So how close is Ky. coming to benchmarks needed to reopen? It's hard to tell, but Beshear says he will discuss possible dates Mon.

Gov. Andy Beshear says he is following benchmarks "to guide his decisions about re-opening Kentucky’s economy during the covid-19 pandemic, but figuring out how to measure the state’s progress has been difficult," reports Lexington Herald-Leader political writer Daniel Desrochers. "The Democratic governor and his administration have provided scant information about how it is defining and tracking each indicator."

Beshear said at his daily briefing Sunday that he would talk Monday about possible dates for reopenings, but "It's gonna be a fluid situation."

The seven benchmarks, Desrochers writes, "really boil down to four things: how many people are getting sick from the coronavirus, how many people can be tested for the virus, how many people are available to trace the contacts of infected people, and how much personal protective equipment is available to those who need it."

The benchmarks follow guidelines recently issued by the White House and the federal Centers for Disease Control and Prevention, one of which is "Downward trajectory of documented cases within a 14-day period." Beshear said Saturday that doesn't mean the number of cases has to decline each day; he previously spoke of looking at three-day averages, noting that the numbers can vary depending on lab reports, especially on and around weekends.

Lexington Herald-Leader chart shows 12 days of metrics Gov. Andy Beshear says he is watching.

The next CDC criterion is "Downward trajectory of positive tests as a percent of total tests within a 14-day period." Desrochers reports, "That number increased steadily from April 12 to April 21, from 7.59 percent to 9.58 percent, before dropping significantly to 8.12 percent on Thursday, when the number of people tested jumped by more than 6,700. It rose to 8.4 percent on Friday. Of those tested over a recent six-day period (April 18-23), 7.2 percent tested positive."

Increased testing is generally considered the most important hurdle, "so people can be reassured that the guy next to them at work or in the restaurant is not infected," as U.S. Sen. Mitch McConnell told Bill Bryant of Lexington's WKYT-TV in an interview broadcast Sunday.

The CDC guidelines say states should not reopen until they have "Ability to quickly set up safe and efficient screening and testing sites for symptomatic individuals and trace contacts" of those who test positive, and also test to screen "for asymptomatic cases and contacts."

Kentucky has tested a smaller percentage of its population than only eight other states; 11 states have found fewer cases. "Since April 13, the state has averaged 1,591 new tests a day, but that is well shy of the 9,000 to 13,000 people the state hopes to be able to test in a single day," Desrochers reports. "It’s not known how quickly the state might be able to reach that goal, or if re-opening the economy would be halted if the state falls short."

Beshear said Friday that he hopes for 20,000 tests this week, but his hopes for testing in previous fell short, so some sites were opened to people without symptoms.

Tracing the contacts of people who test positive will require 700 new employees, Beshear said Friday.

The next CDC guideline is the ability of health-care providers "to quickly and independently supply sufficient personal protective equipment and critical medical equipment," and stockpile enough for a resurgence of cases as social-distancing rules are relaxed. That remains a big problem for Kentucky.

The state's PPE supply "significantly increased between April 14 and April 21, but it’s not clear how long that supply is expected to last or how much state health officials think they should have on hand," Desrchers reports. "Beshear said Friday that the state could probably help provide hospitals and nursing homes experiencing critical shortages of PPE for a month, maybe less."

Beshear vetoes anti-abortion bill; legislature can't override

Gov. Andy Beshear and Attorney General Daniel Cameron, on
the day Beshear appointed Cameron to fill his unexpired term.
Both were elected Nov. 5, but governors take office earlier.

Gov. Andy Beshear has vetoed a bill that would have required health-care providers to give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion.

Senate Bill 9 would have also expanded the power of the attorney general to shut down abortion providers and keep abortion from being allowed as an urgent procedure under Beshear's emergency orders in the coronavirus pandemic.

Attorney General Daniel Cameron and other Republicans had said abortion should be considered an elective procedure; Democrats noted that state law bans most abortions after the 20th week of pregnancy.

Cameron called the veto “reprehensible” and “an affront to the people of Kentucky.” House Speaker David Osborne said, “The governor had a choice and he used it to defend the indefensible.”

The Republican-controlled General Assembly will not be able to override the Democratic governor's veto, because it passed the bill on the day it had to adjourn, April 15.

Beshear said in his April 24 veto message that "existing Kentucky law already fully protects children from being denied life-saving medical care and treatment when they are born. In addition, bills similar to Senate Bill 9 have been struck down as unconstitutional in the majority of states in America when challenged. During this worldwide health pandemic, it is simply not the time for a divisive set of lawsuits that reduce our unity and our focus on defeating the novel coronavirus and restarting our economy."

Beshear did not mention the other aspects of the bill in his veto message. Asked about the veto at his daily briefing April 25, he summarized the message and said, "I'm just not doing divisive issues right now. . . . We’ve gotta have unity in this commonwealth."

Cameron said there’s nothing more divisive than to veto a bill that “protects our most vulnerable.” Some of the protesters who came to the Capitol grounds Saturday to protest against Beshear's emergency restrictions carried anti-abortion signs.

"Beshear supports abortion rights but backs 'reasonable restrictions,' especially on late-term procedures," notes Bruce Schreiner of The Associated Press. "Abortion-rights groups, including Planned Parenthood Advocates of Indiana and Kentucky and the American Civil Liberties Union of Kentucky, praised the governor’s veto. They had denounced the legislation as a 'power grab' meant to make it harder for women to obtain abortions."

Dentists and state officials scramble to set rules for reopening dental offices; Beshear says they won't reopen Monday, but soon

About 15 motorists, most honking their horns, circled the Capitol about 15 minutes before Gov. Andy Beshear's briefing, conducted in the white-curtained room at the building's southeast corner. State police have restricted access to the area near the room, but provided an area for protesters to park. The yellow sign says "The cure is worse than the virus;" the white one says "Gov. Andy, you lied; every life matters," apparently referring to Beshear's veto of a bill that would have required medical care for a baby born alive after an attempted abortion. He said existing law provides full protection in such cases.

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

By Al Cross
Kentucky Health News

Gov. Andy Beshear said Saturday that dentists' offices won't be able to open Monday because they and state officials haven't agreed on rules for it, but suggested that other businesses might reopen on a regional basis.

Beshear had planned to allow reopening of medical, dental and other health-care providers Monday, but said “Dentists aren’t gonna be ready to reopen on Monday because there isn’t agreed-upon guidance. . . . We have to make sure were doing it right, given how those oral secretions happen in a dentist’s office.”

He said in response to a question at his 5 p.m. briefing, “Before a dentist’s office can reopen we need agreed-upon rules. . . . “We think that the guidelines will come together fairly quickly.” He said they will leave “some risk, but we believe we will have mitigated that risk.”

Sharon Turner, secretary-treasurer of the Kentucky Dental Association, said in an email at 7 p.m. that KDA, the Kentucky Board of Dentistry, the Kentucky Dental Hygenists Association and the Kentucky Oral Health Coalition "all agreed on a plan today. It will be filed later today."

