Major measures of pandemic in Ky. fall; deaths remain high, but 14-day average declining; infection rates still high in Southern Ky.

Gov. Andy Beshear visited a vaccination site at Broadbent Arena in Louisville Friday. (State photo)

By Al Cross

Kentucky Health News

All major measures of the Covid-19 pandemic declined in Kentucky Friday, including the percentage of residents testing positive for the novel coronavirus in the last seven days, which dropped to 6.95%, the first time since Nov. 6 that it has been under 7%.

The state remains one of the leaders in new cases over the last seven days, but reported only 1,440 new cases of the virus Friday, lowering its seven-day rolling average of 1,729, the lowest since Nov. 4.

“It looks like we’re going to have fewer cases than last week, which would give us five straight weeks of declining case numbers. The positivity rate also continues to decline,” Gov. Andy Beshear said in a video. In a Facebook post, he said "I am more optimistic than ever about our fight against Covid."

He said in a news release, “This says you’re doing the right things and we’re headed in the right direction. But even if you’ve been vaccinated, we have to continue to wear masks and social distance until we can defeat this thing once and for all.”

The state attributed 42 more deaths to the disease, 35 confirmed and seven probable. The listings occur weeks and sometimes months after the deaths occur, after case reviews. In the last 14 days, the state has listed 41.8 deaths per day; yesterday's 14-day rolling average was 42.9. It has declined the last three days.

Covid-19 hospitalizations in Kentucky are the lowest since Nov. 4, at 1,063, with 277 of them in intensive care and 154 of those on ventilators. Two of the 10 hospital regions reported more than 80% of ICU beds in use: Barren River, 81%; and Lake Cumberland, 96%.

Likewise, counties along and near the Tennessee border continued to have the highest infection rates in the last seven days. Those with rates more than double the state rate of 34.96 new cases per 100,000 residents were McCreary, 103.6; Clinton, 96.5; Allen, 94.5; Russell, 90.1; and Owsley, 87.4. 

Counties with more than 10 new cases were: Jefferson, 244; Kenton, 92; Boone, 86; Fayette, 83; Warren, 61; Madison, 42; Campbell, 40; Daviess, 39; Pulaski, 26; Hardin, 24; Scott, 23; Bullitt and McCreary, 22; McCracken, 20; Laurel, 19; Barren, Boyd and Knott, 18; Nelson, 17; Bell, 16; Perry, 15; Franklin, Hopkins and Lewis, 14; Breckinridge, Henderson and Trigg, 13; Lincoln, Oldham and Simpson, 12; and Boyle and Grant, 11.

In other coronavirus news Friday:

• Beshear visited the Louisville regional vaccination site at Broadbent Arena and a vaccination campaign at a Lexington church to promote African Americans' acceptance of coronavirus vaccines.
• In Lexington, he said, “From the start of this pandemic, our faith leaders have stepped up to protect their congregations and their communities. So often, you lead by example in so many parts of our lives, and your efforts to keep our people safe during this time are inspiring.”
• The list of the 42 newly listed deaths was dominated by Barren County, illustrating how cases are often submitted or reviewed in batches. The county's fatalities were five women, 56, 60, 76, 82 and 92; and four men, 75, 78, 80 and 88.
• The other fatalities were a Butler County man, 89; a Clark County man, 66; a Daviess County woman, 52; a Fayette County woman, 94; three Floyd County men, 75, 78 and 81; a Harlan County woman, 74; two Hart County men, 61 and 77; a Hopkins County woman, 96; a Hopkins County man, 59; a Jackson County man, 71; a Lawrence County man, 85; a Logan County man, 87; a Lyon County woman, 89; two Madison County women, 81 and 100; two Madison County men, 45 and 75; a Metcalfe County woman, 91; a Muhlenberg County woman, 68; a Muhlenberg County man, 79; an Oldham County man, 75; a Perry County woman, 90; a Todd County woman, 69; and a Todd County man, 96.
• The Centers for Disease Control and Prevention issued new guidance saying that schools can safely reopen as long as they follow a list of safety measures, including six feet of social distancing. It did not say that teachers should be vaccinated before in-person schooling resumes.

State announces more vaccination locations, making 156; health chief clarifies CDC mask guidance; Ky. still a new-case hotspot

State Dept. for Public Health chart, with extra labeling by Ky. Health News; click it to enlarge

By Melissa Patrick
Kentucky Health News

Looking forward to the day when Kentucky has enough coronavirus vaccines for anyone who wants one, the state now has 156 locations able to provide what the lieutenant governor called the "shot of hope," six of them new regional vaccine sites.

In addition to the six new regional sites, which can be added to the eight that have already opened, Gov. Andy Beshear announced that 10 Kroger stores, 15 Walmart stores, and 125 pharmacies, along with local health departments and community health centers, will now be providing vaccines.

“That is a big deal," Beshear said at his last news briefing of the week. "It's going to move us forward and build out what we need to ensure especially as supply increases, whenever that's going to happen, that we are ready to get it out and get it out quickly all over the state."

That day could come as soon as early spring, Dr. Anthony Fauci, the nation's leading infectious-disease expert, predicted Thursday,

“By the time we get to April, that will be what I would call, for better wording, ‘open season,’ namely, virtually everybody and anybody in any category could start to get vaccinated,” Fauci said on NBC’s "Today" show, adding that logistically, once that happens it will take several months to get everyone vaccinated who wants one.

Health Commissioner Steven Stack explained that because the state's population is not equally distributed and vaccine access also varies across the state, some sites will move to the Phase 1C category before others. Phase 1C includes people 60 and older, people with high-risk conditions, and all essential workers. He said that getting people 60 and older vaccinated is important because they account for 91 percent of the state's deaths attributed to Covid-19.

Asked if Kentucky would offer a special program like Ohio has started to continue vaccinating staff in long-term-care facilities once the federal program wraps up, Stack said there is no plan to do so, since all staff are in the health-care priority group and can get vaccinated at any of the state's vaccine sites.

As of Feb. 1, the federal vaccine program, led by Walgreens and CVS Health, had vaccinated about 73% of the residents and 45% of the staff, according to data obtained from the state.

New vaccine sites: New regional sites will be in Columbia, Frankfort, Grayson, Henderson, Louisa and Morganfield. The state already has sites in Covington, Bowling Green, Murray, Glasgow, Lexington, Danville and Paducah. Go to vaccine.ky.gov to learn how to sign up for a shot at one of these sites.

Two of the 10 new Kroger sites will be in Ashland. Others will be in Brandenburg, Campbellsville, Carrollton, Elizabethtown, London, Maysville, Murray and Paducah. Go to Kroger.com/Covid Vaccine to make an appointment.

The 15 Walmart sites are in Corbin, Berea, Campbellsville, Carrollton, Central City, Crestwood, La Grange, Mayfield, Paducah, Paintsville, Richmond, Shelbyville, Shepherdsville, Tompkinsville and Winchester. Go to Walmart.com/CovidVaccine to make an appointment.

The Federal Pharmacy Program, which brings about 13,000 first doses to the state, will be offered at 78 Walgreens branches and 47 independent pharmacies that are part of the Good Neighbor Pharmacy brand. Click here for a list of participating pharmacies. Click here to make an appointment at a Walgreens.

Stack said many of the 78 Walgreens locations still have slots available. Click here to get an address for each of the aforementioned new locations.

Lt. Gov. Jacqueline Coleman, who led most of the briefing, announced several state initiatives aimed at providing equitable access to the vaccine. "Our administration is committed to providing equitable access to the vaccine, and we know that there are significant barriers in both rural and urban parts of the state," she said.

One initiative will allow people living in Anderson, Boyle, Casey, Franklin, Garrard, Jessamine, Lincoln, Mercer, Scott, Washington and Woodford counties to get free transportation to and from vaccine sites at the Kentucky Horse Park in Lexington or Ephraim McDowell Hospital in Danville. To reserve a ride, residents should call Blue Grass Community Action Partnership Transit at 800-456-6588 at least 24 hours in advance of their vaccine appointment time.

