Saturday, June 6, 2020

Church whose pastor pressured Beshear to allow in-person services goes back to online after a coronavirus outbreak

The church set up a tent for services Friday, June 6, but postponed them to June 21.
(Lexington Herald-Leader photo by Sam Mallon)
A Lexington-area church "that resumed in-person services in mid-May, and whose pastor pressured the governor to reopen churches early, is now the site of a covid-19 outbreak," Alex Acquisto reports for the Lexington Herald-Leader.

"At least 17 congregants at Clays Mill Baptist Church . . . have been diagnosed with the viral respiratory disease," Acquisto writes. Nine live in Jessamine County, where the church is located, and eight live in Fayette County, according to public-health officials.

"The ages of those with the virus range from children to the elderly," Acquisto reports. "Pastor Jeff Fugate, who’s led the church for nearly 30 years, said on Friday by phone that he felt 'terrible' about the outbreak." He told Acquisto, “I care more about the health of my people than anyone.”

"At least two of the people who’ve tested positive are in Fugate’s family," Acquisto reports. "Over the last few weeks, he’s wondered what he could’ve done differently. But ultimately, Fugate said, ‘I don’t know of anything we could’ve done differently. I don’t. That’s why I just feel so bad.’”

Fugate stopped in-person services in late may after several congregants tested positive, but he told Acquisto he plans to resume them on June 21 at a “huge tent revival.” He originally planned to do that Friday, June 5, but delayed as the outtreak worsened.

Acquisto notes that Fugate joined state Attorney General Daniel Cameron for an event at which "Cameron threatened to sue Gov. Andy Beshear if he didn’t rescind his executive order preventing churches from holding in-person services." Fugate said churches could meet in person safely.

A lawsuit in which Cameron joined authorized Kentucky churches to begin holding services May 10, 10 days before Beshear had planned to let them.

Fugate told Acquisto that he has not offered Sunday School or child care, has encouraged his congregation not to shake hands and to wear masks, had his staff spread out sanctuary chairs, and limited singing to "two or three" songs instead of the usual six or seven.

Health Commissioner Steven Stack has "warned churches of the potential dangers of shouting and singing around others, since those acts release a larger amount of virus particles into the air," Acquisto notes. "A Washington state choir practice with at least one known infected person in mid-March resulted in 53 of the 61 participants catching the virus, according to a Centers for Disease Control and Prevention study that Stack mentioned during a daily news conference in May."

Uptick accelerates as Beshear announces 319 new coronavirus cases, most in more than a month, with 65% in Jefferson County

Kentucky Health News chart shows cases reported each day for the last month. Click on it to enlarge.
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced 319 new cases of the coronavirus on Saturday, one of the highest numbers the state has seen in weeks.

“The virus is still out there. I know we’re tired. I know we all just want to have a normal summer,” Beshear said in a news release. “But we’ve already saved so many lives as Team Kentucky and we can’t let up now.”

That was the closest he came in his news release to addressing the rising trend.

The last day that more than 319 cases were reported was May 5, when Beshear announced 625 new cases, with 309 of them from a Western Kentucky prison and 316 from the general public.  Before that, the highest daily number of cases was April 19, at 322.

Kentucky Health News chart; for a larger version, click on it.
After two weeks of general decline, the state began seeing rises in cases May 29, when 283 were reported. Including that day, seven of the last nine days have had case numbers higher than 213.

It will be important to watch these numbers as the state continues to reopen its economy, and in the wake of protests of police violence and racial injustice.

Mother's Day was May 10, a date that likely increased contacts among people who hadn't seen each other in some time, and it was also the first Sunday that Kentucky churches were authorized to hold in-person services. Kentucky began reopening its economy on May 11; that was 18 days before the numbers started jumping, and the incubation period for the virus can be two weeks or more.

Beshear has incrementally allowed new openings every few days since May 11. Educational and cultural activities, horse shows and some in-home childcare are scheduled to re-open Monday, June 8. Nightly protests in Louisville and Lexington are into their second week.

A graph created by the Lexington Herald-Leader shows that this week's total number of cases is 1,583, up from 1,133 the week ending May 30th; and 833 the week ending May 23; and 1,248 the week ending May 16. Beshear displayed a week-by week chart on May 28, the day before the uptick began.

Lexington Herald-Leader chart by Daniel Desrochers, adapted by KHN; click on it to enlarge.
The state's daily update shows that 207 of the new cases are in Kentucky's most densely populated county, Jefferson, which had 65 percent of Saturday's total. The county has reported high numbers for several days, reporting 149 new cases on Friday and 88 new cases Saturday.

The 319 cases added Saturday brought the state's adjusted total to 11,287, with at least 3,344 of them having recovered. The daily report shows that 495 people are in the hospital and 75 are in intensive care.

Beshear announced four more covid-19 deaths: a 73-year-old man from Clay County, 73- and 90-year old men from Jefferson County, and a 70-year-old woman from Logan County. Kentucky's death toll from covid-19 is 470.

The long-term care facility update was last updated Friday, June 5. It showed that 1,405 residents and 645 staff members had ever tested positive for the virus, and 288 residents and three employees have died from it.

Friday, June 5, 2020

Ky. coronavirus cases still up, with 289 reported Friday; another health-care worker has died of covid-19; how do we safely hug?