She said acceptance of the plan is still up to Health Commissioner Steven Stack, "but we worked with the state director of public health dentistry, Dr. Julie McKee. We tried to address each bullet point that Stack provides in terms of his concerns needing to be addressed. We have scientific evidence behind recommendations."

Turner said in a telephone interview that KDA cited research from the University of Washington about what sort of personal protective equipment is appropriate for the wide range of procedures that dentists, hygenists and oral surgeons perform. She said rubber mouth dams, which neither providers or patients like, are likely to be used more, as well as high-powered suction.

She said some dentists may not be ready to reopen, or may want to test patients for the coronavirus before treating them, and the proposed plan allows room for professional judgment. "We hope it'll be accepted," she said. "If it's not, it will only be around what's enhanced aerosol protection." The virus travels on droplets that are so tiny they remain suspended in the air.

Turner, former dental dean at the University of Kentucky, added that KDA "heard about the need for the filing of the plan Thursday evening," when Stack issued a call for help during Beshear's briefing. "I think we have done a remarkable job of getting consensus from a large group of divergent stakeholders pretty darn quick."

On Friday, Beshear dismissed the idea that other relaxation of social-distancing rules could occur on a county-by-county basis, as some officials in Clark and Jessamine counties requested. Saturday, he opened the door to the possibility of regional differences, but remained cautious.

Asked about those requests, he said, "If a county makes the wrong decision and causes an outbreak, that sets the whole state back." Then he added that there could come a time when reopenings could be done by region, but “It’ll still have to have a lot of thought.”

At the start and end of his daily briefing, Beshear kept urging Kentuckians to stick with his emergency restrictions.

“Today, I'm tired, just like I know so many of you are, but every day we’ve got to bring it,” he said at the start. “We have to be strong, we have to be patient, we have to be resilient.” At the end, he said, “Let’s not be the generation that got halfway through meeting covid-19 and then just decided it was gonna be too hard. . . . There is hope, there is light, but we gotta do it the right way; we have sacrificed too much … to not finish it out the right way.”

Some protesters returned to the Capitol to protest restrictions, circling the Capitol and honking their horns before the briefing, and chanting during it. Without referring to them directly, Beshear said, “We might have some out there that are anxious but I believe we are more united than we have ever been.”

In other covid-19 news Saturday:

• The governor reported 171 new coronavirus infections in Kentucky, for a corrected total of 3,905. The number was lower than the previous two days; he said that could be a result of some labs not reporting on Saturdays, “but we still think we are plateaued, or we’re somewhere in the very top part of that curve.” He said the state “could be potentially starting our decline” needed for major reopenings, but several more days would be needed to confirm that.
• Beshear corrected some news-media reports that major reopenings can't occur unless the number of new cases decline every day for 14 days. “We just have to have a declining rate for 14 days; one day we may have a little more,” he said.
• The number of deaths reported daily declined for the third day, to five, and Beshear said he thought all were “in senior-living settings.” They were an Adair County woman, 79; a Graves County woman, 92; and three Jefferson County women, 87, 88 and 93. He said 17 percent of the deaths have been of African Americans, twice their percentage of the state's population.
• Counties with more than five new cases were Jefferson, 33; Graves, 20; Warren, 19; and Fayette, 9.
• Long-term-care facilities added 24 residents and five employees to the list of those testing positive, for a total of 602 and 273, respectively. Of the 205 covid-19 deaths in Kentucky, 94, or 46 percent, have been in such facilities. The state is issuing a daily report on each facility with a case.
• Beshear cited the number of cases in Warren County as he announced that a planned three days of testing next week at South Warren High School would be expanded to four days and the following week. He said labs have processed 46,558 tests, and “Our testing capacity is significantly increased; we need to do a lot more.”
• Of the approximately 3,900 Kentuckians who have been identified as having the virus, 1,266 have been hospitalized, and 301 remain so, Beshear said; 605 have been in intensive care and 164 still are; and 1,501 have recovered.
  
  Read more here: https://www.kentucky.com/news/coronavirus/article242296216.html#storylink=cpy
• After some recovered patients retested positive, a three-county health department has adopted a stricter definition for being free of the virus. The Wedco District Health Department, which serves Harrison, Nicholas and Scott counties, said 41 people thought to be recovered were retested and 11 tested positive for the virus. Now the department considers patients to be recovered and able to stop quarantine only after they have tested negative and have had the disease for at least 14 days, with seven of those days symptom-free, including at least three without fever. "The decision is crucial to determining who no longer quarantines to prevent spreading the virus, Rick Childress reports for the Lexington Herald-Leader. "There is no indication other counties are following Wedco’s lead." Harrison County had Kentucky's first covid-19 case.
• Emergency-room use at the University of Kentucky hospital has dropped by more than half in the last month, UK officials said. The likeliest explanation? "People are avoiding hospitals — even when they really need to go — because they’re scared of catching the novel coronavirus from patients who are infected, John Cheves of the Herald-Leader reports. "Similar no-show stories are being repeated at hospital emergency rooms around the country, worrying doctors who say people could be putting their lives at risk by not seeking health care right away for serious ailments."

Testing for virus will continue ramping up as May approaches

Cars lined up for testing at Shelby Valley High School south of Pikeville Thursday.

Testing for the coronavirus in Kentucky will be more extensive than ever during the last week of April. Gov. Andy Beshear highlighted 11 sites in which the state has a role, and that doesn't include hospitals and other facilities that are also doing tests.

The third full week of April saw testing reach an apparent new high, as four Kroger-sponsored locations in McCracken, Hopkins, Pulaski and Pike counties did 3,227 tests. The latter location came closest to meeting each site's goal of 1,000, with 942. Beshear said 535 of the test were done Thursday, well above the daily average goal of 333; he said staff stayed until almost 10 p.m. and didn't eat until 11.

"As we move toward the new normal we need to do better and better," Beshear said at his daily briefing. He outlined the 11 drive-through testing locations, "all a little different," that the state Department for Public Health is working with:

Screenshot of slide of testing locations, displayed by Beshear at his Friday briefing

Kroger-sponsored locations in Louisville, Lexington and Bowling Green (South Warren High School) April 28-30 are "fully booked," and the Owensboro Community and Technical College site "has limited availability," on April 30, Beshear said Friday. But on Saturday, he announced that the Bowling Green site would also be open Friday, May 1, and the following week.

The Louisville and Lexington sites will also operate during the first week of May. All will test anyone who makes an appointment; sign up at KrogerHealth.com/covidtesting after 5 p.m. Wednesay, April 29.

Another Louisville site, at the Walmart at 2020 Bashford Manor Lane, will open April 29 and run from 9 a.m. to 4 p.m. each day "until they run out of capacity," Beshear said. It will be open to first responders and health-care workers, and adults with symptoms of covid-19. The site will also dispense masks and sanitizer. Make appointments at DoIneedaCovid19test.com.

Beshear said Walmart "reached out to us" and they chose a site near the predominantly African American neighborhood of Newburg "to make sure we were serving those that are disproportionately impacted and make sure nobody is left out or overlooked." The same is true of the other Louisville site, Shawnee Park, and the Lexington location on Newtown Pike.