Another initiative, through Norton Healthcare vaccine clinics, will work to reach at-risk, under-served people who are 70 and older in Louisville at St. Stephen Baptist Church and Bates Memorial Baptist Church. Stack said the state is also partnering with King's Daughters Medical Center in Ashland, which will do vaccine-outreach with other Black churches and communities in the next few weeks. Deborah Yetter of the Louisville Courier Journal reports on the "quiet" church campaign in Louisville to vaccinate more African Americans.

Another partner, the University of Kentucky, will offer four outreach clinics on successive Saturdays with mobile vaccination units in areas with under-served populations due to race, language, economic or other barriers.

    
In addition, four of the state's federally qualified health centers – or community health centers, as they are commonly called – will be providing vaccines as part of a federal program. They include the Mountain Comprehensive Health Corp., serving Letcher, Owsley and Perry counties; Primary Care Centers of East Kentucky, serving Perry and Leslie counties; Juniper Health, serving Breathitt, Lee and Wolfe counties; and the June Buchanan Clinic, serving Knott County.

David Bolt, CEO of the Kentucky Primary Care Association, said in a release, “We applaud the Biden administration’s decision . . . Our community health centers already provide the medical home for one in eight Kentuckians, more than 550,000 people."

The state's daily report shows 497,256 Kentuckians have received an initial dose of the vaccine.

Masks: Stack cautioned that beyond the new guidance from the CDC that says wearing two mask, a cloth mask over a surgical mask, or knotting and tucking a single medical-procedure mask to prevent air leakage reduces a healthy person's risk of catching the coronavirus by more than 95% – it's important to remember that masking alone is not enough.

"You need to wear a mask whenever you're anywhere near other people who you don't live with, and you need to stay more than six feet away from each other, whether you have a mask or not," he said.

Photos from Centers for Disease Control and Prevention explain new CDC guidance on masking.

Stack also said the new CDC guidance that says people who are seven days past their second dose of vaccine do not need to quarantine for up to 11 weeks if exposed to the virus also came with a warning, that we still don't know for sure if the vaccines will prevent a person from getting infected with a mild disease or be infected with no symptoms, both situations that could result in the spread of the disease. 

Therefore, he said the "key point" from this guidance is that even after being vaccinated, it will be important to follow the current guidance that calls on people to wear mask, social distance, practice good hand hygiene, and to avoid social gatherings.

"We still don't have enough people, anywhere near enough people, protected directly and so . . . we don't take our eye off the ball, we don't let down our guard," Stack said. He also advised that any decision to quarantine or not, even after being vaccinated, should be made in consultation with your local health department.

Daily numbers: Beshear announced 1,880 new cases of the coronavirus on Thursday, bringing the seven-day rolling average to 1,847, the lowest this number has been since Nov. 6. 

The share of Kentuckians testing positive for the virus in the past seven days dropped again, to 7.08%, the lowest this rate has been since Nov. 6. "That is good news," said Beshear.

However, other states have improved too, and Kentucky's infection rate in the week ended Feb. 7 was sixth highest in the nation, according to the latest report from the White House Coronavirus Task Force. A daily compilation by The New York Times ranked Kentucky third on Thursday.

White House Coronavirus Task Force chart, with Kentucky's rank highlighted; click it to enlarge.

Deaths from the virus remain high. Beshear announced that the state had listed 36 more deaths, 31 confirmed and five probable. That took the death toll to 4,211. The 14-day death average went way down, to 42.9; the deadliest day, 69, was 15 days ago. The seven-day average also dropped, to 41.4, because one of the two days tied for second most deaths, 58, was eight days ago. 

Beshear honored the life of Gladys Lowenthal Bass, whose obituary said she died of "Covid-19 and a broken heart." Bass was 94 and the wife of Humana co-founder Lewis "Sonny" Bass, who died from the virus just eight weeks ago.

"So this is vicious. It takes people that we know and love," Beshear said. "Let's make sure we continue to do the right things to protect those around us. I don't want to have 35 deaths again in the course of this pandemic, and we can do something about that. What we do is wear those masks, engage in social distancing, and then prepare to vaccinate people as quickly as possible." 

In other coronavirus news Thursday:

• The state's daily report said the statewide case-incidence rate for the last seven days fell to 37.4 per 100,000 residents. Counties with rates more than double the statewide rate are Russell, 98.8; Allen, 98.5; Clinton, 90.9; McCreary, 90.4; and Marion, 74.9.
• Counties with 10 or more new cases were: Jefferson, 283; Fayette, 109; Kenton, 104; Boone, 59; Daviess, 48; Warren, 48; Pulaski, 46; Hardin, 39; Campbell, 34; Laurel, 34; Barren, 33; Madison, 32; Russell, 31; Montgomery, 30; Franklin, 29; Christian, 27; Bullitt, 26; Taylor, 26; Marshall, 25; Whitley, 25; Rowan, 23; Lewis, 22; Shelby, 22; McCracken, 20; Scott, 20; Allen, Boyle, Hopkins and Nelson, 19; Boyd, 18; Jessamine, 17; Floyd, Henderson and Metcalfe, 16; Harlan, Logan, McCreary, Marion, Pike and Wayne, 15; Lincoln and Perry, 14; Hart and Woodford, 13; Clay, Grant and Trigg, 12; Bell. Grayson, Knott and Washington, 11; and Clinton and Knox, 10.
• The 36 fatalities listed Thursday were a Barren County man, 91; two Calloway County men, 53 and 63; a Clay County woman, 77; a Crittenden County woman, 78; a Fayette County woman, 89; a Fleming County man, 91; three Harlan County men, 38, 59 and 73; a Hart County man, 66; a Jefferson County woman, 92; two Jefferson County men, 66 and 71; a Laurel County man, 55; two Lawrence County women, 92 and 94; two Letcher County women, 69 and 82; a McCracken County woman, 62; three Madison County women, 82, 86 and 91; four Madison County men, 66, 75, 76 and 96; a Marion County woman, 89; two Marshall County men, 64 and 69; a Meade County woman, 75; two Mercer County women, 84 and 85; two Nelson County men, 84 and 88; and a Perry County woman, 70.
• Hospitalization numbers returned to normal after a one-day spike. Kentucky hospitals reported 1,142 Covid-19 patients, down 49 from Wednesday; 278 intensive-care patients, down 58; and 156 of them on ventilators, down 13; but the percentage of ICU patients on ventilation rose to 56%, 4 percentage points above average.
• In long-term-care, 22 more residents and 19 more employees have tested positive for the virus; cases are active in 285 residents and 201 staff. Beshear said four more deaths can be attributed to the virus in these facilities, bringing their death toll to 2,209. Covid-19 deaths of residents of the facilities are down to 54.6% of the state's total.
• Four of the 10 hospital-readiness regions are using more than 80% of their intensive-care beds: Barren River, 82.4%; the northeast region, 84.4%; the easternmost region, 81.6%; and Lake Cumberland, 97.8%. 
• Starting Feb. 15, Kentuckians needing assistance with rent or utilities to cover their past-due or future bills should reach out to the Healthy at Home Eviction Relief Fund. People in Fayette County should apply at covid19renterhelp.org; people in Jefferson County should apply at stopmyeviction.org; and the other 118 counties should apply at teamkyhherf.ky.gov. Click here for the news release. 
• Click here for an unemployment update in the governor's press release. 
• Local health departments in Eastern Kentucky report on their new coronavirus cases and deaths, Hazard's WYMT reports.

Share of Kentuckians testing positive for coronavirus drops again; death rate still high; CDC says two masks are better than one

By Melissa Patrick
Kentucky Health News

Despite the persistently high deaths from Covid-19 in Kentucky, Gov. Andy Beshear sees hope in the state's declining rate of residents testing positive for the novel coronavirus in the last seven days.

Beshear announced 1,914 new cases of the virus on Wednesday, the lowest Wednesday in weeks, and reported that the positive-test rate dropped again, to 7.5 percent, the lowest since Nov. 9.

He also said 49 more Covid-related deaths, 46 confirmed and three probable, brought the state's death toll to 4,175. In the last 14 days, the state has averaged 45.2 deaths per day, a near-record, and the average has been over 40 since Jan. 28.

“We are still seeing far too many deaths, but this decreased positivity rate is a really hopeful leading indicator,” Beshear said in a news release. “We have come so far in our fight against this virus – now, we need to hang on until we reach the finish line.”

