UK finalizing deal to manage Ashland hospital in 'joint venture'

King's Daughters Medical Center (2011 photo)

The University of Kentucky and King's Daughters Heath System, which has a major hospital in Ashland, have formed what they call a "joint venture."

Mark Newman, UK's executive vice president for health affairs, told his colleagues, "This is our most significant hospital partnership since the acquisition of Good Samaritan Hospital" next to UK's Lexington campus in 2007. In this case, UK will manage but not own the 465-bed King's Daughters Medical Center and its 10-bed satellite in Portsmouth, Ohio.

The deal will help UK HealthCare expand its reach into Ohio and West Virginia, making it more competitive with big hospitals in those states, and give patients in the Ashland area easier access to UK facilities.

“We see a tremendous opportunity in Ohio and West Virginia to continue to advance and provide care to people who need it,” Newman told WKYT-TV. “We are not coming in as a white knight. We’re coming to work together to keep them strong and to secure our future.”

King's Daughters President and CEO Kristie Whitlatch told the Ashland Daily Independent that the deal is likely to be finalized in April.

In addition to better “access to academic medical care for our patients and communities,” Whitlatch said, “We are also very excited about the possibility of bringing a formal medical residency training program to King’s Daughters, focusing on primary care. This has enormous potential for physician recruitment and retention, better access to care for our communities, and growth for the health system.”

"Whitlatch said a new governing body will be formed, with David Jones, chairman of the KDMC board, serving as chairman," the Independent reports. "Both programs will have equal representation, Whitlatch said, while she will continue as CEO and also be on the management team at UK HealthCare. Whitlatch said the community will see no difference in day-to-day operations."

Last April, Kings's Daughters recently became the only hospital in the Ashland area, with the closure of Our Lady of Bellefonte Hospital in Russell. 

UK's deal will be similar to the one it has with the state to manage Eastern State Hospital in Lexington, a psychiatric facility, but "This type of relationship is a new one for UK HealthCare," Newman said in an email to the UK community. We have many affiliations along service lines, this will be the first full alliance with an entire health system." 

UK President Eli Capilouto said in the email, "Many people with UK HealthCare – starting with Dr. Newman and his senior team – have worked long and hard to make today possible. We will be communicating more in the coming months about this initiative, but I hope you share with me a sense of excitement for what we are doing to help create a healthier Kentucky."

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Sharp drop in hospital cases led the way Sunday, as every measure of the pandemic in Kentucky declined, but variants loom

Ky. Health News graph; case average from initial, unadjusted daily reports; click it to enlarge

By Al Cross
Kentucky Health News

Every common measure of the pandemic in Kentucky declined Sunday, perhaps most notably the number of Covid-19 patients in Kentucky hospitals.

The hospitals reported 1,327 patients with the disease, the fewest since mid-November and almost 500 fewer than the record 1,817 reported in mid-December. The number has been on a rough decline since early January, and dropped sharply in the last four days; it was 1,597 on Wednesday.

The numbers reflect a national trend. For the first time since Dec. 1, fewer than 100,000 Americans are hospitalized with Covid-19, according to the Covid Tracking Project.

In Kentucky, the post-Christmas surge in cases didn't appear to increase hospitalizations in the way that the post-Thanksgiving surge did.

Kentucky hospitals also reported fewer Covid-19 patients in intensive care: 354, eight fewer than Saturday, and fewer of those on ventilators: 173, down 12 from Saturday.

Only two hospital-readiness regions reported more than 80% of their intensive-care beds occupied: 96% in the Lake Cumberland area, which was using two-thirds of its ICU beds for Covid-19 patients, far more than any other region; and 81.25% in northeastern Kentucky, where the disease accounted for only 11% of the ICU census, according to the state's daily report.

More broadly, the state reported 1,768 new cases of the novel coronavirus, the lowest Sunday of the month. That lowered the seven-day rolling average of new cases to 2,340, just under the 2,350 average recorded exactly a month earlier.

The number of cases in the state's Monday-through Sunday reporting week declined for the third straight week, said the post on Gov. Andy Beshear's Facebook page that announced the daily numbers.

The final, adjusted numbers are reported on Mondays, but initial daily reports showed 16,378 news cases during the week. New cases totaled 19,978 the week before, 23,195 the previous week, and 26,975 the week before that. In the week that ended Jan. 3, the initial, unadjusted total was 19,828.

Morgan County, with a big state prison, continued to have the highest seven-day infection rate, averaging 131 cases a day per 100,000 residents. Other counties above the statewide rate of 48.37 per 100,000 were Metcalfe, 96.5; Butler, 91.0; McCreary, 83.7; Clinton, 82.5; Cumberland, 82.1; Taylor, 81.5; Floyd, 81.1; Hart, 81.1; Daviess, 80.8; Nelson, 77.2; Pike, 73.6; Calloway, 72.2; Knox, 72.0; Barren, 72.0; Hancock, 68.8; McLean, 66.7; Whitley, 63.8; Franklin, 62.5; Edmonson, 61.1; Harrison, 59.8; LaRue, 59.5; Casey, 59.2; Washington, 59.1; Harlan, 58.8; Martin, 56.1; Jessamine, 55.7; Marion, 55.6; Bourbon, 54.1; Anderson, 53.4; Kenton, 53.4; Graves, 53.3; Boyd, 53.2; Fayette, 53.1; Pulaski, 53.0; Campbell, 52.8; Fleming, 51.9; Laurel, 51.9; Logan, 51.7; Henderson, 51.5; Owen, 51.1; Johnson, 50.9; Madison, 50.1; Monroe, 49.6; Caldwell, 49.3; and Allen, 48.9.

The state added 31 fatalities to its list of Covid-19 victims, 27 confirmed and four probable. That raised the state's death toll from the disease to 3,745 and the toll for January to 1,083; it was already the deadliest month.

The percentage of Kentuckians testing positive for the coronavirus in the last seven days was 8.81%, down .01 percentage point from the day before.

In other coronavirus news Sunday:

• Counties reporting 10 or more new cases were: Jefferson, 251; Fayette, 148; Warren, 673; Kenton, 63; Daviess, 56; Campbell, 50; Boone, 49; Madison, 47; Taylor, 45; Bullitt, Calloway and Franklin, 43; Pike, 39; Nelson, 35; Oldham, 34; Boyd and Floyd, 33; Henderson, 30; Barren, 24; Hardin and Jessamine, 21; Greenup, Caldwell, Pulaski and Shelby, 19; Grayson and McCreary, 17; Christian, Muhlenberg and Scott, 16; Carter, Estill, Graves, Marshall and Marion, 14; Lincoln, 13; Logan, Perry, Rowan and Wayne, 12; Mason, Metcalfe and Trigg, 11; and Anderson, Bell, Edmonson and McCracken, 10.
• Precautions against the virus have quashed seasonal influenza. Kentucky has reported only 168 cases of the flu this season, compared to 27,408 at this time in the last season, reports Sarah Ladd of the Courier Journal.
• Experts warned that the more contagious strains of the virus will have a major impact in the next two months, adding urgency to the need to produce vaccines and get them administered. "We are going to see something like we have not seen yet in this country," Dr. Michael Osterholm of the University of Minnesota said on NBC's "Meet the Press."

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Gray works to create high-volume regional vaccination centers in anticipation of the day when there is an abundance of supply

Transportation Secretary Jim Gray

By Melissa Patrick
Kentucky Health News  

State Transportation Secretary Jim Gray manages a $2.2 billion budget, and has been president of an international construction firm, mayor of Lexington and Democratic nominee for the U.S. Senate, but he says none of those responsibilities has been more important than his new one: getting coronavirus vaccines to Kentuckians.

"There's probably, arguably, nothing in my lifetime that has represented more of an important responsibility than this," Gray, 67, said in an interview Friday with Kentucky Health News. 

In his new public-health role, Gray says he hears the voice of his grandfather, Dr. Carl Clifford Howard of Glasgow, who was known as the father of Kentucky's tuberculosis hospital system and was a strong advocate for public health. 

"His voice really spoke to me when the governor asked me to take on this responsibility," Gray said. "It continues to speak to me, in terms of the urgency of this effort, the significance of this effort that impacts so many of our people." 

