Cases top 1,000 for second day in a row; September has highest number of covid-19 deaths; Beshear says all that's a wake-up call

State Department for Public Health graph, adapted by Kentucky Health News

Graph by Daniel Desrochers of the Lexington Herald-Leader, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

With more than 1,000 new coronavirus cases reported two days in a row and the highest number of covid-19 deaths of any month, Gov. Andy Beshear said the numbers should be a "wake-up call" to every Kentuckian to help him get the numbers down.

"The covid report is just too high, two days over one thousand," Beshear said at his daily briefing. "This is not where we ever wanted to be in Kentucky. So I need your help. I need your help. . . . Our kids are counting on us to get back to school, our economy is counting on us to make sure we can continue to rebound, but it's up to us and we have got to get this done." 

He spoke to the need for everyone to wear a mask, saying there have been reports of fewer masks being worn in supermarkets, putting critical front-line workers at risk. He asked retailers to not serve people who don't wear masks in their businesses. "Remember, for retailers, no shirt, no shoes, no mask, no service." And he reminded Kentuckians to keep their social gatherings to 10 or fewer people and to wear a mask if entertaining indoors and to stay six feet apart, indoors or out. 

Beshear reported 1,004 new cases of the coronavirus on Wednesday after reporting 1,018 Tuesday, which was the second highest number to date. The state's seven-day rolling average was 797 cases, by far the highest yet.

Beshear said this week's numbers put the state on track to exceed last week's case numbers, which at 4,949 was the state's highest week of cases yet, and that the state is in an escalation.

About the only good coronavirus news of the day is that the share of Kentuckians testing positive for the virus in the past seven days was 4.07%.

Updated slide used by Beshear Wednesday; click it to enlarge

"We have to be more vigilant," Beshear said, adding later, "We have to continue to be committed to doing the things that are going to stop that escalation and a lot of that are just things that we have been talking about day after day."

Beshear is asked regularly, again today, what it would take for him to take new steps to deal with the escalating number of cases. He said the caseload and positive-test rate are important to watch, but not yet so high that new measures are needed, and the guidelines and rules already issued should be enough to bring the case level down, if only people would follow them.

The governor noted steps he has not taken, such as opening bars and restaurants to full capacity, which some states have recently done. One is Indiana, which he didn't mention.

"At a time when they still have more cases than we do and their positivity rate is higher, they are removing almost any and all of the rules that are out there to help us," he said. "You know at some point, we've got to make value decisions, you know, do we value having 100 percent capacity in certain places? Or do we value trying to get our kids back into school? And right now those are the value decisions that we're making."

"It's just a mathematical fact" that more cases mean more death, Beshear said, showing a graph that showed increased deaths in months with increased cases. He cautioned that while September has the highest covid-19 death rate yet, "We could very definitely see October's being higher than that."

Beshear announced four more deaths from covid-19: an 86-year-old man from Bullitt County; a 70-year-old man from Christian County; an 87-year-old man from Fayette County; and a 74-year-old man from Jefferson County. 

Of the 1,174 deaths so far, 584, or 49.7%, have been in people 80 or older. Those in their 70s have accounted for 26 percent, and those in their 60s have been 15.3% of the total. When it comes to cases, the most infected age group is those in their 20s; they have had 13,517 cases, or 19.6% of the total.

Beshear said 154 of Wednesday's new cases were Kentuckians 18 or under, and "We continue to see an increase among that age group."

In other covid-19 news Wednesday:

• Counties with 10 or more new cases were Jefferson, 187; Fayette, 156; Whitley, 32; Daviess, 26; Henderson, Madison and Scott, 24 each; Warren, 22; Harlan and Kenton, 20 each; Knox and Shelby, 18; Allen, Boone and Oldham, 14 each; Bullitt, Laurel and Rowan, 12; Jessamine and McCracken, 11 each; and Campbell, Hardin and Lincoln, 10 each.
• Covid-19 patients in Kentucky hospitals totaled 541, with 106 of them in intensive care, according to the state's daily report.
• After being in school only three days, more than 120 Lincoln County students are now in self-quarantine after two staff members tested positive for covid-19, Chelsea Jones reports for Lexington's WKYT. The quarantined students, who were all in a room with one of the infected staffers for at least 15 minutes, will move to virtual learning. 
• The state reported were 785 active cases among K-12 students and 376 among employees. In colleges and universities, the state reported 1,499 active cases among students and 48 among employees.
• The University of Kentucky has ordered students who test positive for the virus in any sort of test off campus to give the documentation to the university. Those who don't comply are subject to discipline.
• In 339 long-term-care facilities, there were 611 resident cases and 423 staff cases; the death toll from such facilities is 685.
• In 243 child-care facilities, there were 145 cases among children and 201 among employees.
• Beshear called on Kentuckians to look out for each other during the pandemic and to seek help if needed, providing contact information for domestic-violence shelters, 800-799-SAFE (7233) or KCADV.org and to report child abuse, 877-KYSAFE1 (877-597-2331) or 800-752-6200. 
• Google Maps can now help users “navigate safely” by sharing the latest coronavirus data for their location or destination. 
• A 48-year-old Kentuckian who served his country for almost three decades is the eighth person in the U.S. military to die from covid-19, Emma Austin reports for the Louisville Courier Journal. Mike A. Markins served on active duty in the Air Force in 1990-97 and in the Army Reserve from 2000 until his death.
• The pandemic "has sparked interest in public health careers at both the undergraduate and graduate levels over the last school year," Tom Latek reports for Kentucky Today. The University of Louisville has seen a 34% percent increase in undergraduates, and the Association of Schools and Programs of Public Health "shows a 20% uptick in applications over the same time last year."
• A study published in JAMA Internal Medicine found that official totals of covid-19 deaths "likely undercount deaths due to the virus," because the increase in U.S. deaths in March, April and May over the same months in 2019 exceeded the number of deaths attributed to covid-19 by 28%. "In several states, these deaths occurred before increases in the availability of covid-19 diagnostic tests and were not counted in official covid-19 death records," the study report said. In Kentucky, there was no statistical difference in the number of deaths and expected deaths.
• Another study in the same journal found "no clinical benefit" in having health-care workers take hydroxychloroquine to prevent infection for the virus, and workers taking the drug promoted by President Trump were more likely to have "mild adverse events" than those taking a placebo. Of the 125 workers evaluated, eight tested positive for the virus and six developed covid-19 symptoms, but none required hospitalization. The virus has killed more than 1,700 U.S. health-care workers.
• The University of Louisville, U of L Health, Louisville Metro Government and Passport Health Plan are updating a public-service advertisement that does not mention masks after Kentucky Health News alerted them that it had been recently published in the Courier Journal. "The ad you referenced was part of an awareness campaign, created in the early stages of the pandemic and before the mask recommendations," said a statement from the partnership. "Several media outlets agreed to place it periodically as space permitted. While social-distance guidelines and increased hygiene are still important protection measures to prevent spreading covid-19, our organizations strongly support the mask guidelines and are working to update the messaging." Here's most of the ad:

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Feds give state $7 million to help deal with lingering behavioral-health impacts of 2019 flooding in 21 Eastern Kentucky counties

Grant will help three southeastern regions, highlighted by roughly patterned area.

