Baptist Health Corbin gets $1 million grant to help fight substance abuse by pregnant women and youth in Whitley, Knox counties

Baptist Health Corbin has received a $1 million grant from the U.S. Department of Health and Human Services to fight opioid and substance abuse, mainly among pregnant women, in Whitley and Knox counties.

The three-year grant, which launched Sept. 1, will also help youth and people seeking emergency treatment for conditions related to substance abuse-related conditions, a news release said. The effort will include Cumberland River Behavioral Health, a long-time partner of the hospital.

“With the pandemic, more people than ever are susceptible to overdose deaths and suicide,” Chris Holcomb, Baptist Health's assistant vice president of behavioral health and former executive director of behavioral health at Baptist Health Corbin, said in the release.

“Substance abuse, particularly opioid abuse, has skyrocketed in the communities we serve,” Holcomb said. “Overdoses that involve opioids have more than tripled in the last 20 years. The overdose rate by county in this area is nearly three times higher than the national average. We want to use our resources to support patients with education, prevention and treatment.”

Baptist Health CEO Gerard Colman said the nine-hospital group "has long had a focus on behavioral health and planned to intensify those efforts even before the covid-19 pandemic compounded other major life stressors that make the vulnerable even more at risk of turning to drug use to overcome anxiety."

The chain has expanded its telehealth program, which can be especially helpful for patients with transportation issues or other barriers to seeking treatment. The program consists primarily of videoconferencing sessions between a health-care or mental-health professional and a patient.

"Baptist Health Corbin was an early telehealth pioneer, starting in 2016, as transportation and the geography of the region are considered barriers to accessing care,' the release says. "The service area is mountainous and navigating secondary roads is difficult and time consuming. Inclement weather conditions in the winter frequently force the closing of local schools due to road conditions."

Morehead hospital says covid-19 surge came from patients who delayed treatment for other conditions; telehealth is here to stay

St. Claire Regional Hospital (Youtube photo, from The Daily Yonder)

At the end of 2019, St. Claire Regional Healthcare System restructured its finances after finishing the fiscal year about $9 million in the red. In March, the novel coronavirus hit and basically brought the hospital to a standstill and forced it to make even more changes, Liz Carey reports for The Daily Yonder.

Headquartered in Morehead, St. Claire provides services to eight Eastern Kentucky counties. in addition to its hospital, it hascclinics in Frenchburg, Olive Hill, Owingsville and Sandy Hook. It also provides mental and behavioral health services, palliative care, aesthetics care, dental care, and pharmaceuticals. 

Donald H. Lloyd, II, the hospital system's president and CEO, told Carey that the restructuring had resulted in a positive cash flow by February, but then the pandemic hit Kentucky and Gov. Andy Beshear banned elective surgeries, which account for 90 percent of those at the hospital. This forced them to make more personnel changes, including furloughs.

The first case of covid-19 showed up in Rowan County in March. By then the hospital had been converted into two separate areas, a hot zone for patients suspected of covid-19, and a cool zone for all the rest, Carey reports.  

“You would walk down a corridor and you would see this huge barrier that you had to don and doff protective equipment and then zip through a series of barrier walls in order to enter where the actual patients were,” Lloyd told Carey. “It was just so surreal. It was like from a science-fiction movie.”

Lloyd and his staff found that patients with heart attacks weren't coming into the hospital's emergency room, Carey writes.

“On the video calls with my colleagues, not only here in the commonwealth but across the United States, we were all asking ourselves ‘Where are the heart attacks, where are the strokes?’ We all thought the coroners must be extremely busy,” he said. “My chief medical officer and myself had numerous conversations with our coroners and a realization came that if we did begin to see a spike in deaths in the general population that our coroners would actually be the first to observe them.” 

This realization set the hospital into action to find high-risk patients and a way to care for them. “We aggressively worked to contact these patients, especially those that we knew have chronic conditions, and reminded them that it was imperative that you know they needed their conditions to be monitored and managed,” Lloyd said, estimating that they reached out to more than 25,000 of their 200,000 patients. 

It turned out that the surge caused by covid-19 was indirect: untreated chronic conditions caused by fear of infection. When those patients finally sought medical attention, they had "acute exacerbations," Lloyd said.

This also led to a move toward telehealth, and that led to the realization that many patients did not have access to high-speed internet. So, Carey reports, the hospital set up an area in its empty parking lot where patients could park, use the hospitals' tablet computers, access its wi-fi and visit their health-care provider through telehealth. 

“Our patients have really embraced that, and we perceived that people that, you know, that maybe live at the margins, or that maybe have a lower education level, would be intimidated by the use of that technology. On the contrary, they have embraced it,” Lloyd told Carey. “Many of our patients (in outlying counties) can’t afford to travel to Morehead or they have very limited transportation ability. It is amazing to me how effective this technology and the use of telemedicine has been for us to connect with them now.” 

Since mid-May, Lloyd said, the hospital has started to come back to normal, but telehealth is here to stay. He said, “I think [telehealth] is part of the new reality going forward in the way we deliver care and that there is going to be, for Saint Claire Healthcare and our enterprise, at least 25 percent of our future patient encounters will be virtual."

Ky. has fewer counties in White House Coronavirus Task Force's danger zones; Bowling Green metro area is only one in red zone

White House Coronavirus Task Force tables; click on image for a larger version.

By Melissa Patrick
Kentucky Health News

Kentucky showed some slight improvement on the latest White House Coronavirus Task Force report, for the week of Saturday, Sept. 5 through Friday, Sept. 11. Seven fewer counties were in danger zones and only one metropolitan area, Bowling Green, was in the red zone.

Fifty-seven of the state's 120 counties were in the high-risk zones for the reporting week, down from 64 the previous week. Thirteen counties were in the red zone, down from 24 counties and eight metro areas. Most moved into the yellow zone, which had 44 counties, four more than the previous week.

Communities in the red zone have weekly positive-test rates higher than 10 percent and more than one new case per thousand residents. Yellow-zone communities have new cases between 0.1 and 1 case per 1,000 and a positive-test rate of 5% to 10% -- or one of those, with the other in the red zone.

White House Coronavirus Task Force maps; for a larger image, click on it.

The state as a whole moved out of the red zone for cases in the latest report and is now in the yellow zone for both cases and positivity. The report says Kentucky had 90 new cases per 100,000 people during the reporting week, ranking it 19th in the nation. The national average was 74 cases per 100,000 people. Kentucky's case rate was down 18.2% from the previous week.