Historical marker in Summer Shade,

where he was born, honors Howard.

(Photo from Columbia Magazine)

Dr. C. C. Howard not only opened the first hospital and medical laboratory in Glasgow, in 1914 and 1915 respectively, but was also instrumental in developing the state TB hospital there.

Gray said his grandfather, who died in 1971, "was always interested in trying to help in other locations, to take medical care to other locations," and persuaded Gov. Ned Breathitt (1963-67) to put a health clinic in the Martin County seat of Inez, four hours by road from Glasgow, where Gray grew up.

Gov. Andy Beshear named Gray director of vaccine distribution Jan. 14, tasking him with getting regional high-volume vaccine sites evaluated and secured, in anticipation of the day when the state has enough doses of vaccine to get a shot into the arm of every Kentuckian who wants one.

Gray said the effort is part of the "largest logistical effort and project in world history," according to officials of UPS, who he said clearly understand the scale of the job. The company has a hub in Louisville and delivers vaccines from the manufacturers to all states east of the Mississippi River.

Kentucky's first four regional vaccination sites are opening this week. One, in partnership with Kroger Health, opens Tuesday, Feb. 2, at the Kentucky Horse Park's Alltech Arena. Another will open in Danville, through a partnership with Ephraim McDowell Regional Medical Center. Two will open in Paducah, through partnerships with Western Baptist Hospital and Mercy Health-Lourdes Hospital. More are in the works. 

Dept. of Public Health map; click on it to enlarge.

When Beshear asked him to take this role, Gray said, he recognized the governor's main charge to him was to support and reinforce the work of the state Department of Public Health, led by Commissioner Steven Stack.

"Dr. Stack has done a remarkable job. I say routinely that this is such a high-performance team," Gray said. "I don't think there's a better leader in the country in any state than Dr. Steven Stack." 

Gray brings private- and public-sector experience to his new role, having learned about logistics and distribution during his many years in Gray Construction and about the importance of "listening eloquently" and solving problems when he was mayor of Lexington from 2011 through 2018.  

"It's all about problem solving, putting a bear hug around a problem and wrestling it to the ground," he said. "And that, in many respects, is what a project like this represents as well." 

The big bear right now, vaccine supply, is hard to reach. Beshear has said at least 64,000 shots will be given this week, but the state could vaccinate 250,000 people a week if it could get that many doses. As supplies remain tight and demand has increased, the state has had to delay the third phase of vaccine eligibility, which includes people 60 and older.

Gray said one of the first things he did after being asked to take on this role was to establish a project management office, which is run by Mark Carter, who is also in charge of the program that traces the contacts of people infected with the virus. Carter once ran a Medicaid managed-care firm in Louisville. 

Project management is a basic approach in construction, Gray's main career. "When a project-management system functions well, when it's clear, when the organization is clear and the roles and responsibilities are clear, when the schedule is clear, and the budget is clear, then the project can be more efficiently and effectively managed," he said. "So that's exactly what we've established right out of the gate." 

Gray's other lieutenants include Jamie Emmons, his Transportation Cabinet chief of staff, and Mike Dossett, the director of the state Division of Emergency Management, who leads the team that evaluates potential sites and selects them for implementation. 

Six weeks into the project, Gray said the team has evaluated sites all over Kentucky, but not chosen them all. The ultimate goal, he said, is to make sure there are no "vaccine desserts" in the state. More sites will be announced on each of the next two Thursdays, Beshear said Thursday, Jan. 28.

Gray said his team aims for an "equitable distribution" of vaccines, just like Stack and his lieutenants do when they allocate them, considering such things as the most vulnerable populations; making sure there is vaccine access for communities of color, which have been hard hit by the virus; and ensuring that areas with large populations are covered, because this improves herd immunity, which requires at least 70% of the population to have been vaccinated. 

He said the team uses a two-page checklist to evaluate sites, answering questions such as whether the clinic will be walk-in or a drive-through, the dates of availability, whether there is access to an interstate highway, the number of doses that can be administered per hour, who will provide the workforce, whether there is access to medical-grade refrigerators and high-speed internet service, what type of security is available, and the availability of restrooms. 

"Population densities, vaccine throughput, and drive times are our main drivers," Gray said. "We're trying to avoid anyone having to drive more than one county away to get a vaccine." He added, "The most efficient vaccination system is going to be one that focuses on getting as many vaccines into arms as many shots in arms as we can as quickly [as we can].

One of Gray's memories about his grandfather was that he "often went against the grain, especially against the medical community," and was often described as a socialist because of his dedication to public health. He said his advice continues to guide him: "He would say, Jim, always remember, take care of the people, and the money will take care of itself." 

As of Jan. 29, the state has administered 382,219 doses of vaccine. Of those, 327,473 have been administered in a state program, and 54,746 have been given to residents and staff in nursing homes, through a much slower federal program run by CVS Health and Walgreens.

Both vaccines in use require a booster shot three or more weeks after the first inoculation. National vaccine trackers show 7 percent of the state's population has received at least one shot, just above the national average of 6.9%.

"We're doing, I believe, the best that can be done," Gray said. "I'm going to say more than just the best we can. I think we're doing the best that can be done to distribute the vaccine, this limited supply of vaccine. We have to [get to] as many people as we can, as quickly as we can throughout the state."

Asked about the challenges of adding this new position to his ongoing responsibilities as transportation secretary, he said, "Multi-tasking is sometimes a skill that we all need to acquire and when we're called to a duty, we need to accept that call and accept that duty."

That said, he added that  he had a "really talented team" at the transportation cabinet who came with a wealth of institutional knowledge and talent, and because of that, he was more able to take on this assignment, "which is so vital and so important."

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Pandemic numbers mostly down Saturday, but positive-test rate rises for first time in 13 days; 2-week daily death average also up

Ky. Health News chart; state data; virus case numbers are from unadjusted initial daily reports

By Al Cross
Kentucky Health News

Most metrics of the pandemic continued to decline in Kentucky Saturday, the major exceptions being the two-week average of daily deaths and the one-week average of residents testing positive for the novel coronavirus.

The state reported 2,649 new cases of the virus, lowering the seven-day rolling average of daily new cases to 2,375, almost as low as it was a month ago, as the state was beginning a post-holiday surge in cases.

The Covid-19 deaths caused by that surge continue to mount. The state listed 46 more deaths, 40 confirmed and six probable. That raised the average over the past 14 days to 44.4, a new record.

The percentage of Kentuckians testing positive for the virus increased for the first time in almost two weeks, to 8.82% from 8.75% on Friday. It has declined all but three days since Jan. 10, when it hit a high of 12.45%.

Covid-19 hospitalizations in Kentucky continued a general decline, to 1,415, the smallest number in two and a half months. The number in intensive-care units was 362, seven more than Friday, but the number of ICU patients on ventilators fell by 14, to 185.

ICUs were more than 80% full in three of the state's hospital-readiness regions, but none were over 90%. Lake Cumberland was at 89%, Barren River at 86% and the easternmost region, from Lee to Pike counties, at 81%.

Morgan County continued to be the seven-day hotspot for cases by population, reflecting an outbreak at a state prison there. The county of 14,000 has averaged 131 daily cases per 100,000 residents this week. Others above the statewide rate of 49.48 were Butler, 95.4; Metcalfe, 93.6; McCreary, 86.2; Daviess, 85.7; Hart, 82.6; Clinton, 76.9; Floyd, 75.9; Knox, 75.2; Barren, 73.9; McLean, 72.9, Pike, 72.8; Nelson, 71.7; Cumberland, 71.3; Hancock, 70.4; Harrison, 69.6; Washington, 67.3; Harlan, 67.0; Franklin, 66.7; Lewis, 63.5; Taylor, 62.6; Calloway, 62.3; Whitley, 62.2; Bourbon, 62.1; LaRue, 59.5; Martin, 58.7; Casey, 57.5; Jessamine, 57.3; Kenton, 57.0; Fleming, 56.8; Green, 56.1; Fayette, 55.1; Laurel, 55.0; Marion, 54.9; Campbell, 54.8; Pulaski, 54.3; Monroe, 53.7; Meade, 53.5; Johnson, 53.4; Powell, 53.2; Edmonson, 52.9; Graves, 52.5; Logan, 52.2; Ohio, 50.6; Allen, 50.3; Union, 49.7; and Clay, 49.5.

