One preliminary projection of covid-19's impact in Ky. shows it better off than border states; another one's latest take is worse

Kentucky Health News table of projection models; Virginia and Missouri resembled other border states.

By Al Cross
Kentucky Health News

How many Kentuckians will be infected with the coronavirus? How many will develop its disease, covid-19? How many will die from the disease? And how does Kentucky compare to adjoining states?

The answers to those questions are still unclear, mainly because testing for the virus is still very limited, handicapping scientists who track diseases.

A group of epidemiologists has a model, used by Gov. Andy Beshear, which projects that Kentucky will lose less of its population to covid-19 than any major bordering state except West Virginia, a small state with even more limited data.

However, the latest forecast from another model, first reported in the state by Kentucky Health News a week ago, also shows Kentucky not doing as well as it did in the previous forecast.

The model that Beshear has shown at his daily press conferences, in simplified form, gives estimates in round numbers, indicating how preliminary the forecasts are.

It projects that Kentucky will lose 13,000 people to covid-19 if there is poor compliance with Beshear's orders that have banned mass gatherings, shut down schools and shuttered most businesses and churches. That is 0.29 percent of the state's population. That is less than any other bordering state except West Virginia, which is virtually the same at 0.28%.

If there is strict compliance, the model projects, Kentucky will lose 2,000 citizens, or 0.04% of its population. That is less than any bordering state, with the possible exception of West Virginia, where the forecast is merely for fewer than 1,000, or 0.06% -- apparently rough because of the state's small population and limited data.

The worst bordering state in both scenarios of the model is Illinois, which is projected to lose 0.53% in the poor-compliance scenario and 0.18% with strict compliance.

The model's graph for Kentucky implicitly illustrates how preliminary the projections are.

Graph from Kentucky model by CovidActNow.org (To view a larger version, click on the image)

The graph marks the day it was made, April 6, which is almost two months before June 4, the day the model projects Kentucky hospitals would become overloaded with covid-19 patients if there is poor compliance with Beshear's orders. In the strict-compliance scenario, there would be plenty of hospital beds, but the peak use of hospitals would be even later in June.

A much earlier peak of hospital use, and of deaths, is projected by the Institute for Health Metrics and Evaluation at the University of Washington. It says the likeliest peak for use of hospitals is April 21, and the likeliest peak for deaths is April 24-25, with 54 deaths each day.

This model also predicts a much higher death rate, 0.39% of Kentucky's population, a higher rate than predicted for any bordering state. The latest forecast of 1,750 deaths is more than twice the number that the model projected a week earlier, when Kentucky's projected rate was less than that of any bordering state. The earlier projection also predicted later peaks for Kentucky.

The jumpy numbers also illustrate the paucity of data, and perhaps a reason for the big difference within one week. The IHME model is based on deaths, but attribution of deaths to covid-19 varies among states, and Kentucky may be attributing more deaths to the disease than other states.

Beshear said recently that if a person tests positive for the coronavirus, the state counts that person as a covid-19 death, even though almost all 59 Kentucky victims (as of Monday) had other health conditions that could have killed them anyway. Some other states leave that call up to the physician, and the limited number of tests has prevented post-mortem testing of suspected covid-19 victims in Indiana, The New York Times reported.

In a similar story, The Washington Post said, "Marc Lipsitch, a professor of epidemiology at Harvard, said there are probably some people dying with covid-19 who are not dying of covid-19. Such misattribution is a problem for any cause of death, he said, but it is a minor issue that is 'swamped by the opposite problem: deaths that are caused by covid but never attributed, so the death count is underestimated.'"

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Beshear indicates that he might close churches that keep holding services; announces deal that could 'almost double' testing in Ky.

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at https://kycovid19.ky.gov.

By Al Cross
Kentucky Health News

Kentucky is doing better than most states at limiting spread of the coronavirus, but "We're gonna have to start cracking down a little bit more on those who are willfully denying, or willfully refusing to comply" with social distancing, Gov. Andy Beshear said Sunday.

That could mean closing facilities, and that could include churches, Beshear indicated near the end of his daily press conference, after being asked how he would go about enforcing his order against "mass gatherings."

"I think you're gonna see a couple of announcements from us this week, but if facilities are still trying to open and allow mass gatherings, then perhaps those facilities shouldn't be allowed to be opened any more," he said, immediately citing Jack Roberts, pastor of Maryville Baptist Church in Hillview. (Sarah Ladd and Scott Utterback of the Courier Journal covered his Sunday service.)

Roberts (CJ photo by Scott Utterback)

"To the Bullitt County pastor who is continuing to have service, he knows now, we have at least three examples of church services spreading the virus in Kentucky, and we have multiple deaths tied to it. So we know it's a scientific fact, that him holding his service today spread the virus within his congregation, and at Christmas he's going to have fewer people in his congregation," Beshear said. "My faith would never let me put someone else in that position. It would tell me to love my neighbor as myself, and look at what that is doing, the risk that it is putting people in."

Beshear is a deacon in the Christian Church (Disciples of Christ). From the start of his efforts to limit the spread of the virus three weeks ago, churches have been a challenge, and some other governors have exempted houses of worship from their orders banning mass gatherings. Beshear has often referred several times to his own faith, saying Kentuckians should use the wisdom God gives them; Sunday, he put that point in political context:

"You know, when I was running for governor, or even when I started out, the thought that I would directly be telling a congregation that they shouldn't meet, I mean, that's beyond what you would ever have in political thought, but this is life and death. This is life and death, and what it means politically in the future, I just don't care at this point."

To some church members who had compared their services to grocery or hardware shopping, Beshear said, "You can have your service virtually. It's really hard to get your groceries virtually, and in a grocery store, we are trying to take as many steps as we can, to spread people out, to limit the number that are inside, to do everything that we can. . . . It's time for all of us to understand, and most of us do, what we're dealing with and putting the lives of other people ahead of our own."

Earlier, Beshear said "We believe that folks have done a lot better than we saw last weekend on our social distancing," and showed charts from an outside source indicating that Kentucky "ought to be proud of how we're doing." The charts, produced by Wade Fagen-Ulmschneider, a computer-science professor at the University of Illinois, showed Kentucky near the bottom in number of cases among the states, with an encouraging trend.

The scale of the chart is logarithmic: rising numeric values occupy increasingly less vertical space.
To understand it fully, note the case numbers on the left. For a larger version of the chart, click on it.