Kentucky is getting a $7 million federal grant to expand behavioral-health services in 21 Appalachian counties to help deal with the effects of severe weather in the region last February and March.

“Many counties in Eastern Kentucky suffered terrible loss in 2019 and continue to experience the impact of the flooding and mudslides there,” Gov. Andy Beshear said in a news release.

The grant will fund crisis services, mental-health and substance-use-disorder treatment, recovery services and other related supports to about 3,000 people affected by the disasters in areas served by three community mental-health centers: Mountain Comprehensive Care, Kentucky River Community Care, and Cumberland River Behavioral Health.

“Natural disasters have a serious and often lasting impact on the mental health of communities, who experience large scale destruction, home loss, injuries, and often deaths,” Health and Family Services Secretary Eric Friedlander said in the release. “All of these things, coupled with the fear of disaster happening again, can take a toll on mental health. It is critical we have resources to adequately support our crisis response mechanisms in affected areas to assure we can mitigate the psychological impact of these often life-altering, tragic events.” 

Efforts the grant will fund include:

• Coordination and assessment of crisis-response capacity and behavioral-health services and development of a comprehensive plan to address those needs.
• Prevention, counseling, mental-health and crisis services in schools.
• Community education and outreach.
• Mental-health and substance-use-disorder services for uninsured or under-insured adults, and expanded access to treatment.
• Recovery support including housing, transportation and job services.
• Support for quick response teams or enhanced crisis-response teams for assertive community outreach and engagement for individuals and families in crisis.
• Expanded telehealth services.

The money will go from the Substance Abuse and Mental Health Services Administration to the state Department for Behavioral Health, Developmental, and Intellectual Disabilities.

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Whole grains or no grains? Food labels can be misleading

Food labels contain a wealth of information: calories, serving size, and the amounts of fat, sugar, vitamins, and fiber contained in a food, among other things. But do consumers know how to effectively use this information? A recent study showed that some consumers are struggling, especially when it comes to understanding whole grains.

Recent study highlights consumer confusion

For the study, published in Public Health Nutrition, researchers conducted two experiments to examine consumer understanding of whole grains on food labels. The research, which focused on food labels on bread, cereal, and crackers, was done online and involved more than 1,000 adults.

In the first experiment, researchers displayed pairs of products with different amounts of whole grains (based on the ingredients list and fiber content), sugar, and salt on mocked-up Nutrition Facts panels. One of the products contained a good amount of whole grains but made no claims on the front of the package. The other product had less overall whole grains, but sold itself with terms like “multigrain” or “wheat” on the front of the package. Results showed that 29% to 47% of study participants incorrectly identified the less healthy product as the better option.

The second experiment used actual food labels and asked the study participants to identify which products had 100% whole grain, mostly whole grain, or little to no whole grain. About half of the study participants (43% to 51%) overstated the amount of whole grains in the products that were mostly refined grains. For another product, composed mainly of whole grains, 17% of the consumers understated the whole grain content.

The study concluded that consumers have difficulty identifying the healthfulness and the whole-grain content of some packaged foods, and that they rely on whole-grain labeling on the front of the package rather than considering information from the Nutrition Facts label and the ingredients list.

Why should we eat whole grains?

Whole grains refer to the entire grain kernel, including the bran, germ, and endosperm. The process of refining grains removes most of the bran and germ, leaving the endosperm (white flour). Each component of the whole grain contributes different nutrients, including vitamins, minerals, fiber, and other health-promoting compounds.

Whole grains offer a complete package of health benefits, unlike refined grains, which are stripped of valuable nutrients in the refining process. Studies show that they decrease our risk for several chronic diseases including type 2 diabetes, heart disease, stroke, and death from any cause.

Whole grains are also a rich source of vitamins and minerals. Compared to enriched white flour, 100% whole wheat flour contains: 96% more vitamin E, 82% more vitamin B₆, 80% more selenium, 78% more magnesium, 72% more chromium, 58% more copper, 52% more zinc, and 37% more folate.

Hulled barley, bulgur, whole-grain couscous, oats, rye, spelt, triticale, and whole wheat are all whole grains. Gluten-free whole grains include amaranth, brown rice, buckwheat, corn, millet, quinoa, teff, and wild rice.

Tips for selecting whole grain products

Don’t rely on front-of-the-package marketing. Just because the package shows a photo of a beautiful wheat field does not necessarily mean its contents are made with a whole grain. Even packages that say “multigrain,” “wheat,” “double fiber,” “cracked wheat,” “7 grain,” “stone ground,” “enriched,” “fortified,” or “made with whole grains” may be mostly enriched white flour.

Do not assume that darker is better. Products that are darker in color are not necessarily whole grains. Ingredients such as molasses or caramel coloring may have been used to impart color.

Check the ingredients list. The relative amount of whole grain in the food can be gauged by the placement of the grain in the ingredients list. The whole grain should be the first ingredient — or the second ingredient, after water. For foods with multiple whole-grain ingredients, they should appear near the beginning of the ingredients list. Choose foods that list “whole” or “whole grain” before the grain’s name, such as whole rye flour, whole wheat flour, or whole buckwheat.

Know what the labels really mean

If the label says…	The product contains…
100% whole grain	No refined flour
Made with whole grains	May contain a little or a lot of whole grains
Whole grain	As little as 51% whole grain flour
Good source of whole grain	15% to 25% whole grain
Multigrain	A mixture of grains, possibly all or mostly refined grains

Look at the Nutrition Facts label

The amount of fiber listed on the food label can provide a helpful clue to a food’s whole grain content. When selecting a product, choose breads that contain at least 3 grams of fiber per serving, cereals that have at least 5 grams of fiber per serving, and crackers that contain at least 3 grams of fiber per serving.

But don’t focus solely on whole grains. When trying to improve your diet, use food labels to guide you toward products with less sodium, saturated fat, and added sugar as well.

The post Whole grains or no grains? Food labels can be misleading appeared first on Harvard Health Blog.

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Anthem settles states' lawsuit over data breach that affected 2.3 million Kentuckians; state will get more than $1.9 million

Image from CoreRecon.com

Kentucky will get $1,929,942 from Anthem Inc. as part of a 43-state settlement for a data security breach that "compromised the personal information of 78.8 million Americans," said a news release from Attorney General Daniel Cameron.

Anthem, the state's leading health insurer, "also agreed to a series of data security and adequate governance provisions designed to strengthen its practices," the release said. "Attorney General Cameron’s Division of Consumer Protection served on the executive committee of the multi-state team and was a leader in the investigation."

In February 2015, Anthem disclosed that its data systems had been infiltrated a year earlier. "The attackers gained access to Anthem’s data warehouse and harvested names, dates of birth, Social Security numbers, health-care identification numbers, home addresses, email addresses, phone numbers, and employment information," the release said. "The personal information of 2,305,612 Kentuckians was compromised."

The release said the settlement requires Anthem to:

• Stop making statements about the extent to which it protects the privacy and security of personal information.
• Implement a comprehensive information-security program, including principles of "zero trust" architecture, regular security reporting to its board of directors, and prompt notice of significant security events to the CEO.
• Execute specific security requirements concerning segmentation, logging and monitoring, anti-virus maintenance, access controls and two-factor authentication, encryption, risk assessments, penetration testing, and employee training, among other requirements.
• Get third-party security assessments and audits for three years, and make its risk assessments available to a third-party assessor.

