Coronavirus cases surge again, pushing Kentucky into 'red zone' of White House task force that calls for more restrictions

Measures that state officials and health experts recommend to fight the coronavirus

By Melissa Patrick and Al Cross

Kentucky Health News

As coronavirus cases in Kentucky surged into a "red zone" of the White House Coronavirus Task Force,  Gov. Andy Beshear said again that he expects to take additional steps to curb its spread next week if the cases don't stabilize -- while reminding Kentuckians that it's not too late to control it. 

Beshear reported the second highest daily count of new cases, 836; the highest daily total, 979, was reported last Saturday. He also reported that 5.41 percent of Kentuckians who were tested for the virus last week tested positive, the highest rate reported in the last few months and a sign that the disease is spreading more actively, his news release said.

Kentucky Health News chart

Beshear has said that the White House task force considers positive test rates above 5% to be in the "danger zone," but he didn't note another number that moved it into a "red zone" of the task force, which it uses as tripwires to suggest increased or restored limits on activities. 

The state did that because Saturday's 836 cases brought its seven-day total to 4,673. That took the seven-day average above the task force's definition of a state in a red zone: one with more than 100 weekly cases per 100,000 population. That equals 1,000 cases per million; Kentucky's estimated population is 4.468 million, so its "red zone" threshold is 4,468 cases per week. (Editor's note: An earlier version of this story had an incorrect number for the weekly average as of Friday.)

Beshear said Friday that if the surge didn't abate over the weekend, as he hopes it will due to the mask mandate he imposed two weeks ago, he will have to impose more restrictions. Two steps that the task force has recommended, but that he has not adopted, are closing bars and reducing restaurant capacity to 25 percent from 50 percent. He has said he would also consider other restrictions. 

The state is faring better on the task force's other red-zone metric: the seven-day average of positive coronavirus tests. If a state goes over 10 percent, it goes into the red zone. But Beshear noted that the state has broken the 5 percent "danger zone" threshold two days in a row, and suggested that Kentucky is becoming part of a national surge,

“Yesterday, there were more than 74,000 new cases and more than 1,000 deaths reported across the country,” Beshear said in a news release. “We know how to control this virus. We’ve seen states like New York – which had hospitals overflowing with sick patients in March and April – now reporting a positivity rate of 1 percent or less. If they can do it, we can do it. But we have to work together, stay smart and wear face coverings.”

Personal choices matter

Dr. Steven Stack, the state's public health commissioner, said Kentucky can still avoid the crisis confronting other states, referring to those that are running out of intensive-care beds and seeing increasing deaths due to the virus. 

“Our personal choices, right now and every day, will directly determine Kentucky’s situation in early August," he said in the release. "Small acts of kindness and personal sacrifice will make a big difference. We can choose to delay a party or picnic. We can shop for groceries or go to the pharmacy when it’s less crowded. We can opt for an online or drive-up worship service. We can wear a face mask. Every one of us has a role to play in determining Team Kentucky’s future.” 

The daily report shows 595 Kentuckians are hospitalized for covid-19, 23 fewer than Friday, and 132 of them are in intensive care, about the same as Friday.

Beshear reported five new deaths, raising the state's covid-19 death toll to 696. The fatalities were a 79-year-old man from Casey County; an 80-year-old man from Christian County; a 66-year-old man from Ohio County; and two women, 68 and 93, from Fayette County. 

“This is the part that never gets easier and never will,” said Beshear. “Every day that we do the right thing, we are protecting each other from the worst pain imaginable. My heart is with these families every waking moment.”

Counties with more than 10 new cases Saturday were Jefferson, 244; Warren, 54; Fayette, 49; Kenton, 36; Scott, 31; Daviess, 20; Hardin, 18; Christian, 17; Boone, 16; Jessamine and Oldham, 15 each; Barren 14 and Harlan, 14 each; Bullitt and Laurel, 12 each; Campbell and Franklin, 11 each.

As case numbers hit a near-record and positive-test rate surges, Beshear asks churches to drop in-person services and says he will limit some business activity Monday if the surges don't abate

By Melissa Patrick and Al Cross

Kentucky Health News

After reporting Kentucky's second highest daily number of new coronavirus cases and a surging positive-test rate, Gov. Andy Beshear asked churches to avoid traditional services the next two Sundays -- and said if the surge doesn't stop by Monday, he would have to impose more restrictions on businesses. 

"I recommended for the next two Sundays, with the escalating number of cases that we have . . . that people do the virtual or the drive-up services," Beshear said. If not, "I just ask people to double-down on making sure everybody is wearing a mask, that we do even extra cleaning and that people are spread out."

Beshear said he made the request because health officials have noticed a trend of Kentuckians going on vacation and bringing the virus back with them to church gatherings. He has asked Kentuckians to not travel to states with a 15 percent or higher positive-test rate, and that if they do travel to such states to quarantine for 14 days when they return to Kentucky. 

Beshear said he made his request, which he stressed was not a mandate or an order, in a phone call with the Kentucky Council of Churches and that senior adviser Rocky Adkins was reaching out to the Kentucky Baptist Convention, the largest group in the state's largest denomination. However, the convention's news outlet, Kentucky Today, reported at 7 p.m, "Leaders of the Kentucky Baptist Convention have not been notified of a request to shut down in-person services."

The governor reported 797 new cases of the coronavirus Friday, raising the seven-day rolling average to 631, which is 38 higher than yesterday. The only higher daily total was 979, reported Sunday.

"We are continuing to see an increase and a growth that we absolutely have to stop," Beshear said. "And we'll be watching these very carefully through the weekend and if we do not see the numbers come down, we are going to have both a series of recommendations and steps that we'll need to take sometime early next week."

He said 5.28% of Kentuckians who were tested for the virus in the last week tested positive, pushing the rate over the 5% mark that the White House Coronavirus Task Force and others consider a "danger zone."

The task force recommended last week that Beshear close bars and reduce restaurant capacity to 25% from 50%. It also recommended that he limit gatherings not involving businesses or organized groups to 10 people, which he did, and that he mandate mask wearing, which he did July 10.

Beshear said he would defer any further orders until Monday in hopes that the mask mandate will kick in. "We need to start seeing some impact from it," he said, adding that any actions would be based on the numbers he sees Monday, not observations of activities over the weekend.

"We've got to have a real change in the data," he said. "Our hope is that any demonstrations this weekend, that everybody wears masks, that everybody spreads out, and in bars and the rest -- you've got to do it. I mean, we're going to have to close bars if we don't get control of this. If you are a bar and you are not requiring anybody to do what is required, you are shutting yourself down." 

He noted that today's case numbers reflect activity from two weeks ago, due to the incubation period of the virus. "We'll be looking at the cases, the positivity rates, the hospitalizations and the ICUs," he said. "We need to see a stabilization or the beginning of a decrease in positivity rate."

Hospitalizations for covid-19 rose to 618 Friday, making the week's average 575. Last week, the Tuesday-Saturday average (some cases were missed on Monday of that week) was 456.