Lexington will have another location, on Executive Drive operated by Walgreens, with the same criteria as Walmart. Sign up at Walgreens.com/coronavirus.

The state and Christian County health departments are testing from 9 to 11 a.m. Monday through Friday at Tiebreaker Park in Hopkinsville. The Murray-Calloway County Hospital is testing from 9 a.m. to 5:30 p.m. Monday through Friday. Both are open to health-care workers, first responders and anyone with symptoms.

The Trigg County Primary Care Clinic in Cadiz is testing anyone over 5 months old from 9 a.m. to 4:30 p.m. Monday through Friday.

In Hazard, Primary Care Centers of Eastern Kentucky will test anyone from 8 a.m. to 6 p.m. Monday and Tuesday, April 27-28, and Rockcastle Regional Hospital in Mount Vernon will do likewise Monday through Friday; it requires registration at 606-256-7385.

"That is a significant expanded capacity," Beshear said after going over the list of 11 sites. "Let's make sure we utilize it."

Most cases in one day, but Beshear cites testing and still sees a plateau; releases 352 inmates in jails; 2nd prison death reported

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

By Al Cross
Kentucky Health News

As Kentucky reported the most coronavirus cases in a single day, its main challenges were in institutions: prisons, jails and long-term-care facilities.

Gov. Andy Beshear announced 322 new cases, for a corrected total of 3,779, and nine more deaths, for a total of 200, but said he still believes the state is "still generally plateaued" because more cases are being found by more testing, which is more extensive than ever.

He said there had been five more deaths in long-term-care facilities, for a total of 91, and a second death at the Green River Correctional Complex in Central City. He said he had ordered that each of the 900 inmates be tested; eight more were reported positive for the virus yesterday, for a total of 60; two more staffers were, for a total of 20.

Justice Secretary Mary Noble said in a video report that the prison undergoes multiple bleach cleanings daily, officers' shoes are sanitized when they arrive; masks are required; and officers are required to wear gloves and be checked for temperature and symptoms. She said inmates can have no visitors; spend most of the day in their cells, where they get medical attention; and are allowed out in small groups. Quarantine is imposed on those who show symptoms, and those with whom they have had close contact. An inmate who tests positive is contained in his cell, and is sent to the hospital if needed.

Many state prisoners are housed in county jails. Beshear said he has commuted the sentences of 352 such inmates, using the same criteria he used to release about 750 from state prisons: 339 non-violent and non-sexual offenders who are near the end of their sentences and at elevated risk for covid-19; and 13 who are over 65. He said their release is conditional: They can’t have covid-19; they must have a residence where they can quarantine for 14 days; and can't commit any crimes in their period of release.

River's Bend Retirement Community in Kuttawa, one of
the first with an outbreak, said one of its residents, Lucy
Goodwin, had recovered, and Beshear showed this slide.

Beshear said 61 of the state's approximately 280 long-term-care facilities have had residents or employees test positive for the virus, with 48 more residents and 17 employees added to the list Friday. Two facilities have reported 13 deaths each: Rosedale Green in Kenton County and Ridgewood Terrace in Hopkins County, which reported a death Friday.

Asked about that facility, Beshear said it has had 56 cases among residents and 16 among staff, after all were tested. "It doesn't mean anybody has necessarily done something wrong," he said. The state has sent certified nurse assistants and medical students to the facility to help, he said.

Even as restrictions are eased elsewhere in the coming months, “Visitation is going to be extremely, extremely restricted” at long-term-care facilities, Beshear said.

He disputed the notion expressed by Vice President Pence that "by Memorial Day weekend we will have this coronavirus epidemic behind us."

"Our pandemic, covid-19, won’t be behind us by Memorial Day," Beshear said, adding that even when many restrictions are lifted, life will be different.

"We're gonna reach a point real soon where everybody in public and everybody at work is gonna need to wear masks," he said. At the start of his daily briefing, he reminded his audience about handwashing and acknowledged he hasn't always been diligent about it: “As we’re allowed to have more contacts it’s gonna be really important.”

Immediately after announcing the number of new cases in each county, Beshear indirectly rebuffed a request that he differentiate among counties.

The Clark County Fiscal Court voted 5-2 Thursday night for a resolution asking him "to evaluate counties individually and allow Clark County to enter phase one" of the reopening process, reports Fred Petke of The Winchester Sun. "That would include reopening restaurants for inside dining, theaters and churches, as well as the possibility of an in-person graduation for George Rogers Clark High School."

But Beshear said, "This virus doesn’t care if there's a county line … We’ve got to be sure we're unified in our approach." He said as he makes decisions, "We’re gonna listen to everybody’s input," and local officials "will be full partners."

LaTasha Buckner, Beshear's chief of staff and general counsel, said easing of restrictions will tend to be by economic sector and groupings, which will be determined over next two weeks. She said more than 500 businesses had submitted proposals for reopening, but that won't guarantee that they will, and businesses aren't required to submit plans. She said the administration has talked with local officials and state and local chambers of commerce, and will talk with other states as it decides when and how to ease restrictions.

Screenshot of Adams speaking as Beshear listens (Facebook)

Beshear and Secretary of State Michael Adams agreed on procedures for the June 23 primary election, calling on Kentuckians to vote by mail and saying the State Board of Elections would create an online portal to request absentee ballots, and issue regulations to protect voters who voter otherwise, starting with in-person absentee voting at county clerks' offices, beginning by June 8.

At his daily briefing, the Democratic governor introduced the Republican secretary of state, saying he “deserves a lot more credit on this than I do. He has worked very hard on it; he has been very flexible on it.”

Adams thanked Beshear “for your personal graciousness” and willingness to listen. He said their bipartisan cooperation avoided conflicts like those in Ohio and Wisconsin that caused some voters to be disenfranchised and others to get sick. "Usually in a negotiation, we have different goals," he said. "The governor's goals and my goals were the same, to avoid those two things.

On another point of bipartisanship, Beshear was asked about Senate Majority Leader Mitch McConnell's suggestion that states declare bankruptcy instead of seeking federal aid to address problems that preceded the pandemic, such as pension funding, where Kentucky ranks at or near the bottom among the states.

“Senator McConnell and I have had a very good relationship, not just now but when I was attorney general … but on this piece, I disagree with him, as does every other governor in the United States,” Beshear said. Without direct aid, “We won’t have the dollars we need for teachers and firefighters and police officers; the basic services people need to survive will be cut.” Noting that McConnell voted for direct aid to states in the 2008-09 financial crisis, he said, “I hope the senator thinks about that and hears us.”