Daily cases went down, but the two-week trendline angled farther upward. (Ky. Health News chart)
As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced 289 new cases of the coronavirus in Kentucky, the third straight day the state has seen 265 or more new cases.

“Remember, covid-19 is still out there spreading aggressively and it can be lethal to certain populations,” Beshear said in a news release. “Let’s make sure we’re keeping our social distance, let’s make sure we’re wearing masks, and let’s protect one another.”

Beshear's release did not address the rising number of cases, but he and his health commissioner said Thursday that they are not yet worried about this upward trend, largely because they look at a whole host of metrics to make that determination, such as the percentage of people who test positive, how many people are in intensive care related to covid-19, and the estimated transmission rate of the virus: how many people an infected person infects, on average.

And by those metrics, things are not discouraging. The number of Kentuckians in intensive care remains low, at 73, though this is a lagging indicator of infection; the Lexington Herald-Leader reports that the percentage of people who test positive for the virus in the state has dropped to 3.99 percent, the first time that number has dropped below 4%; and Vox reports, looking at many of those same metrics, that as of Thursday, June 4, Kentucky was one of only six states that met basic federal criteria to reopen its economy and stay safe.
Vox map; for a larger version, click on it.

The bad news is that two different groups that measure the rate of transmission have just put Kentucky's rate above 1. A rate of less than 1 means the virus should eventually stop spreading because the average number of people infected by each infected person is less than 1; a rate of over 1 means that the virus is spreading.

Covidactnow.org reports that as of June 1, the rate of transmission was 1.03 based on reported case numbers, and that it has been on the uptick since May 26. CovidActNow calls this a "medium risk" for the spread of the disease, because it is spreading in a slow and controlled fashion.  Rt.live estimates that as of May 30, the rate was 1.02 and has been above 1 since May 17.

Lexington saw its largest single-day spike unconnected to a previous prison outbreak, with 35 new cases and one new death, Jeremy Chisenhall reports for the Herald-Leader.  Louisville's numbers also remain high, reporting 149 new cases Thursday, and 88 Friday. Other counties with the highest number of new cases are Shelby, with 31; Warren, with 19; and Kenton with 11.

The 289 cases added Friday brought the state's adjusted total to 10,977, with at least 3,316 of them having recovered.

Beshear announced eight more covid-19 deaths: three women from Jefferson County, aged 52, 77 and 87; an 89-year-old man in Jefferson County, a 66-year-old man from Daviess County, a 48-year-old man from Fayette County, an 82-year-old woman from Franklin County and an 86-year-old woman from Graves County.

The deaths included a health-care worker, the third in the state to die of covid-19. “Like the first two we lost, this person worked in a long-term care facility,” said Beshear. “Let’s make sure that we remember not only the seriousness of covid-19 but that we continue to show our compassion to these families.”

The daily long-term care facility update shows that 1,405 residents and 645 employees have ever tested positive for the virus, with 438 residents and 139 employees currently with it. This is an increase of 27 residents and a decrease of two staff who currently have the disease, compared to yesterday's report. The update shows that 288 residents have died from covid-19, an increase of five. Including the three employees, 62% of the state's deaths have been in nursing homes.

The news release adds that the governor has extended an executive order letting pharmacists dispense 30-day refills through July 7 and another prohibiting price gouging throughout the state of emergency.

For additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity, click here.

In other covid-19 news Friday:
  • ACASignups.net has posted a graph of every official covid-19 case per 1,000 residents over time for all 50 states from March 20 through June 3. It shows that Kentucky's rate falls closer to the bottom of the graph, the same as Missouri and Texas. 
  • Experts offered advice in The New York Times on safe ways to hug during the pandemic. Tara Parker-Pope writes, "Not only do we miss hugs, we need them," reporting on how physical affection is known to reduce stress. The experts told Parker-Pope that while the safest thing to do is to avoid hugs, if you choose to hug it is important to take precautions. "Wear a mask. Hug outdoors. Try to avoid touching the other person's body or clothes with your face and your mask. Don't hug someone who is coughing or has other symptoms," she writes. Others advise pointing your face in opposite directions, to not talk or cough when hugging, to do it quickly, don't  linger and to wash your hands afterwards -- and try not to cry. One expert even suggested holding your breath during the hug and another advised choosing your hugs wisely. 
  • At a House committee meeting, Centers for Disease Control and Prevention Director Robert Redfield encouraged protesters to "highly consider" getting tested, The Hill reports. He also voiced concern that the CDCs guidance on masks and social distancing is not resonating with the public and when asked about the use of chemical agents at the protest that cause people to cough, he said, "Definitely, coughing can spread respiratory virus, including covid-19." These concerns have also been regularly voiced by Beshear and Health Commissioner Steven Stack. 
  • Norton Healthcare in Louisville is offering free coronavirus testing at 3101 Poplar Level Road from nooon to 4 p.m. Saturday and Sunday. Registration is required; click here for more information. 
  • The Trump administration will require laboratories to include data that includes race, ethnicity, age and sex of individuals tested for the virus starting Aug. 1, NPR reports. Kentucky labs already collect this data. Click here for the daily report.