Nearly all the state's hospitals, 95%, reported a newly confirmed or suspected case of covid-19 each day. On average, 307 confirmed and 384 suspected covid-19 patients were newly admitted each day to Kentucky hospitals. The capacity of hospitals is a key metric in determining whether the state's economy can remain open.

Dr. Deborah Birx visited the University of  Kentucky
on Monday. (Photo by Pete Comparani, UK)

The report says Kentuckians should be applauded for their use of masks and other efforts to decrease the spread of covid-19, as did Dr. Deborah Birx, coordinator of the White House coronavirus task force, when she visited the University of Kentucky Sept. 14 on a tour of colleges and universities to examine their covid-19 responses, UKNow reports. 

 “We continue to see a week-over-week improvement in Kentucky due to the strong work Kentuckians have done to follow guidelines such as social distancing and wearing masks,” Birx said during a media briefing.

Her praise comes as the Kentucky Supreme Court is set to hear its first day of oral arguments against Gov. Andy Beshear's covid-19 emergency public health orders, including the mask mandate, today. The proceedings will take place Sept. 16-18 and can be watched via the Supreme Court's livestream or via a Kentucky Educational Television livestream.  

Unlike previous reports, this week's report does not include language that says bars must be closed and indoor dining must be restricted to 50% of normal capacity in yellow zones and 25% of normal capacity in red counties and metro areas. It says, "In areas with ongoing high levels of transmission (red and yellow zones), use standard metrics to determine school learning options and capacity limits for bars and indoor dining." It does not provide those standard metrics. Click here for the federal "considerations for restaurants and bars."

On Tuesday, Gov. Andy Beshear announced that bars and restaurants will be allowed to stay open an extra hour, moving last call to 11 p.m. The establishments must continue to operate at 50% capacity, patrons must remain seated unless going to the bathroom and they must close by midnight. 

At his Sept. 15 daily briefing, Beshear said he made the change at the request of restaurants. He said Kentucky, like some other states, has gone against White House recommendations and allowed bars and restaurants to remain open at a larger capacity as a way to create a more controlled social setting that discourages house parties and to provide an avenue for small businesses to stay open.   

The White House report calls for Kentucky to develop a plan for increased surveillance of asymptomatic carriers and to establish weekly testing among critical populations, like teachers and nursing home staff, to monitor the degree of community spread. It also recommends wastewater surveillance at universities to allow for targeted testing. UK has started such testing.

The report also points to the need to review and improve infection control practices at nursing homes to stop the introduction of covid-19. This week's report shows that during the week of Aug. 31-Sept. 6, 10% of Kentucky's nursing homes had at least one new resident case, 20% had at least one new staff case; and 6% had at least one new resident death.

Nurse retires after 41 years at Shelbyville Hospital, says she never dreamed she'd end her career in the middle of a pandemic

Kathi Hornback (WHAS-TV image)

Never dreaming she would work through a pandemic or retire in the middle of one, Kathi Hornback, a nurse of 41 years who has worked in nearly every nursing department at U of L Health's Shelbyville Hospital, has retired, Tyler Emery reports for WHAS-TV. 

Hornback, who spent her last day walking through the hospital hallways on Thursday, Sept. 10, told Emery that working through the pandemic has been challenging.

"I never thought I'd finish my career wearing a mask my whole work day," she said. 

Hornback also talked about why she loved nursing.  "I love helping people, making them feel better," she said. "And seeing them get better or sometimes they don't get better, but being able to be there with them when its not going the way you had hoped." 

Hornback started her career at the hospital in 1979. She told Emery it was her second home.

"It's that small environment where your patients are your neighbors, your friends, you go to church with them and you have people in your community taking care of you," she said. 

Annessa Baker, the chief nursing officer, told Emery that Hornback's retirement is well deserved. 

 "How can you describe how valuable somebody is when they've got 41 years of experience under their belt?" Baker said. "She knows the community, she's an advocate for nursing and has encouraged other people to join our careers and profession. We're happy for her, we're sad for us." 

Emery writes that Hornback's retirement signals the end of a "Hornback era" at the Shelbyville hospital, noting that she followed in the footsteps of a relative of her husband, who started caring for patients there in 1947. 

"A lot of patients have touched me," Hornback said. "I hope I've touched them in some way."

Fewer than 4% of Kentuckians tested positive for virus in last seven days; Beshear allows bars to open until midnight

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

By Mary Meehan
Kentucky Health News

Kentucky’s positive-test rate for the novel coronavirus dropped to the lowest level in two months Tuesday, but Gov. Andy Beshear said wearing a mask continues to be crucial to thwarting the virus as more schools move to in-person instruction.

“Today we are now under a 4 percent positivity rate that is moving in the right direction at a time when we are giving guidance, especially to school systems, about how to at least get back to a hybrid model starting on Sept. 28,” Beshear said at his daily briefing. The share of Kentuckians testing positive for the virus in the last seven days was 3.97%.

Beshear and Health Commissioner Steven Stack rolled out a new plan Monday designed to help schools decide whether to open to in-person learning. The guidance asks schools to consider two things: the statewide percentage of people testing positive for the virus, which needs to be under 6%, and the prevalence of the virus in their community, based on cases per population.

On Tuesday, Beshear announced 745 new coronavirus cases and reported nine more deaths from covid-19, bringing the state's death toll to 1,074.

There was a spike of cases in another vulnerable population – the elderly living in long-term care facilities. Beshear said one had 18 new cases on Saturday that were verified Tuesday, for a total of 59 new residents and 33 new employees testing positive for the virus. Two of the nine deaths announced Tuesday were in long-term care facilities.

Beshear announced that bars and restaurants will be allowed to stay open an extra hour, moving last call to 11 p.m. The establishments must be closed by midnight, he said.

“That was a specific request from those in the restaurant industry,” he said. “We thought it was reasonable. But again, let's make sure that whether you're in that industry or any other that has some rules and regulations that you're trying to do it right, that we're not trying to find a way to get around it.”

Bars and restaurants continue to operate at 50% capacity and patrons must remain seated unless going to the bathroom.

The governor noted that September is Childhood Cancer Awareness Month, stressing that wearing a mask is especially important to children getting cancer treatment.

“Cancer is the number one cause of death by disease for kids in our state, in our country, and around the world,” he said. Kentucky has the fourth highest rate of pediatric brain tumors in the country.

Beshear showed a video of David Turner, Jr., 9, who has a rare form of brain cancer with no known cure. In the video, Turner and his cousin reminded Kentuckians that “Kids get cancer too” and asked them to spread awareness about the disease. Beshear said Turner has spoken at the Capitol rotunda several times to encourage Kentuckians to wear a mask.

