Beshear slams CDC's change in guidance for testing, keeps noting kids' cases in counties that have started in-person classes

By Mary Meehan
Kentucky Health News

Gov. Andy Beshear broke sharply with the Trump administration on a key coronavirus issue Wednesday, calling “wrong and reckless” the Centers for Disease Control and Prevention’s revised guidance for coronavirus testing.

“I haven't criticized Washington much, but is this one, this one hurts us all,” Beshear said at his daily briefing.

The CDC quietly changed its guidance to eliminate advice that anyone who’s had close contact with someone who has the virus should get tested, regardless of whether they have symptoms. It now says, “You do not necessarily need a test unless you are a vulnerable individual, or your health-care provider or state or local public-health officials recommend you take one.”

Health Commissioner Steven Stack so recommended: “I would encourage you, if you have a high-risk exposure to still get tested, and not use this to justify a lack of need to get testing.”

“It's very important to get tested,” Stack said, especially, if you had a high-risk exposure or have symptoms or are around anyone who is (in) a high-risk population.”

Other public-health experts have expressed alarm at the change, Market Watch reports, largely because it is estimated that up to 40 percent of people who have the coronavirus don't have symptoms, but can still spread it. 

“I am dumbfounded by this recommendation,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN. He said the only reason he could think of for it is reduced testing, which will result in “more cases, more deaths.”

CNN reported. based on an unnamed source, that the CDC changed the testing guidance under pressure “from the top” of the Trump administration. The Washington Post reported that it was approved by the White House Coronavirus Task Force; a key member, Dr. Anthony Fauci, the nation’s top infectious-disease expert, told CNN that the vote was taken when he was under general anesthesia in surgery.  "I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern," Fauci said. "In fact. it is."

The Post reports, “Brett Giroir, an assistant Health and Human Services secretary who coordinates coronavirus testing, said the revision does not reflect any effort to reduce testing,” which President Trump has sometimes seemed to want. “He said it reflects evolving understanding that a negative test result a few days after exposure may give someone false confidence that they have not become infected.”

Stack acknowledged that the back-and-forth could confuse the public. But he said the new guidance also says to follow state guidelines in areas where the disease is more active, which applies to much of Kentucky.

Whether or not to get tested is not the only guidance being adjusted. Stack said the state will no longer advise workers who in essential industries such as food, energy and health care that they can pass up quarantine if exposed.

“The entire concept of critical infrastructure worker, an essential worker, has unfortunately become fairly distorted as we've gone on,” Stack said. “Local health departments are finding all sorts of people are claiming they’re critical infrastructure workers and they shouldn't have to quarantine after a high-risk exposure.”

Numbers and schools: Beshear announced 696 new coronavirus cases in Kentucky, putting the state’s seven-day rolling average at 650, sixth highest of the pandemic.     

The percentage of Kentuckians testing positive for the virus in the last seven days is 4.64%, the second time this week it has dipped below the 5% level that puts states in a Coronavirus Task Force danger zone.

“That's one of the lowest numbers we've had in the past four or so weeks,” Beshear said, calling it “still too high.”

Minors accounted for 16% of the new cases, or 114. Beshear said they included three school-age children in both Calloway and Barren counties and nine in Warren County, all of which began in-person classes this week. He said Warren has had 23 such cases just four days after starting school last week, despite Beshear’s recommendation to wait until Sept. 28.

Children testing positive, he said, are “continuing to be a larger and larger piece [in] some school districts that either are opening or have opened.” Then he stepped up his pressure on local school officials, to the point of suggesting that they reverse course.

“We need to make sure that we make decisions based on science on what's in the best interest of those we serve and not just based on complaints,” he said. “When we start making decisions based on that, on comments on Facebook, then you very quickly let a small group of folks that are upset know how to steer your decision-making.

“So, if you're in an area where you think you've made a wrong decision, there’s always time to make the right one.”

According to state data, as of Wednesday there were active cases in 59 students and 28 school staff, in 40 districts and 74 schools.

Kentucky has 606 covid-19 hospital cases, 146 of them in intensive care and 96 of those on ventilators. There are 557 active cases among residents in long-term care and 341 active cases among employees.

Beshear reported seven new covid-19 deaths Wednesday, bringing Kentucky’s total to 896. The fatalities were an 89-year-old woman from Boone County; an 81-year-old woman from Graves County; a 79-year-old woman from Greenup County; two men, ages 50 and 89, from Jefferson County; a 91-year-old woman from Oldham County; and an 83-year-old man from Whitley County.

Counties with 10 or more new cases were Jefferson, 136; Todd, 48; Warren, 47; Christian, 41; Madison, 30; Fayette, 27; Scott, 26; Bullitt, 23; Lewis, 21; Daviess, 18; Jackson, 11; and 10 in Boone, Kenton and Rowan. Beshear noted some of the smaller counties, saying “Our counties are tiny.”

In other covid-19 news Wednesday:

• Ten more athletes at the University of Kentucky have tested positive for an active infection of the coronavirus, Jon Hale reports for the Louisville Courier Journal. UK tested 416 athletes in the latest round, Aug. 7-19. UK did not specify teams of the athletes who tested positive, but football coach Mark Stoops told reporters that three of his players had tested positive in this round..
• Lt. Gov. Jacqueline Coleman gave an update on the Team Kentucky Fund, to which more than $3.5 million has been donated.  She said that through the state’s partnership with Community Action Kentucky, for every $1 given to the fund, $1.70 goes to Kentuckians in need. She showed the top categories: electricity: $101,952; food: $123,209; mortgage: $102,287; rent: $410,291; for a grand total: $789,659.  Coleman said 2,421 vouchers had been issued, helping 1,032 households.

Legislative committee holds hearing on bipartisan bill to ban 'conversion therapy' for changing sexual orientation of minors

A bill to ban the "conversion therapy" for changing sexual orientation got a hearing before an interim legislative committee Tuesday, perhaps improving its chance for passage in the General Assembly session that is scheduled to begin in January.

"Resuming their bipartisan alliance, Republican Sen. Alice Forgy Kerr and Democratic Rep. Lisa Willner referred to conversion therapy as a discredited practice with potentially dangerous consequences," Louisville's WDRB-TV reports.

Kerr, one of whose children is gay, called the procedure “conversion torture.”

The bill would prohibit licensed mental health professionals from using conversion therapy on minors, or on adults deemed to lack capacity for responsible decision-making. "The bill’s supporters also want to block public money from going to any agency in Kentucky involved in conversion therapy," WDRB reports.

The bill is opposed by the Family Foundation of Kentucky, which said it would impede freedom of speech and religion and parental rights. The foundation's Daniel Mingo said the bill discriminates because it would block a form of counseling for unwanted same-sex attractions, but not counseling for those who “want to be gay."

Kerr told the Interim Joint Committee on Licensing, Occupations and Administrative Regulations that parents want to “pray the gay away in their child,” and cited studies indicating that youngsters undergoing conversion therapy are more likely to commit suicide.

Zach Meiners of Louisville, who underwent conversion therapy as a teenager, called it a “shame-based” practice and said it taught him to inflict physical pain on himself anytime he had “a gay thought.” He said he became suicidal.

The Foundation for a Healthy Kentucky endorsed the bill, saying it "joins a long list of major medical and mental-health organizations in supporting legislation to protect LGBTQ youth from the discredited and harmful practice." It said at least 20 states and 700 cities and counties "have taken action to protect youth from these practices, according to the Movement Advancement Project."

