This year, more than 3,700 calls from Kentucky to the 988 suicide-and-crisis lifeline have been routed to the Veterans Crisis Line

This story has been updated.

By Lisa Autry

WKU Public Radio

More than 16,000 Kentucky veterans struggling with their mental health have used the national 988 hotline since it launched two years ago.

The suicide and crisis lifeline doesn’t require callers to disclose personal information, but veterans' overall use can be tracked because callers can be directed to the Veterans Crisis Line. In Kentucky, more than 3,700 calls have been routed to the veterans line so far this year, according to the state Cabinet for Health and Family Services.

In a recent speech to the Veterans of Foreign Wars state convention in Bowling Green, Gov. Andy Beshear urged veterans to seek help.

“We see an epidemic of suicide among our veterans and even our active service members that is unacceptable," Beshear said. "It’s important we have all of the services to make that individual whole at the ready.”

Since the 988 line was launched in July 2022, more than 80,000 calls have been received from residents of Kentucky.

The line connects those in distress to trained counselors 24 hours a day, via calls, chats or text messages. Thirteen of Kentucky's 14 regional mental health centers serve as call centers, and the 14th is in the process of becoming nationally certified. That means 988 calls in all 120 counties can be served by a local center instead of the call being answered out of state.

Calls from all 120 counties are routed initially to an in-state center. If they're not answered within 90 seconds, the calls roll over to an out-of-state backup center.

Since May 2023, the state has seen a 40% increase in calls from Kentuckians to 988 and a 53% increase in the number of those calls that are answered in-state.

"The centers work continuously to recruit, train, and retain compassionate local individuals dedicated to helping fellow Kentuckians in crisis," said Brice Mitchell, a spokesman for the state Cabinet for Health and Family Services. "Using federal grant funding, the centers have increased the workforce capacity through hiring staff and utilizing volunteers."

In May, 84% percent of calls in May were answered at the local level, according to to CHFS. The current in-state answer time of 23 seconds remains faster than the national average of 36 seconds.

Veterans' advocates tell legislators they need help to prevent veteran suicide; Ky. loses about 118 veterans to suicide per year

This story deals with suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide and Crisis Lifeline at 988.

By Melissa Patrick

Kentucky Health News

The legislature's Interim Joint Committee on Veterans, Military Affairs and Public Protection spent over two hours hearing from organizations advocating for resources to prevent veteran suicide at its June 21 meeting.

“We owe these men and women a tremendous debt of gratitude and it is paramount that legislators work to protect and care for Kentucky’s military service members and retirees," Rep. Walker Thomas, co-chair of the committee, said in a news release.

"According to the U.S. Department of Veterans Affairs, in 2020, 119 of the 6,146 veteran suicides nationwide were Kentucky veterans. In comparing the suicide rate of Kentucky veterans to the suicide rate of all Kentuckians, the difference is staggering—with Kentucky veterans’ rate at 41.3 and Kentucky’s total rate at 22.4," says the release.

Michael Stoyonovich, with the Kentucky unit of the Disabled American Veterans, asked the lawmakers to consider a bill to prevent veteran suicide that would strengthen and coordinate proven suicide prevention programs and connect more veterans and their families to mental-health services.

Stoyonovich shared statistics from the University of Kentucky College of Public Health: In 2017, 124 Kentucky veterans died by suicide; in 2018, 126; in 2019, 103; in 2020, 125; and in 2021, 111.

 

Rep. Pamela Stevenson at the June 21 Joint
Committee on Veterans, Military Affairs and 
Public Protection. (Legislative photo) 

Rep. Pamela Stevenson, a Democrat from Louisville who served in the Air Force for 27 years, called on Stoyonovich and the others who spoke to hold the lawmakers accountable. 

"We can pass legislation," she said. " If we don't pass this legislation to stop veterans from killing themselves, then all we've done is made it a bumper sticker.  . . . Everyone here has said they believe in what you said . . . everyone that's testified. Now it's time for you to call us and say, 'Where's the legislation?' We've proven we could get something done in an hour on the floor. Let's get this done in an hour on the floor."

Juan Renaud, the deputy commissioner of the state Department of Veterans Affairs, shared data from Kentucky's Community Mental Health Centers that shows the need in Kentucky is great. In Fiscal Year 2022, which ended last June 30, the centers served 2,372 veteran and active-duty personnel; 601 of them were active and 1,771 were veterans.

He also told the members that a 2012 study found higher rates of suicidal ideas and behaviors among National Guard members after deployment (31 per 100,000) than among actives (20.2) or reserves (24).

Rep. Steve Bratcher, R-Elizabethtown, who is in the Guard, said one reason could be that states are relying on Guard members to do so much more than their monthly commitment, especially in Kentucky with its Covid-19 response, riots, tornadoes and flooding. And on top of that, he said they hold regular jobs.

"I don't think that people realize the challenges that it takes on you personally," he said. "So that's why you probably see a difference in the amount of increase in suicides in the National Guard; they do reserve and active duty." 

Retired Brig. Gen. Steven P. Bullard, who works with the Kentucky Commission on Military Affairs, talked about how hard it is to return to the community after serving in the military.

“I went from commanding a combat squadron during Iraqi Freedom to being with my family in Walt Disney World 48 hours later—and it was the single worst experience I ever went through in my entire life, I can’t tell you how terrible it was for me," he said. "You come back as a guardsman. . . . You’re released back into your community … and you're not in that cocoon any longer and you’re with people who just don’t understand.”

Matt Castor, vice-president of government and corporate relations with USA Cares, a national organization headquartered in Louisville, said his organization works to remove some of the triggers of veteran suicides, like housing, financial struggles and transitioning into a career and that he, like the other organizations who help veterans, needed more funding.

"Simply put, we need your help," he said. "We are looking at the highest number of veterans coming to us this year than we've ever had in 20 years."

Castor said when they started the organization 20 years ago they were largely helping veterans with physical injuries from the war in Iraq, but since those needs have changed.

"Over the last 20 years, those needs have transitioned and we deal now with more of the invisible injuries of post-traumatic stress and traumatic brain injury," he said. "And as we do that, we've realized a few things . . . we may not be able to stop a suicide directly but we may be able to eliminate the factors that push somebody to make that type of terrible decision." 

Castor said in 2022 they received 224 applications for assistance, but could only help 15.3% of them due to a lack of funds. He said it cost about $4,000 per family to stop eviction from their home or foreclosure. He also talked about helping veterans with their car payments, noting that this allows them to take care of their families and get to their jobs.

"These are all triggers. These have a direct and profound impact on these families, that if we don't address these particular issues, then this rate will continue," he said. 

Also at the meeting were representatives for Project Diehard, which provides a respite for struggling veterans, and Check A Vet, a program that calls on people to become educated about suicide and prevention and to meaningfully and routinely engage with veterans. This program is also working on a veteran peer-to-peer pilot program in Kentucky.

Ernie Scott of Letcher County dies of rare brain aneurysm at 46; had been director of the State Office of Rural Health since 2013

Ernie Lee Scott

Funeral services were held Friday for Ernie Scott, who was director of the State Office of Rural Health in the University of Kentucky Center of Excellence in Rural Health. He did Sunday, March 12, at his home in Partridge, in Letcher County. He was 46.

The cause of death was a "random and rare" aneurysm in the brain, Coroner Perry Fowler told The Mountain Eagle of Whitesburg.

Scott started his career as a radiology technologist, earned a bachelor’s degree in health care administration at Midway College, was director of planning and special projects for Mountain Comprehensive Health Corp. in Whitesburg, and became director of the Office of Rural Health in 2013.

