Citing research showing virus is as contagious as chickenpox, Beshear again asks all schools to enforce universal masking

State Dept. for Public Health map, adapted by Ky. Health News; to enlarge, click on it.

By Melissa Patrick and Al Cross
Kentucky Health News

Before announcing the new winners of the state's second vaccine-incentive lottery, Gov. Any Beshear went over the findings of an internal federal health document that says the Delta variant of the coronavirus can spread as easily as chickenpox, appears to cause more severe illness, and can be spread among fully vaccinated people who get the virus. 

"It is one of the most transmissible viruses that they have ever seen, significantly more so than the alpha variant," the first one of significance, Beshear said at the vaccine event. "What this says is we can't just be normal at the moment, and this thing will spread wider and faster than anything that we have seen to date." 

The Centers for Disease Control and Prevention documents from a slide presentation were obtained by The Washington Post, which reports they convey the struggles of convincing Americans to get vaccinated and the need for the agency to revamp its public messaging around vaccination against a variant that is "so contagious that it acts almost like a different novel virus." 

The slides say the Delta variant is more transmissible than MERS & SARS, Ebola, the common cold, the seasonal flu, the 1918 "Spanish" flu, and smallpox. 

The documents, which were to be released Friday, cite data and research showing vaccinated people who are infected with the Delta variant may be able to transmit the virus as easily as those who are unvaccinated. Beshear said that's what prompted the CDC to change its guidance to recommend that vaccinated people should also wear masks indoors in areas with high transmission rates, which includes almost all of Kentucky. 

Fully vaccinated people are less likely to get the virus and less likely to suffer from serious harm or die from it, Beshear said, but "While you might be safe, you might end up harming somebody else" and that's why it's important for vaccinated folks to wear a mask too. 

"If everybody was vaccinated, this thing wouldn't be a problem," he said. "We've got to understand that the guidance didn't change, the virus changed." 

He also called on schools that are not enforcing universal masking to reconsider doing so, noting that an Atlanta school that has already started classes has had to quarantine more than 100 students in the first week. 

"With this new information, I'm calling on school districts that have thus far said that they are not going to require masking to reconsider, because they will fail," Beshear said. "And it'll be the students that lose out on in-person learning."

The good news is that vaccination rates are picking up in Kentucky, although slightly. "Vaccines plus masks equals the win," Beshear said. "Let's make sure we do it." 

Daily numbers: The state reported 1,648 new cases of the virus Friday, about the same as the last two days. That raised the seven-day rolling average to 1,213, the highest since Feb. 25.

The state's new-case rate over the last seven days was 25.9 per 100,000, putting it in the "critical" area for transmission of the virus.

The share of Kentuckian testing positive for the virus in the last seven days is 8.96%, double what it was two weeks ago. Counties with rates more than double the state rate are Clay, 120; Jackson, 89; Muhlenberg, 67.6; Letcher, 61; Knox, 56.4; Floyd, 55.4; Laurel, 55.2;and Knott, 50.2.

Hospitalizations continued to rise. Kentucky hospitals reported 625 Covid-19 patients, double the total of less than two weeks ago; 195 of them were in intensive care and 85 were on mechanical ventilation.

The Lake Cumberland hospital-readiness region reported 91% of its intensive-care beds in use, with 29% of the patients suffering from Covid-19. Both percentages were the highest in the state.

The state reported seven Covid-19 deaths, the most on almost two weeks, bringing the total to 7,334.

Shot-at-a-million winners: The winner of the $1 million prize is Ginger Schultz from Louisville, who encouraged all Kentuckians to get vaccinated. 

“I've never experienced anything like this. It’s shocking because you don’t really think you’re going to win,” said  Schultz. “Why take a chance at getting very sick and possibly die or passing it on to someone else? That’s what my main concern was. My mom is 85 and she has breathing issues and I was always very concerned about her getting it or passing it on to her.”

The five Kentucky youth selected for full postscondary-education scholarships are Shelby Anderson of Louisville; Isabella Brozak of Crestwood; TJ Ponder of Owenton; Reese Johnson of Harrodsburg; and Julian Sandberg of Ft. Mitchell.

The final drawing will be held Aug. 26 and will be announced the next day. Permanent residents of Kentucky who have received at least one dose of a vaccine can enter the lottery at shotatamillion.ky.gov. 

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Beshear calls for universal masking in schools, following CDC; Stack calls Kentucky 'horribly inflamed' with coronavirus

State Department for Public Health map; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear and Health Commissioner Steven Stack updated the state's mask guidance Thursday to call for universal masking in schools, regardless of vaccination status, following new federal guidance.