Beshear says fewer Ky. counties on covid-19 danger list because mask mandate works; positive-test rate goes back above 5%

Lt. Gov. Jacqueline Coleman used this slide to make an announcement at the briefing.

By Mary Meehan and Melissa Patrick

Kentucky Health News 

As the share of Kentuckians testing positive for the coronavirus again rose above the danger level of 5 percent, Gov. Andy Beshear pointed to a federal report that shows fewer Kentucky counties are in covid-19 danger zones, and said that can be attributed to his order to wear masks in public.

“What they say in that report is masks are working,” Beshear said at his daily briefing, adding later, “Federal government says it's working, state government says it's working, all of the public-health officials all the way up and down say it's working.

"So it's easy, just wear a mask. If you refuse to, just know that [you’ll] be spreading it to someone else. Regardless of how you feel about it, everybody else is willing to go through the discomfort. Why won’t you?”

Beshear announced 688 new coronavirus cases in Kentucky, lifting the state’s seven-day rolling average to 644, the seventh highest of the pandemic. The percentage of Kentuckians testing positive for the virus in the last seven days increased to 5.07%, up from 4.77% on Monday. 

“We like being below 5. We really want to get below 4,” Beshear said. “A lot of states that are doing things we really want to do are below 3 or even lower. So . . . let's get competitive with other states and let's get competitive about something that saves lives.” 

Warren County again: Beshear said 96 of Tuesday’s new cases were children, and noted that Warren County had six of them, and “14 school-aged kids in the last three days. That is really concerning.”

Warren County and Bowling Green schools started in-person classes this week, despite Beshear's recommendation to wait until Sept. 28. He has repeatedly called out the county, and did it twice Tuesday.

He noted that the county remains in the federal report’s “red zone,” for places where new weekly cases of the virus numbered more than 1 per 1,000 residents and the share of residents who tested positive for the virus during the week was more than 10%.

Beshear said decisions about when, and how, to return to school matter, as he announced that 57 students and 25 staff have active cases of the coronavirus, an increase of seven and four, respectively, from yesterday. 

“So this is a highly contagious, aggressively spreading virus. We need to be very, very careful,” he said. “And this is one of the reasons that I still don't believe it's safe for schools to open before September 28.” 

The state reported 236 active cases at Kentucky universities and colleges.  

Kentucky has 588 covid-19 hospital cases, 151 of them in the ICU and 81 of those on ventilators. There were 13 new cases of residents in long-term care and 16 new staff members testing positive. Three more residents have died. 

While most of Kentucky’s deaths continue to be older people, Beshear in recent weeks has highlighted the increasing number of children who are testing positive, and emphasized that the long-term health consequences for young people who recover are still unknown.

Child care: Beshear fielded several questions about his limits on the number of children at child-care facilities, the topic of a Republican-led news conference before his briefing. He indicated that a new plan for child-care centers is coming soon. 

Asked about Sen. Danny Carroll's argument that since no children have died, child-care centers should be allowed to expand, Beshear noted that Carroll, a Paducah Republican, is a frequent critic, and expressed frustration that covid-19 has become politically charged.

“Are we really going to base information, decisions that we make for the overall health, just on how many people have died? Is that it? I mean, that's just . . . like consulting not with Dr. Stack or Dr. [Deborah] Birx but with the Dr. Pepper,” he said, repeating a jibe from last week.

He paraphrased Carroll as saying “Kids don't die, so let kids do everything,” and added, “Well, who's watching them? Adults. Adults die, and adults have died.” 

Internet for students: As schools return to class, many of them online, Kentucky announced plans to provide broadband service to the roughly 32,000 students who still don’t have access to the internet. 

“One of those old challenges that Kentucky continues to face is the digital divide,” Lt. Gov. Jacqueline Coleman said at the briefing. “That impacts our kids often in low-income communities in places that are hard to reach in rural Kentucky, as well as low-income families in urban areas of Kentucky.” 

To help them, she said the state is investing $8 million to reduce the monthly internet cost for low-income parents of K-12 students. The “Last Mile” internet service plan will provide eligible families access to high-speed internet at no more than $10 per month for the next two to three school years. She said internet providers should be chosen by Sept. 15.

Knott County schools have put their virtual re-opening on hold after a delay in a shipment of laptops, pushing the start date to Sept. 8 , Liz Moomey reports for the Lexington Herald-Leader. “I cannot with a clear conscience begin school next Monday, Aug. 24 knowing that many households will not have the needed devices to complete their virtual assignments,” Supt. Kim King said in a video posted on Facebook Wednesday.

In other covid-19 news Tuesday:

• Beshear reported 10 new covid-19 deaths Tuesday, bringing Kentucky’s total to 895. Today’s deaths include three women, 80, 84 and 85, from Lewis County, which had an outbreak at a nursing home; an 84-year-old man and a 92-year-old woman from Scott County; an 81-year-old Bell County man; a 59-year-old Daviess County man; an 89-year-old Jefferson County man; an 87-year-old Logan County woman; and a 79-year-old Webster County man. 
• Counties with 10 or more new cases were Jefferson, 203; Warren, 78; Fayette, 45; Madison, 22; Christian, 18; Hardin, 14; Logan and Rowan, 14 each; Greenup, Kenton and McCracken, 12 each; and Laurel, Oldham and Pulaski, 10 each. 
• J. Michael Brown, secretary of Beshear’s executive cabinet, announced that 646 inmates will have their sentences commuted due to covid-19; 121 are considered medically vulnerable to the disease, and 525 have committed non-violent and non-sexual crimes and have less than six months left to serve. The state previously released 1,200 inmates using the same criteria.
• UPS is building a massive vaccine-storage facility that could serve as a national and international distribution hub. The Courier Journal reports that UPS confirmed recently that it's building a "freezer farm" at a South Louisville facility with 300 ultra-low temperature refrigeration units. Each would hold 48,000 vials of vaccines, or 14.4 million units in total across the farm. Grace Schneider writes that the project is part of a larger partnership taking shape between the White House, key agencies and several companies to prepare for the release of a vaccine as early as Nov. 1. President Trump has said a vaccine could be ready by around Election Day, Nov. 3, but health experts have said 2021 is a more likely date.

CDC publishes article about Ky. monitoring system to guide decisions about reopening, which says it could help other states

Kentucky's daily covid-19 status, as calculated with tool developed by state health department.

By Melissa Patrick
Kentucky Health News

As health departments across the nation help states safely reopen their economies and schools, the monitoring system Kentucky officials use to guide their decisions has been lauded in a recent federal report as an example for other states to follow.

The report, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, comes at a time when many Republicans and some commentators have said they need to know more about how Gov. Andy Beshear and his public-health chief are making their decisions around reopening, mitigation and response.

Health Commissioner Steven Stack has said he uses a variety of sources to guide his recommendations, but this report reveals the nitty-gritty of how one tool created by Kentucky's epidemiologists helps guide the state's decision-making on covid-19.

The lead author and six of the other 11 listed authors work for the CDC. Five work for the state Department for Public Health, which developed the tool, called the "indicator monitoring report."

The IMR combines multiple data elements that measure the prevalence and severity of the coronavirus, along with the state's readiness to respond to it. The report says this information is use to generate a daily covid-19 status score that can be used to asses the state's ability to safely reopen. 

