Beshear says Ky. has "exponential growth" of virus cases, so he may impose new statewide restrictions on Wednesday

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

By Melissa Patrick

Kentucky Health News 

Gov. Andy Beshear warned Monday that Kentucky is having "exponential growth" in coronavirus cases, and said that if the trend doesn't change by Wednesday, he may impose further restrictions to slow the spread of the virus.

"This thing is going crazy. It's spreading like wildfire," Beshear said in a comment that was included in a pandemic story on the CBS Evening News. He pointed to what he called the "stair-step graph" that shows 16,748 cases last week, 30% higher than the previous week.  

That is not exponential growth, but Beshear offered this explanation, saying the graph showed "It took us months to have our first day where we had 1,000 cases. It took a shorter period than that to go from a day with 1,000 cases to 2,000 cases. It took us a week to go from 2,000 cases in a day to 3,000, which happened last week.

"So, what do you think happens from here? It either continues to increase like that or we come together as a people, do what it takes, everybody wear their mask, to ultimately lessen the spread of this virus." 

He said Health Commissioner Steven Stack would show models Tuesday "about where we think it’s going; and then on Wednesday, if we don’t see a change in the numbers the first couple days this week, we’ll talk about some additional steps that we may have to take, or by that point we will have to take to try to get this virus back under control."

Beshear provided no detail on what those new restrictions might look like, but said they would not be as restrictive as they were in the spring. 

"If we have to take additional steps, they are going to be more targeted to ensure that we are getting the best possible results," he said. But he indicated that the targeting wouldn't be geographic: "If we have to take extra steps, we ought to do it all together at the same time." 

He added that with most counties in the state's red or orange zones, the two highest levels of infection, the restrictions would be statewide to ensure "maximum impact." 

Beshear said 103 of the state's 120 counties are in the red zone today, up from 94 on Thursday. He said the spread of the virus in these counties is "truly uncontrolled" and that our families and individuals in them "are in danger."

The governor announced the second highest additional case numbers for a Monday, 1,514, a day that is usually low because of limited testing on weekends. He said 173 of the newly identified cases were 18 and younger. The seven-day rolling average of daily new cases is 2,372.

The share of Kentuckians testing positive for the virus in the past seven days is 8.98%, again the highest it's been since testing became widely available in May.

Hospital use: Covid-19 hospitalizations and use of intensive care units again reached all-time highs, with 1,442 people hospitalized in Kentucky with the virus, 309 more than at a week earlier. ICUs have 360 covid-19 patients and 128 of them are on ventilators. 

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

Beshear said that the concern around hospital capacity continues to be less about bed capacity than about staffing, saying health-care workers share the risk when the virus spreads so widely. 

“If we don’t have enough staff to help someone that's in a hospital bed, the bed itself doesn’t help,” he said. “And staffing, we think, is going to run thin before our overall number of beds do.” Asked for the number of staffed beds available, he said he would check.

    

Vaccine and fatigue: Today's good news was that Moderna has announced that its two-dose vaccine is 94.5% effective, according to early data released Monday by the company. The news comes a week after Pfizer Inc. announced its two-dose vaccine was more than 90% effective.

It will take several months to vaccinate most of the U.S. population, but the reports gave the most clear picture yet of when the pandemic might end, and Beshear suggested that should make it easier for pandemic-fatigued Kentuckians to "get their second wind" and do what it takes to protect themselves and others as we wait on the vaccines to become widely available. 

"This is now a time-limited virus," the governor said. "We need everybody with this new news, again, to buckle down to make sure you are making good decisions each and every day because people's lives depend on it."

Long-term care: Beshear warned that unless Kentuckians do what it takes to lower infection rates, especially in counties with the highest number of cases, there is no way to keep it out of long-term care facilities.

"We shouldn't be sacrificing our seniors because we don't want to wear a mask," he said. 

Health Secretary Eric Friedlander announced that visitation in long-term-care facilities would be limited over the holidays and that any resident who leaves a facility should go into quarantine upon return. He also said the state would be further restricting communal dining and group activities.

"We have to take these aggressive actions, and balance it with what we know about loneliness and separation," Friedlander said. "There will be some personal visitation sacrifices . . . so we’re not sacrificing our seniors."

Friedlander said the state will add five additional National Guard "strike teams" to help with non-clinical needs of the facilities, for a total of 10 teams.

The state reported 1,598 active cases among residents and 970 among staff in long-term-care facilities. Beshear said 52 more deaths have been attributed to them, bringing the total to 1,049 resident deaths and six staff deaths. Residents have accounted for 63% of Kentucky deaths associated with covid-19.

Beshear said another veteran has died at the Thompson-Hood Veterans Center in Wilmore, bringing to 25 the number of deaths of veterans who lived at the state facility. He said 11 at the facility have an active case of the virus, with six in isolation and five in the hospital. 

Prisons: J. Michael Brown, Beshear's executive cabinet secretary, said "The news from the corrections front is not good," noting more than 2,000 virus cases among inmates and more than 280 among staff since March.

He called it "alarming" that more than half the 700-plus inmates at Lee Adjustment Center, a privately operated state prison at Beattyville, have tested positive for the virus, and tests on some are still pending. He said 474 have tested positive for the virus and 380 of them still have active cases.

"We wanted to bring this to everyone’s attention just to show that sometimes in spite of our best efforts, this virus continues to strike us," he said. Since March, one in five inmates has been infected, John Cheves reports for the Lexington Herald-Leader.

Deaths: Beshear announced that the state had confirmed three more covid-19 deaths, bringing Kentucky's death toll from the disease to 1,664. 

“We right now are suffering from avoidable loss, meaning we are having loved ones die that we can stop, that we can prevent,” Beshear said.

The fatalities were all women: a 66-year-old from Graves County, a 63-year-old from Henderson County and an 83-year-old from Jefferson County.

In other covid-19 news Monday:

• Counties with 10 or more new cases were Jefferson, 268; Fayette, 190; Kenton, 65; Hardin, 54; Boone, 49; Campbell, 46; Madison, 45; Graves, 44; Powell, 39; Bullitt, 29; McCracken, 27; Oldham, 26; Mercer, 24; Jessamine, 23; Warren, 22; Pulaski, 20; Boyle, 19; Pike, 18; Marshall, 17; Breathitt, 15; Daviess, 15; Perry, 14; Shelby, 14; Grant, Scott and Taylor, 13 each; Nelson, 12; Boyd, Floyd and Whitley, 11 each; and Barren, Franklin, Harrison and Lincoln, 10 each.
• The K-12 public health report, which includes verified cases, shows 929 students and 481 staff testing positive for the virus in the past 14 days, with 334 students and 174 staff reported today. 
• The college and university report shows 693 students and 10 staff testing positive in the past 14 days, with 265 students and three staff reported today. 
• Lt. Gov. Jacqueline Coleman said the state will no longer take applications for the Team Kentucky Fund, which raised more than $3.7 million to help Kentucky families who have been economically hurt by the pandemic. She said the fund has assisted 2,500 families and all funds will likely be exhausted once current applications are processed. Anyone who still needs assistance should contact Community Action Network, which has partnered with the state to distribute the funds. Additional resources can also be found at kycovid.ky.gov, she said. 
• Surgeon General Jerome Adams said Saturday that the coronavirus is more contagious than seasonal flu. Speaking on NPR's "All Things Considered," he said, "Covid seems to spread much more easily than the flu, and it causes much more serious illnesses in some people." He encouraged people to seek medical guidance if they have symptoms that may be from colds or flu, and to not self-diagnose. "And the one symptom that I would alert people to that really differentiates flu from covid is loss of taste or smell," he said. "If you get that symptom, then you need to be reaching out to your health provider right away and going in and getting a covid test." 
• The Occupational Safety and Health Administration has fined the Fayette County Schools Transportation Department $9,000 after 19 employees tested positive for the virus at a bus garage last spring and one died, Valarie Honeycutt Spears reports for the Herald-Leader. The fines were for not reporting the death and hospitalizations; the school district said it reported the cases to OSHA, prompting the investigation.
• Lexington set a one-week record for new coronavirus cases and covid-19 hospitalizations over the past seven days, according to the Lexington-Fayette County Health Department. A spokesman told the Herald-Leader that the surge seems to align with Halloween parties. “We’re not able to trace anything specifically to parties or gatherings, but it’s very likely part of the increases come from events like that,” Kevin Hall said.
• The free version of Zoom caps calls at 40 minutes. On Thanksgiving, Nov. 26, Zoom will lift the limit for free calls globally, the company announced. The limit will be reinstated at 6 a.m. ET Nov. 27, the Herald-Leader reports.
• Becker's Hospital Review has collected 10 clinicians' opinions on what Thanksgiving and the holiday season should look like. Their general advice: cancel, or celebrate only with your household. 
• Twelve hospitals have closed during the covid-19 pandemic, including Our Lady of Bellefonte Hospital in Ashland, which closed April 30, Becker's reports. Its closing was announced Jan. 21.
• Dr. Jonathan Reiner, a medical analyst for CNN, called U.S. Sen. Rand Paul's advice that people who have had covid-19 to throw away their masks and resume life as normal, based on his belief that they are immune, "very, very disturbing." Reiner noted that Paul, an ophthalmologist, was the "medical genius" who went swimming in the Senate pool while awaiting results of his coronavirus test. "I'd put no credence in anything he says about anything having to do with this virus," he said, and encouraged people to consider the "long-haulers," which Dr. Anthony Fauci, the nation's top infectious-disease doctor, has said could be up to 20% of covid-19 cases.

Broker says Anthem's new short-term plan will undermine Obamacare; Anthem says it's designed to complement ACA plans

Screenshot of Anthem Enhanced Choice website

By Melissa Patrick

Kentucky Health News

This story has been updated to reflect that the Anthem Enhanced Choice plans cover all 10 of the required Essential Benefits that are included in the Affordable Care Act. .

Anthem Blue Cross Blue Shield is offering a new, short-term health plan that one insurance broker says could lead to destruction of the Patient Protection and Affordable Care Act, often called Obamacare.

Joel Thompson, a longtime independent broker at LessSellingMoreHelping.com, says six new Anthem plans called "Enhanced Choice" are being marketed as an alternative to ACA plans for healthy people who make too much money to qualify for financial assistance through a tax credit on an ACA plan. 

"What this could have the effect of doing," Thompson said, "is to draw the healthy people out of the ACA insurance pool and take us a step closer to the dreaded death spiral, as far as only the unhealthy being given coverage through the ACA."

Anthem disagreed, and said its new plan is offered as a complement to its ACA marketplace plans, not as a replacement. 

"Anthem offers 2021 ACA marketplace options in every county in Kentucky and is committed to the individual market," Anthem spokesman Jeff Blunt said in an e-mail. "We also know that one size does not fit all in health care. Marketplace plans are a great option for many, but not all." 

He said the plans "were designed as an option for those who don’t qualify for a federal subsidy or have access to employer-sponsored health plans: the working uninsured, for example. Especially now, in the wake of the pandemic, we must find new ways provide more Kentuckians affordable access to care."

Anthem, the nation's second largest health insurer, is offering Enhanced Choice in Kentucky, Indiana, Ohio, Missouri, Wisconsin and Georgia. 

Open enrollment runs through Dec. 15 on healthcare.gov for ACA plans that will take effect on Jan. 1. Short-term plans like Enhanced Choice are not sold on the marketplace and can be bought at any time. 

On its website, Anthem calls the new plan a budget-friendly option for people without health coverage who do not qualify for ACA subsidies. It notes that "Coverage and cost varies based on where you live, the plan you choose, your age, gender, medical history and tobacco usage." 

Thompson said, "The bottom line -- this is pre-existing conditions being snuck into the system by Anthem. It's like a fly in the oatmeal. It's something they are hoping people don't see, but it has the potential to being the first step toward destroying the ACA marketplace." 

The Anthem website that offers details of the Enhanced Choice plan says it is not required to comply with certain federal market requirements for health insurance, principally those contained in the ACA, and that consumers need to "check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of pre-existing conditions or health benefits."

Blunt said the plan covers the 10 essential benefits required by the ACA, including hospitals, prescriptions, office visits to physicians and specialists, urgent and emergency care and 100% payment for preventive care, pregnancy, maternity, and newborns; mental health and substance use disorder treatment;  rehabilitative and habilitative services; laboratory services; and pediatrics. It also covers telehealth visits, which have become increasingly common during the coronavirus pandemic. 

The Anthem website notes that Enhanced Choice may have limits on lifetime and/or annual dollar limits on health benefits. That appears to be $1 million per member, per benefit period, according to the website. Expiration or loss of eligibility for coverage could result in having to wait until the next open enrollment period begins to get other coverage. 

Thompson, who is based in Ceredo, W.Va., near Ashland, said Anthem has made the plan attractive to Kentucky consumers by offering a network of providers for it that is wider than those for its ACA plans. 

And, he said, they have made it more enticing for brokers by paying twice as much commission on sales of the plan than what it pays for selling an ACA plan. Anthem says that this added commission is offered to accommodate a more laborious enrollment process than is required with ACA plans. 

The Enhanced Choice plan also allows a consumer to apply only once for nearly 36 months of continuous coverage.

Blunt said the plan is already generating a lot of interest: "In just the first two weeks of Anthem Enhanced Choice availability in Kentucky, we’ve seen a tremendous response both in terms of consumer interest and enrollment."

Thompson recognized the attractiveness of this new plan for healthy Kentuckians who make more than 400 percent of the federal poverty level, which is the cut-off for a marketplace subsidy. Without a subsidy, Thompson said, ACA plans can be "quite expensive."

In order to get the tax credit for ACA coverage starting in 2021, an enrollee must make between 100% and 400% of the poverty level. "In 2021, the subsidy range in the continental U.S. is from $12,760 to $51,040 for an individual and from $26,200 to $104,800 for a family of four," according to the Kaiser Family Foundation.  

Thompson said, "Frankly, if I'm in the best interest of the consumer, there's no way I would not show them this plan, even though I totally oppose its existence, because my role is to always work in the best interest of the consumer." 

Nevertheless, he added, "It's not something that I think needs to be or should be competing with the ACA."

Thompson said the ACA works because all the underwriting differences have to be uniform across all carriers. "What Anthem is doing here is saying, 'Hey, we're going to be offering something that's off the market,' but it has the severe potential of disrupting the market, especially if it catches on," he said. "This is more of a threat to the ACA than what's in the Supreme Court, by far."

The court heard arguments last week in a challenge to the ACA's constitutionality, but justices' comments indicated that they were unlikely to throw out the law.