Counties with 10 or more new cases on the state's daily report were: Jefferson, 357; Fayette, 177; Franklin, 144; Kenton, 125; Boone, 99; Pike, 69; Daviess, 63; Warren, 61; Campbell, 59; Barren, 52; Madison, 42; Laurel, 39; Morgan, 38; Henderson, 37; Pulaski, 36; Knox, 35, Hardin, 34; Nelson and Shelby, 33; Whitley, 31; Christian and Floyd, 30; Grant and McCreary, 28; Scott, 27; Bullitt and Mason, 26; Jessamine, 25; Oldham, 24; Boyd, 23, Hopkins and Montgomery, 23; Graves and McCracken, 22; Harlan and Hart, 21; Garrard, 20; Anderson, Butler, Marshall and Woodford, 19; Greenup, Logan and Meade, 18; Calloway, Harrison and Simpson, 16; Bell, 15; Bourbon, Carter, Clark, Lewis, Lincoln, Livingston and Taylor, 14; Edmonson, Lawrence and Spencer, 13; Adair, Breckinridge and Clay, 12; Fleming, Johnson, Muhlenberg, Ohio and Washington, 11; and Metcalfe and Perry, 10.

As usual for a weekend, the state did not list the day's deaths by age, sex and gender. The 46 deaths raised the state's death toll to 3,714; 1,052 of those were listed in January, making it the state's deadliest month of the pandemic. Deaths are listed days or weeks after occurrence, following case reviews.

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As Ky. positive-test rate keeps falling and death trend keeps rising, feds say new virus variants make vaccinations more urgent

Johnson & Johnson has completed studies of its one-shot
vaccine and is expected to ask the FDA for emergency-use
authority late next week. (Photo by Dado Ruvic, Reuters) 

By Al Cross
Kentucky Health NewsThe novel coronavirus continued to become less prevalent in Kentucky on Friday, but the Covid-19 disease it causes continued to become more deadly.

The state reported 2,608 new cases of the virus, raising the the seven-day rolling average of daily new cases is 2,539, exactly what it was on Jan. 1, as Kentucky began a post-holiday surge in cases that had made January the state's deadliest month of the pandemic.

That trend continued Friday, as the state listed 57 more Covid-19 deaths, 40 confirmed and 17 probable. The seven- and 14-day averages of deaths jumped to 47.3 and 43.4 per day, respectively.

On the other hand, the percentage of Kentuckians testing positive for the virus in the last seven days fell for the 11th consecutive day, to 8.75%. It has not been that low since late December, when it began a post-holiday surge that peaked at 12.45% on Jan. 10.

“Our declining positivity rate shows that Kentuckians are continuing to make those small sacrifices we’ve been talking about all year in order to protect each other until we get enough vaccines for everyone who wants one,” Gov. Andy Beshear said in a news release.

“Wearing masks around people from different households, social distancing, washing their hands, staying home when they can and getting tested regularly,” Beshear said. “It’s the simple things you’re probably sick of hearing about by now that can make the biggest difference as we near the finish line.”

The 57 deaths raised the state's Covid-19 death toll to 3,668. The fatalities were: a Barren County man, 75; a Boone County woman, 70; a Bourbon County woman, 79; a Boyd County woman, 47; a Boyle County man, 87; a Caldwell County man, 80; two Christian County women, 68 and 71; two Christian County men, 72 and 89; a Clay County man, 79; a Clinton County man, 64; a Daviess County man, 73; two Fayette County women, 86 and 87; three Fayette County men, 83, 97 and 101; a Grayson County woman, 73; three Grayson County men, 66, 72 and 93; a Hart County man, 73; a Hopkins County man, 81; two Jackson County men, 83 and 86; three Jefferson County women, 73, 86 and 96; a Jefferson County man, 74; a Lawrence County woman, 85; a Lawrence County man, 83; a Lewis County woman, 65; a Logan County woman, 77; two McCreary County women, 86 and 92; a Madison County woman, 65; two Madison County men, 67 and 86; a Marshall County man, 67; a Monroe County woman, 73; two Muhlenberg County men, 59 and 73; four Pike County women, 62, 66, 75 and 90; two Pike County man, 61 and 73; a Simpson County woman, 77; a Simpson County man, 72; a Union County woman, 90; two Warren County women, 73 and 94; and three Warren County men, 53, 72 and 83.

Counties with 10 or more new cases were: Jefferson, 360; Fayette, 194; Kenton, 133; Daviess, 114; Boone, 98; Campbell, 89; Morgan, 78; Franklin, 74; Warren, 55; Pike, 54; Hardin, 50; Nelson, 45; Bullitt, 44; Hopkins, 44; Christian, 39; Pulaski, 35; Shelby, 33; Boyd, Henderson, Oldham and Whitley, 32; Floyd and Laurel, 30; Graves, 29; Hart, 28; Barren and McCracken, 27; Jessamine, 26; Muhlenberg and Taylor, 23; Knox, 21; Grayson and Scott, 20; Carter and Harlan, 19; Bell and Marshall, 18; Meade and Simpson, 16; Boyle, Clark, Greenup, Logan and Marion, 15; Allen, Casey, Johnson, LaRue and Rockcastle, 13; Bourbon, Breckinridge, Lincoln, Madison, Ohio and Rowan, 12; Butler, Grant, Henry and Union, 11; and Calloway, Garrard, Powell and Russell, 10.

The state's daily report shows that Morgan County again became the county with the highest infection rate, averaging 106.3 cases per 100,000 residents over the last seven days. It is home to the Eastern Kentucky Correctional Complex, a state prison that continues to be plagued by the virus.

The Kentucky Corrections Department's latest report shows 84 active cases among inmates and 26 among employees at the prison. Two prisons in Oldham County also have scores of cases. Overall, the state prison system reports 240 inmate cases and 96 staff cases.

More than 3,000 prisoners and 500 staff members in local jails have had the virus, reports John Cheves of the Lexington Herald-Leader. They have been turned into "reservoirs for Covid," Jamestown lawyer Matthew DeHart told him: “You take a room that’s designed for eight bunks and a combination sink-toilet. Then you put 16 or 18 people in it. There’s no room left. They’re all right on top of each other, day after day after day.

In other coronavirus news Friday:

• Pinned to the top of Beshear's Facebook page is this message: "Every decision I have made during this pandemic has been to protect our people. The result of removing the emergency powers that allow our state to act is less success and more casualties. This is not the time to play politics." That may indicate that the Republican-controlled legislature is likely to override the Democratic governor's vetoes of bills limiting his emergency powers, rather than the two sides negotiating a compromise. 
• The new variants of the virus are a "wake-up call" to move faster on vaccinations, said Dr. Anthony Fauci and other public-health experts. The threat of the variant first found in South Africa prompted travel bans by Canada and other nations, The Washington Post reports.
• The one-shot vaccine developed by Johnson & Johnson is very effective at preventing illness, hospitalization and death, a study of it shows. "but its protection against sickness was stronger in the United States and weaker in South Africa," due to the variant there, the Post reports. "Johnson & Johnson is expected to apply for emergency use authorization from the Food and Drug Administration late next week. If the review follows the path of two earlier vaccine candidates, the shot could be authorized and available to the public by March . . . but production setbacks mean federal officials are initially expecting only a trickle of doses if the product is quickly authorized for emergency use by the FDA."
• "People diagnosed with schizophrenia were 2.7 times more likely to die from Covid-19 compared to people without the disorder and those with anxiety or mood conditions," according to a new study, Katie Camero reports for McClatchy Newspapers. "Schizophrenia ranked second only to age when bracketed with diabetes, heart failure, sex, chronic kidney disease and smoking status, among other known mortality risk factors for Covid-19."

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Beware of misinformation about vaccines from folks with agendas

Photo by Joe Raedle, Getty Images

"Anti-vaccine groups are exploiting the suffering and death of people who happen to fall ill after receiving a covid shot, threatening to undermine the largest vaccination campaign in U.S. history," reports Liz Szabo of Kaiser Health News.