Soon after its disclosure, Anthem offered an initial two years of credit monitoring to all affected customers, at the request of the Connecticut attorney general.

Anthem then settled a class-action lawsuit by creating a $115 million fund "to pay for additional credit monitoring, cash payments of up to $50, and reimbursement for out-of-pocket losses for affected consumers," the release said. "The deadlines for consumers to submit claims under that settlement have since passed."

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Former Kentuckian recovering from serious health challenges offers hope and advice for others in similar situations

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Kentucky has its second highest day of coronavirus cases, 1,018; Beshear urges mask wearing, asks schools not to take fall breaks

State Department for Public Health map; for a larger version, click on it.

By Lisa Gillespie

Kentucky Health News

Tuesday marked the second highest day of new coronavirus cases since the pandemic arrived in March, with 1,018 people newly testing positive for the virus. 

“We need you to wear a facial covering; 1,018 cases ought to be a wake-up call,” Gov. Andy Beshear said at his daily briefing. “We can’t let this thing get out of control again because maybe we’re tired.” 

The governor cautioned that the number of cases is on an upward trajectory in the state, and colder weather will only increase the risk. 

“Moving into the fall has the potential to be the most dangerous time we’ve seen in Kentucky, and it doesn’t have to be,” Beshear said. “We know there’s a vaccine in our future, we just have to get to the point where we can prove it’s effective and deploy it to enough people. So are we willing to do what it takes to protect one another, until that point? I think that answer is yes, but we’ve got to prove it.” 

He urged parents of school-aged children to stay home for fall break, and strongly suggested that schools not offer one at all. 

“If your kids are going back to in-person classes, be careful about where you travel,” he said. “Bringing covid-19 back to a school can mean the school shutting down.” 

Kentucky also changed its color-coded guidance for K-12 schools today, which is based on how many coronavirus cases there are in a community. 

Previously, the guidance said schools in red counties, which have 25 or more coronavirus cases per 100,000 people, should only provide virtual learning and should halt all athletics until the county moved back into the yellow, meaning it has 1-10 cases of coronavirus per 100,000 people. Now, it says schools  in-person learning is advisable as long as the county isn't in the red zone, with a suggestion for schools to check the incidence rate map on Thursday nights to make decisions for the following week. 

 “It is not our intent to strand people in the wrong categorization,” Health Commissioner Steven Stack said. "The tool is intended to identify when the disease is particularly active in your community." 

Stack also encouraged patience as schools, parents and other stakeholders learn to navigate the new K-12 school covid-19 dashboard, which was launched Monday. It shows the latest available number of coronavirus cases in each school and was created for parents and school officials to use as they make weekly decisions about in-person schooling. Stack said that of the 2,000 private and public schools in the commonwealth, about 1,300 have submitted data. 

“You should be able to find your school by name and be able to find the data that they reported. If you don't find data, I encourage you to call the school and inquire, and work in partnership with them,” Stack said.

He urged Kentuckians to take the steps that are proven to control the spread of the virus: wear a mask, social distance, get tested, and don’t leave home if you are sick. He noted that after a three-month plateau, the state is seeing an increase in cases that Kentucky “can’t afford to let get out of control.” 

 “If we ignore the rules, someone’s going to get bitten, and they’re going to get bitten bad. Everywhere that people got sloppy, the virus got out of control and took more lives,” Stack said. “So please, take this seriously.” 

There’s also increasing evidence that covid-19 will have long-lasting effects on about 10 to 15 percent of those who contract it. Even for those without severe covid-19 symptoms, Stack said a portion report brain fog, shortness of breath and chronic fatigue, “There's a lot we don't know yet,” he said. 

Stack also urged Kentuckians to get a flu shot. 

“It’ll be impossible to know who has covid-19, or who has the flu,” he said. “People who are uncertain [of] their status, they’re going to be subjected to a lot more needless worry and additional testing.” 

The share of people testing positive for the virus in the last seven days in Kentucky was 4.24%.  

In other covid-19 news Tuesday: 

• Counties with more than five new cases were Jefferson, 226; Fayette, 143; Laurel, 58 Warren, 29; Barren, 28; Christian and Madison, 26 each; Hardin, 22, Calloway, 19, Boyd, 18, Rowan, 16; Kenton, 15; Henderson and Scott, 14; Boone and Franklin, 13; Carter, Union and Whitley, 11 each; Daviess, 10; Greenup and Pulaski, 9 each; Bullitt, Lincoln, Magoffin and Pike, 8 each; Bourbon, Boyle, Nelson, Oldham and Trigg, 7 each; and Anderson, Clark, Garrard, Hopkins, Jessamine, Logan and Muhlenberg, 6. 
• Of today's new cases, 157 are under 18. 
• Kentucky has 589 people in the hospital due to covid-19; 129 are in intensive care and 81 are on a ventilator. 
• Beshear reported eight more deaths, raising the state's toll to 1,170. The deaths reported Tuesday include a 93-year-old woman from Bell County; an 86-year-old man from Bullitt County; a 77-year-old man and an 85-year-old woman from Floyd County; a 71-year-old woman from Henderson County; a 68-year-old man from Hickman County; and two women, 86 and 87, from Kenton County. 
• Lt. Gov. Jacqueline Coleman said the state has enough personal protective equipment stockpiled to handle a four-month surge of cases. 
• Beshear said the state would be receiving its share of the 100 million rapid coronavirus tests through the end of the year and was working on a plan for how to distribute them. The Abbott BinaxNOW diagnostic test is the only FDA-authorized antigen, rapid, point-of-care test that doesn't require an instrument and produces test results in 15 minutes, and is costs $5, Becker's Hospital Review reports. The Associated Press reports on the downsides of the tests: "They are less accurate, and positive results often need to be confirmed with higher-grade lab tests. Additionally, because the tests are often performed outside the health care system, state officials have warned that many tests are going unreported. That could lead to under-counts of new cases, skewing government data needed to track the virus."
• Nearly 50 cases of the virus traced back to a church wedding at Lighthouse Baptist Church in Knott County, Madison Pergrem reports for WYMT. “From the time this started until now we had outdoor services we did online services. We looked for the ways to do things right but the one time that we dropped the ball, the one time that we went away from the guidelines is all it took,"  Pastor Jamie Hughes told Pergrem from his hospital room after being diagnosed with covid-19. "Probably not a family in our church that right now that does not have someone being affected by this." His final message: "Regardless of what you think or how you feel we want to encourage people [to] keep wearing the mask and keep social distancing." 
• Kevin Wheatley of Louisville's WDRB talked to a number of school officials who will be responsible for determining targeted closures for their school districts, with district leaders telling him they will consider the state's color-coded covid-19 incidence rate map, but will rely heavily on school-based coronavirus cases to make those decisions. 
• The Centers for Disease Control and Prevention's Morbiditiy and Mortality Weekly Report shows a recent increase in corinavirus cases among 18-to-22-year-olds. The report says between Aug. 2 to Sept. 5, cases in this age group increased 55%, and the rise was not solely attributed to increased testing. 
• The global covid-19 death toll surpassed 1 million Sept. 28, with U.S. deaths accounting for more than 20 percent of the total, Becker's Hospital Review reports.
• There is much discussion about herd immunity and covid-19 in the news these days, most recently coming to the forefront in a heated debate between Sen. Rand Paul and Dr. Anthony Fauci, the top U.S. infectious-disease official. Aneri Pattani with Kaiser Health News breaks down the facts about herd immunity, calling it a risky strategy: "The bottom line, medical experts say, is that natural herd immunity is an uncertain strategy, and attempts to pursue it could result in a slew of unnecessary deaths. A vaccine, whenever one becomes available, would offer a safer route to community-wide protection."