"How we manage this crisis, whether we can bring down cases, is going to determine how many lives we lose, it's going to determine what economic impact we have going forward . . . and it is going to be directly related to when we can get our kids back in school for in-person classes," he said.  

Stressing a point he made Thursday about schools, Beshear said, "If we can't get the numbers under control by the beginning of next week, I think you can expect that we will recommend to superintendents that they push their start date back if it is in early August. . . . We cannot allow an escalation to continue."

"Interim education commissioner Kevin Brown encouraged district leaders to consider starting virtually with nontraditional instruction if they are currently planning an in-person first day on or before Aug. 14," the Courier Journal reported.

Asked it it was possible to apply any new requirements on a limited basis, Beshear said, "I believe that the first set of steps that we'll need to take will likely be statewide. That doesn't mean that there aren't more surgical steps that we can take as related to potentially specific businesses. . . When it reaches a certain level though, you need a full statewide reaction to make sure it doesn't just hop from one county to another. . . . The challenge right now is the spread is so significant that we want to make sure that we are stopping it everywhere and then when we believe that we've generally got it under control, or stabilized . . . that allows us to take much more specific action." 

Beshear was asked about the annual US 127 Yard Sale, scheduled Aug. 6-9. He said he wasn't familiar with it, but noted the state's yard-sale requirements, including wearing a mask, keeping hands washed and practicing social distancing. He also encouraged booth owners to wear gloves and to not allow shoppers to handle the merchandise, unless they plan to buy it. 

Beshear reported seven more deaths and noted that with a known mortality rate of 3%, the state can expect the rising case numbers to accelerate its death toll, now at 691.

"It's going to be heartbreaking," he said. "So let's make sure that we are more committed than ever, let's make sure that we are not violating these basic rules that we know can help us, let's make sure we realize that each and everyone of our actions can impact someone else and let's just realize that this thing is escalating in Kentucky, that we are seeing more cases than we ever imagined before and now is the time for everybody to recognize the severity of the situation that we are in." 

Friday's fatalities were an 81-year-old man from Boone County; a 59-year-old woman from Hardin County; an 85-year-old woman and an 82-year-old man from Jefferson County; a 66-year-old man from Oldham County; and two women, ages 54 and 74, from Warren County.

People 65 or older have accounted for 84 percent of deaths in Kentucky, higher than the national average of 80%, according to an analysis by the Kaiser Family Foundation, using CDC data. "The analysis finds that states that have seen the largest share of covid-19 deaths among people 65 and older include those that have had a disproportionate number of deaths in long-term care facilities," the foundation said. States raking ahead of Kentucky were Idaho (94%), New Hampshire (92%), Massachusetts (90%), Rhode Island (90%), Minnesota (89%), Connecticut (89%), Pennsylvania (87%) and Ohio (86%).

In other covid-19 news Friday: 

• Counties with more than five new cases were Jefferson, 206; Fayette, 76; Warren, 41; Kenton, 27; Boone, 26; Bell, 23; Harlan, 17; Bullitt, 16; Barren, Hardin McCracken and Scott, 15 each; Laurel, 14;  Campbell, Henderson and Shelby, 12 each; Jessamine, 11; Knox, 10 1.25 Pike, 9; Ohio and Oldham, 8; Perry Pulaski and Whitley, 7 each; and Adair and Daviess, 6 each.
• The Lexington-Fayette County Health Department, which follows its own reporting schedule, reported 100 new cases, "marking the first triple-digit spike in cases the city has seen during the coronavirus pandemic," Jeremy Chisenhall reports for the Lexington Herald-Leader. Eleven of the cases were in children and the health department said in a Facebook post that the steady increase in cases show "no signs of slowing." 
• In long-term-care facilities, four more residents and 18 employees tested positive for the virus, and six more deaths were recorded, bringing the respective totals to 2,300, 1,267 and 458 (including four employees, one who died this week).
• The Fayette County school board voted unanimously to begin the school year remotely; the start date has not yet been announced, reports the Herald-Leader. Jefferson County schools will also begin remotely, the Courier-Journal reports.
• The Centers for Disease Control and Prevention's expanded guidance for reopening schools, rewritten to please President Trump, now "heavily emphasize sending students back to school this fall, despite what the CDC described as "mixed evidence about whether returning to school results in increased transmission or outbreaks" of covid-19, CBS News reports. The guidance "reads more like a political document than public-health guidelines," anchor Norah O'Donnell said on the "CBS Evening News."
• New guidance from the CDC says most people who test positive for the virus can stop isolating themselves and take other preventive measures 10 days after their symptoms begin, and if they have been fever free for at least 24 hours without the use of medications. The guidance notes that a limited number of people with sever illness may have to isolate and take precautions for up to 20 days after symptom onset. Those who never show symptoms need to quarantine for 10 days after testing positive. The CDC says these recommendations "are based on the best information available in mid-July 2020 and reflect the realities of an evolving pandemic." The guidance also offers key findings that support this change in guidance. 
• A new CDC study found that recovery from covid-19 can take a long time, even in young adults with no chronic conditions. The study found that 35% of those who had tested positive had not returned to their usual state of health two-three weeks after testing and that one in five previously healthy 18- to 34-year-olds were not back to usual health 14-21 days after testing positive. 
• Beshear often warns that if the number of cases of coronavirus continues to surge, it could easily overtake the state's hospital capacity. McClatchy tells the story of a town in Texas where this has happened, and they are now having to decide who will be sent home to die. 
• Don't forget to wear your mask when you go through drive-thru banking and food services. "Wear a cloth face covering when doing any in-person exchanges and unable to stay at least 6 feet apart from other people," the CDC says on its "running errands" guidance. 
• Health and Human Services Secretary Alex Azar on Thursday signed a continuation of the covid-19 public health emergency that was set to expire July 25, extending temporary payment and enforcement flexibility for a whole range of stakeholders, Inside Health Policy reports.
• If anyone is in the driver's seat for the next coronavirus stimulus bill, it's Senate Majority Leader Mitch McConnell, the editor of a leading liberal magazine told The Hill. David Dayen, executive editor of The American Prospect, said Democrats appear to be allowing the leader to do what he did with the last relief bill: "McConnell writes the bill in his office and then Democrats get a chance to tweak it."
• One sign of the national surge: More new infections were reported yesterday that at any time since the pandemic started, CBS reported. The number: 77,255.

Beshear says he wouldn't ask teachers to return to classrooms now, and may ask schools planning early-August starts to wait

By Al Cross
Kentucky Health News

As Kentucky's coronavirus surge continued Thursday, Gov. Andy Beshear said he wouldn't ask a teacher to resume teaching now, but "I want to see where we are early next week," when he hopes the effect of his mask mandate will be seen in the daily numbers.

“We are in just as critical as moment as were in late March,” he said, adding later, “If we don’t see a stabilization at least by early next week I’m likely to make a recommendation” to school districts planning to start classes “in early, early August that you push back a little bit and give us time to see if we can get it under control.”

