Tuesday, December 8, 2020

New virus cases keep slacking, but intensive-care units in three regions are in 'a very precarious situation," Beshear says

Kentucky Health News graph, from unadjusted initial daily reports

By Melissa Patrick
Kentucky Health News

As new cases of the novel coronavirus kept declining, Gov. Andy Beshear assured Kentucky hospitals not among the 11 slated for the first round of vaccines that they would get some in the second week of distribution. 

"We are committed that the other 85 acute-care hospitals will be allocated and will be shipped in that second week, either Moderna or Pfizer vaccines," Beshear said at his Tuesday briefing. "That means every hospital, acute hospital, that is out there fighting this virus will at least get some by the end of the second week, provided that those shipments do in fact come in."  

The first round of Pfizer vaccines, which are expected to arrive next week, will go to residents and staff in long-term care facilities and frontline workers in the 11 hospitals, but some of them will have to wait for the second round.

Asked about another group in congregate living, prison inmates, Beshear said, "They are not in the top several groups of priority," He said corrections officers, as essential workers, will get vaccinated early in hope of holding down cases in prisons.  

The Department of Corrections reports 44 active cases among staff and 299 among inmates in its 14 institutions. Since March, it has had 456 staff cases and three staff deaths from covid-19 and 2,895 inmate cases and 24 inmate deaths.  

Beshear  announced 3,114 new coronavirus cases in Kentucky on Tuesday, lowering the state's seven-day rolling average down to 3,236, the third day in a row it has declined. 

And while that's "more than we want," he said the "good news" is that it's 1,000 fewer than reported last Tuesday and said, "The growth in cases appears to be slowing and we hope that holds through the rest of the week."

The share of Kentuckians who have tested positive for the virus in the past seven days fell for the fifth day, to 9.56% -- although that is still more than twice what it was six weeks ago. 

"Again, we hope and we believe that the exponential growth that we're seeing is slowing," Beshear said in his closing remarks. "And we absolutely believe the steps we are taking are the primary factor in that slowing of growth." 

Dept. for Public Health map, adapted by Ky. Health News; click to enlarge
Hospitals: A main concern about the recent escalation in cases is that hospitals will become overwhelmed. 

Beshear said today there are 1,760 people hospitalized with covid-19 in Kentucky; 416 are in intensive care and 207 of those are on a ventilator.

For the first time, he gave detailed information about hospital capacity around the state, showing which areas are filling up.

Beshear said anything over 80% capacity is cause for concern. The only part of the state that is struggling with overall bed capacity is in Northern Kentucky, which is 87.6% full. Beshear noted that this includes all patients.

He said the real concern right now is about intensive-care units; three areas are over 80% capacity: The Lake Cumberland region is at 95.7%; the easternmost region is at 90.4%; and Barren River is at 95.7%. 

"We're in a very precarious situation," Beshear said. 

Kentucky Health News asked for such information Nov. 4. The state released it only after federal officials released a database showing hospital admissions and ICU capacities in every hospital across the nation.

"The dataset, uploaded to Healthdata.gov, provides a weekly snapshot of how Covid-19 is impacting individual hospitals across the country," NPR reports. "The information dates back to July 31. Going forward, the data is expected to be updated each week." 

As case numbers rise, Lexington is seeing a record number of its residents hospitalized, Jeremy Chisenhall reports for the Lexington Herald-Leader. The local health department said 97 Lexington residents were hospitalized with Covid-19 Tuesday, a record, following six straight weeks of increases.

Health department spokesman Kevin Hall pointed out that overall hospitalization numbers in Lexington are higher, since his agency doesn't track non-residents. Despite that, he said, some people remain in denial.

“There’s just so much misinformation out there,” Hall said. “I saw people arguing yesterday that hospitalizations were low, and that couldn’t be further from what we’re seeing in Lexington.”