“His family never knows exactly how many days they might have with the person they love most in the world,” said Beshear. “So, it is not a lot to ask for each of you out there to wear a mask to ensure that these parents and this child get as much time together as possible.”

In other covid-19 news Tuesday: 

• There were 533 people hospitalized in Kentucky with covid-19 and 125 in intensive care.
• The deaths announced Tuesday were a 90-year-old man from Bullitt County; an 83-year-old woman from Hopkins County; two women, 65 and 94, and two men, 48 and 73, from Jefferson County; a 93-year-old woman from Kenton County; and two men, ages 84 and 88, from Warren County. 
• Counties with more than 10 new cases are Jefferson, 131; Fayette, 57; Logan, 50; Warren, 49; Madison, 32; Hardin, 29; Kenton, 18; Daviess, 17; Oldham, 17; McCracken, 16; Boone, 14; Shelby and Taylor, 11 each; and Barren and Bullitt, 10 each. 
• There were 313 active cases in children in grades K-12 and 159 active cases in employees. There were 1,124 active cases at Kentucky colleges or universities and 49 active cases in employees.
• Louisville's top health official questioned the accuracy of President Trump’s timeline for a coronavirus vaccine. Dr. Sarah Moyer said a vaccine may be approved by late October or November, but doses will be reserved for health-care professionals and vulnerable populations, and most Americans won't likely be in line for a shot for another year, the Courier Journal reports. Moyer, speaking at a morning briefing with Mayor Greg Fischer, said there are Phase III clinical trials underway, including one starting up in Louisville soon, but she doesn't expect that study to be completed by November. 
• WKYT reports that a normal blood donation could help save three lives, but now one at any Kentucky Blood Center could help save even more. “We’re antibody testing all the blood donations, platelet donation, and double red blood cell donations at our donor centers,” the center's Mandy Brajuha said. That could be a boost for critically ill covid-19 patients. “The hope is that we’re able to identify folks [who] have the antibodies for covid-19 so we can recruit them to donate plasma to help treat critically ill patients,” Brajuha said. 
• Minority children represent the majority of U.S. kids' deaths from coronavirus, according to The Washington Post.  The coronavirus is killing Hispanic, Black and American Indian children at much higher numbers than their white peers, according to federal statistics released Tuesday. William Wan writes that the numbers — the most comprehensive U.S. accounting to date of pediatric infections and fatalities — show there have been 391,814 confirmed cases and 121 deaths among people under the age of 21 from February to July. Of those killed by covid-19, more than 75% have been Hispanic, Black and American Indian children, even though they represent 41% of the population, according to the Centers for Disease Control and Prevention. The federal agency collected data from health departments throughout the country.

Beshear administration lays out detailed guidance for schools to consider throughout the pandemic, says it's up to them to follow it

State chart available here, or click on this one for a larger version.

By Melissa Patrick
Kentucky Health News

Kentucky's school officials got Monday what they'd long been asking for, a plan that helps them decide whether to open their schools, based on a dashboard of data that will be regularly updated – and maybe more importantly, assurance from Gov. Andy Beshear that he won't be offering them any more advice on how to manage their districts. 

“Let me be clear that there is not going to be an overall recommendation coming from me or my office, post-September 28th," Beshear said, referring to the date he recommended that in-person schooling resume. “What’s going to be provided is the information to make a week-by-week decision in our various school districts and counties based on prevalence and what public health and experts believe is the right course based on that prevalence.”

But Health Commissioner Steven Stack said if the rate of Kentuckians testing positive for the novel coronavirus shoots up to more than 10% and hospitals are running out of beds, "We're going to come back, and we're going to step in, and we're going to give different guidance."

Stack explained that schools will need to look at two things to determine if they should be holding in-person classes: the statewide percentage of people testing positive for the virus, which needs to be under 6%, and a color-coded map that shows the prevalence of the coronavirus in their community. 

The metric-directed guidance provides a framework for schools in each category to follow. The levels are determined by the number of cases in a county per 100,000 people. (See chart, above.)

Schools in green or yellow counties are generally instructed to follow the "Heatlhy at School" guidance, with yellow counties encouraged to take additional precautions. Orange counties will have "accelerated" spread of the virus and be encouraged to consider remote learning only. Red counties will be "critical" and should be limited to remote learning and should cancel all school-related activities until they return to yellow status. 

Beshear was asked if he would order a school in the red to move to virtual learning. "This is guidance," he replied. "But if you're in the red, it means there's widespread community spread of covid-19 and if you're in the red, it is not responsible, it is not responsible to be doing every-day, in-person learning."

Beshear also signed an emergency regulation to require parents and guardians of children who test positive for the virus to notify schools within 24 hours. He said the state already requires that for all communicable diseases, but he wanted to clarify that covid-19 was included.

 

New data platform: The new plan involves the creation of an up-to-date dashboard that will include self-reported data from both private and public schools, including the number of new covid-19 cases and the number of quarantined persons in their schools.

Schools will need to start submitting this data Sept. 28, but Stack said schools already doing in-person learning can go ahead and start submitting it.

Stack said his state Department for Public Health will maintain its K-12 school report, but the data will always lag behind the new dashboard and the numbers will not match up. Beshear said the dashboard is meant to provide quick information in the short term, while the public-health report will be used for long-term analysis because everything on it will have been verified. 

Beshear said he was confident that schools would report accurate data because the public-health report would eventually reveal any discrepancies. 

Stack said each individual college and university will be keeping its own up-to-date dashboard, along with the state's public health records. 

Lt. Gov. Jacqueline Coleman, who also serves as secretary of the Education and Workforce Development Cabinet, said she will be working with the health department and the Department of Education to hold town halls with superintendents, teachers and other stakeholders about the changes: "Our goals are to be transparent and communicative, to ensure accountability and inclusion and to allow every voice to be heard.”

Dr. Houston Barber, superintendent of the Frankfort Independent Schools and a student of analytics in the Harvard University Business Analytics Program, praised the new program. 

“As a father of four . . . I empathize with all Kentuckians about what school looks like today and how you’re navigating that course,” Barber said. “This tool that has been developed for K-12 is incredible. It allows for districts all across the state of Kentucky to work together with their local health officials, to work with their local board teams and come up with a strategy that makes sense for their students, for their families and for their communities.”

Sam Griffin, 6, created this sign for the Lexington protest.
(Photo by Arden Barnes, Lexington Herald-Leader)

In Lexington, which has seen a surge of cases partly driven by students at the University of Kentucky, Fayette County school officials said they wouldn't resume in-person classes "until at least after the fall break on Oct. 1 and 2 . . . as a group of parents rallied outside Central Office for an immediate return," Valarie Honeycutt Spears reports for the Lexington Herald-Leader.