Beshear said more Kentuckians are wearing masks, but “The facial covering mandate isn’t showing up yet in our numbers” and “if we don’t see a significant leveling off,” he will have to look at closing bars and cutting restaurant capacity to 25 percent from 50%, as recommended by the White House Coronavirus Task Force, as well as other measures.

“If we continue to have an escalation, we couldn’t ignore the advice we’ve gotten from the White House and other experts,” he said. “There are steps we would have to take, and we would be looking at others as well. Our goal would be how to we get the maximum impact on reducing the virus with the smallest impact on our economy and other areas.”

Daily data: Beshear reported 611 new cases of the coronavirus Thursday, raising the seven-day rolling average to 593, more than double what it was on July 7, as the surge was beginning.

“High numbers today, but I’m hopeful,” he said at the end of his daily briefing. “I’m hopeful again, from what we are seeing out there, that we are taking this seriously and we are going to do what it takes to stop this. Next couple of days are going to be really important. The data we see early next week is gonna drive a lot of decisions.”

Beshear said 4.94% of Kentuckians tested for the virus in the last week have tested positive, which he said was about two percentage points higher than it was three weeks ago. Wednesday's seven-day rolling average was 4.92%.

“We continue to see a very disturbing trend of kids under 5 testing positive,” he said. “Today it’s 21 kids” in 13 counties.

On the plus side, covid-19 hospitalizations were down slightly, as were the number in intensive care. “We are still in a generally good place with our overall bed capacity,” Beshear said, “but in escalating cases that can get out of control really fast and we continue to see hospital systems in states to our south running out of ICU beds.”

Beshear reported seven more deaths from covid-19, noting a younger trend. The fatalities were a 49-year-old woman from Fayette County, a 57-year-old woman from Jefferson County; a 60-year-old woman from Casey County; a 64-year-old woman from Knox County; a 68-year-old woman from Whitley County; and two women, 88 and 89, from Ohio County.

Another employee of a long-term-care facility died of the disease, bringing that total to four. Health and Family Services Secretary Eric Friedlander announced that all employees at congregate residential settings serving older or disabled adults will be tested at least every 14 days. Those who test positive will be tested again for confirmation, and residents with symptoms will also be tested.

Louisville study indicates wider infection: Four to six times more people than previously reported may have been exposed to the coronavirus since the beginning of the pandemic, according to researchers tracking it in Jefferson County. The University of Louisville's Co-Immunity Project tested a representative sample of 509 residents and got results from 1,728 others who heard about the project and were tested on their own.

"At least 0.05 percent of the participants had an active infection," and somewhere between 3.2 and 5.1 percent "had detectable levels of antibodies in their blood, indicating they had been exposed to the virus earlier in the year," the project reported. “It would suggest that as many as 20,000 people may have been exposed to the virus – many more than the 3,813 cases reported in the city by the end of June,” said Aruni Bhatnagar, director of U of L's Brown Envirome Institute.

"This difference may be due to the fact that people did not have symptoms and were not aware they were infected," a university news release said. Beshear, at his briefing, said that if the study is accurate, it indicates a much larger number of people have the virus without symptoms. Research shows they can still spread it.

Rachel Keith, the assistant professor of environmental medicine who conducted the study, said in the release, “This suggests that the virus is much more widespread in our community than previously estimated. I believe this indicates a need for continued and widespread testing, including antibody testing, which plays an important role in understanding the spread of disease.”

Child care: A poll of Kentucky parents and families, taken as many Kentuckians went back to work June 24 through July 14, found that nearly 30% struggled to find child care, and more than half said they were moderately to extremely stressed about sending their child back to child care, mainly for reasons of health and safety. The poll was commissioned by the Prichard Committee for Academic Excellence, Kentucky Youth Advocates and other organizations including local United Way philanthropies.

Asked about the poll, Beshear said child care is one of his many worries. "It’s a heck of challenge," he said. "I’m a big supporter of child care but I’ve had to make some tough decisions. Friedlander said there is a greatly reduced capacity across our system” because 20% of centers haven’t reopened and the state has limited the size of groups to 10 children. He said officials need to discuss additional support and services for the centers.

Consortium chart; most labels added by Ky. Health News

Polls on leaders: Before Beshear issued his mask order on July 9, Kentuckians' approval of his handling of the pandemic had dropped to around 60 percent, from the nearly 80 percent in late April, according to polls by The Covid-19 Consortium for Understanding the Public’s Policy Preferences Across States, formed by a group of survey researchers at several major universities.

President Trump remains popular in Kentucky, which he carried by almost 30 percentage points in 2016, but the polls showed his rating on the pandemic well under Beshear, a Democrat. The gap has narrowed in each poll, and Trump's rating may have risen in June, but the increase was only 4 points and the poll's margin of error for Kentucky is plus or minus 6 percentage points.

Largest available screenshot of map in CDC-published study

A warning: Kentucky is among the states most vulnerable to severe covid-19 illness due to five underlying medical conditions in the population, says a study published by the U.S. Centers for Disease Control and Prevention. The conditions are chronic obstructive pulmonary disease, cardiovascular disease, diabetes, chronic kidney disease and obesity; the data are from 2018.

"Prevalence was higher in more rural counties," the study says. "The findings can help local decision-makers identify areas at higher risk for severe COVID-19 illness in their jurisdictions and guide resource allocation and implementation of community mitigation strategies."

In other covid-19 news Thursday:

• Counties with more than five new cases were Jefferson, 116; Warren, 49; Oldham, 32; Fayette, 28; Boyle, 27; Harlan, 19; Laurel, 19; Bell, 17; Kenton, 16; Campbell and Graves, 14 each; Christian and Daviess, 13 each; Jessamine and Scott, 12 each; Hardin and Ohio, 10 each; Boone and Henderson, 9 each; Bullitt and Madison, 8 each; Pike, 7; and Trigg, 6.
• The University of Kentucky, blaming a software problem, reported that 26 of its 30,000 coronavirus tests had produced false positive results. Noting the small percentage, Beshear said “We believe that with the number of tests out there the error rate is very low.”
• The state Supreme Court allowed Circuit Judge Brian Privett of Georgetown to keep hearing a lawsuit challenging Beshear's emergency orders. Beshear had cited a social-media post in which Privett referred to one of the plaintiffs, Agriculture Commissioner Ryan Quarles of Georgetown, as a friend, but he said in court that he has no personal relationship with Quarles.
• Current research confirms that direct person-to-person transmission is the main way the virus spreads, so "That’s why social distancing and using protective equipment including face masks is really critical for reducing the spread," says UK virologist Rebecca Dutch. She says one big question is the coming flu season; getting one virus could make you more vulnerable to the other, "but we also know that in some cases, having one virus can essentially keep the other from infecting. . . . I would strongly suggest going into this flu season that everyone get a flu shot."
• "Republican infighting has led to an embarrassing setback on new coronavirus aid," Politico reports.

Foundation's annual policy forum shifts gears in pandemic, to be a series of monthly webinars on children's health, starting Sept. 21

The Foundation for a Healthy Kentucky's 20th annual policy forum will focus on policies and programs that reduce the chances of disease and unhealthy behaviors that often begin in childhood, including substance use, suicide and vaping.