In other covid-19 news Friday:

• Beshear said the state had a record week of testing, and will have 11 sites next week. He said the state has results from 45,000 tests, not including thousands done in the last two days.
• "Here's why the U.S. can't get its coronavirus testing act together," The Washington Post reports: "Labs straining to increase testing are up against unprecedented demand and a hugely complex supply chain that doesn’t just turn on a dime. . . . A host of people and things need to be in the right places doing the right things to achieve widespread testing. The United States isn’t there yet. . . . The companies selling testing machines typically also make the chemical reagents needed to actually carry out a test, so labs are often limited by brand. . . . There’s a shortage of the supplies needed to process tests. But it’s unclear exactly where the chain is breaking down. . . . The federal government is mostly staying out of it."
• The counties reporting 10 or more new cases were Jefferson, 121; Warren, 35; Muhlenberg,19; Adair, 17; Daviess, 13; Grayson, 13; Hopkins, 11; and Kenton, 10.
• The deaths included three women in Graves County, aged 93, 88 and 82; a 59-year old man in Muhlenberg County, an 89-year-old woman in Adair County, a 74-year-old man in Shelby County, a 79-year-old woman in Jackson County, a 90-year-old woman in Hopkins County, and a 54-year-old man in Hopkins.
• State unemployment director Josh Benton said his agency is "really close" to getting checks to “a significant number” of people whose benefits have been delayed. “Nationally, we really are ahead of the curve overall, but that does not diminish the issues that we do have,” he said. Beshear said, “Josh is working hard . . . Don’t blame him. I’m the governor. It comes back to me.”
• Noting the start of the Muslim holy month of Ramadan, Beshear said, "To my knowledge, every single mosque across Kentucky has agreed not to conduct in-person services."
• The Centers for Disease Control and Prevention has listed additional symptoms of covid-19: chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. These are in addition to the previously symptoms: fever, cough and shortness of breath or other breahting difficulty.
• The U.S. Department of Health and Human Services extended the deadline for hospitals to apply for some of the $10 billion allocated for hospitals in areas hit hardest by the pandemic; they have until 2 p.m. CT tomorrow to apply. The original deadline was yesterday.

Use of hand sanitizers and homemade cleaners for covid-19 apparently causes an increase in calls to poison-control centers

Increased use of hand sanitizers and homemade cleaners appears to have caused a spike in household poisonings in Kentucky and other states.

Kentucky Poison Control Center logo

Last month, the Kentucky Poison Control Center of Norton Children’s Hospital in Louisville "saw a 30 percent increase in overall exposure calls related to disinfecting agents, including a 56% increase in poisonings from household cleaners and a 30% increase in poisonings from hand sanitizers," Norton Healthcare said in a news release.

Nationwide, the U.S. Centers for Disease Control and Prevention says poison-control centers got more than 45,000 calls related to cleaners and disinfectants in the first three months of the year, "about a 20% increase," Norton reports. "While the increase affected all age groups, children ages 5 and under were impacted the most. Complaints included shortness of breath, dizziness and vomiting."

“The data shows many of the exposures are from consuming or inhaling these products,” said Maria Chapman, poison-prevention coordinator for the Poison Control Center. “We’ve had reports of young kids drinking hand sanitizer, as well as adults breathing in toxic fumes as they mix together combinations of cleaners.” She said parents and caregivers can protect children by:

• Storing all household products out of a child’s sight and reach. Young kids often are at eye level with items under the kitchen and bathroom sinks.
• Installing child safety locks on cabinets containing poisonous items.
• Always following all instructions and warnings, and wearing eye protection.
• Not mixing chemicals.
• Not leaving poisonous products unattended while in use.
• Never putting a potentially poisonous product in something other than its original container where it could be mistaken for something else.

The Poison Control Center's free, confidential hotline is 800-222-1222. It is also Kentucky’s covid-19 hotline. “It’s important to protect against covid-19,” Chapman said, but also make sure in your race to prevent the virus, you’re not also putting yourself and your family in another dangerous situation.”

'Your business cannot look the same,' officials tell health-care providers; 'Expect masks to be a greater part of your life'

A slide of Owensboro Health employees was displayed at Gov. Andy Beshear's daily briefing.

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

By Al Cross and Melissa Patrick
Kentucky Health News

State officials detailed their plans for reopening some health-care providers, saying Thursday that the process will be their "proof of concept" for opening other businesses and warning that "Your business cannot look the same."

That's what Gov. Andy Beshear said after Health Commissioner Steven Stack laid out protective measures to be followed Monday by medical offices, clinics, chiropractors, optometrists, physical therapists and, especially, dentists.

Addressing dentists, Stack said, “You are constantly spraying oral secretions, so there’s probably gonna have to be extra protections. . . . You have unique challenges that have to be addressed.” He asked them for suggestions.

Stack said officials still want health-care providers to use telehealth when possible, and screen all arrivals for temperature and symptoms of covid-19. "You can expect masks to be a greater part of your life," he said.

Beshear said health-care workers should be most aware of the need to use personal protective equipment and follow other safety procedures, but suggested they need to do better than they did when he recommended they stop elective procedures. He said he had to make that mandatory because a few wouldn’t go along.

"Just a couple of folks not doing it right can ruin it for everybody else, and spread the virus … and set our timetable back," he warned, adding later, "We gotta prove we can do this and we can do it the right way . . . These aren’t going to be suggestions; they’re going to be requirements."

He said as more businesses are allowed to reopen, the Labor Cabinet and local officials will enforce restrictions he will put in his emergency orders. "We’re gonna reopen this economy," he said. "We’re gonna be the smartest; not the fastest, but the smartest."

Patsy Carol Stith of Kenton County
was spotlighted Thursday. Beshear
said "she seemed to be recovering
but declined," then rallied and went
off ventilator; "too much damage
had been done and she passed
away about two days later."

Beshear announced nine more covid-19 deaths in Kentucky long-term-care facilities, for a total of 86. That is 45 percent of the state's overall death toll of 191. That total grew by only six yesterday; Beshear said some reports from the facilities are delayed.

Acting Health Secretary Eric Friedlander said, "We are working very hard to address the issues we've seen in long-term-care facilities. . . . This is not an area were talking about opening. This is an area where we're talking about giving greater scrutiny."

Friedlander said the health cabinet has been testing all residents of some facilities, starting with those that need the most help, and works with all facilities (53 as of Tuesday) that have a case. Beshear announced positive tests for 32 residents and 27 staff members, bringing those totals to 530 and 251, respectively.

He said the cabinet has provided staffing support to several facilities, and referred to "communication problems," reminding the facilities that they need to make daily reports, including data on personal protective equipment.