UK's efforts to thwart the virus got an on-site endorsement Monday from Dr. Deborah Birx, response coordinator for the White House Coronavirus Task Force. She said UK has an “incredibly sophisticated” plan to test, detect and quarantine or isolate students, Alex Acquisto reports for the Herald-Leader: "She said as long as it continues to function in the way it has, and as long as students continue to wear masks, the university shouldn’t need to close before holiday break" on Nov. 25.

Daily numbers: Beshear announced 342 new cases of the virus Monday, 53 of them in Kentuckians 18 and younger 

The share of Kentuckians testing positive for the virus in the last seven days was 4.17%. It has remained under 5% for about three weeks. 

Beshear reported five new deaths from covid-19 Monday, raising the state's death toll to 1,065. 

They were a 71-year-old woman from Christian County; two men, ages 77 and 80, from Fayette County; an 82-year-old woman from Pulaski County; and a 49-year-old man from Shelby County, which he pointed out to show the disease doesn't kill only old people.

“If you’re a person – whether you’re in the state legislature over there or you're at home on your keyboard – that is saying, ‘Oh, but these people are older,’ unh-unh, shame on you. These are children of God, just like everyone else, who deserved more time on this planet,” Beshear said. “Their life is just as important as everybody else’s. The moment that we desensitize ourselves to the fact that even a 90-something-year-old has more time with his or her family, grandkids, maybe great-grandkids, and covid takes it from them – it’s not acceptable."

Rebecca Shadowen, M.D. 

The governor honored the lost life of a doctor who was at the forefront of fighting covid-19 in one of the state's hotspots. Dr. Rebecca Shadowen, an infectious-disease specialist and epidemiologist at Med Center Health in Bowling Green, died Friday after battling the disease for four months. Beshear showed part of an interview in which Shadowen encouraged Kentuckians to wear a mask. 

“I’m praying for her family, her friends and her colleagues,” Beshear said. “I’m praying that people will listen to her, listen to the gift and the wisdom that she left for us. And recognize that this was somebody who was out there fighting for the lives of those suffering from covid, who gave her own to help us out. You want to know why you should wear a mask? For her.”

In other covid-19 news Monday:

• In long-term care facilities, the daily report showed 12 new residents and 11 new staff tested positive for the virus and 517 residents and 361 staff had active cases of it. The report shows 598 residents and five staff have died from covid-19. 
• The K-12 school report shows 10 more students and two more employees have tested positive for the virus and 321 students and 157 employees with active cases. 
• The college and university report shows 119 more students have tested positive, and no more employees. The report shows 1,155 students and 49 employees have active cases. 
• Counties with 10 or more cases on the state's daily report were Jefferson, 86; Fayette, 40; Hardin, 12; Madison, 11; and Bullitt, 10.
• The report shows 504 people are hospitalized in Kentucky with covid-19 and 119 of them are in intensive care.
• Beshear announced that over 1 million coronavirus tests have been done in the state. 
• The state advisory against travel to states with positive-test rates of 15%, and for self-quarantine if they do, only applies now to only three states: South Dakota, Alabama and Idaho.
• Pfizer Inc. announced that it will likely know by Oct. 31 whether its coronavirus vaccine is effective, and if it is, the company plans to begin distribution by the end of the year but does not believe the vaccine will be widely available to the general public until 2021.
• The top spokesman for the Department of Health and Human Services "accused the Centers for Disease Control and Prevention of harboring a 'resistance unit' determined to undermine President Trump," reports Sharon LaFraniere of The New York Times. She writes that Michael Caputo, who has tried to "warp CDC weekly bulletins to fit Mr. Trump’s pandemic narrative," also "said left-wing hit squads were preparing for armed insurrection after the election," and "suggested that he personally could be in danger." She quotes remarks from a video on his Facebook page: “If you carry guns, buy ammunition, ladies and gentlemen, because it’s going to be hard to get.”
• Beshear announced that with the addition of a donation of 2 million masks from Ford Motor Co., the largest gift yet, the state has almost reached its goal of having enough personal protective equipment to last 120 days in the event of a surge of cases. Health-care providers are required to have 14 days' supply on hand. 

Gov. Andy Beshear said the state PPE warehouse would be full by Sept. 30. (Facebook) 

Teenagers' use of e-cigarettes drops by 1/3 following 'T-21' law, but many now use disposable e-cigs, which still have all flavors

Puff Bars are disposable electronic cigarettes meant for one-time use. Survey shows use of  disposables
by youth has surged since last year. Other brands include Blu, Posh and Stig. (Photo: The Truth Initiative)

By Melissa Patrick
Kentucky Health News

The number of U.S. teenagers who use electronic cigarettes has declined by one-third, according to the latest national poll on their use of tobacco products.

The poll followed passage of a federal law raising to 21 the legal age to buy tobacco products, including e-cigarettes, and a ban on most flavors in e-cigs. However, the flavor ban does not apply to one-use, disposable e-cigs that have quickly become popular. Kentucky and other states passed similar "T-21" laws. The poll report did not give state figures for youths' e-cig use.

Electronic cigarette manufacturers have made them easier to inhale than traditional cigarettes, and continue to offer flavors that appeal to youth, the U.S. Centers for Disease Control and Prevention reports. The CDC notes that most e-cigs contain nicotine, which is highly addictive, can harm the adolescent brain and can increase risk for future addiction to other drugs. 

The 2020 National Youth Tobacco Survey found that 19.6 percent, or nearly one in five, high-school students and 4.7% of middle-school students said they currently used e-cigarettes or some other vaping product. That's down from a record high of 27.5% of high-school students and 10.5% percent of middle-school students in last year's survey. 

The percentages translate to 3.6 million U.S. youth currently using e-cigarettes, down one-third from the 5.4 million estimated from the 2019 survey.

"This is good news," Stephen Hahn, commissioner of the Food and Drug Administration, said in a statement. "However, the FDA remains very concerned about the 3.6 million U.S. youth who currently use e-cigarettes, and we acknowledge there is work that still needs to be done to curb youth use." 

Of great concern is an alarming uptick in young people's use of one-time-use, disposable e-cigarettes. The 2020 survey shows disposables being used by 26.5% of high-school e-cigarette users, up from only 2.4% in 2019. Among middle-school students who vape, the use of disposables rose from 3% in 2019 to 15.2% in 2020.

That said, the most commonly used type of device used by teenagers continues to be pre-filled pods or cartridges, such as Juul. They are used by 48.5% of high-school and 41.3% of middle-school vapers. 