"Our growth curve is flatter and better than just about any state out there," said Dr. Steven Stack, the state health commissioner. At other points, he also said, "If we don't social-distance, we run the risk of undoing this. . . . It's because you listened to what we asked you to do, because the governor took decisive action."

On another matter, Stack said the new federal recommendation to wear cloth masks when around other people is no replacement for social distancing. "Overall, I think they're a distraction," he said, adding that people should stay six to 10 feet apart.

Other coronavirus news on Sunday:

• Beshear announced five more covid-19 deaths, all women, bringing the state's total to 45. Three were in Jefferson County, aged 80, 66 and 54; the others were an 85-year-old from McLean County and a 90-year-old from Woodford County. (The Woodford County Health Department said later that "We have confirmed with the Department for Public Health that this was a mistake. No deaths have been reported for Woodford County at this time.")
• Beshear said all decedents who have covid-19 are counted as victims of the disease, though some might have died without it, but not all deaths from it will be known. Health experts agree, The New York Times reports.
• The governor reported 38 new cases of covid-19, but said that relatively low number probably stemmed from limited reporting on Sundays. One hotspot was Christian County, with seven new cases; Jefferson County had six. The official case total has reached 955; Beshear said 306 have recovered.
• Beshear announced that the state had signed a deal with Gravity Diagnostics, a Northern Kentucky firm, to provide up to 2,000 coronavirus tests per day, and results the next day, for high-risk individuals and first responders. He said the volume of tests will depend on the number of long cotton swabs that the test requires, but the deal could almost double testing in the state and "make sure there isn't any area of the state that doesn't have, at least compared to the rest of the country, a pretty significant ability to test."

• 

  Jean Massamore tested positive. (Photo
  submitted to Ky. Ctr. for Investigative Reporting)

  Beshear said not all residents of a Lyon County nursing home with four cases of covid-19 (two residents and two employees) have been tested because the state doesn't have enough test kits to do both wings of the home. Of the 80 tests, 12 were done by the state, 23 by Lab Corp and 45 by the University of Louisville, he said: "We are doing our best, and this is a significant amount of resources that have been provided." He said one resident with covid-19 is at home and the other has two dedicated nurses, who are on 12-hour shifts and have self-quarantined.
• Asked how satisfied he is with the crisis response by President Trump and the federal government, Beshear said, "I don't worry about that on a given day. . . . I think everybody is working to try to increase our testing and our health-care capacity. We certainly have lot of calls and a lot of communication from the White House, and we appreciate that."
• He added, "We have difficulty, but everybody's having difficulty buying personal protective equipment because the federal government, typically through FEMA, buys it all first, but they're buying it to send it to other places [that] are pretty hard-hit. So my goal is to work with anyone and everyone that can work with us. There are days that I'm frustrated with the White House; there are days when I'm thankful for things that they've done."
• He concluded, "Whether we're praising or criticizing an administration right now, let's make sure it's based on what we need done in this crisis and not any of our previous political views."
• Beshear said a federal judge has denied a temporary injunction to a Northern Kentucky woman who challenged his order requiring people who travel out of state for reasons other than work or legal obligations to go into quarantine for 14 days.
• Asked how local officials in border counties should handle violators of that order, Beshear said he had told officials on the Tennessee border, "We need to contact them and ask them to self-quarantine."
• Asked whether the order should prevent a former Kentucky resident from moving back to the state, Beshear said the person should self-quarantine, and "Now is probably not the best time to be moving. That's a whole bunch of people touching your stuff."
• Beshear said two Frankfort gyms that let people in their back doors have been cited for violating his order closing inside service by businesses that are not life-sustaining. "Shame on those that are doing that," he said.
• John Inscore Essick of Port Royal, a professor at Baptist Seminary of Kentucky, wrote in the Courier Journal that with his daily briefings, Beshear “has become 'Pastor Andy' to Kentuckians of much, little, and no faith,” not in a religious sense, but “much as President Franklin Roosevelt did with his 'fireside chats'.”
• Jamey Temple, the granddaughter of June Hill, who died of covid-19 in Hopkins County, wrote about it for the Courier Journal. 
• Lt. Gov. Jacqueline Coleman, secretary of the Education and Workforce Development Cabinet, said in a video that more than 300 employees of other agencies are helping the Office of Unemployment Insurance deal with the avalanche of claims and are "working diligently to fix the problems that you're having."  

Op-ed: Addiction recovery amid the covid-19 outbreak

By Tim Robinson

Tim Robinson is CEO of Addiction Recovery Care and a founding member of RECON KY, a consortium for recovery in Kentucky.

When grave new challenges emerge, it would be nice if existing ones would subside. Sadly, that is just not how the world works.

Tim Robinson

In communities across the commonwealth and throughout the U.S., mental-health and addiction-treatment providers are facing a new set of challenges as they continue to care for some of our population’s most vulnerable amid a global pandemic.

According to the National Institute on Drug Abuse, 67,367 Americans died from drug overdoses in 2018—more than 1,300 in Kentucky. While public-health officials and providers battle one crisis, we cannot afford to overlook another that has been impacting our communities for years—and one that will most certainly still be here even after the covid-19 outbreak subsides.

RECON KY was formed as a consortium for recovery in Kentucky, bringing together stakeholders from all parts of the treatment system to advocate for a more comprehensive, long-term approach to recovery. And, in light of current events, a statewide coalition focused on strengthening and expanding addiction and mental health services has never been more needed and important. RECON KY is focused not only on bolstering and expanding access to treatment services but on addressing the underlying factors that can lead to substance use disorders.

Addiction is a complex and multifaceted disease, affecting people of all ages, genders, races and backgrounds. However, numerous studies have shown that social determinants—socioeconomic status, education level and where you live, among others—can indeed indicate who in our communities is most at risk for developing substance-use disorders and other mental health conditions.

Now, with our country weathering the covid-19 outbreak, we anticipate an even greater influx of mental and behavioral health needs in the months ahead: exacerbated symptoms, increased substance use and relapses and higher rates of overdose.

Thankfully, Gov. Andy Beshear and the Cabinet for Health and Family Services have acted swiftly in recent days and weeks to protect, and even expand, access to proven forms of treatment and counseling for substance use disorders and behavioral health.

As efforts to address the outbreak continue, lawmakers at all levels must remember the crucial role that mental health and addiction treatment providers play—and will continue to play, moving forward—and include them as essential pieces of the health care system when making emergency policy decisions.