Planning a Thanksgiving gathering? Here are more than a dozen questions to ask, and some expert advice about testing

Kentucky Department for Public Health graphic

Because just about everything that involves a traditional Thanksgiving meal creates a perfect storm to spread the virus that causes covid-19, health experts are encouraging people to scale back holiday gatherings to just those in their immediate household, or to practice what epidemiologists call "harm reduction" if they choose to gather.

That poses the question, "If we're going to celebrate the holiday . . . how can we make it as safe as possible?" Brian Resnick writes for Vox. 

Resnick poses questions that offer options to help reduce the risk of spreading the virus, with the recommendation to initiate several of these strategies at the same time, instead of just one. Here are his questions, and answers; in some cases, you will have to provide your own answers: 

1. Can the holiday be held remotely? "Celebrating virtually or with members of your own household (who are consistently taking measures to reduce the spread of covid-19) poses the lowest risk for spread," says the Centers for Disease Control and Prevention Thanksgiving guidance. 
2. Can Thanksgiving be held outdoors? Resnick notes that while an outdoor gathering is far safer than indoor one, it's important to remember that this strategy isn't foolproof, and people still need to socially distance and wear a mask. 
3. Can it be a very small gathering? Know this, he writes: The more people you include, the more dangerous it will be. 
4. If it's indoors, can it be well ventilated? Open windows, use fans in some windows to remove old air and in others to introduce new air. Run a HEPA air purifier is you have one. Still, he writes, "We can't ventilate and air-purify our way out of the need to wear masks, reduce occupancy in indoor spaces and physically distance." 
5. Can it be quick? Yes, and the longer you spend with an infected person, the more likely the virus is to be transmitted. 
6. Does there really need to be food? If the goal is to bring family together, can you perhaps have Thanksgiving without a sit-down meal that necessitates the removal of masks and encourages heavy mouth-breathing activities like shouting, he asks. 
7. Can guests quarantine beforehand? And maybe afterward, Resnick adds.
8. Will vulnerable people be in attendance? Consider excluding those at high risk, such as older people and those with underlying conditions like diabetes and heart disease.
9. Can the number of people traveling from hot-spot regions be reduced? 
10. Is everyone attending on the same page in terms of masking and personal risk?  For example, families should ask one another, "How often do you wear a mask, and where?" 
11. Is everyone in attendance willing to be transparent and honest if they do get sick? Resnick writes, "It's how we can prevent an outbreak in one family from becoming a huge cluster." 

Resnick says the overarching question is: "Can you live with a scenario where someone — or many people — at the gathering get covid-19?"

Julia Marcus, a Harvard University epidemiologist, told Resnick that it’s important to think hard about what really matters most to you: “What can I live with here? And can I live with not having a traditional Thanksgiving?” 

And there's another question that some are asking: How about we gather after we all get tested? That may sound like a good idea, but it has too many pitfalls to rely on, Christie Aschwanden writes for Wired.

"As a means of eliminating risk in the midst of a pandemic, the everyone-has-gotten-tested method is utterly absurd," writes Aschwanden, an award-winning science journalist. "A negative test doesn’t guarantee that anyone is covid-free, and it’s never license to let down your guard. You might, for instance, contract the virus in the interim between being tested and receiving your results, or between getting your results and seeing your friends and family. (The testing site itself could even be where that happens.) 

"The tests are not 100 percent accurate. In practice, their error rates may be even higher than the chance that you’re infected in the first place. The probability that you’ll receive a wrong result on any medical test depends not just on the test’s innate accuracy but on your baseline risk. Even a very good test will turn out more false positives than real ones if you go in as someone who isn’t likely to have the disease. Conversely, getting a negative result won’t give you that much information you didn’t have before. It might only increase your confidence at the margins, say from 95 to 98 percent, that you’re not already sick."

Getty Images

That said, tests can be part of a multi-faceted preventive approach.

For The Conversation, a nonprofit that offers research-based journalism from academics, American University epidemiologist Melissa Hawkins writes that her family's plans for the holiday include testing, less travel and fewer people.

She says instead of their usual pilgrimage to Florida, along with both grandparents, to celebrate with all of the cousins, this year her family will stay home and keep their gathering "small and flexible."

She suggested that people headed to a gathering should agree to be vigilant in their public-health practices beforehand, especially if grandparents and older guests will be in attendance. She said her family has agreed to limit contacts with people as much as possible the week before the holiday, including the few people they see regularly. 

In conjunction, everyone coming to her house has agreed to get a laboratory based, "gold-standard" PCR test within 72 hours of Thanksgiving, to allow time to get the results back. She added that if need be, they will get rapid test, but noted that this is a second choice because they are less reliable.

She said her family will have a short, outdoor Thanksgiving with a small group in a space that allows plenty of space between them, and she will provide individual "care packages" that allow everyone to have their own blanket, hand sanitizer, utensils and mask. If the weather doesn't cooperate, Plan B involves lots of open windows, exhaust fans and air purifiers, and everyone spread out to eat. 

And whether inside or out, she writes that everyone will wear masks when they aren't eating, and social distance. She also notes it's important to be mindful of alcohol consumption, since it lowers inhibitions.

The Kentucky Department for Public Health has issued guidance for celebrating Thanksgiving to prevent the spread of the virus. 

This guidance says anyone with an active case of the coronavirus, anyone with symptoms of the virus, anyone waiting for test results, anyone who may have been exposed to someone with the virus in the last 14 days and anyone who is at an increased risk of severe illness from the virus should "not host or participate in any in-person festivities."

Virus-case average is at new high in Ky., as are hospital and ICU cases; national expert advises, 'Don't swap air with people'

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

This story has been revised to correct a statement in the news release.

By Al Cross

Kentucky Health News

It was the highest Sunday and the highest week for cases of the novel coronavirus in Kentucky, and hospital numbers also set new records.

The state reported 1,449 new cases of the virus, which a news release from Gov. Andy Beshear said was the highest Sunday yet. Actually, the highest Sunday was Oct. 25, with 1,462, according to state records.

The state's seven-day rolling average of new cases, based on unadjusted initial daily figures, is 2,406; that's 40 more than it was on Saturday.

The release said "Kentucky again set a record for cases reported in one week." The state measures weekly totals from Monday through Sunday, and delivers an all-but-final number for each reporting week on Mondays.

In the reporting week ended Sunday, the state announced 16,832 cases. That was 36 percent more than the 12,421 initially announced the week before. The figure announced each day is adjusted slightly downward as duplicate test results are removed.

“Coronavirus is present in every corner of the commonwealth and it’s spreading at a truly alarming rate,” Beshear said in the release. “This is not a drill; this is a health emergency that we all need to take seriously. Let’s come together as Team Kentucky to defeat this virus.”

The number of covid-19 patients in Kentucky hospitals and their intensive-care units hit more records Sunday, at 1,383 and 330, respectively. ICU ventilator cases were down slightly, to 156.

The share of Kentuckians testing positive for the virus dropped slightly but remained high, at 8.88%.

Beshear reminded community leaders, schools, businesses and residents in the 94 "red zone" counties, those with the highest infection rates as of Thursday, to follow the state's Red Zone Reduction Recommendations through Sunday, Nov. 22. They are:

• Employers allow employees to work from home when possible
• Non-critical government offices to operate virtually
• Reduce in-person shopping; order online or curbside pickup
• Order take-out; avoid dining in restaurants or bars
• Prioritize businesses that follow and enforce mask mandate and other guidelines
• Reschedule, postpone or cancel public and private events
• Do not host or attend gatherings of any size
• Avoid non-essential activities outside of your home
• Reduce overall activity and contacts, and follow existing guidance, including 10 Steps to Defeat Covid-19

Beshear announced three more covid-19 deaths, bringing the state's toll to 1,661: an 84-year-old woman and an 85-year-old man from Oldham County, and a 93-year-old woman from Fayette County.