Beshear tacitly acknowledged that the move is controversial: "Now, I know that people are tired. I'm tired, too. I know that people are frustrated. I'm frustrated too. We're strong enough to do this. We are resilient enough to do this. And we are compassionate enough to where we know that we have to do this."

He said Kentuckians' decisions about masking will be critical, due to aggressive spread of a more contagious coronavirus variant. "Places that haven't taken steps are seeing results that we should know by now: widespread outbreaks, clusters, large amounts of quarantines," he said at his weekly briefing.  

Asked about school districts that have said they would not require universal masking, Beshear asked them to consider the science that clearly indicates such policies will limit Covid-19 cases and subsequent quarantines in both classrooms and extracurricular activities, including sports.

Beshear suggested that school districts could be liable for sickness and death if they don't follow guidance from the U.S. Centers for Disease Control and Prevention that is based on research showing that vaccinated people can acquire the virus and spread it without having symptoms. He called that "the game changer."

"You teach science in your classroom," he said. "You should have to consider it when making decisions."

Beshear said he isn't considering a mask mandate, but would act based on how the surge in cases goes. The difference between this surge and before, he said, is that people have access to vaccines that work.

Asked if he would require state employees to get vaccinated, as some states are doing, Beshear said he would not, but is looking at the possibility of requiring them to have regular tests. Wednesday, he required everyone in the vicinity of others in state offices to wear a face coverings. 

Beshear said the mask recommendations are temporary and will be removed when it is safe to do so, as he did before. He said there is a simple equation that will keep Kentuckians at work, school and play: "more people getting vaccinated, and when you need to, wear a mask."

Without such prevention efforts, Beshear said the more contagious Delta variant will spread through unvaccinated workplaces and classrooms, disrupting education and slowing economic growth through loss of productivity and frequent quarantines.

Stack displayed color-coded maps that showed on June 28 there were no "red zone" counties in Kentucky, but on July 28 there were 36. A red-zone county has more than 25 daily cases per 100,000 people over seven days and is considered to be at a "critical" level for transmission of the virus. 

“We have changed in the blink of an eye from a quiet, calm state to a horribly inflamed state,” said Stack. “We all know what we need to do . . . We all need to get vaccinated."

He said that since March 1, 94.5% of Covid-19 cases, 91.8% of Covid-19 hospitalizations and 88.8% of Covid-19 deaths in Kentucky were among unvaccinated or partially vaccinated or unvaccinated people.

Local health-department director Crystal Miller also spoke at the news briefing, encouraging Kentuckians to remember the beginning of the pandemic, when her home Harrison County had the first case and everyone had the same goal and was willing to do what it takes to protect themselves and their loved ones. 

“Somehow we’ve grayed those lines. We’ve gotten away from that mission," she said. "It’s been a long 16 months. It’s been frustrating. It’s exhausting. But the difference between March 6 and today is that we have a solution. We know exactly what works: vaccines and masking."

Stack and Miller asked Kentuckians to seek out reliable sources and trusted experts for information about the virus and the vaccines. Stack said, "Don't look to cable [TV] sources for your medical advice, period. Don't look to social media for your medical guidance, period. If we would do that, he said there would be no controversy or debate and we could get over this pandemic a lot faster." 

Republican pushback: Most Republicans who lead independent state agencies, three of whom may run for Beshear's job in 2023, said they would not enforce his mask mandate for state workers. Agriculture Commissioner Ryan Quarles' chief of staff, Keith Rogers, said they "will continue to leave it up to employees to decide for themselves whether to wear a mask while at work," Daniel Desrochers reports for the Lexington Herald-Leader. Treasurer Allison Ball said likewise, and so did State Auditor Mike Harmon, on Wednesday.

Mike Wynn, a spokesman for the Legislative Research Commission, said the legislative branch of government will continue enforcing the mask policy it implemented on May 23, which said vaccinated people do not need to wear a mask, Desrochers reports.

Beshear said he can't discipline employees who work for separate constitutional officers, but warned that they will face a greater risk of getting sick. He said it's more important to do the right thing than to "try to score political points," and noted that the new-case rate in Franklin County skyrocketed this month. 

"I care more about the people than my popularity," he said. "I've got the backbone to do what's right for them, and wish other people did too."

Vaccinations: Beshear noted the slight uptick in vaccinations in Kentucky. CDC data presented by The Washington Post showed 10,048 shots were given Wednesday, the most since July 11. The seven-day average is 7,563.