Deaths are a lagging indicator of the virus, and many of them continue to be the result of the escalation of cases seen in November and during the holidays. The hope and expectation is that as case numbers go down, so too will the deaths, but more contagious strains of the virus have made it easier to catch.

One way to decrease cases is to follow the public-health measures known to thwart the spread of the disease: wear a mask, social distance, wash your hands, limit your social contacts, get tested, especially if you think you've been exposed, and stay home if you are sick. 

The Centers for Disease Control and Prevention released a study, performed with dummies, that shows wearing two masks -- a cloth mask over a surgical mask, or knotting and tucking a single medical-procedure mask to prevent air leakage --  reduced a healthy person's risk of catching the coronavirus by more than 95%.

When the infected wearer and receiver were both fitted with the double mask or a knotted and tucked mask, the cumulative exposure of the receiver were reduced by 96.4 percent and 95.9 percent, respectively.

"The data in this report underscore the finding that good fit can increase overall mask efficiency," the CDC said. "Multiple simple ways to improve fit have been demonstrated to be effective."

The number of people hospitalized in Kentucky with the virus is down 13 from yesterday, to 1,191, but the number in intensive care rose 54, to 336; and 21 more were on ventilators, totaling 169. 

Two of the state's hospital-readiness regions reported more than 80% use of their intensive-care beds: the easternmost region, 81.6%, and the Lake Cumberland region, 97.8%. 

The state's daily vaccination report shows 482,039 Kentuckians have received the first dose of a coronavirus vaccine.

In anticipation of inclement weather, three of the state's Kroger regional vaccination sites in Lexington, Bowling Green and Covington will be closed on Thursday. Beshear said earlier Wednesday that the appointments will be rescheduled to Thursday of next week at the same appointment time.

Beshear also encouraged Kentuckians with appointments scheduled in the next few days to keep a close eye on their e-mails and voice mails for possible notifications from their provider.

Today's fatalities were an Anderson County woman 93; a Boone County woman, 83; a Bourbon County man, 68; a Boyd County man, 74; a Boyle County woman, 81; a Breathitt County man, 67; a Campbell County man, 93; a Christian County woman,75; a Clinton County woman, 76; two Fayette County women, 74,84; three Garrard County women, 93, 95 and 96; a Hardin County man, 80; three Harlan County women, 41, 56 and 63; a Harrison County man, 67; a Hart County woman, 82; a Jefferson County woman, 84; a Jessamine County man, 81; a Kenton County woman, 82; two Kenton County men, 77,96; a Lawrence County woman, 80; a McCracken County woman, 81; a McCracken County man, 73; two McCreary County women, 76 and 80; a Madison County woman, 93; a Marion County woman, 48; a Mercer County man, 66; a Muhlenberg County woman, 66; a Nelson County man, 69; an Ohio County man, 89; a Pulaski County woman, 76; a Pulaski County man, 71; a Shelby County woman, 91; a Shelby County man, 92; a Simpson County woman, 74; four Warren County women, 64, 72, 92 and 92; two Warren County men, 87 and 89; a Wayne County woman, 82; and a Wayne County man, 78.

Counties with 10 or more new cases were Jefferson, 244; Fayette, 145 Kenton, 74; Madison, 58; Boone and Daviess, 56; Warren, 55; Barren, 51; Hardin, 49; Montgomery, 43; Christian, 36; Laurel, 35; Campbell, 33; Bullitt and Hopkins, 31; McCracken, 27; Russell, 26; Boyd, Marion and Pulaski, 25; Jessamine, 23; Perry, 23; Henderson, 21; Clinton, Hart and Pike, 19; Casey, Clark and Marshall, 18; Caldwell, 17; Whitley, 16; Franklin, Lawrence and Scott, 15; Allen, Boyle, Green, Nelson, Oldham and Taylor, 14; Knox, Larue, Lincoln and McCreary, 13; Greenup and Shelby, 12; Butler, Meade, Monroe, Muhlenberg and Woodford, 11; Floyd, Grayson, Letcher, Logan and Mason, 10.

The state's case-incidence rate declined to 38.7 per 100,000 residents. Counties with rates more than double that rate were all in Southern Kentucky: Allen, 93.2; McCreary, 78.8; Russell, 77.3; and Clinton, 76.9.

We must break the silence about suicides of nurses as they fight for patients in the pandemic, UK's dean of nursing writes

By Janie Heath
Dean, College of Nursing, University of Kentucky

While the Covid-19 pandemic rages on with new variants, the urgency for Kentucky nurses to stay on the front lines now extends to a massive vaccine campaign. Just like Florence Nightingale and Mary Jane Seacole, a British-Jamaican nurse, did in the Crimean War, nurses today are working 24/7 to get the mission accomplished. Although the practice settings may change from a critical-care unit one day and the next to a large parking-lot tent, football stadium or drive-through clinic, the shepherding of public health in the commonwealth remains the same.

Janie Heath, Ph.D.

A key question is, “Who is shepherding the mental health and wellness of nurses?” What about turning up the call for action with a “warp speed mission for the mental health and wellness for Kentucky nurses,” like a “vaccine to help build up immunity” from the pandemic’s triple impact on health, daily life disruption and economic downturn?

Nurses are human, too, and experience the same worries and anxieties as all Americans. Pre-Covid, the prevalence of nurse suicide was higher than the United States’ general population and now with compassion fatigue escalating, the urgency is greater for evidence-based interventions so another life is not lost to suicide.

1. Staying focused on what we can control – stopping COVID-19 single handedly is out of our hands but we can control how we react to the challenges by following CDC recommendations for double masking, handwashing, physical distancing and vaccination.

2. Taking time to breathe and reflect – thinking about how our new world with COVID-19 brings opportunities for creative adjustments and family connections by returning to simpler times in our lives.

3. Practicing gratitude – finding something positive every day and being grateful for simple things like beautiful days of sunshine or spending more time with pets is vital.

4. Taking care of ourselves – prioritizing “me time” is challenging but critical if we are going to come out healthy on the other side. We must get adequate sleep, exercise and eat healthy.

Embracing helpful resources – accessing ANA resources for well-being such as “a nursing state of mind podcast series,” confidential 24/7 calls to talk about wellness, recovery and resilience and the National Suicide Prevention Lifeline 1-800-273-TALK (8255).

Read more here: https://www.kentucky.com/opinion/op-ed/article249089915.html#storylink=cpy

Leaders of the Kentucky Nurses Action Coalition have been actively engaged to address “the silence of nurse suicide.” Leveraging the recently passed Kentucky Nurses Association and the Kentucky Nursing Deans and Directors resolution (October 2020), “A Call to Action for Kentucky Nurse Leaders to Promote Practices for Optimal Resilience and Suicide Prevention in Schools of Nursing,” multiple venues are unfolding to “break the silence.”

In collaboration with KNA, KNAC leaders are advocating for Friday, May 7, to be declared Kentucky Nurse Suicide Prevention Day. In honor of the extension of Year of the Nurse and Midwife, in May the KNA will expand “nurses’ week” for a month and will offer free continuing education programs to include evidence-based strategies to build nurse resiliency and shift from mental health crisis intervention to prevention.

In an upcoming legislative session, KNAC and KNA will partner with the Kentucky Board of Nursing for a legislative proposal to require a suicide-prevention training course as a requirement for nurse licensure. By working together, committing time and resources to implement these intentional strategies, we will emerge stronger and healthier:

1. Staying focused on what we can control: Stopping Covid-19 single-handedly is out of our hands but we can control how we react to the challenges by following Centers for Disease Control and Prevention recommendations for double masking, handwashing, physical distancing and vaccination.

2. Taking time to breathe and reflect – thinking about how our new world with Covid-19 brings opportunities for creative adjustments and family connections by returning to simpler times in our lives.

3. Practicing gratitude – finding something positive every day and being grateful for simple things like beautiful days of sunshine or spending more time with pets is vital.

4. Taking care of ourselves – prioritizing “me time” is challenging but critical if we are going to come out healthy on the other side. We must get adequate sleep, exercise and eat healthy.

5. Embracing helpful resources: Accessing ANA resources for well-being such as “a nursing state of mind podcast series,” confidential 24/7 calls to talk about wellness, recovery and resilience and the National Suicide Prevention Lifeline 1-800-273-TALK (8255).

