Tuesday, December 15, 2020

Plain talk's understood: 'Snot and spit ... spread infection,' health chief says as he advises us to 'hunker down' during the holidays

White House task force graph shows national numbers; Kentucky's trends have been similar.
By Melissa Patrick
Kentucky Health News

Coronavirus cases in Kentucky appear to have plateaued, but infection rates remain high, and the state's top doctor said Tuesday it's too dangerous to travel.

Meanwhile, the response director of the White House Coronavirus Task Force came to Kentucky and complimented the pandemic work of Democratic Gov. Andy Beshear, who arranged a private meeting between her and Republican legislators who have been critical of him.

Beshear announced 2,946 new virus cases, the lowest number on a Tuesday in four weeks; 3,114 cases were reported last Tuesday, and the one-day record of 4,151 the Tuesday before that. The seven-day rolling average, which smooths out peaks and valleys caused in part by weekends, stood at 3,179 -- down for the fourth straight day, and eight of the last 10 since it topped out at 3,440.

Health Commissioner Steven Stack praised Kentuckians for stopping a surge for the third time, but cautioned that the full impact of social gatherings and travel during the Thanksgiving holidays is not fully reflected in the case numbers, so we need to "hunker down" during the Christmas holidays. 

Stack said Kentucky's health ranking among states is low, but "Despite that, we have one of the best performances in the entire country for low numbers of death across the state. At this point, we've shown three times that when we intervene, we can have a positive impact, save lives and minimize disease." 

He announced an official advisory discouraging all out-of-state leisure travel and urging such travelers to self-quarantine for 14 days upon return -- or to follow the latest federal guidance for ways to shorten the quarantine. Beshear said, "Our new travel advisory is: Don't travel. Right now it is dangerous."

Stack also advised against gathering outside your household during the holidays, and to order carry-out instead of dining indoors if at all possible. And for those over 60 or with high-risk conditions, he said, "It is not safe to go into indoor settings with other people not wearing masks. It simply is not safe." 

A physician, Stack described the risk in earthy terms: "When people get close to each other without a mask on and spread their secretions, and essentially spray snot and spit at each other, you spread infection. And when we stay away from each other and we cover our faces, we don't do those things -- the infection doesn't spread, hospitals don't get overrun and people don't die."

Dr. Deborah Birx (Image from WDRB)
White House visitor:  In an exclusive interview with WDRB,'s Lawrence Smith, Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, said she was well aware of the controversy surrounding Beshear's aggressive handling of the virus, but had nothing but praise for his actions.

“Now that we are 10 months in, we can really see in the states where the governors were very proactive, did things before others might have thought it was important, have much lower hospitalizations and much lower fatalities by population, compared to other states,” Birx said. “I think as we look back on this, we're really going to applaud those governors who were proactive.”

This was Birx's second trip to Kentucky. This time she met not only with the Democratic governor, but  with Republicans who control the legislature. 

Beshear said, "I think that what that foremost expert told them, without me in the room, is that the steps we've taken work and where people are not taking action, or don't have the authority to take action, you see really dire consequences."

Early in his briefing, Beshear showed a graph of surging Covid-19 deaths in South Dakota, which has taken few steps to fight the virus, and suggested that if legislation is passed to take away his ability to aggressively fight the pandemic, Kentucky could very easily look like South Dakota.  

Republicans in the state Senate have already filed two bills to rein in the governor's emergency powers. 

Birx issued a written report, which Stack recounted. It said the current surge in cases is faster, has a broader reach and has lasted longer than the first two; that any indoor gathering without masks is a viral spreading event, whether in a restaurant or bar or around a dining-room table; and stressed the importance of tests as an intervention equal to masking, social distancing and hand hygiene. 

She also said transmission of the disease through people without symptoms must be identified through testing. Earlier, Beshear said she had called on Kentucky to increase its testing of adults 18 to 30, and suggested tailoring testing sites to that age group or offering them rapid tests to get more tested.