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Sick child this school year? Planning for the inevitable during a pandemic

Children get sick; it’s part of life. They catch colds, they get fevers, they throw up and get diarrhea. Most of the time, it’s nothing at all. But this year, as we struggle through the COVID-19 pandemic, every sniffle will be complicated.

The problem is, the symptoms of COVID-19 can be not just mild, but similar to the symptoms of all the common illnesses kids get all the time. Symptoms can include

• fever, even a mild one
• cough (that you don’t have another clear reason for)
• breathing difficulty
• sore throat or runny nose (that you don’t have another clear reason for)
• loss of taste or smell
• headache (if with other symptoms)
• muscle or body aches
• nausea, vomiting, or diarrhea.

And even if there is another explanation for that sore throat or cough, it doesn’t mean that your child couldn’t also have COVID-19. People can get two germs at once.

Set the bar low for keeping sick children home

This is not a year when you can send your child to school or daycare with that cough, or that one vomit, or that low-grade temp, and hope for the best. This is a year when we need to do our best to keep every sick person home, whether they have COVID-19 or something else. This is also not a year to skip the flu shot. We need there to be as little influenza as possible this year for everyone’s safety and well-being.

Here’s what you should do if your child gets any of the symptoms above:

• Keep them home from school or daycare. I understand that this may mean missing work, but there is simply no choice.
• To the extent that it is possible, keep them away from other family members.
• Call your doctor. If they have any trouble breathing, a high fever, severe pain or irritability, or unusual sleepiness, you should go to an emergency room. Otherwise, your doctor will advise you about next steps, including testing for COVID-19.

Theoretically, everybody with any of the above symptoms should be tested. But that may not be possible. And for some children — those with mild symptoms who aren’t in daycare or school, whose parents are working remotely and who don’t have contact with high-risk individuals — a test may not be crucial as long as everyone can stay home. Make sure you talk with your doctor and understand exactly what you and other family members need to do if your child is not tested.

The difference between quarantine and isolation

Quarantine and isolation are two terms that are used a lot these days, and while they are often used interchangeably, they aren’t the same thing.

• Quarantine means staying home: no trips to stores, or anywhere outside of the house or yard.
• Isolating means staying away from other people in the home — in a separate room, preferably with a separate bathroom (or wiping down in between), wearing a mask when they must leave their room, and not sharing utensils, towels, or anything else with anyone.

What to do if a test for COVID-19 is positive or you cannot get a test

The American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend these steps:

If your child tests positive for COVID-19:

• Make sure you are in touch with your doctor, follow all recommendations, and call for help if you have any concerns about how your child is acting or feeling.
• Isolate your child at home, to the extent that this is possible.
• Don’t send them back to school or daycare until at least 10 days from the start of their symptoms (longer if they are still sick), and until they have not had a fever for at least 24 hours without any fever-reducing medications.

Children who test positive are considered infectious until that 10 day/no fever point. So family members living with the child need to quarantine until 14 days after the 10-day point (if anybody gets sick, call your doctor). They also should wear masks and do their best to isolate from others at home, as you never know which person might get sick.

Getting family members tested doesn’t change the quarantine requirement — because the incubation period can be as long as 14 days. Theoretically you could be infected at day nine of your child’s infection — and not show symptoms for 14 days after that. It’s best to wait four to five days after the 10-day day point to be sure the test will be accurate (although any family member with symptoms should schedule a test right away). Testing family members can pick up asymptomatic cases — and may reset the quarantine clock for everyone else. Your doctor can guide you through.

This is going to be hard, and very disruptive, but it’s the only way to contain the virus.

If you can’t or don’t test your child, all the same instructions apply — because you don’t know if they have COVID-19. So you need to act as if they do, to be safe.

What to do if a test for COVID-19 is negative

If your child tests negative for COVID-19, talk to your doctor about what to do and when your child can return to school or daycare. It will depend on your child’s symptoms and whether another diagnosis was made.

What to do if your child is exposed to COVID-19 away from home

If your child is exposed to someone with COVID-19 outside of the home (being within six feet of them for 10 to 15 minutes), call your doctor for advice. Most likely, you will be told that your child needs to quarantine for 14 days after their last exposure to that person. As above, if you decide to test you should wait a few days — unless your child develops symptoms, in which case testing right away is a good idea. A negative test won’t get your child out of quarantine, but if they test positive then you will know to start isolating them — and start the clock for everyone else’s quarantine.

This is complicated, I know. Call your doctor’s office if you have questions — and check out the website of the American Academy of Pediatrics.

The post Sick child this school year? Planning for the inevitable during a pandemic appeared first on Harvard Health Blog.

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Ky. could be heading to its third major escalation of virus cases, just as most of the state's children are returning to schools

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

By Melissa Patrick
Kentucky Health News

After Kentucky hit the highest number of weekly coronavirus cases yet, Gov. Andy Beshear said a "third escalation" has begun, and called on Kentuckians to commit to a sense of urgency in their actions to thwart it. 

"With our kids going back to school in many places today or in some version we need urgency from everybody," the governor said at his daily briefing.

"Let's step up and show the urgency we need so we don't have another escalation, so it doesn't impact our economy, our kids, their education. So it doesn't take more lives of Kentuckians," 

Beshear again pleaded with Kentuckians to wear masks, which are proven to slow the spread of the virus, but stressed it more than usual, saying mask-wearing has become urgent. 

"We're not seeing enough of it at the moment," he said. "I can plead, I can beg, but I can also tell you that for a fact, the amount of our economy that's open, the ability to get our kids back in school, and the number of lives we lose or do not lose depends on a number of things, but primarily, the number of people willing to wear these masks," he said, holding one high.  

Beshear said certain events seem to cause a relaxed approach to the virus, such as the beginning of summer, which preceded the escalation that prompted him to issue a mask mandate on July 9.

With the onset of colder weather, when more people move activities inside and are more susceptible to infection, he said, "I now believe that we are not sitting at a plateau, but we are seeing what would be the third escalation that we've dealt with here in the commonwealth," he said. "We have to do better. We have to act with that urgency."

Beshear used the word time and again, including in his next-to-last slide.

Screenshot of next-to-last slide also shows Facebook comments with differing views. Click to enlarge.

This week's White House Coronavirus Task Force report also speaks to the need for urgency, with Kentucky's case numbers moving into the critical "red zone." The report puts 56 of the state's 120 counties into one of the danger zones; 14 of them in the red zone. 

Kentucky's own case-incidence map has 13 counties in the red zone, and the state's color-coded guidance calls for schools in such counties to move to remote learning and halt all sports until they can get to the yellow zone, the lowest danger level.

But Beshear said some counties in the red zone are still holding in-person classes. "If the approach is we're gonna do what we want to do no matter what," he said, "then we can't manage the virus in that way."

Beshear said at least 44 of Kentucky's 538 high-school sports teams are under quarantine.