Schools and Lawsuits: The American Medical Association and the Louisville Metro Department of Public Health & Wellness, calling themselves medical experts, filed an amicus brief with the U.S. Supreme Court on Tuesday in support of Beshear's decision to temporarily halt in-person classes in both public and private schools until Jan. 4 for middle and high schools, and Dec. 7 for elementary schools that  are not in counties with high community spread of the virus.  This order is being challenged by Attorney General Daniel Cameron and 17 private Christian schools. (The HL has reported 17 schools)

"The public health order at issue in this case, which temporarily ordered the closure of all Kentucky schools from kindergarten through high school for in-person learning, was based on sound scientific considerations," they write. 

In the argument, they write that Health Commissioner Steven Stack's declaration offers a "detailed scientific explanation" for the in-person classroom closures, and explains why other Kentucky institutions face fewer restrictions, adding that this declaration "is based on solid medical reasoning." . 

In conclusion, they write, "The science indicates that under certain circumstances, such as those described in Dr. Stack’s declaration, temporary school closures in grades K-12 for in-person learning, including closure of religiously oriented schools, may be necessary public health measures."

Beshear said again that he expects to have options for in-person learning for all schools on Jan. 4, even for those that are in "red zone" counties, which means the county has at least 25 new cases per 100,000 people in the last seven days.   

"We'll work on having that guidance out as early as next week," he said. 

Health officials safety and Rule of Law: In regards to a  police report in Hopkinsville about a social media post that the county health department saw as a threat against one of its employees, which coincided with local restaurant that continues to operate despite having its food service permit suspended on Friday, Jennifer Brown with the Hoptown Chronicle asked Beshear what the state was doing about such threats and whether the resistance to the governor's orders had in effect reached a point that diminished the authority of county health officials. 

Beshear didn't provide a direct answer, but instead gave a long, impassioned reply that called such actions 'absolutely unacceptable" and implored anyone who would engage in such "evil" behavior against health department officials to stop it. 

"Stop it. Stop it. Whoever's out there doing this, stop," he said. "You do not have the right to make other people fear for their safety, you do not. That is not an American liberty. That is not your freedom of speech. And in many cases, it's criminal."

As for those who continue to operate their businesses, even though the Supreme Court has deemed the governor's order to close in-person dining in restaurants and bars to be legal, he said they are "diminishing not just the authority of a state or a country during a pandemic, you are diminishing the rule of law," which he called one of the "bedrocks of this country" that allows us to be a peaceful society. He added that there will be "long standing implications for what we are seeing right now" if people continue to not follow laws they disagree with. 

White House Coronavirus Task Force report: 






Beshear noted that this latest White House report calls on states and local governments to implement the same mitigation policies that Kentucky has already put in place. 

"This is exactly what we did in Kentucky. We have already acted, done what the White House is pleading for other states to do," he said. "Has it been hard? Yes. But it is time-limited sacrifice to slow growth and ultimately plateau, and then decrease our number of Covid cases. While today's number in the report is high . . . it is a little over 1000 fewer cases than this day last week. These steps work, the White House know that they work." 

Deaths: Beshear announced 20 new deaths on Tuesday, with five of them under the age of 60. That brings the state's total number of confirmed deaths from covid-19 to 2,102. 

Beshear honored the life of Henderson resident Louise Connell who died at 93 on Thanksgiving Day just 10 days after testing positive for Covid-19. Beshear said she was a mother of three, a grandmother to four and a great-grandmother to nine children. She was married for 70 years to Oliver, who died in 2016. 

“The heartbreaking fact about this memorial is Louise was living in a long term care facility and likely would have been one of the first to receive the life saving vaccinations coming this month," said Beshear.