Health Commissioner Steven Stack, a physician, reminded Kentuckians to watch their space, wear a mask and wash their hands to save their life and the lives of those around them. 

He said “United We Stand, Divided We Fall,” the state motto, “has never been more applicable than now, as we fight the most deadly pandemic in over 100 years. Unless Kentuckians come together, we will continue on this dangerous trajectory with disastrous consequences.”

One key to preventing spread of the virus, especially now that cold weather has arrived, is to avoid "swapping air" with others, said Dr. Michael Osterholm, a member of President-elect Joe Biden's pandemic team. "It's very important that, first of all, we don't swap air with people. That's how this is being transmitted," Osterholm said on NBC's "Meet the Press." He is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

In other coronavirus news Sunday:

• Counties with 10 or more new cases were Jefferson, 346; Fayette, 210; Hardin, 84; Kenton, 38; Nelson, 36; Boone, 28; Bullitt, 28; Laurel, 27; Warren, 24; Daviess, 22; Calloway, 21; Taylor, 20; Barren, 19; Campbell, 18; Greenup, 18; Whitley, 17; Boyd, 16; Floyd, 16; Adair, McCracken and Oldham, 15 each; Boyle, Christian, Powell and Russell, 14 each; Carter, Jessamine, LaRue, Marion and Pulaski, 13 each; Franklin and Scott, 11 each; and Henderson, 10.
• Fayette County Schools paused all athletics and extracurricular activities, citing surging case numbers. Officials said there had been no outbreaks and they would reassess after Thanksgiving, WKYT reports. 
• Black Kentuckians' shares of coronavirus cases and covid-19 deaths continued to decline, very gradually, but both remained higher than African Americans' 8.4% of the state's population. Their share of cases is 10.76% and their share of deaths is 11.51%. The numbers are reported daily.
• "Thousands of medical practices are closing, as doctors and nurses decide to retire early or shift to less intense jobs," due to the pandemic, The New York Times reports.
• Dr. Anthony Fauci said on CNN's "State of the Nation" that he expects a coronavirus vaccine to be available for health workers and first responders "sometime around mid to late December." He said the news that a reportedly effective vaccine is coming should make people "double down" on prevention, not ease up. "We’ve got to hang on a bit longer, particularly as we get into the holiday season," he said. "We can make it turn around. We really can."
• Fauci is director of the National Institute of Allergy and Infectious Diseases. Asked if he sees any circumstances for local or state stay-at-home orders, he said, "I think that likely will happen if we don’t turn around this surge."
• Asked when Americans could again safely gather for family events, he said that depends on further vaccines and their uptake. "We have to get people to take the vaccine," he said, and if an " overwhelming majority" do, the country "can start getting back to normal in second and third quarter of the year." However, he cautioned that because no vaccine is 100% effective, "I would recommend to people to not abandon all public-health measures just because you’ve been vaccinated."
• Fauci said response to the pandemic would be helped if President Trump would start the transition to President-elect Joe Biden. "The process is really important," he said, noting he has been through six transitions. "It’s almost like passing a baton in a race."
• Asked how will history remember the government's response to the pandemic, he said that would take detailed research, but "Obviously, it's not gonna be a good report, because of the suffering that we’ve had." He attributed that partly to the federal system, in which states "tend to want to do things differently," and the character of Americans: They "don’t like to be told what to do."

Webinar focuses on importance of nutrition and physical activity to improve the health and learning of Kentucky's children

Photo: Kentucky Coalition for Healthy Children

By Melissa Patrick
Kentucky Health News

The third of five webinars about reducing disease and unhealthy behaviors in Kentucky's children focused on policies and programs to improve nutrition and physical activity.

The Nov. 9 webinar, "Promoting Healthy Lifestyles Through Nutrition & Physical Activity," came in a monthly series that is serving as the Foundation for a Healthy Kentucky's annual policy forum, due to the coronavirus pandemic. 

"We need to come back to the realization that student health improves student learning and outcomes," Bonnie Hackbarth, the foundation's vice-president for external affairs, told Kentucky Health News. "If we really want to improve scores in our state, health is a key part of improving those scores." 

Amanda Goldman, health-care industry strategist, Gordon Food Service, talked in the webinar about the importance of nutrition to growth and learning. 

"We know that a good, balanced diet ensures essential vitamin and mineral support to support healthy growth," she said. "We also know that healthy eating, in addition to regular physical activity, helps children and young adults to decrease their risk of such chronic diseases as Type II diabetes, obesity, hypertension, cardiovascular disease, as well as certain types of cancers."  

She also noted that school nutrition programs, like the national school-breakfast program that serves over 80% of U.S. schools, has not only improved students' nutrition, but their learning, attendance and test scores.

Goldman added that throughout the pandemic, school districts across Kentucky have worked to find ways to make sure their students get nutritional meals even if they are learning from home.

The foundation is partnering with Kentucky Youth Advocates on this year's Howard L. Bost Memorial Health Policy Forum. The next webinar, "Understanding Youth and Building Good Mental Health," will be held at 2 p.m. ET Monday, Dec. 14. 

Jamie Sparks, school health program manager for ETR, a national nonprofit working to advance health equity, pointed out that while health and wellness is a priority in some Kentucky schools, it is not  in every school. "Why do all students not have the same accessibility and the same amount of time allocated around these issues?" he asked. 

He pointed to a national shift toward a "whole child" approach when it comes to education and stressed that "nutrition and physical education and physical activity are all critical components" that need to be included.

Further, he said many of the changes that have resulted from the pandemic, like taking away the focus on standardized testing, has created an opportunity to move toward this "whole school, whole community, whole child" approach. 

Sparks also spoke to the challenges schools face to improve achievement gaps, which often comes at the expense of physical education and physical activity time within the school day. 

Added to that, Kentucky only requires a half-credit of physical education to graduate high school, though school districts can require more. 

So, as Kentucky works toward increasing physical activity in the school day, Sparks said mandating daily PE time is not the solution, largely because schools don't have enough PE teachers or building space. Instead, he said schools must find ways to incorporate movement throughout the day and ways to partner with communities to increase movement. 

Sparks is also the executive director for SHAPE America in Kentucky and the former coordinated school health director for the Kentucky Department of Education. 

An example of how schools and communities can work together to improve nutrition and activity, especially in children, can be found in the Healthy Hometown Project in Clinton County, said Paula Little, assistant superintendent of Clinton County Schools.

The project, which is made up of about 30 community partners, is part of a six-year grant-funded by the foundation that addresses both nutrition and physical activity in the community. 

Clinton County (Wikipedia map)

Little said that in 2012, 74% of adults in Clinton County were overweight; only 17.1% of school-aged children ate the recommended amount of fruits and vegetables; and only 21% of kids were active on a daily basis. Further, the county's rates of diabetes, heart disease, hypertension and other chronic diseases related to obesity were significantly higher than the rest of the state. "Clearly, we were a county that needed to do some work," she said.

She said the Healthy Hometown Project, created in 2013, has worked to change the culture of the community with a "strong, consistent, good health message everywhere" and to make "the healthy choice the easy choice." She added that the focus has been on changing children's nutrition and physical activity behaviors, which is thought to be more doable than changing those behaviors in adults.