The report says state epidemiologists "developed the IMR after recognizing the need for a plain-language assessment that could facilitate reopening and ongoing response decision-making addressing multiple stakeholders." 

The assessment is compiled Monday through Saturday and distributed to about 90 stakeholders in and out of state government, including the governor's office and local health-department directors. 

The system monitors five primary indicators: new coronavirus cases, deaths from covid-19, health-care capacity, contact-tracing capacity and syndromic surveillance, which allows the state to track symptoms before a covid-19 diagnosis is confirmed. It was implemented on May 19. 

The indicators are scored on a three-point scale, from excellent to poor, and are given equal weight in producing the composite status score, and the analysis is "combined with publicly available data into a user-friendly composite status that KDPH and local policy makers use to assess state-level covid-19 hazard status," the report says.

The composite status score, which assesses the ability of the state to safely reopen and remain open, is reported at five levels: 5 = excellent (reopen/remain open); 4 = good (monitor); 3 = moderate (caution); 2 = fair (increase mitigation); 1 = poor (reopening risky, slow reopening or close); 0 = poor (reopening risky, slow reopening or close).

The report shows how the state's score worsened between May 19 and July 15, dropping to "fair" between June 17 and July 15, indicating the need for increased mitigation. Beshear issued an executive order for a mask mandate in certain settings on July 9.

The report says this user-friendly system could help other states "guide decision-making for covid-19 mitigation, response, and reopening," and is easily adoptable because its data sources "are publicly available, data are analyzed with familiar software, and a standardized method is used to compile the report."

Click here to see a table of each of the indicators and how they are scored.

Beshear OKs fall sports, says he can't make all the calls; issues and funds executive order to resolve disputes over evictions

State graph, adapted by Kentucky Health News; weekly numbers reflect adjustments made after initial daily reports, including elimination of duplicate cases

By Melissa Patrick and Al Cross
Kentucky Health News

Gov. Andy Beshear said the state will not overturn the decision by the Kentucky High School Athletic Association to allow fall sports in the midst of the highest coronavirus case numbers the state has seen. 

"It's not because I think that it is a good decision or a wise decision," Beshear said at his daily news conference. "But if we're going to defeat this virus, we need people, other than me up here, all over Kentucky taking responsibility to make good and wise decisions."

Pressed for his reasoning, he said, "At some point it can’t be every single decision comes to the governor. . . . We also have to keep our regulations and our decisions in a certain area that people are willing to live with."

Earlier, as he announced his decision, he said, "I have concerns . . . that by starting with some of the most high-contact sports we risk shortened season, we risk what I think can be successful plans to get our kids back in school, that we risk every other sport that's going to follow. But we can't be making every decision for what's best for folks out of the governor's office and it's gonna be incumbent on our superintendents, on coaches, on the different groups to make the wisest decisions that they can."

On Aug. 20, the KHSAA Board of Control voted 16-2 to keep its schedule for fall sports, starting football practice today and games Sept. 11. Cross-country, field hockey, soccer and volleyball will begin Sept. 7. The KHSAA had said its plan was subject to approval by the state Department of Education, the Department of Public Health and Beshear himself. 

Players, coaches and parents rallied Monday on the steps of the Capitol in an effort to get the governor's green light for fall sports with the message: "Let them play," Lexie Ratterman reports for WDRB.  WKYT reports that Republicans in the state House issued a statement calling on Beshear to let the schools play. 

Asked later if he reserves the right to intervene if things are out of control in October, Beshear said, "Heck, yeah, I do." 

Beshear stressed that it will be important for schools to be transparent and do the right thing if and when team members test positive, even if it's the biggest game of the season and the star player is quarantined.

He and Health Commissioner Steven Stack pointed out some of the differences between high-school sports and the Southeastern Conference, which is proceeding with its fall season. The SEC is testing its players three times a week and has stringent requirements that have to be met before a player who has tested positive is allowed to return to the game. 

"If you're in a public school in the state or you're in a private school, do you have the money and the resources and the ability to secure three tests a week for the students to play sports?" Stack asked. "I think you all know the answer to that."

Stack said there is still much unknown about the long-term effects of the coronavirus, pointing to several studies that show it can affect the heart, including one by a sports cardiologist at Ohio State who says the university's doctors have found that up to 13 percent of college athletes who test positive for the virus develop inflammation of their heart muscles, called myocarditis, which Stack said can result in a range of outcomes from complete recovery to death.  

"You can have sudden cardiac death because you have an irritable heart muscle," he said. "I hope this doesn't happen, but it's just going to take one 16- or 17-year-old to drop dead on the sporting field before someone notices that it's not fictional, it's real."

Evictions and covid-19

Beshear issued a new executive order on evictions that dedicates $15 million of federal coronavirus relief funds to create a Healthy at Home Eviction Relief Fund. He said funding is also available from several other sources.  

The order says landlords must give tenants 30 days' notice of their intent to evict for nonpayment of rent and during that 30 days, the landlord and tenant must meet and try to work out an agreement. The order also says there will be no penalties, late fees or interest charged relating to nonpayment of rent between March 6, when the pandemic arrived in Kentucky, and Dec. 31. 

This stems from three Northern Kentucky landlords' lawsuit challenging the governor's ban on evictions. He said mediation efforts have failed, but the lawsuit is now moot because the executive order it was based on is no longer in effect. 

Beshear said his new order is designed to meet three challenges: making sure Kentuckians don't end up on the street, making sure landlords are being treated fairly, and making sure Kentuckians don't end up with so much debt that they can't dig out of it. 

"Kentuckians cannot be healthy at home without a home," he said, directing Kentuckians who need help with an eviction issue to visit kycovidlegalhelp.org or call 833-540-0242. 

Don't let your guard down

Beshear voiced concern that Kentuckians might get complacent about following preventive measures as schools start to reopen and sports rev up, as they did around July 4 when a surge in cases "almost sent us spiraling out of control." 

He said his worry is compounded because the state is seeing more people trying to get out of quarantine and more people not wanting to help health departments, which are trying to trace and quarantine people who have been in contact with infected Kentuckians.

"Those feelings are natural, but they're harmful," he said. "They could lead to another spike and it would be a spike from where we are right now. This is a war. Whether we win or lose, how many Kentuckians we lose, it's all based on the number of battles that we win, or lose. So please, don't get tired. Let's pick it up. Lives, lives depend on it."

Kentucky has seen more 4,000 new cases in each of the past two weeks. Beshear pointed out that for each of those weeks, with a 2% mortality rate, the state will lose 80 people a week to the virus. 

"They trail the weeks in which we see those cases, meaning it's gonna be a tough month, and next month is going to be a tough month," he said.

Beshear reported four more covid-19 deaths Monday, bringing the state's death toll to 885. The fatalities were a 71-year-old woman from Marion County, a 74-year-old man from Harlan County and an 82-year-old man and a 94-year-old woman from Jefferson County. 

The governor added that while today's death toll was lower than it's been, "We had more deaths announced last week than in any week in which we've been battling this virus," and there are 19 deaths pending in front of the committee that determines if a death is related to covid-19.

The state recorded 373 new coronavirus cases on Monday, bringing its seven-day rolling average to 635. The percentage of Kentuckians testing positive for the virus in the last seven days was 4.77%, a slight drop from Saturday, the last day the figure was reported. Reporting is typically limited on Sundays, and labs are still catching up on Mondays, reducing case figures for both days. 