Some activists are "fabricating stories of deaths that never occurred," such as concocting a death certificate for a Chattanooga, Tenn., nurse who fainted when she got a coronavirus vaccination.

These are largely the same people who "have falsely claimed for decades that childhood vaccines cause autism," and spun conspiracy theories involving government, corporation and the news media, Szabo reports.

The mass vaccination of millions gives these bad actors plenty of opportunities to mislead the public, because they exaggerate the very few cases of bad reactions to the vaccines. And journalists sometimes help them, says infectious-disease specialist Michael Osterholm, an adviser to President Biden.

“The media will write a story that John Doe got his vaccine at 8 a.m. and at 4 p.m. he had a heart attack,” Osterholm said on his weekly podcast. “They will make assumptions that it’s cause and effect.”

Osterholm, who runs the Center for Infectious Disease Research and Policy at the University of Minnesota, said that as the first round of general-public vaccinations starts with older people, many will have heart attacks, strokes or other serious medical episodes not related to vaccination.

"In a group of 10 million people, about the number of Americans who have been vaccinated so far, nearly 800 people ages 55 to 64 typically die of heart attacks or coronary disease in one week, Osterholm said. . . . Public health officials need to do a better job communicating the risks — real and imagined — from vaccines, said Osterholm."

There's always the possibility that a batch of vaccine won't be up to par, and with hundreds of millions of doses to be produced in this case, it will happen, Osterholm told Szabo, who notes, "California authorities have recommended pausing vaccinations with a particular batch of covid vaccines made by Moderna because of a high rate of allergic reactions."

“We have to follow up on every one of these cases,” Osterholm said. “I don’t want people to think that we’re sweeping them under the rug.”

Be wary of reports about such cases, especially from groups with an anti-vaccine agenda, says Dr. Peter Hotez, an infectious-disease specialist at the Baylor College of Medicine in Texas: “They will sensationalize anything that happens after someone gets a vaccine and attribute it to the vaccine.”

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69 more Kentuckians, a record, dead from Covid-19, but other metrics keep trending down; four regional vaccine sites to open

Ky. Health News graph; dates are those on which deaths were added to the list after review of cases.

Kentucky Health News chart, from state data

By Melissa Patrick
Kentucky Health News

Thursday was a day for good news and bad news in Kentucky about the pandemic.

Gov. Andy Beshear announced the state's highest single-day number for Covid-19 deaths, 69. He also said the state's new case and positive-test rates continue to trend down and four regional vaccination sites will open next week, with more to be announced over the next two weeks. 

"Folks, our trends are going in the right way and that's a good thing. And it's because of your work wearing a mask, social distancing, cutting down on your contacts -- thank you for that," Beshear said at a last news briefing of the week. "The result of so many cases and of our exponential growth, and times when we were having five thousand cases in a day, is we are seeing significant loss that that creates."

The new Covid-19 deaths (63 confirmed and six probable) brought the state's death toll to 3,611. Over the last 14 days, the state has averaged 40.6 deaths per day, and the seven-day average is 44.3. Both are records. By comparison, the 7- and 14-day death averages in late December were in the low 20s. 

Beshear said not all of the newly reported deaths are recent, because many of them must go through a review committee to confirm that the cause of death was Covid-19.

The governor reported 2,947 new coronavirus cases, bringing the seven-day rolling average down to 2,560, the lowest it's been since Jan. 1. He said today's case count is the lowest for a Thursday in the last month.

The share of Kentuckians who tested positive for the virus in the past seven days is 9.04%, the lowest it's been since Dec. 30, when that rate was 9.09%. 

Vaccination sites (from Dept. for Public Health map) 

Vaccines: Beshear said four regional vaccination sites will open next week. One, in partnership with Kroger Health, will open Tuesday, Feb. 2, at the Kentucky Horse Park's Alltech Arena. The site will offer 3,000 appointments in the first week. It will be open from 10 a.m. to 4 p.m. Tuesday through Saturday and will schedule appointments one week at a time. Sign up at kroger.com/covidvaccine. 

Another site will open in Danville, through a partnership with Ephraim McDowell Hospital. And two will open in Paducah, through partnerships with Western Baptist Hospital and Mercy Health-Lourdes Hospital. 

All the locations require an appointment, with no walk-in availability. As more vaccines become available, more regional sites will be opened, Beshear said. He said at least 64,000 shots will be given next week, up about 8,800 from the prior week, thanks to a supply boost from President Biden.

Beshear said with the four new sites, there will be 34 Kentucky locations offering vaccinations.

Health Commissioner Steven Stack again called for patience, noting that people need to recognize that not everyone will be able to get vaccinated in the first weeks, but "This will get better with time."

Transportation Secretary Jim Gray, who is coordinating the logistics, said the additional regional sites will be announced as vaccine supplies becomes available.

State graphic, amended by Kentucky Health News

Starting Monday, Feb. 1, Beshear said, vaccination priority will be given to those in Phase 1B, which includes persons who are 70 and older; others are willing educators and other school employees, who Beshear said should largely be done next week; and first responders, almost all vaccinated except the unwilling.

Persons in Phases 1A and 1B will continue to remain eligible. Beshear added that there will be times when those in phase 1C will be vaccinated to ensure that each vaccination site administers 90% or more of all of its doses within seven days of arrival. 

Beshear said the state had planned on being able to start immunizing those in phase 1C, which includes people 60 and older, essential workers and anyone over the age of 16 with high-risk health conditions, by the first week of February, but that has now been delayed at least several weeks, largely due to supply.

Stack said nearly 100,000 Kentuckians age 70 and older have received their first shot, leaving about 400,000 more to immunize.

The governor encouraged Kentuckians to visit vaccine.ky.gov to determine whether they are eligible for vaccination. The website will also recommend a vaccine location in their region. This information can also be obtained by calling 855-598-2246 between 8 a.m. and 7 p.m. Monday through Friday. 

Long-term care: Beshear said case numbers in long-term care facilities are down again, reporting 26 more residents and 34 staff testing positive for the virus, and 692 residents and 364 staff having active cases. He attributed six more deaths to Covid-19, bringing total deaths from the facilities to 2,160. 

Beshear said that this improvement could be the result of vaccination, noting that some of the residents and staff are getting their second doses and that many of the staff who were initially hesitant are now signing up for the vaccine. 

"I believe our long-term care residents are better protected today than they were before they got the first vaccination, and that's why we prioritized them," he said.

Jonathan Alexander

Memorial: Beshear honored the life of Jonathan Alexander, who was a team member of the Transportation Cabinet's Office of Information Technology. He died at age 43 on Jan. 23 from surgery complications and Covid-19.

Beshear said Alexander was known for his kindness and his work in helping others, having recently organized a fundraiser for restaurant workers whose work had been impacted by the pandemic and in his annual efforts to organize the Salvation Army Tree for OIT. 

"Jonathan always said, 'If you’re fortunate enough to be able to help somebody, do it. It’s an amazing experience'," said Beshear. "Jonathan’s passing is such a loss for Kentucky. I hope we can learn from his words and do the right thing for our people." 

Gray, who had gotten to know Alexander as an employee, said, "His death was a blow to everyone who knew him." 