Beshear said he thought the state is having success with its vaccine lottery, which held its second drawing Thursday. The winners will be announced Friday; an adult will win $1 million and five youth will get full postsecondary-education scholarships. The final set of winners will be announced Aug. 27. 

Asked if the state was working on any other incentive programs to get more Kentuckians vaccinated, Beshear said they were looking at different options and noted that there were more and more private incentives being offered. "The Delta variant ought to encourage them to do more," he said. 

Daily numbers: The state reported 1,618 new cases of the virus Thursday, with 328 (20%) in people 18 and under. That raised the seven-day rolling average by nearly 100, to 1,120 -- the highest in six months. 

The percentage of Kentuckians testing positive for the virus in the past seven days rose for the 33rd straight day, to 8.55%. Two more Kentuckians have died from Covid-19, bringing the death toll to 7,327. 

The statewide rate of daily new cases over the last seven days is 23.63 per 100,000 residents, very near the "critical" level of 25. Counties with rates more than double the statewide rate are Clay, 113.4; Jackson, 82.5; Muhlenberg, 57.8; Laurel, 57.8; Letcher, 57.7; Floyd, 52.6; Webster, 51.9; and 

Hopkins, 47.3.

Hospitalizations for Covid-19 continued to rise. Kentucky hospitals reported 608 patients with Covid-19, with 189 of them in intensive care and 82 of those on mechanical ventilation.

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UK, Ashland hospital celebrate partnership that's been in effect since April 1; joint venture now holds hospital's assets

King's Daughters Medical Center in Ashland has 465 beds. (2011 photo)

The University of Kentucky's health-care system and King’s Daughters Health System in Ashland are now partners, they announced Wednesday in Ashland, with Gov. Andy Beshear and his top health official on hand.

The partnership, which was announced as a "joint venture" in January, "went live April 1," UK HealthCare said in a press release. "Together we created a joint venture, which holds the assets, and we have a management agreement in place for UKHC to operate the KDHS health system," said Allison Perry, the university's deputy public-relations director.

Kristie Whitlatch, president and chief executive officer of King’s Daughters, said in January that her hospital would have a new governing body, with its current chairman but equal representation for UK, and that she would be on the management team at UK HealthCare. That is now in effect, Perry said.

The press release said the joint venture "creates new opportunities for both organizations to better serve patients throughout Kentucky, southern Ohio and West Virginia by expanding the delivery of specialty health care services throughout the region."

Secretary Eric Friedlander (Photo
by Matt Jones, Daily Independent)

The hospital already had a partnership with UK's Markey Cancer Center. After Our Lady of Bellefonte Hospital in nearby Russell closed in April 2020, Eric Friedlander, secretary of the state Cabinet for Health and Family Services, told Beshear's senior adviser, Rocky Adkins, that there was an opportunity to create a partnership, Adkins recalled at Wednesday's announcement, Aaron Snyder reports for the Ashland Daily Independent: "Adkins pointed out Friedlander in the crowd, who gave him a rousing applause."

Whitlatch said Wednesday, “This partnership is an excellent example of how health care providers can successfully collaborate to share resources to facilitate patient care, physician recruitment and improve essential services. We are already seeing benefits of the collaboration as we are able to invest in our team members and our facilities.”

The UK release said, "The partnership will allow for expanded offerings in other needed health-care services for the area, including pediatric cardiology. Last week, the two organizations collaborated on their first pediatric echocardiogram read, and in the near future the Kentucky Children’s Hospital team will be providing onsite pediatric cardiology services at King’s Daughters."

King’s Daughters has 465 beds at its hospital in Ashland and 10 at King’s Daughters Medical Center Ohio, in Portsmouth. The system also includes a long-term care facility, seven urgent-care centers, and 30 primary-care and 36 specialty-physician practices.

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Vaccination rate of Kentucky Medicaid members is about half the overall rate; even $100 incentives seem to have little effect

One of the biggest obstacles to protecting Kentucky from the coronavirus is Kentuckians on Medicaid, who make up about a third of the state's population.

"Of the 1.6 million people in Kentucky covered by the government health plan, only 27% of those eligible have received at least one dose of the vaccine, compared to about 51% of Kentuckians overall," based on state data, reports Deborah Yetter of the Louisville Courier Journal.

"That means more than 870,000 adults and children 12 or older covered by Medicaid remain unvaccinated," Yetter reports, using figures from the state Cabinet for Health and Family Services. "The current COVID-19 vaccines are not approved for children under 12. A little more than 320,000 Medicaid enrollees have received the vaccine, according to the cabinet."