"We wanted our children everywhere they looked in the community to be able to say, 'Oh, that's a good healthy choice. That's easy. Let's do that'," she said. "And that needed to come not only from the school, but the community, the media, the church, everybody we could get, we tried to get involved." 

Some of their efforts include providing healthy meals to students during the summer in a mobile café, offering after-school supper programs, offering free fruits and vegetables in the elementary schools, providing a grab-n-go breakfast carts in the schools, creating student walking clubs, offering classroom activity programs as well as increasing PE time, and they built a community playground. "The focus is on being healthy, moving and eating better," she said. 

And the results are paying off, she said. Since starting the program, Clinton County moved up 30 notches in health outcomes in the latest county health rankings issued by the Robert Wood Johnson Foundation, from 94 to 64. 

Little closed her presentation with her favorite quote by Margaret Mead: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." 

"If our community can do it, so can others," she said.

Nellie Ellis, a freshman at Centre College and graduate of Whitley County High School, spoke about the importance of positive messaging when it comes to talking to students about nutrition and activity. 

"So, when we're talking about food, we should do it in a neutral way, instead of using terms like good, bad, clean, nice, etc.," she said. "Talk about what bodies do or how they feel, rather than what they look like. Encourage exercise for the sake of health and enjoyment, not for weight control." 

Click here to register for the Dec. 14 webinar. 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 youth speaker Beatrice Roussell of Louisville Manual High School's STAMINA suicide prevention group. The moderator will be Sheila Schuster, executive director of Advocacy Action Network. The webinars are free, but registration is required for "attending" each one. 

The foundation is also seeking members for the Kentucky Coalition for Healthy Children, which will work to identify and promote policies to improve children's health in school settings. Go to kentuckyhealthychildren.org to learn more about this coalition.

After more new records for virus and hospital cases, Beshear says he will have to 'take additional steps' if trend continues

Department for Public Health map, relabeled by Kentucky Health News; to enlarge it, click on it.

By Al Cross
Kentucky Health News

Kentucky continued to set records for coronavirus cases and covid-19 hospitalizations Saturday, prompting Gov. Andy Beshear to warn that he will have to "take additional steps" if the daily numbers don't drop.

The state reported 3,303 new cases, 130 more than the record set Friday, and the seven-day rolling average jumped by 163, to 2,366.

All the hospitalization numbers were new highs. Kentucky hospitals reported 1,378 patients with covid-19, 308 of them in intensive care and 167 of those on ventilators. Beshear said this week that hospital systems in some areas are being strained by covid-19 patients, and hospitals would be overrun if the current trend continues.

The percentage of Kentuckians testing positive for the virus in the last seven days is 8.95%, more than double what it was a month ago.

“If we don’t grab ahold of those red-zone-county reduction recommendations, if we don’t see those steps being done and ultimately see those numbers coming down, we are going to have no choice but to take additional steps as we move forward,” Beshear said in the release.

“Please take this seriously. You are either a part of the solution fighting the good fight to help other people or you’re helping to spread this virus. So please, do your part. Do your civic duty. Wear your mask. There is so much suffering out there right now.”

Beshear was asked more than once this week if he was planning to impose more restrictions due to the surge in cases and hospitalizations. He said Thursday, after the state Supreme Court upheld is authority to issue emergency orders, that he was not looking to add new mandates: "Right now, we've got to get more buy-in from people for current mandates, for later ones to work."

He said in Saturday's news release, “If we’re not careful, it’s going to get even worse than this, which is almost unimaginable compared to where we were months ago.”

Health Commissioner Steven Stack said in the release, “We have had some frightening setbacks lately and the outlook is grim. I urge all Kentuckians to protect themselves and others by wearing a mask, watching your space and washing your hands. While we wait for a coronavirus vaccine, we should all be getting the flu vaccine.”

Stack said an influenza outbreak on top of the pandemic in the next few months, the heart of flu season, "would be disastrous."

The state confirmed 11 more deaths from covid-19, raising Kentucky's toll from the disease to 1,378. Beshear's news release noted there have been "68 deaths in the last four days alone."

The fatalities were a 90-year-old woman and 94-year-old man from Fayette County; a 72-year-old man and 93-year-old man from Jessamine County; a 70-year-old man from Kenton County; a 65-year-old man from Knott County; a 79-year-old woman from Lee County; a 69-year-old man from Lewis County; an 88-year-old man from McLean County; a 91-year-old woman from Perry County; and a 90-year-old woman from Wolfe County.

Lee County (Wikipedia map)

Lee County, population 7,000, had 178 of the 3,303 new cases, driven by outbreaks at a prison and a nursing home. Over the last week, its daily cases have averaged 0.6 per 1,000 residents; the next highest county, Monroe, has a rate of 0.18.     

Other counties with more than 10 new cases were: Jefferson, 668; Fayette, 231; Hardin, 113; Boone, 100; McCracken, 80; Kenton, Daviess, 66; Nelson, 65; Warren, 63; Madison, 62; Shelby, 61; Floyd, 57; Campbell, 54; Bullitt, 49; Elliott, 46; Marshall, 41; Laurel, 38; Christian, 35; Spencer, 35; Graves, 34; Boyd, 33; Jessamine, 32; Taylor, 32; Marion, 31; Calloway, 30; Hopkins, 28; Johnson, 28; Barren, Boyle, Oldham and Rowan, 27 each; Greenup, 23; Carter, Clark and Henderson, 22 each; Whitley, 19; Bell and Scott, 18 each; Edmonson, Logan, Montgomery, Muhlenberg and Pulaski, 17 each; Clay, Henry, Knox, Lawrence and Wayne, 16 each; Caldwell, Grayson, Perry and Pike, 15 each; Casey, Monroe and Woodford, 14 each; Bourbon, Clinton, Franklin, Powell and Washington, 13 each; Grant, 12; Anderson, Breathitt, Breckinridge, LaRue, Metcalfe and Webster, 11 each.

In other coronavirus news and opinion:

• "The uncontrolled coronavirus outbreak is prompting government officials across the nation to impose new restrictions on consumers and businesses, sapping the economy’s momentum and delaying the recovery of millions of jobs lost during the recession," The Washington Post reports, noting tighter restrictions on restaurants and indoor gatherings in Virginia and a threat of a statewide stay-at-home order by the Illinois governor.
• The Post adds, "Washington’s failure to provide additional financial support is compounding the economic distress." President Trump said on Twitter, "Congress must now do a Covid Relief Bill."
• "As a third wave of covid-19 bears down on the United States, we are increasingly a society of defensive, self-protective winners and angry and resentful losers," Post columnist Helaine Olen writes. "The virus, which many once hoped might at least help bring our fractured society together, has turned into yet another way to divide us."

Ky. Center for Smoke-free Policy recognizes communities, groups and individuals who work to create smoke-free communities

Lori Fulton Brookbank is Smoke-free Advocate of the Year. Image from the Smoke-free Tomorrow Facebook page

The Kentucky Center for Smoke-free Policy honored communities, groups and individuals from across the state who are making progress in creating healthier, smoke-free communities. The awards were presented Nov. 10 at a virtual award ceremony. 

“Kentucky has had an amazing year as we now have 38 communities with comprehensive smoke-free workplace laws, covering 36.2 percent of Kentuckians," said University of Kentucky nursing professor Ellen Hahn, director of the Kentucky Center for Smoke-free Policy. "We have experienced extraordinary momentum and leadership by local elected officials and advocates for smoke-free and tobacco-free protections even during the pandemic. These community heroes are making Kentucky a better place to breathe.” 