The mental-health system includes many moving, critically important pieces—residential treatment, detoxification, outpatient, medication-assisted treatment, recovery housing, advocacy, prevention, workforce training—that must be maintained during this crisis.

Beyond quality health care, long-term recovery requires a great deal of resources and support: employment and educational opportunities, safe and affordable housing, transportation, childcare to encourage workforce participation.

Great strides have been made in recent years to build up Kentucky’s recovery infrastructure, and we cannot let that progress fall to the wayside at a time when many Americans are facing greater strains on their mental health.

Like all public health crises, addiction is not something that one group alone can or should solve. Now more than ever, we must all do our part to support our fellow Kentuckians who are struggling with and recovering from substance use disorders and other mental health conditions.

Covid-19 update: Beshear says drop in flu cases shows social distancing works; says mass gatherings at churches etc. likely kill

Gov. Andy Beshear displayed a photo montage of covid-19 victim Aaron Jordan and his family during
Saturday's press conference. (Screenshot of Facebook page; emojis on right were posted by viewers)

Department for Public Health weekly chart of flu cases; dates are end of each reporting week 

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at https://kycovid19.ky.gov.

A steep drop in flu cases in Kentucky shows that social-distancing measures taken to fight the coronavirus are working, Gov. Andy Beshear said Saturday.

“It is preventing wider spread of, certainly, the flu,” Beshear said. “Now, we believe the coronavirus spreads a lot faster and a lot more aggressively at this point, but look at that downward trend and know that if we stick with this, if we follow the rules and restrictions, we will absolutely lessen or slow the spread of the coronavirus.”

Beshear said those who follow Friday's Centers for Disease Control and Prevention recommendation to wear cloth masks in public when around others, such as grocery trips, “does not replace the social distancing piece. Just because you wear a mask doesn’t mean you can get withing six feet of somebody and still have a conversation.” He also warned against fiddling with masks: “You can't touch your face;” and using surgical or N95 respirator masks that are needed by health-care workers.

Urging social distancing despite pleasant weather, Beshear said, “What every single one of us does matters every day, every decision, every action.”

Asked about Jack Roberts, a Bullitt County pastor who plans to hold services Sunday despite the ban on mass gatherings, Beshear said, “If you are still holding mass gatherings, church or otherwise, you are spreading the coronavirus and you are likely causing the death of Kentuckians.”

The Louisville Courier Journal's story on Maryville Baptist Church in Hillview and other churches noted that Our Savior Lutheran Church in Hillview is holding services, but "attendance is limited to those who register online" and "seating is restricted to every other pew."

Beshear said he had heard reports of people going door to door seeking church attendees. “You cannot go door to door right now for any reason,” he said. “I mean, folks, that's how people die.”

At his daily press conference, Beshear displayed a photo montage of ARon Jordan, a 49-year-old bricklayer from Ashland who died of covid-19 in a Detroit hospital after quarantining himself in the city so he wouldn't risk infecting his family. Mandy McLaren of the Courier Journal told his story, marking the first time a Kentucky covid-19 victim was identified.

Jordan is believed to be Kentucky's youngest covid-19 victim. Beshear announced three new deaths Saturday: A 56-year-old woman in Lexington, a 52-year-old woman in Bullitt County and an 81-year-old man in Boone County, bringing the state's death toll to 40.

Beshear said Kentucky confirmed 92 new cases Saturday and eliminated six duplicates from Friday's report of 90, for a total of 917; he said 130, or 14 percent, have been hospitalized and 76 remain so. The day's two relative hotspots were Hopkins and Simpson counties, which each reported five cases.

Other developments on the covid-19 front Saturday:

• Two residents and two staffers at a Kuttawa nursing home tested positive for the virus, and most of the test results haven't come back yet. Beshear said the state tested everyone in a wing with a patient who developed covid-19, "the most testing we've seen in any of these facilities." But Lyon County Judge-Executive Wade White wants broader testing, and "said state officials were initially reluctant to provide tests, and most were provided by local hospitals," reports the Kentucky Center for Investigative Reporting.
• Beshear has allowed trails at state parks to stay open, but some local officials wish he would close them because of gatherings at trailheads, Will Wright reports for the Lexington Herald-Leader.
• Senate Majority Leader Mitch McConnell said there needs to be a fourth covid-19 relief bill, "a more targeted response to what we got wrong and what we didn't do enough for" in previous bills, with health care at the top of the list.
• Beshear and Health and Family Services Secretary Eric Friedlander urged Kentuckians without health insurance to sign up for Medicaid. "We've taken a 20-page application and made it one" page, and people are available to help complete the application.
• Friedlander said the state has asked the federal government for a waiver to allow people in the Supplemental Nutrition Assistance Program to use their electronic benefit transfer cards to order groceries online.
• People in the small town of Midway enjoyed Yard Art, the latest in a series of events to occupy children and, in this case, adults.
• Noting sacrifices made by other generations, Beshear said that for them, “The time or even the victory was uncertain. We know here we’re not looking at years, we’re looking at months, and we know we will come out of this on the other side.”

Beshear projects number of deaths based on compliance rates; plasma from recovered patients helps two critical ones; story tells risks to health workers; what are best materials to make masks?

Slide shown by Beshear at his Friday press conference; he did not say how the numbers were figured.

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item will be updated. Official state guidance is at https://kycovid19.ky.gov.

Gov. Andy Beshear put the need for social distancing to fight covid-19 in stark terms Friday, displaying a chart that said poor compliance with his orders could cost 11,000 Kentuckians their lives. The chart resembled others he has shown, but was the first specific to Kentucky, and he said, "As the days go by I'm going to show you other projections. . . . Your choices could save 11,000 people."

One line on previous charts, but not on Beshear's, is a horizontal marker showing the capacity limits of the health-care system. His orders are designed to flatten the bell-shaped curve that pandemics follow, so the number of cases doesn't exceed the system's capacity. But that also means the restrictions that began in mid-March could last longer, and his projection of 2,000 deaths with strict compliance was for three months.

"If we're going through May, it's working," he said at his daily press conference. "If we have really great success we may be at it a little bit longer." He said that as the curve subsides, restrictions could be relaxed gradually. At another point, he said, "We know we're gonna be at this for weeks or months."