Lt. Gov. Jacqueline Coleman announced the rollout of the state's new K-12 coronavirus dashboard, which will require each school to report daily the number of students and staff who have tested positive for the virus. The data will lag one day behind and can be sorted by state, county, school district and individual school. 

Coleman said parents and caregivers "deserve to know how the covid pandemic is impacting not just the greater community, but specifically the school building that they send their children to every day. It also is very imperative for our teachers and our school staff to know how this covid pandemic is affecting the children and other adults that they interact with every day."

Beshear, asked about Florida's decision to open its bars and restaurants to full capacity, noted that Florida has more than 700,000 cases and huge numbers of deaths (more than 14,000, according to a state covid-19 website), said "What Florida is doing is reckless and it's dumb."

He said every public-health expert says it's not a good idea, and "As long as I am governor, we're not pretending like this virus doesn't exist until we have a vaccine, and until we can deploy it. We're gonna continue with our current levels on bars and on restaurants. And if anybody out there thinks that we should just fully open 'em up to 100 percent capacity and fill up an internal arena, well, you've got the wrong governor. I'm going to do what it takes to protect people. And just because there might be states around us making dumb decisions, we're not going to here in Kentucky; we care about each other way, way too much."

Last week, Indiana Gov. Eric Holcomb allowed restaurants and bars can to open at full capacity, creating more competition for those in Louisville. 

Beshear announced 456 new cases of the coronavirus today, bringing the state's unadjusted seven-day average up to 740, the highest yet. 

The share of Kentuckians testing positive for the virus in the past seven days was 4.41%.

In other covid-19 news Monday:

• Beshear reported five more deaths from covid-19, raising the state's death toll to 1,162. The fatalities were a 56-year-old woman from Fayette County; an 84-year-old woman from Johnson County; and a 91-year-old woman and two men, 93 and 97, from Jefferson County.
• Beshear noted the Thursday death of Alice Sparks, 86, of Fort Mitchell, a prominent civic activist and philanthropist, from covid-19. “She lived a wonderful life and lived life to its fullest, but she should still be with us,” he said.
  
• Fayette County led the list of counties with new cases, with 108. Others with five or more cases were Jefferson, 100; Warren, 25; Daviess, 13; Madison, 13; McCracken, 12; Boone, 11; Allen, 10; Bullitt, Pike and Whitley, 8 each; Henderson, 7; Fulton, Harlan, Kenton, Pulaski and Union, 6 each; and Barren, Calloway, Marshall and Mercer, 5 each.
• The state's daily report said 507 people were hospitalized in Kentucky for covid-19 and 106 of them were in intensive care.
• In 338 long-term-care facilities, there were active cases in 630 residents and 450 employees, and the total of residents dead of covid-19 reached 667.
• In 232 child-care centers, there were 191 cases among employees and 138 among children.
• In 564 K-12 schools, there were 731 active cases among students and 337 among employees. In 55 post-secondary education institutions, the state reported active cases in 1,415 students and 47 employees.
• The coronavirus infection rate of 12- to 17-year-olds is about double that of 5- to 11-year-olds, says a study report from the Centers for Disease Control and Prevention. The study also found that children with underlying conditions were more likely to have severe covid-19 outcomes. "Among school-aged children who were hospitalized, admitted to an intensive care unit, or who died, 16%, 27%, and 28%, respectively, had at least one underlying medical condition," said the report, which added that testing of school-aged children varies across the nation. 
• CDC Director Robert Redfield “suggested in a conversation with a colleague Friday that Scott Atlas is arming Trump with misleading data about a range of issues, including questioning the efficacy of masks, whether young people are susceptible to the virus and the potential benefits of herd immunity,” NBC News reports. “‘Everything he says is false,’ Redfield said in a phone call made in public on a commercial airline and overheard by NBC. He acknowledged that he was speaking about Atlas, a neuroradiologist with no public-health background.
• The U.S. Department of Health and Human Services is assembling a $300 million advertising campaign to "defeat despair" about the coronavirus, reports Dan Diamond of Politico. "The effort has been roundly criticized by Democrats, particularly given the timing of trying to rush ads on air" before Election Day, Nov. 3. Politico's "Monday Pulse" update observes, "This is not how the department has ever run a public health awareness campaign, particularly one of this size, and it gives significant power to a small group of political appointees with little oversight." Career HHS spokesman Mark Weber said, "There is no room for political spin in the messages and materials designed by HHS to help Americans make informed decisions about the prevention and treatment of Covid-19 and flu."
• "The nearly 1 million people around the world who have lost their lives to covid-19 have left us a gift: Through desperate efforts to save their lives, scientists now better understand how to treat and prevent the disease — and millions of others may survive," Marilynn Marchione of The Associated Press reports. "Though more deaths are expected this fall because of the recent surge in coronavirus infections in the U.S. and elsewhere, there also are signs that death rates are declining and that people who get the virus now are faring better than did those in the early months of the pandemic."
• In what could be a harbinger of Kentucky's next legislative session, the Republican-controlled Louisiana legislature has called itself into session for 30 days to deal with 70 topics, and "A political tug-of-war over Democratic Gov. John Bel Edwards' orders to curb the coronavirus may take center stage," The Advocate reports. In Kentucky, only the governor can call a legislative session.
• WKYT reports on a weekend demolition derby held by the Lincoln County Fair Board at its fairgrounds near Stanford, showing photos of grandstands full of people siting close together with few if any of them wearing masks. "I was very disappointed," county Health Director Diane Miller told 

• 

  Screengrab from WKYT
  

  Phil Pendleton, saying she had given the board guidelines to follow. An attendee told Pendleton that people were "extremely respectful" of one another's space and "I’ve never seen that much active consideration for the space between people in a crowd this size." The fair board told Pendleton that signs had been posted with CDC guidelines at the gates and ticket booths, that free masks were provided, and that they walked the grounds reminding people to spread out, and attendees were asked for their names and phone numbers for contact tracing. Below is a wider view, also from WKYT, which said it was taken with a drone:

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Treating mild hypothyroidism: Benefits still uncertain

Your thyroid, a tiny, butterfly-shaped gland located in front of your windpipe (trachea) and below your voice box (larynx) can have a profound impact on your health and well-being. Throughout life, your thyroid is constantly producing hormones that influence your metabolism. These hormones affect your mood, energy, body temperature, weight, heart, and more.

A brief overview of hypothyroidism

Your thyroid produces two kinds of thyroid hormones: T4, or thyroxine, and T3, or triiodothyronine. These hormones influence every cell, tissue, and organ in your body, from your muscles, bones, and skin to your digestive tract, brain, and heart, by controlling how fast and efficiently cells convert nutrients into energy — a chemical activity known as metabolism.

The thyroid gland is under the influence of the pituitary gland. No larger than a pea and located at the base of the brain, the pituitary gland controls your thyroid’s production of thyroid hormone by releasing thyroid stimulating hormone (TSH).

TSH levels in your bloodstream rise or fall depending on whether there is enough thyroid hormone made to meet your body’s needs. Higher levels of TSH prompt the thyroid to produce more thyroid hormone, while lower levels signal the thyroid to produce less.

Hypothyroidism occurs when the thyroid fails to produce enough thyroid hormone to meet the body’s needs, thereby slowing metabolism. In someone with overt hypothyroidism, thyroid hormone levels are below normal and TSH levels are well above the normal range.