Thursday, June 4, 2020

Coronavirus cases continue to rise in Kentucky; governor touches on many topics: testing, politics, schools, health disparities, etc.

State map, labeled by Kentucky Health News, shows rates through June 3. Click on it to enlarge.
As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

The number of new, daily coronavirus cases in Kentucky continues to creep up, hitting a seven-day high of 295 on Thursday.

Beshear called the number "pretty high . . . elevated from where we were going for more than a week," but said it is "a little too early" to say the trend has reversed and is on an upward trajectory.

"Again, it's not enough data to say that I am concerned or to raise a high level of concern," he said, pointing to other metrics: "We have a lot of tests that are out there. We are testing more asymptomatic people than ever. Our ICU current beds are really low."

Kentucky briefly celebrated a two-week downward trajectory in new cases just last week, but starting May 28 the number jumped to 283, and for five of the last seven days the case numbers have been over 213.
Kentucky Health News chart shows cases for last two weeks and trendline for the period.
Of the 295 new cases, most of them, 149, were in Jefferson County. No one asked Beshear or Health Commissioner Steve Stack about that, and neither of them offered any comment on the unusual figure. Other leading counties were Kenton and Warren, 14 each; Boone, 13; and Clark, nine.

Beshear reported an adjusted total of 10,705 cases in the state, with at least 3,303 of them having recovered. He said 518 people are hospitalized with covid-19, including 67 in intensive care. So far, the state has had 262,714 tests.

Beshear said Kentuckians should expect to see more positive tests as the state continues to ramp up its testing and as people's contacts begin to increase with the economy reopening.

"Now, I hope that they are lower than this, but we're going to have more," he said. "We're going to watch the numbers as we continue."

Stack noted that the state's testing capacity is well above the federal guidance to test 2 percent of the population each month.

He said another way to reach this guideline is to test until the number of people testing positive for the virus is less than 3%, which indicates that enough people are being tested to find the positive cases. Kentucky is currently at 4.07%, reports the Lexington Herald-Leader.

While the state has more than enough testing capacity, Beshear said he remains worried about "testing fatigue," noting that the sign-ups in the free Kroger-sponsored sites have been slowing. He called on employers to get their employees tested regularly.

"If you are running a business, you ought to want your employees to continue to go to get tested so that someone who is asymptomatic doesn't spread it throughout the office or the factory or the environment that they work in," he said. An estimated one-fourth to one-half of the people with the virus have no symptoms but still spread it without knowing.

Deaths and classifications: Beshear announced that eight more Kentuckians have died of covid-19, bringing the state's death toll to 458.

The new dead were an 87-year-old woman from Boone County, a 72-year-old man from Franklin County, an 82-year-old man from Grayson County, a 92-year-old man from Kenton County, a 71-year old woman and 91- and 92-year-old men from Jefferson County and an 86-year-old woman from Metcalfe County.

Asked it he would consider doing a separate count of people who have died from multiple issues, he said that could be counterproductive.

"Almost everyone that has died from the coronavirus has underlying health conditions and many of them are serious and significant health conditions," he said. "I don't want to over-complicate in our numbers what this virus does. Yes, there are other causes, but without this virus in most cases, we do not believe that the death would be there.

"And there may be some that say, 'Oh, well, that's conflating it.' No, this is killing people and if we don't take it seriously, again if we pull out our numbers in different ways that let us rationalize that it is not a problem, then we don't do what is necessary to defeat it."

Politics: Asked about Attorney General Daniel Cameron's suggestion to a legislative panel that the governor's executive authority during such emergencies should be limited, Beshear referred to his presentation the day before defending his orders and noting three studies showing they "saved thousands of lives."

"It's after we've blunted the curve and crushed the curve that politics comes back into it," he said. "But, if a future governor did not have the power to take urgent action when it is needed, it would have resulted in significant additional death. . . . Every action that I've taken is for the life and the safety of our Kentuckians."

Schools: Asked about schools reopening, Beshear said he hopes there will be a regular reopening, but cautioned that school will look much different than it currently does.

He pointed to recent testimony at a legislative hearing that objected to public-health suggestions for social distancing, wearing masks and keeping one group of students together all day, while teachers move from class to class. 

"If schools don't do things differently, they have an outbreak, you shut down that school," Beshear said. "I think we've seen that in France and in some other places. My hope is that we can start school normally in the fall, but those schools that are willing to embrace the things you need to do to prevent the spread are likely going to be able to continue and not have interruption." 

He said state officials are still working on guidance for schools and this will be influenced by what happens with the virus over the next few months. 

Disparities: Beshear said he would announce actions that his administration will take to address disparities in health care and other areas among "communities of color." on Monday. North Carolina Gov. Ray Cooper signed an executive order Friday establishing a task force to address the issue, ensure that relief funds have been fairly distributed and giving minority-owned businesses access to more opportunities and resources. Beshear said he wants to change the situation, not just come up with recommendations.

For additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity, click here.