"So those are ideas that we're looking at and we need to flesh out and figure out," Beshear said. "It's certainly a population that if we could get to do regular testing, we can not only see and prevent asymptomatic spread, but we can also get some behavioral changes." 

Vaccine: Beshear announced that seven more Kentucky hospitals have received shipments of the coronavirus vaccine, developed by Pfizer Inc. and BioNTech. They were Baptist Health in Corbin, Louisville and Madisonville; Norton Hospital in Louisville; UK HealthCare in Lexington; Pikeville Medical Center; and St. Elizabeth Healthcare in Edgewood. The first shipments went Monday to UofL Health in Louisville, Baptist Health Lexington and the Medical Center at Bowling Green

Abby Bailey was vaccinated by fellow UK HealthCare
nurse Janie Lawson. (UK photo by Mark Cronelison)
“After 10 months of being on the front lines of the Covid-19 pandemic, we are excited for the good news that a vaccine is now available and that we can offer it to some of our health care workers at UK HealthCare,” Dr. Mark Newman, UK's executive vice president for health affairs, said in a news release. “We will be providing the first vaccinations to our front-line workers, employees who have direct patient care primarily for Covid-19 patients or under investigation for Covid-19. While we know that we have a long way to go in ending this pandemic, we are grateful to be part of this momentous first step.”

The Lexington Herald-Leader reports that UK got a shipment of 1,950 doses of the vaccine at 10:30 a.m., and vaccinated 88 frontline staff. It plans to vaccinate 258 more Wednesday and another 260 Thursday.  Newman said it will take about a week to administer all the doses, which will still not cover the roughly 2,500 staff who have direct contact with coronavirus-positive patients. 

Beshear showed pictures of hospitals receiving the vaccine shipments from across the state and said, “These front-line heroes know that we’ve got their back. They fought for us every single day. We value their safety and we need their help getting through these next couple of months.”

Long-term care facilities are expected to start being vaccinated on Monday.

Stack called on Kentuckians to be patient over the next six or more months as the state works to distribute the vaccine. 

Deaths: Beshear announced 15 more Covid-19 deaths, bringing the state's death toll to 2,239. He said two more veterans at Thomson-Hood Veterans Center in Wilmore had died from the disease, bringing its toll to 33. He said there are no active cases at the state's four long-term-care facilities for veterans.

Chief Robert Lee Orkies 
Beshear honored the life of Zoneton Fire Chief Robert Lee Orkies of Shepherdsville, who died at 55 after a battle with cancer and Covid-19 on Dec. 11. Beshear said Orkies had been a firefighter since 1984. 

“To Rob’s family, to those little granddaughters, we are so sorry for your loss,” Beshear said. “In his honor, we’re going to protect other people just like he did during his life. We’re going to wear masks, we’re going to do right by our neighbor and we’re going to live up to the example that he set for all of us.”
 