What is mild hypothyroidism?

Subclinical, or mild, hypothyroidism doesn’t meet the standard definition of hypothyroidism. In mild hypothyroidism, you may or may not have symptoms and your levels of T4 and T3 are normal, but your TSH levels are slightly elevated. Mild hypothyroidism is diagnosed by a blood test.

More than 10 million adults in the US have hypothyroidism, the vast majority of which is subclinical.

What are the risks of leaving mild hypothyroidism untreated?

Whether or not to treat mild hypothyroidism is a subject that has been studied and debated for years. What worries doctors most about mild hypothyroidism is the potential link between untreated mild hypothyroidism and coronary artery disease. Results of research on whether subclinical thyroid disease causes heart problems have been conflicting. The condition has been associated with heart and blood vessel abnormalities, and studies indicate that treating mild hypothyroidism can improve various markers of heart structure and function.

However, a recent study published in the Journal of the American Medical Association may give doctors pause. The researchers studied people with mild hypothyroidism who had also had a heart attack. They treated one group of these patients for their mild hypothyroidism, and left the condition untreated in the other group. The study showed that those treated for mild hypothyroidism did not have better heart function than those who were not treated.

What are the downsides of treating mild hypothyroidism?

When mild hypothyroidism is treated, levothyroxine (T4) is the treatment of choice.

A 2017 trial published in The New England Journal of Medicine found that treating people ages 65 and older for mild hypothyroidism doesn’t have much of a benefit. The authors found no real differences in symptoms between participants who received levothyroxine and those who got a placebo. The authors say many older adults revert to normal thyroid function on their own, without treatment. A follow-up study recently published in the Annals of Internal Medicine analyzed data from patients enrolled in the 2017 NEJM study, and determined that even those with the greatest number of symptoms did not benefit.

In addition to the possibility that the treatment may not offer any benefit, there are other reasons for caution. Overtreatment — prescribing thyroid medication to someone with subclinical disease who may not need treatment, or giving excessive thyroid medication — comes with serious risks, particularly thyrotoxicosis, the presence of too much thyroid hormone in the body. This happens frequently; estimates suggest 20% or more of those treated with thyroid hormone experience thyrotoxicosis. Long-term complications of even mild thyrotoxicosis can include heart problems and bone loss.

Considering the risks and benefits of treatment

If you are weighing the pros and cons of treatment for hypothyroidism, discuss the following questions with your doctor:

• How might I benefit from treatment? Could it treat my symptoms? Prevent heart disease? Help me conceive?
• What are the risks of treatment?
• How will we know if treatment is working, and how long will it take to determine this?
• For how long will I need to continue treatment?

The post Treating mild hypothyroidism: Benefits still uncertain appeared first on Harvard Health Blog.

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State hits the White House red zone for coronavirus cases, but has fewer counties in red or yellow zones than previous week

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

The latest report from the White House Coronavirus Task Force puts Kentucky it its worst danger zone for number of cases, but has fewer counties in that zone and the two others.

"Kentucky is in the red zone for cases, indicating 101 or more new cases per 100,000 population last week, with the 21st highest rate in the country," the report says. "Kentucky had 111 new cases per 100,000 population in the last week, compared to a national average of 93 per 100,000."

The state is much better off in the percentage of people testing positive for the virus during the week, landing in the yellow zone.

The report covers the seven days from Saturday, Sept. 19, through Friday, Sept. 25. It puts 56 of the state's 120 counties into one of the danger zones, down from 67 the previous week. The count of red-zone counties fell from 17 to 14, while the orange-zone count rose from 20 to 22. The biggest change was in the yellow zone, which fell from 30 counties to 20. (The table above shows only the top 12 counties in each zone, but all are listed below the table.)

The report recommends that the state "rapidly scale up testing" to identify infected people, "with support for isolation to reduce community transmission." It says testing should target areas with persistently high levels of transmission "and rapidly increasing incidence from east to northwestern parts of the state."

White House Coronavirus Task Force maps; for a larger image, click on it.

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Case numbers virtually assure worst week yet; student parties near UK stir worry about campus cases thwarting K-12 classes

Students partied on University Avenue in Lexington Saturday. (Herald-Leader photo by Alex Slitz) 

By Al Cross
Kentucky Health News

The state recorded 456 more cases of the novel coronavirus yesterday, virtually guaranteeing that it will report the highest weekly number of cases once the numbers are checked and adjusted.

The seven-day rolling average of daily new cases was 733, midway between the previous two days, and the unadjusted number of cases for each of those 7-day period was more than 5,100. The highest number for any of the state's official Monday-to-Sunday reporting weeks has been 4,742, Aug. 31-Sept. 6.

“We know we must do better if we want to continue on the path toward regaining the parts of our lives that have been on hold,” Gov. Andy Beshear said in a press release. “If we want to protect each other and our economy, if we want to get our kids back to school, the message is clear for Team Kentucky: Wear a mask, maintain social distance, wash your hands regularly and avoid crowds.”

Neighborhoods around the University of Kentucky campus were filled Saturday afternoon "with large groups of young people, most of whom were not wearing masks," Karla Ward reports for the Lexington Herald-Leader. "Scores of students attended parties in yards in the area around Elizabeth Street," off South Limestone Street, as the UK football team played its opening game in Auburn, Ala.

In Saturday, Lexington reported 110 new coronavirus cases, exactly half of whom were college students. Ward noted concern that cases from the campuses are keeping Fayette County from returning to in-person schooling, as most counties will Monday.

Nikki Fast Pollock, who lives in a neighborhood near Kroger Field, told Ward that seeing students in hold parties without masks or social distancing is “just kind of like a slap in the face.” Ward reports, "She said her son started kindergarten this year, and she’s had to explain to him that maybe he’ll get to go to school later, but he has to learn on the computer first."

University spokesman Jay Blanton "said UK and Lexington police have been sharing information about reports of large gatherings, and university officials are 'following up with property managers' when they get reports about specific addresses where parties are being held," Ward reports. Blanton said about 500 students attended a socially-distant football watch party at the UK baseball stadium.

"Students who violate UK’s social distancing policy, even if the violation is off campus, can face consequences ranging from a warning to suspension or expulsion," Ward notes. "So far this year, UK has found about 100 students guilty of violating the rules."

In other covid-19 news:

• Schools in Clinton County resumed in-person classes Wednesday, Sept. 23, after going remote and initially planning to be on a covid-driven hiatus until Oct. 12. Supt. Tim Parson "said he didn't think the county would recover as quickly as it did, the Clinton County News reports.
• Beshear announced three more covid-19 deaths Sunday, bringing the state’s death toll to 1,157. The fatalities were a 97-year-old woman from Bell County, an 87-year-old man from Kenton County, and an 81-year-old woman from Fayette County.
• Counties with more than five new cases on the state's daily report were Jefferson, 94; Fayette, 61; Madison, 20; Warren, 19; Henderson, 16; Hardin, 13; Daviess, 10; Greenup, Jessamine, Kenton,  Letcher and McCracken, 9 each; Bell, 8; Boone and Harlan, 7 each; and Boyd, Campbell, Estill, Knott, McCreary and Oldham, 6 each.
• Sixty of the newly reported cases were in Kentuckians 18 and younger, of whom 10 were 5 and younger, the release said. The youngest was 2 months old. Other figures won't be announced until Monday due to limited reporting on Sundays, Beshear's release said.

