Beshear to step up enforcement of mask mandate, says more would obey it if Trump wore one; criticizes the president's tweet

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

By Melissa Patrick
Kentucky Health News

In response to an escalation in coronavirus case numbers, Gov. Andy Beshear and his health commissioner escalated their pleas for Kentuckians to stop it. 

"If current trends continue it will be a difficult fall and a difficult winter, but I believe that we have the opportunity to improve our situation," Beshear said at his daily briefing. "One of the big ways we do that is wearing a mask."  

Later, he mixed the practical with the philosophical: "Now's our test, a test of values, a test of faith. Are we willing to live for other people? Wearing a mask is inconvenient at most. Are we willing to accept inconvenience to protect life, to protect our economy and to get our kids in school? That's our choice.

"Or are we willing to say that we shouldn't have to go through any inconvenience and because we don't see people suffering from covid because they're either in their home or in the hospital. that we're not going to respond appropriately?" 

Beshear announced 543 new cases of the coronavirus, high for a Monday, reflecting less lab activity on weekends. That brought the seven-day average of unadjusted daily cases up to 915, a record. The average of the week that ended Sunday, after removal of duplicate results, was 875. 

Kentucky has seen a weekly increase in cases since Sept. 7, with a huge jump last week to 6,126, the highest weekly case count yet, up from 4,949 the week before. 

"We are clearly now in an escalation, there is no doubt about it," Health Commissioner Steven Stack said. 

"This is scary," he said, because unlike the April spike that the state was able to flatten, this one is starting so high that it could increase quickly, like what happened in New York, Florida, Arizona, and Texas. 

"I think that one of the tragedies that plays into this is this is something that is at least theoretically within our control, if we choose different behaviors," said Stack, a physician. 

Beshear was asked several times what he planned to do about the escalation. He said he was stepping up enforcement of his mask mandate and will ask mayors and county judge-executives to do help enforce it – but suggested that their help might be as spotty as compliance with the mandate: "After seeing this escalation, I hope they're on board too." 

The governor said every government official must do something if they see anyone not following the rules, and businesses must refuse service to people violating the mask mandate: "We need to make sure that everybody out there is getting back to the place where in your business you cannot check somebody out if they're not wearing a mask; it shouldn't matter who they are."

He added later, "If it is in our power to get better adherence, we're gonna do it." He called on local health departments to fine bars and restaurants if they are not following the 50% capacity rules, instead of merely educating them about the rules and the reasons for them. He also noted that the state Labor Cabinet and Alcoholic Beverage Control agents could help enforce the rules. 

He added that if the escalation continues, the White House Coronavirus Task Force will make new recommendations that he will "take a very serious look at." The task force's weekly report, usually posted on Mondays, was still pending at 10 p.m. 

Map adapted by KHN; for a larger version, click on it.

Stack said the state's incidence-rate map, which shows infections in the last seven days, "is about as ugly as it has looked" and it will get much worse if the trend continues. The Oct. 5 map shows 21 counties in the red, meaning they have at least 25 cases per 100,000 people. 

He then displayed a graph comparing U.S. coronavirus cases and deaths with Canada, Germany and New Zealand. They showed the U.S. has 22,000 cases per million people, compared to about 4,000 in Canada and Germany and hardly any in isolated New Zealand. The U.S. death rate is three and one-half times higher than Canada, six and a half times higher than Germany and 650 times worse than New Zealand, the world's most isolated urbanized democracy.

"Other democracies have figured this out," said Stack. "Tragically, the United States of America has not. Our nation, for its many wonderful attributes, unfortunately, is a spectacular failure in this regard. Our results for this disease management are really embarrassing, quite frankly. And we should be humiliated as a country that we haven't been able to come together better to get this done well." 

Stack noted a newly published study from the Centers for Disease Control and Prevention showing that one 13-year-old was the source of a coronavirus outbreak at a three-week family gathering, infecting 11 of 14 people who attended, but six people who attended for a short time, while practicing social distancing outside and wearing a mask while inside, were not infected.

He said it resembled the current situation at the White House, where the Rose Garden event President Trump held to introduce his Supreme Court nominee appears to have been a source of infection, perhaps even Trump's.

Beshear, asked if he approved of how Trump had managed his illness, said it was good that he had made public his diagnosis and had sought medical care, but shouldn't have violated quarantine and needs to wear a mask.