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

The foundation is partnering with Kentucky Youth Advocates in offering this year's forum, titled "Moving Kids Toward Natural Highs: Kentucky Opportunities to Prevent Youth Substance Use, Suicide and Risky Behaviors."

The series will feature speakers on "The State of Child Health in Kentucky" (September), "Intervening Early" (October), "Promoting Healthy Lifestyles through Nutrition and Physical Activity" (November), "Understanding Youth and Building Good Mental Health" (December), and "Stopping Vaping and Substance Use" (January). In each webinar, a Kentucky youth will offer comments regarding peer interventions, except the one regarding early interventions.

Voices from the coronavirus pandemic: Oral histories from just a few of the millions whose lives have been changed by it

Lori Wagoner at her work station in North Carolina (Photo by Eamon Queeney, The Washington Post)

As the coronavirus continues to surge across Kentucky and the nation, The Washington Post is continuing its series of oral histories from people affected in significant ways by the pandemic. Here are a few.

Becoming a defacto mask enforcer: Lori Wagoner, 63, never expected that her job as a retail clerk in a small North Carolina town would become so dangerous. But covid-19 has drastically changed her job responsibilities. After escalations with customers who refused to put on a map, Wagoner installed a doorbell and keeps the front door locked. And next to her, behind her register, is pepper spray. With the local sheriff’s office refusing to help enforce the mandate, she said, she is now acting as enforcer of the mask mandate.

A coroner’s tale: Michael Fowler delivers his story from Albany, Ga., population 77,000, where he’s in charge of examining deaths and keeping track of the numbers. Since March, cases have exploded, and his work has started to take a toll on him: “I don’t believe in getting hysterical. It doesn’t do any good. This is a numbers-and-facts job. But we have numbers and facts that are screaming out by themselves. I console people on the death of their relative one week and end up pronouncing them the next.”

A grocer’s account: Burnell Cotlon tells the stories of customers at the small grocery he started in the Lower Ninth Ward of New Orleans after Hurricane Katrina. It’s the only place to get fresh produce in his historically Black neighborhood; his customers have especially felt the pinch of job loss, since the pandemic largely shut down tourism in the city. Here’s one story: “She’d been having a hard time. She lost her income and needed groceries, so we started her on a tab. Then she caught the virus, and I delivered more groceries to her porch. She died last week, and a few days later, I went into the book to look at her tab. There are a few accounts closing like that now, and probably more coming. Hers was 72 dollars and 14 cents. I found her name and drew a line through it.”

One of the first: One of the most heartbreaking stories is about Indiana’s first covid-19 victim: Birdie Shelton from Indianapolis. Tony Sizemore, Shelton’s partner of close to a decade, blames himself for her death. He suspects she got the virus from her job, transporting rental cars, and says he should have made her quit, but “She liked to drive and we needed the money.” At first doctors didn’t know she had the virus; it was mainly in New York and Seattle then, and knowledge of it was still growing, he says: “Would it have gone any different if they knew what it was? Maybe. Or maybe they would have quarantined her right then, and I would have lost a few more days with her. See, I could analyze this to death. I’ll be doing this for the rest of my life.”

Reaching for a lifeline: Johnny Rivero of Tampa, Fla., relays his account of waiting in line at a food pantry for the first time in his life. A former maintenance worker who lost his job due to the pandemic, his family is slowly running out of savings; now they’re running out of food. His wife and daughter also lost their incomes due to the pandemic. The ending is bittersweet, with his delight at the fresh produce and the kindness of pantry workers, coupled with the reality that this food will last for three to four days.

Risking his life in a last-ditch effort to save others: Cory Deburghgraeve is a doctor in Chicago. His job of helping deliver high-risk babies quickly changed to full-time intubating covid-19 patients on the last leg of life. It's dangerous; when patients can no longer get enough oxygen on their own because of the disease, he sedates them and puts a breathing tube down their throats, inches from their mouths. For him, it’s especially dangerous because he has asthma, which puts him at higher risk of getting a severe version of covid-19.

A son comes home to his mother’s passing: Paul Swann delivers the story of his mother’s death due to covid-19 complications. Swann, who recently returned home from the military, serves as his mother’s primary caregiver in the run-up to her death in their home outside Syracuse, N.Y. It’s a heart-wrenching account of her pain and dementia-like symptoms and his struggle to keep her alive.

Guilt over a parent’s death: In Hartford, Conn., Francene Bailey falls ill with covid-19 and self-isolates in a bedroom within her multi-generational family home. Her mother later gets the disease and dies. Convinced she passed it to her mother, Bailey struggles with feelings of guilt and remorse.

Older, alone and at risk: 75-year-old Gloria Jackson self-isolates in her home in Minnesota, and talks about her feelings as being seen as disposable and in one of the highest-risk groups for death from covid-19.

If they’d seen what I saw: A New York paramedic who has responded to many calls from patients with covid-19, and so many deaths, is frustrated that people have stopped social distancing and carrying out other measures that could prevent more cases and deaths.

Hospitalizations and positive-test rates increase; daily cases fall, but 7-day average inches up; Beshear says deaths will rise

By Al Cross and Melissa Patrick

Kentucky Health News

More Kentuckians are testing positive for the coronavirus and more of them are being hospitalized with its covid-19 disease, but state officials say the surge can be stopped if Kentuckians wear masks, keep six feet from each other and practice good hygiene.

“We are taking the type of aggressive action that should work if we can band together and get most Kentuckians wearing some form of facial covering, have that social distancing,” Gov. Andy Beshear said as he reported the daily numbers.

They included 603 Kentuckians hospitalized for covid-19, which appears to be a record, and 145 of them in intensive care, the most since the first month of the pandemic. Beshear said the share of Kentuckians testing positive for the virus in the last seven days was 4.92 percent, also the highest since those days, when tests were largely limited to people with symptoms.

"That is a concern, and it shows it's not just an increase in testing" that is driving up the case numbers, Beshear said. Becker's Hospital Review offers a list of states ranked by the average of positive results in coronavirus tests over the last seven days; Kentucky ranked 20th.

Beshear said he disagreed with Louisville health officials' advice that people there get tested only if they have symptoms. "I still think we have enough testing capacity," he said, while acknowledging that is is worried about that supplies of testing reagents will run short.

He reported 518 new cases, less than the average of the previous three days. A better indicator, the seven-day rolling average, rose by six, to 565.

The governor reported three more covid-19 deaths, but added, "I think we need to expect that we will see in the coming weeks a significant increase in that," due to the surge in cases. The fatalities were a 49-year-old woman in Simpson County, who Beshear said had underlying health conditions; a 69-year-old woman in Allen County and 81-year-old man in Webster County. They raised the death toll to 677.

Noting that the Republican governors of Ohio and Indiana issued mask orders like the one he issued July 9, the Democratic governor said, “This should tell you that the step we took was the right step,” and said it would make the regional response more effective.

