State cuts vaccine orders as demand falls; Beshear wants single-dose vials for doctor offices, but they probably won't appear soon

State Dept. for Public Health graph, relabeled by Ky. Health News; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

As Kentuckians' demand for coronavirus vaccines slacks off, the state is not ordering as much vaccine as it could, but its full order can be restored at any time, Gov. Andy Beshear said Monday. 

"We are not bringing the full amount that's available to Kentucky into Kentucky because we don't have enough people that are willing to be vaccinated," Beshear said at a news conference. "We make sure that we match everybody's orders with what they can do, and they still have extra on hand."

Monday's vaccination number saw a one-time adjustment as the state lined up its numbers with those of the Centers for Disease Control and Prevention. The adjustment added an additional 14,623 Kentuckians who have received at least one dose of the vaccine, adding Kentuckians who were vaccinated in other states and subtracting out-of-staters vaccinated in Kentucky.

To accommodate this change, the state created a new vaccine dashboard to make it easier for Kentuckians to keep up with the vaccine data. The dashboard, which will be updated daily, will show how many Kentuckians have received at least one dose of a vaccine, statewide and by county. Data on how many Kentuckians are fully vaccinated is available on the CDC Covid Data Tracker. 

The state dashboard highlights the top and bottom five counties for percentage of population vaccinated with at least one dose. The top five are Woodford, 55%; Franklin, 54%; Fayette, 52%; Scott, 45%; and Jefferson, 44%. The bottom five are Christian and Spencer, 17%; Ballard, 19%; McCreary and Lewis, 20%.  

The shift to CDC figures and addition of vaccinations administered Sunday brought to 1,848,275 the number of Kentuckians who have received at least one dose of a coronavirus vaccine. 

That means 651,725 more Kentuckians need a first shot to reach 2.5 million, the level at which Beshear said April 13 that he will lift all capacity restrictions from most businesses and activities. As vaccine demand slowed, he made incremental changes and indicated more were possible, and expanded on that Monday. 

Asked about that, Beshear said as the state gets closer to the goal, he will consider further increasing capacity limits in office-based businesses and private gatherings. Right now, they are at 60%. 

He called on unspecified "folks" who are criticizing him and his decisions around the state in "silly season" to spend some of that time encouraging people to get vaccinated, "especially if you're a part of a demographic that may be hesitant. . . . I don't care who the message comes from. I just want our people to be safe."

Beshear said he would like to get more vaccine in health-care providers' offices, since polls show people want to get vaccinated by their own provider, but that has been difficult because each vial has about 10 doses, and once it is open, it must be used within hours, and doctors' offices might not have that many willing patients. 

Asked if there has been any discussion about making a one-dose vial, Beshear said state officials had talked with their federal counterparts about that, but it "appears to be going the other way," since Pfizer-BioNTech is shifting from a 10-dose vial to a 15-dose vial. 

"It would be incredibly helpful to get a single-dose vial," Beshear said. "That does not look like that's going to happen."

Asked about lack of people wearing masks at the Kentucky Derby, Beshear that needs improvement, but added that "I do think a large percentage of people who were there were vaccinated." He added, "We'll watch carefully in what we see afterwards."

Saying it was an outdoor event, which is largely but not completely true, Beshear said that as more information is released about virus spread at such events, the state could relax its outdoor mask mandate even further. Right now, no masks are required at outdoor events with fewer than 1,000 people.

So what does he say to the many Kentuckians who are exhausted by the mask mandate, especially if they have been vaccinated and have to wear one because there are so many hold-outs? He said he asks people to "Just give us a little more time" to get as many people vaccinated as we can and to get through the school year. "We are really, really close, and we're all tired." 

Daily numbers: Beshear announced 313 new cases of the coronavirus Monday, raising the seven-day rolling average by 15, to 616. It has risen five days in a row, from 532 last Wednesday. 

Beshear said the new-case rate among Kentuckians 50 and older is 8.03 cases per 100,000 residents and 13.41 for those under 50, showing the need for people under 50 to get vaccinated.  