Beshear did not say how his numbers were calculated. The latest projection for Kentucky from the Institute for Health Metrics and Evaluation at the University of Washington says the state's most likely peak for deaths and hospital-bed needs is May 17, with a curve that largely subsides by late June. Its likeliest number of deaths is 821, but like all projections it suffers from limited data; it says the possible number of deaths on the peak day ranges from 1 to 37.

Health Commissioner Steven Stack said on KET's "Coronavirus Update" Friday night that the IHME  projections "seem to me to be more optimistic than a number of other sources that are publicly available."

Beshear reported six more deaths Friday, for a total of 37, and 90 more confirmed cases, for a total of 831. "We are not escalating every day," he said. "I believe that’s directly attributable to the steps that we’re taking, and your hard work . . . 90 will become a small number moving into the future [but] it's better news at least than many are having."

Here is other news on covid-19 today:

• Beshear said the deaths were two women in Louisville, aged 60 and 88; two men in Louisville, 64 and 69; an 85-year-old woman in Madison County, and a 66-year-old woman in Hopkins County.
• Baptist Health Lexington has used blood plasma from a recovered covid-19 patient "as a potential treatment for two critically ill covid-19 patients," the hospital announced. "The mortality rate for patients in their conditions is 50 percent to 80 percent, according to Dr. Mark Dougherty, infectious disease specialist and ... epidemiologist," the Lexington Herald-Leader reports. "But he said the two patients were improving and that he was “cautiously optimistic” about their conditions."
• "Many frontline health-care workers’ protection is being sacrificed for the sake of conservation," Alex Acquisto reports for the Lexington Herald-Leader, in a chilling story about the critical shortage of personal protective equipment.
• Beshear announced a toll-free number to guide donations of PPE: 1-833-GIVE-PPE. He said donations are being accepted at state police posts and Transportation Cabinet district offices in Louisville and Lexignton. "I believe we have millions and millions of pieces of PPE that are out there in Kentucky," he said.
• Beshear called on 3M Corp. to temporarily license its patent for the badly needed N95 respirator mask so other companies can make it, and President Trump invoked the Defense Production Act "to ensure the federal government acquires more N95s," the Louisville Courier Journal reports.
• The University of Kentucky said it would convert its football practice facility, Nutter Fieldhouse, into a 400-bed field hospital.
• UK researchers and faculty have formed a workgroup "to focus on advising covid-19 patient care and clinical trials based on emerging research and potential treatment options," UK says.
• Kentucky homeless shelters say the state's homeless are highly vulnerable to the coronavirus, and the shelters have asked Gov. Andy Beshear to use some of the state's emergency federal money to help them, the Herald-Leader reports.
• "Four in 10 Americans are not properly allowing disinfectant sprays and wipes to kill the viruses and germs that can make us sick," says the American Cleaning Institute, citing a poll it commissioned.
• Stomach pain, diarrhea, nausea without vomiting and loss of smell could indicate you have the virus, Louisville's health director says.
• Music can help people deal with the stress caused by isolation and other ramifications of the coronavirus, an Ohio State professor says.
• Asked by Kentucky Health News about farmers' markets, Beshear said social distancing must be practiced, and there should be one big change: "If you touch it, you buy it."
• Louisville Mayor Greg Fischer urged retailers that are still open to enforce social-distancing rules. "Everybody has to act like they have the virus. . . . Put six feet of live-saving space between you and other people. . . . This is not negotiable." He said he would have to close parks and other public spaces if noncompliance continues.
• Bank and real-estate lobbies have asked Beshear "to put guidelines in place for county clerk’s offices, saying that their closure halts essential services," the Lexington Herald-Leader reports. "While some clerk’s offices have remained open or adjusted their operations, others have closed in an effort to help slow the spread of covid-19." Beshear said Thursday that the Kentucky County Clerks Association told him it was working with the groups that sent the letter to address their concerns.
• With the Centers for Disease Control and Prevention expected to recommend that Americans wear masks in public, the town of Midway, population 1,700, is rounding up volunteers to make them.
• The type of fabric used in homemade masks "is key to their effectiveness, according to tests performed at Wake Forest Baptist Health," it says in a news release. "The best-performing design was constructed of two layers of high-quality, heavyweight “quilter’s cotton” with a thread count of 180 or more, and those with especially tight weave and thicker thread such as batiks. A double-layer mask with a simple cotton outer layer and an inner layer of flannel also performed well. . . . The inferior performers consisted of single-layer masks or double-layer designs of lower quality, lightweight cotton."
• Responding to increased consumer demand for eggs during the pandemic, the Food and Drug Administration is allowing grocery stores to sell eggs in unlabeled flats and cartons that are typically sold to restaurants and bakeries.
• Senate Majority Leader Mitch McConnell told McClatchy Newspapers that there are “bound to be plenty of mistakes” with implementing the covid-19 economic-rescue package. “You can’t pass a bill of this magnitude in a week and have a perfect implementation of $2.2 trillion.” The Washington Post has details.
• The Herald-Leader and the Courier Journal did front-page stories on the Dawson Springs church whose revival sparked a covid-19 outbreak in Hopkins and other counties.
• Covid-19 "seems to be causing gun sales to skyrocket across the country, but  . . . Kentucky was the only state to have a decrease in gun background checks, according to data released by the FBI, the Herald-Leader reports.
• A Northern Kentucky woman is suing Beshear and Attorney General Daniel Cameron in federal court, challenging Beshear's order that people entering Kentucky from other states must quarantine themselves for 14 days.
• "A Lexington-based uniform company that provides N95 masks to police has been accused of price gouging by two Arizona lawmakers," the Herald-Leader reports. Galls, a uniform, equipment and gear store, was targeted in a letter to U.S. Attorney General William Barr Wednesday. "Galls provides masks to Phoenix’s police and fire departments, according to a letter posted online by Scripps." UPDATE: Gall's said it would sell to the agencies without making a profit.

Rural Ky. hospitals to get 'hundreds of millions in damages' from old lawsuit with the state, with federal government paying the bill

By Melissa Patrick
Kentucky Health News

More than 50 rural hospitals in Kentucky are set to receive "hundreds of millions in damages" to settle an old lawsuit with the state, and the federal government is paying the bill, Gov. Andy Beshear and Senate Majority Leader Mitch McConnell announced Friday.

That is likely welcome news to an industry that is gearing up for a surge of covid-19 patients at a time when many of them are struggling to stay afloat.