In other covid-19 news Thursday:
  • "Less than a year after Kentucky celebrated its first decline in overdose deaths in five years, evidence is building that the covid-19 pandemic and its fallout have fueled a rise in drug relapses and fatal and nonfatal overdoses in parts of Kentucky," Chris Kenning reports for the Louisville Courier Journal. 
  • The long-term-care facility webpage has been updated to an easier-to-read format. It shows that 1,384 residents and 639 staff have ever tested positive for the virus, with 411 residents and 141 staff currently with it; 283 residents and two staff have died of covid-19. 
  • Six Eastern Kentucky counties are among the 25 U.S. counties with the highest overall food-insecurity rates, and the covid-19 pandemic is making it worse, Liz Moomey reports for the Lexington Herald-Leader. Michael Halligan, the chief executive officer of God's Pantry Food Bank, told her that the region had never quite bounced back from the 2008 financial crisis. She writes that many food banks are just beginning to reopen. 
  • Beshear announced that Nascar would be allowed to race at the Kentucky Speedway July 9-12 without fans and more information on this would be coming Monday. He said betting parlors for "historic horse racing" can open Monday, June 8, at 33% capacity. 
  • Also opening Monday are in-home childcare, libraries, horse shows, and educational and cultural activities. The Kentucky Horse Park and state park campgrounds can open June 11.

Allison Adams, longtime public-health official, is new vice president for public policy at Foundation for a Healthy Kentucky

Allison Adams
Allison Adams, a longtime Maysville-area public-health official, will join the Foundation for a Healthy Kentucky as vice-president for public policy on June 15.

She will replace Veronica Cecil, who was named deputy Medicaid commissioner in the state Cabinet for Health and Family Services.

Adams has directed the Buffalo Trace District Health Department since 2008 and presided over the Kentucky Health Directors Association for the past four years. She began her public health career in 2000 as a health educator at the district department, which serves 20,000 residents in Mason and Robertson counties.

"The current pandemic has reinforced the importance of public health in preventing and responding to disease, and Allison's laser focus on improving and appropriately funding Kentucky's public-health system is critical to ensuring that we're even better prepared in the future," said Ben Chandler, president and CEO of the foundation.

Most recently, Adams played a key role in getting passed in the 2020 General Assembly a public health transformation bill that refocuses the state's health departments on core public health-policies and strategies, and makes their funding more equitable.

Adams has a B.S. in sports medicine from Marietta College and a masters in public administration from Northern Kentucky University. She completed an associate degree in nursing in 2016.

Wednesday, June 3, 2020

Beshear defends actions to control virus as trendline keeps going up; nursing homes will likely be last to lift covid-19 restrictions

Today's report increased the upward tilt of the two-week trendline. (Kentucky Health News chart)
As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Amid further signs that the coronavirus is resurging in Kentucky, Gov. Andy Beshear offered his most comprehensive defense of his actions to control it.

"We didn't take these steps because anybody loves power or is trying to do anything; we took them to save lives," the Democratic governor said, repeatedly saying that all his moves were in step with White House guidelines.

After two weeks of a downward trajectory in new cases, a key federal metric for reopening state economies, four of the last six days have shown an increase, with today's number hitting 265. That made for a six-day average of 216, well above the previous six days' average of 128.

"I don’t think this 265 is a cause for alarm, though it is at least a reminder … that this virus is still out there and spreading," Beshear said. "We do have to watch this pretty carefully."

Health Commissioner Steven Stack used a different metric, the percentage of tests that find infection. That number has been on a slow decline for two weeks, to about 4 percent. The goal is 3 %.

Stack didn't give a number for Wednesday, but said the positive results at Kroger-sponsored testing sites, which are likely a "decent snapshot" of the overall rate in a community, are generally about 1 %, ranging from near zero to over 2%.

He said the positive rate at health departments and hospitals in the last week has ranged from 1.1% to 4.4%, and that has been "relatively consistent over the last two to three weeks." The rates have been higher at long-term-care facilities, where the state is testing all residents and employees.

"So right now the data does not say that we are in an uptick," Stack said. "At worst it would be a plateau of some sort; it may still be a downward slope."

rt.live estimate of transmission rate, with low point noted
He said the CovidActNow website estimates the rate of transmission of the virus in Kentucky to be 0.96. A rate of less than 1 means the virus should eventually stop spreading because the average number of people infected by an infected person is less than 1. However, the rate estimated by the rt.live website is 0.99, and has been on an uptick since May 7, when it was 0.95.

The CovidActNow site estimates rates for counties; Kentucky's high counties include Christian, 1.36; Shelby, 1.32; Allen, 1.24; and Logan, 1.20.

Stack, who has expressed concern about a resurgence of the virus because not enough Kentuckians are taking it seriously, cautioned that "there is significant time delay" between actions that may increase the spread of the virus and a significant increase in cases, because of its incubation period.

"So if we are going to see a surge after a major event, it is going to be two or three weeks later that maybe we start to see a signal that there is a surge, and it's probably going to be a month and a half to two months later that we really hit a bad place," he said. "So we'll keep watching carefully."

Beshear's pitch: In his presentation of his actions to combat the virus, Beshear noted that the state's mortality rate is much lower than that of the nation as a whole and the world. Kentucky's rate is 4.3%, compared to the U.S. rate of 5.7% and the world rate of 6.1%.

"We are not just beating the national and the world average, but we're doing it with a population in Kentucky that is relatively sick, that has heart and lung and kidney disease more so than many other places," he said. "Yet still, we are taking care of each other in very important ways." He estimated that the economic restrictions he imposed saved more than 10,000 lives, based on modeling that forecast tens of thousands of deaths.

