hot or cold car. If you take insulin, keep it in a cooler, but avoid placing insulin directly on ice as it may get too cold or freeze, damaging it.

Bring healthy snacks: Travel with portable, ready-to-eat snacks in case of meal delays or food unavailability.

Dress comfortably: Wear comfortable clothing and supportive well-fitting shoes with plenty of cushioning. Make sure to never walk bare foot, even on the beach. While traveling, check your feet for swelling and blisters regularly.

Tami Ross is a nationally recognized registered dietitian and certified diabetes care and education specialist and a diabetes education services coordinator with UK's Barnstable Brown Diabetes Center.

Coronavirus cases and positive-test rate in Kentucky are rising, but deaths and hospital numbers are declining more

Kentucky Health News chart from state data

By Melissa Patrick
Kentucky Health News

Daily cases and the share of Kentuckians testing positive for the coronavirus are rising again, apparently reflecting a national trend.

The state's report for the last Monday-Sunday period showed 3,257 new cases of the virus, an average of 465 per day, up 4.5% from 445 a day the week before.  

The New York Times reports that cases are rising again in the U.S., going up 39% in the last two weeks. It notes that case numbers are likely higher than reported, because of the prevalence of home Covid-19 tests.

Kentucky Health News graph, from state data

The percentage of Kentuckians testing positive for the virus in the past seven days is 3.12%, up from 2.27%. 

The Times ranks Kentucky's infection rate 20th among the states and Washington, D.C. Of the week's new cases in Kentucky, 25% were in people 18 and younger. 

Kentucky's seven-day infection rate also showed an uptick, to to 5.63 cases per 100,000 residents from 4.09 the week before. Counties with rates more than double the latest statewide rate are Franklin, 23.5; Campbell, 11.9; and Jefferson, 11.6. Twenty of the 120 counties reported no cases last week.

While leading indicators showed more risk of infection, deaths related to Covid-19 dropped 43 percent and hospital numbers continued to decline. 

The state attributed 97 more deaths to Covid-19, an average of just under 13.9 per day. That's down from 24.6 per day the week before and 19.3 per day the week before that. All told, the state has attributed 15,297 deaths to the pandemic. 

Kentucky hospitals reported 176 patients with Covid-19, with 20 of them in intensive care and only nine on mechanical ventilation. All of these numbers are lower than last week's Monday report; hospitalizations were down 11%; intensive-care cases were down 31%.

Very few intensive-care beds in Kentucky are being used for Covid-19 patients, but six of the state's 10 hospital regions are using at least 80% of their intensive care beds. Statewide, 78.7% of the beds are in use. 

Kentuckians who are not vaccinated or boosted are still encouraged to do so. The Washington Post reports that an average of 4,753 Covid-19 vaccine doses per day were given in Kentucky last week, a 6% increase over the week before.

The numbers include second doses and booster shots. They have been increasing since late March, when a second booster shot was authorized for people 65 and older and other more vulnerable populations. But the rate of increase in Kentucky since then has not been as fast as nationwide. 

So far, 65% of the state's total population has received at least one dose of a vaccine; 57% of the total population is fully vaccinated; and 44% of those eligible have been boosted. The Post adds that nearly 61% of the state's eligible population, those 5 and older, have been fully vaccinated. 

"Let's keep going," Gov. Andy Beshear said at last week's press conference. "It's not enough." 

Travel masks out: On Monday, a federal judge in Florida struck down the federal mask mandate on airplanes and other modes of public transportation, saying it exceeds the statutory authority of the Centers for Disease Control and Prevention and violates administrative law. 

Last week, the CDC extended the public transportation mask mandate through May 3. The Biden administration has not decided on an appeal.

"White House spokesperson Jen Psaki said Monday afternoon that it was a 'disappointing' decision, and that the Department of Homeland Security and the CDC were reviewing the ruling" and that "the Justice Department will make any determinations about a legal response," CNN reports.

Under new masking guidance, CDC says people in all but 18 Kentucky counties should still wear masks in indoor public spaces

Centers for Disease Control map, adapted by Kentucky Health News; to enlarge, click on it.

By Al Cross

Kentucky Health News

The federal Centers for Disease Control and Prevention has relaxed its guidance for wearing masks to thwart the pandemic, but says infections and hospitalizations in most of Kentucky are so high that people in all but 18 of the state's 120 counties should continue to wear masks in indoor public spaces.

The new CDC system ranks the risk to each county as high, medium or low, based on new coronavirus infections, new Covid-19 hospital admissions, and the share of staffed hospital beds occupied by patients with the disease. That puts 104 Kentucky counties at high risk, invoking the masking guidance.

In the 18 counties ranked at medium risk, the CDC says residents who are immunocompromised or at high risk for severe illness should talk to a health-care provider about "additional precautions, such as wearing masks or respirators indoors in public. If you live with or have social contact with someone at high risk for severe illness, consider testing yourself for infection before you get together and wearing a mask when indoors with them."

The 18 Kentucky counties with medium risk are Fulton, Calloway, Todd, McLean, Warren, Green, Taylor, Adair, Russell, Cumberland, Clinton, Trimble, Gallatin, Owen, Pendleton, Bracken, Mason and Fleming.

No Kentucky counties are in the low-risk category. In such counties, the CDC advises, "Wear a mask based on your personal preference, informed by your personal level of risk."

The CDC also advises, "You may choose to wear a mask or respirator that offers greater protection in certain situations, such as when you are with people at higher risk for severe illness, or if you are at higher risk for severe illness. It is important to wear a mask or respirator when you are sick or caring for someone who is sick with Covid-19. When caring for someone who is sick with Covid-19, a respirator will provide you the best level of protection."

People more likely to become very sick with Covid-19 are those who are older or have certain medical conditions, or who are pregnant and have recently been pregnant. It says people at increased risk, and those who live with or visit them, should talk to a health-care provider about whether they and the people around them should wear a mask or respirator when the Covid-19 community level is medium. Wear a mask or respirator that provides them with greater protection when the Covid-19 community level is high."

For the CDC's complete guidance, including recommendations for children, travelers and disabled people, click here.

The CDC's recommendations are only that, but it has maintained its order that travelers wear masks while using public transportation and indoor transportation hubs. U.S. Sen. Rand Paul of Kentucky said Friday that he would force a vote in the Senate on his resolution to repeal that requirement.

As first U.S. Omicron case is found, Beshear says Delta remains 'deadly and highly contagious' in Ky.; over 3,000 new cases today

Ky. Health News chart (click to enlarge); case numbers are from initial, unadjusted daily reports. 

By Melissa Patrick
Kentucky Health News

Kentucky saw another day of increasing coronavirus cases, a positive-test rate that is accelerating, and a daily infection rate that is higher than it was before Thanksgiving, all on the day that the first case of the Omicron virus variant has been identified in the United States. 

"I know that we're all nervous waiting for more information on the on the Omicron variant," Gov. Andy Beshear said in a Facebook post. "But today I want to talk about how concerned we ought to be about our escalating number of cases here in the Commonwealth of the Delta variant, which is proved to be deadly and highly contagious. Today, for the first time in over two months, we have over 3,000 new cases. This is not the direction we want to go."

Kentucky reported 3,312 new cases Wednesday, the most in one day since Oct. 1, when the seven-day rolling average was 3,076. Today's average is 1,636. Of today's new cases, 25.5% are in people 18 and younger. 

Beshear encouraged Kentuckians to get vaccinated or to get a booster "as quickly as possible" and to wear a mask when indoors and away from home. 

Kentucky Health News graph; click it to enlarge.

The percentage of Kentuckians testing positive for the virus went up again, at a steeper rate, to 8.56%. 

Kentucky hospitals reported 948 Covid-19 patients, 18 more than Tuesday; 249 of them in intensive care, down 17; and 123 on mechanical ventilation (up one).

Eight of the state's 10 hospital regions are using at least 80% of their intensive-care beds, with five of them over 90%. 

The state's seven-day infection rate is 33.05 daily cases per 100,000 residents. Counties with rates more than double that rate were Carroll, 96.8; Powell, 91.3; Cumberland, 73.4; Lawrence, 72.7; Harlan, 70.9; Monroe, 68.4; Estill, 67.9; and Robertson, 67.8. 