“We fought hard for this funding, which will now help dozens of Kentucky’s rural hospitals with the crucial support they need to help fight against covid-19 and confront this pandemic in the Commonwealth,” Beshear said in a news release, thanking McConnell “for helping us secure this essential funding for our rural health-care providers.”

McConnell said, “I was proud to raise this important Kentucky priority to the highest levels of the federal government. I look forward to continuing to work with Gov. Beshear and our rural hospitals to help give them the tools necessary to care for patients and fulfill their mission.”

The issue stems from rural hospital claims that between 2007 and 2015, under then-Gov. Steve Beshear, the governor's father, the state Cabinet for Health and Family Services used a Medicaid reimbursement formula for hospitals that was too low.

Two Kentucky courts have said this was not legal; and the cabinet had appealed these decisions to the state Supreme Court. The Lexington Herald Leader reported in February that the Supreme Court had not yet decided to take the case, giving the two sides extra time to negotiate a settlement.

According to the release, the Centers for Medicare and Medicaid Services approved the state's request for funding, which was initiated by Beshear and followed up on by McConnell, to cover the Medicaid federal match rates for the shortfall and that the total amount is still to be determined.

“As Kentucky’s rural hospitals and medical professionals stand on the frontline of the coronavirus crisis, I’m glad the Trump administration answered our call to deliver these critical federal funds,” McConnell said.

Nancy Galvagni, president of the Kentucky Hospital Association thanked both Beshear and McConnell for their efforts in securing these funds and said the association was "delighted with the outcome of this lawsuit."

"These funds couldn’t come at a better time, given the challenges all hospitals are facing," Galvagni said in an e-mail. " In order to prepare hospitals for a possible surge in patients and conserve personal protective equipment for health care workers, Kentucky hospitals have cancelled all elective procedures in response to the covid-19 emergency. While hospitals were ready and willing to do everything in their power to protect their health care workers and the public, this has caused a significant reduction in revenue. These funds will be invaluable to the involved hospitals."

The state has been anxiously awaiting this decision because if the federal government did not agree to pay for part of the bill, it would have fallen to Kentucky taxpayers.

Book about opioid epidemic on the Tug Fork also tells story of reporter who overcame obstacles to win Pulitzer Prize

A new book from former Charleston Gazette-Mail reporter Eric Eyre takes a deep dive into the opioid epidemic through the lens of Kermit, W.Va., a town of 382 people whose pharmacy distributed 12 million pain pills in three years. It's right across the Tug Fork of the Big Sandy River from Warfield, Ky., in Martin County. Death in Mud Lick details one woman's fight to seek accountability from major pharmaceutical companies after her brother's overdose death.

"The story is also a reporter’s firsthand account about what it’s like to mine for the truth while working for a newspaper fighting for survival on multiple fronts, as greedy corporate owners make serious budget cuts to maintain the paper’s profit margins and as combative politicians stonewall," Ralph Berrier Jr. reports for The Roanoke Times. "Death in Mud Lick is for readers who root for the underdog, who want justice served and who love newspapers."

Eric Eyre

Readers should appreciate the scale of Eyre's battle and what it accomplished, ProPublica reporter Ken Armstrong, a former colleague of Eyre's, writes for The New Yorker. Eyre researched and wrote the book while he was still cranking out near-daily stories for the paper, facing off against the powerful drug industry with little funding, decrepit equipment, and an increasingly difficult battle with Parkinson's disease. He persevered, and "his reporting led to restrictions on prescriptions, greater tracking, more transparency. He shamed an industry and saved lives. Working at a small newspaper, Eyre made a big difference," Armstrong writes.

For Eyre, who won a Pulitzer Prize in 2017 for his coverage of the opioid epidemic in rural West Virginia, the book perhaps serves as his final bow in journalism: With his Parkinson's getting worse, he submitted his resignation letter last week; Armstrong reports: "The same day his book came out, Eyre left the paper."

Beshear asks schools to stay closed through May 1, releases 186 inmates, orders quarantine for Ky. visitors, closes state parks to overnight guests; health departments start limiting numbers of shoppers in stores; hospitals worry about keeping staff healthy

Concepts by Jason and Brooke Ison and @tizbitz; design by @SinclairArt for KyforKy.com

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item will be updated. Official state guidance is at https://kycovid19.ky.gov.

• Gov. Andy Beshear reported 11 new deaths in the state from covid-19; that was the largest one-day total yet, but he said the deaths covered a three-day period due to reporting delays. He said it appears that all but one victim had other health conditions, but that case is still being investigated. He said that could be the first death attributable solely to the disease.
• Beshear recommended to school superintendents that they extend the closure of schools another two weeks, to Friday, May 1. "There's a real chance" that the school year will have no more in-person classes, he said.
• Health departments began limiting the number of people in stores, according to the square footage, and limiting shoppers to one per family and one per cart, Lexington's WTVQ reported.
• Beshear announced an executive order that says anyone traveling into Kentucky from out of state to stay -- not just those passing through -- must quarantine for 14 days at their destination.
• He also said that starting tomorrow, April 3, there can be no overnight stays at state park campgrounds or lodges. 
• To help prevent spread of the coronavirus, Beshear commuted sentences of 186 prisoners convicted of nonviolent and non-sex-related class C and class D felonies. Cabinet Secretary J. Michael Brown said they have been screened and found to be more vulnerable to getting the virus. He said the state has identified 743 more inmates who are within six months of completing their sentence and could be released next week after a final screening. 
• Kentuckians did not reduce their travel last week as much as people in adjoining states with state-at-home orders, according to a New York Times analysis of cell-phone data.
• Louisville Mayor Greg Fischer said the metro health department had received more than 1,100 complaints about non-compliant businesses, mostly non-essential firms that should not be operating. Seven have been ordered to close.
• Hospital systems say their main worry is that the coronavirus will keep their employees off the front lines as the surge of patients increases. "Our biggest concern right now … is keeping staff healthy and keeping them in the game," Dr. Jody Prather, chief strategy and marketing officer for Baptist Health, said on Fischer's daily chat. "We can always find the space and locations but we only have a certain number of health-care professionals."
• Dr. Steven Hester, chief medical officer of Norton Healthcare, said in the chat, "The biggest thing I think you can do for the caregivers is follow the recommendations of state and local governments." He said a big challenge with the virus is "a lot of asymptomatic spread" by people who have the virus but don't know it because they have no symptoms. At least a fourth of infected people are asymptomatic.
• Noting data showing that the virus can last on a surface for six to seven days and in the air for three hours, Hester said, "We’ve got to get folks compliant with staying at home . . . If everyone follows self-isolation it’s our greatest chance."
• Beshear said the state is moving ahead with plans for a 2,000-bed field hospital at the Louisville Fair Grounds to make sure Kentucky is ready when the surge comes. He said the National Guard and the Army Corps of Engineers will help with this, "and if we don't need it, hallelujah!"
• He said no field hospitals are being planned in Lexington at this time. Instead, the state is working on a hotel to use for this purpose if needed, and he promised more information soon. 
• Beshear continues to press for social distancing and against gatherings of any size. "There are not ways to get exceptions around this," he said at his daily press briefing. "If you are outside exercising [and] 10 people get together six feet apart -- that is not OK. We can't be doing that. We've got to make sure that we are avoiding crowds and gatherings entirely." 
• Beshear called on Kentuckians to donate gloves if they have them. He said the National Guard is coordinating this collection and to call 502-607-6844 if you have some to donate. 
• Beshear explained that the state must sometimes correct the number of new cases on some days because there are many contributors to the final numbers. He pledged transparency in the process and said that would mean the numbers might change from day to day. That said, he reported 100 new cases today, bringing the state's total to 770.
• He said while there have been four positive cases reported at Western State Psychiatric Hospital, the state has only been able to confirm three of them so far.
• Valarie Honeycutt Spears of the Lexington Herald-Leader profiles a father and daughter who are the only two identified covid-19 cases in Breathitt County and have recovered.
• James Hohmann of The Washington Post writes in his "Daily 202" roundup, "As Americans turn inward and the U.S. government becomes preoccupied by domestic considerations, the world remains a tinderbox. This pandemic could turn out to be a match that lights a brushfire, fueling strife within other countries and raising the probability of wars. There are blinking red lights that the world is on the verge of becoming a more dangerous place." He gives many examples.