Also, “It should show you that there’s no political division in what is the right public-health response,” he said. “We all agree that one of the most important things we can do right now is encourage people to wear facial coverings. . . .This’ll be the number-one thing to determine if we can keep our economy open and this will be the best tool to try to get our kids back into school.”

Health Commissioner Steven Stack said at least one Kentucky hospital has accepted a covid-19 patient from a sister hospital in Tennessee, where hospitals are filling up with them.

As for Kentucky's recent surge, Stack said, "Whether that turns into a little hill, relatively speaking, or a big mountain, is entirely dependent on the actions of Team Kentucky. We can blunt this curve just like we flattened the first one."

The first curve was flattened by shutting down most of the state's economy. The White House Coronavirus Task Force has recommended that the state close down bars and cut restaurants' capacity to 25 percent from 50 percent, but Beshear said he would do that "if we see a sharp uptick in cases." He and Stack reiterated that they hope to see masks having an effect on case numbers by next Tuesday.

Alluding to President Trump's new posture toward the pandemic, Beshear said, “I’m hopeful. We’re seeing a lot of people out there doing the right thing. We’re seeing a lot of other people coming around. We’re seeing people on the national stage wearing a mask and saying it’s patriotic.”

Rhonda King leaves the hospital. (Image from WLKY-TV)

As he has resumed daily briefings, Beshear has also returned to telling encouraging stories posted on social media. One Wednesday was that of Rhonda King of Louisville, who was in intensive care for three months, much of it on a ventilator in a medically induced coma, but went home Tuesday. Beshear said the story had several heroes, including the recovered covid-19 patient who donated blood plasma that King received and King's husband, who called her three times a day.

Other metrics: Two websites that estimate reproduction rates for the virus say Kentucky's rate is 1.23, meaning that every 100 infected people would infect 123 others. Epidemiologists like to keep the rate below 1.1. On Tuesday, Kentucky had the highest estimated rate, 1.37, on the Rt.live site, but it recalculates rates every day; it now says the rate has been 1.23 since July 12.

The CovidActNow site also estimates rates for counties with enough data; counties with estimated rates higher than the state rate are Oldham (site of a virus outbreak in a prison), 1.85; Harlan, 1.47; Jefferson, 1.25; and Ohio, 1.24.

Counties with more than 10 new cases on Wednesday's report were Jefferson, 215; Fayette, 41; Kenton. 37; Hopkins, 33; Boone, 23; Shelby, 22; Graves, 21; Adair, 19; Logan, 19; Warren, 19; Butler, 14; Jackson, 14; Campbell, 13; Edmonson, 12; and Grayson, 11.

Another prison: The federal prison near Manchester is the fifth correctional facility in Kentucky to have an outbreak of the virus. The Bureau of Prisons reported that 39 inmates and five employees were infected, and one inmate has recovered from an infection.

The prison "houses a daily average of 1,082 inmates ranging in age from 20 to 74, according to a federal audit conducted in February. It employs 277 people,"reports John Cheves of the Lexington Herald-Leader. "The 240-acre facility includes a medium-security prison that held 950 people in February and a minimum-security satellite camp that held 138 people."

In other covid-19 news Wednesday:

• Beshear reported that 31 more residents and 22 more staff in long-term-care facilities had tested positive for the virus, raising the respective totals to 2,276 and 1,243. Two more deaths raised that total to 451. "We do think that it’s stabilizing, but as long as we have covid-19 its going to be a fight," Beshear said.
• Five more employees and three more children attending child-care centers tested positive, raising the respective totals to 30 and 21. Beshear said 36 centers now have at least one case associated with them.
• Stack urged parents whose children need vaccinations to get them, and said people who need medical care shouldn't hesitate to seek it. "The hospitals are much better prepared now," he said.
• He said "a small number" of deaths previously listed as related to covid-19 have been taken off that list by a review committee. "We're committed to being honest and open and trying to be as credible as possible," he said. "They know a lot more about how to keep people safe."
• Beshear said economizing by state agencies means that the state won't end the 2019-20 fiscal year with a shortfall, but it will need help from the federal government to avoid record budget cuts of 13 to 17 percent in the fiscal year that began July 1. He said he will talk to Senate Majority Leader Mitch McConnell about it: "I think he knows how much we need this."
• Franklin County Public Schools will reopen Aug. 26 with "100 percent virtual instruction," Valerie Honeycutt Spears reports for the Herald-Leader. A separate article explores the pros and cons of school reopenings, and notes a study showing that school-age children can spread the virus just as well as adults, especially as they get older.
• WDRB provides a transcript from Dr. Jason Smith, chief medical officer at U of L Health, that addresses the recent spread of the virus, covering such topics as death rates, testing, long-term impacts of the virus and the effectiveness of masks. 
• WFPL has a Q-and-A transcript with a pandemic expert on mask orders and school re-openings. Dr. Gerald Keusch, citing studies to support his claim, said, "There’s no question in my mind that the universal use of masks in public spaces is an effective, simple, cheap behavioral tool. This is totally separate from the value of contact tracing and spacing, both things that are relatively easy to do and were neglected during our initial reopening. The problem is that, like everything on the public health side, we’re unprepared to do it effectively. These measures are all interconnected, and they all need to be in place to get this under control."
• Drew Altman of the Kaiser Family Foundation writes for Axios that over a 14-day period ending July 10, new cases in long-term care facilities rose by 18% across the 23 states, including Kentucky, for which data are available. His bottom line: "The lesson for long-term care facilities may be the same as the lesson for schools: There is no way to get a handle on coronavirus in one setting without first controlling community spread overall."
• Derek Thompson reports for The Atlantic about how long covid-19 immunity may last, saying a recent study showing it could be lost in months only looked at one part of the issue.

Tick that can clone itself is found on cattle in Southern Ky. and wildlife in Eastern Ky.; it's also a threat to pets, and hard to identify

Asian longhorned tick (Photo by Anna Pasternak, UK)

By Katie Pratt
University of Kentucky College of Agriculture, Food and Environment

The Asian longhorned tick, which preys on a variety of hosts including humans and wild and domestic animals, has been found in Kentucky. This new tick is known to attack animals in large numbers and will be a concern to livestock producers, wildlife enthusiasts and pet owners.

“This tick is an aggressive biter and frequently builds intense infestations on domestic hosts that can cause stress, reduced growth and severe blood loss,” said Jonathan Larson, UK extension entomologist. “One reason for their rapid buildup is that the female ticks can lay eggs without mating. It only takes a single fed female tick to create a population of ticks. Potentially, thousands can be found on an animal.”

The tick has been found in small numbers on elk in Martin County and black bear in Floyd County. It was found in large numbers on a bull in Metcalfe County in the south-central part of the state.

“The Metcalfe County ticks were submitted by a veterinarian who answered a call about a bull so infested that it was showing signs of severe fatigue,” said Anna Pasternak, UK entomology graduate student who manages the Kentucky Tick Surveillance Program. Pasternak and Monica Cipriani, a student in the UK College of Public Health, sampled the Metcalfe County field and found more Asian longhorned ticks.

Metcalfe County (Wikipedia map)

“The Metcalfe County finding is particularly troubling,” Pasternak said. “It means the tick may have already spread farther across the state.”