Reporting to increase

Beshear said the state will put coronavirus information for schools and universities online and update it regularly. He cautioned that because of processes involved, the state's reporting may lag behind local reporting. The state will ask schools to submit data daily "because parents deserve to know," he said. 

The governor reported that 31 school districts had at least one positive coronavirus test and they believe that at least 50 cases are active. He said there are 223 active cases in the state's colleges and universities.

State's first report on colleges and universities; click to enlarge. Click here for report on K-12 schools.    

Stack said that in response to a demand for county-level data, he will work with the state Department of Education to create a simple metric with county-level data that counties can use to inform their decisions, cautioning that such localized data will have severe limitations. 

Stack reiterated that the virus does not respect lines on a map. "If you are next to a county with very active disease, your county could be very active very quickly; when you get hot red, it takes longer to cool off than it does to accelerate up," he said. 

In other covid-19 news Monday:

• Jefferson County again accounted for almost a third of the new cases, 152, Other counties with five or more cases were Fayette, 76; Madison, 29; Kenton, 20; Calloway, 11; Marion, 10; Bullitt, 9; Daviess and Warren, 8 each; Knox, 6; and Boone, Casey, Hardin, Simpson, Trigg and Woodford, 5 each.  
• Kentucky hospitals have 564 covid-19 patients, 149 of them in intensive care and 82 of those on ventilators, Beshear said. 
• In long-term care facilities, active cases numbered 513 among residents and 310 among staff, after four more in each category were added Monday. 
• Beshear reported nine veterans and one staff member have tested positive for the Eastern Kentucky Veterans Center in Hazard, the first veterans' nursing home with an extensive outbreak. He said it has been confined to one hallway of one unit, and all of the cases trace to an aide who is recovering at home. He said all the veterans who tested positive have been moved to the local Appalachian Regional Healthcare hospital, allowing everyone left on the hall to have a single room. He said all veterans in facility will be tested by Wednesday. 
• In child-care centers, 10 more employees and three children tested positive, for totals of 128 staff and 99 kids; 158 facilities have had at least one case. 
• After five students and one staff member tested positive for the coronavirus at Lexington Catholic High School, it switched to virtual learning Monday for two weeks. It opened last week to in-person learning despite Beshear's recommendation to delay until Sept. 28, Valarie Honeycutt Spears reports for the Lexington Herald-Leader.  The local health department also reported one student at Lexington Christian Academy and two students at Sayre School had tested positive.
• Beshear's travel advisory, asking people to avoid traveling to state's with positive-test rates of 15% and to self-quarantine if they do, now applies to fewer states: Mississippi, South Carolina, Texas, Nevada and Idaho. 
• KFC announced suspension of its “Finger lickin’ good” slogan, calling it “a bit off” during a pandemic when people are advised not to touch their faces with unwashed hands. in a YouTube video, the Louisville-based chain blurred "finger lickin’" from some of its old ads and advised, “That thing we always say? Ignore it. For now."
• Senate Majority Leader Mitch McConnell is urging Americans to wear hemp face masks to prevent the spread of coronavirus, Kyle Jaeger reports for Marijuana Moment. He was speaking at the Kentucky-based hemp company Ecofibre on Monday. 
• Kentuckians with children eligible for free or reduced-price school meals have until Aug. 31 to apply to get help with their home purchased groceries, Jack Brammer reports for the Herald-Leader. Jessica Klein, policy associate for the Kentucky Center for Economic Policy, said at a news conference that parents or guardians of roughly 117,000 Kentucky students who qualify have not applied. Brammer reports there is no income limit to participate and persons can apply regardless of their immigration status.  The benefits are called P-EBT, for Pandemic Electronic Benefit Transfer. Click here for more information about requirements and qualifications. 
• Researchers from McGill University in Montreal set out to find out what makes one person more likely than another to believe fake news and conspiracy theories about covid-19. The study, published in Misinformation Review, found that "even after adjusting for demographics such as scientific literacy and socioeconomic differences, those who regularly consume social media rather than traditional media were less likely to observe social distancing and to perceive covid-19 as a threat," Quentin Fottrell reports for Market Watch. The paper concluded that "those that consume more traditional news media have fewer misperceptions and are more likely to follow public-health recommendations like social distancing," Fottrell reports. 
• In their weekly "Covid Watch" article, Deborah Yetter and Grace Schneider of the Courier-Journal reports on how the state determines the covid-19 death count; the reliability of the state's data; death rates for the flu and covid-19 in Kentucky; and issues of immunity and recovery from the virus.

Kentucky has fewer counties in White House Coronavirus Task Force 'red zone' but nine moved into it while 13 moved out

Table from White House Coronavirus Task Force report; for a larger version, click on it.

Kentucky Health News

Kentucky got a better report from the White House Coronavirus Task Force Monday, with 52 counties in danger zones for the reporting week of Aug. 15-21. The previous week, 63 of the state's 120 counties were on those lists.

Sixteen counties were in the task force's "red zone" for places where new cases of the virus numbered more than 1 per 1,000 residents and the share of residents who tested positive for the virus during the week was greater than 10%, with the other in the red zone. The report put 36 counties in yellow, down from 43 last week.

Moving into the red zone were Clinton, Franklin, Green, Metcalfe, Monroe, Nelson, Oldham, Simpson and Washington counties. Moving out of it were Barren, Bell, Clay, Hardin, Henry, Hickman, Lewis, Logan, Powell, Scott, Spencer and Wayne counties.

The report does not include county-by-county figures, but it has maps showing counties within ranges of new cases and positive tests during the week.

Maps by White House Coronavirus Task Force report; for a larger version of any image, click on it.

Statewide, the report says Kentucky had fewer new cases and a lower positive-test rate than it did last week. It had 89 new cases per 100,000 population in the past week, compared to a national average of 93 per 100,000.

The report also includes graphs for many major and red-zone counties, which show the daily new cases and the seven-day rolling average.

White House graphs show daily cases in dark blue, seven-day rolling averages in orange.

Ky. study shows syringe exchange programs decrease infections associated with IV drug use, could result in 'big money saved'

By Melissa Patrick
Kentucky Health News

A new analysis of Medicaid claims data suggests that Kentucky counties with syringe-service programs have slightly lower rates of diseases associated with intravenous drug use, such as HIV and hepatitis C.

The analysis estimated a progressive reduction of 0.5 percent per month, adding up to a 6% increase over a year. That can add up to savings, not only in lives, but money. So said Dr. Connie White, deputy commissioner of clinical affairs for the Kentucky Department for Public Health, at the Kentucky Harm Reduction Summit Aug. 20. 

White said, "As a public-health person, I think of all the emotional tragedy for the patient and for the family with one of these co-morbidities," diseases and conditions that occur together. "But if you're trying to sell this program to a bunch of politicians and legislators, you're talking about money saved, we're talking big money saved."

Kentucky has more syringe-service programs than any other state in the nation, but 56 of the state's 120 counties still don't have one -- and 20 of those are considered highly vulnerable to an HIV or hepatitis C outbreak among IV drug users, according to the Centers for Disease Control and Prevention. Thirty-four of the state's most vulnerable counties have operational syringe exchanges. 

The vulnerable counties without an exchange include Bell and Clinton, which rank sixth and 11th on the national list of 220; Cumberland, Casey, Edmonson, Harlan, Johnson, Lawrence, Lewis, Menifee, Monroe, Rockcastle and Wayne, also in Appalachian Kentucky; and eight in the rest of the state: Carroll, Gallatin, Green, Breckinridge, Grayson, Green, Allen and Hickman. 