Lawmakers pass one-year budget, including pension reprieve for health departments; funding remains similar to last year's budget

By Melissa Patrick
Kentucky Health News

Amid an expected revenue shortfall from the coronavirus pandemic, Kentucky lawmakers passed a conservative one-year budget, instead of the usual two-year one, that offers another reprieve for health departments in a year that they were looking to enact big reforms.

The budget will freeze pension contribution rates for health departments, regional universities and quasi-governmental agencies at 49.47 percent of payroll, allowing them to dodge for another year the looming 93% rate that was set to kick in on July 1.

Many health departments have said that rate would force them to close. The legislature was planning to revamp the contribution system, but the uncertainty about state revenues killed that idea, at least for now.

"While this budget doesn’t provide the language or funds to support our public health transformation and ensure the number of foundational employees to meet our statutory obligations, we understand as well as anyone the uncertainty of our times and recognize the legislatures need to try and maintain current operations for all government another year," Randy Gooch, executive director of the Jessamine County Health Department, said in an e-mail. "However, I have great confidence the legislature will now have more clarity than ever of the need to fund public health at a an appropriate level and will take that action when considering changes to the budget in the future."

The budget provides $23 million for regional mental health boards' pension payments and $25.4 million for health departments' pension payments. The overall budget for public health remains about the same as the previous budget, around $370 million.

Health departments, state health officials and legislators worked for months to help the departments afford their pension obligations, and were nearing success when the coronavirus hit, making likely a huge drop in state revenues. Costs are expected to rise, too, and exactly how much financial help the state will get from federal government remains an unknown.

"We have no way to know how far this recession is going to go, how deep it will truly be and what it will mean to the coffers here in Frankfort," House budget chair Steven Rudy, R-Paducah, said on the House floor while offering the House-Senate compromise budget bill April 1.

All of this has resulted in a one-year budget for the fiscal year that begins July 1 that largely keeps spending at current levels, with plans to pass a budget next year for the 2021-22 fiscal year.

Here are some of the health-related provisions in the budget:

From the Tobacco Settlement Fund:

• $500,000 for a rural mental-health and suicide-prevention pilot program 
• $1.4 million for substance-abuse prevention and treatment for pregnant women with a history of substance abuse 
• $7 million for the Health Access Nurturing Development Services Program (HANDS)
• $942,000 for Healthy Start initiatives
• $942,000 for early childhood mental health 
• $989,100 for early childhood oral health
• $2 million for smoking cessation, much less than advocates want  

From the General Fund:

• $93,700 each for grants to the Brain Injury Alliance of Kentucky and the Epilepsy Foundation of Kentuckiana to help veterans who have experienced brain trauma
• $7.4 million for more school-based mental health services
• $300,000 in the current fiscal year and $1.9 million in the next one for the Kentucky Poison Control Center, which operates the recently created covid-19 hotline
• $500,000 for the Kentucky Colon Cancer Screening Program 
• $2.5 million to the Kentucky Pediatric Cancer Research Trust Fund
• $500,000 for ovarian cancer screening

The budget does not provide any money for additional social workers, or raises for social workers, as had been included in all previous versions of the budget. It also lacks any new waivers for community-based care for individuals with disabilities, as all previous versions had provided.

The General Assembly will reconvene April 13 to reconsider bills Beshear vetoes. House Speaker David Osborne said that more bills are also likely to get passed, including one to help rural hospitals.

Kentucky didn't cut travel as much as bordering states did last week; some moving about were helping spread the coronavirus

NYT map shows change in average travel, by county, last week. Dark red
is normal travel; orange is half of normal; lightest gray is no travel. Outlined,
shaded areas had stay-at-home orders or an equivalent before March 27.

Kentuckians did not reduce their travel last week as much as people in adjoining states that had stay-at-home orders, despite state and local officials' pleas to stay home to limit spread of the covid-19 coronavirus, according to a New York Times map based on cellphone data.

Gov. Andy Beshear has not issued a stay-at-home or "shelter in place" order, but the Times counted Kentucky as among the states with such orders, apparently concluding that Beshear's other orders amount to an equivalent. Beshear said at his daily press conference that his orders are of "equal strength" to those in states with such orders, and it's natural to see continued travel from places where grocery stores may be 12 to 20 miles away.

The maps showed, not surprisingly, that travel was closer to normal in the most rural areas, with a few exceptions. "Disease experts who reviewed the results say those reductions in travel — to less than a mile a day, on average, from about five miles — may be enough to sharply curb the spread of the coronavirus in those regions, at least for now," the Times reports.