Most Medicaid members' care is overseen by insurance-company subsidiaries known as managed-care organizations, or MCOs. The other 141,500, including nursing-home residents and people with certain disabilities in special programs, have a 55% vaccination rate. Nursing homes were the top priority for vaccination.

Cabinet Secretary Eric Friedlander has warned the MCOs that "I expect them to do better," he told Yetter. "The MCOs, in the most important public-health crisis of our time, are underperforming."

The six MCOs "say they are trying through outreach, incentives and other efforts to increase vaccinations," Yetter reports. "They say they are calling, texting and mailing information to try to reach members and offering incentives including gift cards."

Joseph Goode, a spokesman for for CVS Health, told Yetter that its Aetna subsidiary was the first MCO in Kentucky to offer $100 gift cards for getting vaccinated, but only 22% of members 12 or older have received at least one dose of a vaccine.

Anthem is also offering a $100 incentive, and has a vaccination rate of about 25%, it told Yetter. Louisville-based Humana, has a 28% rate, she reports, and "The other companies, Wellcare, United Healthcare and Passport by Molina report similar efforts and said they are continuing to try push vaccination numbers higher." 

But "in areas where skepticism remains high about the vaccine and misinformation abounds," people on the front lines of health care said the MCOs impact will be limited. Yetter reports. She quotes Dr. John Jones, who treats Eastern Kentucky Medicaid patients, some of whom continue to refuse a corinavisus vaccine: "I don't know how much sway some insurance company's going to have over the phone. It usually takes someone you know to persuade you."

Also, in the counties of Perry, Leslie and Knott, where Jones works, "There's just a distrust of outsiders in general," he told Yetter.

"That distrust isn't limited to rural Kentucky, said E. Ann Hagan-Grigsby, CEO of Park DuValle Community Health Center, which is based in west Louisville and sees a large share of Medicaid patients," Yetter reports, quoting her: "We've hit a wall. The people who really wanted the vaccine have found where to get it and are getting it. The others who have not gotten it need some convincing."

"Friedlander said the state hired the MCOs to oversee health care and improve outcomes for Medicaid enrollees and he expects better results when it comes to the COVID-19 vaccine," Yetter reports.

"The MCOs ought to be really pushing hard to get these folks," Ben Chandler, president of the Foundation for a Healthy Kentucky, told Yetter. "You'd think it would be in their interest to get everybody vaccinated."

The chair of chairman of the legislature's Medicaid oversight committee, said he was disappointed by the low vaccination rate of Medicaid enrollees. "I thought they would have been reasonably close to the state's average," Sen. Steve Meredith, a Republican from Leitchfield, told Yetter.

Jones told Yetter that vaccine demand at his clinic had dwindled in recent weeks, "with unvaccinated patients expressing doubts or worries about the vaccine," she reports. "Often, they report anecdotal information shared by others or seen on social media, such as one patient who cited a case of a healthy young adult dying after being vaccinated, a report Jones said he could not verify."

"Some of it's directly linked to social media," Jones said. "The stories, there's no way to confirm them."

Jones told Yetter that he has persuaded some patients to get vaccinated, but "Sometimes, they refuse to talk about it."

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UK HealthCare again best Ky. hospital in U.S. News & World Report rankings; Baptist Health has two of top six in the state

By Melissa Patrick
Kentucky Health News

Six Kentucky hospitals have been named among the nation's "Best Regional Hospitals" in the annual ranking by U.S. News & World Report magazine.

They are, in order: the University of Kentucky hospital; hospitals in Covington and Edgewood; Baptist Health Lexington; Baptist Health Louisville; and Louisville's Norton Hospital and UofL Health-Jewish Hospital.

Dropping off the list this year is Saint Joseph Hospital-Lexington.

To make the list, a hospital must:

• Offer a full range of services;
• Rank nationally in one of 11 measured specialties, or have six or more high-performance rankings for procedures and conditions; and
• Have at least three more "high performing" than "below average" rankings for procedures and conditions. 

The report offers an overview of 122 Kentucky hospitals with a breakdown of each of the measured categories, according to the services a hospital provides.
UK HealthCare, for the sixth straight year, is No. 1 with Albert B. Chandler Hospital. It ranked in the top 50 for cancer care for the fifth consecutive year. Its Markey Cancer Center is the only National Cancer Institute-designated cancer center in the state, and one of only 71 in the nation. 