In other covid-19 news Thursday:

• The House passed and sent to President Trump a $484 million package of funding for small-business loans and health-care providers, including coronavirus testing. "Many lawmakers wore masks on the House floor, some even speaking through face coverings as they delivered impassioned remarks," The Washington Post reports. Republican Rep. Thomas Massie of Kentucky's Fourth District was one of five members who voted no.
• Beshear said state and local governments must get aid in the next relief package or "We will be hit with a rougher recession . . . We will have to cut vital services . . It’ll hit public safety in a really significant way." Asked about Senate Majority Leader Mitch McConnell's suggestion that states could take bankruptcy, Beshear said he has been in touch with McConnell's office but the last time the two spoke was a week ago. He said bankruptcy "puts a judge in a place to potentially raise taxes."
• Researchers at the University of Kentucky and the University of Louisville are working on rolling out coronavirus-antibody blood tests for clinical trials, Alex Acqisto reports for the Lexington Herald-Leader. Researchers say they hope to determine who is immune to the virus as well as to locate plasma donors, which is used to help treat covid-19 patients.
• UK announced that it is furloughing 1,700 workers, 1,500 of them in UK HealthCare, but hopes the furloughs will be short as hospitals are allowed to resume elective procedures.
• Target workers are planning a sickout in protest of unsafe work conditions during then pandemic, Dawson White reports for the Herald-Leader. “The foot traffic and guest behavior have been atrocious, putting us at needless risk when greater safety measures are required to ensure social distancing,” the group wrote online. “Workers nor guests have been required to wear masks.”
• Andrew Wolfson reports in detail for the Louisville Courier Journal about the poor conditions at  Green River Correctional Complex in Central City, where 32 inmates have tested positive for the virus. Five have been hospitalized and one has died. Beshear said Justice Secretary Mary Noble would make a report on the prison system Friday.

Beshear sets first reopenings, in health care; reveals expanded testing; U of L researchers developing therapy to block virus

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

By Melissa Patrick
Kentucky Health News

Slow and steady goes Gov. Andy Beshear's plan for opening the state's economy, with only a few health-care services being allowed to open Monday. But he also announced Wednesday that testing for the coronavirus, a key step needed for more opening, would expand significantly next week.

"We are very close to coming to a consensus and an agreement in being able to put out guidelines for the gradual re-opening of many of our hospital and health-care services," Beshear said at his daily briefing.

He said plans were being made based on health-care capacity and whether there would be enough personal protective equipment to protect everyone. He said final guidelines are still being worked on, but said he felt confident enough about it to announced that diagnostic radiology and non-urgent but  emergent doctor visits could resume Monday.

He said pre-anesthesia testing services will also resume, to prepare for the "ramp-up" of surgical procedures over the next few weeks, starting with outpatient and ambulatory procedures. Kentucky hospitals have said they are losing $20.4 million a day because they can't do elective procedures.

"We know that it is incredibly important, that it has hit the bottom line of our health-care institutions," Beshear said. But he cautioned that medicine will not look the same; for example, no general waiting rooms: "The new regular waiting room is your car."

And when asked if it would be OK to make plans for summer camps and other children's activities, he said it is too early to say for sure, but "Those are gonna be very difficult to do safely." He noted that the three-phase White House reopening guidelines call for avoiding such activities in the first phase. "My goal is to have us as close to the new normal going into the school year," he said.

Beshear said the state has "passed the test of sacrifice; now we’re in the second part of that test, planning and patience," which he said would take "the next month to month and a half. . . .We have to be sure were doing it right and we’re rolling it out right."

The governor's third phase is perseverance. "until we get to a vaccine or very effective treatment," he said. "Perseverance is gonna be that new normal."

Progress on testing

The White House guidelines say reopening should be preceded by widespread testing for the virus, and not just of people with symptoms. Beshear announced several steps in that direction Wednesday.

He said state is ramping up its testing capacity, announcing several new sites, and for the first time issued a clear, general invitation for people who don't have symptoms to sign up for tests.

He said the Kroger-sponsored drive-through testing that runs through Thursday in Madisonville, Somerset, Paducah and Pikeville completed about 571 tests Wednesday, much less than the 1,000 tests available at each location. 

"We will now test anybody that wants a test" at those locations and new ones that will be open for the next two weeks in Lexington, Louisville, and April 28-30 in Owensboro and Bowling Green. At Shawnee Park in Louisville and the Bluegrass Community and Technical College on Newtown Pike in Lexington, those being tested will also receive a mask and hand sanitizer. 

Those two locations were chosen to serve predominately African-American communities, Beshear said: "We have seen the disproportionate impact, especially in the death rate of this virus," among black Kentuckians, who make up about 8.5 percent of the state's population.

He gave the latest statistics, with about 84% of the known cases accounted for: 77.2 percent of Kentuckians who have tested positive are white, 13.4% were black, 4.8% were multiracial, 4.6% were Asian and 0.04% were Native Americans or Alaska Natives.

The disparity in deaths is even worse. With about 85% of the known cases accounted for, Kentucky deaths have been 79.7% white, 17.7% black, 1.9% Asian and 0.64% multiracial.

Louisville Mayor Greg Fisher said African Americans' covid-19 death rate in Louisville Metro is about 40% higher than their share of the population. "That is something that is just completely unacceptable," he said.

In Lexington, Walgreens at 2296 Executive Drive will offer drive-thru testing seven days a week, from 9 a.m. to 5 p.m., but only for adults with symptoms, health-care workers and first responders. Beshear said another testing partner would be announced later this week. 

Listing the current testing capacity in the state, Beshear said,"Our goal is to be able to use this capacity and to try to start being able to deploy about 20,000 tests, this would be a start, per week." He noted that the state has only done 36,075 tests so far. 

Beshear again asked associations, businesses and industries to keep submitting plans for how they could open under Centers for Disease Control and Prevention guidelines. Plans can be sent to HealthyAtWork.ky.gov. He said the state has already received a number of well-thought-out proposals. 

"It gives me a lot of hope that we will move through this in a smart, deliberate, and gradual fashion where we can do everything we can to prevent a future spike, which will open up our economy in a way to where I believe we can be more successful than many others who are currently taking different steps," he said, alluding to other Southern states that are moving faster.

In other covid-19 news Wednesday:

• The state reported 196 new cases of the coronavirus, for a corrected total of 3,373. Beshear reiterated that the number of new cases has plateaued. 
• The governor announced 14 new deaths from covid-19, raising the state's total to 185. They were 68-year-old woman from Boyd County; a 74-year-old woman from Campbell County; a 71-year-old man from Fayette County; a 96-year-old woman from Graves County; a 76-year-old woman from Grant County; an 88-year-old woman from Hopkins County; and a 68-year-old man and an 83-year-old woman from Kenton County; and from Jefferson County, three men aged 50, 74, 87; two women aged 85 and 80; and a 58-year-old victim of undisclosed gender.
• University of Louisville researchers have developed a technology that they believe can keep the coronavirus from infecting human cells. The university says it wants to "fast track" development of the therapy, including an application to the U.S. Food and Drug Administration for approval to start treating seriously ill covid-19 patients.
• In a wide-ranging interview, the Centers for Disease Control and Prevention Director Robert Redfield told The Washington Post that the second wave of covid-19 is likely to be even more devastating than the first because it will likely coincide with the start of flu season. 
• The Kentucky Rural Health Association said the latest coronavirus relief package includes a new $225 million grant program exclusively for federally certified rural health clinics, for testing and related expenses associated with the pandemic. The Senate passed the bill Tuesday and the House is expected to do so Thursday.
• Two nursing homes in Kentucky have had at least 10 residents die from covid-19, and at least 14 of them have had a death from it, Daniel Desrochers reports for the Lexington Herald-Leader, along with an easy-to-read list of all of the nursing homes that have been affected.
• The Supplemental Nutrition Assistance Program, formerly food stamps, has been expanded during the pandemic, giving families the maximum monthly benefit regardless of “reportable income and other factors” that would otherwise reduce it, a Department of Agriculture release said. "For households with two adults and three children with no income, the maximum benefit is $768 but can be $528," the Herald-Leader reports. 
• In a separate story, the Herald-Leader reports that Walmart and Amazon will soon allow people with SNAP benefit cards to use them online. Jeremy Chisenhall reports that Kentucky was one of three states to get federal approval for the pilot program.  
• The Herald-Leader reports on yet another complication for some with severe cases: blood clots. “The number of clotting problems I’m seeing in the ICU, all related to covid-19, is unprecedented,” Dr. Jeffrey Laurence, a hematologist at Weill Cornell Medicine in New York City, told CNN, calling the problem “widespread.”
• Bill Estep and Will Wright of the Herald-Leader report on Kroger-sponsored coronavirus testing in rural Kentucky, including sites in Somerset, Pikeville, Paducah and Madisonville. Testing will continue there through Thursday. 
• The Herald-Leader reports that Louisville lawyer James Gregory Troutman, 53, "was charged with threatening Gov. Andy Beshear after he allegedly referenced an assassinated governor in a Facebook post before saying he hoped people would shoot at Beshear, police said." Troutman's lawyer, Steve Romines, told WDRB that Troutman's social-media comment was "not a threat" to kill Beshear. 
• Morgan Eads of the Herald-Leader tells the story of a family who had to say goodbye to a loved one who died from covid-19 on FaceTime. Eads reports that three family members got sick after being visited by a home-health nurse, cautioning that people without symptoms can still spread the disease.  
• The Lexington History Museum wants your covid-19 pictures, stories,letters and memorabilia for a Pandemic History Project, the Herald-Leader reports.  
• Click here to see the Kentucky Department of Public Health Covid-19 Dashboard found at kycovid19.ky.gov. 
• Click here for a Kentucky Chamber of Commerce webinar titled, "How Can Business Re-open and Protect Public Heath?"

Ky.'s deadliest pandemic day: 17 deaths, 13 in nursing homes; Beshear warns against states 'making decisions that are reckless'

Drive-thru coronavirus testing in Somerset (Twitter photos by Alex Slitz, Lexington Herald-Leader)

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

By Melissa Patrick
Kentucky Health News

Marking Kentucky's deadliest day of the coronavirus pandemic, Gov. Andy Beshear announced that 17 more Kentuckians had died from covid-19, and 13 of them were in long-term-care facilities. The total number of pandemic deaths in the state is now 171, with 40 percent in nursing homes.

"Seventeen is a hard number to take," Beshear said. "Let's make sure that we are doing everything we can to not have days like today." He said the pandemic has "likely plateaued" in the state, but "It's still really deadly, especially for those in our senior living facilities; and while we are all ready to get to some type of new normal, these are people's family and we've got to do this safely, we've got to move forward safely and people are counting on us."

Beshear announced an outreach to businesses to work on helping them reopen safely, but that was overshadowed by the record number of covid-19 deaths, a record he did not note. He said that along with the 13 deaths, there have been 46 new cases in residents and 12 new cases in staff.

A news release issued immediately after the governor's daily briefing included a table showing the number of cases and deaths for both residents and staff in each of the 53 long-term-care facilities with cases as of April 21. It says a total of 454 residents have tested positive for the virus and 68 residents have died from its disease. Three more residents are considered possible covid-19 deaths. Among staff, 196 have tested positive  and one staff member has died from it.

"I don't think this means that people have done anything wrong," Beshear said. "We are all responding as quickly as we can. We are going to provide a significant amount of our testing capacity that is not necessarily being used at the hospitals. We are sending it to these nursing homes." He said he would make an announcement Wednesday about a significant increase in testing capacity.

Increased testing is a major benchmark for easing social-distancing rules and opening up the economy. Beshear announced an initiative to seek plans from industries, trade associations and individual businesses describing how they can open safely, following Centers for Disease Control and Prevention guidelines. Plans can be submitted to HealthyAtWork.Ky.gov.

Beshear said the plans would be reviewed by Transportation Secretary Jim Gray, Economic Development Secretary Larry Hayes, Labor Secretary Larry Roberts and LaTasha Buckner, the governor's chief of staff and general counsel.

Some Southern states, including Tennessee, have announced they would start easing restrictions soon, though they had not yet met the first benchmark, a two-week downward trajectory in new cases or positive-test rates. Beshear strongly urged Kentuckians to not travel, especially to states that act prematurely.

“When other states are making decisions that are reckless, that I believe will cause a spike that will prolong this coronavirus in their state -- we cannot travel and make other people's poor decisions impact us,” he said. Earlier, he said, “We don’t have to do something first; we just have to do it the best.”

Graph of deaths in 1918: Philadelphia didn't act early;
St. Louis did, but eased up and had a major resurgence.

Beshear cautioned that opening the economy too soon would likely result in a spike in cases that would cause the state to have to shut down again; he said that happened in St. Louis during the 1918 influenza pandemic, and we need to "make sure that ultimately when we look at the long-term reopening of the economy, that we end up doing it in a shorter duration by not making some foolish or some very risky decisions."

He added, "How we do this has to be data-driven. It has to be well-thought-out and well-planned, and it has to happen in phases. That is how we protect those around us, continue to pass the test of humanity and not frustrate all of the sacrifices we've made."

Asked about letting hospitals resume elective surgeries, which Indiana plans to do, Beshear said he is talking to hospitals about a phased approach and handling outpatient and inpatient procedures differently.

The Kentucky High School Athletic Association canceled all spring sports Tuesday. Asked about fall high-school sports, Beshear said. "Without fans, the fall may be possible."

In other covid-19 news Tuesday:

• The state reported 177 new cases. The highest numbers were 71 in Jefferson County; 32 in Hopkins; 16 in Kenton; and 11 in Warren. 
• The 17 deaths were a 52-year-old man in Jackson County; an 86-year-old woman in Lyon; three men, 80, 85 and 90, and two women, 80 and 81, in Hopkins; a 92-year-old man and two women, 90 and 94, in Graves; an 81-year-old man in Butler; a 73-year-old man and a 93-year-old woman in Kenton; a 58-year-old woman in Grant; and two men, 71 and 81, and one woman, 81, from Jefferson. 
• A wreath was aid in the state Capitol rotunda in memory of the dead. Beshear again asked Kentuckians to light their houses green for all of those who have died, and noted one Hopkins County family lost two members in two days: Frieda F. Woods and most recently John Doug Woods, an Air Force veteran.
• He said 286 Kentuckians are currently hospitalized, 165 of them in intensive care; and 1,266 have recovered.
• Beshear said more than 700 coronavirus tests were done yesterday as of 4:30 p.m. ET at the four drive-through sites in Paducah, Madisonville, Somerset and Pikeville. He had hoped for more, and announced that people without symptoms might be able to get tested. The sites will be open through Thursday. Drive-through testing is also being done in Murray and Hopkinsville.
• Beshear said the state was making progress in getting personal protective equipment, but said it still needs much more, to not only prepare for a surge of cases, but to also start doing elective medical procedures. 
• Emergency rules make it easier for people with opioid addiction to get treatment, Phil Galewitz reports for NPR. Under the national emergency declared by President Trump, a federal law that required patients to have an in-person visit with a provider before they could be prescribed medications for the treatment of opioid use disorder, like Suboxone, has been suspended and now patients can get these prescriptions via telemedicine, he reports. Addiction experts have been calling for this change for years. 
• The Associated Press reports that a malaria drug widely touted by the president for treating covid-19 showed no benefit in a large analysis of its use in U.S. veterans' hospitals, with more deaths among those given hydroxychloroquine versus standard care. The AP reports that the study of 369 patients is the largest look yet at hydroxychloroquine with or without the antibiotic azithromycin, and notes that it has not yet been peer-reviewed.  The NIH and others continue to do more rigorous tests. 
• The Lexington Herald-Leader's coronavirus tracker has been updated. Daniel Desrochers reports that of the 154 deaths from covid-19, 1.08% are in people between the ages of 40 and 49; 1.64% are between 50 and 59; 7.87% are 60-69; 13.73% are 70-79; 30.2% are 80-89; and 47.22% are 90-99. 
• State Rep. Robert Goforth, R-East Bernstadt, told the Herald-Leader that several employees at Signature HealthCare at Jackson Manor, a nursing home where 35 residents have the virus and four have died, texted him to say they were ordered back to work while they still had covid-19 symptoms, such as fever. At least 19 employees at the facility have tested positive since April 6, and at least 10 have recovered, he reports. Signature is the state's largest nursing-home chain, with 42 facilities. 
• Craig Martin, an infectious-disease specialist and associate dean at the University of Kentucky College of Pharmacy answers questions about what to expect with summer activities and vacations: "We have to approach the summertime with caution. Unfortunately, planning events months ahead is risky." 
• The Associated Press reports that "a flood of new research" suggests many people have had covid-19 with no symptoms, fueling hope that it will turn out to be much less lethal than originally feared. However, people without symptoms can spread the virus, which complicates decisions about opening the economy.  
• Tim Sullivan of the Louisville Courier Journal reports on the struggles of rural hospitals to survive as their main source of revenue, elective surgeries, has been cut off. “A lot of them are just hanging on and serving their populations as best they can,” Dr. Francis DuFrayne, chief medical officer for Owensboro Health, told Sullivan. “Short of a big infusion of cash, which I do not see coming, they’re going to continue to struggle.”
• The Kentucky Center for Economic Policy breaks down the essential and front-line workers  in Kentucky, concluding that women and African Americans are over-represented in front-line industries, Jessica Klein writes for KCEP on its KY Policy Blog. 
• Kristina Goetz of the Courier Journal tells the story of Meghan Harpole, a nurse with covid-19 who thought she was going to die. "It felt like my bones were breaking," she said. 
• Mayors in Somerset and Prestonsburg have sent Gov. Andy Beshear proposals to gradually re-open their economies, the Herald-Leader reports. 
• USA Today reports that the World Heath Organization says coronavirus originated in animals in China late last year and was not made in a lab, as has been theorized. 

The story of a rumor is a cautionary tale for small towns in the time of the coronavirus

By Al Cross
Kentucky Health News

When a rumor becomes a news story, it often has a larger story to tell.

Such is the case in Grayson County, population 27,000, where local officials held a news conference to quash rumors on social media that an identified man who had tested positive for the coronavirus was not isolating himself at home, when in fact he was as soon as he got the test result.

The posts on April 11 and 12 "wrongly claimed the 52-year-old man — whose diagnosis was announced publicly the afternoon of April 11 — had been spotted throughout the county after his diagnosis," reported Rebecca Morris, editor of The Record, one of the county's two weekly newspapers.

County Judge-Executive Kevin Henderson (The Record photo) 

County Judge-Executive Kevin Henderson said at an April 13 news conference, “The Leitchfield Police Department, the sheriff’s office and health department — just about every law enforcement agency in the county was busy squashing rumors that were brought to our attention.” he said.

Morris reported, "In all, officials received between 200 and 300 complaints over the weekend, he said. Henderson said county officials had been told the man had been spotted inside Walmart and other stores. Yet when law enforcement and County Attorney Jeremy Logsdon reviewed surveillance videos Saturday and Sunday of the complaints 'all were false,' Henderson said."

“We have followed up on every call,” he said. “We’ve had people who said they saw the person out but it’s turned out to be a false report.” He added that several of the informants were asked to sign affidavits, but refused because their complaints turned out to be based on third-person information.

Not only did the man self-isolating since he got his results, he willingly gave his car keys to county officials, Henderson said. “That patient has cooperated with us 100 percent,” he said. “Quite honestly I feel sorry for him, because (he’s) received a lot of threats — just a lot of bad things happening to them right now. . . . If you want to do something for him, pray for him. Reach out to him and make sure he’s doing well. Some of your statements are pretty harsh (and) we’re better than that.”

Logsdon, the county attorney, said reports of people violating self-isolation and other rules are helpful — if they’re not false. “The audacity of some individuals in this time of crisis is mind-blowing,” he said, noting that making false reports or starting false rumors is a crime — especially when it’s done with the intent to bully or harass, The Record reported.

The episode may have been repeated in small towns across the country, and may be even likelier to be repeated as social-distancing rules are relaxed and health departments track down people who may have been exposed, and if they have, order them to self-isolate for 14 days.

Health Department Director Joshua Embry
(Photo by Matt Lasley, Grayson County News-Gazette)

Joshua Embry, the director of the Grayson County Health Department, "said there is no way to make people stay in their homes unless and until they test positive for the virus. Those who undergo covid-19 testing are encouraged to stay home until they get the results, but cannot legally be made to stay there in the absence of an executive order by Gov. Andy Beshear," Morris wrote.

"If someone tests positive, they are given an isolation order, signed by Embry representing the state, saying he or she cannot leave home. If someone is accused of breaking a self-isolation order, the health department and law enforcement will investigate the truth of the allegations, Embry said. Officials simply can’t act on hearsay, he said."

Referring to social-media criticism of local officials, Henderson said, “Please don’t beat up on our health department, please don’t beat up on our hospital — these folks are doing all they can possibly do. It’s not their fault. They are following the exact same guidelines that are sent down to us from Frankfort from the governor, and we’re trying to do the best we can.”

Schools advised to close for rest of academic year; nine deaths in nursing homes raise their share of Ky. death total to 39 percent; study suggests obesity is top risk for a severe case of covid-19

Nutter Field House at the University of Kentucky is now a 400-bed field hospital. (UK photo by Mark Cornelison)

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

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear has recommended that Kentucky schools not hold in-person classes for the rest of the school year and continue nontraditional instruction and food service for students.

"Every health care professional had advised us that this is the right course of action to take," Beshear said at his daily covid-19 briefing.