In 2014 Scott received the Emerging Leader Award from the National Organization of State Offices of Rural Health, and in 2020 he won the Kentucky Rural Health Association's Dan Martin Award for lifetime contributions to rural health. Last year, the office was one of three organizations in the nation to receive a three-year, nearly $900,000 grant from the federal Office of Rural Health Policy to improve access to health care for veterans living in rural Kentucky and to improve coordination of veterans' care.

Scott is survived by his wife, Tiffany Bullock Scott, and their daughter, Addyson Grace Scott. The couple owned and operated the General Store at Pine Mountain Crossing on US 119 and ran a hospital gift shop. Other survivors include his mother, Iris Jean Scott; siblings Howard Wayne Scott (Renee) and Sherry Scott Geiger (David); and many nieces and nephews.

"To know Ernie was to love him," his obituary says. "He quickly became a friend to all he met. He always greeted folks with a smile and often a big hug. He was a planner, a goal setter, and achiever. He loved his family, friends, church, and his community. He poured his heart and soul into Letcher County (specifically Cumberland River) and made huge impacts in many other rural communities."

His funeral was at Lewis Creek Pentecostal Church, along the Poor Fork of the Cumberland River in Partridge, with burial in the D.L. Creech Cemetery four and a half miles downstream, at Cumberland. Tri-City Funeral Home was in charge. Memorial donations may be made to a health-care scholarship fund in Scott’s name at Commercial Bank, 1701 E. Main St., Cumberland KY 40823.

New VA policy is expected to save some Ky. veterans by providing free emergency mental-health care to all vets, even if not enrolled

By Sarah Ladd
Kentucky Lantern

This story discusses suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988. Veterans and service members calling 988 can press 1 for specific crisis help from the Veterans Crisis Line.

Combat veteran Jeremy Harrell founded
Veteran’s Club, based in the Louisville
area, and advocates for mental health.
(Photo courtesy of Jeremy Harrell)

Once a veteran has decided to take their own life, “every minute counts,” said Army combat veteran Jeremy Harrell.

That’s why he believes a new federal policy aimed at decreasing veteran suicides through free emergency mental health care will be “an actual lifesaver” for Kentucky, which is home to about 370,000 veterans. It’s unclear how many of those aren’t enrolled in the Department for Veterans Affairs health-care system. Up to 9 million could benefit nationwide.

The new policy went into effect Jan. 17. It bypasses VA's enrollment rules, which Harrell said have kept some veterans from enrolling, Harrell said.

The policy allows veterans – both those enrolled in the VA system and those who are not – can go to any health-care facility – VA or non-VA – to get free emergency mental-health care in the case of a suicide crisis.

Enrollment in the VA system is open to veterans who served 24 continuous months or their entire active-duty stretch. The minimum-duty rule doesn't apply to those discharged because active duty caused or worsened a disability, and those who served before Sept. 7, 1980. 

The new, free emergency care includes 30 days of inpatient or residential care and outpatient care for up to 90 days, says the VA.

“This is a really, really big step in the right direction when it comes to veteran suicide,” said Harrell, who founded Veteran’s Club, based in the Louisville area, and advocates for mental health through a variety of organizations.

The new access also makes his job as an advocate easier, he said. He always recommends the suicide prevention lifeline, 988, to folks who call him in crisis. But in the past he also had to ask a series of eligibility questions to find out how to help the person. That takes up precious time.

“The clock is ticking,” Harrell said. “What we know is that when a person makes the decision, particularly in the veteran community, to take their own life … every minute counts.”

Now, help is simpler. Call or text 988. Or, he said, “find your way to the nearest emergency room.”

In 2020, there were 119 veteran suicides in Kentucky, up from 100 in 2019, according to the VA. Data for 2021 and 2022 is not yet available. Harrell said he’s aware of six Kentucky veterans who died by suicide since November.

“It’s heartbreaking to know,” he said, “how many lives that we may have lost because of the bureaucracy.”

Who is eligible?

Eligibility criteria for this program are, according to the VA: 

• Veterans who were discharged or released from active duty after more than 24 months of active service under conditions other than dishonorable.
• Former members of the armed forces, including reserve service members, who served more than 100 days under a combat exclusion or in support of a contingency operation either directly or by operating an unmanned aerial vehicle from another location who were discharged under conditions other than dishonorable.
• Former members of the armed forces who were the victim of a physical assault of a sexual nature, a battery of a sexual nature, or sexual harassment while serving in the armed forces

Are there enough mental health professionals in Kentucky?

Kentucky has a shortage of mental-health-care providers, according to the Health Resources & Services Administration. In fact, 2022 data from the Rural Health Information Hub showed every single Kentucky county as a mental health shortage area.

That’s “very much a concern” for Harrell, he said, pointing to pandemic-induced burnout as a culprit and the need for more social workers.

Private entities also need to be trained in military lingo so they can best communicate with veterans who come in, he said.

But for now: “My hope is that, if nothing else, (hospital staff) can help stabilize the individual, putting eyes on the individual, and at least try to support them, because that’s a big part of it.”

State rural-health office will get $299,999 a year for the next three years to help veterans get care; one of three such grants in U.S.

The Kentucky Office of Rural Health is one of three organizations in the U.S. to receive a three-year, nearly $900,000 grant from the federal Office of Rural Health Policy to improve access to health care for veterans living in rural Kentucky and to improve the coordination of care for veteran patients. The University of Kentucky Center of Excellence in Rural Health in Hazard serves as the federally designated Kentucky Office of Rural Health.

The $899,997 grant, provided through the Rural Veterans Health Access Program, will fund a range of efforts: conducting a needs assessment focused on the resources, programs, best practices and organizations currently available to assist the state's rural veterans; establishing and regularly calling together a stakeholder advisory group to guide projects; and hosting training sessions and community health days events for veterans, their families, health-care organizations and other community members.

The Office of Rural Health will also partner with community stakeholders to support projects at the local level that address veterans' access to care. Much of the work will be focused in the 27 counties where Kentucky’s 28 critical-access hospitals — rural facilities with 25 or fewer acute care inpatient beds — operate: Allen, Breckinridge, Caldwell, Carroll, Casey, Cumberland, Estill, Fleming, Floyd, Grant, Green, Hart, Knox, Leslie, Lincoln, Livingston, Madison, Marshall, Mercer, Morgan, Ohio, Russell, Simpson, Trigg, Union, Wayne and Woodford.

“This is a project and a population that we’ve been interested in working with for some time. We’re nothing short of excited,” said KORH Director Ernie Scott. “We have a veteran on our staff, a number of veterans working at the UK Center of Excellence in Rural Health and most of us here have a direct connection to at least one veteran in our own families. Our veterans are near and dear to our heart. It’s a population with a significant presence in rural Kentucky — more than 40% of Kentucky’s veterans live in rural communities — and it’s our honor to work with them, to support them and to seek out ways we can have a positive impact on their health and their ability to navigate the health-care system.”

Scott said the project also provides an opportunity to develop a closer relationship with the Veterans Health Administration, the country’s largest integrated health system, and to encourage innovative community partnerships between the VHA’s clinics and medical centers and Kentucky health-care professionals.

“There are plenty of efforts taking place here in the commonwealth to meet the needs of our rural veterans, and we’re not here to duplicate those efforts,” Scott said. “Instead, what we hope to do is call attention to any gaps that might exist in the care being provided to veterans and work with partners to develop solutions. We also want to showcase the good that’s being done and that can be replicated in other communities. This project is a win-win for everyone involved.”

The Office of Rural Health, established in 1991, is a federal-state partnership authorized by federal legislation. It works directly with clinicians, clinic and hospital administrators, policymakers and other stakeholders to improve the accessibility of health care services for the state’s rural and under-served residents. The office connects communities and health-care organizations to local, state and federal resources while working toward long-term solutions to financial, quality improvement and workforce challenges.