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First webinar of annual health forum shows much work needed to improve the lives of Ky. children; effects of covid-19 still unknown

By Melissa Patrick
Kentucky Health News

The first of five webinars focusing on policies and programs that reduce the chances of disease and unhealthy behaviors that often begin in childhood opened with a slew of data that shows the state has much work to do in this arena, with an expectation that the pandemic is only going to make things worse.  

But not to despair, Terry Brooks, executive director of Kentucky Youth Advocates, offered a message of hope, saying that such programs and policies are ones that generally have widespread support.  

"I'm sure that we all are aware that there is an element of toxicity and bifurcation in Frankfort and Washington these days," said Brooks. " I frankly think that's an opportunity instead of an obstacle because what we have consistently found is that kids . . . provide a common ground for legislators and the administration to work with."  

Brooks explained that KYA works to create a consensus agenda around children's issues that is based on a limited number of common ground priorities before each legislative session and that for the last two to three years, they have been almost 100 percent successful in getting those priority bills passed, with 90% of the vote in the House and Senate. "Things can get done," he said. 

The webinars are part of the Foundation for a Healthy Kentucky's annual policy forum, which will be offered in a free monthly webinar series this year due to the coronavirus pandemic. The next webinar titled "Intervening Early" will be held 2 p.m. ET Monday, Oct. 19. 

The foundation is partnering with KYA on this year's Howard L. Bost Memorial Health Policy Forum, which held its first webinar, titled "State of Child Health in Kentucky," Sept. 21. 

"We're focusing on programs and policies that help move Kentucky kids away from substance use, suicide and other risky behaviors and toward more natural, healthy behaviors that will benefit them throughout their lives," said Ben Chandler, president and CEO of the foundation. 

Brooks opened the meeting by painting a broad picture of what it means to be a child in the commonwealth, citing data from  the Kids Count Data Book on children's well being, released annually by the Annie E. Casey Foundation and KYA. The latest report shows Kentucky ranks 37th for overall child well-being.   

While the economic well-being of the state's children has shown slight improvement over the last few years, Brooks said Kentucky still has at least one in five children living in poverty and one-third of them live with parents that lack full time, year round employment -- and that's before the pandemic began. 

He added that it is also important to acknowledge that disparities exist around race and ethnicity, noting that while one-fifth of Kentucky's white children live in poverty, about one-third of the state's Hispanic and Black children live in poverty.  

"There are clearly systemic factors at play when Black and Hispanic children are more likely than their white peers to be poor," he said.

Brooks also expressed concern about the pandemic's effect on education, which has forced schools into an extended period of virtual learning. 

Brooks said there has been "too much happy talk and too little real talk" about education in Kentucky, pointing out that prior to the pandemic 65% of the state's fourth graders were not minimally proficient in reading and 71% of the state's eighth graders were not minimally proficient at math -- and that these numbers are even higher for  Black and Hispanic children.

He said Kentucky has the highest rate in the nation of children with incarcerated parents and the highest rate of children being raised by kin outside the foster care system, almost 100,000 of them. Brooks reminded the listeners that such events in the live of a child are considered "adverse childhood experiences" and have the potential for serious long-term impacts, including a shortened life, if not countered with protective factors that build resilience.  

He also pointed out that 38% of Kentucky's children between 10-17 are either overweight or obese, the second highest rate in the nation. And again, he called for local and state action to address this issue that will have lasting effects on the state's children. 

Brooks encouraged those attending the webinar to view the Kids Count data as "formative rather than summative," especially during the pandemic.

"That, frankly is always the case, but never more than in the midst of covid," he said. " No one and I emphasize that no one can truly predict how the pandemic will impact these numbers, but I do think it is a reasonable hypothesis to suggest that the pandemic will exacerbate current trend lines. In other words, I think what these numbers are suggesting will fit the post covid landscape, but perhaps be intensified."

Dr. Hatim Omar, retired professor at the University of Kentucky and founder of the Stop Youth Suicide Campaign, said prior to covid, there had been a sharp increase in the percentage of teens suffering from depression, anxiety, suicidal ideation and suicide attempts over the past few years. 

He said data from the latest Youth Risk Behavior Surveillance System survey is "the most disturbing since I've started working with preventing youth suicide 22 years ago," with 10-12 percent of Kentucky's kids saying they had attempted suicide over the past 12 months. Further, he said over the last three years there has been a three-fold increase in suicide attempts among African American children. 

As for how teens feel about the coronavirus, when asked to use one word to describe their feelings about the virus, Omar said their top three answers were anger, frustration and confusion. 

"The  key for us as grown ups, adult parents and teachers and anybody who deals with teens,  the most important thing for us to remember is that teenagers will not remember what we said, they will remember how we made them feel later in life," Omar said, while reminding parents to hug their teens and to be authentic in their interactions with them, even amidst their own stress and anxieties. 

"But most importantly," he said. "be available to our kids." 

Omar offered a list of things to pay attention to and encouraged parents and guardians to not delay in seeking help. For example, he said seek help if  your teen sleeping too much, or barely sleeping at all; if they're eating too much or not eating at all; if they are more irritable than usual or are feeling sad and fearful; if they are thinking thoughts that scare you; if they can't find a way to relax; if they have no motivation to do anything; if they are isolated all of the time or spending all of their time on social media and not doing anything else; or if they are fighting with parents and friends or feeling unsafe. 

"Really, this is a time where we shouldn't wait long, we should seek professional help for our kids," he said. "Because if we don't, then ultimately we'll end up with increased levels of suicide." 

Dr. Henrietta Bada, director, Maternal and Child Health Division with the Kentucky Department of Public Health, said that while there are many risk factors that affect the health and well-being of a child, there are also numerous protective factors that can mitigate those threats, even at a very early age. 

For example, she pointed to the importance of a healthy pregnancy and creating wholesome attachments in a nurturing family and home environment as ways to mitigate risk and build resilience in children. 

Kentucky offers a voluntary home-visitation program called Kentucky Health Access Nurturing Development Services, or Kentucky HANDS, that is designed to help the state's high-risk mothers with these early interventions. 

Bada said "exposure to violence, trauma or adverse childhood experiences is the single most prevalent risk factor for children today" and that repeated exposure to such experiences creates 'toxic stress," decreases resilience and can lead to death and disabilities in adults. 

"Knowing what we know now we can do better in preventing, mitigating and treating toxic stress," she said. 

Ben Robinson, a senior at Daviess County High School and a member of the KYA student advocate team, talked about the importance of youth involvement to improve the health of Kentucky's children. Robinson said he had lobbied to get the Tobacco-21 bill passed and is currently working to get bills passed that would stop corporal punishment in Kentucky schools and to increase the e-cigarette tax. He has also worked to educate his fellow-students about the dangers of vaping and on projects to decrease childhood obesity in his community. 

During his closing remarks, Brooks with KYA summed it up when he said: "Let's make sure that among the takeaways of this 2020 Bost Forum is a profound recognition -- whether it's obesity or vaccines, hard to cover kids or little boys and little girls inundated with life's traumas -- we have to ensure that Kentucky's health policy attends to core issues and social determinants, that Kentucky's health policy for kids is about local action and state action, that health policy depends on big time players like the foundation, but it also depends on each of us. And yes, that means you." 