The survey also found that most teens continue to prefer flavored products. The poll found that 83% who vape use flavored products, with fruit, mint, menthol and candy among the most common. This is the first year the poll has distinguished between mint and menthol flavors.

“As long as any flavored e-cigarettes are left on the market, kids will get their hands on them, and we will not solve this crisis,” Matt Myers of the Campaign for Tobacco Free Kids and other advocates said in a joint statement.

Menthol products and disposables are popular for a common reason: They were exempted from the new federal laws that regulate most flavored e-cigarettes.

The poll also shows that the percentage of youth who vape frequently has grown every year since 2015, the Tobacco Free Kids statement noted.

The poll found that 39% of high-school students and 20% of middle-school students who use e-cigarettes said they use them more than 20 days a month. It also found that 22.5% of high-school students and 9.4% of middle school students reported daily use. 

"The message is clear," the Campaign for Tobacco Free Kids said. "Unless we reverse that trend quickly and decisively, we are condemning this generation of youth to a long-term addiction."

The FDA report did not give figures for states. According to the 2019 Youth Risk Behavior Surveillance System, which has the latest Kentucky data available, 26.1% of high schoolers in the state said they currently used e-cigarettes, meaning they vaped at least one day in the month prior to the survey. That was up from 14.1% in 2017. The survey found that 11.1% of them vaped on 20 or more days prior to the survey, up from 2.7% in 2017; and 8.7% of them vaped daily, up from 1.9% in 2017,  

The 2019 survey found that 17.3% of Kentucky's middle-school students used e-cigarettes or similar products, up from 3.9% in 2017; 2% of them vaped on 20 or more days prior to the survey, up from 0.3% in 2017; and 1.2% of them vaped daily, up from 0.1% in 2017. 

The national survey was released on the same day all U.S. vaping manufacturers were required to submit their products for FDA review to keep their products on the market. Among other things, the FDA will assess if a company's products show they can help addicted smokers who are trying to quit, while also weighing their popularity among young people. 

The Tobacco Free Kids statement said it looks at this as another opportunity for the FDA "to get this right and eliminate all flavored e-cigarettes." 

The CDC report calls for the comprehensive implementation of evidence-based strategies at the national, state and local levels, in coordination with FDA regulation, to prevent and reduce youth use of tobacco products. Such strategies include strong public health media campaigns, price increases and comprehensive smoke-free policies.

Feds send nursing homes quick-test kits, but with rules that deter their use; so do other factors, chief nursing-home lobbyist says

By Melissa Patrick
Kentucky Health News

Testing is one of the few tools nursing homes have to keep the novel coronavirus out of their facilities, and the Trump administration has tried to help by sending them equipment to conduct tests that give quick results.

But while they were sent with good intention and are appreciated, the head of the state nursing-home association told Kentucky Health News that they are largely not being used in Kentucky right now.

Betsy Johnson

Betsy Johnson, president of the Kentucky Association of Health Care Facilities, ticked off several reasons: concerns that the tests are less accurate than laboratory-based tests; the state is paying for more accurate lab-based tests through the end of the year; the tests come with daily reporting obligations; and nursing homes get only two free test kits per employee, with concerns about how to get more.

The idea behind this aggressive testing strategy was to be able to identify people who had the virus but didn't have symptoms, but the problem is that these point-of-care antigen tests are not designed to do that. 

Kaiser Health News reports that the two manufacturers that have received authorization to provide the test, Becton, Dickinson and Co., (known as BD) and Quidel, say their tests are intended to be used for people within the first five days of showing symptoms. The federal Centers for Disease Control and Prevention estimates that as many as 40 percent of infected people may be asymptomatic.

Kaiser also reports that the rates of false negatives, which show someone isn't infected when they actually are, are about 15% for BD's product and 3% for Quidel's. 

Meanwhile, Politico reports that nursing homes have been told that it could be weeks before they will be able to buy more supplies for the rapid test. 

On top of that, Johnson said the federal requirements are much more onerous than the state's guidelines, which are not mandatory and require only testing every other week. She said the federal rules have "caused us a lot of heartache." 

Federal rules require nursing homes to test staff based on the overall positive-test rates in their county. If the rate is less than 5%, they must test once a month; between 5-10%, once a week; and above 10%, twice a week. The guidelines do not require them to use the antigen testing, but say that any off-site testing must have a turnaround of less than 48 hours. 

For the week ending Sept. 2, according to Centers for Medicare and Medicaid Services data, 29 Kentucky counties had positive-test rates of less than 5%, 41 were between 5% and 10%, and 50 were above 10%. 

Johnson said some long-term care facilities are confused because CMS reports one rate and the state reports another for the same county. She said they're working to resolve these discrepancies. 

Johnson stressed several times that her association supports increased testing, but said they need to find a way to make it simpler.

"We don't oppose ongoing testing as important for protecting not only our residents, but our staff," she said. "But I think we need to make sure there's a common-sense element and that we're not just testing for the sake of testing, that it makes sense for every community, and that we have reliable data to determine when that testing should occur."

Dr. Steven Stack

Health Commissioner Steven Stack told legislators on the Program Review and Investigations Committee Thursday that the federal rules are "very demanding" and stressed that they must follow them under threat of penalty from the federal government for their conditions of participation as a nursing home. 

"If you lose your ability to bill Medicare or Medicaid, you can't run a nursing home," he said. 

He also noted that if they use the testing equipment sent to them by the federal government, they essentially become laboratories with all of the daily reporting requirements that other laboratories now have around covid-19. 

“These are facilities that haven’t used machines like this before and don't know how to use them . . . at least 280 of these nursing homes in the state.” Stack said.

Johnson expressed concern that such rigorous testing schedules would cause staff to quit facilities that are already struggling to maintain an adequate workforce. 

"We are concerned, especially in our counties with high positivity rates, that, you know, that we're going to have some staff leave because they just simply either cannot get to the facility to get tested due to child-care issues or other personal obligations or transportation, or they simply just, you know, get exhausted with it all," she said.

"It's just so many moving parts," Johnson told Kentucky Health News.

Speaking more bluntly to Politico, she said, "It's a complete and utter mess." 

A Kaiser Family Foundation report shows that infections in Kentucky's long-term care facilities are on the rise, increasing from 4.5 new cases per week per 100,000 people in May, to 5.1 in June; 5.3 in July and 8.4  in August. Deaths, however, do not appear to be increasing, down from 0.5 per 100,000 people in July to 0.3 in August. 