Beshear said the actions he took were similar to those of other governors, and he highlighted the actions of Republican governors in Indiana, Ohio, Maryland and Massachusetts. He said actions were taken in "red states, blue states; it didn't matter." What he didn't say is that Republican governors have generally been quicker to relax restrictions than their Democratic counterparts.

Beshear reported an adjusted total of 10,410 positive cases of the virus in the state, with at least 3,283 of them having recovered. He said 488 people are hospitalized with covid-19, including 68 in intensive care, which is the lowest number for this measure the state has seen in a while.

Infant death: He said eight more people have died from the virus, including a nine-month-old girl from Hopkins County, a case he mentioned at the start of his briefing. "This is a reminder of how deadly this virus can be," he said.

Stack said that if not for the pandemic, the death would have been attributed to Sudden Infant Death Syndrome, but he said it would be counted as a covid-19 death because the infant tested positive for the virus. He said the virus may or may not have contributed to the child's death, and the truth may never be known.

He reminded parents that children "overwhelmingly do just fine" with the virus and the vast majority of them have no symptoms. Some have developed a multi-system inflammatory syndrome that is linked to the virus; Kentucky has reported four cases, and all the children have recovered. "I would encourage parents to not worry overly, but that you should be concerned," he said.

More warnings: Stack also cautioned that while younger people also tend to recover from the virus or don't have symptoms, this is not always the case, pointing to a 48-year-old man from Shelby County with no pre-existing conditions who was among the list of those who have died from the virus.

Stack cautioned that as the weather warms and normal activities resume, it becomes even more important to do everything we can to slow the spread of the disease, because there is no vaccine and no treatment, and no evidence that warm weather will slow the virus.

“I have tried all along not to be sensational about these things, but to be factual, to be even-handed,” he said. "This is a very serious disease. It is not influenza. . . . It can rapidly spread, it can rapidly overcome the health-care system."

Today's other deaths were two women, ages 91 and 99, from Edmonson County; an 84-year-old woman from Gallatin County; and three women, 91, 92 and 93, from Jefferson County.

In long-term care facilities, Beshear reported that 15 more residents and nine more staff have tested positive for the virus, bringing those totals up to 1,366 and 633, respectively. He said 10 more deaths in these facilities were attributed to covid-19, bringing that number up to 245 deaths.

Beshear said testing for the virus has been completed in about half of the state's nursing homes, and to his and others' surprise, some of them had no positive cases. Nursing home have accounted for about 58 percent of the state's covid-19 deaths.

Beshear warned against "testing fatigue," and urged Kentuckians to sign up for free, drive-thru testing sites for next week at Kroger-sponsored sites in Louisville, Lexington, Bowling Green and Elizabethtown. Spots are still available this week and sign-ups have opened for next week.

Beshear once again asked Kentuckians who are protesting against police violence to make sure they are wearing masks, social distance where possible, to protect those in their lives who may be more vulnerable to the disease, and to consider getting tested in the coming days.

In other covid-19 news Wednesday:
  • The counties with the highest number of new cases Wednesday were Jefferson, 55; Fayette, 37; Boone, 30; Kenton, 27; and Warren, 24. Beshear said only one county has no reported cases. That is Robertson, which has about 2,300 people. 
  • Nursing homes and medical centers will be among the last places to lift covid-19 rules, Bailey Loosemore reports for the Louisville Courier Journal. "Normal considerations where people were coming in like they used to, I think, is way down the road, maybe even until we get a vaccine or effective therapeutics," Tim Veno, president of LeadingAge Kentucky, a group that represents nursing homes and assisted-living centers, told Loosemore. "We hear from residents every day who want to see their loved ones, and it's very painful, with regard to that. But we also believe we have a paramount duty to protect their health and welfare."
  • Emergency department visits declined 42% during the early part of the pandemic, with the steepest decreases in persons 14 or younger, females and the Northeast, all while the proportion of infectious disease-related visits was four times higher, according a study published in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention. The CDC advises increased health messaging about the importance of seeking immediate care for serious conditions, and to encourage virtual visits for those who have conditions that are not emergencies.
  • Among other coronavirus information, The Guardian offers a coronavirus "deaths per capita" and "cases per capita" map, pointing out that the actual death toll is thought to be far higher than the tally compiled from government figures. It says that as of June 3, Kentucky has 10 deaths per 100,000 citizens and 228 cases per 100,000.  
  • Becker's Hospital Review has compiled a non-exhaustive list of data and stories about why racial disparities and covid-19 matters in healthcare. 
  • The Lexington Herald-Leader explores safe sexual practices during the pandemic.

Career-college CEO says to take a look at health care careers

By Bruce Kepley

In the mid-1990s, I started and ran a business that trained workforces on specific computer software. Large companies would hire us to come in and train their entire workforce to use the new tools the company had purchased.

It was interesting work and we were good at it, but a small segment of our business was even more interesting to me. Our industry called them “career-changers.”

These were individuals who wanted to do more than just learn a specific piece of software that they would use at their existing job. They wanted to retool their career for a newly emerging, more tech-savvy economy. The students wanted to become software developers or engineers.

Each of those students had a different personal story, but they were united in realizing that economic shifts represent opportunity for those who are willing to keep learning.