In other coronavirus news Thursday: 

• The 69 fatalities were an Anderson County woman, 93; a Bath County woman and man, 90and 92; a Boyd County woman, 91; two Boyle County women, 76 and 77; a Boyle County man, 79; a Casey County woman, 90; four Daviess County men, 72, 80, 87 and 91; an Edmonson County man, 91; two Fayette County men, 57 and 80; a Fleming County woman and man, 101 and 73; a Graves County man, 79; three Hardin County women, 81 83 and 83; four Hardin County men, 53, 69, 73 and 89; two Harlan County women, 61 and 77; a Hart County man, 77; a Henderson County woman, 83; a Henry County man, 88; a Jackson County man, 83; three Jefferson County women, 75, 81 and 85; seven Jefferson County men, 62, 74, 77, 86, 88, 90 and 94; a Knox County woman, 83; a Lincoln County woman, 92; two McCracken County women, 77 and 80; a McCracken County man, 67; a Madison County woman, 80; a Marshall County man, 72; two Mercer County women, 80 and 95; an Oldham County woman, 83; two Oldham County men, 71 and 87; a Perry County woman, 71; a Pike County man, 59; a Pulaski County man, 64; a Rowan County woman, 80; a Shelby County woman and man 84 and 74; a Taylor County man, 77; a Todd County woman, 72; a Warren County woman, 74; three Washington County women, 69, 83 and 94; a Washington County man, 41; a Wayne County man, 63; and a Webster County woman and man, 89 and 71.
• Only one county has an incidence rate of more than 100 new cases per 100,000 residents in the past seven days: Clinton, at 103.5 per 100,000.
• Counties with 10 or more new cases were: Jefferson, 433; Fayette, 218; Kenton, 138; Daviess, 104; Greenup, 104; Boone, 87; Hardin, 70; Madison, 70; Campbell, 67; Laurel, 61; Bullitt, 55; Warren, 52; Pike, 49; Jessamine, 44; Calloway, 39; Pulaski, 39; Boyd, 38; Barren, 34; Graves, Hopkins and Whitley, 33; Johnson and Knox, 31; Harlan, 30; Floyd and Nelson, 29; Shelby, 28; McCracken, 27; Christian and Marshall, 26; Bourbon, 25; Henderson, Meade and Scott, 23; Lincoln, 22; Anderson, Boyle, Grayson and Rowan, 21; Grant and Woodford, 20; Bell, Letcher and Taylor, 19; Franklin and Perry, 18; Harrison, Hart and Logan, 17; Metcalfe, 16; Leslie and McCreary, 15; Butler, Casey, Clay, Morgan and Wayne, 14; Carter, Clinton and Spencer, 13; Henry and Larue, 12; Allen, Fleming, Marion, Ohio, Oldham and Washington, 11; and Cumberland, McLean, Rockcastle and Russell, 10.
• Kentucky hospitals reported 1,561 patients with Covid-19; with 370 in intensive care; and 205 of those on ventilators. 
  
• The K-12 school dashboard shows that this week 950 students and 377 staff have tested positive and 4,750 students and 629 staff are quarantined; 388 schools have not reported any data this week. 
• Two hospital readiness regions had intensive-care units above 80% capacity: Lake Cumberland, 93.3%, and and the easternmost region, at 86.8%. Northern Kentucky is at 81.92% overall hospital capacity. 
• Amy Cubbage, Beshear's general counsel, gave an unemployment update, and encouraged Kentuckians to reference a new "What You Need to Know" graphic to learn more about how to keep receiving benefits, or begin receiving them for the first time. Click here for the news release with an overview of the information she shared.

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Kentucky was a pandemic hot spot in mid-January, but was cooling; deaths spiked, but new Covid-19 hospital admissions fell

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

Kentucky was a pandemic hot spot in the week covered by the first White House Coronavirus Task Force report from the new Biden administration, issued Thursday for a reporting week that was nearly a week old.

White House Coronavirus Task force map; click to enlarge

Perhaps the most striking figure in the report was that deaths from Covid-19 were up 35 percent from Jan. 16 to Jan. 22, compared to the previous week. That reflected the increasingly lengthy lists of deaths that the state announces on weekdays (with numbers on weekends).

Week-to-week comparisons are tricky, because deaths are not listed until they are confirmed by a review process, which can take days or even weeks after death. During the reporting week, Kentucky had 275 deaths, or 39.4 per day, 35% higher than the 205 deaths and 29.3 average of the previous week. Gov. Andy Beshear has blamed the spike in deaths on the surge in cases during and after the holidays.

The report ranks Kentucky 12th in the rate of new coronavirus cases Jan. 16-22, and sixth in the percentage of residents testing positive for it. State officials say the federal calculation method overstates the state's positive-test rate, but unofficial pandemic trackers ranked Kentucky as a hot spot.

Both rates were down from the previous week, but how much was unclear because the outgoing Trump administration did not issue a report that week. Cases were also down in nursing homes, where the first round of vaccinations has been completed, with perhaps a few exceptions.

White House Coronavirus Task force map; click to enlarge

The first Biden administration report did not begin with the usual narrative about the status of the pandemic in the state and recommendations of what to do about it. A short note at the top of the report said, "The weekly State Profile Reports are currently under review. The format and content may change in coming reports."

It said the rate of new hospital admissions for Covid-19 was high, but down slightly from the previous week. A graph in the report showed that new Covid-19 admissions at the 98 reporting hospitals were lower than in any of the eight weeks immediately preceding the reporting week.

Age by color: orange 18-39; green 40-69; red 70+; gray unknown; lighter shade for suspected cases

The report said coronavirus testing was down 15% during the week, but a footnote on the chart said reporting of tests may have been delayed.

The report has county-level maps showing new cases going back four months. 

White House Coronavirus Task force chart and maps; click on any image to enlarge it.

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Biden reopens marketplace for subsidized health insurance under Affordable Care Act, from Feb. 15 to May 15, citing pandemic

President Biden is reopening enrollment for federally subsidized health insurance policies under the Patient Protection and Affordable Care Act for three months, giving Kentuckians another chance to get help from a program that has had decreasing participation in the state in recent years.

Open enrollment for "Obamacare" policies is usually from Nov. 1 to mid-December. Biden's executive order will open it from Feb. 15 through May 15, a White House briefing paper says.

"The actions represent the first steps the new administration is taking to fulfill a major part of the president’s campaign agenda to make health insurance and health care more accessible and affordable — goals that have taken on more urgency as 25 million have been infected with the coronavirus and millions of others have lost jobs," reports The Washington Post's Amy Goldstein.

The Biden administration will also resume federal aid to states "for paid advertising, other outreach efforts and community groups that help people figure out how to sign up," Goldstein reports. "The Trump administration, during its first two years, slashed most of the funding for such efforts, saying there was no evidence they were effective."

In recent years, enrollment for subsidized plans in Kentucky has declined, from about 90,000 to 77,821 in the last enrollment period, which ended Dec. 21. The previous year, enrollment totaled 83,139. Nationally, enrollment remained about the same, though New Jersey and Pennsylvania left the federal exchange and started their own exchanges.

In Kentucky, Gov. Andy Beshear has said he will re-establish the state-based exchange, Kynect, that his father, then-Gov. Steve Beshear, established when he embraced the ACA.

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Coronavirus cases and positivity rates are trending down, but Beshear cautions that the risk to you and your family remains high

Kentucky Department for Public Health graphic; URL leads to list of testing sites

By Melissa Patrick

Kentucky Health News

While numbers of new coronavirus cases and percentage of Kentuckians testing positive for the virus continue to trend down, Gov. Andy Beshear cautioned Wednesday that the numbers are still too high for comfort and that the risk of spread, and harm to you or your family, remains high.

"This is still a dangerous time in America," Beshear said at a news conference. "Virus levels are still at some of the highest that they have been since the beginning of the pandemic and with some new variants . . . the risks of spread and of harm to you or your family are still at some of the highest that they've ever been."  

Beshear reported 2,424 new coronavirus cases on Wednesday, bringing the state's seven-day rolling average to 2,672, the lowest average of the month, except for Jan. 1 and 2. Today's number is also the lowest Wednesday since Jan. 6, when the state reported what remains the single-day record high of  5,742 new cases. 

The share of Kentuckians testing positive for the virus continues to decline. Today, it was 9.35%, which is down to the levels of late December. 

Health Commissioner Steven Stack said the state's two cases of the United Kingdom variant of the coronavirus, which were initially reported yesterday, were found in Kenton County. 

Stack cautioned  that this variance is more contagious, meaning it spreads more easily and you are more likely to get infected by it.  

"It's not more dangerous for the person who gets it than the previous version of the virus, but since more people can get it more quickly and more easily, that means you could have more people get sick or more people could die," said Stack. 

 Because of that, he said it is even more important for people to wear their mask, to stay six-feet away from each other, to keep our hands washed , to get tested if you think you've been exposed and to stay home if you are sick.

Beshear said the two individuals are "doing OK" and are not hospitalized. He did not answer if the two were connected or had traveled outside the country. And because of how the virus spreads, he said it has likely that it has already spread beyond these two individuals.  

