Beshear gives recommendations, not mandates, for red-zone counties; health chief says infection risk has never been higher

Department for Public Health graph; numbers for most recent week are unadjusted

By Melissa Patrick

Kentucky Health News

As coronavirus cases escalate across Kentucky like never before, Gov. Andy Beshear made new recommendations, not mandates, for high-infection counties. That put the responsibility for thwarting the virus squarely on communities, much as he did with school districts. 

"I believe that we, as each one of these communities, have a duty first to prevent our county, our area from becoming red because that puts everybody that we live around in danger," Beshear said at his daily briefing. "But I think we certainly have a responsibility when our county becomes red, to look at all of the things that we can do, to lessen the spread, to tamp down the numbers, to get back to orange and yellow."

A county is considered in the red zone if it has at least 25 cases per 100,000 people. As of Oct. 26, 55 of the state's 120 counties are in the red zone.

Here are the new "red zone" recommendations:

• Employers should let employees work from home when possible;
• Government offices that do not provide critical services need to operate virtually;
• Reduce in-person shopping; order online or pickup curbside as much as possible;
• Order take-out; avoid dining in restaurants or bars;
• Prioritize businesses that follow and enforce the mask mandate and other guidelines;
• Reschedule, postpone or cancel public events;
• Do not host or attend gatherings of any size;
• Avoid non-essential activities outside your home; and
• Reduce overall activity and contacts, and follow existing guidance, including the "10 Steps to Defeat Covid-19."

For a larger image, click on it.

Asked why he didn't issue new mandates, Beshear said “We know encouragement will do more than enforcement to get people on board. It puts ownership in each community.”

If the recommendations are followed, he said, it should only take a week or two to get a county out of the red zone.

He said the recommendations wouldn't be necessary if everyone would follow those that have been in place for months: wearing a mask, social distancing, limiting the size and number of social gatherings, staying home when sick, and getting tested if you are exposed or have symptoms. 

"Fatigue and, I guess, a cultural war that's somehow sprung up around what keeps you alive and keeps people around you alive have led to less compliance as the summer ended and as we move into fall," Beshear said. Later, he said, "We're in a dark, difficult time that's about to get darker."

He said an unnamed Republican governor told him in a conversation about Halloween parties, "We are seeing a striking disregard for the health of our neighbor." Addressing people who won't mask up, he said, "Talk to your minister. Read your Bible. Wearing a mask isn’t a statement about your own personal freedom. It’s about how much you care about somebody else."

Health Commissioner Steven Stack, a physician, said the danger from the virus is the greatest ever, and gave a statewide warning, beyond the red zones.

"It is not a good time to be out in public," Stack said. "The likelihood you will come into contact with someone and get infected if you're sitting too close at a restaurant, if you're at a bar having drinks with folks, if you're at a place where people are shouting and cheering, if you're engaged in personal parties or gatherings in your own home, where you're mixing people from outside of your house -- the risk of you getting infected in the state of Kentucky has never been higher than it is today.

"And so I have to urge, if you're listening to this, if you can be persuaded, you should stay healthy at home, to the fullest extent possible. You should stay with your immediate family, minimize your physical contact with other people. And if you go out, you should wear your mask and you should maintain the distance with others."

Alluding to the controversy attached to masks, Stack said, "Please be kind to each other. People have made controversies where there should not be controversies. This is public health. There's no politics in this, it's a silly piece of cloth that keeps your spit from hitting other people and the air you breathe from coming into contact with other people. This is pure public health. It is the tool we have, as inelegant as it seems and as uncomfortable as it sometimes feels, this is what we can do along with distancing, and it's both, it's not one or the other. It's six feet plus a mask."

DPH map, relabeled by Ky. Health News; to enlarge, click it.

Referring to the state map that shows 55 of the 120 counties in red, Stack said that if the guidance as followed for a month to six weeks, "We would find most of that map would turn yellow, not the orange or red. . . . We could get back to a more normal life, have kids in school, people at work. So I have to encourage you, if you won't listen for the well-being of others, for yourself now, it is every bit as important that you follow these rules in this guidance and please stay healthy at home to the fullest extent possible."

The new recommendations were made at a time when the positive-test rate and hospitalizations for covid-19, not just virus cases, are rising. 

Beshear announced 953 new cases, the most ever on a Monday, a day that typically has fewer cases because of limited testing on Sundays. 

The share of people who have tested positive for the virus in the past seven days has been above 5 percent for five days in a row. Today, it is 5.84%.

Beshear said 848 people are hospitalized in Kentucky for covid-19, another record, with 253 in intensive care and 112 on ventilators. He said the state still has adequate hospital capacity, with 64% of beds and 70% of intensive care beds occupied and 27.6% of ventilators in use. 

The governor announced three more deaths from covid-19, bringing the state's death toll to 1,410: a 75-year-old man from Garrard County, a 73-year-old woman from Graves County and a 54-year-old man from Lewis County. 

To those who would dismiss covid-19 deaths, saying that most who die from it also have another health condition, Beshear pointed out that high blood pressure and diabetes are a few of the most common "co-morbidities" that people have who die from it, both of which are common in Kentucky. 

"And that doesn't mean you're a walking corpse; you are far from dead," he said. "It means that when covid hits you, it makes a serious impact." 

In other covid-19 news Monday:

• Jefferson County had nearly 35% of Monday's new cases, 331. Other counties with 10 or more new cases were: Fayette, 61; Kenton, 24; Floyd, 23; Barren, Boone and Bullitt, 22 each; Hardin, 21; Campbell, 19; McCracken, 17; Boyd and Scott, 16 each; Greenup and Taylor, 14 each; Madison and Marshall, 13 each; Daviess, Jessamine, Perry, Shelby and Warren, 10 each.
• In long-term care, 26 new residents and 23 new staff have tested positive for the virus, with 963 active resident cases and 556 active staff cases. There have been 848 resident deaths and six staff deaths related to the virus.
• Beshear gave an update on the outbreak at Thomas-Hood Veterans Center in Wilmore, reporting that there have been eight more covid-19 deaths from the facility, 10 patients from the facility are in the hospital, there are 51 active resident cases and 49 active staff cases and that four residents and 26 staff have recovered.
• The college and university report shows 71 new student cases and four new staff and faculty cases, with 522 new student cases and six new staff and faculty cases in the last 14 days.
• The K-12 public health report, which includes verified case numbers, shows 592 students and 280 staff tested positive for the virus in the last 14 days. The K-12 dashboard was last updated on Oct. 23. 
• Ten states are on Kentucky's travel advisory because they have a positive-test rate of 15% of higher. They include: South Dakota, Idaho, Wyoming, Iowa, Alabama, Nebraska, Kansas, Nevada, Utah and Wisconsin.  Kentuckians who travel to these states are asked to isolate for two weeks upon return. The list also includes Florida, which has a positivity rate of 10.25%, "due to the removal of public health restrictions." Today, Beshear said, "We advise that you do not travel to these states, though depending on where you're living right now in Kentucky, we may be advising you, do not travel at all."