Along the way, I’ve shifted too. I moved away from workforce training, to career-oriented colleges. And I’m now the majority owner of MedQuest College, which is focused on health-career related occupations. But the students we work with today have much in common with those students I met 30 years ago.

The economic tides have shifted several times since the mid-90s. The dot.com bubble came and went. The terrorist attacks of 9/11 caused huge shifts in our national priorities and interests. Then, in 2008 we saw the beginning of the Great Recession.

What I saw each time was greater interest in education and higher enrollment at colleges like MedQuest. According to the U.S. census, enrollment jumped 29 percent at two-year colleges during the Great Recession.

Our current economic downturn is unlike anything any of us have experienced. The future is filled with many uncertainties. Unemployment has skyrocketed — and it’s hard to know how quickly those jobs can come back.

But this month, MedQuest and other colleges — proprietary, private and public — will be starting new classes. Those classes will be filled with students who see education as a path into a brighter future. At MedQuest in particular, the students tell us that by preparing for a career in health care they are choosing to be part of the solution in a time of uncertainty.

When responsible colleges see sudden growth in interest or enrollment, they worry about outcomes — will all these new students be both dedicated to finish and will there be jobs waiting for them when they are done? But my experience in previous downturns makes me confident that, in fact, education is part of the way we pull ourselves out of economic slumps.

For the high-school seniors who graduated this month, for the people who are watching health-care heroes and wondering how they can become a part of that critical industry, and for those who have suddenly experienced reduced hours, furloughs or layoffs, I recommend that you take a moment to explore higher education options. Whether you’re adding a new skill or credential, or revamping your career entirely, this may be the best time to act. That’s a way all of us can help build a better economy.

Bruce Kepley is CEO of MedQuest College in Louisville. This first appeared in the Courier Journal.

Tuesday, June 2, 2020

Federal appeals court upholds ruling against 2018 Kentucky law banning abortion procedure used in second trimester

Beshear says more time needed to detect a 'new bump' in virus cases; says Supreme Court upholds his orders on gatherings

Kentucky Health News chart shows upward two-week trendline slightly lowered by latest report. 
As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

As he announced 155 more cases of the novel coronavirus in Kentucky, Gov. Andy Beshear said he still wants more time to analyze the upward trend of recent days.

"It's going to take five, six, seven days to try to truly see if this was perhaps related to our testing in long-term care [where] we are seeing an escalation of cases," he said at his daily briefing. "We want to try to make reasonable determinations based on data and we simply don't have enough right now to suggest that there is a new bump right now."

Beshear said a week ago that the state had begun the long-forecast decline from a plateau of several weeks, but high numbers at the end of the week reversed the two-week trendline, a key metric for any epidemic. Tuesday's number of 155 cases was much lower than those on three of the last four days, which had 214 or more cases. But the two-week trend remained decidedly upward.

"I still believe that if we are not plateaued, we are decreasing, but the data is going to bear that out," Beshear said. "We are going to have to watch and see."

The governor did not give an update on long-term care facilities Tuesday, but the latest long-term care facility report, dated May 31, showed that 1,358 residents and 621 employees had tested positive for the virus in 124 facilities, and 250 residents and two employees had died from it.

Beshear reported an adjusted total of 10,185 cases of the virus in Kentucky, at least 3,275 of whom have recovered. He said 481 people are hospitalized with covid-19, including 85 in intensive care. The counties with the highest number of new cases Tuesday were Jefferson, 46; Franklin, 17; and Fayette and Warren, each with 10.

He said 253,585 tests for the virus have been done in Kentucky, bringing it into the top half of states. As he has reopened the state's economy, Beshear has encouraged Kentuckians to consider getting tested monthly, and more often if they have lots of contacts, to track the spread of the virus. "If we can continue our pace that we are on right now, it will certainly help us in restoring our economy more safely," he said.

Beshear also announced that there have been three more deaths from covid-19, bringing the state's death toll to 442. The fatalities were a 69-year-old woman from Clay County, a 94-year-old man from Jefferson County and a 92-year-old man from Muhlenberg County.

“Let’s keep lighting our homes up green” in honor of the dead, Beshear said. “Let’s continue to ring our bells at 10 a.m. Let’s do it for those that we’ve lost from this and from senseless violence. Everybody that we’ve lost that should still be here deserves that same level of compassion.”

The first part of Beshear's briefing was spent on an update of the protests against police violence that have been going on in Louisville and across the state. He reiterated that black Kentuckians continue to be disproportionately affected by the virus, at a rate more than double their share of the state's population.

"Before what we are seeing in Louisville and around the country, this again was showing what inequality results in, which is death," he said. "We were seeing that because of inequalities that have lasted hundreds of years and absolutely exist in our health-care system. . . . This is not OK and we're going to do something about it."

Beshear said he would announce later this week an initial plan to address inequalities in health care, which will intend to "actually make change in the health of individuals."

“Just like in many ways it shouldn’t have had to take some terrible incidents around our country to wake people up or to get them to listen to the type of injustices that are occurring in our society, it shouldn’t take a one-in-every-100-year pandemic for us to see the same in health care," he said.

Beshear again cautioned protesters that the virus is still spreading, and asked them to do their best to be safe by wearing a mask, social distancing, and staying away from seniors and others vulnerable to the disease.