This year’s awards include:

The Smoke-free Indoor Air Excellence Award recipients were the cities of Hazard, Perryville, and Hodgenville as well as Perry County (which includes Hazard) for their leadership and collaborative efforts in promoting the health of their citizens by enacting comprehensive smoke-free workplace ordinances.

The Smoke-free Excellence in E-Cigarette Policy Award recipients were the cities of Corbin, Campbellsville, and Williamsburg for their leadership and collaborative efforts in promoting the health of their citizens by strengthening their comprehensive smoke-free ordinance to include e-cigarettes.

The Smoke-free Endeavor in E-cigarette Policy Award recipients were Franklin County, its seat of Frankfort and the City of Hopkinsville for their leadership and collaborative efforts in promoting the health of their citizens by adding e-cigarettes to their partial smoke-free ordinance.

The Lee T. Todd Jr. Smoke-free Hero Award  recipients were Hayley Leach and Sierrah Miley, UK Tobacco-Free Take Action Ambassadors, for their commitment to smoke- and tobacco-free environments in the face of adversity.

The Timothy W. Mullett, MD, Lung Cancer Prevention Award went to Angela Criswell of the Lung Cancer Alliance, and Lindi Campbell of Breath of Hope KY, for their devotion and passion for preventing lung cancer through education, advocacy, or policy change. 

The Lifetime Achievement in Tobacco Control Award recipient was Mary Singler, retired health -promotion manager with the Northern Kentucky District Health Department, for her exceptional career devoted to leadership in tobacco control.

The Tobacco-free Campus Award recipient was Western Kentucky University for its leadership and collaboration in promoting a healthy campus environment by implementing a 100% tobacco-free campus policy.

The Smoke-free Youth Advocate Award recipient was the Mason County High School Family, Career and Community Leaders of America chapter for excellence in promoting secondhand smoke education and smoke-free policy.

The David B. Stevens, MD, Smoke-free Advocate of the Year recipient was Lori Fulton Brookbank, with the Smoke-free Partnership of Mason County, for her excellence in promoting secondhand smoke education and smoke-free policy. 

The other two nominees for the Smoke-free Advocate of the Year award were Shirley Daulton of the Lake Cumberland District Health Department, and Jennifer Osborne of the Lincoln Trail District Health Department.

CDC's updated guidance on face masks says they also protect those who wear them from the novel coronavirus

By Melissa Patrick
Kentucky Health News

Masks not only protect people around the wearer from the spread of the coronavirus, but they also protects the wearer, the Centers for Disease Control and Prevention says in updated guidance that is the agency's most explicit endorsement yet of masks to fight the pandemic.

The guidance says that while "masks are primarily intended to reduce the emission of virus-laden droplets," they "also help reduce inhalation of these droplets by the wearer." 

"And you know what that says?" Gov. Andy Beshear asked at his Thursday, Nov. 12, briefing. "It says the same thing that we've been saying, that wearing one of these masks not only keeps you from spreading the virus to others, but protects you. So with cases surging, wear your mask; it protects you." 

Beshear regularly pleads with Kentuckians to follow public-health guidance that has been proven to slow the spread of the virus, like wearing masks and social distancing, and those pleas have escalated as cases continue to surge across the state. On Friday, the state announced 3,173 new cases of the virus, by far the state's highest single-day yet for cases. He also announced 25 more deaths from covid-19, also a record. 

The CDC report says that mask mandates "can help avert future lockdowns," especially if combined with "social distancing, hand hygiene and adequate ventilation." Kentucky has had such a mandate since July 9, but compliance has been spotty.

Previous CDC guidance said wearing a mask was important to prevent people who were infected with the virus from infecting those around them, especially for those who have the virus but not symptoms. But growing evidence shows that a mask can also provide protection to the person wearing it. 

"Studies demonstrate that cloth mask materials can also reduce wearers' exposure to infectious droplets through filtration, including filtration of fine droplets and particles less than 10 microns," says the report.

It adds that multiple layers of cloth with higher thread counts have demonstrated superior performance, compared to single layers of cloth with lower thread counts. 

The CDC's update cites seven studies to support this new guidance, including several that show wearing cloth masks can reduce the risk of contracting the virus by 70 percent. 

"Think about everybody wearing a mask and having a 70 percent reduction in the spread right now, what that would means," said Beshear.

The report also highlights  an economic analysis that found "increasing universal masking by 15% could prevent the need for lockdowns and reduce associated losses of up to $1 trillion, or about 5% of gross domestic product."

Asked what he would say to those who question the CDC's guidance because it's always changing, Beshear noted that the coronavirus wasn't even known until the end of last year, and we are learning more about every day. He said, "So if the CDC now knows from their studies that you can reduce the spread by 70 percent and protect yourself by wearing a mask -- why the heck argue?"  

New records: 3,173 cases; 1,358 hospitalizations, 307 in ICUs; 25 deaths; nursing-home cases and deaths follow similar trend

Kentucky Health News chart; case numbers are from unadjusted initial daily reports.

By Al Cross
Kentucky Health News

The coronavirus pandemic in Kentucky exploded Friday, with record numbers of cases, hospitalizations and deaths.

The state reported 3,173 new cases, almost 18 percent more than the previous record of 2,700 set just two days earlier. That raised the seven-day rolling average of new cases to 2,203, more than three and a half times, or 259 percent, what it was two months ago.

Kentucky hospitals reported 1,358 covid-19 patients, 307 of them in intensive-care units, both records; 147 of the ICU patients were on ventilators.

The state reported 25 more covid-19 deaths, the most ever confirmed on one day. That raised Kentucky's toll from the disease to 1,647.

Kentucky Health News chart

The percentage of Kentuckians testing positive for the coronavirus in the last seven days took another jump, to 8.68%. Again, that was the highest rate since testing became widely available in May. The new rate was double the rate reported Oct. 12, just over a month earlier.

“This is the toughest spot that we’ve been in so far,” Gov. Andy Beshear said in a video. “We cannot let this escalation continue. I need your help. . . . Too many of us are hurting. Too many of us are dying. We have to defeat this virus.”

Beshear asked Kentuckians in the 94 counties in the state's "red zone" to follow recommendations for limiting activities, and asked schools to follow similar recommendations. Some school districts in red zones have continued in-person classes, contrary to the recommendations.

“You must do your part,” Beshear said. “If you are not wearing a mask, you are putting yourself at personal risk. Everybody’s got to pull their weight. . . . Come on, Team Kentucky. Too many of us are hurting and too many of us are dying.”

The surge is part of a national phenomenon; more than 150,000 new cases were reported Friday, the most ever. “Like almost every state in America, we are seeing a surge here in Kentucky that is concerning and deadly,” Beshear said. “But like every state in America, the power to stop it is in our hands.”

The number of active coronavirus infections in Kentucky nursing home residents and staff "has nearly quadrupled since mid-August to about 2,200, while the industry’s death toll from the virus this week passed 1,000, according to state data," John Cheves reports for the Lexington Herald-Leader.

Herald-Leader chart; for a larger version, click on it.

“This amount of community spread continues to hit our more vulnerable,” Beshear said, noting another death at the Thomson-Hood Veterans Center, a state-operated home at Wilmore.

Cheves writes, "There is no realistic way to keep it out of nursing homes anymore, experts say. Employees return every day to their surrounding communities, and if the virus is pervasive enough, it will come in with one of them, despite constant temperature checks and questions about symptoms, they say."