Omicron keeps setting records; tests are over 30% positive, not counting home tests; hospitals adopt crisis standards for staffing

Ky. Dept. for Public Health graph, adapted by Ky. Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

As the Omicron variant of the coronavirus continued to set new records in Kentucky and Covid-19 hospitalizations accelerated, some hospitals moved into what is called "crisis standards for staffing."  

Kentucky reached a new high for the number of Covid-19 cases reported in a Monday-to-Sunday reporting week, 72,165. That's more than double the records set during the Delta surge, said Gov. Andy Beshear.

On Saturday, the state reported 14,896 reported new cases, a record for one day. More than 1 million Kentuckians (1,014,703) have now had a confirmed case. Of today's 8,742 new cases, 27.8% were in people 18 and younger.

Another record: the share of Kentuckians testing positive for the virus in the past seven days hit yet another, 30.25%. "We never dreamed that almost one out of every three people being tested would be positive," Beshear said. 

Those numbers do not include any at-home tests, and the case numbers do not indicate any positive test results, which may not be accompanied by symptoms.

The state's daily report was the first since Friday, due to the Martin Luther King holiday. The seven-day rolling average of new cases surged to a record 10,673 on Monday but dropped slightly Tuesday, to 10,572.

The statewide daily incidence rate is 213 cases per 100,000 residents. The rate in 41 of the state's 120 counties is above 200 cases per 100,000, and every county has more than 25 cases per 100,000, considered a high level of transmission, putting all of them in red on the state infection map. 

Despite the big increases, most other states are in worse shape. The New York Times ranks Kentucky's rate 44th among the states, with a 47% increase in cases in the last 14 days. 

Dept. for Public Health graph, adapted by Ky. Health News

But hospital numbers continue to go up, causing some to instigate "crisis standards for staffing," which give them to have latitude for bringing staff back from quarantine or isolation. State Health Commissioner Steven Stack said more than 450 National Guard members continue to support the state's health-care facilities. 

"It is a tough time to work in a hospital," Stack, an emergency-room physician by trade, said as he thanked them for their service.

Hospitals reported 2,200 Covid-19 patients on Tuesday; 431 of them in intensive care and 244 on mechanical ventilation.

Recently, public-health experts in major cities have noted that many patients with Covid-19 were admitted with other conditions but were identified as such after they tested positive for the virus, Beshear said hospitals are not breaking down those patients into different categories. 

Asked about the U.S. Supreme Court's decision that allows the federal government to require vaccination of employees at health-care facilities that get federal money, Beshear said he expects very few workers in such facilities to refuse vaccination, so it should not have any significant impact on their workforces. 

Nine of the state's 10 hospital regions are using at least 80% of their intensive care beds, and five of them are above 90%. Northern Kentucky is at 100%. 

With hospital capacity so stretched across the state, Beshear again encouraged Kentuckians to get vaccinated. "Get vaccinated, get boosted and you're very unlikely to end up in the hospital for Omicron," he said. 

Three-fourths of of Kentuckians 18 and older have received at least one dose of a vaccine, but health experts say three doses of the Pfizer of Moderna vaccines, including a booster shot, are needed for Omicron immunity.

Both the percentage of adults and children 5-11 who have been vaccinated increased by one percentage point recently, but only 19% of those children have had a shot, With schools reopening, Beshear said, "We have to do better." 

So far, 2.8 million Kentuckians have gotten at least one dose of a Covid-19 vaccine, or 63% of the total population; 2.4 million are fully vaccinated, or 55% of the total. Among the fully vaccinated population, 959,754, or 39%, have been received a booster shot.

In yet another push for shots as a way to stay out of the hospital or to have less severe symptoms,  Beshear said, "If you are unvaccinated, it hits you like a Mack truck and we see people in the hospital and dying from Omicron because of that failure to get vaccinated."

Addressing unvaccinated people who think they can get monoclonal-antibody treatment or an anti-viral pill if they get sick, Stack said there is not enough of the anti-viral medications available to meet demand. 

"The bottom line is that you can't rely on finding these medications reliably, no matter how we distribute them, and this won't change before the Omicron surge recedes," Stack said. "Vaccines though remain abundant and are highly effective in preventing severe and life-threatening disease." 

Stack noted President Biden’s plan to make 1 billion at-home tests directly available to the public. You may order four at-home tests per household at COVIDtests.gov.

Besehar said 294 state prison staff and 392 inmates have tested positive in the current outbreak but no inmates have been hospitalized. He said the Eastern Kentucky Correctional Complex, the Kentucky State Reformatory and the Kentucky Correctional Institution for Women have been quarantined and 85% of all inmates have been vaccinated, with 55% of them boosted. 

Beshear also listed state veterans' centers with cases: one at the Eastern Kentucky Veteran Center, one at Radcliff Veterans Center; two at Thompson-Hood Veterans Center in Wilmore; and five cases at Western Kentucky Veterans Center. 

Beshear said he had not heard of any outbreaks in Kentucky nursing homes. 

The state has reported 131 more Covid-19 deaths since Friday, with one of the deaths a 28-year-old, three of them in their 30s, and 10 of them in their 40s. The pandemic death toll in Kentucky is 12,614. 

"If you are in your 40s, this thing is killing you right now," said Beshear. "Please get vaccinated."

Health portion of Beshear's budget would help nursing homes, fund training and retention of nurses; mental health, and more

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear previewed the health portion of his budget plan Wednesday, with new money for nursing homes, retention and recruitment of nurses, along with funding for senior hunger and mental health. 

Beshear will deliver his budget address at 7 p.m. ET Thursday, Jan. 13. In an unprecedented move that he called a stunt, Republicans who control the House filed their own version of the budget Friday. 

There are many differences in the plans for spending the state's money from July 1, 2022 to June 30, 2024, but Beshear said, "Any of our values that they fund more than we do, we're in favor of it."

The legislature makes the final decisions on the budget. The Democratic governor can remove line items with vetoes, but Republicans can override him with simple majorities in the House and Senate.

Nursing home relief: Both plans would keep paying nursing homes the additional $29 a day they have been getting for each of their Medicaid patients during the pandemic. 

The money comes mainly from the federal Centers for Medicare and Medicaid Services. The normal federal match rate for Medicaid is 72%, but that has been increased 6.2% during the pandemic.

The state is asking CMS to re-approve this additional funding retroactive to Jan. 1 and until the end of the federal health emergency, which is expected to be extended at least one more time, said Betsy Johnson, president of the Kentucky Association of Health Care Facilities, the nursing-home lobby.

"We are very grateful that it appears that both the Kentucky General Assembly and Governor Beshear are both on the same page with regard to the needs of skilled nursing facilities in Kentucky."

Johnson said she also was pleased to hear the governor say that the rate increase will be re-evaluated at the end of 2024. (Voters will decide in November 2023 if Beshear gets a second term.) 

"I believe the Kentucky General Assembly realizes that we're not going to ever be able to go back to pre-Covid days," Johnson said. "Our costs have gone way up, so this $29 add-on really should continue because that's just the reality of operating a skilled nursing facility today."

Money to retain and recruit nurses: Beshear said his budget will include scholarship money to recruit nursing students and loan-forgiveness money to keep nurses in the profession and in Kentucky. 

He said it will have $6 million a year to "significantly increase" scholarships, doubling the maximum award to $3,000 per semester. "That is a huge difference to students who want to pursue this path, but worry about the cost of doing so," Beshear said. Currently, about 150 students get scholarships funded by nursing-license fees.

To keep nurses on the job, Beshear's budget would create a five-year student-loan forgiveness program with up to $3,000 annually for each year a nurse or faculty member is employed in and stays in their job in Kentucky.

"We love our Kentucky nurses," Beshear said. "We want to support them and we want more people to join the ranks."

Lerae Wilson of St. Claire Regional Medical Center (Image from video)

Lerae Wilson, chief nursing officer and vice-president of patient services for St. Claire Regional Medical Center in Morehead, thanked the governor in a video. 