Switching to the courts and politics, Beshear noted that last Friday, the Supreme Court issued an order upholding the California governor's orders limiting mass gatherings in houses of worship, orders similar to those issued by Beshear and other governors. The vote was 5-4, with Chief Justice John Roberts joining the court's four liberals.

A Beshear news release noted that Roberts said state officials have broad latitude to protect public health. Roberts wrote, “Where those broad limits are not exceeded, they should not be subject to second-guessing by an ‘unelected federal judiciary,’ which lacks the background, competence, and expertise to assess public health and is not accountable to the people.”

Beshear said the ruling should resolve all current federal-court challenges to his emergency orders.

For additional information, including an up-to-date list of cases and deaths, as well as breakdowns of the virus by county, race and ethnicity, click here.

More covid-19 news for Tuesday: 
  • MedPage Editor in Chief Dr. Martin Makary of Johns Hopkins University talks about what the second wave of infections could look like, what vaccines and treatments in the pipeline are most exciting to him, and the value of wearing a mask, noting that the risk of airborne transmission is far greater than from the transmission of the virus through surfaces. "We're increasingly learning the value of wearing masks in a situation like this," he writes, "and I think it's powerful."
  • White House coronavirus response coordinator Deborah Birx said the U.S. should not expect the coronavirus outbreak to wane over the summer, Politico reports.. "None of us can be lulled into this false sense of security that the cases may go down this summer," Birx said in a discussion with the German Marshall Fund president during the organization's Brussels Forum webcast. She added that American leaders are preparing actively for the possibility of finding and containing future outbreaks through contact tracing and proactive surveillance.
  • About seven in 10 Americans say they would get a vaccine to protect against the coronavirus if it was free and available to everyone, according to a Washington Post-ABC News poll. This number was higher among Democrats than Republicans, 81% and 58% respectively, the Post reports.
  • The University of Kentucky's College of Public Health and Gatton College of Business and Economics will hold a free webinar from noon to 1 p.m. June 3 to discuss research demonstrating that strong social-distancing measures imposed at the onset of the pandemic were effective in slowing disease transmission, thereby saving lives. Click here for more details.
  • The Lexington Herald-Leader offers tips on how to stay safe at yard sales in the pandemic. Experts also tell the Herald-Leader in a separate article that playgrounds are not safe and can lead to the spread of the disease. 
  • A Lexington pharmaceutical company is developing a nasal spray to treat covid-19, Alex Acquisto reports for the Herald-Leader. The spray would be used on patients who've been diagnosed with the virus, but who "have not yet exhibited symptoms severe enough to require hospitalization," says the press release
  • The pandemic has resulted in the closing of more than 100 day centers for elderly adults and adults with disabilities in Kentucky, leaving about 9.500 individuals "suddenly cut off from the daily meals, health services, therapy and social activites they and their caregivers rely on," Deborah Yetter reports for the Louisville Courier Journal. 

Writer worries about spread of virus in Central Ky. restaurants

By Randy Patrick

I'm worried that many of the restaurants I've visited in Clark and Jessamine counties are following the guidelines for safe reopening of their dining rooms.

I just went to one of my favorite places for carryout, and there must have been 10-15 people crowded into a small space, many at a lunch counter not more than six inches apart (rather than the six feet required). None of the tables were closed off. There was a big jug of sanitizer on the counter, but no dispenser. You would have to handle it and unscrew the cap to use it. The condiment bottles and salt shakers were sitting out on the counter so everyone could handle them. And I was the only one wearing a mask. The cook wasn't. The server wasn't. Not one of the customers were. And none of the workers were wearing gloves.

This was the worst I've seen, but it's been almost as bad at other places. Is no one enforcing the public safety rules? I like to support local, independent businesses, but they've been the worst among the few I've visited. At least the big chains seem to make a bit more of an effort. Two that seem to be doing it right are Starbucks and Jimmy John's. But for the mom-and-pop places, it's like "The deadly virus is over because the governor has allowed us to reopen." It isn't.

We just passed the 100,000 dead mark in this country. Think about that -- 10,000 people a week in only about 10 weeks, or nearly twice as many as died in 10 years of the Vietnam war. I don't want to sound like an alarmist, but people, this is a crisis. If you can't do this right, the government is going to have to shut it all down again, and the gains we made in March and April through social distancing and business closures will have been for nothing.

I know people who have had this disease. I know people with relatives who have had it. Here in Clark County, the numbers have more than doubled in the past few days. Epidemiologists say it hasn't even come to rural America yet, but it's coming.

Randy Patrick is a reporter for the Winchester Sun. He posted this on his personal Facebook page. He posted the first comment: "I'll have to say, as much as I like the food at the place I got lunch at today and the guy who owns it, I won't be going back. He may not take this seriously, but I do."

Monday, June 1, 2020

214 new covid-19 cases reported Monday, keeping trendline up; protests spread virus; experts say key is 80% wearing masks

Kentucky Health News chart shows two-week trendline about where it was on Saturday: up.
As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Coronavirus cases showed a big drop on Sunday, but jumped again on Monday to a number similar to the elevated numbers seen near the end of last week. Prior to the elevation in numbers late last week, the state had seen a downward trend for almost two weeks. 