The tick was found in the U.S. in 2017. It has also been confirmed in Arkansas, Tennessee, the Carolinas, West Virginia, Pennsylvania, Maryland, Delaware, New Jersey, New York and Connecticut.

In addition to wildlife, the asian longhorned tick preys on cats, dogs, horses and chickens. Humans also are a host. It is a known or suspected vector of several important livestock viral, bacterial and protozoan agents. Scientists are conducting tests on ticks collected in the United States, and it is likely that some ticks will contain germs that can be harmful to animals. 

The tick is hard to identify because it has no distinctive markings and unfed adults are smaller than other common adult ticks in Kentucky.

If you find an unusually large number of ticks on a pet or livestock, contact a veterinarian. If you think a tick might be an Asian longhorned tick, work with your county extension agent for agriculture and natural resources to submit the sample to UK entomologists for positive identification.

Ticks are a bigger problem than they once were, Kentucky Health News reported recently. UK has information on tick-bite prevention and removal at https://entomology.ca.uky.edu/ef618 and at county offices of the Cooperative Extension Service.

Spring lockdown followed by summer events makes people let their guard down and spread the virus, health departments say

Lexington Herald-Leader map, relabeled by Kentucky Health News

Coronavirus cases are surging in Kentucky because "people are letting their guard down" at summer events like barbecues, parades and vacations, Alex Acquisto of the Lexington Herald-Leader reports after interviewing local health-department directors and employees.

“Things are open, [people] have been locked down for three months and they want to live their lives thinking they can’t get it,” said Alicia Thompson, an infection-control nurse in Graves County, where cases have risen 18 percent in the last two weeks, the seventh-highest increase per-capita increase in the state.

"It’s the smaller communities across the state where growth rates are exploding," Acquisto writes. "While outbreaks in congregate settings such as nursing homes continue to be reliable hotspots, it’s the patchwork of small-to-medium sized interactions between people, including outdoor cookouts, that are largely to blame for Kentucky’s surge, according to eight health department directors across more than 30 counties."

People in their 20s and 30s are driving the increase in the eight Southern Kentucky counties served by the Barren River District Health Department, Director Matt Hunt said, "The average age of those who’ve tested positive is 38," Acquisto writes. "This may not be a surprise, many said, but it should serve as a reminder: even small groups of people can propagate aggressive spread of the virus."

Lake Cumberland District Health Department Director Shawn Crabtree tracks major causes of infections in his 10-county area: 14% from churches, 3% from restaurants and 18% from businesses, but he notes, “One person could be tied to more than one area. You could be tied to travel and church if you are positive during both of those activities.”

Directors told Acquisto that use of masks has increased since Gov. Andy Beshear ordered it, but remains spotty. “It seems like we’ve got half that take it seriously and half that don’t. Half that believe it’s a hoax or is being inflated,” Crabtree said.

Another director "wonders if Kentucky’s early success at keeping its infection rates at bay is now working against it," Acquisto reports. "The state’s health care system has so avoided being hobbled by unmanageable case loads or deaths, making it easy for some to dismiss the still-present dangers of the virus."

Kentucky River District Health Department Director Scott Lockard told Acquisto that the success of preventive efforts can go unappreciated: “Nothing is happening and people get complacent and think, ‘Oh, this is not as bad as it’s been made out to be,’ so they start getting together again,” he said.

Now Lockard worries about the many people in his area whose underlying health conditions make them more vulnerable to dying of covid-19. “When it hits us full force, which I still do not think it has hit us like it’s going to hit us here in Eastern Kentucky, we’re going to see some very negative impacts on some very medically fragile people,” he said. “We’re playing with life and death here.”

Ky. records second highest number of cases and most patients in intensive care in one day; Beshear defends statewide approach

Kentucky Health News chart; daily numbers may have been slightly adjusted since initial report.

By Al Cross

Kentucky Health News

Gov. Andy Beshear reported Tuesday the second highest number of Kentucky coronavirus cases in day, 674, and a record higher number of covid-19 patients in Kentucky hospitals' intensive-care units, 132.

Beshear largely rebuffed Republican legislators' suggestions that his limits on activity be reduced in areas that have low infection rates, saying the virus can spread too quickly for that, and he urged Kentuckians to follow his advisory against traveling to states with high rates.

Slide displayed by Beshear details his travel advisory.

"I need you to cancel your plans if you’re going to a beach … in any of these states," he said, referring to those with a 15 percent or higher rate of tests for the virus.

The number of new cases drove Kentucky's seven-day rolling average to 559, a new high. "These numbers today are not a surprise," Health Commissioner Steven Stack said.

Only three more covid-19 deaths were reported Tuesday, but Beshear said the disease's mortality rate means that the 674 new cases could lead to 20 deaths, and he noted that deaths "lag by about 14 days or more from the announced cases."

Another "worrisome number," the governor said, is the 532 covid-19 patients in Kentucky hospitals, 10 fewer than reported the day before but still well above last week's average of 453.

"We've gotta be committed to doing better, and I see a lot of that out there," he said.

As cases surged in the first full week of July, Beshear ordered Kentuckians to wear masks in indoor public spaces and outdoors when they can't keep six feet apart. He said not enough time has passed to see the effect of the order, but “Our hope is that we will start seeing results from the mask requirement by early next week.” Earlier, he said he hoped to see case numbers level off by next Tuesday.

Asked about the fate of next month's state fair and the Sept. 5 Kentucky Derby, both of which he has allowed to continue with restrictions, Beshear said "We just need to get hold of this virus," and "That mask requirement’s gonna have to be really, really enforced; social distancing, really, really enforced."

Legislators weigh in: House Speaker David Osborne and Speaker Pro Tem David Meade said in a joint Facebook Live interview that Beshear should relax restrictions in areas with low infection rates. "We continue to need to be a little more surgical," Osborne told Richard Nelson of the Commonwealth Policy Center, which lobbies for conservative, faith-based policies.

Without referring directly to the legislators, Beshear rejected the idea in his opening remarks: "There is only one way to address this virus and that's with statewide policies. You can't pretend people don't drive between counties. I think every public-health expert here in Kentucky would agree that this is the time for statewide action."

He introduced Stack, who said, “We would like to be as precise as can in our interventions, but if we want to do things county by county, it just doesn’t work. . . . We will continue to look for ways to be as precise as we possibly can so we can limit the impact on our daily activities.”

During questioning, Beshear said more "surgical" action might be the best alternative to control outbreaks in specific areas or businesses.

Stack also tried to deliver the message that the virus, which was identified Dec, 31, is much more serious than many skeptics make it out to be.

"There’s a lot we don’t know about this disease," he said, noting that it can cause stroke, heart trouble, respiratory failure, blood clots in the lungs, and other issues. "We don’t really know the true extent of our vulnerability."

Beshear said, "The positive news is that we know how to beat it . . . but we are in such a critical period." He asked Kentuckians to remember the "hands, face and space" mantra for washing hands, wearing face coverings and keeping six feet apart, and said they should have masks around their necks outdoors in case they come into close contact.