"Nurses are warriors," she said. "We are fighting for the lives of those we serve. . . . but these warriors are tired. They're exhausted. The pandemic has shown us that while we're good at what we do, mandatory overtime can only continue for so long. And with the shortage like it is we have got to have people who are willing to step into those shoes and continue that fight. . . . We have to have replacements." 

The Kentucky Nurses Association projects that the state will need more than 16,000 more nurses by 2024 to replace those who will retire or leave the profession, as many have during the pandemic.

A KNA survey of 850 nurses in October found that one-fourth said it was likely or extremely likely that they would leave their job in the next three months, and 16% said they were likely to leave nursing.

Beshear also wants to use $2 million of federal pandemic relief money for a marketing and outreach program for the profession, and includes nurses in his proposed $400 million "hero bonuses" for pandemic through-work.

In December, Beshear signed an executive order allowing the state to take special steps to educate and license more nurses. Among other things, it requires the state Board of Nursing to approve requests for enrollment increases in schools that show sufficient resources to handle more students; requires schools to report vacant student seats to the board each month; and requires the board to post them online, allowing schools without vacancies to refer applicants to the open slots. 

Senior hunger: Using pandemic money, Beshear said, Kentucky eliminate a waitlist of about 7,000 seniors to receive free meals. 

"I'm bit ashamed that I did not know before this pandemic that we had a waiting list for seniors that were going hungry in Kentucky," he said. "That's right. We had a list of how many seniors couldn't afford regular meals and needed our help and we weren't reaching all of them."

So that never happens again, Beshear said, he wants $36.2 million over the next two and a half years for an additional 49,000 meals for seniors per week, which fully meets the current needs of Kentucky’s citizens.

"We should never have a waiting list for seniors who are going hungry to get help ever again," he said. 

Mental health: Beshear's plan includes several boosts for mental health: 

• $3.4 million in fiscal year 2023 and $9.9 million in fiscal year 2024 to phase in 170 additional staff to Kentucky's Community Mental Health Centers, which offer support 24-huors a day, seven-days a week. 
• Implementation of the new 988 crisis support line, a three-digit number set to replace the National Suicide Prevention Lifeline in July 2024.
• Funding to expand Tim's Law to two other psychiatric hospitals in the state: Eastern State Hospital and the Appalachian Regional Hospital system. Tim's Law allows judges to order assisted outpatient treatment for people who have been involuntarily hospitalized, aimed at stopping the revolving door of these individuals in and out of jails and state psychiatric hospitals. 

Also proposed in Beshear's health portion of the budget:

• Full funding of Medicaid, which covers one in three Kentuckians, including more than 650,000 children. 
• Money for 500 more slots in the "Michelle P." waiver program and 100 more slots in the Supports for Community Living waiver program, both for people with intellectual or developmental disabilities. Thousands of Kentuckians are on the programs' waiting lists. 
• More than $36 million for health departments, which are shifting to a new funding model. The money can be used to help with staffing and operations. 
• A 34% increase in funding for domestic violence centers, rape crisis centers and child advocacy centers; an additional $19.6 million a year to sustain and expand prevention services; and a 17% rate increase for residential and therapeutic foster-care providers. 
• A $2 per-child, per-day increase in the child-care assistant program reimbursement rate, using federal relief funds.
• Various funds to help veterans' causes, including $1 million in fiscal year 2024 to phase in operations at the newest state veterans center in Bowling Green.
• Funding of the Pediatric Research Trust Fund, which organizes all Kentucky research on pediatric cancer, would rise to $3.75 million a year from $2.5 million.

A mixed bag of metrics: Positive-test rate is up and Covid-19 deaths remain high; virus cases and hospital numbers are down

State graph, adapted by Kentucky Health News; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

While several of the metrics used to measure the impact of the novel coronavirus in Kentucky are on the decline, indicating that the post-holiday surge is waning, the number of Kentuckians dying from the disease remains high and the positive-test rate has inched up again. 

Deaths are a lagging indicator of the pandemic, and Gov. Andy Beshear reported 40 more on Monday, 39 of them confirmed as caused by Covid-19 and one probable. That brings the state's death toll to 3,167. The seven-day average for deaths is 35 per day, and the 14-day average is 30, both new records.

Because of the Martin Luther King holiday, Beshear did not hold his usual Monday news briefing, nor did the state release a detailed list of the new fatalities. 

A leading indicator, the percentage of Kentuckians testing positive for the virus in the last seven days, inched up again, to 11.54 percent. That's up from 11.49% the day before and the first significant increase in this rate since Jan. 10, when it hit the record of 12.45%. 

New cases of the virus are also considered a leading indicator, and that one appears to be improving. Beshear announced 1,998 new cases Monday, a day that often has a lower case count because fewer labs report over the weekend. The number was lower than the last two Mondays.

The seven-day rolling average, which is a better measure of the pandemic because it smooths out daily fluctuations, continued to decline, to 3,301. That's about halfway between where it was on Jan. 7 and 8, when it was in the middle of a steep, post-holiday increase.

Kentucky also saw a decrease in newly reported cases last week, with 3,749 fewer than the week before. The state reported 23,050 cases Jan. 11-17, down from 26,799, which had been the highest week yet. 

Numbers from Kentucky hospitals also declined. They reported 1,587 Covid-19 patients on Monday, 25 fewer than Sunday. This is the first time hospitalizations have numbered less than 1,600 since Nov. 23, except for three days from Dec. 21 to Dec. 28. The report shows 387 Covid-19 patients in intensive care, 23 fewer than Sunday; and 208 are on a ventilator, four fewer than Sunday. 

The hospital-capacity report also shows improvement, with three of the 10 hospital readiness regions reporting intensive-care units more than 80% full: Northeast, 86%; East, 81%; and Lake Cumberland, 84%. Sunday, four were over 80% ICU capacity and Northern Kentucky was above 80% overall capacity.

The two counties with the highest infection rates continue to be Morgan and Oldham, both sites of virus outbreaks at state prisons. Respectively, they averaged 369.2 and 247 cases per 100,000 residents over the past seven days. Other counties with more than 100 new cases per 100,000 residents (1 per 1,000) were: Clinton, 174.8; Wayne, 120.8; Hancock, 111.4; Harrison, 107.4; and Pulaski, 104.9. Statewide, the rate is 69.27.

In other coronavirus news Monday: 

• Counties with 10 or more new cases were Jefferson, 342; Fayette, 230; Oldham, 208; Madison, 67; Kenton, 66; Boone, 64; Campbell, 51; Warren, 48; Franklin, 38; Greenup, 36; Bullitt, 32; Graves and McCracken, 28; Marshall, 25; Scott, 23; Shelby, 22; Daviess, 21; Harrison, 20; Pulaski, 1;9 Bell, Bourbon and Harlan, 18; Muhlenberg and Pike, 17; Barren, Jessamine and Taylor, 15; Boyd, Christian, Clay and Hopkins, 14; Boyle, Mercer and Woodford, 13; Calloway, Clinton and Floyd, 12; Caldwell, Laurel and McCreary, 11; and Hart, Montgomery and Pendleton, 10.
• The U.S. Department of Veterans Affairs in Lexington told WKYT that about 4,000 veterans will have received the first dose of a Covid-19 vaccine following a three-day hospital clinic that ended at 2 p.m. Monday.
• Vaccine sign-ups are available at the University of Kentucky Kroger Field location for vaccinations that will begin at noon Tuesday, Jan. 19. By completing the vaccine request form, you will be added to the database of those requesting vaccination at this location. Priority will be given to healthcare workers, essential workers and older people. Click here for more information. 
• "Inundated with requests for Covid-19 vaccines for people 70 or older, all three of Louisville's hospital systems have been forced to suspend appointments — just three days after they started scheduling them, Deborah Yetter reports for the Louisville Courier Journal. Meanwhile, the waiting list for people seeking appointments has grown to about 40,000 since Friday, Dr. Jason Smith, chief medical officer for University of Louisville Health, said on a press call Monday. Yetter reports that people are encouraged to to keep trying to sign in and that spots will be added as more vaccines become available. 
• The state's vaccine report shows that the state program has received 226,175 doses and has administered 177,197 of them, or 88%. Beshear's goal is 90%. The long-term-care facility program, run by Walgreens and CVS under federal contracts, has received 106,275 doses and administered 36,370, or 34%.