The number of counties in red on the state infection map, for counties with rates over 25 per 100,000, considered a high level of transmission, rose to 85 Wednesday, from 73 on Tuesday. The orange zone (more than 10 to 25 daily cases) has 32 counties. Three are in yellow (up to 10 cases).

The state reported 44 more Covid-19 deaths Wednesday, raising the pandemic death toll to 10,987. Over the last seven days the state has reported an average of 27 deaths per day; the 14-day average is 35.

Health officials on Wednesday detected the first U.S. case of Covid-19 linked to the Omicron variant, The Washington Post reports. The case was identified in a fully vaccinated San Francisco resident who recently returned from South Africa, wasn't yet eligible for a booster shot, and has mild symptoms.

“The individual is self-quarantining and all close contacts have been contacted and all close contacts thus far have tested negative,” Anthony S. Fauci, President Biden’s chief medical adviser and longtime director of the National Institute of Allergy and Infectious Diseases, said Wednesday.

"Since the new variant was first reported in southern Africa last week, it has been identified in at least 20 countries spanning the globe, and officials had expected it to appear in the United States as international travelers passed through airports and returned from trips abroad," the Post reports. 

Fauci also "advised Americans to resume wearing masks in indoor group settings, including at restaurants when not eating or drinking, and to get boosted as soon as possible for adults who are six months out from their last vaccine dose," the Lexington Herald-Leader reports.

The head of the firm that developed the first effective vaccine against the virus told The Economist, “I am personally not scared about the situation. We expected such a variant to come.” Ugur Sahin is chief executive of BioNTech, the German firm that produced the vaccine with America’s Pfizer.

"Sahin’s relative optimism contrasts with the foreboding tone struck by a rival vaccine-maker, Moderna, whose chief executive, Stéphane Bancel, told the Financial Times this week that there would be a 'material drop' in vaccine effectiveness," The Economist reports. "Both men acknowledge that the world remains very ignorant about Omicron. But Mr. Sahin balances that with reassurance. He explains that even if Omicron overcomes the antibody response, the first layer of direct protection against the virus, it is known that the immune system can fall back on the second layer, which involves T-cells. These attack infected cells to stop the virus reproducing. Mr. Sahin also sought to ease concerns that the vaccinated population will get very ill if infected with Omicron, though he cannot allay them altogether. He says his 'scientific expectation' is that vaccinated people with boosters should fall only mildly or moderately ill if they catch Omicron."

Some pandemic numbers in Kentucky keep rising, slightly

State Dept. for Public Health map, adapted by Ky. Health News; for a larger version, click on it.

By Al Cross
Kentucky Health News

Several measures of the pandemic in Kentucky increased Friday, as the state moved into its second Easter weekend with the novel coronavirus.

The share of Kentuckians testing positive for the virus rose for the sixth straight day, to 3.08%, 0.2 percentage points above Sunday's 2.88%.

The state's 7-day rolling average of new virus cases has risen on five of the last six days. Friday it stood at 641, after the state reported 690 new cases.

However, the state rate of new cases fell slightly, to 10.9 per 100,000 residents. Counties with rates more than double the statewide rate were Powell, 50.9; Simpson, 43.8; Harlan, 40.1; McCreary, 34l Whitley, 32.7; Knox, 26.6; Lee, 25.1; Allen, 22.8; Owsley, 22.7; Lyon, 22.6; and Menifee, 22.

Kentucky's new-case rate was 31st in the nation, up from 34th on Thursday, according to The New York Times data tracker.

The number of Covid-19 patients in Kentucky hospitals and intensive-care units fell slightly, but the share of ICU patients on ventilators zoomed to 74%, the highest since Kentucky Health News began tracking it in October. Daily hospital reports have had occasional spikes that turned out to be temporary.

The Lake Cumberland hospital region was the only one with more than 80% of its ICU beds in use, at 84%. Only 16% of the region's ICU beds were occupied by Covid-19 patients; that was by far the state's highest rate.

The state added 21 more deaths to its list of Covid-19 fatalities, all but three of them from its ongoing audit of death certificates. The 14-day average of regularly reported deaths continues to fall; it is now 15.6 per day, 38 percent lower than it was a month ago.

Because it was Good Friday, the state did not issue a list of deaths itemized by age, sex, county and date. Its daily report is here.

In other pandemic news Friday:

• Counties with 10 or more new cases were: Jefferson, 106; Simpson, 31; Fayette, 28; Letcher, 20; Warren, 19; Kenton, 17; Knox, 17; Daviess, 15; Boone, 13; Hardin, 13; Bell, 12; Barren, Bullitt and Pike, 11; and Christian, Laurel, McCracken, Oldham and Whitley, 10.
• The number of active cases in Kentucky prisons fell again, to only 20 (six staff and 14 inmates), according to the Corrections Department's latest report, dated April 1.
• The Centers for Disease Control and Prevention issued new guidance saying travel poses little risk to fully vaccinated people, but is still not recommended, due to rising numbers of cases. CDC Director Rochelle Walensky said "I would advocate against general travel, overall. Our guidance is silent on recommending or not recommending fully vaccinated people travel. Our guidance speaks to the safety of doing so."
• Coronavirus-related deaths in nursing homes have dropped by 91% since late December, when they got priority for vaccination, according to a report from the main lobby for the homes.
• Some Kentucky landlords are refusing to apply for the millions of dollars available to help their tenants pay rent, reports Graham Ambrose of the Kentucky Center for Investigative Reporting.
• Fauci, a 3-year-old colt named for President Biden's chief medical adviser, was the favorite but ran second in the $100,000 Palisades Turf Sprint on opening day at Keeneland Race Course. The winner was stablemate Chasing Artie, a gelding. Fauci has placed second in four of his five races and won another 5½-furlong turf race at Keeneland last July. The opening-day crowd in Lexington liked him; his morning line odds were 2-1, but he was bet down to 8-5.

Contrary to the national trend, pandemic numbers in Kentucky stay on a rough plateau or decline slightly

By Bruce Maples
Kentucky Health News

As the rest of the country is seeing increasing numbers of new coronavirus cases, Kentucky continues at a rough plateau or even a slight a decline in its numbers, such as its seven-day average of new cases.

The Washington Post reports that new cases across the country have increased by 13% in the past week, with the seven-day average topping 63,000 new cases a day for the first time in a month.

Kentucky seems to be bucking the national trend, or at least not joining it. On Tuesday, the state announced 751 new cases of the coronavirus, bringing its seven-day average of new cases 589. That was a drop of 21 from the day before, after two days in which it increased by nine.

The percentage of Kentuckians testing positive for the virus in the last seven days stayed virtually the same: 2.9%, after two days at 2.89%.

Kentucky's seven-day average of daily new cases per 100,000 residents fell to 10.83, from 11.07 on Monday. It moved down to 35th among all the states on the New York Times national Covid-19 tracking site; the ranking has improved as other states' rates have increased.

“We are on a positive trajectory – we are leading all of our seven border states in administering at least one dose of the vaccine and our positivity rate continues to decline –  but we need to keep working hard and not give up,” Gov. Andy Beshear said in a press release. “We need every eligible Kentuckian to join the team and get the first vaccine available them.”

The state has delivered at least one dose of a coronavirus vaccine to about 40% of all adults in the state. There are over 570 vaccination sites across the state, and many have openings. Vaccinations are available to people over 40, and some sites vaccinate younger people in order to use available vaccine.

Beshear reported 13 new deaths, bringing the state's total to 6,065. He also reported 10 new deaths found through the state's audit of death certificates. The 14-day average of deaths reported fell to 18.8, from 19.6 the day before. 

Today's reported fatalities include an Anderson County man, 75; a Breckinridge County man, 89; a Carroll County woman, 65; a Fayette County woman, 82; a Garrard County man, 90; two Hopkins County women, 52 and 61; two Jefferson County men, both 78; a Laurel County woman, 72; a McCracken County woman, 77; a Trigg County man, 69; and a Trimble County man, 91.

