Kentucky remains in most dangerous zone for virus cases and positive tests; White House calls for 'significant behavior change'

White House Coronavirus Task Force table; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

For the second week in a row, Kentucky is in the worst danger zone for both coronavirus cases and the share of Kentuckians who tested positive for the virus in the past seven days, according to this week's White House Coronavirus Task Force report. 

Kentucky has been in the red zone for case numbers, indicating 101 or more new cases per 100,000 people, every week since the Sept. 27 report, but this is only the second week it has been in the most dangerous zone for test positivity, meaning it has a rate above 10%.

Gov. Andy Beshear has noted several times that the state uses a different data stream than the White House, which results in a lower positive-test rate. The White House reports a 13% percent positivity rate in Kentucky. On Nov. 24, the state reported that rate to be 8.82%. 

As other states have surged even more, Kentucky's ranking in the White House report has fallen a bit. The latest report, which covers Saturday, Nov. 14, through Friday, Nov. 20, says Kentucky ranks 24th highest in the country for cases and 20th for positivity.

It says 92% of Kentucky's counties had a moderate or high level of community transmission, with 70% of them having high levels. That's up from 89% and 55%, respectively, in last week's report. 

It shows Kentucky with 433 new cases per 100,000 people. This number continues to show huge weekly increases. It was 344 per 100,000 in the prior week, and 274 per 100,000 the week before. The national average is 356 per 100,000.

In the state's Monday-to-Sunday reporting week, last week Kentucky had most cases ever: 20,514, up 22% from the week before. 

The number of counties in the White House red zone increased by 18, from 66 to 89; the orange zone number decreased by 11, from 24 to 13; and the yellow zone decreased by three, to 14. 

This week's report included a strong warning, saying the "aggressive, rapid, and expanding" spread of cases requires both "proactive, focused testing" to identify asymptomatic and pre-symptomatic individuals, combined with "significant behavior change of all Americans." 

Those behaviors include wearing a mask at all times in public, social distancing, significant reductions in public and private indoor capacity limits, and making sure that "every American understands the clear risks of ANY family or friend interactions outside of their immediate household indoors without masks." 

   

Some argue that Kentucky does not have a reliable estimate of the virus' spread because it depends on "convenience samples" from voluntary tests instead of statewide random testing. Beshear has argued that the state does so much testing that it has a pretty accurate picture of how many people have the virus, especially among those with symptoms. 

He was asked Tuesday about White House's recommendation for "proactive, focused testing" to catch the virus in people without symptoms, and the latest analysis from the University of Louisville's Co-immunity Project – which does random testing in Jefferson County, finding that the infection rate is now 10 times what it was two months ago and that the infection rate is nearly five times higher than the publicly reported number of cases.

Beshear said the state is doing a study with LabCorp, a large testing laboratory, "that is giving us data on how widespread that we think the virus is in Kentucky." He said Health Commissioner Steven Stack would talk about it next week. "It's got some different numbers than the co-immunity project, but it's also statewide."

The White House report also called for "strong Thanksgiving messaging" that encourages people to limit events to individuals in their household and to wear masks while indoors around high-risk and vulnerable people. In addition, it says to expand public-health messaging to all media platforms, to warn people about the risks of social gatherings and re-emphasize the need for masks and social distancing. 

The report also called on Kentucky to stay vigilant to protect nursing home residents and staff, ensuring that they have full testing capacity and are properly isolating those who test positive. It also calls on the state to ensure that all hospitals have expansion and contingency plans and up-to-date treatment protocols.

The report included a graph showing covid-19 hospitalizations by age and by week.

White House Coronavirus Task Force graph; for a larger version, click on it.