Kentucky has 74 operational syringe-service programs in 63 counties, with one more in Christian County approved but not operational. Bracken County's exchange is marked on the state's map as not yet operational, but it started operating July 8. 

Syringe-service programs are more broadly referred to as harm-reduction programs and are designed to prevent outbreaks of HIV and hepatitis C, which are commonly spread by needle sharing among IV drug users. They also provide health screenings and vaccines, and connect drug users to treatment. 

They are allowed by a 2015 state law that requires approval by the county health board, the fiscal court and the city where the exchange is to be located.

Syringe exchanges reduce disease

The Kentucky Office of Health Data and Analytics did the analysis at the request of the Department for Public Health.

One reason the study is so important is that it helps to root the debate about such programs in empirical data, said Mathew Walton, a researcher with the office. 

Walton pointed to a national study that shows a person's political affiliation, income, and amount of stigma they feel about addiction and syringe-service programs are significant predictors of whether or not someone supports these programs -- not the facts.

The study looked at Medicaid claims from January 2015 through June 2019 in any county that had implemented a syringe-service program during that time.

It looked for six infections largely connected to IV drug use and minimally associated with other activities: HIV, hepatitis C, endocarditis, osteomyelitis, and, in people diagnosed with opioid-use disorder, skin and soft-tissue infections. The researchers only included new infections in their analysis. 

The study looked at infection rates before and after the syringe exchange was established in 42 counties. Recognizing that results might not be seen immediately, included lag times of one month, three months and six months. It also adjusted for a list of variables, many related to demographics.

Cameron Bushling, a statistician with the office, said each of the lag-time scenarios showed a decrease in infections after the syringe exchange was established. 

"The infection rate in your county will go down by roughly half a percent each month after you implement a syringe service program," he said. "So some, some may think this is a small number, but it's important to keep in mind that our infection rates were very low. . . . So half a percent is still a pretty big find."

In conclusion, Walton pointed out that most of the counties in the study were rural, outside metro areas. 

"There's an evidence of an association that they were successful in reducing infection, new infections," Walton said. "These do seem to be an effective use of resources for preventing costly and harmful infectious disease." 

He said the savings would come with even small reductions in infections caused by IV drug use.

"While this analysis revealed that this set of infectious-disease diagnoses was rare, even preventing a small percentage of them can have a significant effect on the Medicaid program," he said. "A single course of treatment for hepatitis C can be as much as $85,000 or more, so even a small outbreak prevention can be both a sort of economic benefit as well as a humanitarian and medical population health benefit."

Advice for resistant counties

Van Ingram, executive director of the Kentucky Office of Drug Control Policy, after a separate presentation, was asked what advice he would give counties that have been resistant to syringe exchanges. 

"I realize these can be controversial in some communities," said Ingram, who was Maysville's police chief before taking the drug-control job, and back then opposed syringe exchanges. Many law-enforcement officers do, believing, that they encourage drug use, despite research to the contrary.

"Well, first, just don't give up," he said. "Second, do everything you can to get the public on your side, the voters on your side. . . . and continue to keep raising this issue."  

He also suggested identifying the thought leaders in a community, those who have influence, and then educating them on why it's important to have one. His last bit of advice was to reach out to public health departments that have already fought this fight successfully and learn from their strategies.

Asked the same advice question, Frankie Haynes, the harm reduction coordinator for the Barren River District Health Department, stressed that educating the public is the key. 

"I can't tell you how many times we went into different entities and just explained to people what harm reduction was, or what needle-exchange services are, what are we doing," she said during a panel discussion about exchanges, "And once you give them a whole rundown on what it looks like to be a part of our program, what to expect within the program, you really start seeing eyes opening to the need for these programs across the state." 

The Bowling Green-based Barren River department is working to expand syringe services into Logan County, which has received approval from its Board of Health, but still needs the approval of the Russellville City Council and the county Fiscal Court. Two of the district's eight counties (Warren and Barren) have exchanges. 

Jennifer Twyman, health-education specialist with the Louisville Metro Public Health and Wellness syringe exchange program, agreed with Haynes. She said discussions with the public put a face on the program: "Talking to people in the community, so that they know what we're doing, makes just a huge difference."

Kentucky stays on four-week elevated plateau of new virus cases; 7-day average is more than triple what it was two months ago

Kentucky Health News chart based on state data; for a larger version, click on it.

This story has been revised to correct an error by the editor.

By Melissa Patrick

Kentucky Health News

While Kentucky remains on a rough, elevated plateau of new coronavirus cases, Sunday's addition of 467 cases pushed the state into an apparent new high for a Monday-to-Sunday reporting week -- 4,450 cases reported Aug. 17-23. However, that was based on the uncorrected daily totals, which are revised downward by the removal of duplicate tests. The revised weekly total was 4,214, 119 less then the previous week, which remains the record.

The new seven-day rolling average of 636 is the eighth highest of the pandemic, and more than triple what it was two months ago.

“We remain in a plateau with our number of new cases, which is positive, but we have to see those numbers steadily decline,” Gov. Andy Beshear said in a news release. “All of your sacrifices are working, and we must all continue to be patient and do our part to drive those numbers down.”

The new weekly high is 117 more cases than the 4,333 reported last week.

As some school districts and day-care centers push back against Beshear's recommendations around reopening dates and capacity limits, he has taken to reporting the daily number of children newly infected by the virus. Today, he said 79 of the newly reported cases were from people 18 and younger, of which 15 were five or under. The youngest was 3 days old. 

“We are seeing a steady number of coronavirus cases among the young in Kentucky, and make no mistake: Youth is not a guarantee of a good outcome against this virus,” he said.

As usual, Sunday's report did not include some data, including the share of Kentuckians testing positive for the virus in the last seven days. Saturday, it fell below the key level of 5 percent for the first time in 30 days.

Beshear reported nine more deaths from covid-19, raising the state's toll to 881. Two small, rural counties each had two covid-19 deaths. Green County lost two residents, a 90-year-old woman and a 91-year-old man; and Lewis County lost two men, 73 and 78. 

The other fatalities were a 63-year-old man from Johnson County; a 63-year-old man from Shelby County; a 72-year-old man from Knox County; a 77-year-old woman from Oldham County; and an 88-year-old woman from Scott County. 

Health Commissioner Steven Stack kept imploring Kentuckians to follow public-health guidelines that he said are having a positive impact, saying in the release that even though Kentucky is on an "elevated four-week plateau . . . we remain in a difficult place, and Kentucky could quickly begin a rapid escalation."  

Stack, a physician, joined Beshear in putting gentle heat on school leaders and other local officials: “These are difficult times without simple solutions. Through their actions, local leaders have an obligation to keep the virus under control to reduce the risk of medical harm to their students, staff, and larger communities.”

He added basic reminders: “Please, socially distance greater than six feet. Wear a mask at all times when in public and around others. Wash your hands often. Check for signs of infection and get tested if ill. Cooperate with contact tracing if you are called. If we do these things, we can contain the coronavirus and get back to more of the activities we miss.” 