Of the deaths found through audit, one was from October, seven were from December and two were from January. The daily lists of deaths are at https://governor.ky.gov/attachments/20210330_COVID-19_Deaths.pdf.

In other pandemic news Tuesday:

• Counties in the state with daily new-case rates more than double the state rate of 10.83 cases per 100,000 residents over the last seven days were: Owsley, 45.3; Simpson, 34.6; McCreary, 34; Harlan and Powell, 32.4; Lee, 28.9; Whitley, 28; Lyon, 26.1; and Martin, 21.7.
• Counties with more than 10 new cases in today's report were Jefferson, 130; Fayette, 55; Christian, 26; Scott, 25; Whitley, 23; Daviess, 22; Warren 21; Adair and Boone, 19; Hardin, 18; Pike, 17; Kenton and Laurel, 16; Knox and Madison, 13; and Campbell, Harlan, and Pulaski, 11.
• Kentucky's hospitals reported 378 persons hospitalized with Covid-19, up 14 from Monday. Of those, 91 were in the ICU, up 4 from Monday, and 37 were on ventilators, down 4 from Monday.
• A New York judge has ordered the state to vaccinate all prisoners in the state's prisons, jails, and other detention facilities. In issuing the order, Alison Y. Tuitt said “There is no acceptable excuse for this deliberate exclusion.” New York thus becomes one of the few states to make public its plan for vaccinating their incarcerated population. In many states, prisoners are already eligible due to age or health conditions, but have still not been vaccinated, as the focus has been on vaccinating the general population.
• U.S. Sen. Mitch McConnell, on stops around the state during a Senate recess, urged his listeners to get vaccinated. “I’m here today because it’s time to start emphasizing the importance of getting the vaccine,” he said in Bowling Green. “I read the other day that one of the segments of our population that was reluctant to get the vaccine was Republican men. I’m a Republican man, and I took my vaccine as soon as I was eligible. And I certainly encourage everybody to do it. It’s been extraordinarily successful.”
• Signs are pointing to travel being on the rebound in America, even as health officials are warning about "getting back to normal" too soon. Multiple airline companies, including American, Delta, and Southwest, are reporting surges bookings. Gasoline demand is up, too; those not flying are traveling by car. “What we’re seeing now is more travel than we saw throughout the pandemic, including the Christmas and New Year’s holidays,” which were followed by surges in new cases, CDC Director Dr. Rochelle Walensky said at a White House briefing. “I would just sort of reiterate the recommendations from CDC, saying please limit travel to essential travel for the time being.”

As Ky. positive-test rate keeps falling, but death trend keeps rising, feds say new virus variants make vaccinations more urgent

Johnson & Johnson has completed studies of its one-shot
vaccine and is expected to ask the FDA for emergency-use
authority late next week. (Photo by Dado Ruvic, Reuters) 

By Al Cross
Kentucky Health News

The novel coronavirus continued to become less prevalent in Kentucky on Friday, but the Covid-19 disease it causes continued to become more deadly.

The state reported 2,608 new cases of the virus, raising the the seven-day rolling average of daily new cases is 2,539, exactly what it was on Jan. 1, as Kentucky began a post-holiday surge in cases that had made January the state's deadliest month of the pandemic.

That trend continued Friday, as the state listed 57 more Covid-19 deaths, 40 confirmed and 17 probable. The seven- and 14-day averages of deaths jumped to 47.3 and 43.4 per day, respectively.

On the other hand, the percentage of Kentuckians testing positive for the virus in the last seven days fell for the 11th consecutive day, to 8.75%. It has not been that low since late December, when it began a post-holiday surge that peaked at 12.45% on Jan. 10.

“Our declining positivity rate shows that Kentuckians are continuing to make those small sacrifices we’ve been talking about all year in order to protect each other until we get enough vaccines for everyone who wants one,” Gov. Andy Beshear said in a news release.

“Wearing masks around people from different households, social distancing, washing their hands, staying home when they can and getting tested regularly,” Beshear said. “It’s the simple things you’re probably sick of hearing about by now that can make the biggest difference as we near the finish line.”

The 57 deaths raised the state's Covid-19 death toll to 3,668. The fatalities were: a Barren County man, 75; a Boone County woman, 70; a Bourbon County woman, 79; a Boyd County woman, 47; a Boyle County man, 87; a Caldwell County man, 80; two Christian County women, 68 and 71; two Christian County men, 72 and 89; a Clay County man, 79; a Clinton County man, 64; a Daviess County man, 73; two Fayette County women, 86 and 87; three Fayette County men, 83, 97 and 101; a Grayson County woman, 73; three Grayson County men, 66, 72 and 93; a Hart County man, 73; a Hopkins County man, 81; two Jackson County men, 83 and 86; three Jefferson County women, 73, 86 and 96; a Jefferson County man, 74; a Lawrence County woman, 85; a Lawrence County man, 83; a Lewis County woman, 65; a Logan County woman, 77; two McCreary County women, 86 and 92; a Madison County woman, 65; two Madison County men, 67 and 86; a Marshall County man, 67; a Monroe County woman, 73; two Muhlenberg County men, 59 and 73; four Pike County women, 62, 66, 75 and 90; two Pike County man, 61 and 73; a Simpson County woman, 77; a Simpson County man, 72; a Union County woman, 90; two Warren County women, 73 and 94; and three Warren County men, 53, 72 and 83.

Counties with 10 or more new cases were: Jefferson, 360; Fayette, 194; Kenton, 133; Daviess, 114; Boone, 98; Campbell, 89; Morgan, 78; Franklin, 74; Warren, 55; Pike, 54; Hardin, 50; Nelson, 45; Bullitt, 44; Hopkins, 44; Christian, 39; Pulaski, 35; Shelby, 33; Boyd, Henderson, Oldham and Whitley, 32; Floyd and Laurel, 30; Graves, 29; Hart, 28; Barren and McCracken, 27; Jessamine, 26; Muhlenberg and Taylor, 23; Knox, 21; Grayson and Scott, 20; Carter and Harlan, 19; Bell and Marshall, 18; Meade and Simpson, 16; Boyle, Clark, Greenup, Logan and Marion, 15; Allen, Casey, Johnson, LaRue and Rockcastle, 13; Bourbon, Breckinridge, Lincoln, Madison, Ohio and Rowan, 12; Butler, Grant, Henry and Union, 11; and Calloway, Garrard, Powell and Russell, 10.

The state's daily report shows that Morgan County again became the county with the highest infection rate, averaging 106.3 cases per 100,000 residents over the last seven days. It is home to the Eastern Kentucky Correctional Complex, a state prison that continues to be plagued by the virus.

The Kentucky Corrections Department's latest report shows 84 active cases among inmates and 26 among employees at the prison. Two prisons in Oldham County also have scores of cases. Overall, the state prison system reports 240 inmate cases and 96 staff cases.

More than 3,000 prisoners and 500 staff members in local jails have had the virus, reports John Cheves of the Lexington Herald-Leader. They have been turned into "reservoirs for Covid," Jamestown lawyer Matthew DeHart told him: “You take a room that’s designed for eight bunks and a combination sink-toilet. Then you put 16 or 18 people in it. There’s no room left. They’re all right on top of each other, day after day after day.

In other coronavirus news Friday:

• Pinned to the top of Beshear's Facebook page is this message: "Every decision I have made during this pandemic has been to protect our people. The result of removing the emergency powers that allow our state to act is less success and more casualties. This is not the time to play politics." That may indicate that the Republican-controlled legislature is likely to override the Democratic governor's vetoes of bills limiting his emergency powers, rather than the two sides negotiating a compromise. 
• The new variants of the virus are a "wake-up call" to move faster on vaccinations, said Dr. Anthony Fauci and other public-health experts. The threat of the variant first found in South Africa prompted travel bans by Canada and other nations, The Washington Post reports.
• The one-shot vaccine developed by Johnson & Johnson is very effective at preventing illness, hospitalization and death, a study of it shows. "but its protection against sickness was stronger in the United States and weaker in South Africa," due to the variant there, the Post reports. "Johnson & Johnson is expected to apply for emergency use authorization from the Food and Drug Administration late next week. If the review follows the path of two earlier vaccine candidates, the shot could be authorized and available to the public by March . . . but production setbacks mean federal officials are initially expecting only a trickle of doses if the product is quickly authorized for emergency use by the FDA."
• "People diagnosed with schizophrenia were 2.7 times more likely to die from Covid-19 compared to people without the disorder and those with anxiety or mood conditions," according to a new study, Katie Camero reports for McClatchy Newspapers. "Schizophrenia ranked second only to age when bracketed with diabetes, heart failure, sex, chronic kidney disease and smoking status, among other known mortality risk factors for Covid-19."