Covid-19 death numbers keep ticking up as most other measures of the pandemic decline; holiday surge appears to be over

Kentucky Health News graph; case numbers are based on initial, unadjusted daily totals

By Al Cross
Kentucky Health News

Sunday's Kentucky pandemic report was much like Saturday's, with most metrics showing a decline but death rates setting more records, likely in part the results of cases that were part of surges during recent holiday periods.

The state added 34 more names to the list of people whose deaths have been officially attributed to Covid-19, 24 of them confirmed and eight probable. That raised the seven- and 14-day daily averages to 32.3 and 28.9, new highs.

Kentucky's death toll from the virus reached 3,127. As usual for a Sunday, the state did not release a detailed list of the additional fatalities.

New cases of the novel coronavirus in Kentucky totaled 2,362 – 372 of them probable and the rest confirmed. That was almost 11,000 fewer than last Sunday, and concluded an official reporting week with about 14 percent fewer cases than the week before. Final weekly numbers are reported on Mondays.

The seven-day rolling average of new cases, the most common measure of the pandemic, is 3,314. It has fallen steadily for five straight days since setting a record of 4,002 on Tuesday, Jan. 12. That was for a seven-day period with the three highest daily totals of the pandemic, as well as the sixth highest.

Another sign that the post-holiday surge has ended is a continued decline in the percentage of Kentuckians who have testing positive for the virus in the last seven days. That stands at 11.49%, one week after hitting a record 12.45%.

Numbers from hospitals remained steady or declined. Kentucky hospitals reported 1,602 Covid-19 patients, 29 fewer than Saturday; 410 of them were in intensive care and 410 212 were on ventilators.

But for the first time, five of the state's 10 hospital readiness regions were flagged for having case numbers above 80 percent capacity, four of them involving intensive-care beds: Lake Cumberland, 89%; Northeast, 87.5%; Barren River, 85%; and the easternmost region, from Lee to Pike counties, 82%. Northern Kentucky was at 81% of overall capacity but its ICU beds were only 56% full.

The two counties with the highest infection rates were Morgan and Oldham, both sites of virus outbreaks at state prisons. Respectively, they averaged 596 and 205 cases per 100,000 residents over the past seven days. Other counties with more than 100 per 100,000 (1 per 1,000) were: Clinton, 191.5; Wayne, 132.1; Hancock, 113; Harrison, 108.9; Pulaski, 104.4; and Taylor, 100.9.

Counties with 10 or more new cases were: Jefferson, 350; Fayette, 222; Oldham, 187; Boone, 131; Kenton, 119; Pike, 58; Campbell, 54; Pulaski, 53; Daviess, 49; Graves, 46; Calloway, 38; Bullitt, 37; Madison, 34; Harrison, 33; McCracken, 32; Jessamine, 31; Christian, 27; Hardin, 25; Floyd, Muhlenberg, Scott and Warren, 24; Barren and Franklin, 23; Laurel, 22; Boyle, Henderson and Shelby, 21; Logan, Ohio and Rowan, 19; Clinton, 17; Boyd and Greenup, 16; Anderson, Bell, Grant an d Woodford, 15; Breckinridge, 14; Carter, Hopkins, Marshall and Nelson, 13; Perry and Taylor, 12; Bourbon, Johnson, Letcher, Meade, Rockcastle and Spencer, 11; and Hart and Leslie, 10.

In other coronavirus news Sunday:

• Veterans seeking a coronavirus vaccine besieged a federal veterans hospital on the University of Kentucky campus that offered walk-in vaccinations without appointments Saturday and Sunday. It created "massive traffic jams from all directions," some vets gave up, and Saturday's clinic ended two hours early to save vaccine supplies for Sunday and Monday, reports Sofia Millar of WLEX-TV. Many of the vets had not previously registered to get care at the hospital, so that created a second waiting line. On Saturday, some elderly vets waited in the cold weather, but on Sunday they were able to sit in their vehicles and wait to be called. Officials said they scheduled the clinic because they had been able to schedule only 400 appointments a day; they said 1,600 doses were administered Saturday.
• The university said it will centralize all its vaccinations at Kroger Field beginning Tuesday. President Eli Capilouto said in an email that UK will vaccinate K-12 school personnel, "members of our campus community" and others in its health-insurance plan, "in alignment with state guidelines." He added, "As we have received more vaccine doses – earlier and in larger volumes than we anticipated – we have been vaccinating more and more people. That is a good thing. But it also is an incredible logistical challenge. . . . The state has – rightly – told us that we are to use every dose we get, each week, as quickly as possible. This is our commitment."
• Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, said on NBC's "Meet the Press" that Johnson & Johnson appears likely to get approval for its one-shot vaccine in "a matter a weeks, not months."

As virus cases, hospitalizations and deaths tick back up, Beshear says holiday actions may determine who's around for next year's

Kentucky Health News graph; virus case numbers are based on unadjusted daily reports.

By Al Cross
Kentucky Health News

As Kentucky headed into another holiday with cases, hospitalizations and deaths from covid-19 trending slightly upward, Gov. Andy Beshear's parting message was upbeat but cautious.

“With the rest of the country on fire, with hospitalizations escalating in almost every other state, we are seeing a stabilization that is protecting the lives of our people, and we want to make sure we continue to plateau or even decrease cases as we move toward this vaccine,” Beshear said, referring to the shots he and other top officials got earlier in the day. 

“How we do Christmas and New Year’s, those celebrations, is gonna be critical to protecting as many Kentuckians as possible until we can get this vaccine disseminated,” the governor said. At the end of his last briefing until next week, he said, “How you handle Christmas and New Year’s may determine who’s around next Christmas and New Year’s.”

While the pandemic has hit a rough plateau in Kentucky, the state reported 3,057 new cases of the coronavirus Tuesday, pushing the seven-day rolling average upward for the second day in a row, to 2,803.

“Our numbers are high but pretty close to what we saw last week,” Beshear said. Last Tuesday's new-case number was 2,946.

At the other end of the disease process for some, Beshear reported 28 deaths, raising the state's 7-day and 14-day death means to new highs, 28.7 and 24.1.

As he usually does, Beshear urged Kentuckians to display green lights and ring bells in memory of the 2,440 Kentuckians who have died of Covid-19.

“You never know who’s listening; you may never know who will find a moment of help in them,” he said, adding that green lights and the sound of the bells may make survivors of Covid-19 victims realize that “even though we don’t see and get close, we are in this together.”

Norris Hardison, who served in the Army, was the first vet
at the center to get a shot. (Photo from governor's office)

As vaccinations at nursing homes and hospitals continued, the first were performed at the Thomson-Hood Veterans Center in Wilmore, one of four state facilities for vets, which has lost 34 residents to Covid-19.

The first was Norris Hardison, who was quoted in Beshear's press release: “I am not afraid. I want everyone to see me take it and know that it is safe. Every single person should get this vaccine. I have been talking to my family, and even my daughter, who is afraid of needles, is going to take it. It’s the best way to protect us all from this Covid virus, and I am just so happy that it’s finally here.”

Beshear said 90 vets and more than 100 employees at the center were vaccinated Tuesday, and the two homes in the east and west would be next, on Jan. 9, with the Radcliff home soon afterward. 