Kentucky nurse leaders are grateful for the relentless efforts of so many who continue to build a culture of health ,and now we invite you to help us strengthen the mental health and wellness of our nursing workforce. Use these hashtags: #TogetherKY #KYNursingStrong. #STOPnurseSuicide

Janie Heath is president of the Kentucky Nurses Action Coalition and Warwick Professor of Nursing at the University of Kentucky. This was first published in the Lexington Herald-Leader.

Read more here: https://www.kentucky.com/opinion/op-ed/article249089915.html#storylink=cpy

Kentucky to get 6% more vaccine doses next week; meanwhile, case numbers and positive-test rate continue to trend down

Ky. Health News graph; new-case numbers are initial, unadjusted reports; click it to enlarge.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear praised Kentuckians for their efforts in thwarting the spread of the novel coronavirus, announcing that case numbers and the positive-test rate keep trending down, and the federal government is sending more vaccine. 

"We are seeing really good compliance out there. Keep it up," Beshear said. "Right now you're showing that we can win. We can decrease cases just through our behavior, and this is at the same time that we're vaccinating, so all that's good."

Beshear announced 2,339 new cases of the virus, bringing the state's seven-day rolling average to 2,032, which is 15 less than Monday.

The share of Kentuckians testing positive for the virus in the past seven days dropped again, to 7.66 percent. "This is a good thing," he said. 

Asked if the state's case numbers are lower because fewer people are getting tested, Beshear said testing numbers are in a "generally good place." In addition, he said the decline in the positivity rate supports the low case numbers. He said it's too early for vaccines to have had an impact on case numbers.

While Kentucky's case numbers have generally declined for a month, so have other states', so the state ranks seventh in new cases in the last seven days.   

Beshear said he had not heard of any more variants of the virus being reported, beyond the one today in Jefferson County. 

He cautioned that the existence of these highly contagious variants doesn't necessarily mean case numbers will go up because wearing a mask and social distancing and the other public health strategies are "still pretty effective." 

"The variants make everybody nervous," he said, "but they don't change the game plan and what it's going to take to protect ourselves until we're out of this and what we do to get out of it in terms of vaccinations."

Kentucky Health News graph; click on it to enlarge.
Daily listings of deaths are made after cases are reviewed.

Beshear said the number of Covid-19 deaths is still "stubbornly high" after he announced 35 more, 16 from Louisville. That took the state's death toll to 4,126. The 14-day death average is the same as yesterday, 45.1 per day. 

Also, all of the hospital numbers are up, with 1,204 Covid-19 patients in Kentucky hospitals (up 41 from yesterday); 282 in intensive care (up eight) and 148 of those on ventilators (up six). Beshear said these increases are within normal variations. 

For the first time since the state started reporting hospital capacity on a regular basis, none of the hospital readiness regions reported ventilator use, ICU use or overall patient numbers above 80% capacity.

Schools: The state's K-12 school dashboard shows that 182 schools have never reported their case or quarantine numbers, and last week 401 of them did not. Schools have been asked to self-report daily.

Asked about that, Beshear first commended schools that regularly report, saying they are "living their values of being transparent." He voiced disappointment in the rest, "because what they do is they remove the real information . . . that they need" in deciding whether to send a child to school or not, especially as the state works toward getting every school open to in-person learning in some capacity.

"It's highly disappointing that schools would not be reporting, and I would not feel safe with my children going to the ones that do not," he said. "That would not give me confidence that those schools are doing everything it takes to battle Covid because they're not doing everything it takes for public health and local health departments and others to know the situation in their schools."

Asked what he is doing about it, he said the state is encouraging them to participate, and "that's probably where it's going to be." He added, "I think we should all be disappointed that there are schools that claim they can keep our children safe, but won't show us the data that backs it up."

Last week, 1,295 students and 523 staff tested positive for the virus, resulting in 5,197 students and 738 staff being quarantined, according to the dashboard.

The Centers for Disease Control and Prevention is expected to issue guidance on school reopenings this week, CNN reports.

Click here for the Kentucky Department of Education's considerations for reopening Kentucky schools after vaccination. 

Vaccines: Beshear announced that the federal government is increasing Kentucky's vaccine supply for the third time in three weeks, this time by 6 percent. He said that means the state will get 71,675 doses next week, up 28% from the 56,175 three weeks ago. This week, the state received 68,475 doses. 

"It's not enough, but it's great," the governor said. 

At least 452,532 Kentuckians have received at least one dose of the vaccine, according to the state's daily vaccination report.

Beshear said the state's larger vaccine sites will likely move to phase 1C, which includes people 60 and older, people with high-risk conditions and all essential workers, when they find that slots are not being filled up by those in the higher priority groups, which means that some of the regional centers may move to that phase earlier than others. 

In anticipation of severe winter weather expected through Thursday night, Beshear said the regional vaccination sites at the Kentucky Horse Park, Bowling Green and Covington will be closed Thursday to ensure the safety of all staff, volunteers and vaccine recipients.

“If you have waited a long time to get this appointment, I am really sorry,” Beshear said. “But I also don’t want to put you out on the roads with thick amounts of ice. . . . We will get you vaccinated.” He said the appointments will be automatically rescheduled no later than the following week. 

The University of Kentucky said it would keep close its vaccination site inside Kroger Field open, despite due to the weather, and encouraged people to keep their appointments if possible. UK also encouraged them to dress warmly since they may stand outside for a few minutes before checking in. (Updated 2/10)

Adam Mather, inspector general of the Cabinet for Health and Family Services, gave an update on vaccinations in long-term-care facilities. Under a federal contract, CVS Health and Walgreens manage that for all states but West Virginia, and are scheduled to offer three vaccine clinics in each facility. 

Mather said CVS has completed its second clinics in 88% of long-term-care facilities and 79% of assisted-living facilities. He said Walgreens is 28% into its third clinics in long-term care and 90% through second clinics in assisted living. 

He added that the state is also vaccinating Supports for Community Living residents, a program that helps 3,524 people with intellectual or developmental disabilities. He said more than 1,110 have received a shot from Walgreens, local health departments or other providers. 

Mather said the state is working on a program for health departments to vaccine seniors who live in lower-income congregate housing.

On Feb. 5, the Lexington Herald Leader reported that an estimated 45% of long-term-care employees have received the vaccine, compared to an estimated 73% of residents.

Marianne Lee Snowden was 29.

Memorial: Beshear honored Marianne Lee Snowden of Walton who died at age 29 on Jan. 14 at St. Elizabeth Medical Center in Florence from Covid-19 complications. Beshear said she was actively involved in NorthKey Community Care in Williamstown and also in the Special Olympics, where she loved cheerleading, running track, bowling and playing softball. 

“Marianne was sick for 11 days before she passed, begging to go home every day," Beshear said, quoting her mother: "If you don’t think Covid is bad, it’s worse than you think. My daughter passed away from it. Gone almost four weeks and I don’t know what to do with myself. Send prayers, wear your masks and keep your distance." Beshear said, "To the Snowdens, we are so sorry for your loss." 

In other coronavirus news Tuesday: 