The meaning of the data, gathered anonymously March 23-26, is not entirely clear. "The coronavirus outbreak is unprecedented in scale in recent history, and it is hard to know the exact relationship between changes in travel patterns and how quickly the virus spreads," the Times notes. "Other factors play a big role, including how quickly sick people are tested and isolated, how closely people tend to congregate — and luck. Sheltering in place is protective and clearly reduces people’s contact with others, but the existing evidence that the policy can effectively contain an epidemic within a large population is uncertain, experts said."

Here's part of a Times map showing when the average distance traveled first fell below two miles. It is limited to the southern half of the country, where travel has been heaviest. Not surprisingly, rural counties were less likely to fall below that threshold. For a larger version of the map, click on it.

Bill to tax electronic cigarettes at 15% goes to governor; health advocates say it will decrease young people's use of the products

By Melissa Patrick
Kentucky Health News

Kentucky lawmakers gave final approval Wednesday to a tax on electronic cigarettes, which is expected to decrease teen use of the products by increasing their price.

Centers for Disease Control and Prevention illustration; click for larger version 

The Senate added the 15 percent excise tax to the catch-all revenue bill, House Bill 351. It was a trimmed-down version of HB 32, which, among other things, would have put a 25% tax on e-cigarettes, generating about $50 million.

The reduced tax is expected to generate $25 million, but most of that will be negated by tax breaks for agriculture, coal and alcohol industries, the Lexington Herald-Leader reports.

HB 351 will reduce the taxes to 15% on open "vaping" systems, like those typically sold in "vape" shops, and added a $1.50-per-pod tax on closed vapor cartridges, like those sold by Juul Labs. Gov. Andy Beshear is expected to sign it.

Health advocates expect the tax to decrease teen use of the products. Following is a statement from the Foundation for a Healthy Kentucky, joined by the Kentucky Chamber of Commerce, the Kentucky Cancer Foundation, the Kentucky Equal Justice Center, the Kentucky Health Collaborative, the Kentucky Medical Association, the Northern Kentucky Chamber of Commerce and Kentucky Youth Advocates:

"This new tax is clearly a win for health in Kentucky, especially for our adolescents and teens, because it will result in a significant price increase that will deter many of our youth from using dangerous e-cigarette products," said Ben Chandler, president and CEO of the foundation. "E-cigarettes are the only tobacco product sold in Kentucky currently not subject to an excise tax. The relatively low cost has been a factor -- along with the kid-friendly flavors -- in luring up to 80,000 Kentucky kids to try these highly addictive products.

"We applaud the legislature for adopting a pod tax that will substantially increase the price of the products that are most popular among youth right now, including the Juul and knock-off reusable devices and the Puff Bar and Posh disposable e-cigarettes. In the midst of the coronavirus pandemic, inhaling toxins that are shown to damage the lungs puts these kids and every other smoker and vaper in the Commonwealth at greater risk for serious complications from covid-19. This is an important bill today and for the future, and a strong step in the right direction."

Rep. Jerry Miller, R-Louisville, the sponsor of HB 32, questioned why the Senate didn't include the section of his bill that would have raised the tax on snuff products as a way to generate more revenue. His bill would have doubled the tax on snuff, which includes Snus packets, and he alluded to the lobbying influence of Altria Group, the maker of Snus and the nation's largest tobacco-product manufacturer, with a smokeless-tobacco factory in Hopkinsville.

"Given that Altria had accepted the doubling of ad-valorem tax on snuff and Snus, and was therefore included in the governor's budget and the House budget, I cannot understand why the Senate would not accept that increase in revenue," Miller said in a statement read by House Republican Caucus Chair Suzanne Miles as most members voted and communicated remotely due to the threat of the coronavirus. But some thought the bill was still too much.

Sen. Robin Webb, D-Grayson, said she voted against it because she had not had time to read and digest it, and because she had filed several amendments, including one for a 10% tax. Sen. Tom Buford, R-Nicholasville, who also favored that rate and voted no, said "I am fearful that the vaping tax at 15 percent will drive many of our individuals trying to free themselves from the tobacco products back to them, not only that, but our youthful individuals."

Others voting no in the Senate were C.B. Embry of Morgantown, Jimmy Higdon of Lebanon, Albert Robinson of London, John Schickel of Union, Brandon Smith of Hazard and Whitney Westerfield of Hopkinsville, all Republicans. Five senators passed and five did not vote, for a roll call of 20-8-5. The House passed the bill 68-22.

Here are some resources to help quit smoking:

• Quit Now Kentucky offers nicotine replacement therapy and counseling , call 1-800-QUIT-NOW (800-784-8669) or text QUITKY to 797979.
• My Life, My Quit, a quit-vaping service for teens that provides coaching by text message, by phone, or by online chat; call 855-891-9989 or text START MY QUIT to 855-891-9989.
• This is Quitting, a free coaching service for those ages 13-24 to help them quit using e-cigarettes; text KENTUCKY to 88709.

Covid-19 update: Beshear implores Kentuckians to stay at home, at least not gather; says Hopkins Co. revival was a site of spread

For a larger version of this graphic, click on it.

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item will be updated. Official state guidance is at https://kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

As Kentucky looks forward to another round of fine spring weather, Gov. Andy Beshear is imploring Kentuckians to stay at home, saying that home is the best place to not get the coronavirus and also the best place to not spread it.

"It's going to be a beautiful weekend again, and we cannot repeat last weekend where we saw a lot of crowds come together," he said at his daily press conference. "And so as the weather gets nicer, I need you to be even stronger to make sure that we are doing what it takes."

Beshear stressed that practicing social distancing is the one part of the show that Kentuckians can run in this time of uncertainty and that by doing this, they will reduce the spread of this virus.

"This is the one part that is entirely in our control, where we as Kentuckians without any help from the federal government or anybody else can slow the spread of this virus, can make sure we have the health-care capacity we need by decreasing the number of cases over time or at least lessening them," he said. "This is the best way that you as an individual can help in this fight. . . . I need you, we as a state need you; your actions are so important."

Beshear showed a recent White House graph, which President Trump has used, to demonstrate the importance of social distancing and the reason for community mitigation measures to limit the spread of the virus. It showed upwards of 2.2 million deaths from covid-19 with "community mitigation" interventions and between 100,000 and 240,000 deaths with them.