“This is a great step forward, but it’s gonna take time,” he said, noting that preventive measures will still be needed for months, and that even people who have been vaccinated may still catch the virus and spread it.

Kentucky's long-term care facilities have accounted for two-thirds of the state's Covid-19 deaths. Yesterday they reported 115 more cases of the virus among residents and 72 among staff, and the state attributed 18 more deaths of residents to Covid-19. There are 3,346  active cases in 408 facilities.

Beshear said it will take a few weeks, maybe all of January, before the state can move on to vaccinations of other groups. He said the state could easily set up a program for people 75 and over, as the Centers for Disease Control and Prevention has recommended, but it will be impossible to include at the same time all of the "essential workers" the CDC listed. He said he would probably have more information next week on that front.

The 28 Covid-19 fatalities reported Tuesday were a 91-year-old woman from Boyd County; two Calloway County women, 91 and 94; a Casey County man, 66; two women, 64 and 87, and a man, 71, from Daviess County; a Fleming County man, 67; a Graves County woman, 67; two women, 57 and 63, and two men, 58 and 83, from Henderson County; a Henry County man, 67; a Hopkins County man, 67; a Jackson County woman, 74; a woman, 53, and a man, 62, from Jefferson County; a Knott County man, 81; three Marion County women, 86, 94 and 96; two McCracken County men, 79 and 85; a woman, 87, and a man, 59, from Monroe County; a Perry County woman, 60; and a Todd County woman, 54.

In other coronavirus news Tuesday:

• Counties with more than 10 new cases were: Jefferson, 468; Warren, 136; Madison, 127; Fayette, 125; Kenton, 113; Christian, 105; Daviess, 89; Boone, 88; Laurel, 81; Pike, 61; Clay, 53; Campbell, 47; Henderson, 44; Knox, 43; Hardin, 42; Pulaski, 40; Wayne, 39; Lincoln, Logan and Oldham, 38; Barren and McCreary, 37; Bullitt, 36; Whitley, 32; Scott, 31; Hopkins and Simpson, 30; Grant and Nelson, 29; Boyle, 28; Jessamine, 27; Allen and Mercer, 26; Clinton, 25; Clark, Ohio and Taylor, 24; Carter and Harlan, 23; Graves, 22; Johnson, 21; Bath and Grayson, 20; Boyd Franklin and Muhlenberg, 19; Greenup and Monroe, 18; Calloway and McCracken, 17; Bourbon and Letcher, 16; Anderson and Perry, 15; Harrison and Montgomery, 14; Adair, Lewis and Trigg, 13; Estill, Marion, Marshall, Meade and Russell, 12; and Breathitt, Butler, Fleming, Jackson and Shelby, 11.
• Beshear said that while the pandemic relief bill passed by Congress doesn't include general budget relief he wanted, "It includes a lot of things that help us out, such as hundreds of millions of dollars for vaccines and distribution, testing and contact tracing. "That’s what we needed the very most."
• The bill gives states another year to spend money that they received from last spring's relief bill. Beshear said Kentucky will have $200 million to $250 million of that remaining on Dec. 31, the original spending deadline, but will use most of the money to pay off the loan it obtained for unemployment benefits.
• Kentucky has been one of the slowest states to deliver unemployment benefits. Beshear has blamed an avalanche of claims and a system not maintained by previous administrations. He said the state had received such differing guidance from the U.S. Department of Labor that the department's inspector general "has launched an investigation."
• Beshear said the next state budget needs money to improve that system and others. The Democratic governor said the Republican-heavy legislature will have to decide, in Depression-era terms, “whether this state is gonna be FDR or Herbert Hoover."

Kentucky sees worst coronavirus day yet, with more than 4,000 new cases, 35 deaths and other record measurements of misery

From Gov. Andy Beshear's Twitter page

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced record numbers for almost every metric the state uses to measure the coronavirus pandemic Tuesday, calling it "a terrible day." 

"No way to sugarcoat it," Beshear said at his daily briefing. "Today is the very worst day that we have had for reporting on the spread of the coronavirus and it is the deadliest day that we have had. This is exponential growth. . . . If we don’t all do our part, if we try to be the exception, then slowing down this thing won’t work and we will lose a lot more Kentuckians we love and care about.”

Beshear announced record highs for new coronavirus cases, covid-19 deaths, hospitalizations, patients in intensive care and on ventilators, and the highest percentage of Kentuckians testing positive for the virus since the testing became widely available in May: 9.59%.

The governor reported 4,151 new cases of the virus, well beyond the previous record of 3,870, set on Thanksgiving.  

The new record of 35 deaths brought the state's covid-19 death toll to 1,943. The previous single-day high was 33, set Nov. 17.

The number of covid-19 patients in Kentucky hospitals hit a high of 1,777, with 441 in intensive care and 241 of those on a ventilator. And while covid-19 patients' share of beds in the state's hospitals remained the same as Monday, 21%, their percentage of ICU beds increased to 32%, from 30%, and their share on ventilators increased to 41% from 38%. 

“Covid is spreading like wildfire, taking record numbers of people from us, infecting record numbers of people out there,” Beshear said. "That's why we're fighting back. That's why we're trying to be aggressive and not wait for it to overwhelm us, but to try to stem this third wave just like we stopped the first two and not surrender and accept unacceptable fatalities." 

Restrictions: On Nov. 18, Beshear imposed new limits, including bans on in-person schooling and indoor service in bars and restaurants, and tighter numerical limits on at-home social gatherings. All have been controversial.

“We do believe right now that the steps that we’ve taken are absolutely necessary,” Beshear said. "And maybe today’s report will convince those out there who disagree. . . . Today is a terrible day that shows us how quickly this thing is spreading. It shows why it is so important to take steps to stop it before it gets any worse.” 

Asked why he is allowing elementary schools outside counties with the highest range of infections to reopen next Monday, Dec. 7, but keeping middle and high schools closed until Jan. 4, Beshear said evidence shows less virus spread among elementary students, and in-person learning is more important for them. 

As for the Dec. 7 reopening, he said, "Our hope is that we have tamped down the virus by that point to where there's significant opportunity out there. But right now, we don't see that changing."

Contact tracing: Mark Carter, head of the state's contact-tracing program, said it has shifted to a focus on mitigation instead of containment because the virus is so widespread. He said tracers are are only contacting patients who test positive, and instructing them to inform their close contacts.

“We’re being overwhelmed in terms of our disease investigation and contact tracing efforts," Carter said. "I think that is in part because we haven't had the level of compliance that we need to have with public health recommendations around masking and social distancing, and so forth.

"But we can turn that around, we can make a difference with that by taking our individual personal responsibility to heart knowing that we're protecting our loved ones and friends and family and, and we're just being good citizens. And we can we can turn that around." 

Seniors: Community spread is also taking a toll on nursing homes. The state reported 2,251 active cases among residents and 1,193 among staff, with 173 new resident cases and 109 new staff cases reported today. Beshear said at least 57 long-term-care facilities have 15 or more active cases. Nursing home residents and staff have accounted for 65% of the state's covid-19 deaths.

"Our community response isn't where it needs to be," Beshear said. "Whether or not people in long-term-care facilities get covid is about what we do in our daily lives, the decisions we make and whether or not we do what it takes to prevent it from spreading to those around us."

Beshear reported that another veteran at the state's Thomson-Hood Veterans Center in Wilmore, who was previously listed as recovered, had died, bringing the center's death toll from the virus to 31. He said there is currently two active cases in the center and no new cases have been reported for 18 days. 

He also announced that the veteran who was the first active case at Western Kentucky Veterans Center in Hanson had died. In addition, he said a 37-year-old inmate from the Lee Adjustment Center, a privately operated state prison, had died from covid-19. 