• Today's fatalities were two men from Barren County, 89 and 91; two men from Boone County, 88 and 92; a Boyle County woman, 97; a Breckinridge County man, 84; a Fayette County man, 57; a Graves County man, 72; two Hardin County women, 75 and 89; two Hardin County men, 67 and 70; a Hopkins County woman, 68; a Hopkins County man, 75; 10 Jefferson County women, 58, 65, 70, 74, 75, 76, 77, 87, 92 and 94; six Jefferson County men, 74, 75, 76, 77, 86 and 93; a Kenton County woman, 95; a Larue County woman, 76; a Nelson County man, 68; a Washington County woman, 102; and a Washington County man, 61.
• Counties with 10 or more new cases were Jefferson, 396; Fayette, 116; Kenton, 115; Boone, 92; Madison, 82; Laurel and Warren, 66; Pulaski, 64; Hardin, 61; Daviess, 58; Campbell, 53; Nelson, 46; Pike, 45; Oldham, 42; Taylor, 38; McCreary, 33; Barren, 30; Bullitt, Russell and Scott, 28; Allen, 27; Grant and Knox, 25; Christian, 24; Henderson, 21; Caldwell, Hopkins, Jackson and Whitley, 20; Marshall and Shelby, 19; Clinton, Franklin and Marion, 18; Lawrence, 17; Mason, 16; Bell, 15; Boyd, Green and McCracken, 14; Clay and Grayson, 13; Jessamine, Livingston, Logan, Owen, Perry and Trigg, 12; Anderson, Graves and Wayne, 11; Floyd, Magoffin, Meade, Pendleton and Simpson, 10.
• In long-term care, there are 14 new cases among residents and 15 among staff; 303 active resident cases, and 204 active staff cases. The state attributed 12 more long-term-care residents' deaths to Covid-19, bringing that death toll to 2,205. 
• The British B117 variant of the virus has been identified in Jefferson County, WDRB reports. "Between that and Super Bowl and people tired of staying home, these numbers can change direction at any minute," Dr. Sarah Moyer, Louisville's chief health strategist, said at a news conference. She said the variant does not produce more severe outcomes, but is much more contagious, "so if before, if you would have infected one or two people if you had Covid, now it's a greater number, like four or six."
• Five weeks into the high-school basketball season and five to go before playoffs, WKYT reports that 16% of games were cancelled in the first week, increasing to 24%, 35% and 37% in subsequent weeks. In week 5, it was back down to 29%. KHSAA Commissioner Julian Tackett told WKYT  that "It's gone about as we expected" and that most cancellations were the result of quarantines following a positive test.
• As teachers' vaccinations begin to wrap up, new state guidance says Kentucky schools don't have to offer virtual work if teachers refuse a shot, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. The requirement to offer accommodations extends until the eligible employee is at least seven calendar days past getting their final vaccine dose, and will be offered to those who refuse the vaccine for medical reasons, Honeycutt reports. A spokeswoman for the Kentucky Department of Education told her that some schools may decide to let staff without medical exemptions who don't get vaccinated continue to work remotely.  
• UK is looking for 200 adult volunteers for a trial to test the efficacy of getting two shots of the Johnson & Johnson vaccine, instead of the currently recommended single dose.  Click here if you are interested in participating in the study. 
• Matt Mencarini reports for the Louisville Courier Journal on the challenges in Kentucky's prisons and jails that have been hit hard by the coronavirus. Medical experts told the paper that the best tools for them would be to provide vaccinations and to reduce their populations. Early in the pandemic, Kentucky reduced its inmate population, but at this time, inmates are not included in any priority list for vaccines. 
• Corinne Boyer of Ohio Valley ReSource reports on the challenges of staying in addiction treatment while staying safe from Covid-19.

As we queue up, or don't, for vaccines, West Kentucky columnist sees some of the Seven Deadly Sins but also a couple of virtues

Constance Alexander

By Constance Alexander

MURRAY, Ky. – Pride, covetousness, lust, anger, envy, sloth, scandal. That was how we memorized the Seven Deadly Sins at St. Francis School. Our source was the Baltimore Catechism, which the Sisters of Mercy used relentlessly as they drilled us in the finer points of our faith. The good nuns did such a thorough job that every girl could recite the no-no’s flawlessly. Today, thus indoctrinated, I still remember them, in order.

Amidst the general hubbub around Covid-19 vaccinations, those teachings have taken on new relevance. Many people want a shot; some even lust for one, but confusion reigns as they ponder their eligibility.

“Am I an a, b, or c?” they fret.

Suddenly we are catapulted back to elementary school, waiting to be chosen for the best team in volleyball and hoping not to end up the last one picked.

Uncertainty about the availability of the vaccines provokes anger, another flaw. So used to instant gratification – fast food, scratch-off lottery tickets, instant messaging – delays are infuriating. Those who venture onto Facebook discover who has been shot already, leading to the green-eyed monster, envy.

Upon learning that some have experienced the vaccination without being an a, b, or c, covetousness emerges, a white-hot, all-consuming desire for anything that will help fight Covid. These folks might be tempted to ingest bleach, try to score a dose of Regeneron, or even find a way to irradiate their bodies with UV light.

Those successfully inoculated sometimes succumb to pride. They puff up with a sense of accomplishment as they tell how it came to be that they learned there were vaccine doses in Mayfield or Hopkinsville or Paducah. Often scarce on the details, they mention a vial with just enough vaccine for another shot or two.

“There were some left-overs and I got a call. Don’t know who or how, but I jumped into the car and was there in ten minutes. I was just lucky, I guess. Luck of the draw,” they say,

Others are bogged down in sloth. Unable to exert themselves to do research and determine the particulars regarding the availability of Covid-19 shots, they cluster together on Facebook and other social media, complaining and trading misinformation.

A quick visit to Gov. Andy Beshear’s site would be a partial remedy for what ails most of us. The home page is packed with details and data, including a quick survey to determine whether you are an a, b, or c. With that, a visitor can access a map of locations where shots are to be given, including a recent addition — Murray’s own CFSB Center on the Murray State University campus. The County Health Department site also provides information about signing up, including a form that earns an individual a spot on the vaccine list.

While a plethora of information is available, there are glitches in the system, leaving many unanswered questions. My husband and I signed up online weeks ago, for example, but have no idea if, when we clicked “Submit,” that we were added to the database. After learning that shots would be administered locally, we signed up again, just in case. This time, an email confirmed the information had been received.

Meanwhile, as early as January 4, eleven top state legislators received Moderna shots, while working on legislation that would limit the governor’s decision-making in emergency situations associated with the pandemic. The law passed, was vetoed, and passed again. On Friday, however, Franklin Circuit Judge Phillip Shepherd issued a court order to temporarily block the law, saying it could create “chaos” and asking to hear more arguments.

In response, Senate President Robert Stivers, one of those lucky ones vaccinated way back in December, declared that he needed to review Shepherd's order to “better understand” his rationale.

This brings us to Dolly Parton, a woman whose mere presence has inspired visions of a deadly sin or two. She, who generously donated a million dollars to help fund the promising Moderna vaccine, is not giving up her shot, but virtuously waiting her turn.

“I’m going to get it, though,” she said Thursday. “I didn’t want to jump line. I didn’t donate the money so I could be protected. I did it for everybody.”

And that, dear readers, leads to the Seven Virtues: Faith, Hope, Charity, Fortitude, Justice, Temperance, and Prudence. For those in search of Covid shots, please pray for patience.

Additional information is available through a Covid hotline at 800-722-5725. A Facebook group, managed by Dr. Robert Hughes, also provides information and background.

Constance Alexander is a columnist, award-winning poet and playwright, and president of INTEXCommunications in Murray. She can be reached at constancealexander@twc.com. Or visit www.constancealexander.com. This was originally published by KyFoward.com.

As key metrics fall for 4th week in a row, Beshear says Ky. is still 'hot' due to strategy that kept hospitals from being overwhelmed

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

By Melissa Patrick

Kentucky Health News

For the first time in the pandemic, new cases of the novel coronavirus have dropped in Kentucky for four weeks in a row. Likewise, the state's positive-test rate has also declined for the last four weeks.

"The trends are all moving in the right direction, and that only happens from your hard work," Gov. Andy Beshear said at a news conference. "We have more people wearing masks, we have more people social distancing, we're having fewer large gatherings at homes or out in public; we must keep this up because we do not want to lose this progress."

Asked if that means that it's time to relax some of the remaining restrictions on business and other activities, Beshear said it's too early for that, but if these trends continue to hold, he would consider it. 

"If we continue on this trend, that's something that we hope to be able to do," he said. "Think about two different levels, the vaccine numbers going up and the cases going down, and if that continues to happen, then yes, we hope to do that."

He said it's important to pay attention to the new, highly contagious variants and case numbers "are still pretty elevated," but if those numbers continue to drop, "Then we'll see what we can loosen."

He cautioned that these positive trends could easily turn the other way: "Remember, it's fragile. If we let our guard down, everything changes. There are variants out there that appear to spread more aggressively. We're moving in the right direction, we've just got to keep it up."

Kentucky's downward trend hasn't been as rapid as in the rest of the nation, so it remains among the top states in new cases per person. Beshear said that's a result of Kentucky's strategy to stop exponential growth in cases, to "push that curve down," delaying cases into the future in order to avoid overwhelming the health-care system. He said some states have had a "big peak" of cases that have since fallen as quickly as they went up. 