In other coronavirus news Tuesday:
  • Today's deaths include a 92-year-old woman and a 92-year-old man from Bullitt County; two men, ages 52 and 72, from Boyd County; a 74-year-old woman from Fayette County; a 58-year-old man and a 74-year-old woman from Hopkins County; a 35-year-old woman and a 90-year-old man from Jefferson County; two men, ages 56 and 71, from Johnson County; two men, ages 37 and 83, from Lee County; a 78-year-old man from Marshall County; a 62-year-old man from Nelson County; an 87-year-old woman from Owsley County; two women, ages 78 and 90, and a 79-year-old man from Pike County; and a 66-year-old man from Scott County.
  • In long-term care facilities, the state reports 2,505 active resident cases and 1,226 active staff cases, with 118 new residents and 88 new staff reported today. There have been 1,417 resident deaths and seven staff deaths attributed to covid-19. 
  • Beshear declared Dec. 10, 2020 as "Get Covered Day" and joined a broad coalition of states, health care groups and providers in an effort to encourage mask wearing and to encourage people to sign up for health coverage. Dec. 15 is the last day to sign up for a federally subsidized health plan on healthcare.gov. One part of the campaign is to encourage people to practice the three W's to reduce Covid-19: Wear a mask. Wash your hands. Watch your distance. 
  • Walmart and Sam's Club are now selling coronavirus test collection kits online, ranging from $99 to $135, depending on the collection method, Dawson White reports for McClatchy Newspapers. White walks through how it works: The buyer is asked to fill out a survey, which generates a physician's order for a kit if appropriate. After the buyer gets a kit in the mail and takes a nasal swab or a saliva sample, the sample is mailed to a laboratory and results take between 24 and 48 hours. 
  • Scientists at AstraZeneca and the University of Oxford are the first coronavirus vaccine developers to publish full data from a clinical trial in a peer-reviewed scientific journal, confirming earlier claims that their coronavirus vaccine is 70 percent effective overall, but there's less data on how well it works in people over 55, suggesting the need for more trials, William Booth and Carolyn Y. Johnson report for The Washington Post. The results, published in the British medical journal The Lancet, show a "highly effective" vaccine that is cheaper and easier to manufacture that its competitors, according to Maria Deloria Knoll of the John Hopkins Bloomberg School of Public Health in a commentary with the article. Because of limited supplies of the Pfizer and Moderna vaccines, the U.S. is going to need this vaccine, a health official told the Post. 
  • The first two doses of the Pfizer vaccine were administered today in the United Kingdom to a 90-year-old woman and an 81-year-old man.
  • The Centers for Disease Control and Prevention warns that large gatherings like weddings are considered "highest risk" when it's difficult to social distance and people travel from different areas. Summer Lin of McClatchy reports on several weddings that have been been "superspreader" events, and explains the risks. 
  • Billy Kobin of the Louisville Courier Journal explores how vaccines will affect Kentucky schools, including information about several Republican legislators who want to change state immunization laws. 
  • Three of Kentucky's 171 school districts reopened elementary classrooms this week, Kevin Wheatley reports for WDRB, including Crittenden County, Breckinridge County and, in that county, Cloverport Independent. 
  • "The economic relief package attracting bipartisan interest in Congress is at risk of imploding in part over Senate Republicans’ insistence on granting sweeping legal immunity to businesses and other entities from coronavirus-related lawsuits," The Washington Post reports. The issue may have been reduced to the time period for immunity; Senate Majority Leader Mitch McConnell wants five years, while some Democrats reject it completely and some Republican supporters of the package have suggested in apply only for 2020. "It is unclear whether McConnell will ultimately support whatever compromise language the bipartisan group may develop," the Post reports.
  • The Washington Post shares stories from seven intensive-care nurses about experiences in an article titled: "What seven ICU nurses want you to know about the battle against Covid-19." 
  • Gallup poll of 2,968 adults taken Nov. 16-29 found 63% of Americans would agree to be vaccinated against the coronavirus if the vaccine was "available right now at no cost." That's an increase from 58% in October and 50% in September, but not as high as the 66% reported in late July. The poll found 37% said they would not agree to be vaccinated. That's down from 42% in October and 50% in September, and near the low of 34% reported in July. The poll found that Democrats are more willing than Republicans to be vaccinated: 75% and 50% respectively. 

    Gallup graph

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