Sherry Culp, Kentucky’s state long-term care ombudsman, told Cheves, “This is really in the hands of individuals now. It’s up to people to wear their masks, to wash their hands, to not have big social gatherings — basically, to take responsibility for keeping transmission rates down where they live.”

Nursing-home patients have accounted for 61% of Kentucky's covid-19 deaths.

The 25 covid-19 deaths confirmed Friday were four women, 76, 79, 88 and 92, and three men, 73, 81 and 88, from Barren County; two women, 71 and 92, from Bullitt County; a 93-year-old woman from Christian County; a 65-year-old woman and an 84-year-old man from Hardin County; a 62-year-old man from Harlan County; an 87-year-old woman and a 69-year-old man from Hart County; two men, 76 and 94, from Logan County; a 65-year-old man from Marion County; a 79-year-old woman from Mason County; a 69-year-old man from Ohio County; an 83-year-old woman and two men, 62 and 83, from Pike County; and a 79-year-old woman and an 81-year-old man from Warren County.

Counties with more than 10 new coronavirus cases were: Jefferson, 630; Fayette, 221; Hardin, 133; Kenton, 124; Boone, 116; McCracken, 78; Campbell, 71; Bullitt, 68; Calloway, 66; Warren, 63; Graves, 59; Laurel, 52; Nelson, 47; Daviess, 43; Whitley, 41; Floyd, 39; Shelby, 39; Henderson, 38; Madison, 37; Oldham, 37; Meade, 34; Hopkins, 32; Grant, 31; Pulaski, 31; Perry, 30; Christian, 29; Marion, 29; Johnson, 28; Pike, 28; Grayson, 26; Marshall, 25; Greenup, 24; Barren, Clay, LaRue, Magoffin and Taylor, 22 each; Franklin, 21; Jessamine, Lee and Monroe, 20 each; Boyle, Scott and Washington, 19 each; Pendleton, 18; Lincoln, Muhlenberg and Spencer, 17 each; Anderson, Boyd, McLean, Mercer, Union and Webster, 15 each; Casey and Martin, 14 each; Wayne, 12; and Bourbon, Knott, Knox, Letcher, Logan, Ohio, Powell and Woodford, 11 each.

In other covid-19 news Friday:

• With the pandemic setting records in Lexington, Fayette County Schools said they would suspend the targeted, in-person classes that they have offered to some students since October, the Lexington Herald-Leader reports. The county is in the red zone, but state recommendations have greenlighted the two-hour classes.
• People of color have about double the risk of picking up the virus in indoor spaces, says a study from Stanford University. “In the past, these disparities have been assumed to be driven by preexisting conditions and unequal access to health care, whereas our model suggests that mobility patterns also help drive these disproportionate risks,” study co-author David Grusky said in a news release. Places that employ people of color are “often smaller and more crowded,” Grusky said, so “occupancy caps on reopened stores can lower the risks they face.” The Miami Herald reports, "The study found that limiting the number of people who are close together indoors for an extended period of time — such as in gyms, hotels, cafes, religious centers and restaurants — can reduce infections by about 80%."
• More than 130 Secret Service officers "have recently been ordered to isolate or quarantine because they tested positive for the coronavirus or had close contact with infected co-workers," The Washington Post reports, citing "three people familiar with agency staffing" who spoke on the condition of anonymity and linked the outbreak "to a series of campaign rallies that President Trump held in the weeks before the Nov. 3 election."
• An interactive map developed by researchers at Georgia Tech shows the risk of different-sized gatherings in each county. The map, which is updated daily and is adjustable by certain event sizes, could provide guidance for holiday plans.

Screenshot of interactive map shows predicted risk for a gathering of 25 in each county. Risk level is the chance that at least one person with the virus will be at an event, given the size of the event.

Kentucky Office of Rural Health's Ernie Scott receives the 2020 Dan Martin Award for lifetime contributions for rural health

Ernie Scott

Ernie Scott, director of the Kentucky Office of Rural Health, is this year's recipient of the Dan Martin Award for lifetime contribution to rural health in Kentucky.

“It is an absolute honor to receive this year’s Dan Martin Award,” Scott said in a news release. “For decades, Dr. Martin played such a key role in the state — as a medical professional, as an educator, as a leader. In so many ways, we are all walking in his shadow, continuing to do the work that’s necessary to help the communities and people of rural Kentucky.”

The award was announced Nov. 5, during the opening day of  the Kentucky Rural Health Association's annual conference, held virtually this year due to the COVID-19 pandemic.

Scott joined KORH in 2012 as a rural project manager and has served as its director since 2013. He has served as an ex-officio member on the rural health association's board of directors and as the chair of the group’s education committee.

At the national level, Scott serves as a regional representative to the National Organization of State Offices of Rural Health and serves on the organization’s rural health clinic committee, national conference committee and on two workgroups.

“As a true Appalachian, I’m convinced Ernie has never met a stranger and this shows in the network of collaborators he has brought together to address various rural health issues,” said KRHA President Ashley Gibson. “He understands what’s at stake and is always willing to go the extra mile to meet the needs of our rural communities. Kentucky is lucky to have Ernie Scott." 

Started in 2003, the award is named after its inaugural honoree Dan Martin of the Trover Foundation in Madisonville. The award recognizes individuals who have played key roles in developing innovative solutions to rural health challenges in Kentucky — in the areas of patient care, health professions education, health administration, health promotion or public advocacy.

Cases and positive-test rate continue to surge; Beshear says if cases keep increasing, Kentucky hospitals "will end up overrun"

State Department for Public Health chart shows 94 counties in highest danger zone.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced 2,342 new cases of the novel coronavirus in Kentucky on Thursday, the second highest day yet, and warned that Kentucky hospitals are having difficulty dealing with it.

"This virus continues to spread at such an alarming rate," Beshear said at his daily news conference, reminding Kentuckians that each of those cases represents a new person who has been infected with the virus. 

He also announced that the share of Kentuckians testing positive for the virus in the past seven days has gone up again, to 8.29%, another record for the period since testing became widely available. 

"This is a high positivity rate with an abundance of testing, which means that the virus is at an all-time high in its spread," the governor said. 

Hospitalizations for covid-19 also hit another all-time high, 1,311, up 37 from yesterday, and patients in the intensive care and on ventilators have also inched up since yesterday, by two in the ICU, to 299, with 163 if those patients on a ventilator, up by 12. 

Beshear said the state is seeing "a strain on a number of our hospital systems," which are monitoring it very closely. And while the state is likely to run out of nurses and doctors before it runs out of hospital beds, he said, "We are seeing some signs that our hospital system could be overrun . . . If cases keep increasing at the rate they are now, we will end up overrun. You're seeing that in other states."

Beshear's daily news release offered examples of what other states are dealing with as cases surge across the nation. It says, "Texas alone has surpassed 1 million cases; El Paso, Texas, is doubling its supply of mobile morgues; the Mayo Clinic Health System is reporting that 100% of its hospital beds are full in northwestern Wisconsin; and North Dakota is allowing covid-19-positive health care workers to continue working in covid-19 wings because of a significant health care worker shortage."

Today, Beshear announced 94 of the state's 120 counties are in the "red zone," which means a county has had at least 25 new cases per 100,000 residents in the last seven days. That's up from 80 counties last week.

Each Thursday, the governor is asking counties in the red zone to follow a set of community and school recommendations to slow the spread of the virus. 