The state's daily long-term care report on Sept. 12 showed the homes have 516 residents and 351 staff with active cases of the virus and 593 resident and five staff deaths from it, making up 57% of the state's covid-19 deaths.

The pandemic has brought a new focus on "skilled-nursing facilities and long-term care," Johnson said. "And although it's been uncomfortable at times, I think we need to continue to have this conversation because it's so important, and we need to figure it out -- because we need to make sure that we as a nation, and we as a state are doing everything we can to protect and care for elders. They deserve that."

State reports 536 more coronavirus cases, 3 deaths from covid-19

The state reported 536 more cases of the novel coronavirus in Kentucky on Sunday, a day when case reports are usually low because of limited weekend reporting by testing laboratories.

“Our case numbers often dip during the weekend as not all labs are reporting,” Gov. Andy Beshear said in a press release. “We can expect higher counts during the week, but the real work we have is to get these numbers to begin really going down.”

Noting “some troubling increases” in case numbers in recent weeks, Beshear said, “Let’s remember that we’re not powerless in this fight. We wash our hands often and properly. We can keep our gatherings small and make sure we maintain a safe social distance. We can avoid traveling to hotspots. But most of all, we can wear a mask. It’s the best advice from the nation’s top experts and how we protect those we love during this pandemic.”

Beshear's press release said 87 of the new cases were from Kentuckians 18 and younger. Counties with 10 or more new cases were Jefferson, 117; Fayette, 63; Clay, 19; Daviess, 17; Knox, 15; Barren, 14; Henderson, 14 and Warren, 14 each; Kenton, 13; Boone, Madison 11 and McCracken, 11 each; and Union, 10.

The governor reported three more covid-19 deaths Sunday, raising the state's toll to 1,060: a 96-year-old man from Fayette County, a 76-year-old woman from Taylor County, and a 58-year-old man from Warren County.

“These are three of our fellow Kentuckians we’ve lost, and it hurts just as much for their friends, their families and their communities as any that have come before or will be announced in the future,” Beshear said. “Light up your homes and businesses green tonight to let them know they are not alone in their grief.” 

In other covid-19 news:

• The opening football game for the University of Louisville and Western Kentucky University Saturday night at Cardinal Stadium drew 11,179 fans, under the 12,000 limit, the Courier Journal reports. Recorded crowd noise was added.
• The New York Times reports, "White House and Republican officials struggled to respond to sharp questioning by Sunday morning news-show hosts about why President Trump knowingly played down the coronavirus in the crucial early months of the pandemic, as revealed by the journalist Bob Woodward in his new book, Rage."
• "Politically appointed communications aides have demanded the right to review and seek changes to the Centers for Disease Control and Prevention’s weekly scientific reports charting the progress of the coronavirus pandemic, in what officials characterized as an attempt to intimidate the reports’ authors and water down their communications to health professionals," reports Dan Diamond of Politico. "In some cases, emails from communications aides to CDC Director Robert Redfield and other senior officials openly complained that the agency’s reports would undermine President Donald Trump's optimistic messages about the outbreak." Michael Caputo, a former Trump campaign official who is the chief spokesman for the Department for Health and Human Services, told Diamond, "Our intention is to make sure that evidence, science-based data drives policy through this pandemic—not ulterior deep-state motives in the bowels of CDC."

Health chief goes another round with legislators, pushing back on data questions and answering queries on schools, other topics

By Al Cross
Kentucky Health News

FRANKFORT, Ky. – Republican legislators kept up their questioning of the state's coronavirus data Thursday, and the state health commissioner and Democratic lawmakers pushed back.

Sen. Danny Carroll

Sen. Danny Carroll of Paducah, co-chair of the Program Review and Investigations Committee, was the leading questioner and most outspoken legislator, just as he was at the panel's Aug. 13 meeting, when the committee heard from Dr. Steven Stack, commissioner of the Department for Public Health, and Doug Thoroughman, the state's acting chief epidemiologist.

Carroll kept relying Thursday on Thoroughman's tacit acknowledgement, in response to a Carroll question last month, that the positive-test rate that the state reports daily is not accurate, because of imperfect state and federal reporting systems. Thoroughman also said that the rate is useful for comparison over time because its method of calculation remains the same.

Thursday, Carroll noted that some test results have been delayed for weeks, and asked, "How can we have faith in daily numbers?" He said Democratic Gov. Andy Beshear never includes a disclaimer when giving the figure.

Dr. Steven Stack

Stack replied that while the data is "imperfect," it is "incredibly valuable. He noted that the state's daily report has an asterisk leading to a long footnote explaining how the rate is calculated.

He noted that the rate is an average over the previous seven days, and “I believe it becomes a very useful and accurate measure” for seeing trends. He said his department has undertaken "an unprecedented process" to get enough data for rates for about 80 counties.

Carroll replied, "The public sees the governor on TV talking about cases and positive rate" that changes from day to day . . . There is a stress that is put on our people as a result of these numbers." He quoted Thoroughman as saying that the numbers are not accurate, and said. "From an ethical standpoint, I struggle with the comfort level of putting this information out on a daily basis."

Stack replied, "I’m sorry you have such low confidence . . . " and Carroll interjected, "It’s not me. I hear it from my constituents daily. They’re mad about this."

Stack said he hears from others who are grateful for the information, and "It's possible for people to reach different conclusions from same information."

He added, "I don’t feel my ethics are compromised or challenged. . . . The metrics we use and the way we create them are consistent with the state of the art as best as public-health professionals can do it." He said President Trump uses weekly data on positive tests, and told Carroll, "Your concern might be that the president of the United States is misleading the public."

At another point, Carroll noted that the committee had also asked to hear again from Thoroughman, and asked why he wasn't present. Stack replied, "I’ve got him doing a lot of other work and I’m the commissioner," the person ultimately responsible for answering questions about the department.

Carroll said that was "disappointing . . . were it not for Dr. Thoroughman, I’m not sure we would know now that our positivity rates were off."

Toward the end of the meeting, after he and Stack went back and forth about a medical waiver to exempt a special-needs student from the mask mandate, Carroll boiled over.

He said of the state's reporting, "It’s being used to manipulate our people, to make our people scared, to control our people. It’s not accurate and its portrayed as being accurate."

Essentially repeating what he said at the last meeting, Carroll said, "Half of this state does not believe a word that you all say when it comes to the data." He said "All of this could have been avoided had the administration reached out" to leaders of the legislature's Republican majority about pandemic matters.

Sen. Karen Berg, M.D.