Governor finalizes school reopening rules, makes them only advisory for private schools; all pandemic metrics down for day

State Dept. for Public Health map, relabeled by Ky. Health News; to enlarge, click on it.

By Al Cross

Kentucky Health News

As the novel coronavirus ebbed slightly in Kentucky, Gov. Andy Beshear finalized rules for reopening schools, and made them only advisory for private schools, precluding a renewed battle in federal courts.

In a press release, Beshear announced 3,179 new cases of the virus, 14 percent less than the previous Friday. The seven-day rolling average of daily new cases is 2,884, which is 2.5% below Thursday's figure. Hospitalization figures, which are steadier, were lower on all fronts: 1,712 Covid-19 patients in Kentucky hospitals, 410 of them in intensive care and 227 of those on ventilators.

The share of Kentuckians testing positive for the virus in the past seven days also remained steady, at 8.59%. 

Beshear announced 28 additional deaths, well over the average of 21 for the last month but well below the record 54 he announced Thursday.

The governor issued an executive order finalizing his plan for school reopenings in the new year, which he outlined Monday. The order begins by saying it applies to all K-12 public schools but "It is also recommended that all private schools follow these provisions."

Beshear's Nov. 18 order banning in-person instruction until Jan. 4 applied to all schools, prompting a lawsuit that went all the way to the U.S. Supreme Court, which sat on the case long enough to say Thursday that it was largely moot because the holiday break was arriving.

The latest order allows schools in red zones -- counties averaging at least 25 new cases of the virus per 100,000 population -- to open Jan. 4 if they follow new safety guidelines and have "meaningful virtual options for all students" but recommends that they not open until Jan. 11.

Beshear said Monday that he recommends waiting another week because the virus has a 14-day incubation period, and public-health officials fear increased spread of the virus during Christmas holidays.

The plan adjusts the recommendations for counties in red and orange zones, primarily by asking schools in those counties to implement "more aggressive" hybrid learning to reduce the number of people in school buildings. Schools must accommodate employees who fall into a high-risk category with a virtual option.

Friday, Beshear reminded Kentuckians to follow new holiday guidance that the health department issued Thursday.

“Christmas is probably my favorite day of the year, and I know we all want to celebrate the way we usually do, but this year we need to do things differently,” he said. “With vaccines arriving this week, we can see the bright light at the end of the tunnel. Now we just need everyone to keep doing their part to protect one another.”

In other coronavirus news Friday:

• The 28 latest Covid-19 fatalities were a 64-year-old woman from Boyd County; two Christian County men, 67 and 71; a Clark County man, 75; a woman, 92, and a man, 84, from Fayette County; a Graves County woman, 93; a Greenup County woman, 71; a Hardin County man, 70; two Hopkins County men, 54 and 86; a woman, 95, and five men, 58, 74, 77, 77 and 79, from Jefferson County; a Johnson County woman, 57;  a Kenton County woman, 84; a LaRue County woman, 93; a Lee County woman, 75; a Marshall County man, 90; a Mason County man, 66; a woman, 83, and a man, 59, from McCracken County; a Pike County man, 74; a Taylor County woman, 95; and a Union County woman, 62.
  
• Counties with more than 10 new cases were: Jefferson, 434; Fayette, 189; Pulaski, 150; Kenton, 149; Warren, 104; Boone, 85; Daviess, 78; Oldham, 77; Wayne, 73; Pike, 66; Whitley, 61; Laurel, 49; Hardin, 47; Henderson, 46; Campbell, 45; Greenup, 44; Taylor, 43; Bullitt, 41; Bath, Hopkins McCreary and Russell, 37; Franklin, 34; Bourbon and Madison, 33; Clark and Clay, 32; Boyd and Grant, 30; Boyle and Lincoln, 29; Christian, McCracken and Marshall, 28; Knox, 27; Carter, Clinton, Floyd and Letcher, 26; Mercer, 25; Hart and Jessamine, 23; Nelson and Scott, 22; Mason, 21; Bell, Carroll and Green, 20; Logan, 19; Adair, Marion, Montgomery and Simpson, 18; Muhlenberg, 17; Shelby, 16; Perry, 15; Graves, Grayson, Henry and Ohio, 14; Casey and Lewis, 13; Anderson, Barren, Butler, Powell and Union, 12; Garrard, Meade and Robertson, 11.
• Beshear issued a reminder that Friday is the deadline to apply for the $40 million Team Kentucky Food and Beverage Relief Fund. Check eligibility and apply here.

Plain talk's understood: 'Snot and spit ... spread infection,' health chief says as he advises us to 'hunker down' during the holidays

White House task force graph shows national numbers; Kentucky's trends have been similar.

By Melissa Patrick

Kentucky Health News

Coronavirus cases in Kentucky appear to have plateaued, but infection rates remain high, and the state's top doctor said Tuesday it's too dangerous to travel.

Meanwhile, the response director of the White House Coronavirus Task Force came to Kentucky and complimented the pandemic work of Democratic Gov. Andy Beshear, who arranged a private meeting between her and Republican legislators who have been critical of him.

Beshear announced 2,946 new virus cases, the lowest number on a Tuesday in four weeks; 3,114 cases were reported last Tuesday, and the one-day record of 4,151 the Tuesday before that. The seven-day rolling average, which smooths out peaks and valleys caused in part by weekends, stood at 3,179 -- down for the fourth straight day, and eight of the last 10 since it topped out at 3,440.

Health Commissioner Steven Stack praised Kentuckians for stopping a surge for the third time, but cautioned that the full impact of social gatherings and travel during the Thanksgiving holidays is not fully reflected in the case numbers, so we need to "hunker down" during the Christmas holidays. 

Stack said Kentucky's health ranking among states is low, but "Despite that, we have one of the best performances in the entire country for low numbers of death across the state. At this point, we've shown three times that when we intervene, we can have a positive impact, save lives and minimize disease." 

He announced an official advisory discouraging all out-of-state leisure travel and urging such travelers to self-quarantine for 14 days upon return -- or to follow the latest federal guidance for ways to shorten the quarantine. Beshear said, "Our new travel advisory is: Don't travel. Right now it is dangerous."

Stack also advised against gathering outside your household during the holidays, and to order carry-out instead of dining indoors if at all possible. And for those over 60 or with high-risk conditions, he said, "It is not safe to go into indoor settings with other people not wearing masks. It simply is not safe." 

A physician, Stack described the risk in earthy terms: "When people get close to each other without a mask on and spread their secretions, and essentially spray snot and spit at each other, you spread infection. And when we stay away from each other and we cover our faces, we don't do those things -- the infection doesn't spread, hospitals don't get overrun and people don't die."

Dr. Deborah Birx (Image from WDRB)

White House visitor:  In an exclusive interview with WDRB,'s Lawrence Smith, Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, said she was well aware of the controversy surrounding Beshear's aggressive handling of the virus, but had nothing but praise for his actions.

“Now that we are 10 months in, we can really see in the states where the governors were very proactive, did things before others might have thought it was important, have much lower hospitalizations and much lower fatalities by population, compared to other states,” Birx said. “I think as we look back on this, we're really going to applaud those governors who were proactive.”

This was Birx's second trip to Kentucky. This time she met not only with the Democratic governor, but  with Republicans who control the legislature and their Democratic counterparts.

Beshear said, "I think that what that foremost expert told them, without me in the room, is that the steps we've taken work and where people are not taking action, or don't have the authority to take action, you see really dire consequences."