“Kentucky has had 131 new positive cases with zero new deaths on Sunday and 214 new cases with eight new deaths on Monday,” Health Commissioner Steven Stack said in a news release. “We continue our efforts to expand testing, ramp up contact tracing and urge the public to practice social distancing and wear cloth face coverings to reduce the spread of covid-19.”

After almost two weeks with no day higher than 166 new cases, Kentucky's numbers jumped to 283 last Friday and 247 on Saturday. Gov. Andy Beshear said Saturday that those numbers were driven by increased testing in long-term care facilities, but no explanation was given for today's increase.

The counties with the highest number of new coronavirus cases on Sunday were Jefferson, 27; Kenton, 17; Fayette, 16; and three counties with 14, including Boone, Oldham and Warren.

Monday, the most new cases were in Jefferson, 54; Fayette, 30; Allen, 21; Warren, 19; and Boone and Shelby, both with nine.

The state has reported 10,046 cases of the novel coronavirus, with 457 people currently hospitalized with covid-19, including 90 in intensive care. At least 3,232 have recovered. The number of reported deaths stands at 439.

The deaths include an 84-year-old woman from Campbell County; an 82-year-old woman from Gallatin County; a 98-year-old woman from Grayson County; three Jefferson County men, aged 33, 53 and 75; a 90-year-old woman from Kenton County; and an 88-year-old man from Logan County.

Beshear did not hold his daily news conference today, having already held one to address the weekend protest against police violence in Louisville that resulted in a death.

At the end of that briefing, Beshear asked protesters to wear masks, practice social distancing if possible, and avoid contact with seniors and those with underlying health conditions.

The state provides additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity: for Sunday’s information, click here; for Monday’s information, click here.  The daily nursing home report was last updated Saturday, May 30.

Other covid-19 news Monday: 
  • Public-health officials say that protests could lead to a surge of coronavirus cases, Route Fifty reports. “There’s going to be a lot of issues coming out of what’s happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings,” former Food and Drug Administration commissioner Scott Gottlieb said Sunday on CBS's "Face the Nation."
  • Dr. Kevin Kavanagh of Somerset, founder of HealthWatchUSA, a group focused on preventing infection in health care, writes in Infection Control Today about why the public should wear masks during the pandemic, reporting that "new modeling is reported to show that if over 80% of the public wears a mask, the epidemic will markedly decrease." 
  • The University of Louisville Trager Institute offers a weekly online covid-19 information session. The next one is 10 to 11 a.m. EST Tuesday, June 2, with the topic "Restaurants are Up for the Reopening Challenge." Click here for the Zoom link and here for more information. 
  • Fewer Americans are concerned about necessary medical trips exposing them to the virus, according to a Gallup poll taken May 14-24. The poll found that 64 percent of U.S. adults are very concerned or moderately concerned about exposure to the virus at a doctor's office or a hospital. This is a 20-point drop from the March 28-April 6 poll. It also found that the number of U.S. adults who are not concerned about medical trips has more than doubled, from 16% to 37%. The poll found that men are less concerned than women (55% and 70%), and Republicans are much less concerned than Democrats (58% and 19%). 
  • An epidemiologist and evolutionary biologist at the University of Chicago, Sarah Cobey, tells reporters at The Washington Post, "The virus is here to stay. The question is, how do we live with it safely?" William Wan and Carolyn Y. Johnson write, "Even after a vaccine is discovered, and deployed, the coronavirus will likely remain for decades to come," like measles, HIV and chickenpox. They write that combating the virus will require long-range thinking, as well as "time, money and, most of all, political will." 
  • According to a Washington Post-ABC News poll, nearly six in 10 Americans say the pandemic has had a severe economic toll on their communities, and 57% of them say trying to control the spread of the virus is more important than restarting the economy (favored by 37%). By party, 81% of Democrats say controlling the virus is more important than restarting the economy, 59% of independents; and 27% of Republicans, reports the Post. 
  • Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, talked with Stat about covid-19 reopenings, vaccines and more, with a copy of the transcript included in the article.

Rural Kentucky writer blames Trump, toxic masculinity, for many red-state residents' dislike of wearing masks

Teri Carter
When Kentucky slowly began to reopen businesses a few weeks ago, Gov. Andy Beshear, a Democrat, asked all Kentuckians to wear masks in public spaces. But many refused, seeming to view the notion as weak or foolish.

The decision to wear a mask or not has become a cultural and political flash point in Kentucky and many other red states, Teri Carter of Anderson County writes in an op-ed for The Washington Post.

Carter writes that President Trump has been a poor role model by not wearing a mask or following social distancing protocols at multiple public appearances, behavior she believes is driven by toxic masculinity.

Carter correlates Trump's refusal to wear a mask with rising pandemic rates in red states: "Infection counts are rising in Alabama, and Mississippi, Utah, Wisconsin, South Carolina and Arizona all set records for daily case totals Friday. Not coincidentally, those are all states where, like Kentucky, Trump remains popular."

"In red states such as Kentucky, where allegiance to Trump so often trumps all else, I pray we don’t see a spike in sickness and death simply because wearing a mask in Trump country has been deemed 'weak' and 'unmanly' by the example of the president himself," Carter writes.