In other covid-19 news Sunday:

• Jefferson County had nearly one-third of the new coronavirus cases Sunday, with 152. Other counties with more than 10 new cases in the daily report were Fayette, 76; Madison, 29; Kenton, 20; Calloway, 11; and Marion, 10.  
• Conflicting orders have left unclear who is and who isn't protected from eviction in Kentucky, Matt Mencarini reports for the Louisville Courier Journal. Cathy Hinko, head of the Metropolitan Housing Coalition, told him, "Now we're down to this arm-wrestling between sheriffs and the court system and the governor. . . . The lack of clarity in the face of a pandemic maelstrom of displacement is beyond comprehension." Beshear said at his Thursday briefing that he will make an announcement Monday about an agreement to settle a Northern Kentucky eviction lawsuit and funnel some CARES Act money to landlords. Chris Otts of WDRB also reports on the issue.
• The University of Louisville will require its students to be tested for the coronavirus, after initially only encouraging them to do so, Sarah Ladd reports for the Courier Journal. Free testing will begin Monday and tests must be taken between Aug. 24 and Sept. 4. Failure to comply may lead to "disciplinary action if necessary," U of L said. 
• Chris Kenning of the Courier Journal tells the story of a hospital chaplain and the entries from a journal he has kept since the start of the pandemic: "His journal, alternating in tone between the brevity and stoicism of a sea captain’s log about a gale to passages of emotional storytelling, is filled with instances of front-line health workers scrambling bravely amid the dangers and chaos of life-and-death emergencies."
• Six positive coroanavirus tests have been confirmed at the Eastern Kentucky Veterans Center, a nursing home in Hazard, among one employee and five veterans, Evan Hatter reports for WYMT-TV.

Substance-use research at UK aims to slash ODs, quash hepatitis C, help pregnant and incarcerated women, and much more

By Melissa Patrick
Kentucky Health News

Research about substance abuse has become a major enterprise at the University of Kentucky, legislators heard last week as they got an update on UK research projects, including one that aims to cut overdose deaths 40 percent in 16 counties and another that aims to eliminate hepatitis C in a county. 

UK Vice President for Research Lisa Cassis told the Substance Use Recovery Task Force Aug. 11 that since substance -use research was added as one of UK's six institutional research priorities in 2018, it has experienced the largest growth in grants and contracts, increasing from 75 projects in 2018 to 105 in 2019, with a 151% increase in funding, to more than $75 million.

Sharon Walsh, director of UK's Center on Drug and Alcohol Research, reviewed a few projects, starting with one that has the largest grant ever awarded to UK: the $87 million, four-year HEALing Communities Study, which has a goal of reducing opioid-overdose deaths by 40 percent in 16 counties that represent more than a third of the state's population.  

Photos are from PowerPoint presentation to the Substance Abuse Recovery Task Force

The 16 counties are Jefferson, Fayette, Jessamine, Clark, Franklin, Boyle, Madison, Bourbon, Kenton, Campbell, Mason, Greenup, Carter, Boyd, Floyd and Knox. 

The grant is part of a larger National Institute on Health initiative called HEAL, which stands for  Helping to End Addiction Long-term. 

Walsh said the UK project is moving into its implementation phase, which involves communication efforts to increase demand for medication for opioid use disorder (MOUD) and naloxone, which negates overdoses; increase MOUD prescribing; increase access to naloxone; and reduce high-risk prescribing. The campaign will also work to decrease the stigma of substance-use disorder. 

She also pointed to an $8 million grant-funded project, Justice Community Opioid Innovation Network, which is working to increase initiation and maintenance of MOUD to reduce relapse and overdose among women who are in transition from jail to the community. This program will involve about 900 women across nine Kentucky jail sites. It is part of the HEAL initiative. 

Walsh said that in the fiscal year ended June 30, UK had about 133 projects related to substance use, with 69 principal investigators, or head researchers.

One is funded by a a $15 million, five-year grant to treat every resident of Perry County who is chronically infected with hepatitis C, in order to examine the concept of "treatment as prevention." This project, called KeY Treat, not only provides hep-C treatment and training for providers to deliver it, but substance-use-disorder treatment and case management, and harm-reduction services such as a syringe exchange if needed. Intravenous drug users are especially vulnerable to hepatitis C and can spark outbreaks of it.

KeY Treat is led by Jennifer Havens at the UK Center on Drug and Alcohol Research. It builds on her ongoing research project that has followed, for over 10 years, more than 500 people who use drugs in Appalachia. In 2008-10 her research shows 42.9% of those who injected drugs had hepatitis C; that increased to 65.8% in 2018, Walsh said.

She said 151 people had enrolled in the KeY Treat program, and 97% had started medication to treat their hepatitis C. Among those, 83% have completed treatment, and 97% of them are considered cured. Only about half of those enrolled in treatment are actively using drugs, she said.

As part of the National Rural Opioid Initiative, Walsh said, the CARE2HOPE project has partnered with residents of the 12 counties in the Gateway Health District and Kentucky River Health District to build evidence-based, community-rooted public health responses to the opioid epidemic, overdoses, hepatitis C and HIV. It is funded by a $5.4 million grant.  

Walsh said several of UK's projects fall under the Kentucky Opioid Response Effort, or KORE, which is designed to support services that address the opioid crisis, rather than to drive research. She said KORE currently provides support for 61 different entities across the state and UK is just one of them. 

One of the KORE-funded projects at UK is the First Bridge Clinic, which provides "on-demand" treatment access for those suffering with opioid-use disorder. From its opening in January 2018 to present, this clinic has seen 1,111 patients, and 450 of them began medication to treat their opioid-use disorder, Walsh said.

She said KORE has expanded its model to St. Elizabeth Healthcare, University of Louisville Hospital, the Appalachian Regional Healthcare System, Baptist Health in Lexington and Corbin, and Norton Healthcare in Louisville. 

Another KORE-funded program is the Addiction Consult and Education Services program (ACES) that provides a way for UK hospital patients to get an addiction consultation while hospitalized. It also provides education services for providers. Walsh said this program has done 1,314 consults since October 2018. Of those, 702 initiated medication-assisted treatment while in the hospital. After they were discharged, ACES referred 373 to the First Bridge Clinic, and 190 kept their first appointment. 

The PATHways program was available before KORE funding was available, but has since gotten support from it. The Perinatal Assistance and Treatment Home program works to expand opioid-use disorder treatment access to women immediately before and after giving birth. Since August 2018, 306 mothers have enrolled in PATHways and 251, or 82% of them, initiated MOUD.

Another KORE-funded program, Beyond Birth, provides opioid use disorder treatment to postpartum women, along with comprehensive, wraparound services in coordination with social workers in the Kentucky Department for Community Based Services. 

Walsh also mentioned several other KORE-funded programs, including one that works to increase pharmacists' capacity to administer Vivitrol, a medication for opioid-use disorder; one that trains students in evidence-based practices for opioid-use disorder; one that provides psychiatric care for people who have opioid-use disorders; one that provides treatment for infectious diseases associated with intravenous drug use; and another that is working to build a substance-use-disorder workforce in the Appalachian region.

Nearly half of teenagers who use electronic cigarettes say they want to quit; there are several programs to help them

By Melissa Patrick

Kentucky Health News

Nearly half of teens who use electronic cigarettes said in a national survey that they wanted to quit, and about a quarter said they had tried to in the past year.

Photo from Your Teen magazine

“This suggests to me that vaping-cessation interventions are urgently needed,” Adam Leventhal, co-author of the study and founding director of the University of Southern California's Institute for Addiction Science, said in a news release. “Youth deserve information about how to quit vaping. And for those not interested in quitting, public education campaigns that increase motivation to quit could be useful.”