Prison outbreak: A coronavirus outbreak "has ravaged the Kentucky State Reformatory, a state prison in Oldham County, killing three inmates and infecting at least 168 inmates and 14 employees" over the last two weeks, John Cheves reports for the Lexington Herald-Leader. "The prison, which is primarily meant to hold medically vulnerable inmates," is Kentucky's third to have a major outbreak.Six inmates have died; at least seven more have died at a federal prison in Lexington.

"The Department of Corrections website confirms a recent scattering of employee infections at prisons including Bell County Forestry Camp, Kentucky State Penitentiary, Lee Adjustment Center, Northpoint Training Center and Roederer Correctional Complex," Cheves reports. "With inmate visitation canceled due to the coronavirus pandemic, prison staff are the primary people moving between the institutions and outside communities each day, potentially carrying the virus with them."

Inmates are suing the department in federal court "for what they describe as a slow, clumsy response," Cheves reports. Department spokeswoman Lisa Lamb "said Tuesday that prison officials are carefully screening anyone who enters the prisons for symptoms of covid-19; they have increased cleaning of the facilities using a germicide and bleach solution; and they have provided masks for all inmates and employees, for mandatory usage."

In other covid-19 news Tuesday:

• The three covid-19 fatalities were a 63-year-old man from Calloway County, a 91-year-old woman from Casey County and a 95-year-old man from Shelby County. "We continue to see a lot of people in their 60s passing away," Beshear said, "and I hope a lot of us don't believe that is old."
• Counties with new-case numbers in double figures Tuesday were Jefferson, 180; Fayette, 35; Warren, 24; Barren, 23; Harlan and Madison, 22 each; Hardin, 19; Kenton, 17; McCracken, 14; Bullitt, Campbell and Henderson, 13 each; Boone, Casey and Daviess, 12 each; Oldham, 11; and Laurel, 10.
• Lt. Gov. Jacqueline Coleman announced that the state is allowing school districts to use online instruction for an unlimited number of days and is waiving the attendance-based funding formula, which will allows hybrid models, such as having some students in classrooms on some days and  others on other days.
• Coleman also announced a "virtual town hall" from 2 to 4 p.m. Thursday on reopening schools, mainly for educators and staff.
• The University of Kentucky is requiring students who have at least one class on campus to get tested for the virus. It said students will be able to schedule free tests from 8 a.m. to 4 p.m. Aug. 3-22. They can also get tested off campus within a week of arriving on campus. Classes begin Aug. 17.
• Researchers reported that tests for antibodies to the virus indicate that millions of Americans have been spreading it without knowing that they have it.
• President Trump resumed briefings on the pandemic and said it will probably get worse before it gets better, reversing previous statements. He also advised Americans to wear masks.

Beshear limits private gatherings to 10 people, issues travel-and-quarantine advisory for states with high rates of positive tests

Gov. Andy Beshear showed a version of this chart; current figure was added later by Kentucky Health News.

By Melissa Patrick and Al Cross
Kentucky Health News

Trying to tame the surging coronavirus, Gov. Andy Beshear limited private social gatherings to 10 people, down from the 50 allowed for the last three weeks, and issued a travel advisory saying Kentuckians shouldn't visit states with high positive-test rates -- and if they do, should isolate for two weeks upon return.

“We’ve got to, in the next 10 to 20 days, stop the increase,” Beshear said. “Otherwise, we’re gonna have to take more significant action.”

The advisory can't be enforced, and the limit on gatherings does not affect businesses, including wedding venues. "They have licenses that give them the motive to clean and do the right things," Beshear explained.

“We’re seeing clusters created by our backyard barbecues, by our block parties, and it’s because we let our guard down," he said. "We have a lot of friends over and we know them. We figure they’re probably doing everything right. We take off our masks about half way in between, we relax, we get too close, we stand around while people are grilling -- and we’re seeing some very difficult outcomes because of it."

The latest numbers: Nearly 1,000 new cases found in Kentucky on Sunday obliterated the previous record and drove the seven-day rolling average of new cases to 547, more than double what it was two weeks earlier. It is now 545, tempered by Monday's new-case figure of 258, which Beshear said was low due to lack of reporting from testing laboratories closed on Sunday.

"I expect that number will grow some tomorrow," as the labs catch up on reporting, Beshear said at the first of newly resumed daily covid-19 briefing. "I expect the number to be much higher by Wednesday or Thursday."

Then he reminded Kentuckians that more cases results in more deaths from covid-19, the disease caused by the virus. While Kentucky has a lower mortality rate than the nation, its rate of 3% still means that the state can expect about 30 more deaths from the 979 cases reported Sunday, he said.

"Those are 30 people that we love and we care about, and it just shows you that these numbers aren't just numbers," he said. "They represent real people that are put in danger and the higher the number, the more people that are going to be put in danger for the worst."

Beshear reported only one new death Monday, a 94-year-old Casey County woman, bringing the state's toll to 671. However, deaths are a lagging indicator of virus activity; hospital data are less so. The governor said 542 people are hospitalized with the virus, with 114 of them are in intensive care, and both those numbers appear to be the highest yet.

The rate of positive tests for the virus has also been going up. On Monday, the seven-day average was 4.52 percent. Beshear displayed a graph showing how the weekly rate has risen for more than a month, showing that the rising case numbers aren't driven by more testing. 

“Any concept that there’s just more testing out there and that the virus is still in the same place is absolutely and categorically false,” he said. “We need people to know that. A fact’s a fact. Twitter can’t change that.” President Trump regularly makes this assertion, most recently on "Fox News Sunday."

Possible options: Beshear didn't mention Trump, but noted that the White House is advising states with significant surges to do three things: require masks, which he did July 10; reducing restaurant capacity to 25% in hard-hit areas; and closing bars.

Last week's report to governors included Kentucky among those states. Beshear said Kentucky's situation isn't dire enough to adopt the other two suggestions, but they "show us the inevitable if we can't get this under control."

Restaurant capacity is now limited to 50%, and "I remember how many of our restaurants can’t operate even at 33%,” Beshear said. He urged restaurants, "Please encourage mask wearing. . . . I want to make sure we don’t hit that surge that we have seen in other places so we don’t have to adopt those White House suggestions. One facility doing the wrong thing can hurt everyone else."

He said Monday's action "is us trying to stop this thing before if gets out of control," and that the surge threatens school re-openings. “We gotta make sure that we’re not asking schools to open at a time when cases are increasing significantly,” he said.

Asked at what point he would have to further tighten restrictions, Beshear didn't reply directly but said business owners -- the front-line enforcers of his mask mandate -- need to think about their long-term interests. “What we really need is their help educating everybody else,” he said.

Travel is a problem: Beshear's travel advisory calls on anyone who has traveled to a state with a 15% positive test rate or greater to quarantine for 14 days when they return to Kentucky. He can't make it mandatory, under a ruling several weeks ago from U.S. District Judge William O. Bertelsman.