The move follows the White House's guidance for re-opening the economy, which calls for schools and day-care centers to stay closed in the first phase. Beshear noted that Ohio, Indiana and Tennessee have decided likewise.

“I know for many this is hard,” Beshear said. “We have seniors that were looking forward to an in-person graduation and a prom.” He encouraged schools to be creative in finding ways to celebrate graduation, virtually or in drive-up ceremonies.

“The experience you are losing is hard," he said, "but your willingness to do it is going to help us save lives."

Beshear reported that six more Kentuckians had died from the disease, bringing the total up to 154. He said that because the state has exceeded 150 deaths, a State Police honor guard would hold a wreath-laying ceremony in the Capitol rotunda tomorrow.

The governor said 59 of those deaths have occurred in long-term care facilities. That is nine more than the total he reported Sunday; he said some happened earlier in the weekend. So far, 39 percent of the state's deaths have been in such facilities, much higher than the national average of about 25%.

Beshear acknowledged that the facilities are a challenge and said the state would direct a large portion of its available testing capacity toward them. He said 22 more residents and 12 more staffers had tested positive, bringing the totals to 408 and 184, respectively.

William Dean Smith

One of the nursing-home residents who died over the weekend was William Dean Smith of Leitchfield, 96, a retired music teacher and decorated airman in World War II and the Korean War. Beshear cited him as an example to follow, "a mentor and life-shaping force."

“We’ve now lost at least a couple of war heroes,” Beshear said. “Let’s make sure we’re doing our part. Let’s make sure we’re living up to the example that his generation set for us. Let’s make sure that we protect people from this virus.”

Beshear said that tomorrow he would introduce a plan for associations and trade groups to submit proposals on how they could re-open under the new Centers for Disease Control and Prevention's guidelines. That approach is similar to one that was included in a bill amendment that was added in the last days of the legislative session that failed to pass. In particular, he said he was looking forward to seeing plans from pet boarders and chiropractors. He said that by the end of this week or early next week, some additional health-care providers will be able to offer certain services.

In other covid-19 news Monday:

• The six new deaths included a 59-year-old woman from Crittenden County; a 92-year-old woman from Adair County; an 85-year-old woman from Hopkins County; and a 64-year old man and two women, 62 and 76, from from Jefferson County. 
• Beshear said the state had 102 new positive tests, bringing the statewide adjusted total to 3,050. He said it continues to look like the state's number of cases is plateauing.
• In all, he said, 32,830 people have been tested, 263 are hospitalized, 147 are in intensive care, and 1,034 of the 3,050 people who have tested positive have recovered.
• Beshear said another staffer has tested positive at Western State Hospital, a psychiatric center in Hopkinsville, where two people have died of covid-19 and 13 patients and 28 staff have tested positive for the virus. 
• John Cheves reports for the Lexington Herald-Leader that inmates at Green River Correctional Complex in Central City "complain of inadequate cleaning of common areas; a reduction of meals to once a day, usually served late; failure to test people inside the complex for the coronavirus unless they are showing symptoms, such as fever or cough; and an inability to properly segregate sick inmates from the rest of  the population because of a lack of available space." A wife of an inmate said, "It's a death trap at this point." 
• Beshear said there have been seven new cases of covid-19 at Green River, five inmates and two staff. In all, there have been 46 total cases, 29 inmates and seven staff; one inmate has died of the disease. 
• The New York Times reports that new studies (not peer-reviewed) find that the most important predictor of severe covid-19 is obesity, especially for younger patients who are otherwise healthy. Kentucky ranks fifth in adult obesity, with a rate of 36.6%; and more than one of five Kentucky children between 10 and 17 are obese, ranking the state third in the nation. 
• Drive-through testing will begin in Madisonville, Paducah, Somerset and Pikeville tomorrow through Thursday, with a goal of testing 1,000 people at each location. To sign up for testing, go to thelittleclinic.com/drivethru-testing. 
• Lt. Gov. Jacqueline Coleman, secretary of the Education and Workforce Development Workforce, said via a video-link report that the state processing 13,000 new unemployment claims a day and answering about 25,000 calls. She said applicants who haven't received benefits should not reapply, which slows the system. She said that the priority now is reaching out to people who were past the two-week waiting period to be paid. She said only those whose original benefits have expired should reapply. 
• "Ripples from the coronavirus impact on meat-processing plants are hitting Kentucky farmers hard," Janet Patton reports for the Herald-Leader. Covid-19 has shut down large processing plants across the nation, and now that it's time for Kentucky farmers to sell their beef and hogs, the prices are so low they won't be able to make a profit, she reports. In Kentucky, the Tyson Foods chicken-processing plant near Albany closed for one day this month after a worker tested positive for covid-19. What all this means for most of us is probably that meat will continue to be scarce.
• The number of children infected with the coronavirus is far more extensive that what is currently being reported, according to a University of South Florida study. It estimates that for each child who requires intensive care for covid-19, there are 2,381 children infected with the virus, said a news release about the study. From March 18 to April 6, it found that 74 U.S. children were admitted to pediatric intensive-care units, signaling that an additional 176,190 children were likely infected during that period. "Researchers point out the infection rate will be much higher for children in low-income families with parents in blue-collar and service jobs, which preclude the option of working from home," the release says. "There's also an increased risk to children who live in urban public housing projects due to the close proximity of housing units and small communal recreation and commons areas." 
• Becker's Hospital CFO Report breaks down how the Centers for Medicare and Medicaid Services will divvy out the next $30 billion in hospital aid: "About $20 billion will be distributed based on a hospital's proportion of total revenue, including money from private insurers and Medicaid. The remaining $10 billion in the second round of funding will be distributed to hospitals with large numbers of covid-19 patients, according to The Washington Post."
• CMS is now requiring nursing homes to report covid-19 cases directly to the Centers for Disease Control and Prevention, as well as to patients and their families. This marks a "significant change in practice," since the CDC has not formally tracked this information while thousands in nursing homes have died, Politico reports.
• Betsy Johnson, president of the Kentucky Association of Health Care Facilities, told Cheves this month that the state's roughly 280 nursing homes are "pretty much sitting ducks if we get someone who is infected in our buildings." Cheves writes about the need for more personal protective gear, beds, staff and access to testing for the virus, saying nursing homes have been left out of the supply chain. On Sunday, Beshear reported that there have been 50 covid-19 deaths in long-term-care facilities, with 386 residents and 172 staffers testing positive. 
• Frank Romanelli, professor and associate dean of the University of Kentucky College of Pharmacy, writes for UKNow, "What Medications are Safe in Cases of Covid-19?" He says the World Health Organization does not recommend against the use of ibuprofen, based on currently available information, despite reports from France that it might impede recovery. 
• The conversion of the UK football team's practice facility, Nutter Field House, to a temporary 400 bed field hospital to care for covid-19 patients is now complete, according to a UK news release. 
• The Supreme Court of Kentucky will hear oral arguments by video conference Wednesday, for the first time in its history, since the justices are not meeting in person. A news release says the public may watch arguments in a family-law case from Oldham County at 10 a.m. ET Wednesday, April 22, via livestream on the KET website.