A research letter accompanying the study in the journal JAMA Pediatrics says it is the first of its kind and is significant, because programs to help teenagers stop vaping are not widely disseminated and existing programs have received little empirical investigation.

The survey of 14,798 teens found that among the nearly 500 who said they had used electronic cigarettes in the past 30 days, 44.5% said they were seriously interested in quitting and 24.9% said they had tried to quit in the past year. 

 

The researchers say teens who use e-cigarettes are at risk for nicotine addiction, toxicant exposure, and transitioning to traditional tobacco cigarettes. 

"This new data is just one more example that it''s best not to start in the first place, because half of the kids want to quit and are struggling," said Bonnie Hackbarth, vice-president of external affairs at the Foundation for a Healthy Kentucky. "And it's hard to quit. As we've said multiple times, nicotine is one of the most addictive substances on the planet and youth are particularly susceptible because their brains are still developing." 

As part of the Coalition for a Smoke-free Tomorrow, the foundation lobbied during the last legislative session for more funding for tobacco prevention and cessation, with plans to use much of the $10 million on a multimedia campaign that targeted youth. 

But amid the coronavirus pandemic and the financial uncertainty that came with it, Kentucky lawmakers passed a conservative one-year budget that ended up cutting the state's prevention and cessation budget by nearly 40%, to $2 million from $3.3 million in the fiscal year that ended June 30.

"We know that vaping has an immediate effect on youth, in terms of their attention span, in terms of their brain development, so prevention for youth is just critical and our hope would be that the legislature would at least restore that budget to the 2020 levels," Hackbarth said. She also noted that tobacco prevention in youth will save significant amounts of money in healthcare cost down the line, since 90% of smokers started smoking by the age of 18. 

In Kentucky, 26.1% of high-school students reported current use of e-cigs, defined by at least one day of use during the 30 days before the survey, and 8.7% reported daily use, according to the federal Youth Risk Behavior Surveillance System for 2019. Nationally, the survey found 32.7% of high-school students in the U.S. reported current use and 7.2% reported daily use. 

The study, citing the Monitoring the Future survey, says that in 2019, 25.2% of U.S. high-school students reported current use and 11.7% reported daily use, defined as use of electronic nicotine products. 

Elizabeth Anderson-Hoagland, health promotion section supervisor with the Kentucky Chronic Disease Program, said the latest federal survey also showed that about half of all Kentucky teens who use tobacco have tried to quit in the past year. 

"I think there is a myth that teens do not care about their health or that they don’t think about consequences of tobacco use," Anderson-Hoagland said in an e-mail. "We know they absolutely do care about their health. They do care about saving money. They do care about having the trust of their parents and teachers and friends." 

She noted immediate side effects of vaping are dry mouth, throat irritation, cough, and shortness of breath, adding that there are also potential long-term effects, like heart disease or stroke.  

At this time, she said, the state directs youth who want to quit vaping, smoking or using other tobacco products to a program called "My Life, My Quit," a free service for minors. The program includes live support by phone, text, or online chat.

Participants can join by texting START MY QUIT to 855-891-9989 or going to MyLifeMyQuit.com. Teens are eligible for up to five calls with an experienced and trained Quit Coach. The program does not provide nicotine replacement therapy. 

"What teens do need is a support network for a successful quit, because teens need help with creating plans and resisting cravings," Anderson-Hoagland said. "MLMQ is a great resource to provide that support."

Due to low participation, she said, Kentucky no longer offers a program targeting young adults called This is Quitting. She said the state has re-directed its funding to other priorities.

Here are other resources for teens who are looking to quit include:

• Truth Initiative text message program: Text DITCHJUUL to 88709 or visit https://truthinitiative.org/research-resources/quitting-smoking-vaping/quitting-e-cigarettes 
• Not On Tobacco (NOT), a 10-week, voluntary program for small groups of teens aged 14-19: https://www.lung.org/quit-smoking/helping-teens-quit/not-on-tobacco
• Become a Smoke-Free Teen: Quit Vaping explains tools to help you quit and how to use them, from the U.S. Department of Health and Human Services: https://teen.smokefree.gov/

State records fourth-highest number of new virus cases, but positive-test rate falls below 5 percent for first time in 30 days

Kentucky Health News chart; daily figures are adjusted slightly after initial report.

By Al Cross
Kentucky Health News

Kentucky recorded its fourth highest daily total of new coronavirus cases Saturday, but the share of Kentuckians testing positive for the virus in the last seven days fell below the key 5 percent threshold for the first time in 30 days.

“We are seeing our positivity rate go down, which means if we’re patient, we can find the right time to do things safely and that’s what I want us to be able to do,” Gov. Andy Beshear said in a press release. “Now is the time when we determine if we can open schools safely, if we can get back to doing so many things we care about; so do your part.”

Beshear reported 814 new cases Saturday, bringing the seven-day rolling average to 625, the ninth highest since the pandemic began five and a half months ago. Both are now more than double what they were when cases started surging in early July.

Ky. Health News chart; for a larger version, click on it.

However, the positive-test rate fell to 4.84%, and that was also significant.

A positivity rate above 5 percent put Kentucky in the "yellow zone" of the White House Coronavirus Task Force and prompted recommendations from the task force for more restrictions, most of which Beshear has followed. However, he allowed bars to reopen and let restaurants return to 50% of indoor capacity.

A rate above 5% is also a trouble sign for the state's efforts to contact individuals who have been exposed to people with the virus and ask them to self-isolate for 10 days. Several Kentucky counties have positive-test rates above 10% and are in the task force's "red zone."

Some school systems in red-zone counties are planning to resume in-person classes Monday, despite Beshear's recommendation that schools delay in-person instruction until Sept. 28. He again suggested the risk, noting that 110 of the 814 new cases were in Kentuckians under the age of 19.

“A hundred and ten kids 18 and under on today’s report – we continue to see far too many,” he said. “And in many of the places hardest hit for kids, they’re looking at opening schools this Monday or very soon.”

Beshear reported eight more deaths from covid-19, raising the state's toll to 872. The fatalities were a 60-year-old man from Perry County; a 64-year-old man and an 84-year-old woman from Lewis County; two 73-year-old women, one from Bell County and one from Garrard County; a 78-year-old woman from Oldham County; an 81-year-old man from Scott County; and an 88-year-old woman from Jefferson County.

The number of covid-19 hospitalizations in Kentucky was 622, an increase of 5.1% from Friday, but the number of those in intensive care fell 4.8%, to 158.

Also in the news release, Health Commissioner Steven Stack urged people who need medical care, for either acute or chronic illness, to seek it.

“Don’t let fear of contracting the virus stop you from seeking care,” Stack said. “This is Immunization Awareness Month; please make plans now to get your flu shot. We need to do all we can to avoid what’s being referred to as the ‘Twindemic,’ a flu season that’s projected to be very active at the same time as we continue to battle the coronavirus.”

Lyndsey Gough (Photo via UK)

On Facebook, Beshear highlighted the story of 27-year-old Lyndsey Gough, a University of Kentucky journalism graduate and weekend sports anchor in Savannah, who was hospitalized with covid-19 for 11 days and has been documenting her experience on social media. "Listen to her advice on protecting yourself and never taking your health for granted," the governor wrote.