Funding: Both Carter and Beshear made urgent pleas for more federal money. 

"Essentially all of our disease investigation and contact-tracing effort across the commonwealth has been funded by the federal CARES Act," Carter said. "We're required to have spent that funding by December 30. We desperately need either an extension of that date or additional funding, or both in order to take this program into 2021 and get us through the months that we need to get through 'til we reach the point where we have a widely available vaccine." 

Speaking more broadly, Beshear said that without any more federal relief funds there won't be any additional relief for restaurants and bars, for additional unemployment aid, for local governments, for eviction relief, or for contact tracing and the state's testing efforts: "Everything stops at the end of December unless we get a new act of Congress."

A bipartisan group of lawmakers outlined a $908 billion relief proposal Tuesday as an attempt to jump-start negotiations so that they can pass relief before the holidays, Andrea Noble reports for Route Fifty. Senate Majority Leader Mitch McConnell said there was "no reason" that Congress can't pass one by the end of the year, the Lexington Herald-Leader reports.

Bruce Gadansky

Beshear honored the life of Bruce Gadansky, who died of covid-19 at the age of 76, leaving behind his wife Mickey, two sons and five grandchildren. 

“As Bruce passed on, his wife and son were left to say their goodbyes, urge him on to a better tomorrow, through a phone held to his ear by a nurse," said Beshear. " That is what covid does to our loved ones." 

Beshear said Gadansky was a U.S. Navy veteran who served in Vietnam, was a deputy sheriff in Oldham County for 10 years and championed causes for the elderly during his time as vice-president of operations for the Louisville Better Business Bureau. He had also been a volunteer for St. Matthews Baseball.

“What we must stress here is that Bruce and Mickey tried to do it all right," Beshear said. "They barely left the house in nine months and they always wore a mask. But that’s the thing about masks – it takes all of us wearing them correctly to protect one another. If we do, we can prevent the loss of individuals like Bruce, and the heartbreak of his family who is now mourning." 

In other covid-19 news Tuesday: 

• Tuesday's deaths were a 70-year-old Boyd County man; a 75-year-old Calloway County man; an 82-year-old Christian County man; a 96-year-old Daviess County woman; a 95-year-old Graves County woman; two women, 79 and 86, and two men, 57 and 66, from Grayson County; a 93-year-old Henderson County woman; an 87-year-old Hopkins County man; six women, 61, 64, 76, 77, 77 and 80, and seven men, ages 62, 64, 64, 66, 72, 73 and 94, from Jefferson County; a 62-year-old Jessamine County woman; a 76-year-old Kenton County man; a 79-year-old Marshall County woman; a 66-year-old Mason County woman; two men, 59 and 64, from McCracken County; a woman, 88, and a man, 64, from Monroe County; a 65-year-old Montgomery County man; a 93-year-old Robertson County woman; and an 82-year-old Union County man.
• Counties with 10 or more new cases were: Jefferson, 700; Fayette, 238; McCracken, 172; Warren, 148; Kenton, 126; Hardin, 120; Daviess, 119; Boone, 102; Madison, 97; Laurel, 89; Oldham, 80; Campbell, 73; Christian, 72; Hopkins, 67; Marion, 62; Bullitt, 61; Lincoln, 56; Nelson, 55; Hart, 54; Pike, 51; Montgomery, 50; Carter and Clay, 49; Barren and Graves, 48; Pulaski, 44; Greenup, 41; Magoffin, 39; Marshall, 38; Rowan and Woodford, 36; Whitley, 35; Jessamine, 34; Boyle, 32; Floyd, 31; Ohio, 30; Bell and Henderson, 29; Franklin, 28; Knox and Washington, 27; Clark, Johnson and Logan, 26; Harlan, 25; Anderson, Boyd, Mercer, Rockcastle and Taylor, 23; Lawrence, 22; Garrard, 21; Adair and Scott, 20; Calloway, 18; Grant, Larue and Simpson, 17; Monroe, Perry and Shelby, 16; Bracken and Jackson, 15; Edmonson, Muhlenberg and Pendleton, 14; Grayson and Harrison, 13; Livingston and Mason, 11; and Butler, Letcher, Martin, Union and Wayne, 10.
• Beshear said 2,650 restaurants and bars have applied for the Food and Beverage Relief Fund, for a total of $25.6 million in assistance. The state has already approved applications for $1.7 million. To apply, click here. Beshear said he expects bars and restaurants will be able to resume indoor service on Dec. 14 as planned.
• As cases continue to surge in Kentucky, Beshear encouraged Kentuckians to get tested. Click here to find a location near you. 
• The Healthy at Home Utility Relief Fund still has about $11 million in it that must be dolled out before Dec. 30. “Eligible households can receive a one-time $500 benefit towards their water and or wastewater bills and $400 towards their natural gas or utility bills,” said Beshear. Households who have an income up to 200% of the federal poverty line and have been economically impacted due by covid-19 can apply through their local Community Action office. Click here to find your local office, as well as a list of required documentation, or call 800-456-3452. 
• Food and Drug Administration Commissioner Stephen Hahn told McClatchy Newspapers on Tuesday that the FDA will not automatically authorize emergency use of coronavirus vaccines before completing a rigorous independent review. “The urgency of the situation is a pressure that I think is substantial on all of us,” he said in the phone interview. “Our career staff recognize that and are working with great speed. But also we’ve maintained a commitment to using data and science, and we will continue to do that.”
• The coronavirus may have been spreading in America as early as December 2019, according to a Centers for Disease Control and Prevention study that found coronavirus antibodies in 106 of the 7,389 blood samples from routine blood donations to the American Red Cross between Dec. 13, 2019 and Jan. 17, 2020, the Herald-Leader reports. However, the researchers also said they wondered if the detection of antibodies in these samples indicates a past coronavirus infection, or that of another pathogen in the coronavirus family, such as the common cold. They also say "widespread community transmission was not likely until late February." 
• In a decision released Monday, Attorney General Daniel Cameron said Kentuckians who report people or businesses to the state for failing to comply with its pandemic restrictions should not be granted anonymity, John Cheves reports for the Herald-Leader. The ruling was made against the Labor Cabinet in an appeal under the state Open Records Act. "In a letter to Cameron, the cabinet warned that publicly identifying tipsters 'will have a chilling effect on citizens’ good-faith reporting of non-compliance with public health orders,' especially if their names are posted online by Beshear’s critics," Cheves writes. 
• Dalton Godbey of Louisville's WDRB looks at why state and local coronavirus and covid-19 statistics don't always match up. 
• The director of the Laurel County Health Department told Phil Pendleton of WYMT that he expects a surge of coronavirus cases in mid-December. Health leaders told him most of their contact tracing points to the virus being spread in household gatherings.

Ky. expects first coronavirus vaccines in mid-December, for long-term-care residents and staff, and some frontline health workers

State Department for Public Health chart, relabeled by Kentucky Health News

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced Monday that Kentucky expects to get its first shipment of coronavirus vaccines by mid-December and is making plans for how to distribute it. 

"The light at the end of the tunnel is brighter than its ever been but we still have along way to go," Beshear said at his daily briefing – where he announced record numbers of covid-19 patients in intensive care and on ventilators, and another big jump in the percentage of Kentuckians testing positive for the virus.

Beshear said that as early as mid-December, the state expects to get 38,025 doses of the Pfizer Inc. vaccine, about a third of what it had expected, Health Commissioner Steven Stack said. Beshear said the vaccine supply had been overestimated, and states' allocations are based on population. 

He said 26,000 doses will go to residents and staff of long-term care facilities and 12,000 will be given to "front-line covid health-care workers" throughout the state. Beshear said the list of health-care facilities to get the vaccine is being finalized and will be submitted to federal officials by Friday. 