He then showed a graph translating the White House model to Kentucky, showing that the state would have between 21,000 and 29,000 deaths without any mitigation, and 1,300 to 3,200 deaths with them.

Beshear called the White House modeling an "optimistic scenario" and cautioned that modeling being done by the state, which he would soon share, is "more pessimistic" and "will be tough for people to see." He added, "Our concerns are that this virus can spread faster than this and its toll may be greater than this."

Then the governor painted a grim picture of what can happen when Kentuckians don't obey his order banning gatherings, reading from a Hopkins County Health Department document that he said had been slightly edited:

Hopkins County has been hit really, really hard. We know the community is reeling. .. . We had a church that had a preacher from Texas come down to Dawson Springs March 15 and 16 for a revival at another church. When he left multiple families were sick. The church placed a post on social media that those people did not have the corona, they just had the flu. According to several people interviewed, they were encouraged not to self-quarantine and still come to church. They did not practice social distancing at the revival. Hopkins County now has 24 cases, hundreds of contacts and two deaths with an epidemiological link to this revival. We've additionally had cases in Muhlenberg, Clark and Warren counties related to it as well. Also we have a nursing home with a case, a business with a potential outbreak from this one revival, a health-care facility and an ambulance service that has had multiple personnel affected and we closed a hospital unit and opened up a covid unit. This has spread throughout our community.

Hopkins County is a "hotbed" for covid 19, County Judge-Executive Jack Whitfield told The Messenger of Madisonville. The county has been among the daily leaders in new cases in the past week.

Beshear said, "To anybody who is not listening to the recommendations, to anybody that is still trying to hold -- it's not just a service, but a meeting -- notice what one meeting can do, and it spreads far beyond those that are there. But because a couple of leaders in a different part of the community decided that they were going to ignore the guidance, they have put the entire community at risk. . . . You absolutely can't be doing that."

Hopkins County in red, Pike in blue

On the other end of the state, "The judge-executive of Eastern Kentucky’s largest county sharply criticized residents during a news conference Wednesday when he announced that Pike County has its first confirmed case of covid-19, saying many residents have refused to abide by social distancing," Will Wright reports for the Lexington Herald-Leader. "Despite Eastern Kentucky’s high population of at-risk residents, many have continued to gather in large groups and complain about orders issued . . . to slow the spread of the deadly virus, Pike County Judge-Executive Ray Jones said."

Other news about the virus and its covid-19 disease Wednesday included:

• Beshear reported 93 new cases and two more deaths, a 60-year-old man Daviess County man and a 76-year-old Hopkins County woman. "A third death, which the governor did not officially confirm, was announced in Louisville earlier Wednesday, bringing the death toll . . . to 20," the Herald-Leader reported.
• People over 60 are most vulnerable to the virus, but "in Tennessee, it is disproportionately affecting young people," the Chattanooga Times Free Press reports. "On Wednesday, Hamilton County health officials announced the county's first child death due to coronavirus. In Tennessee, where there were 2,239 confirmed cases . . . as of Tuesday afternoon, more than 25% of people who had tested positive (566) were in their 20s and 15% (346) were in their 30s."
• Beshear said Kentucky continues to work to increase its number of hospital beds, ICU beds and ventilators. He said right now the state has 18,500 hospital beds, 1,300 ICU beds and 1,352 ventilators. He said the state has plans that would allow for an additional 8,000 hospital beds, with 1,600 of them in hotels that could be used for low-acuity patients. He said the state had secured an additional 70 ventilators, and was trying to double its amount.
• The governor said the state is working every day to secure more testing and his office is running an audit to determine how many tests have been completed by outside labs. He said he could confirm that more than 10,000 tests have been completed, and all labs had not reported their numbers; previously he estimated 15,000-21,000.
• The state opened a pilot site for drive-through testing in Frankfort, for vulnerable people who have covid-19 symptoms and for first responders. Beshear said he hopes to eventually have 40 such sites.
• Beshear and Health Commissioner Steven Stack both cautioned people to be wary of any pop-up testing site that wants payment in cash. They said any testing site in Kentucky should be working with the state Department of Public Health.
• With rent due on the first day of the month, Beshear reminded renters that evictions are illegal during the covid-19 emergency. Last month, Kentucky Chief Justice John Minton issued an order delaying all eviction cases, and last week's federal rescue bill "prohibits landlords that participate in certain federally backed housing programs from filing an eviction, WFPL reports. "On Wednesday, a new Supreme Court order went a step further and said courts will not accept new eviction filings at all until at least mid-May."
• John Benton, deputy secretary of the Education and Workforce Development Cabinet, continued to ask for patience as it works to take care of the huge influx of unemployment claims. He encouraged most people to use the claims site, kcc.ky.gov, so those who really need to speak to someone at a call center can get through. Beshear said 40,000 acceptance letters were sent Tuesday night to many who had been told at first that they didn't qualify.
• Kentucky Educational Television, which brands itself as KET, has gotten closer to its roots, replacing its normal programming on the main KET channel from 7 a.m. ET to 5 p.m. ET with a special lineup specific to at-home learning for PreK-third grade, grades 4-8, and grades 9-12. Visit KET.org/learnathome for an updated schedule.
• Does the pandemic have a silver lining? "Among those lucky enough to have access to food and safe housing, and not be sickened by covid-19, there are indicators that the pandemic itself, and the massive shutdown it has triggered, is forcing the adoption of more-healthful behaviors," Dr. Daphne Miller, a family physician and author, writes for The Washington Post. She says many are exercising more, spending more time with nature, eating out less and cooking more from scratch at home. Also, mental-health apps are showing a dramatic increase in downloads.
• Blood-donation centers across the nation are ramping up efforts to collect plasma from people who have recovered from covid-19 in hopes it can be used to save the lives of others infected with the virus, JoNel Aleccia reports for Kaiser Health News. "The treatment is not a sure thing," she writes, adding that studies show injecting the plasma from those who have recovered into those who are still suffering has had some success in reducing symptoms and death in past outbreaks, but has not had time to be proven in clinical trials.
• Betty Nunn, a patient at Norton HealthCare in Louisville, told Deborah Yetter of the Louisville Courier Journal that she was very happy with her decision to do a telehealth visit, which she did through an app on her phone. "I was really happy with it," she said. "I would do it again." This sentiment comes as Kentucky primary care providers and behavioral health providers transition to caring for their patients through telehealth during the covid-19 outbreak.