Early in his briefing, Beshear showed a graph of surging Covid-19 deaths in South Dakota, which has taken few steps to fight the virus, and suggested that if legislation is passed to take away his ability to aggressively fight the pandemic, Kentucky could very easily look like South Dakota.  

Republicans in the state Senate have already filed two bills to rein in the governor's emergency powers. 

Birx issued a written report, which Stack recounted. It said the current surge in cases is faster, has a broader reach and has lasted longer than the first two; that any indoor gathering without masks is a viral spreading event, whether in a restaurant or bar or around a dining-room table; and stressed the importance of tests as an intervention equal to masking, social distancing and hand hygiene. 

She also said transmission of the disease through people without symptoms must be identified through testing. Earlier, Beshear said she had called on Kentucky to increase its testing of adults 18 to 30, and suggested tailoring testing sites to that age group or offering them rapid tests to get more tested.

"So those are ideas that we're looking at and we need to flesh out and figure out," Beshear said. "It's certainly a population that if we could get to do regular testing, we can not only see and prevent asymptomatic spread, but we can also get some behavioral changes." 

Vaccine: Beshear announced that seven more Kentucky hospitals have received shipments of the coronavirus vaccine, developed by Pfizer Inc. and BioNTech. They were Baptist Health in Corbin, Louisville and Madisonville; Norton Hospital in Louisville; UK HealthCare in Lexington; Pikeville Medical Center; and St. Elizabeth Healthcare in Edgewood. The first shipments went Monday to UofL Health in Louisville, Baptist Health Lexington and the Medical Center at Bowling Green. 

UK nurse Janie Lawson vaccinated nergency-medicine
pharmacist Abby Bailey. (UK photo by Mark Cornelison)

“After 10 months of being on the front lines of the Covid-19 pandemic, we are excited for the good news that a vaccine is now available and that we can offer it to some of our health care workers at UK HealthCare,” Dr. Mark Newman, UK's executive vice president for health affairs, said in a news release. “We will be providing the first vaccinations to our front-line workers, employees who have direct patient care primarily for Covid-19 patients or under investigation for Covid-19. While we know that we have a long way to go in ending this pandemic, we are grateful to be part of this momentous first step.”

The Lexington Herald-Leader reports that UK got a shipment of 1,950 doses of the vaccine at 10:30 a.m., and vaccinated 88 frontline staff. It plans to vaccinate 258 more Wednesday and another 260 Thursday.  Newman said it will take about a week to administer all the doses, which will still not cover the roughly 2,500 staff who have direct contact with coronavirus-positive patients. 

Beshear showed pictures of hospitals receiving the vaccine shipments from across the state and said, “These front-line heroes know that we’ve got their back. They fought for us every single day. We value their safety and we need their help getting through these next couple of months.”

Long-term care facilities are expected to start being vaccinated on Monday.

Stack called on Kentuckians to be patient over the next six or more months as the state works to distribute the vaccine. 

Deaths: Beshear announced 15 more Covid-19 deaths, bringing the state's death toll to 2,239. He said two more veterans at Thomson-Hood Veterans Center in Wilmore had died from the disease, bringing its toll to 33. He said there are no active cases at the state's four long-term-care facilities for veterans.

Chief Robert Lee Orkies 

Beshear honored the life of Zoneton Fire Chief Robert Lee Orkies of Shepherdsville, who died at 55 after a battle with cancer and Covid-19 on Dec. 11. Beshear said Orkies had been a firefighter since 1984. 

“To Rob’s family, to those little granddaughters, we are so sorry for your loss,” Beshear said. “In his honor, we’re going to protect other people just like he did during his life. We’re going to wear masks, we’re going to do right by our neighbor and we’re going to live up to the example that he set for all of us.”

 

In other covid-19 news Tuesday: 

• The share of Kentuckians testing positive for the virus in the past seven days is 8.53 percent, down slightly from Monday.
• There are 1,788 Covid-19 patients in Kentucky hospitals, 438 of them in intensive care and 246 of those on ventilators.
• Counties with more than 10 new cases were: Jefferson, 418; Fayette, 162; Warren, 123; Daviess, 122; Madison, 120; Pulaski, 84; McCreary, 73; Hardin, 68; Laurel, 66; Boone, 63; Whitley, 60; Kenton, 59; Oldham, 51; Clinton, 51; Hopkins, 46; Adair, 46; Knox, 42; Russell, 41; Taylor, 40; Nelson, 35; Bullitt, 34; Green, 34; Henderson, 33; Jessamine, 31; Boyd, 30; Campbell, 29; Greenup, 28; Lincoln, 28; Mercer, 27; Casey, 26; Boyle, 25; Clay, 24; Christian, 23; Floyd, 23; Cumberland, Muhlenberg, Logan and Marion, 22; Graves and Meade, 21; Montgomery, 20; Clark and Breathitt, 19; McCracken and Franklin, 18; Anderson, Barren, Scott, Grayson, Todd and Wayne, 17; Perry, Ohio and Harlan, 16; Allen and Union, 15; Bell, Johnson and Simpson, 14; Letcher, Garrard and Washington, 13; Edmonson, 12; and Hart, Monroe, Metcalfe, Morgan, Pendleton and Wolfe, 11.
• The 15 deaths confirmed Tuesday were of a 68-year-old man from Boyd County; a Caldwell County woman, 62; two Daviess County men, 77 and 80; Graves County woman, 88; a Hardin County man, 77; five Jefferson County men, 61, 64, 78, 83 and 92; a McCracken County woman, 90; and three Ohio County women, 91, 87 and 91.
• There are 2,723 active cases of the coronavirus among long-term-care residents and 1,406 active cases among staff. Beshear said 20 additional deaths in these facilities are attributable to Covid-19, one of them a staff member. There have now been 1,563 residents and eight staff members die from Covid-19, or 70% of the state's total Covid-19 deaths. 
• As the daily Covid-19 hospitalizations and deaths across the U.S. reached all-time highs, with someone dying from the disease every 35 seconds, the Centers for Disease Control and Prevention Director Robert Redfield told CNN it will only get worse: "The reality is, December and January and February are going to be rough times."   
• Compared with children who tested negative for the coronavirus, children who tested positive were more likely to have attended gatherings, like weddings, parties, playdates and funerals, and not more likely to have attended child care or in-person school, according to the CDC's latest Morbidity and Mortality Weekly Report. 
• Click here for the Kentucky Department of Education "Covid-19 Considerations for Reopening Schools" that provides details for how the department is preparing for Covid-19 vaccinations. 
• The Food and Drug Administration approved the first over-the-counter coronavirus test, developed by Ellume. It "can be used to diagnose people 2 years of age and older, connects to an app that delivers results to patients’ phones, and reports results to local public health officials," Kelly Lienhard reports for Inside Health Policy. "Ellume expects more than 3 million tests to be manufactured by the end of January 2021."
• The FDA released a detailed analysis on Tuesday that supports the authorization of the Moderna coronavirus vaccine for emergency use, NPR reports. On Thursday, the Vaccines and Related Biological Products Advisory Committee, an advisory group, will discuss the vaccine in a public meeting. Beshear said "if everything goes the way we think it" will go, Kentucky will have a shipment of the Moderna vaccine on Monday. 
• The state's Eviction Relief Fund will stay open until all funds are exhausted. Beshear said the fund still has about $1.4 million remaining it to help Kentuckians pay any past rent due from March through December. Click here to apply. He said since opening the applications for this fund in September, the state has approved $12.3 million in eviction relief funds to 3,254 Kentucky households. 
• Beshear said the Food and Beverage Relief Fund, which makes grants that don't have to be repaid, has had nearly 4,300 applications, requesting $37 million, and has distributed $30.2 million of the $40 million available. Applications will close Dec. 18. Click here to apply. 
• Deborah Yetter of the Courier Journal reports on the first of "12 notable individuals committed to the advancement of Kentucky," as identified by the Louisville newspaper, and the first one in the series is Stack, whom she calls "the front man in the state's fight against Covid-19." She reports that Stack "has no regrets about taking on the job that has come with grueling hours and political firestorms over restrictions the state imposes, often on his advice, to try to limit the spread of Covid-19."  He said, "Yes, I would do it again. How many times do each of us have an opportunity in our lives to have such a meaningful impact?"
• Dr. Jon Klein, vice dean for research and professor at the University of Louisville School of Medicine, and Dr. Melissa Walton-Shirley, who graduated from the school and completed her internal medicine residency and cardiology fellowship in Louisville, answered questions about the Covid-19 vaccine in an opinion article for the Courier Journal.
• Stephan Johnson of WDRB interviewed Dr. Joseph Flynn, chief administrative officer for Norton Medical Group and physician-in-chief of Norton Cancer Institute at Norton Healthcare, to get some answers about what to expect moving forward now that the Covid-19 vaccine is here.