The Northern Kentucky Health Department says in a news release that the UK variant of the virus has now been detected in 293 cases in 24 states in the United States. 

Stack said the two available vaccines are effective against the new variant strains of the virus. He added that when he asked whether a person should take the Pfizer, Inc. vaccine or the Moderna one, he tells them to best one is "the one you can get." 

Vaccines: Beshear said the federal governments 16% to 17% increase in weekly doses will bring the state's total up to about 65,000 initial doses next week.  

But even with these improvements, Beshear continued to lament the need for more supply, saying again that the state has the capacity to vaccinate 250,000 people a week if it only had the supply. 

"Our only limitation at this point is that our capacity already exceeds our supply," he said. 

Beshear said his request to the federal government to double the state's supply of the vaccine is separate from this latest allocation, and that he had not yet gotten a response to that request. 

Beshear said the state is also in the process of receiving 12,675 first doses of the vaccine from CVS Health and Walgreens, which are extra doses that were not used after they vaccinated residents and staff in the state's long-term care facilities, a program that was run by the federal government. 

Beshear said he was talking to the Biden administration about getting one of the 
FEMA vaccination centers that is in the works, and that he would be receptive to being one of the states that gets vaccines sent to independent pharmacies, but it will depend on whether the programs come with their own supply of the vaccine. 

"We want all of these programs, but it's all about the supply and the Biden administration agrees. If we can get a huge influx, then absolutely," he said. 

Looking forward, Beshear said it will be important for independent pharmacies and local health departments to help the state reach out to hard-to-reach individuals. 

He said for now, in order to ensure the most equitable distribution of the vaccine, the plan is to distribute it regionally.  

Asked if being a smoker would put a person into the 1C category to get the vaccine, as is suggested on the CDC website, Beshear said that while conditions that are exacerbated or caused by smoking are on Kentucky's list, "You can't smoke your way into 1C." 

Schools: Asked if the CDC report that says with strict mitigation efforts, there is little spread of the the virus in schools impacts his thinking about getting Kentucky kids back to school, Beshear encouraged everyone to read the full report, which also comes with recommendations regarding community spread, like closing bars and restaurants, and calls for getting teachers vaccinated.

He said the state should finish vaccinating K-12 personnel by the end of next week. 

"Remember, we don't have any order that prevents in-person learning at the moment, we do have guidance. We're gonna be able to loosen that significantly once everybody is through [getting vaccinated]," he said. "We do have an order out there, though, that does require a virtual learning option for students and accommodations for teachers, some of those accommodations are going to be able to be loosened or removed once we have folks that have been offered the vaccine." 

"We are going to be the fastest state to get there to have the very safest schools, he said, regarding getting all of the school personnel that are willing vaccinated. 

Stack said the state will work on getting the remaining people who are 70 and older vaccinated in February, He said 90,000 of this group have already been vaccinated, leaving 400,000 more. 

Deaths: He announced 47 new deaths from Covid-19, 41 of them confirmed and six of them probable, bringing the state's death toll to 3,542. The 14-day death average hits a new high, 39.4. The seven-day average is 42.7, just under the record of 43 that was set yesterday. 

Today, Beshear honored the life of Ernest A. Bates, who was a heating, ventilation and air conditioning inspector with the Kentucky Department of Housing, Buildings and Construction for over 13 years, having been in that business for over 48 years. He died at age 76 from Covid-19. 

Beshear said Bates is survived by his wife of 28 years, Nancy, his son, Alan, who also works as an HVAC inspector in state government, his stepdaughters, Robin and Toni, nine grandchildren and two great grandchildren. 

"Today we lift up his family in prayer and we give thanks to the many years of service he gave to the commonwealth," said Beshear. "To Ernest's family, we are so sorry for your loss." 

In other Covid-19 news Wednesday: 

• Today's fatalities were a Barren County man, 87; a Campbell County woman, 84; a Christian County woman, 67; a Christian County man, 78; four Daviess County women, 86,86,87,99; one Daviess County man, 83; a Fayette County man, 84; a Fleming County woman,79; a Fleming County man, 96; a Graves County man,73; a Green County woman, 77; a Harlan County woman, 89; a Harlan County man,73; a Harrison County woman, 90; two Hart County women, 73,77; a Hart County man, 71; a Henderson Count man,77; a Hopkins County man, 76; three Jefferson County women, 56,69,72; five Jefferson County men, 57,68,69,73,81; two Kenton County men, 66,91; four Menifee County women, 64,75,80,87; two Menifee County men, 75,90; and Ohio County woman, 81; a Rowan County man,80; a Todd County man, 77; three Warren County women, 46,70,95; a Warren County man, 39; a Wayne County man, 75; and a Webster County man, 69.
• Counties with 10 or more new cases were Jefferson, 330, Fayette, 180; Daviess, 102; Kenton, 88; Boone, 82; Warren, 76; Pike, 70;  Madison, 67; Pulaski, 62; Hardin, 56; Bullitt and Laurel, 45; Jessamine, 44; Calloway, 38; Campbell, 37; Christian, 36; Nelson, 35; Barren, 34; Oldham, 32; Whitley, 31; Floyd, McCracken and Scott, 26; Anderson, Graves, Greenup and Knox, 24; Shelby, 23; Henderson, Mercer and Montgomery, 22; Taylor, 21; Clark, 20; Boyd, 19; Meade and Russell, 18; Perry, 17; Menifee, 16; Carter and McCreary, 15; Allen and Ohio, 14; Casey and Marion, 13; Fleming, Hart, Marshall and Woodford, 12; Grant, Harlan, Larue and Muhlenberg, 11; Bell, Bourbon, Clay, Edmonson, Hopkins, Metcalfe, Rowan, Spencer, Union and Washington, 10.
• The K-12 school dashboard shows that so far this week, 703 students and 228 staff have tested positive for the virus, and 3,680 students and 481 staff are in quarantine. 414 schools had not reported. 
• In long-term care, there are 28 new residents and 14 new staff who have tested positive for the virus, bringing the total number of active cases to 708 residents and 380 staff. Beshear attributed 24 more deaths in these facilities to Covid-19, bringing the total number of staff and resident deaths from the disease to 2,154.
• Three of the hospital readiness regions have an intensive care capacity rate of 80% or more: Barren River, at 82.41%; the easternmost region, at 91.18%; and Lake Cumberland, at 95.56%. The Northern Region has an overall hospital capacity of 81.53%. 
• There are 1,597 people hospitalized with the virus (up 31 from yesterday); 387 in intensive care (up four); and 225 (down three) of those on a ventilator. 
• On Jan. 20, Beshear sent a two-page letter, obtained Tuesday by the Lexington Herald-Leader through an Open Records request, to Senate President Robert Stivers and House Speaker David Osborne that offers suggestions to "create a reasonable framework around which to have a conversation” about the legislation he vetoed that limits his authority, Jack Brammer reports for the Herald-Leader. The letter was in response to Stivers comments to the Louisville Courier Journal that the legislature's decision to override the vetoes could depend on the governor's willingness to talk to them, Beshear said in his letter that his “strong preference is for any legislation to wait until Kentucky has emerged from this deadly pandemic," reports Brammer. As of Jan. 27, Kentucky has seen more than 350,000 cases and 3,495 deaths from the virus.
• Brammer continues,  “To ‘mess’ with emergency powers that have helped us achieve this relative success would be like legislating troop movements and tactics in the middle of a battle,” said Beshear. “The inevitable result is less success and more casualties.” If the General Assembly is determined to pass legislation, he said, “then I recommend we discuss narrowly tailoring” the legislation to address lawmakers’ concerns.
• The pandemic has left thousands of Kentuckians in need of both financial help and other types of assistance. Sarah Ladd with the Courier Journal has compiled a list of many of the assistance funds and programs available for Kentuckian. 
• WDRB tells the story of a Spencer County man, Jerry Harden, who has diabetes and was diagnosed with Covid-19 in December and was given bamlanivimab monoclonal anitbody infusion and quickly recovered. Doctors told WDRB that it is important that this treatment be given early in the illness and encouraged Kentuckians who test positive for the virus to ask their provider if they are eligible for it. 
• Eli Lilly, which makes bamlanivimab, released a large, late-stage study on Tuesday that found bamlanivimab combined with another monoclonal antibody, etesevimab, was found to be "extremely effective in high-risk patients diagnosed with Covid-19," Karen Weintraub reports for USA Today. "Among patients who received a placebo, 10% of those at high risk ended up in the hospital, compared with just 2% of those who received the drug cocktail – a 70% drop. Patients were diagnosed an average of four days before treatment," she writes. It's important to now that to get the benefit from these drugs, they must be given in the early stages of the disease. "Once hospitalized with Covid-19, the drug does nothing to help," a Lilly study has shown, Weintraub reports. 
• For more information about bamlanivimab in the U.S., Lilly has set up a 24-hour support line at 1-855-545-5921. Patients and physicians can also visit covid.infusioncenter.org or the HHS Therapeutic Distribution locator to find a potential treatment location.
• The Axios/Ipsos poll of 1,112 adults conducted Jan. 22-25 found trust in the federal government to provide accurate information on Covid-19 (50%), willingness to get the coronavirus vaccine immediately (49%) and improvement in mental health in the last week (14%) have all increased since Biden’s Jan. 20 inauguration. It also found that a small subset, 18%, of Americans is driving the most risky behavior -- with fewer than half of this group, 44%, saying they wear a mask all of the time and only one-third of them concerned about the pandemic.  