Earlier, Democratic Sen. Karen Berg of Louisville, a physician, complimented state health officials' work and said, “They need us to understand it and trust it” so legislators can tell constituents “We have got our best minds working on it . . . It will never be perfect. . . . My constituents have different reactions from Senator Carroll’s. . . . Our responsibility is to get on board and let’s do the best we can.”

Apparently addressing her colleagues, Berg said health-care providers are scared of the virus, and “You all need to understand . . . this is not the flu, this is not a hoax, this has nothing to do with politics or how you want it to be.”

Rep. Adam Koenig

A moderate voice: Rep. Adam Koenig, R-Erlanger, said health-care providers “deserve more thanks than they’re getting,” but “There’s nothing wrong with asking difficult questions.” He told Stack, “It’s been a wonderful opportunity for you to dispel misinformation. . . . No one up here thinks this is a hoax; this is not a political witch hunt; these are questions we get; there’s a lot of frustration.”

Earlier, Carroll had asked Stack, "Why do we not react the same way to these other diseases that we do to covid-19?"

Stack replied, "It's much more dangerous, everybody’s susceptible, and the sheer numbers . . . It's killing a lot more people," and there is no treatment that works on most patients. "There’s over 190,000 Americans who have died in six months. That way outstrips influenza." 

He said that the ultimate mortality rate for covid-19 will probably be about 1 percent, and if only one-third of Kentuckians got infected in a year's time, and 1% died, "That’s 15,000 Kentuckians. . . . That’s why it’s getting so much attention."

Death data: Rep. Lynn Bechler, R-Marion, the other co-chair, asked Stack about the recent notice from the Centers for Disease Control and Prevention that only 6 percent of covid-19 fatalities had no other health conditions that could have contributed to their deaths.

"I didn’t think it was newsworthy, quite frankly," Stack said, "because what we have said all along is that the most vulnerable population is people over 60 or 65 and with chronic medical conditions."

Bechler asked if it was "reasonable to suspect that 94 percent of deaths in Kentucky have underlying conditions." Stack said, "It could be even higher," since Kentucky ranks very high in chronic medical conditions.

Sen. Steve West, R-Paris, told Stack that "a lot of Kentuckians are wondering" about the death rate.

Stack replied, "The question is, how do we assign the immediate cause of death?" He said it's possible that people who have died of covid-19 "would have died in six months anyway" from another condition, but the state "follows the long-established norms we use for any other disease case."

In one of his written responses to questions asked at the last meeting, Stack said, "For death certificates for which the cause of death is not clear as to the contribution of covid-19, or appears to incorrectly include or exclude covid-19 as contributory to the cause of death, the committee reviews patient medical records, discusses the information available, and reaches consensus opinion on whether covid-19 is appropriate for inclusion or exclusion." 

He said the committee had reviewed 41 deaths through Sept. 8 and found that 17 had been removed from the covid-19 list. Through that date, the state had reported just under 1,000 covid-19 deaths.

Sen. Whitney Westerfield

In another written response, to a question posed by Sen. Whitney Westerfield, R-Hopkinsville, Stack said the positive-test rate "is more challenging to make precise due to variable timing of sample collection vs. test-result reporting and due to longstanding limitations in test-reporting policies, processes, and technologies. However, when these limiting variables stay constant, and data are averaged over a period of time, this metric is very helpful for trending purposes."

Asked how long health officials keep contact-tracing data, and whether it is being used for any purpose other than to trace contacts, Stack said, "Basic information is gathered; name, address, phone number, e-mail, etc. Local health departments and Department for Public Health epidemiologists, disease investigators and limited supervisory personnel have access to this. This data is not used for any other purpose other than to trace contacts. Privacy and data security standards are well established and maintained."

Schools: Westerfield asked Stack if he had "any information indicating a return to in-person schooling" before Sept. 28, the date Beshear has recommended.

Stack said they are sticking to that date, and wanted the extra time to learn from the experience of other states. He said he and Beshear are "working on number of things to announce Monday." They have indicated that will include county-level data to guide local decisions.

He said fans are being allowed in stadiums, with strict limits, because "the public demands to be in those stadiums. . ..  Going into a stadium in the middle of an epidemic is not a good idea." He said one stadium wanted 18,000 fans, "which means 600 infected people, shouting and screaming," and people in VIP suites. He estimated that could result in nine to 20 hospitalizations per game, and two deaths.

“We certainly can’t live in fear and not get back to some activities, but we can’t be reckless and careless about it, Stack said. “You could just turbocharge an epidemic,” especially in a major city like Louisville.

In a written question from the last meeting, Westerfield asked if "school data related to abuse/dependency/neglect referrals, substance use [and] behavioral health referrals [is] weighed against covid data when making the recommendations and orders related to schools."

Stack replied in writing, "These are all public-health issues. Social-emotional status of students, food insecurity, drug overdoses, child abuse, etc. all weigh on the minds of public health. Balancing these issues with the effects of a deadly virus that spreads so rapidly presents challenges. However, death or long-term health impacts on individuals from this virus cannot be reversed. Currently, these unintended consequences of managing covid-19 are not contemporaneously measureable as [are] individuals diagnosed with covid and any associated deaths. Data is being collected on abuse/neglect as well as for overdose deaths and other behavioral health impacts. The use of medication-assisted therapy, telehealth and other tele-visitation put in place since the very early stages of covid-19’s entrance into Kentucky has been very helpful. The assessment of the full consequences of covid-19 and impact of the measures taken to minimize the impact on individuals and the economy will be measured and studied for years to come."

A video of the committee meeting is on the KET website.

Saturday numbers: 721 virus cases, 13 deaths, 4.14% positive-test rate; health chief says to get a flu shot to block 'twindemic'

Kentucky Health News chart from initial daily reports, which are revised slightly downward.

By Al Cross
Kentucky Health News

After a Thursday with the most covid-19 deaths ever, and a Friday with the third-highest number of coronavirus cases and a big jump in the positive-test percentage, Kentucky recorded 721 cases, fewer deaths, and a return to a lower positive-test rate Saturday.

The percentage of Kentuckians testing positive for the virus in the last seven days fell to 4.14%, the same rate that was reported Thursday. On Friday, it was 4.7%, close to the 5% rate that public-health experts like to avoid.

“Our positivity rate is down from yesterday but we need to continue to push that number down,” Gov. Andy Beshear said in a press release. “Make sure you’re protecting your family, yourself and one another.”

Beshear reported 13 more deaths, raising the state's covid-19 toll to 1,057. The fatalities were an 89-year-old man from Barren County; an 83-year-old woman from Bell County; two 81-year-old men and two women, 80 and 83, from Jefferson County; a 78-year-old woman from Logan County; a 59-year-old woman from Muhlenberg County; a 76-year-old woman from Simpson County; and four from Warren County: three women 62, 81 and 93, and a 72-year-old man.