Among other things, the red-zone reduction recommendations ask people to not eat in restaurants, to allow employees to work from home when possible, and to not host gatherings of any size. School recommendations call on schools in these hard-hit counties to move to virtual learning only. Long-term care facilities also have a set of recommendations to follow if they are located in a red zone.  

“Remember, what this is supposed to do is to provide a way for these communities, 94 of them, to come together, with government,  business, school system, everybody, long-term care, working together in a unified effort to stop the spread of this virus,” Beshear said.

Frankfort and Franklin County are in the red zone, so Beshear said state government will follow the recommendations next week. "We are going to live up to what we’re asking other people to do," he said. 

Asked if he plans on turning these recommendations into mandates, or if he is willing to shut down non-essential businesses again for a couple of weeks to stop this surge of cases, especially after the Kentucky Supreme Court unanimously upheld his authority to do so, Beshear again said he was not looking to add new mandates, though "We are committed to taking actions as we need to," and called for better compliance with the existing ones.

"Right now, we've got to get more buy-in from people for current mandates, for later ones to work," he said.

Asked if rural Kentucky counties would have access to the new Pfizer Inc. vaccine when it becomes available, because it requires ultra-cold storage units, which are reported to cost up to $15,000 and aren't readily available in many rural hospitals, Beshear said vaccine distribution plans are a "work in progress" but "We need to get them to those that need them the most, that are the most vulnerable. And we're gonna make sure that happens in rural populations just as soon as it happens in urban populations." Other vaccines are under development.

Beshear announced 18 more people had died from covid-19, bringing the number of Kentuckians who have died from the disease to 1,622.

John Vereb

He honored John Vereb, 52, of Mount Washington, an Army veteran, an emergency nurse and a nursing instructor, who died from covid-19 on Oct. 23, just 13 days after his diagnosis.

He leaves behind his wife, Angela, and their three children, Harrison, Conner and Alayna. Beshear said Vereb was detailed to the emergency department at the Robley Rex Veterans Affairs Medical Center in Louisville in March, where he often treated covid-19 patients.

"To honor John, his family asks that Kentuckians do their patriotic duty to protect themselves and others by wearing a mask and social distancing,” said Beshear. “It is a small sacrifice to make for those on the front lines who serve you.”

In other covid-19 news Thursday: 

• Counties with more than 10 cases were Jefferson. 507; Fayette. 285; Christian. 86; Kenton. 64; Warren. 58; Boone. 56; Daviess. 47; Jessamine. 43; Campbell. 41; Hardin. 41; Carter, Laurel and Shelby, 33 each; Pulaski, 31; Barren, 30; Monroe, 29; Nelson and Oldham, 27 each; Bullitt and Madison, 25 each; Floyd, Franklin and Greenup, 24 each; Henderson, 23; Ohio, Rowan and Taylor, 22 each; Johnson, 21; Calloway, Marshall and McCracken, 18 each; Lewis, 16; Logan, Marion and Woodford, 15 each; Hopkins, 14; Bath, Boyle and Scott, 13 each; Casey, Graves, Mason, Mercer, Pike and Whitley, 12 each; Adair, Boyd, Lincoln, Montgomery and Wayne, 11 each; Hancock, Hart, McCreary, McLean and Morgan, 10 each.
• Today's fatalities were a 77-year-old man from Allen County; an 86-year-old woman from Christian County; a 66-year-old man from Clay County; a 75-year-old woman from Clinton County; two 75-year-old men from Henderson County; two women, 89 and 96, from Jefferson County; a 76-year-old man from Lee County; an 80-year-old man from Lincoln County; two men, 57 and 90, from McLean County; a 78-year-old man from Oldham County; two women, 68 and 86, and an 82-year-old man from Pike County; and a 93-year-old woman and a 70-year-old man from Rockcastle County.
• In long-term care, there are 150 new resident cases and 133 new staff cases, with 1,360 active resident cases and 839 active staff cases. There have been 997 resident deaths and six staff deaths attributed to covid-19. 
• The K-12 student dashboard shows 613 students and 321 employees have tested positive for the virus this week, with 3,941 students and 738 staff quarantined. 
• The college and university report shows 620 students and 13 employees have tested positive for the virus in the past 14 days, with 242 students and three staff reported today. 
• Three partner agencies of Cabinet for Health and Family Services have been awarded $1.4 million from the Coronavirus Relief Fund to assist with services that support prevention of abuse and domestic violence. For the news release, click here.

Pandemic may not have hurt Trump as much as expected, but McConnell adviser says it still made the difference in the election

President Trump may not have suffered as much from his handling of the coronavirus pandemic as some of his allies and adversaries said before and just after the election.

"Democrats and Republicans alike are reconsidering what they thought they knew about the public’s view of the viral outbreak and Trump’s handling of it, convinced the issue wasn’t as helpful politically for Democrats as they once expected," Alex Roarty reports for McClatchy Newspapers. "Some strategists go so far as to say they think the president’s insistent push to lift economic restrictions, compared with Joe Biden’s emphasis on health and safety, even helped his cause with voters."

“It’s possible that the pandemic actually didn’t accrue to Biden’s benefit at all,” Tim Miller, political director of Republican Voters Against Trump, told Roarty. “And in certain areas, the open-it-up debate might have cost him votes.” Such strategists say Trump's economic emphasis led to his "narrower-than-expected losses in battleground states" and helped Republicans gain seats in the House and retain, at least for now, control of the Senate, Roarty reports.

Others "argue that although fewer voters were ultimately moved by the crisis, those who did were still crucial to Biden’s margin of victory in closely fought states like Wisconsin and Arizona. And few disagree that the pandemic, which since the spring has reshaped many facets of American life, was ever-present on voters’ minds, or that large majorities viewed Trump’s response to it negatively."

Republican strategist Josh Holmes, who is close to Senate Majority Leader Mitch McConnell, told The Washington Post soon after the election that the pandemic was the difference between Trump winning and losing. But he suggested to Roarty that Democrats didn't gain as much from it as they could have because they “overvalued an upper-middle-class view” of the pandemic that didn't make enough of the difficulties of people in service industries. While the pandemic “was by far and away the most significant impactful environmental piece of this election,” he said, “the question is which way does it break amongst which parts of the electorate.”

Jason Bresler, a Democratic strategist who was the Democratic Congressional Campaign Committee’s national political director in 2018, told Roarty that his research showed that voters were more likely to be persuaded by advertising that stuck to a basic health-care message (such as guaranteeing protections for pre-existing conditions, as the Affordable Care Act does) instead of combining such a pitch with references to the pandemic.

"Other Democratic strategists said their data showed that voters grew so tired of the pandemic by the end of the campaign that they grew hesitant to even mention it in their ads, fearful that anything more than a fleeting image of people wearing masks would provoke a backlash," Roarty reports, citing Ian Russell: “People were exhausted by it. They wanted to move on.”

Democratic strategist Danny Barefoot told Roarty that he ran a post-election focus group of persuadable voters who wound up voting for Trump -- 20 mostly white working-class women from battleground states -- and many recoiled at the idea of more lockdowns. “I can’t do that again, no matter how bad it gets,” Barefoot recalled one saying. “And everybody in the group was nodding their heads.”

Presidents can't order lockdowns. Biden said “We’ll have a national mandate to wear a mask,” but presidents can't do that, either. Democrats also talked about "mask mandates, listening to scientists, ramping up production of protective equipment and implementing a national testing strategy," Roarty notes. "That message would poll well, but wasn’t tangible enough for many voters, some Democratic strategists quietly conceded."