Ky. pandemic numbers hold mostly steady as vaccine is shipped

New York Times map (colors differ from map used by Ky. Department of Public Health); for county numbers, click here.

By Al Cross
Kentucky Health News

The coronavirus pandemic in Kentucky stayed mainly on a slightly downward tick Saturday, as Gov. Andy Beshear and his health commissioner urged Kentuckians to keep observing precautions while vaccines slowly roll out.

“Late yesterday, the FDA approved Pfizer’s vaccine for Covid-19,” Beshear noted in a press release. “That’s great news, but it will still be some time before everyone can get vaccinated and we have to stay vigilant until that time.”

He added, “It is morally imperative that we get the vaccine to the most vulnerable Kentuckians first, and that is why we are starting with our long-term care facilities and front-line health care workers. In the meantime, please keep doing what you know is right: wear your mask, keep your distance from others and don’t have large gatherings. Together we can defeat this virus.”

Beshear said Kentucky’s first shipment is expected to arrive early next week. Responding to a New York Times survey, his office said the state would get at least 147,000 doses of vaccine before the end of the year, including at least 38,000 from Pfizer doses and 109,000 from Moderna, which is expected to get FDA approval next week.

Pharmacy chains CVS and Walgreens have national contracts to handle vaccination of residents and staff at nursing homes. Because the Pfizer vaccine requires ultra-cold storage, only 11 Kentucky hospitals will get it at first; the Moderna vaccine is expected to go to many if not most of the 85 other hospitals in line for vaccine.

The United Parcel Service hub in Louisville, which will handle the shipping of about half the Pfizer vaccines, will start getting them Sunday, WLKY reports.

The state reported 3,558 new cases of the virus Saturday, relatively close to the new seven-day rolling average of 3,244. The percentage of Kentuckians testing positive for the virus fell for the ninth consecutive day, to 8.79%.

“Decreasing statewide positivity rates are encouraging, but they are the result of difficult choices made to decrease spread of disease,” Health Commissioner Steven Stack said in the news release.

Among the daily numbers, the biggest change was in the number of Covid-19 patients on ventilators in Kentucky hospitals; it dropped from 253 on Friday to 199 on Saturday, the smallest number since Nov. 20. Intensive-care use and overall hospitalizations declined slightly, to 423 and 1,711, respectively.

“Multiple Kentucky hospitals are still under strain, and the market for available health-care workers has become extremely tight as states around the nation experience massive Covid-19 surges, overwhelming their hospitals,” Stack said. “Every Kentuckian has choices to make – choices that matter tremendously – in the weeks ahead. Wear your mask, socially distance and if you are sick, seek medical care or stay at home until you are fully recovered. And if you are over 65 or have medical problems, stay healthy at home as much as you possibly can, since leaving your home now places you at high risk of exposure to Covid-19.”

The state confirmed 24 more deaths from Covid-19: a 73-year-old woman and a 75-year-old man from Adair County; Campbell County man, 86; a Casey County man, 81; a Clinton County woman, 50; a Fayette County man and woman, 49 and 89; a Hardin County woman and man, 88 and 90; a Mason County man, 75; a Metcalfe County woman, 62; two Muhlenberg County women, 88 and 98; a Nelson County man, 94; a 71-year-old man and two women, 78 and 80, from Pike County; a 77-year-old woman and two men, 71 and 90, from Pulaski County; a Russell County woman, 70; a man, 81, and a woman, 92, from Warren County; and Whitley County woman, 89. 

In other coronavirus news Saturday:

• Counties with more than 10 new cases were: Jefferson, 588; Fayette, 265; Pulaski, 127; Kenton, 122; Boone, 94; Daviess, 93; Warren, 83; Hardin, 81; Wayne, 60; Boyd, 58; Whitley, 54; McCracken, 53; Pike, 52; Campbell, 50; Floyd, 50; Madison, 48; Boyle, 46; Laurel, 46; Jessamine, 43; Adair, Hopkins and Russell, 42; Mason, 41; McCreary, 40; Taylor, 37; Christian, 36; Mercer, 35; Franklin and Greenup, 34; Bullitt and Fleming, 32; Nelson and Oldham, 30; Henderson, 29; Graves, 27; Marion, Meade, Scott and Shelby, 26; Barren, 25; Simpson and Trimble, 24; Knox, Logan and Todd, 23; Rowan and Spencer, 22; Anderson, Clinton, Grant, Muhlenberg and Ohio, 20; Bell, Hart and Marshall, 19; Calloway, 18; Bourbon, 17; Allen, Henry, Perry and Washington, 16; Breathitt, 15; Carter, Harlan, Letcher, Lincoln and Woodford, 14; Carroll, Casey and McLean, 13; Breckinridge, Clark and Montgomery, 12; and Garrard and Magoffin, 11.
• Many states have 14-day quarantines for visitors, or for residents returning after visits to highly infected states, but only one enforces them, Olga Khazan reports for The Atlantic: "Americans who drive to, say, Cincinnati, and do not isolate in the days that follow do not risk arrest. Ohio, like Hawaii, has introduced a quarantine for people who have visited high-risk areas. But complying with Ohio’s restrictions is voluntary. In other states, you are 'urged' or 'asked' to quarantine, but no one will check that you did." Kentucky and other states do likewise. "Everyone enters Hawaii through its airports, which makes enforcing a quarantine easier there than in almost every other state."

Hospitalizations up 5% in one day; health-department workers are afraid to enforce orders because of threats, abuse, Beshear says

Beshear showed a video of nurse practitioner Katie Rogers asking Kentuckians to take care at Thanksgiving in order to keep hospitals from being overwhelmed.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced a 5.4 percent jump in Kentucky's covid-19 hospitalizations Tuesday, making for another record high, while making a final plea for Kentuckians to keep their Thanksgiving gatherings small – and saying health-department workers are afraid to enforce his emergency orders because of abuse and threats. 

Beshear said covid-19 hospitalizations totaled 1,658, 85 more than Monday; 390 of them are in intensive care, and 207 of those are on a ventilator. 

The governor warns almost daily that a main reason Kentuckians need to stop spreading the novel coronavirus and bring case numbers down is to keep the state's health-care system from being overwhelmed – and there are already signs that that is beginning to happen. 

Beshear pointed to newspaper headlines across the state reporting that local hospitals were either at capacity or near capacity. 

The Albert B. Chandler Hospital at the University of Kentucky announced that it will close five of its 32 operating rooms to make room for an influx of covid-19 patients, whose number has jumped from about 30 in late October to 81 early Tuesday, notes Alex Acquisto of the Lexington Herald-Leader.

Beshear said the disease is beginning to overwhelm the health-care capacity of the state and the region. "If we do not stop the exponential growth of cases, we will exceed our health-care capacity," he warned. "We will experience more loss and more death than we have to."

In the question session of his daily briefing, Beshear was quick to confirm that Kentucky's health-department workers are being targeted by death threats and doxxing – malicious posting of personal information online – over the enforcement of coronavirus orders, similar to episodes in other states. 

"It's going on every day, in every local health department, to every single worker," Beshear said. "It is awful and it is disgusting. Our local health department workers are scared. They're scared to release their local numbers, they're scared to do basic enforcement. They're people's neighbors, fighting for the lives of neighbors, and people treating them this way is unacceptable. It is not in accordance to our values. It's not in accordance to my faith. It is not Christian." 