"So we're burning off a little slower than other places did because we prevented that massive spike that would have overwhelmed our health-care system," he said. "That's at least what we think it is. Obviously, we're humbled and knowing that there are things we don't know about the virus, and it may take time for us to be able to look back and tell."

Daily numbers: Beshear announced 1,003 new cases of the virus on Monday, bringing the state's seven-day rolling average to 2,047. That's the lowest it's been since Dec. 29, when it was 2,031. 

Kentucky has 1,163 people hospitalized with Covid-19, the lowest since Nov. 9; 274 are in intensive care, the fewest since Nov. 3; and 142 of those are on ventilators, just two more than yesterday. 

The share of Kentuckians testing positive for the virus in the past seven days is 7.78%, the lowest since Nov. 10. 

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

Only 95 of the state's 120 counties are in the "red zone" for counties averaging 25 or more daily cases per 100,000 people over the last seven says. Beshear said it's not time to celebrate, but "let's just keep it up." 

The only trend not going down is deaths. Beshear reported 40 more Covid-19 deaths, 31 confirmed and nine probable after official reviews. He said most of them were from January and February, and one was from December. That brings the state's death toll to 4,091. 

Health Commissioner Steven Stack said about 10% of deaths have to go through a "very methodical process" to determine if Covid-19 contributed to them, and the process can take months. He said each death is reported in the state's daily records on the date the process is completed, but the date of death in the "historical record" remains the actual day that the death occurred.

In the last two weeks, the state has averaged 45.1 deaths per day, second only to the record 45.3 of Friday and Saturday. 

But even with such high death counts, Stack reminded Kentuckians that because "Team Kentucky pulled together and followed our guidance in so many ways," our death numbers are much lower overall than many other states, including some bordering the state.

Vaccines: Beshear said more than 460,000 Kentuckians, over 10% of the state's population, have received at least one dose of a coronavirus vaccine. He said the state has administered 91% of all of the first doses of vaccine that it has received.

Beshear encouraged Kentuckians who are eligible for vaccination to "keep trying" to make an appointment, noting that at this time the state is giving out vaccines faster than it is receiving them. Again, he called for patience, saying, "We can't give you a dose that we don't have."

Asked on KET about the shortage of vaccinations among employees of long-term-care facilities, Stack said the reluctance varies by geography, job description and other factors. He said efforts to get them comfortable and vaccinated "are going to have to escalate" as vaccine supplies increase.

Facebook "is expanding its ban on vaccine misinformation and highlighting official information about how and where to get Covid-19 vaccines," NPR reports.

Pfizer Inc. could cut its vaccine production time in half now that it has learned how to make the new messenger RNA vaccine more efficiently, USA Today reports.

Demographics: For the first time, Beshear shared demographic vaccine data, representing Kentuckians who have received a first dose. 

By far, Kentuckians 70 and older have received the most doses, 159,953 of them, followed by those 40-49 (66,073); 50-59 (65,183); 30-39 (57,619); 60-69 (54,949) and 16-29 (41,153).

People 70 and older, K-12 educators, first responders, and health-care workers continue to be the priority groups for vaccination. Nearly 75% of the state's Covid-related deaths are in those 70 and older. 

By far more women than men have received a first dose, 284,755 and 157,950 respectively, likely because teachers and healthcare workers, positions largely held by women, are top priority groups.  

The data also shows 336,318 of the first-time vaccines have gone to white Kentuckians and that 16,579, or only 4.3%, have gone to Black Kentuckians, who are about 8.5% of the population. Beshear said this disparity is "not acceptable" and his goal is to make sure that at least 8% of doses go to Blacks. About 1.1% of the vaccines where ethnicity is know have gone to Hispanics, who are nearly 4% of the population.

Stack said the state is committed to ensure equity of vaccinations. “We look forward to expanding that network and working to reach people who need access to this vaccine and require a little extra assistance for us to give it to them so they can have the same benefit as everyone else," he said.

Holladay with grandchildren

Memorial: Beshear honored the life of Roy "Doc" Holladay of Paducah, who died of Covid-19 at age 73. He is survived by his wife of 52 years, Martha Holladay; his daughter Heather and her husband Jim, who are friends of Beshear. He said Holladay was a master electrician who loved the outdoors and served in Germany with the Air Force. 

"We're thinking about this entire family, their loss, a loss in the community, and realizing that their grief is felt by more than four thousand families out there," he said, noting the statewide death toll. "But we all grieve with you and care about you. And we'll continue to do the best we can to make sure we don't lose any other Doc's because everybody is special and everybody is irreplaceable."

In other coronavirus news Monday: 

• The 40 fatalities were five Barren County women, 68, 70, 71, 82 and 82; two Barren County men, 55 and 73; a Boyd County woman, 76; three Butler County men, 70, 78 and 83; an Edmonson County woman, 68; a Fulton County man, 75; a Graves County woman, 94; a Hardin County woman, 44; a Hardin County man, 59; a Harrison County man, 63; two Hart County women, 69 and 94; a Hart County man, 82; a Hopkins County woman, 63; a LaRue County woman, 80; a Laurel County woman, 61; a Logan County woman, 73; a Marshall County woman, 69; a Meade County woman, 75; a Meade County man, 67; four Metcalfe County men, 63, 69, 71 and 78; a Russell County man, 77; a Scott County man, 49; a Simpson County woman, 68; two Simpson County men, 58 and 70; a Warren County woman, 68; two Warren County men, 69 and 85; and a Washington County man, 66.
• Counties with 10 or more new cases were Jefferson, 205; Fayette, 69; Warren, 38; Campbell, 30; Bullitt, 26; Kenton and Madison, 25; Boone, Daviess and Shelby, 24; Graves and McCracken, 20; Allen and Hardin, 18; Franklin and Oldham, 17; Marion and Marshall, 15; Calloway, 14; Barren, Boyd, Greenup, Livingston and Pike, 13; Floyd, Nelson and Whitley, 12; Bourbon, Jessamine and Trigg, 10.
• Two hospital-readiness regions have 80% or more of their ICU beds filled: the northeast region, at 81%; and Lake Cumberland, which has been running near full capacity, at 80%. 
• In long-term care, 332 residents and 235 staff have an active case of the virus, with 19 new residents and 20 new staff testing positive for the virus today. Beshear said 10 more deaths can be attributed to Covid-19, bringing the total number of deaths in these facilities to 2,193
• WDRB tells the story of how Louisville nurses are working to build trust for the coronavirus vaccine among Black communities in Louisville and in a separate story about the urgent call for a mass vaccination site in west Louisville.

Tired of wearing a mask? Keeping your distance? Washing your hands? How to keep it up as a more contagious virus threatens

By Dr. Diana Heiman
Family and Community Medicine, University of Kentucky

Covid-19 restriction fatigue and mask fatigue are real. We likely are all at the point where we are tired of wearing masks and not being able to visit family, eat out in restaurants and socialize the way we are used to. So, why is it important to address this fatigue?

Photo by JNemchinova, iStock/Getty Images

Covid-19 is still out there and the variant from the United Kingdom has been identified in Kentucky. This variant is significantly more contagious than the original virus. Because it is more easily spread, it is predicted that this variant will lead to most new Covid infections by the end of March.

Fatigue for mask-wearing, physical distancing and handwashing can lead to carelessness in performing these activities. This can then lead to an increased spread of infection, and possibly hospitalization and death. It will take many months to vaccinate enough people across the U.S. and world to gain the herd immunity that is needed to be able to stop community spread of the virus.

You may ask, how do I decrease this fatigue and make sure I’m staying safe?

First would be to identify your fatigue-like behaviors. The more aware you are of this negative approach could impact you, the more good choices you could make in the future.

Second, make sure you remain connected to family and friends. Take time to call, email, text, FaceTime or Zoom with them. Focus on being physically distant, not socially. Maintaining connections with those who support you is crucial. Being able to communicate, vent, socialize, or whatever is important to you, can make the difference in reducing restriction fatigue.

Third, avoid negativity and focus on positive things. Spend some time each day thinking about three good things that happened that day It could be as simple as hearing a funny joke that makes you laugh, hearing from a friend or reading a good book. Reflecting on those things at the end of the day can make a huge difference in your mood and ability to refocus. It will help to create a more positive outlook overall. Since we tend to focus more on the negative things that happen, using this simple technique can lead to an improved mood the next day, and on and on.