In other covid-19 news Tuesday: 
  • The share of Kentuckians testing positive for the virus in the past seven days is 8.53 percent, down slightly from Monday.
  • There are 1,788 Covid-19 patients in Kentucky hospitals, 438 of them in intensive care and 246 of those on ventilators.
  • Counties with more than 10 new cases were: Jefferson, 418; Fayette, 162; Warren, 123; Daviess, 122; Madison, 120; Pulaski, 84; McCreary, 73; Hardin, 68; Laurel, 66; Boone, 63; Whitley, 60; Kenton, 59; Oldham, 51; Clinton, 51; Hopkins, 46; Adair, 46; Knox, 42; Russell, 41; Taylor, 40; Nelson, 35; Bullitt, 34; Green, 34; Henderson, 33; Jessamine, 31; Boyd, 30; Campbell, 29; Greenup, 28; Lincoln, 28; Mercer, 27; Casey, 26; Boyle, 25; Clay, 24; Christian, 23; Floyd, 23; Cumberland, Muhlenberg, Logan and Marion, 22; Graves and Meade, 21; Montgomery, 20; Clark and Breathitt, 19; McCracken and Franklin, 18; Anderson, Barren, Scott, Grayson, Todd and Wayne, 17; Perry, Ohio and Harlan, 16; Allen and Union, 15; Bell, Johnson and Simpson, 14; Letcher, Garrard and Washington, 13; Edmonson, 12; and Hart, Monroe, Metcalfe, Morgan, Pendleton and Wolfe, 11.
  • The 15 deaths confirmed Tuesday were of a 68-year-old man from Boyd County; a Caldwell County woman, 62; two Daviess County men, 77 and 80; Graves County woman, 88; a Hardin County man, 77; five Jefferson County men, 61, 64, 78, 83 and 92; a McCracken County woman, 90; and three Ohio County women, 91, 87 and 91.
  • There are 2,723 active cases of the coronavirus among long-term-care residents and 1,406 active cases among staff. Beshear said 20 additional deaths in these facilities are attributable to Covid-19, one of them a staff member. There have now been 1,563 residents and eight staff members die from Covid-19, or 70% of the state's total Covid-19 deaths. 
  • As the daily Covid-19 hospitalizations and deaths across the U.S. reached all-time highs, with someone dying from the disease every 35 seconds, the Centers for Disease Control and Prevention Director Robert Redfield told CNN it will only get worse: "The reality is, December and January and February are going to be rough times."   
  • Compared with children who tested negative for the coronavirus, children who tested positive were more likely to have attended gatherings, like weddings, parties, playdates and funerals, and not more likely to have attended child care or in-person school, according to the CDC's latest Morbidity and Mortality Weekly Report
  • Click here for the Kentucky Department of Education "Covid-19 Considerations for Reopening Schools" that provides details for how the department is preparing for Covid-19 vaccinations. 
  • The Food and Drug Administration approved the first over-the-counter coronavirus test, developed by Ellume. It "can be used to diagnose people 2 years of age and older, connects to an app that delivers results to patients’ phones, and reports results to local public health officials," Kelly Lienhard reports for Inside Health Policy. "Ellume expects more than 3 million tests to be manufactured by the end of January 2021."
  • The FDA released a detailed analysis on Tuesday that supports the authorization of the Moderna coronavirus vaccine for emergency use, NPR reports. On Thursday, the Vaccines and Related Biological Products Advisory Committee, an advisory group, will discuss the vaccine in a public meeting. Beshear said "if everything goes the way we think it" will go, Kentucky will have a shipment of the Moderna vaccine on Monday. 
  • The state's Eviction Relief Fund will stay open until all funds are exhausted. Beshear said the fund still has about $1.4 million remaining it to help Kentuckians pay any past rent due from March through December. Click here to apply. He said since opening the applications for this fund in September, the state has approved $12.3 million in eviction relief funds to 3,254 Kentucky households. 
  • Beshear said the Food and Beverage Relief Fund, which makes grants that don't have to be repaid, has had nearly 4,300 applications, requesting $37 million, and has distributed $30.2 million of the $40 million available. Applications will close Dec. 18. Click here to apply. 
  • Deborah Yetter of the Courier Journal reports on the first of "12 notable individuals committed to the advancement of Kentucky," as identified by the Louisville newspaper, and the first one in the series is Stack, whom she calls "the front man in the state's fight against Covid-19." She reports that Stack "has no regrets about taking on the job that has come with grueling hours and political firestorms over restrictions the state imposes, often on his advice, to try to limit the spread of Covid-19."  He said, "Yes, I would do it again. How many times do each of us have an opportunity in our lives to have such a meaningful impact?"
  • Dr. Jon Klein, vice dean for research and professor at the University of Louisville School of Medicine, and Dr. Melissa Walton-Shirley, who graduated from the school and completed her internal medicine residency and cardiology fellowship in Louisville, answered questions about the Covid-19 vaccine in an opinion article for the Courier Journal.
  • Stephan Johnson of WDRB interviewed Dr. Joseph Flynn, chief administrative officer for Norton Medical Group and physician-in-chief of Norton Cancer Institute at Norton Healthcare, to get some answers about what to expect moving forward now that the Covid-19 vaccine is here.

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