Beshear and Stack explained that it's important to target long-term care first because its residents and staff have accounted for 66 percent of the state's covid-19 deaths, and limiting hospitalization of residents will also decrease the burden on hospitals, since they require more care on average. 

"Our goal is to quickly vaccinate the most vulnerable parts of our population," Beshear said. 

The initial round won't be enough to cover all the state's long-term care facility residents or staff, or all health-care workers. The Louisville Courier Journal reports that Kentucky nursing homes have 27,600 residents and 35,000 staff, and hospitals employ 80,000. 

Stack, a physician, said the smaller-than-expected deliveries will require "difficult decisions." He said he has asked hospitals to place their employees in tiers based on which ones are most at risk of infection. 

Essential workers, educators and adults with very significant conditions would be next in line for the vaccine. Beshear said educators had been "elevated" in priority, and said earlier, "There’s gonna be a big priority on teachers because once we have teachers vaccinated, school is gonna be really safe."

To fight increasing spread of the virus, Beshear has banned in-person schooling in middle and high schools until Jan. 4 and in elementaries until at least Dec. 7.

In late December, the state expects to get 76,700 doses of the Moderna vaccine, and will distribute it in the same way as the Pfizer one, said Beshear.

Moderna applied Monday for an emergency-use authorization from the U.S. Food and Drug Administration. The company said it anticipates the FDA advisory committee will discuss its vaccine Dec. 17, a week after it is set to discuss the Pfizer vaccine, with authorizations expected to come a few days after each meeting. Karen Weintraub of USA Today reports that the Moderna trial was conducted "to the gold standard" and explains why it is important to have more than two coronavirus vaccines. 

Beshear said the state is participating in a test-run of the vaccine with the Centers for Disease Control and Prevention to ensure that the state's shipping and distribution plan is in good order. 

Kentucky's final plan depends on the actions of the CDC's Advisory Committee on Immunization Practices, which is scheduled to vote Tuesday on who should get the first doses. 

Other vaccines may be approved, but none of them will be available to most Kentuckians until next summer, said Stack. "We're going to have to make sure we get it to the people who need it the most, who will benefit the most and then work forward from there," he said. 

Stack warned, "We're not out of the woods yet," and said there is a real risk that between the "cold weather, holiday gatherings, increased travel, a fatigued public who has not fully complied with the mask mandates and with the social distancing," cases and deaths will continue to soar. 

Again, Stack called on Kentuckians to wear masks, socially distance and not socialize with each other "while the disease is so high," saying this is necessary to avoid overwhelming the state's hospitals.

"There are better days ahead, and as 2021 unfolds we have every reason to be very optimistic we'll end up in a better place," he said.

Beshear defended what he called his "aggressive actions" against the virus with a graph of daily covid-19 deaths per 100,000 people in Indiana, Tennessee and Kentucky: "The distance between those lines . . . is how many more lives we are saving."

"I know it comes with sacrifice," he acknowledged, but said, "Our sacrifice, the difficulties we go through, is truly making a difference."

Beshear announced 2,124 new coronavirus cases on Monday, the second highest Monday for cases yet, with last Monday being the highest, at 2,135. Monday figures are usually low due to less testing and lab work on weekends.

The state's seven-day rolling average of daily new cases, the most widely used measure of the pandemic's trend, is 2,727, one less than it was Sunday. 

Beshear cautioned that cases could be under-reported because of the long holiday weekend, and "We may have a very large week this week or next."

The governor encouraged Kentuckians who gathered in large groups over Thanksgiving or who traveled over the holiday to act like they have the virus and get tested and to  "Please, please wear a mask." 

He said that's the advice of Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, who told The New York Times that if you traveled or met with people outside of your household for Thanksgiving, you should “assume that you were exposed [to the virus] and you became infected, and you really need to get tested in the next week.” She also urged them to avoid anyone in their family over 65 or with an underlying illness. 

The Lexington Herald-Leader provides guidance on when you should get tested in the wake of Thanksgiving. Experts told the paper that if you have symptoms, get tested right away, but those with no symptoms should wait at least five days because the average amount of time it takes to show symptoms after infection is five days – and many get the virus but no symptoms.

Daily numbers: The share of Kentuckians testing positive for the virus in the past seven days is 9.42%, the highest since testing became widely available in May.  

State Department for Public Health graph, adapted by
Kentucky Health News; for a larger version, click on it.

Covid-19 patients' use of intensive-care units and ventilators also hit new highs, at 421 and 229, respectively. Kentucky hospitals reported 1,741 covid-19 patients, just six short of the record set on Thanksgiving.

The state has begun reporting the total number of hospitalized patients in Kentucky, along with the total in intensive care and on ventilators. Its report shows 21% of hospital patients have covid-19, nearly 30% of patients in ICUs have the disease and nearly 38% of those on ventilators do. 

There were 12 more covid-19 deaths, bringing the state's toll to 1,908: two Caldwell County women, 74 and 86; a Daviess County woman, 50; a Fayette County man, 90; a Grayson County man, 68; a Jefferson County woman, 56; a Marshall County man, 77; a McLean County woman, 87; a Webster County man, 84; and a woman, 75, and two men, 67 and 75, from McCracken County.

The Herald-Leader reports that November is the highest month of coronavirus cases and covid-19 deaths since the pandemic began, with at least 71,822 cases reported in November and 433 deaths. 

In other coronavirus news Monday: 

• Counties with 10 or more new cases were Jefferson, 354; Fayette, 219; Kenton, 97; Daviess, 90; Warren, 82; Boone, 73; Oldham, 52; Pulaski, 46; McCracken, 45; Campbell, 43; Jessamine, 40; Boyle and Mason, 37; Bullitt, 36; Grant, 33; Henderson, 31; Scott and Shelby, 30; Boyd, Greenup and Marshall, 28; Barren, Caldwell and Christian, 27; Woodford, 24; Madison, 21; Lee, Pike and Taylor, 18; Graves, 17; Calloway and Mercer, 16 each; Floyd and Laurel, 15; Rowan and Wayne, 14; Henry and Simpson, 13; Hart, Magoffin and Montgomery, 12; Franklin, Hardin, Logan, Muhlenberg and Trigg, 11; Harlan and Ohio, 10.
• In long-term care, there are 2,259 active cases among residents and 1,252 among staff, with 445 resident cases and 292 staff cases reported since Friday. 
• Two more veterans at the state's Thomson-Hood Veterans Center in Wilmore died of covid-19, bringing its toll to 30. He said there are only two active cases left there, but the Western Kentucky Veterans Center in Hanson now has its first active case. 
• The state updated its travel advisory, which incudes 16 states that have a positive-test rate of 15% or higher. From highest to lowest, they are: Idaho, South Dakota, Iowa, Kansas, Wyoming, Pennsylvania, Alabama, Oregon, Oklahoma, Arizona, Utah, Missouri, Mississippi, Montana, Nevada 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.
• Covid-19 patients are filling up rural hospital beds and making the staff sick, which is resulting in changes in how hospitals are staffing, with a greater reliance on agency supplied nurses, which come with a hefty price tag, Corinne Boyer reports for Ohio Valley ReSource. “They’re having to pay anywhere from four to 500% more than what they would normally be paying for an agency nurse,” Nancy Galvangi, president of the Kentucky Hospital Association, told Boyer. “And that is because Kentucky is in competition with other states, other states that can pay a lot more.”
• The owners of qualifying bars and restaurants in Kentucky that have been required to stop indoor service until at least Dec. 14 can apply for $10,000 grants from the Kentucky Food and Beverage Relief Fund. The $40 million allotted to the fund from federal relief money could help at least 4,000 establishments, Chris Otts reports for WDRB, adding that the money will not be distributed until Dec. 8, and will be awarded on a first-come, first-served basis through Dec. 18. Beshear's news release said more than 2,000 applications had already been submitted, requesting nearly $19 million in aid.

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