Finally, try to think about things you can change and not the things you can’t. You can control your risk by wearing your mask, staying at least 6 feet from others and washing your hands frequently. You can’t change the behavior of others, and getting frustrated by what they do or don’t do will only increase your fatigue. Focus on yourself, stay positive and continue to be safe.

Moral distress, the inability to do what's right, plagues health-care workers in pandemic; first step to fight it may be talking about it

By Abigail Latimer

Since last spring, news-media headlines have been inundated with stories describing the scary circumstances facing medical workers in hospitals and facilities across the nation. Medical workers have been praised as heroes and regarded as the backbone of fighting this pandemic. We have heard stories of 80-hour-plus work weeks, with physical and mental exhaustion, and many of them contracting Covid-19, sometimes fatally.

The long-term consequences of their work in the pandemic is not yet known. Recently, as another Covid-19 surge overwhelmed some hospitals in other states and triggered restrictions again, we heard cries of burnout and hypothetical phrases like, “You think Covid is bad, wait till you don’t have an ICU nurse.” And they’re not wrong.

Some may be familiar with the concept of burnout — the point at which a helping professional has reached maximum capacity to be able to care compassionately while still preserving some trace amounts of sanity and emotional reserve. But what we’re not talking about is the devastating consequences that something called “moral distress” is causing and will likely cause long-term. 

Moral distress is the immediate and lingering reaction that health-care professionals have when they cannot do what they feel is ethically and morally right to do. Moral distress can cause psychological, emotional, and physical pain and consistently contributes to why professionals quit their professions.

Moral distress is not a new concept in health care, but is likely exacerbated by the pandemic. Examples of moral distress could be when there is not enough personal protective equipment or staff to care for a patient, or a medical worker cannot alleviate suffering at the end of life. Feelings like powerlessness, anger, worry, and guilt wreak havoc as so many helping professionals tie their identity to their professional identity; it’s who they are: "If I cannot do my job as I am professionally obligated to do, what does that say about me?" These reactions occur despite many of the situations being out of their control.

We do not yet know how to alleviate moral distress without addressing the sociopolitical and environmental factors that contribute to its presence in the first place. For some, talking with other people and naming their distress has been helpful. For others, distraction and avoidance to get through it seem like the best thing to do.

Treatment for moral injury, a similar concept rooted in military service, tells us that acceptance and forgiveness may help lessen the impacts of accumulating moral distress. But accepting difficult and distressing thoughts and feelings, and then forgiving ourselves or others, are not easy tasks. They are especially challenging when so many of these circumstances could be avoided by the actions of others. But latching on to blame and anger has typically only worsened distressing feelings, as natural and expected as these feelings may be.

Although there are no easy answers or quick fixes to a complicated problem, talking about it may be a start.

Abigail Latimer is a licensed clinical social worker and a Ph.D. candidate in the University of Kentucky College of Social Work, researching moral distress in health-care professionals and advanced illnesses in older adults. This was first published in the Lexington Herald-Leader.

Pandemic keeps waning, but Ky. new-case rate ranks 6th; positive test rate falls under 8%; hospital numbers best in nearly 2 months

Screenshot of New York Times interactive map (available here), with line about Kentucky added.

By Al Cross
Kentucky Health News

Every major measure of the pandemic in Kentucky declined Sunday, from new cases to hospital figures to deaths.

It was the end of the state's Monday-to-Sunday reporting week, which was the fourth straight week with fewer cases, Gov. Andy Beshear said on social media.

Final numbers will be reported Monday, but there were a total 14,949 cases on the state's initial, unadjusted, daily reports. That was almost as low as the week that ended Dec. 27, just before a post-holiday surge.

The seven-day rolling average of new cases is 2,136 per day. It has declined every day but four since reaching a high of 4,002 on Jan. 10.

But new cases are declining nationwide, so Kentucky remained among the top states in new cases per person, ranking sixth in a New York Times compilation. It was fifth on Saturday. The list is led by South Carolina, followed by Arkansas, North Carolina, Oklahoma and Texas.

Another sign of a waning pandemic was the percentage of Kentuckians testing positive for the novel coronavirus in the last seven days: 7.97%, the first time it has been below 8% since Nov. 10.

The state recorded 31 more deaths from the virus's Covid-19 disease, 29 confirmed and two probable. Deaths are listed after a review process that can take weeks. The two-week average stands at 45 per day, just below the record 45.3 average of Friday and Saturday.

 

Kentucky hospitals reported 1,235 Covid-19 patients, 290 of them in intensive-care units, and 140 ICU patients on ventilators. All those figures were the fewest since Nov. 10.

Three of the 10 hospital-readiness regions reported their ICU beds more than 80% full, but two just barely. The east and northeast were at 81% and Lake Cumberland, usually the fullest, was at 93%.

The state's case-incidence rate fell again, to 41.9 per 100,000 population in the last seven days. Counties above 60 on the state's daily report were Allen, 83.1; Webster, 76.2; Butler, 72.1; Washington, 72; Daviess, 71.9; Madison, 67.9; McCreary, 63.8; Nelson, 61.2; and Ohio, 60.7.

Counties with 10 or more new cases Sunday were Jefferson, 245; Fayette, 130; Kenton, 84; Daviess, 70; Boone, 65; Madison, 37; Hardin, 36; Warren, 36; Jessamine, 30; Nelson, 29; McCracken, 27; Ohio, 27; Shelby, 26; Boyd, 24; Campbell, 23; Barren, 22; Bullitt, 20; Scott, 20; Henderson, Logan and Muhlenberg, 18; Christian, 17; Clay and Laurel, 16; Grant, 15; Graves, Grayson and Trigg, 14; Caldwell and Hopkins, 13; Floyd, Greenup, Hart and Oldham, 12; Bell, Harrison, Marion, Rowan and Wayne, 11; and Boyle, 10.

In other coronavirus news Sunday:

• The Russell County Detention Center stopped accepting new inmates after 22 tested positive for the virus and several others were exposed, WJRS Radio reports. Tests were conducted after two inmates who had been released to halfway houses tested positive, Jailer Bobby Dunbar said.
• In state prisons, case counts were down from last week, according to the Corrections Department report last updated Friday. The Eastern Kentucky Correctional Complex in West Liberty remained the main trouble spot, with 113 active cases among inmates and 13 among employees.

Covid-19 death toll in Ky. passes 4,000, and death trend remains at peak; new cases keep falling, but this week's rank is 5th in U.S.

Kentucky Health News chart; dates are those on which deaths were listed after state reviews.

By Al Cross

Kentucky Health News

The pandemic's death toll in Kentucky passed 4,000 Saturday, as the state listed 49 more deaths attributable to Covid-19. Eight of the deaths were listed as probable and 41 were confirmed.

The death toll is 4,020, 360 of which are listed as probable and 3,660 are confirmed by a panel of experts that reviews each case. The toll passed 3,000 just 23 days ago, showing of deaths have increased lately.

Saturday's deaths kept the state's 14-day rolling average at 45.3 deaths per day, the highest of the pandemic. The seven-day average is 43.7.

Kentucky's Covid-19 death rate in the last seven days is 25th among the states, at 0.76 per 100,000 residents, according to a compilation by The New York Times. Alabama is first, at 2.57, and Tennessee is second, at 1.95. All other states bordering Kentucky except one, Missouri at 0.88, have lower rates: West Virginia, 0.75;  Ohio, 0.61; Virginia, 0.59; Indiana, 0.53; and Illinois, 0.51.

Residents of long-term-care facilities have accounted for 56.6 percent of Covid-19 deaths in Kentucky, while being only 11.7% of the cases. People 70 and older have made up 75% of the state's Covid-19 fatalities, putting them in current priority for vaccination against the novel coronavirus.

As usual on a weekend, the state did not release details of the recently listed fatalities, but its daily report lists total deaths by county and percentage of the state's total. The top 20 are Jefferson, 727 (18.1%); Fayette, 199 (5%); Daviess, 150 (3.7%); Hopkins, 116 (2.9%); Warren, 112 (2.8%); Kenton, 110 (2.7%); Hardin, 78 (1.9%); Christian, 71 (1.8%); Pulaski, 70 (1.7%); Oldham, 68 (1.7%); Boone, 66 (1.6%); Graves, 66 (1.6%); Madison, 63 (1.6%); McCracken, 60 (1.5%); Harlan, 56 (1.4%)' Henderson, 55 (1.4%); Pike, 51 (1.3%); Adair, 49 (1.2%); Jessamine, 48 (1.2%); and Logan, 46 (1.1%).