The percentage of Kentuckians testing positive for the virus in the past seven days is 3.45%, just slightly higher than Sunday, but also up for the fifth day in a row and the highest it's been in about two weeks.  

Asked why the rate is important, Beshear said it speaks to sufficiency of testing and shows how much the virus is increasing. "It is a leading indicator," he said. "Your positivity rate will start going up faster than your number of cases will go up. So it gives you maybe a snapshot into the intensity of the spread of the virus."

Both the weekly case total and positive-test rate inched up this week, but overall it appears the state remains on a rough plateau for both of these measures, with the weekly case number on down-and-up pairs the last six weeks.

State Dept. for Public Health graph, relabeled by Ky. Health News; for a larger version click on it.

So far, the state has detected 407 virus cases with "variants of concern" in Kentucky, with 381 of them the highly contagious B.1.1.7 variant, which was first detected in the United Kingdom and is now the dominant strain in the U.S.

The statewide rate of daily new cases over the last seven days is 11.45 cases per 100,000 residents, up .18 from yesterday. The New York Times ranks Kentucky's rate 24th among the sates, which continues to be the highest it's been since mid-March. 

Counties with rates double that statewide rate were Powell, 62.4; Robertson, 47.4; Lewis, 38.7; Menifee, 33; Bath, 29.7; Hickman, 29.4; Todd, 27.9; Trimble, 27.0; Mason, 24.3; Wolfe, 24; and Simpson, 23.8.

Hospital numbers also remain on a plateau. Kentucky hospitals reported 414 patients with Covid-19 (down two from Sunday); 102 in intensive care (down 4); and 47 of those on a ventilator (down 1).

The Lake Cumberland hospital-readiness region remains the only one out of 10 that is using more than 80% of its intensive-care beds, at 82.22%. Only 6.7% of those beds have Covid-19 patients. 

Beshear expressed concern that new-case and death numbers in long-term-care facilities are up, and said that if they continue to go up, the state has the ability to "add some additional steps or restrictions if necessary."

"We're starting to maybe see this trending up and it's of concern," Beshear said. Later adding, "We're watching this very closely. . . . We cannot let these numbers go up. Far too many have died in these facilities." 

He reported eight new residents and 16 new staff had tested positive for the virus, bringing the active cases up to 78 residents and 113 staff. He reported eight more deaths in long-term care, bringing its death toll to 2,294. 

The state's overall death toll from Covid-19 is 6,525, following Monday's report of eight fatalities, five from regular health-department reports and three from an ongoing audit of death certificates.  

In other pandemic news Monday: 

• Counties with five or more new cases were Jefferson, 67; Shelby, 28; Boone, 24; Laurel, 14; Trigg, 13; Fayette, 10; Kenton, Montgomery, Spencer, and Trimble, 8; Bullitt, Daviess, Franklin and Henry, 7; Clark, 6; and Morgan and Oldham, 5. 
• The five regularly reported deaths were a Fayette County woman, 84; a Harrison County woman, 65; a Hart County man, 78; a Henderson County man, 93; and a Nelson County man, 94. The three audit deaths were a Boone County man, 70; a Lawrence County woman, 80; and a Washington County woman, 77. 
• McClatchy News explores what health officials have to say about whether those who are not vaccinated, but have recovered the disease can safely gather with their fully vaccinated friends and family -- and the answer is not a simple yes or no. 
• Berea College appears to the the first Kentucky institution of higher learning to require students to be vaccinated when they return to campus in the fall, Sarah Ladd and Deborah Yetter report for the Louisville Courier Journal. So far, these universities are strongly encouraging them, but not mandating them: University of Kentucky, the University of Louisville and Western Kentucky University.
• At a UK University Senate meeting, a senator asked President Eli Capilouto if his decision to not require vaccination of students is final. "We keep our minds open on those things," and will consult with experts and Stack, Capilouto said. He said UK HealthCare staff is 93% vaccinated, faculty 83%, all staff 70%, and students over 60%, but "This is a time when all of Kentucky needs more arms to come forward."
• Beshear signed an executive order that extends previous orders allowing pharmacists to dispense emergency 30-day refills.