Health departments have been tasked with enforcing Beshear's mask mandate since July, and now they are being asked to enforce his new orders that include, among other things, banning indoor service in bars and restaurants. 

Some restaurants have refused to follow that mandate, forcing health departments to become involved, and in some cases suspending their food service permits. 

One such restaurant is Bean's Cafe and Bakery in Dry Ridge. Rachel Cheatham reports for the Grant County News that the bakery has decided to keep its dining room open, despite the order to close all indoor dining by 5 p.m. Nov. 20. Outdoor dining is allowed, under certain requirements.  

Bean's owner Richard Hayhoe told Cheatham, “It is our understanding that to defy an order like we have will bring out the situation to a head and make the governor’s office prove that they have the legal authority to strip business owners of their constitutionally protected ability to earn a living. These regulations are the political overreach of an office that is bent on controlling every aspect of life and taking away your ability to make your own decisions.”

A Bean's Facebook post said the restaurant had received a notice from the Northern Kentucky District Health Department that its food-service permit had been suspended. "We will remain open until it can be proven that this is unlawful for them to do in a court of law." The office of Grant County Attorney Stephen Bates II declined to comment other than to say the case will be a matter of public record. 

In London, Bill Estep of the Herald-Leader reports that the Laurel County Health Department planned to shut down Wingz 2.0, a restaurant that had not shut down its dining room. Janet Patton of the Herald-Leader reports that the Lexington health department has ordered closure of a coffee shop, Brewed, and suspended its permit, but its dining room remains open. 

Asked what level of enforcement defiant restaurants can expect, Beshear noted that the state Supreme Court recently ruled – in a case involving Bean's and other Northern Kentucky businesses – that he has legal authority to issue such orders, and offering indoor dining is a violation of the rule of law. 

"Our society can't move forward with people who openly violate the law if they don't like it," Beshear said. "Once the Kentucky Supreme Court has ruled, that's supposed to be it." 

Beshear noted that there has been a rush on testing in the last few days. He said that is a good thing, but cautioned that it is not safe to think that a negative covid-19 test means you can safely gather for Thanksgiving, because it can take time for an infection to show up on a test. The incubation period for the virus is 14 days. 

"A single [negative] test can't guarantee a safe Thanksgiving," pointing to a Time article that expands on this topic.

The state Department for Public Health has asked Kentuckians to avoid travel and only have dinner with people who live in their household, or at a maximum, people from two households (no more than eight people total).

 “Please keep your Thanksgiving celebration as small as you can," he said. 

Beshear reported 2,690 new coronavirus cases on Tuesday, bringing the state's seven-day rolling average down to 2,994, 1 percent below yesterday's average. He also reported 17 more covid-related deaths, bringing the state's death toll to 1,809.

The deaths were a 90-year-old woman from Calloway County; two women, 64 and 81, and a 52-year-old man from Daviess County; an 81-year-old Hardin County man; a 67-year-old Henry County man; an 86-year-old woman and five men, ages 64, 67, 75, 76 and 88, from Jefferson County; a 78-year-old Kenton County woman; a 60-year-old Martin County man; a 90-year-old McLean County woman; an 88-year-old Metcalfe County woman; and an 81-year-old Shelby County woman.

The share of Kentuckians testing positive for the virus in the past seven days remained under 9% for the second day in a row, after being above that threshold since Tuesday, Nov. 17. Today, it was 8.82%.

In other coronavirus news Tuesday:

• Counties with 10 or more new cases were Jefferson, 394; Fayette, 201; Hardin, 118; Madison, 80; Daviess, 73; McCracken, 72; Boone, 71; Warren, 70; Boyd, 65; Nelson, 54; Pike, 49; Kenton, 45; Graves, 43; Oldham, 39; Hopkins, 38; Bullitt, Jessamine, Laurel and Pulaski, 34 each; Montgomery, 33; Henderson and Shelby, 32 each; Marion, 31; Carter, Greenup and Mercer, 29 each; Scott, 27; Barren and Lincoln, 26 each ; Campbell, 25; Larue and Simpson, 23 each; Clark, Franklin and Johnson, 22 each; Christian, 21; Magoffin, Muhlenberg, Ohio and Pendleton, 20 each; Washington, 19; Calloway, 18; Lee, 17; Floyd, Marshall, Meade and Whitley, 16 each; Martin, 15; Clay, Harlan, Logan and Webster, 14 each ; Grant, 13; Boyle, Garrard, Harrison, Leslie, Monroe and Spencer, 12 each; Bell, Knox, Powell and Wayne, 11 each; and Metcalfe, Rowan and Woodford, 10 each.
• In long-term care facilities, there are 1,572 active cases among residents and 1,044 among staff cases, with 92 resident cases and 115 staff cases reported Tuesday. There are 1,173 resident deaths and seven staff deaths attributed to covid-19, with 18 resident deaths reported today. 
• Beshear announced another covid-19 death at the Thomson-Hood Veterans Center in Wilmore, bringing the total there to 28. He said the facility has gone 10 days without a new case and that none of the other three veteran facilities in the state have reported any cases. 
• Fifteen states are in Kentucky's travel advisory because they have a positive-test rate of 15% or higher. From highest to lowest, they are: Wyoming, South Dakota, Iowa, Idaho, Kansas, Pennsylvania, New Mexico, Missouri, Alabama, Utah, Montana, Arizona, Mississippi, Oregon and Ohio. Kentuckians who travel to these states are asked to isolate for two weeks upon return. The state also recommends a 14-day self-quarantine for anyone returning from any international travel.
• The U.S. Department of Labor has abruptly ended extended unemployment benefits for 4,723 Kentuckians, according to a state news release. Claimants who continue to be off work due to the pandemic may be eligible for another form of benefit through the end of the year. This also does not affect the ability of Kentuckians losing their jobs to qualify for traditional unemployment benefits, the release says. 
• "Some Americans downplaying the novel coronavirus insist improved treatments have made the virus far less deadly than last spring, but that’s a far too rosy take," writes Paige Winfield Cunningham of The Washington Post. "Better treatments are now available, but their impact isn’t nearly big enough to avoid an impending surge of deaths" as hospitals reach or exceed capacity. "While the case-fatality rate declined early in the pandemic, it hasn’t budged since the summer" from 1.7 percent.
• Essential workers are likely to move ahead of adults 65 and older and people with high-risk medical conditions on the Centers for Disease Control and Prevention's priority list, coming after health care workers and those living in long-term care facilities, members of the Advisory Committee on Immunization Practices said on Monday, Stat reports. No formal vote has been taken. Stat writes that the intention is to bring "many people of color closer to the front of the vaccine priority line -- should they want to be vaccinated -- in recognition of the fact that the pandemic has disproportionately hit Black and Latino communities." Further, one expert notes that essential workers have less opportunity to social distance, compared to seniors and those with high-risk medical conditions.
• Matthew Glowicki of the Louisville Courier Journal tells the stories of grieving families who have lost a loved one to covid-19 as they prepare for the Thanksgiving holiday. 
• Local health departments in Eastern Kentucky release a report with their covid-19 numbers on Monday's; this week's report includes three deaths, WYMT reports.
  
  

Beshear calls new daily record of coronavirus cases 'staggeringly high' as he defends new rules and asks churches to go remote

Dept. for Public Health map, relabeled by Ky. Health News; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear reported what he called a "staggeringly high" number of coronavirus cases on Thursday, 3,649, setting the record for a single day. Five of the top five days for new cases have been in the last week. 

“This is exponential growth,” Beshear said. “It’s continuing to grow and it will continue to grow. Our job is to stop it and that's why we have put these new steps into place.”

Those new steps include, among other things, shutting down in-person schooling on Monday, stopping indoor service in bars and restaurants at 5 p.m. Friday, and placing further limits on at-home social gatherings -- which Beshear acknowledged can't be easily enforced but said should be followed. 

In defending his actions, Beshear said the numbers will get worse before they get better. 