The state reported 1,998 more cases of the virus Saturday, lowering its seven-day rolling average to 2,169, the lowest since Dec. 30. However, new-case numbers in other states have been declining, and The New York Times says Kentucky ranks fifth in new cases over the past seven days, at 52 per 100,000. South Carolina ranks first, at 68 per 100,000, followed by Arkansas, Oklahoma and Texas.

Other measures of the pandemic in Kentucky continued to improve. Hospitals reported 1,294 Covid-19 patients, the fewest since Nov. 12. Of those, 318 were in intensive care and 164 were on ventilators. The figures reflected usual trends: about a fourth of Covid-19 patients are in intensive care, and about half of those are ventilated.

The percentage of Kentuckians testing positive for the virus in the last seven days is 8.07%, the lowest since Dec. 27. It has declined pretty steadily since hitting a high of 12.45% on Jan. 10.

The counties with the top 20 rates of new cases in the last seven days are Allen, 81.8 per 100,000 residents; McCreary, 73.8; Webster, 72.9; Washington, 72; Butler, 71; Daviess, 69.5; Madison, 69.3; Caldwell, 68.4; Taylor, 66; Metcalfe, 65.3; Edmonson, 64.7; Nelson, 62.7; Floyd, 57.4; Anderson, 56.5; Whitley, 54.8; LaRue, 54.6; Grant, 54.1; Knox, 54.1; Monroe, 53.7; and Laurel, 52.9. The statewide rate is 42.3 per 100,000.

Counties with 10 or more new cases Saturday were: Jefferson, 299; Fayette, 148; Kenton, 89; Boone, 82; Laurel, 54; Warren, 54; Pike, 51; Allen, 47; Campbell, 46; Pulaski, 43; Christian, 40; Jessamine, 39; McCreary, 35; Henderson, 34; Daviess, 33; Madison, 29; Franklin, 28; Barren, 26; Taylor, 25; Scott, 23; Boyd, Greenup and Russell, 22; Hardin, 21; Floyd and Oldham, 20; Whitley, 18; Mason and Montgomery, 17; Anderson, 16; Bullitt, Clark, Clinton, Letcher and Nelson, 15; Grayson, Perry and Wayne, 14; Lawrence and Rowan, 13; Adair, Bell, Carter, Casey, Knox, McCracken, Meade and Shelby, 12; Boyle, Marshall and Mercer, 11; and Graves, Hopkins and Trimble, 10.

In other coronavirus news Saturday:

• Only 45% of the employees at long-term care facilities in Kentucky had been vaccinated for the virus as of Feb. 1, according to data from CVS Health and Walgreens, which are handling vaccinations at the facilities. Betsy Johnson, director of the Kentucky Association for Health Care Facilities and the Kentucky Center for Assisted Living, told the Lexington Herald-Leader, that persuading staffers to get the shots “is a day-to-day struggle with day-to-day goal setting,” due to their distrust of government and misinformation about vaccines.
  
  

Ky. Covid-19 death trend at new high; new cases keep falling but 7-day average is 7th in U.S.; positive-test percentage falls again

New York Times chart, labeled by Kentucky Health News; it is updated daily on the Times site.

By Al Cross
Kentucky Health News

Kentucky's Covid-19 death trend reached a new high Friday, but the percentage of Kentuckians testing positive for the novel coronavirus dropped to a level not seen for five and a half weeks. Meanwhile, the number of daily new cases kept falling but remained one of the highest in the nation.

State officials listed 50 more deaths from the disease, 43 confirmed and seven probable, raising Kentucky's death toll to 3,971.

The daily death count was the third highest of the pandemic, but daily figures are for deaths that are listed after case reviews that can take weeks. A better measure is the 14-day rolling average of deaths, which reached 45.3, the highest yet. Nationally, daily deaths topped 5,000 for the first time.

The state reported 2,261 new cases of the coronavirus, lowering its seven-day rolling average to 2,262, the lowest since Dec. 30. However, most other states' new-case numbers have also been declining, so Kentucky's average was the seventh highest in the country, according to The New York Times. The state's seven-day death average ranked 23rd.

In a press release, Gov. Andy Beshear reminded Kentuckians to keep their Super Bowl gatherings small and safe.

“No matter who you’re rooting for on Sunday, let’s make sure we hold on to our progress against this virus as Team Kentucky,” he said. “We’ve already vaccinated 10% of our population and every day we get closer to the finish line we’ve all been waiting for. Hang in there and do what it takes to protect each other a little bit longer.”

Hospital measures of the pandemic declined. Kentucky hospitals reported 1,318 Covid-19 patients, the fewest since Nov. 12; 330 of those were in intensive care and 167 of those were on ventilators.

Only two hospital-readiness regions reported more than 80 percent of their intensive-care beds full: Lake Cumberland, 95.6%, and the easternmost region, from Lee to Pike counties, 85.3%.

The 50 additional fatalities were an Allen County woman, 87; an Anderson County woman, 74, a Bath County man, 57; a Boone County man, 64; two Campbell County men, 72 and 90; a Casey County woman, 63; a Clay County man, 76; a Daviess County woman, 69; three Fayette County men, 76, 88 and 94; a Grayson County woman, 88; a Hardin County woman, 78; two Hardin County men, 59 and 88; five Jefferson County women, 55, 61, 72, 81 and 87; five Jefferson County men, 52, 62, 62, 65 and 70; three Kenton County women, 68, 75 and 76; a Kenton County man, 71; a Knott County woman, 85; a LaRue County man, 65; two Letcher County women, 76 and 88; a Letcher County man, 84; a Lincoln County man, 92; a McLean County man, 68; a Marshall County woman, 87; a Meade County woman, 64; a Menifee County woman, 86; two Nelson County men, 49 and 66; an Ohio County woman, 82; two Perry County women, 79 and 89; a Pike County man, 89; a Pulaski County man, 63; a Robertson County man, 82; a Rowan County woman, 58; and a Shelby County man, 78.

Counties with 10 or more new cases were: Jefferson, 394; Fayette, 135; Boone, 115; Kenton, 112; Daviess, 68; Campbell, 64; Warren, 64; Pulaski, 54; Christian, 53; Hardin, 52; Webster, 45; Laurel, 43; Nelson, 39; Graves, 34; Bullitt, 31; Jessamine, 31; McCracken, 30; Scott, 30; Madison, 29; Grant, 26; Floyd, Franklin, Henderson and Oldham, 24; Hopkins and Pike, 22; Anderson and Barren, 21; Clark, 20; Boyd and Whitley, 17; Knox, Marshall and Ohio, 16; Bell, Greenup, Mason, Shelby and Woodford, 15; Allen, Johnson and Logan, 14; Clay, Marion, Meade and Taylor, 13; Muhlenberg and Russell, 12; Perry, 11; and Calloway, Hart, Mercer, Montgomery and Morgan, 10.

In other coronavirus news Friday:

• Black Kentuckians' share of coronavirus cases and deaths continued to decline, according to the state's daily report. They are 8.5% of cases, equal to their share of the state's population, and 8.6% of deaths. Early in the pandemic, those rates were double or almost double the population percentage.
• After years of declining drug-overdose deaths in Fayette County, it had more than ever last year, the Lexington Herald-Leader reports. That reflects the preliminary report from the state drug-policy director that when the cases are reviewed and compiled, 2020 will be a record year for overdoses in Kentucky. Jeremy Chisenall, citing substance-abuse official Amy Baker, reports: "Restrictions put in place to stop the spread of the coronavirus meant many face-to-face support meetings and other therapies were stopped or curtailed."
• In rate cases, the state Public Service Commission is ordering utilities to drop surcharges for late payment of bills, saying they have “no material effect on the percentage of customers paying on time,” by freshman Rep. Josh Bray, R-Mt. Vernon, has a bill to let them charge the fees no matter what the PSC says, John Cheves reports for the Herald-Leader.