EXTRA QUOTE: 

"I'm convinced that one of the reasons we are seeing trends going the right way is that every single one of you across Kentucky is doing more, and is doing better even if you were doing it right every other day. More people wear a mask, more people trying to follow the rules. Let's be the most vigilant we've ever been knowing that victory is around the corner, we've got to protect one another until then," he said. 

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CDC study suggests that with proper mitigation, kids can go back to school, but schools have often been accused of noncompliance

Illustration by Hannah Brown, Kaiser Health News, Kaiser Family Foundation

By Melissa Patrick

Kentucky Health News

A new study shows that rural schools holding in-person classes with heavy masking, social distancing and limited group sizes had few transmissions of the novel coronavirus. But a separate analysis shows that such precautions are not always being taken.

The Centers for Disease Control and Prevention's 13-week study involved 4,876 students and 654 staff from 17 rural K-12 schools in Wisconsin. Data was collected between Aug. 31 and Nov. 29.

The study found that only seven of the 191 coronavirus cases in the groups resulted from in-school transmission, and no infections among staff members were found to have been acquired at school.

It also found that there was no in-school transmission between separate classroom groups, and that case rates among students and staff were 37 percent lower than those in the county overall.

"These findings suggest that, with proper mitigation strategies, K-12 schools might be capable of opening for in-person learning with minimal in-school transmission of SARS-CoV-2," the report says, using the scientific name of the virus. "These findings suggest that attending school where recommended mitigation strategies are implemented might not place children in a higher risk environment than exists in the community."

Student masking compliance was reported as greater than 92%, but only 54% of the teachers filled out the weekly survey on this topic. Staff masking compliance was not measured. 

The researchers gave the districts money to buy two- to three-layer cloth face coverings for all students, who were given three to five masks apiece. All schools were under a district and statewide mask mandate during the study period, and students were asked to wear masks when within six feet of others outdoors and at all times indoors. Classroom cohorts were created, ranging from 11 to 20 students, and all classes and lunch periods were held indoors, with efforts made to seat students near the same cohort. School staff also wore masks, kept their distance, and limited their time in shared indoor spaces. 

The researchers acknowledged that some states, like Kentucky, have set thresholds for reopening schools based on the percentage of positive test results in the community. They said that the percentage of positive test results in the school district's county ranged from 7% to 40%. 

Kentucky's recommendations for "mode of instruction" are based on each county's incidence rate, asking counties with 25 or more cases per 100,000 residents to move to a "more aggressive hybrid" plan or to "consider remote learning." As of Jan. 26, only nine Kentucky counties met that criteria.  

The researchers noted that their study had several limitations, including dependence of the mask data on voluntary teacher response, no data being collected on the school's ventilation systems, and the lack of routine screenings to measure spread of the virus by people who had no symptoms of Covid-19.

Citing several other studies, including an international one, all with similar results, three of the CDC researchers said in a "Viewpoint" article for the Journal of the American Medical Association, "As many schools have reopened for in-person instruction in some parts of the U.S. as well as internationally, school-related cases of Covid-19 have been reported, but there has been little evidence that schools have contributed meaningfully to increased community transmission." 

They added, "Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (such as restrictions on indoor dining at restaurants). In addition, all recommended mitigation measures in schools must continue: requiring universal face mask use, increasing physical distance by de-densifying classrooms and common areas, using hybrid attendance models when needed to limit the total number of contacts and prevent crowding, increasing room air ventilation, and expanding screening testing to rapidly identify and isolate asymptomatic infected individuals. Staff and students should continue to have options for online education, particularly those at increased risk of severe illness or death if infected with SARS-CoV-2." 

All of these suggestions have been recommended in Kentucky, with state guidance calling for schools to follow the "Guidance on Safety Expectations and Best Practices for Kentucky Schools (K-12), which includes masking, social distancing, handwashing and sanitation protocols.  

Compliance is the challenge

Regardless of official guidelines, many schools are not taking such precautions, says a Kaiser Health News analysis of federal and state workplace-safety data. It found more than 780 Covid-related complaints covering more than 2,000 public and private K-12 schools, Laura Ungar reports for KHN. 

The number of complaints is likely under-reported, Ungar notes, because a federal loophole prevents public-school employees from lodging complaints in 24 states that lack their own Occupational Safety and Health Administration agencies or federally approved OSHA programs.  Even when complaints are made, she reports the vast majority are closed without an inspection. 

"Still, the complaints filed provide a window into the safety lapses: Employees reported sick children coming to school, maskless students and teachers less than six feet apart, and administrators minimizing the dangers of the virus and punishing teachers who spoke out," Ungar reports. 

Also, KHN found that "practices contradicting safety experts' advice" are often codified: About half of states don't require masks for all students, including 11 that have exempted children of various ages from mandatory masking in school. 

“The response to the virus has been politicized,” Dr. Chandy John, an expert in pediatric infectious diseases at the Indiana University School of Medicine, told Ungar. “There’s a willingness to ignore data and facts and go with whatever you’re hearing from the internet or from political leaders who don’t have any scientific knowledge.”

Another challenge is that the scope of infection in schools across the nation remains unknown because states are not collecting uniform data, although President Biden's new orders call for tracking it on the federal level, Ungar reports. She adds that Biden's orders also call for OSHA to bolster enforcement and work with states and local governments to ensure workers are protected from the virus.  

That's certainly true in Kentucky. While Kentucky provides a school dashboard that schools are asked to self-report cases and quarantine data daily, compliance is sketchy, with 182 of the state's schools having never reported any data and 332 of them in the prior week failing to submit data -- which means the case and quarantine numbers are likely low. 

In the week ending Jan. 22, 1,419 students and 632 staff had newly tested positive for the coronavirus, resulting in 5,786 students and 828 staff being quarantined. 

A "very promising" study

Despite the gaps and pitfalls, state Sen. Max Wise, R-Campbellsville, who chairs the Senate Education Committee, called the CDC study "very promising." 

State Sen. Max Wise

"I think this points in the direction, of the push, to get students and teachers and staff back in the school walls and in the classroom," he said. "The study is very encouraging. I think it's even pushing for five days a week. And I know many students in school district right now are trying to make that push to get students back into in-person [classes] and with as normal a routine as possible."

Wise said he thinks it is important to get Kentucky's children back into classrooms, not only because of their learning outcomes, but also because of their mental health. 

"I think when children do not have relationships, when they don't have that accessibility to mental-health counselors, I think the push for in-person learning is one of those things that can't hurt at all with what we're going through with mental health issues and teenagers," he said. 

Further, he said it is important because it is affecting the state's workforce, especially related to child-care issues.

Asked if he supports Biden’s request for $130 billion to improve school safety, federal guidance for making schools safer and improving workplace protections to safeguard teachers and other workers from the virus, Wise said that that is a question best suited to the state's school superintendents. 