"I've been begging for months to have this president wear a mask in public. I sure hope that we will see that now every day, all the time, when he's not up speaking and can put it on and and take it off," Beshear said, adding that many people who aren't wearing masks "will start if the president will, and that's a way to protect a lot of people out there." 

Asked about Trump's tweet that said, "Don't be afraid of covid. Don't let it dominate your life," Beshear said the second point is correct, but "We need to have a healthy fear of a pandemic that's killed twelve hundred Kentuckians . . . If we don't, other people pay the price."

Beshear announced five more covid-19 deaths, bringing the state's death toll to 1,214: a 69-year-old man from Boyd County; an 85-year-old man and two women, 91 and 99, from Daviess County; and a 71-year-old man from Robertson, the state's smallest county.

The share of Kentuckians testing positive for the novel coronavirus in the past seven days is 4.68%, a bit above the seven-day averages of the past week.

In other covid-19 news Monday: 

• Of today's cases, 69 were 18 and under, and nine of those were 5 and under, the news release from Beshear's office said. 
• The state's daily report says 563 people are hospitalized with covid-19 in Kentucky and 145 of them are in intensive care.
• Fayette County had 32% of the state's new cases, 173; Beshear said it was catching up on a reporting backlog. Other counties with 10 or more cases were Jefferson, 87; Daviess, 32; Henderson, 18; Whitley, 11; and Kenton and Pike, 10 each. 
• Beshear said 156 more residents and 117 more staff in long-term-care facilities have tested positive since his last update on them, and that 22 more deaths of residents can be attributed to covid-19. He said one reason for more staff cases is an increase in staff testing, as required by the federal government. There are 762 active resident cases and 462 active staff cases in the facilities, and there have been 704 resident deaths and five staff deaths from covid-19. 
• Beshear announced an outbreak at the Thompson-Hood Veterans Center in Wilmore. He said at least 18 veterans and nine staff members have tested positive for the virus and that five of those infected are hospitalized. 
• The state's K-12 schools report shows 803 active student cases and 406 active staff cases. Since last Thursday, Beshear reported, 157 more students and 82 more staff have tested positive. 
• In colleges and universities, Beshear reported 194 more students testing positive since Thursday. The daily report show 1,116 active student cases and 45 active staff cases.
• More states have been added to Kentucky's travel advisory because they have a positivity rate above 15% or higher. They include, Mississippi, South Dakota, Idaho, Wisconsin, Iowa, Missouri, Kansas, Wyoming and Florida. Florida, at 11.08%, was also added last week because it does not have a statewide mask mandate, has allowed bars and restaurants to fully reopen and is a destination for many Kentucky families during school breaks. Kentuckians who travel to these states are asked to isolate for two weeks upon return. "For God's sake, don't go to the beach during fall break when you want to keep your kids in school," Beshear said. "We've already seen people die from other people's beach trips."
• Stack asked Kentuckians to answer two questions and send their answers only via postal mail to Dr. Steven Stack, Commissioner for Public Health, Kentucky State Capitol, Frankfort KY 40601. The questions are: "Why does covid-19 concern me? Why I am concerned for my fellow Kentuckians?"
• At the University of Kentucky's first football game of the pandemic, "Everyone seemed to obey the rules, minus a few physical-distancing infractions," former Lexington Herald-Leader employees Bruce Engel and Mary Sondergard  write for the paper. "Going to Kroger Field didn’t seem any more dangerous than going to Kroger." But much was different: "Lineup cards and programs? No. Hot dog hawkers? None. Halftime show? Fuhgeddaboudit. Still, it sounded and felt like a college football game, but with the volume set at 4 rather than 10."
• "Nearly a third of hospitalized covid-19 patients experienced some type of altered mental function, ranging from confusion to delirium to unresponsiveness," according to a study in Annals of Clinical and Translational Neurology, The New York Times reports. The study in the Chicago area is "the largest study to date of neurological symptoms among coronavirus patients in an American hospital system. . . . After they were discharged, only 32% of the patients with altered mental function were able to handle routine daily activities."
• The Washington Post's Fact Checker column has a sampling of President Trump's claims that "that success was just around the corner and that his administration has done a terrific job in confronting the pandemic."