"If you're upset that schools [have] got to be virtual, you can be upset with me, but it's the virus. If you're upset about what we're having to do with restaurants and bars, the virus has chosen that area, because people take their masks off and congregate," he said.

"Upset about group classes at gyms or the pause on winter sports? Again, that's what this virus does. And so really, you've got two choices: You can just do nothing but be upset at me or those that are making these choices. Or we can do our part and put on the mask, tamp down the numbers. And then we can all do these things. It's really that simple."

Beshear also announced 30 more deaths from covid-19, the second-highest daily toll from the disease, bringing the state's total to 1,742.

The share of Kentuckians testing positive for the virus in the past seven days hit another new high since widespread testing began in May, 9.18 percent. The news release says the state has experienced a 400% increase in positive cases over the past nine weeks. 

Beshear confirmed that he had asked religious leaders across the state to immediately suspend all in-person services for the next three to four weeks, at his bi-weekly call with the Kentucky Council of Churches. 

"This is a request from the governor, not a mandate, and it seems perfectly reasonable given the situation we are in with covid-19,” Kent Gilbert, the president of the council and the pastor of the historic Union Church in downtown Berea, told Jack Brammer of the Lexington Herald-Leader. The state's largest religious group, the Kentucky Baptist Convention, is not part of the council.

John K. Carter

Beshear received fresh pushback from Republicans, including Oldham County Attorney John K. Carter, who said on Facebook that his office would not prosecute anyone charged with violating the home-gathering order and added, "Have a happy Thanksgiving with as many of your family members as you want to celebrate this national holiday, as you desire."

"My God," Beshear exclaimed after reading Carter's words in response to a question about them. "That is horrible advice that could mean that families that follow it don't have the same people for Christmas that they do for Thanksgiving."

Beshear also said, "I wasn't asking him to prosecute anything. . . . This is advice that could be absolutely deadly. You're a public servant, don't be irresponsible. . . . You are putting yourself at risk if you follow his advice." Later, he called it "crazy."

Asked how he expects new rules to be successful without the support of state and local leaders, Beshear said he does because they are based on science, have worked in other states and are enforceable.  

He added, "Nobody else has given a plan of action, right? They just criticize the action we're taking. Our two choices are action, which is difficult, or inaction, which is deadly." 

Asked to address the concerns that these new rules are being applied inconsistently, he said they all were made on the advice of public-health officials. 

“It is different going into a restaurant, taking off your mask and eating while congregating around other people than going to Walmart to buy toilet paper and wearing your mask,” he said. “It’s entirely different. It’s different to have 10 people over to your house, where people are going to relax and take their masks off, than if you are at a venue that has people working there that are constantly reminding you to keep your mask on.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said public-health officials around the country are telling him they are seeing increasing numbers of infections from small gatherings. "Each family unit should do a risk-benefit determination about the holidays," he said on CNN. "Maybe the prudent thing to do now is just pull it back and do it with the family unit you live in."

Beshear, asked more than once whether the state's contact tracers had data on infection hotspots, said they were gathering that from local health departments. Case numbers are so high that contact tracers are only being asked to contact individuals who have tested positive for the virus and instructing them to be the one to contact their close contacts and to ask them to quarantine.

Beshear said 1,550 people were hospitalized with covid-19 in Kentucky on Thursday, with 358 of them in intensive care and 199 of those on a ventilator. The number of ventilators in use was the highest yet, he said. 

The number of counties in the state's "red zone," indicating they have 25 or more new cases per 100,000 people over the past seven days, is up to 112 out of 120. It was 107 yesterday, and 94 a week ago. 

Alexa Rose Veit

The governor highlighted the lost life of Alexa Rose Veit, a 15-year-old from Ballard Memorial High School, who died of covid-19 complications. He noted that while Alexa was born with Down syndrome, she never let that stop her from accomplishing whatever she set her mind to. He said Alexa was in remission from leukemia, but tested positive for the virus the week after Halloween. 

"Those who knew Alexa asked we help raise awareness of how deadly this virus is and how important it is to follow the guidelines put in place," said Beshear.

In other covid-19 news Thursday:

• Today's deaths include a 93-year-old man from Boone County; a 75-year-old Breckinridge County man; a 73-year-old Calloway County woman; a 79-year-old Campbell County man; a 94-year-old woman and a 79-year-old man from Daviess County; two men, 67 and 77, from Fayette County; a 67-year-old man from Gallatin County; a 70-year-old Graves County woman; an 80-year-old Hopkins County woman; three women, 53, 69 and 96, and two men, 70 and 95, from Jefferson County; five women, 75, 86, 90, 95 and 96, and three men, 64, 77 and 96, from Kenton County; a 73-year-old woman and a 58-year-old man from Lee County; a 69-year-old McCracken County woman; two women, 92 and 96, from Monroe County; and an 89-year-old Rockcastle County woman.
• Counties with 10 or more cases were Jefferson, 724; Kenton, 179; Fayette, 178; Boone, 165; Warren, 115; Hardin, 108; Campbell, 104; McCracken, 90; Lee, 69; Bullitt, 64; Graves, 63; Madison, 62; Nelson, 59; Daviess, 56; Calloway, 51; Pulaski, 43; Pike, 41; Hopkins and Shelby, 39 each; Oldham, 38; Clay and Laurel, 37 each; Marion, 34; Woodford, 33; Barren, Christian, Montgomery and Muhlenberg, 31 each; Floyd, 30; Scott and Taylor, 29 each; Boyd, 28; Greenup, 27; Boyle, Henderson, Jessamine and Whitley, 26 each; Logan, Mercer and  Rowan, 24 each; Meade, 22; Adair, 21; Washington, 20; Marshall, 19; Clark, Johnson, Lincoln, Mason and Perry, 18 each; Anderson, Casey, Grant, Grayson, Harrison and Webster, 17 each; Bell, Carter and Harlan, 16 each; Bourbon, Edmonson, Franklin, Hart and LaRue, 15 each; Lawrence and Russell, 14 each; Knox, Pendleton and Spencer, 13 each; Garrard, Morgan and Ohio, 12 each; Livingston, Owsley and Powell, 11 each; and Martin, Monroe and Wayne, 10 each.
• Beshear said 437 of today's new cases were 18 and younger.
• In long-term care, 1,656 residents and 1,077 staff have active cases, with 130 new resident and 104 new staff cases reported today. There have been 1,119 covid-related resident deaths and six covid-related staff deaths, with 17 new resident deaths confirmed today. 
• The college and university report shows 716 students and eight staff have tested positive for the virus in the past 14 days, with 78 students reported today.
• Beshear said another veteran from the Thomson-Hood Veteran Center in Wilmore died of covid-19, bringing its total covid-related deaths to 26. He said the center has gone six days without any new cases and that the state's other three veteran centers had no positive cases. 
• The governor said that over the last two weeks, about 1,359 health care workers have tested positive for the virus and that 8,300 have since the first Kentucky case was found in March. 
• Beshear encouraged Kentuckians to donate blood, noting that it is safe to do so. For more information visit RedCross.org/giveblood or KYBloodCenter.org. On Nov. 10, the Kentucky Blood Center told the Herald-Leader that for several weeks, it has had less than a half-day's supply available. Bill Reed, president and CEO of the center, said in a news release, “The ongoing effects of the pandemic have our blood supply at a critical level and our partner blood centers across the country are experiencing the same issues.”
• The Centers for Disease Control and Prevention now recommends Americans avoid Thanksgiving travel altogether. The guidance says, "Travel may increase your chance of getting and spreading covid-19. Postponing travel and staying home is the best way to protect yourself and others this year."
• The Herald-Leader explores why experts say getting a test before Thanksgiving with family isn't enough. Health professionals continue to suggest only celebrating the holiday with members of your immediate household.
• Dr. Sarah Moyer, the head of the Louisville health department, pointed out places where infected people were reported visiting the two days before they noticed symptoms: "They were traveling, attending parties or gatherings, going to the grocery store, restaurants, schools, churches, workplaces, healthcare settings," she said. "If we want to stop the spread of the virus, we really need to stop moving." 

Slide from Louisville Mayor Greg Fischer's Nov. 17 coronavirus briefing