But he added that he hopes that any federal money that comes to the state's schools is used wisely, and with the understanding that it is only available for a short time. 

All that said, Wise said that when schools open to in-person learning, just like the CDC study indicates, it will still be important for them to follow public health guidelines to keep everyone safe. 

"You don't want to put your guard down," he said. "We need to stay vigilant, following those CDC guidelines of what the school rules are. It's, you know, masks up, mask when your mobile, six feet separation, and washing hands. We'll still have to do those things."

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Beshear says Biden sending Ky. 17% more vaccine and feds will give 3 weeks notice of supply; Ky. finds cases of U.K. variant

By Melissa Patrick

Kentucky Health News

The federal government will be increasing Kentucky's supply of Covid-19 vaccines by 17 percent, Gov. Andy Beshear announced Tuesday. He had asked the new Biden administration to allocate more doses to the state.

“That is a great start, especially for an administration just six days in,” Beshear said in a YouTube video after his scheduled news briefing was postponed to Wednesday.

He also announced that federal officials will now inform states three weeks in advance about the amount of vaccine they can expect, “guaranteeing a minimum amount of supply for three straight weeks. One of the tough things that we’ve been dealing with is only knowing on a Tuesday what we would have the next week and not knowing what we were having weeks after.”

Beshear said this advanced information will help both his administration and vaccinators plan better, and will help them get more people signed up for appointments because they will know what their supply is. 

The governor also announced that Kentucky has confirmed its first two cases of the novel coronavirus variant first discovered in the United Kingdom, a mutant that spreads more aggressively. He said Health Commissioner Steven Stack would talk about it at Wednesday's briefing. 

Beshear reported 2,714 new cases of the virus Tuesday, which he said is slightly more than the 2,250 new cases reported last Tuesday, but lower than the 3,053 cases reported two weeks ago. That raised the state's seven-day rolling average of daily new cases to 2,816, up 66 from Monday.

The share of Kentuckians testing positive for the virus in the past seven days is 9.63% and has dropped 14 of the 16 days since it set a record of 12.45% on Jan. 10.

Beshear announced 35 more Covid-19 deaths, 30 confirmed and five probable. That brings the state's death toll to 3,495. Since last Tuesday, 328 deaths have been attributed to the disease. Beshear said the high death counts are the result of the "significant escalation that we faced leading up into November, and then probably some from that holiday bump." 

In Washington, President Biden said the government would buy 200 million more doses of vaccine, half from Pfizer Inc. and half from Moderna. He said that will give the country enough to fully vaccinate 300 million Americans by the end of summer or early fall. That nation has 331 million people. Each company's vaccine requires two doses; a Johnson & Johnson vaccine nearing submission for regulatory approval requires one shot.

Meanwhile, both Biden and Beshear said it will be important for everyone to continue following the public-health measures that are proven to work, especially wearing a mask. 

"We need you to continue to be really careful. Wear your mask; it's working," Beshear said. "We're seeing numbers overall go down, but we've got to protect one another until we get this protection from the vaccine out there to everyone." 

Biden said, "The truth is, it's going to take months before we get the majority of Americans vaccinated, months. In the next few months, masks, not vaccines, are the best defense against Covid-19." 

In other coronavirus news Tuesday: 

• Today's fatalities were an Adair County woman,74; a Carter County woman, 81; a Casey County man, 78; a Clay County woman, 87; two Crittenden County women, 76 and 86; a Cumberland County woman, 70; five Daviess County women, 75, 86, 89, 93 and 96; three Fayette County men, 81, 85 and 92; a Greenup County man, 74; a Hancock County woman, 87; a Harrison County woman, 84; a Henderson County man, 75; three Jefferson County women, 72, 78 and 86; a Jefferson County man, 92; a Laurel County man, 94; a McCracken County woman, 63; a Montgomery County woman, 67; five Ohio County women, 82, 86, 89, 92 and 92; a Todd County man, 84; and three Wayne County men, 70, 71 and 83.
• Counties averaging at least 100 daily new cases per 100,000 residents in the past seven days are Hancock, 103.2 per 100,000; Hart, 102.1; and Butler, 102.0. The state's overall incidence rate is 60.25 per 100,000.
• Counties with 10 or more new cases were Jefferson, 440; Fayette, 186; Daviess, 119; Warren, 94; Kenton, 86; Pike, 76; Madison, 63; Nelson, 60; Campbell, 58; Floyd, Hardin and Pulaski, 48; Boone and Laurel, 46; Christian, 41; Jessamine, 39; Barren and Oldham, 35; Knox, 34; Scott, 33; Hopkins and Taylor, 31; Harlan, 27; Marshall and Whitley, 26; Boyle, Bullitt, Hart and Meade, 25; Franklin and Shelby, 24; Boyd, 22; Lincoln, Muhlenberg and Ohio, 21; Butler and Casey, 20; Clinton, 19; Allen and Martin, 18; Henderson and Logan, 17; Carter, Graves, Harrison, Johnson and McCreary, 16; Breckinridge, Fleming and Lewis, 15; Owen, 14; Green and Perry, 13; Grayson, Hancock, Metcalfe and Todd, 12; Larue, McCracken, McLean and Rockcastle, 11; and Anderson, Bell, Clay, Lawrence, Marion, Montgomery, Simpson and Washington, 10.
• The long-term care daily report shows 772 active resident cases and 411 active staff cases, including 32 new residents and 51 new staff. It shows 293 resident deaths and four staff deaths can be newly attributed to Covid-19, for a total of 2,146 resident deaths and 13 staff deaths since the pandemic came to Kentucky in March. 
• Kentucky hospitals have 1,566 Covid-19 patients (up 27 from Monday); 391 in intensive-care units (up 17); and 228 of those on a ventilator (up 25). The share of ICU patients on ventilators is a high 58.3% and has generally increased in the last week.
• Three of the hospital readiness regions are reporting their ICU beds at least 80% full: Barren River, 85.19%; the easternmost region, 84.56%; and Lake Cumberland, 97.78%. 
• As of Monday, the K-12 school dashboard showed 434 new students and 186 new staff had tested positive for the coronavirus, with 2,507 students and 331 staff quarantined, but 655 schools had not reported any data.
• Among others, The New York Times is keeping tabs on how how many people in each state have received at least one coronavirus vaccine shot, and how many have received two. In Kentucky, it reports that 6.3% have received one shot, and 0.7% have received two. It also shows a table of who is eligible in each state to get the vaccine. In Kentucky, that includes health-care workers, adults who are 70 and older and some other essential workers, but local variations in supply and demand mean that some people not in those groups have been vaccinated. Click here to see the NYT Coronavirus Vaccine Tracker. 
• Louisville has launched the "Masks for Kids" initiative to distribute face masks to thousands of local children as they move closer to resuming in-person classes, Billy Kobin reports for the Courier Journal. In addition to already established donations, the public is encouraged to donate new masks by dropping them off at any YMCA location in the Louisville region. "To think that the lack of a mask could be a barrier for a child to stay safe, or get back to school at the appropriate time, that's unthinkable, and it's unacceptable,"  said YMCA of Greater Louisville President and CEO Steve Tarver. "So together, we can eliminate this barrier."
• Norton Healthcare in Louisville has taken over the online waiting list for those 70 or older who are looking to get vaccinated after the city's health department shut its site down, Deborah Yetter reports for the Courier Journal. The people on the health department's list, which numbers about 60,000, should have received an email Tuesday directing them to sign up through Norton at nortonhealthcare.com. People without online access may call 502-861-4499.
• In a separate article, Yetter reports on the frustrations of Louisville's seniors as they try to get vaccinated and officials seek solutions.  
• The Better Business Bureau warns people to look out for scammers who are calling people looking for Medicare and Medicaid information and trying to sign people up for a vaccination, or promising to get you higher on a vaccination list for money, WKYT reports. "Remember, the vaccination is free, and if you’re looking on the web to sign up for the shot, look for the “dot org” at the end of the website. It’s an indication the site is legitimate," WKYT writes.
• Health departments are informing their citizens that there are not enough vaccines for those who want it, including the Franklin County Health Department, reports The State Journal of Frankfort.

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