Click here to register for the Oct. 19 webinar. The panelists will be: Lisa Lee, commissioner, state Department for Medicaid Services; Anthony Zipple, senior associate, Open Minds; Allison Miller, family learning specialist, National Center for Families Learning; and Dr. Julia Richerson, pediatrician, Family Health Center Iroquois. The moderator will be Tracey Antle, chief operating officer, Cumberland Family Medical Center. The webinars are free, but registration is required for "attending" each one." 

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A message to Kentucky journalists: Don't let fatigue and friction discourage you from covering the pandemic

Illustration from Medium.com

By Al Cross
Director and professor, Institute for Rural Journalism and Community Issues, University of Kentucky; publisher, Kentucky Health News

Just as some people are tiring of taking precautions against the novel coronavirus, helping it spread, I'm sure some newsrooms are tiring of covering it. And that helps it spread, too, by making it seem less of a threat, and discouraging precautions.

And I fear that some newsrooms aren't just tired of covering the pandemic, but have scaled back their coverage because of objections from people who think the pandemic is overblown or even a hoax that will fade after the election.

Let me be quick to say that I haven't seen such a trend in the newspapers I read regularly, but I tend to read high-quality newspapers, so that's not probative evidence.

What I do know is that news organizations all over the country are getting pushback. 

"No matter how carefully we report . . . for the first time, our readers are questioning the credibility of our reporting on the virus, and that's dismaying," said Les Zaitz, editor-publisher of the weekly Malheur Enterprise in eastern Oregon.

Zaitz made the comment on a panel during the Society of Professional Journalists conference this month, and I followed up with him via email.

"We consistently have people telling us they don't believe the numbers we report about total coronavirus infections, and the positive testing rate," he wrote. "They accuse us of being in league with government officials to overstate the cases. Some say this is to effect more government control over people. We cite our sources, link to those government sources, and regularly explain the data in plain terms.

He added, "We also get pushback in reporting on when government imposes restrictions (limiting restaurants, for instance). We are accused of fear-mongering and trying to panic people. Again, we clearly cite our sources."

I got similar reports from some editors and publishers of Shelbyville-based Landmark Community Newspapers, with the help of Editorial Director John Nelson, who surveyed them at my request.

Publisher Stevie Lowery

Stevie Lowery, publisher of The Lebanon Enterprise, wrote, "When we share the press releases from the governor’s office about the covid-19 pandemic on our Facebook page, we get HATE HATE HATE HATE spewed at us!!!! It’s insane!!!"

"The most intense feedback has been on social media, specifically Facebook," wrote Editor Hugh Willett of the Roane County News in East Tennessee. "We are posting the regular updates on positives cases, deaths, etc., that come from the county mayor’s office. These posts generate a large number of responses and quickly deteriorate into name calling over mask use, government overreach, etc."

"We have gotten a lot negative feedback on Facebook," wrote Editor Travis Jenkins of The News & Reporter in Chester, S.C. "Lots of folks calling it the 'plandemic' and so forth. Lots of people arguing masks don’t work, it infringes on their rights, and such as that. Anytime we post anything about mask ordinances or covid, it goes berserk."

Ben Sheroan, who edits one of Landmark's two dailies, The News-Enterprise in Elizabethtown, wrote that the paper "sees a lot of rude remarks and argumentative interaction on posts about daily covid reports and other covid-related stories."

Sheroan said the paper has sometimes changed its coverage "by simply being responsive to questions raised. For example, adding the positivity rate in a subsequent daily report, or providing data about the number of people hospitalized in a neighboring county. We have found sources to do stories about people who have lost family members or suffered illness."

Editor Miranda Cantrell on the job in Morgan County

The stories of the sick are important, to impress upon skeptical readers that covid-19 is a real disease, and a tough one. Leads can come from social media. That's what the weekly Licking Valley Courier in West Liberty, Ky., did when a county official posted on Facebook, "For those who don’t think covid-19 is real, it is. I tested positive."

Editor Miranda Cantrell put a note at the end of her story about the official's post, asking other victims to tell their stories, because readers in her Eastern Kentucky county wonder "whether the effects are as severe as mainstream media outlets have reported."

Yes, they do, but they are more likely to trust a local news outlet than one based somewhere else, so local editors and reports have a responsibility to tell the story of the pandemic and not flinch from friction or fatigue.

"Our main obligation is to give information to the public that's authoritative, truthful and important," Stat Executive Editor Rick Berke said during another SPJ session. He said it's "urgent" to write more stories "about how bad this is and how it affects people."

Berke, who covered politics for The New York Times, recalled that covering the topic after the 2001 terrorist attacks "was really hard because everyone was so nice to each other," so he was shocked to see the pandemic "become so politicized."

Another editor in the session, Steve Riley of the Houston Chronicle, said some readers are suspicious of national newspapers. He said anytime his paper publishes a front-page story from the Times or The Washington Post, both of which President Trump has attacked, it gets "emails that seem scripted from Fox News . . . It's our job to cut through the crap and provided unfettered, straight, reliable news, no matter where it falls."

Times science correspondent Donald McNeil Jr. said, "Every organ of government has been corrupted in this pandemic . . . Our role in this pandemic has been more important in many more crises in this country because there has been such an effort to suppress the truth, and we're fighting that."

Riley advised, "Be engaged with your critics." He said he tries to "explain in a calming way the role that we have. . . . the folks will at least nod their head and appreciate the response."

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973 new cases, 4th highest, making biggest week yet; Beshear asks for mask wearing, says he sees less of it sometimes

Kentucky recorded 973 new cases of the novel coronavirus Saturday, the fourth highest daily number of the pandemic, and making almost certain the week will set a record.

Gov. Andy Beshear said in a press release, “We are on pace to have the single highest week in terms of positive cases that we’ve ever had.” The state reporting week is Monday through Sunday; the daily unadjusted totals in the calendar week that ends today is 5,113 cases, the highest ever.

“We simply have to do better,” Beshear said. “Please wear a mask. Sadly, sometimes I’m seeing less of these out there than more. This will save lives.”

Beshear said 132 of the say's new cases were in Kentuckians 18 and younger, with 18 of them 5 and younger and the youngest 2 months old.

The state reported five more deaths from covid-19, raising its death toll to 1,154.

“We’ve already lost more than 200,000 Americans,” Beshear said. “Do your part as Team Kentucky, do your patriotic duty – mask up, Kentucky. It may save the life of someone you know.”

The fatalities were an 88-year-old man and a 101-year-old woman from Boyd County, a 67-year-old man from Scott County; an 80-year-old woman from Union County; and an 86-year-old woman from Christian County.

The share of Kentuckians testing positive for the virus in the last seven days remained relatively stable at 4.42%. 

In other covid-19 news Saturday:

• Counties with 10 or more new cases were Jefferson, 235; Fayette, 108; Henderson, 35; Warren, 35; Whitley, 29; Laurel, 27; Pike, 25; Bullitt, 23; Christian, 20; Boone, 17; Mercer, 17; Franklin, 16; Kenton, 15; Knox, 15; Boyd, 13; Daviess, 13; Scott, 13; Calloway, 12; Hardin, 12; McCracken, 11; and Jessamine, 10.
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