Gough told UKNow, "I have reported on covid-19 for months and asked others to share their stories, so as far as transparency goes, I think it’s only fair that I share mine. My hope was that I could help someone by sharing my experience. . . . It’s not 'just the flu' and it doesn’t just affect the elderly population or those with underlying health conditions. . . . My surgeons tell me that the virus caused so much stress to my body that my appendix ruptured, and a host of other complications followed."

In other covid-19 news Saturday:

• Counties with more than 10 new cases were Jefferson, 230; Fayette, 62; Warren, 51; Madison, 39; Christian, 25; Hardin, 23; Calloway, 19; Lewis, 19; Kenton, 17; Daviess, 15; Boone, Bullitt and Shelby, 13 each; Franklin, 12; Marion and Pulaski, 11 each; and Pike and Scott, 10 each.
• The online portal to request an absentee ballot for the Nov. 3 election, govoteky.com, is open. Officials had planned to open it Friday, then said it would be Monday, but it worked Saturday morning. The portal is to be open through Oct. 9. Voters should not expect to get a requested ballot until mid- to late September, because ballots cannot be printed until then.
• U.S. Rep. Brett Guthrie of Bowling Green told the Grayson County News-Gazette last week that he expects the Food and Drug Administration to approve a coronavirus vaccine "in September or October, by mid-fall." Editor Matt Lasley reports, "Guthrie said officials are working to set a plan for who should be vaccinated first, such as healthcare and front-line workers, as well as people in nursing homes. . . . However, Guthrie added that he does not believe the country will return to 'normal until we get a vaccine,' so it is important to ensure the vaccine is safe and effective to ensure people feel confident in taking it, “because if we don’t take the vaccine, we’re not going to get back to normal.” Guthrie is the ranking Republican on the House subcommittee that oversees the FDA.
• It's easy to get numb about the risks of getting covid-19, but there are things we can do about that, writes science reporter Elizabeth Svoboda for The Washington Post. But it's not easy, because the usual "reward-punishment calculus" for behavior modification gets reversed. "With parties, when you do the right thing and stay home, 'you feel an immediate cost; you’re not able to be with your friends'," University of Oregon psychologist Paul Slovic told her. There's an upside, thwarting the virus, "but it feels distant," Svoboda writes."By contrast, Slovic said, when you flout guidelines about wearing masks or avoiding gatherings, you get an immediate reward: You rejoice at not having to breathe through fabric, or you enjoy celebrating a close friend’s birthday in person." Risk perception fails as we learn to live with covid-19, risk-perception expert Dale Griffin told her. He and other researchers want tougher government mandates to fight the virus "as perhaps the only things that can protect us from our own faulty judgment," Svoboda writes, "but these kinds of measures aren’t enough on their own, Griffin said. It’s also important for authorities to supply in-your-face reminders of those mandates, especially visual cues, so people won’t draw their own erroneous conclusions about what’s safe."

As last days of summer approach and pandemic continues, here are many tips to navigate outdoor and social gatherings safely

Barbecues can be risky. (Photo from High Speed Training blog, The Hub)

First, remember that any such gathering needs to be small. Gov. Andy Beshear issued an executive order on July 20 that only allows for gatherings of 10 or fewer people. 

The order also calls for such gatherings to adhere to the Centers for Disease Control and Prevention guidance to the greatest extent possible, which includes social distancing, wearing masks indoors and outdoors if guest are unable to stay six feet apart, ample access to hand sanitation, and reminders for guests to stay home if they are sick.  

The Los Angeles Times reported 42 ways to minimize the risk of entertaining during the pandemic, with suggestions from disease specialists and caterers. 

First and foremost, the Post and others say it's important to keep everyone outside, where the virus is less likely to spread --and to only invite the number of people your outdoor space can safely handle. For example, if your outdoor space can only accommodate six people, six feet apart, then that's as many people as you should include. And if the weather is bad, cancel the event, don't take it indoors.  

The Times stresses the importance of limiting the number of people who touch items that are commonly shared, such as serving spoons, condiments and even the food, especially if it is a pot-luck event. One way to minimize this is to assign servers, who should be wearing both face masks and gloves, or to provide individual servings of "fixings," chips, dessert and drinks for each of your guest, while one person serves the main dish. And while disposable dishes and utensils are not the greenest options, they are the safest choices. 

Another suggestion: Consider each guest's level of risk before inviting them, and reveal the guest list to everyone invited so that they can make their own decisions about risk. 

In the bathroom, provide paper towels and liquid soap instead of shared cloth towels and bar soap. 

And most importantly, the Times says to make sure your guests understand your expectations before they arrive, and to be clear about what is non-negotiable.  

The Washington Post offers tips on how to navigate several outdoor activities. 

Public restrooms: Gretchen Snoeyenbos Newman, an infectious-disease physician at the University of Washington, told the Post that "public restrooms are already gross" and many have poor ventilation. Her advice: wear a mask, wash your hands when you go in, close the lid before you flush (flushing aerosolizes dirty water), wash your hands again; don't touch your phone or your face in the restroom; and as soon as you are out, use a hand sanitizer. And as with all indoor spaces, don't go into a crowded bathroom. 

Restaurants: While takeout continues to pose the lowest risk, if you decide to eat in a restaurant, make sure your server and other employees are wearing masks, and ideally, all of the other patrons if they are not eating; eat outside if at all possible; make sure appropriate social distancing is practiced; and don't linger too long after your meal.

Bike paths and other outdoor exercise: "Infectious-disease experts say that if you are outside and keeping a proper distance, the risk is actually pretty low," says the Post. 

Farmers' markets: Everyone should be wearing a mask and social distancing. It's also important to pay attention to crowd control and to wash your produce when you get home. 

Road trips with someone outside your household: This is a high-risk activity, Nahid Bhadelia, an infectious-disease physician, told the Post. You can reduce the risk by opening the windows, wearing mask and spacing yourself. However, she advises that if you or someone you live with is in a high-risk category, you should drive separately. 

Hotels and other lodging: Bhadelia called these a moderate risk, as long as linens are clean and the surfaces have been disinfected. That said, avoid the common areas and keep your hands washed. 

Barbecues: The Post says experts consider these "a pretty high-risk activity" because it is hard to wear a mask while socializing with food. The risk at barbecues also increases because people often drink alcohol at them and when people drink they stand closer to each other and talk louder, both of which increases the risk of transmission.

Camping: If you are camping with people you live with, that is fine. If you are camping with others, then make sure you maintain the six-foot distance rule. 

Swimming: The Post reports that there is no evidence to suggest the virus is transmitted through water, so any risk comes from other people, especially in close, confined spaces like locker rooms or indoor showers. Pools and public beaches should provide some kind of crowd control to help people stay six-feet apart. 

Playgrounds: The Post reports there is still not much consensus on how to manage playgrounds, which has caused many to remain closed. The CDC and other groups of experts have found that transmission of the virus from contaminated surfaces is low, so the biggest risk is likely from interactions with other children. If your child does go to a playground, experts advise making sure they can sanitize or wash their hands afterward. 

Recreational games: Experts tell the Post that as long as you are maintaining social distancing and not touching shared objects, the risk is low. Think tennis, pickle ball or bocce ball, not volleyball or basketball.

Ice cream shops: While there is some evidence that the coronavirus survives better in low temperatures, experts again say the biggest risk here is the other people in the store, so masks and social distancing remain key measures of prevention.