As of Monday, the states were Alabama, with an 18.13% positive test rate; Arizona, 23.56%; Florida, 18.72%; Georgia, 15.24%; Idaho, 18.15%; Nevada, 19.14%; South Carolina, 15.71%; and Texas, 15.01%. Beshear's news release also included Mississippi, which has a positive test rate of 14.82% and is "quickly approaching" 15%, the release said.

Beshear said travel has been the major cause of case clusters. "We’re not seeing near the number related to bars as related to travel," he said. "I've been begging and pleading for people not to go when we know how much has been brought back."

Health Commissioner Steven Stack said going to one of these states "is like going to a nuclear waste zone as far as how intense the infection is spreading. It is not a real good idea to go there." He said of the 15% threshold, “It’s not like we’re setting a low bar; that’s a red-flashing-light danger area.”

Asked how long it would take to see impact of Beshear's mask mandate, Stack said. "If people really followed it," at levels of 80 to 90 percent, a decrease could be expected in two to three weeks." 

Beshear said, "We know it will have an impact . . . What we’re gonna find out is how much it will."

Stack noted the numbers of the last two weeks and said, "All the indications are that we are in that accelerating phase. . . . The problem is once you start that turn, once you hit the inflection point you start this vertical climb and it's like going up Mount Everest."

He added, “Sunday was a rude wake-up call. Sunday is a warning. It’s a shot across the bow. If we don't intervene, then we are going to see the fate here in Kentucky that they are seeing in some of these other states."

Stack said, "We're not really at the phase [where] I want to instill fear," but warned, "Where we go from here is in each one of your hands, whether we can adopt a simple measure like wearing a mask . .. This one measure could help control this pandemic well enough to bridge us until we get to a vaccine, treatments and cures."

Beshear said that while Kentuckians are tired of dealing with the virus, "We don't get to take days or hours off. . . . We are in a war against this virus and right now we are sitting in that trench, knowing that we've got to dig in  if we want to win," he said. "And in doing that, we've got to be able to count on the person beside us, which is every single Kentuckian to do the right thing."

Beshear again noted that children are increasingly affected by the virus, with eight of today's cases in children under five and two of the eight under three months old, both in Louisville.

Louisville and Lexington had the highest number of new cases Monday, with 93 and 36, respectively. Counties with more than five new cases were Kenton, eight; Shelby and Warren, seven each; Boyd, six; and Campbell, Christian, Daviess, Graves, Hardin and Harlan, five each.

Baseball episode: Beshear was asked about the youth baseball game in Louisville where officials said he expressed concern about lack of mask wearing. He said his son was supposed to pitch in the game, but "I looked around and said 'This isn't safe for my kid'."

Beshear began his response to the question by saying, "I really think kids and the situations around them need to be off limits," adding that some unknown person has been taking pictures of his 11-year-old son at games and posting them online, trying to send a message.

"I know when people try to post pictures of my kids, what they're really trying to tell me is, 'We know where you are. We can get to you'," Beshear said. "I am not going to be bullied by you. We are doing the right thing to protect people's lives. We're doing the right thing to protect our economy. And it takes a small person to go after somebody's kids."

In other covid-19 news Monday:

• An outbreak among Hazard High School football players has spread to at least 38 people: "18 football players, three coaches and 17 of their family members and close contacts," the Lexington Herald-Leader reports. Kentucky River District Health Department Director Scott Lockard said the outbreak has been traced to one family's vacation to a place he declined to name. But he said the football weight room "was a big part of the transmission. Last week, Beshear mentioned an outbreak in a football weight room but declined to name the school.

• A Radcliff couple who refused to sign a self-isolation order when one tested positive for the virus is under house arrest with ankle monitors. Elizabeth Linscott said she refused to sign a form saying she would check in daily, self-isolate and “not travel by any public, commercial or health-care conveyance such as ambulance, bus, taxi, airplane, train or boat without the prior approval of the Department of Public Health.” She said she might have had to do that in an emergency.

• The Scott County Detention Center in Georgetown has stopped accepting new inmates for two weeks after finding several cases of the virus in the jail. It has no “safe space” for new inmates, Jailer Derran Broyles wrote on Facebook.

• The Louisville Courier Journal summarizes what's at stake as the Supreme Court of Kentucky prepares to consider legal challenges to Beshear's emergency orders and the law he cites in them.

• "Dysfunctional politics, a lack of funding for public health and a rush to reopen the economy ignited the resurgence of the virus," The Washington Post says in a comprehensive report: "The country’s ineffective response has shocked observers around the planet. Many countries have rigorously driven infection rates nearly to zero. In the United States, coronavirus transmission is out of control."

• "Dr. Anthony Fauci, the nation’s foremost expert on infectious diseases, will throw out the first pitch Thursday to start the abbreviated Major League Baseball season. Fauci, who wore a Washington Nationals face mask when he testified before a House committee in June, was invited by the defending World Series champions, who host the New York Yankees on Opening Day," McClatchy Co. newspapers report.

Report prepared for task force says Ky. should tighten limits on gatherings and restaurants, close bars where positive tests are up

A report prepared for the White House Coronavirus Task Force recommended that Gov. Andy Beshear should close bars in all counties with rising percentages of positive tests for the coronavirus, limit social gatherings to no more than 10 people, decrease indoor restaurant capacity to 25 percent and "increase outdoor dining opportunities."

The recommendations were in a previously unpublicized document published by the Center for Public Integrity, a nonprofit newsroom based in Washington, D.C. It is unclear whether the recommendations were delivered to states. ProPublica reports, "Dr. Deborah Birx, a leader of the task force, referenced an earlier version of what appears to be the same report — which she said was updated weekly and sent to governors — in a press conference July 8."

If adopted, the recommendations would be significant rollbacks; Beshear has limited bars and restaurants to 50 percent capacity and allowed gatherings of up to 50 people. The governor said Sunday that he would have to take action in response to a surge of daily new cases, particularly the new record set Sunday.

The report listed states and counties in a "red zone" if they had more than 100 new cases per 100,000 population in the previous week. It said that was true of five Kentucky counties and listed them in this order: Shelby, Graves, Carroll, Casey and Carlisle.

It said people living in red zones should reduce their public interactions and activities to 25 percent of normal; not go to bars, nightclubs and gyms, which should be closed; and wear a mask at all times outside the home, among other precautions.

Screenshot from White House Coronavirus Task Force report

The report said the state was in a "yellow zone" because its positive-test rate had exceeded 5 percent, but said it was in the red zone in terms of cases, with a 51 percent increase in the previous week. That trend has continued since, with a the seven-day rolling average of new cases setting records six days in a row and Sunday's new-case number of 979 exceeding the old record by hundreds.

It said 54 counties were in the yellow zone and listed the top 12: Jefferson, Fayette, Warren, Boone, Laurel, Daviess, Hardin, Christian, Campbell, Knox, Bell and Hopkins.

The report said the state's positive-test rate in the previous week was 7.8 percent, much higher than the rates of 4 to 5 percent than state officials have been reporting. It said the rate had increased 1.2 percentage points from the previous week. State officials have not explained this discrepancy.