Beshear's press release referred to the record 22 deaths reported Thursday and "a recent recent spike in new daily cases," then quoted Health Commissioner Steven Stack urging Kentuckians to get a flu shot.

“As we wait for a vaccine, there’s one thing we can do,” Stack said. “We can get an immunization that already exists: the flu vaccine. Protecting ourselves against the flu is more important than ever. An influenza outbreak on top of the covid-19 pandemic could be disastrous this fall and winter. The health care systems upon which Kentuckians rely could be overwhelmed by what some say is a looming ‘twindemic’.”

Stack added, “If Kentuckians don’t follow guidelines, such as social distancing, mask-wearing and hand-washing, we could be headed into the worst fall, from a public-health perspective, that we've seen in a long time. Flu shots are widely available right now, and this weekend is as good a time as any to see your primary care provider or head to a clinic, drug store or other place offering it. In some cases, there’s even no charge, so please, take one for the team. Take one for Team Kentucky.”

In other covid-19 news Saturday:

• Counties with 10 or more new cases are Jefferson, 144; Warren, 55; Fayette, 50; Hardin, 27; Madison, 27; Daviess, 24; Christian, 22; Allen, 21; Henderson, 19; Oldham, 18; Barren, 16; Franklin, 12; Lyon, 11; and Jessamine, Meade and Mercer, 10 each.
• The Lexington-Fayette County Health Department, which reports on a different schedule, said the city set a single-day record for new cases for the second day in a row, with 167, and “We are continuing to see a rise in cases among University of Kentucky students.”
• Dr. Anthony Fauci, the nation's top infectious-disease specialist, contradicted President Trump's assertion that the country is rounding the "final turn" in its fight with the virus. "By the time you mobilize the distribution of the vaccine and get a majority or more of the population vaccinated and protected, that’s likely not going to happen until the end of 2021,” he said, adding that if Americans are looking for "a degree of normality that resembles where we were prior to covid, it's going to be well into 2021, maybe toward the end of 2021."
• Trump scheduled weekend events in Nevada, contrary to the state's 50-person limit on gatherings. Campaign spokesman Hogan Gidley said people have the First Amendment right to "stand shoulder to shoulder" to express their views and "It can't only be Trump events that cause coronavirus."
• A doctor who was at the forefront of fighting covid-19 in one of the state's hotspots died of the disease Friday night. Rebecca Shadowen, an infectious-disease specialist and epidemiologist at Med Center Health in Bowling Green, battled the disease for four months, said a news release from the hospital chain, which has five other hospitals in Southern Kentucky. Shadowen was a leader in the Bowling Green-Warren County Coronavirus Workgroup, the release said. “Dr. Shadowen will forever be remembered as a nationally recognized expert who provided the very best care for our patients and community,” said Connie Smith, president and CEO of Med Center Health, where Shadowen had been on the medical staff since 1989.
  

Foundation's annual policy forum agenda announced; due to pandemic, it will be a monthly webinar series on children's health

The Foundation for a Healthy Kentucky has announced the full agenda for its annual policy forum that will focus on policies and programs that reduce the chances of disease and unhealthy behaviors that often begin in childhood, including substance use, suicide and vaping.

 

The Howard L. Bost Memorial Health Policy Forum, which typically draws 350 policymakers, health advocates and health care providers, will be a free monthly webinar series this year due to the coronavirus pandemic. The first webinar will be held at 2 p.m. ET Monday, Sept. 21.

The forum is named for Dr. Howard L. Bost, who helped create Medicare and Medicaid, developed the Appalachian Regional Hospitals system, improved mental-health services in Kentucky and created the vision for the foundation.

The foundation is partnering with Kentucky Youth Advocates on this year's forum, titled "Moving Kids Toward Natural Highs: Kentucky Opportunities to Prevent Youth Substance Use, Suicide and Risky Behaviors." The webinars are free, but registration for "attending" each one is required. Here's the schedule:

State of Child Health in Kentucky: Monday, Sept. 21, 2-3 p.m. ET. The panelists will be: Dr. Henrietta Bada, director, Maternal and Child Health Division, state Department for Public Health; Dr. Hatim Omar, founder of the Stop Youth Suicide Campaign; Terry Brooks, executive director, KYA; and Ben Robinson, Daviess County student, youth speaker. The moderator will be Vivian Lasley-Bibbs, director, Office of Health Equity, DPH.  Click here to register. 

Intervening Early: Monday, Oct. 19, 2-3 p.m. ET. The panelists will be: Lisa Lee, commissioner, state  Department for Medicaid Services; Anthony Zipple, senior associate, Open Minds; Allison Miller, family learning specialist, National Center for Families Learning; and Dr. Julia Richerson, pediatrician, Family Health Center Iroquois. The moderator will be Tracey Antle, chief operating officer, Cumberland Family Medical Center. Click here to register.

Promoting Healthy Lifestyles through Nutrition and Physical Activity: Monday, Nov. 9, 2-3 p.m. ET. The panelists will be: Amanda Goldman, health-care sales strategist, Gordon Food Service;  Paula Little, assistant superintendent, Clinton County Schools; Jamie Sparks, school health program manager, ETR; Nellie Ellis, Whitley County High School graduate, youth speaker. The moderator will be Marianne Smith Edge, founder/principal, The AgriNutrition Edge. Click here to register.  

Understanding Youth and Building Good Mental Health:  Monday, Dec. 14, 2-3 pm ET. The panelists will be: Felicia S. Smith, licensed psychologist, co-owner of StrongMinds;  Dr. Allen Brenzel, medical director, state Department for Behavioral Health;  Kerry Gallagher, director of K-12 Education, ConnectSafely; and Beatrice Roussell, Manual High School STAMINA Suicide Prevention Group, youth speaker. The moderator will be Sheila Schuster, executive director, Advocacy Action Network. Click here to register. 

Stopping Vaping and Substance Use:  Monday, Jan. 11, 2021, 2-3 pm ET. The panelist will be: Devine Carama, community coordinator, Lexington FEND Movement and  the founder of Kingtucky, LLC ; Van Ingram, executive director, state Office of Drug Control Policy;  Shannon Baker, director of advocacy, American Lung Association, "How to Talk to Your Kids About Vaping;" and Abby Hefner, anti-vaping advocate, McCracken County High School, youth speaker. The moderator will be Eva Stone, health coordinator, Jefferson County Public Schools. Click here to register. 

Questions about registration? Email Alexa Kerley, akerley@healthy-ky.org.