“These rankings recognize UK HealthCare as the major health system best equipped to meet the needs of patients across Kentucky, and they recognize the incredible work and dedication of our physicians, nurses and health care providers across our academic health system,” Dr. Mark F. Newman, UK executive vice president for health affairs, said in a news release. “At UK HealthCare, our commitment has been and always will be to provide the most advanced specialty care to the citizens of the commonwealth, without the need to travel far from home.”

UK also ranked as high-performing in gastroenterology and gastrointestinal surgery; geriatrics; orthopedics; and urology.

The 32nd annual rankings compared more than 4,750 medical centers nationwide in 15 specialties and 17 procedures and conditions. This year's report expanded to cover seven new procedures and conditions. It also added a new health-equity measure. Of the 4,750 hospitals, 175 were nationally ranked in at least one specialty and 531 were ranked among the Best Regional Hospitals in a state or metro area, according to a news release. 

Baptist Health Louisville was the top rated hospital in Louisville. Baptist CEO Gerard Coleman said in a news release, that the rankings "reflect the unrelenting dedication of our physicians, staff and support teams in providing exceptional and compassionate care to our patients. I am proud of the work that we do. We’ve been tested by the pandemic, which has made us more mindful of what’s important and that our mission to serve the needs of our communities has never been more vital."

The report recognizes hospitals that are "high-performing" for 17 common adult procedures and conditions, including abdominal aortic aneurysm repair; aortic valve surgery; back surgery (spinal fusion); chronic obstructive pulmonary disease; colon cancer surgery; congestive heart failure; diabetes; heart attack; heart bypass surgery; hip fracture; hip replacement; kidney failure; knee replacement; lung cancer surgery; pneumonia; stroke; and transcatheter aortic valve replacement.

UK HealthCare ranked high-performing in all those categories except abdominal aortic aneurysm repair,  aortic valve surgery, transcatheter aortic valve replacement, diabetes, back surgery (spinal fusion), knee replacement, hip fracture. It ranked average in each of these categories. 

St. Elizabeth in Edgewood and Covington ranked high performing in all the categories except aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture. It ranked average in each of these categories.

Baptist Health Lexington ranked high performing in all categories except aortic valve surgery,  transcatheter aortic valve replacement, diabetes, kidney failure, knee replacement, hip replacement, and pneumonia. It ranked average in each of these categories. 

Baptist Health Louisville ranked high performing in all categories except lung cancer surgery, heart failure, transcatheter aortic valve replacement, kidney failure, back surgery (spinal fusion), hip replacement, hip fracture and pneumonia. It ranked average for each of these categories.

Norton Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture and pneumonia. It ranked average for each. 

UofL Health-Jewish Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery,  transcatheter aortic valve replacement, knee replacement, hip replacement, hip fracture, and pneumonia, ranking average for each of those; and back surgery (spinal fusion), where it ranked below average.

Click here for a list of frequently asked questions about how the magazine ranks the hospitals. 

Nationally, the Mayo Clinic in Rochester, Minn., claimed the No. 1 spot, followed by Cleveland Clinic and UCLA Medical Center in Los Angeles.

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With state nearing 'critical' level of virus spread, and some places much higher, Beshear requires all in state buildings to mask up

Gov. Andy Beshear is requiring all state employees and visitors to state buildings to wear face coverings, even if they are fully vaccinated against the coronavirus, which continues to surge in Kentucky.

Beshear said in a two-minute video that he took the action to protect state workers "and those they interact with." It takes effect Thursday, July 29.

The rule "came on the heels of a shift in guidance from the U.S. Centers for Disease Control and Prevention, which on Tuesday said everyone in the United States, including fully-vaccinated people, should resume wearing masks in public indoor settings in parts of the country where spread of the Covid-19 Delta variant is considered dangerously 'high' or 'substantial'," the Lexington Herald-Leader notes.

Dept. for Public Health map, adapted by Ky. Health News; click to enlarge

That could apply to 36 of Kentucky's 120 counties, which appear in red on the state's infection map because virus transmission there is considered "critical." That applies to counties with 25 daily cases per 100,000 residents over the last seven days; the statewide rate is not far from that, 21.58. 

Counties with rates more than double the statewide rate are Clay, 82.6; Jackson, 76.1; Floyd, 59.4; Laurel, 52.4; Muhlenberg, 49.5; Webster, 48.6; Letcher, 47.7; Hopkins, 45.7; Simpson, 44.6; and Whitley, 44.5. All but Simpson are in the state's eastern or western coalfields.

The state reported 1,693 new cases of the virus Wednesday, raising the daily average for the last seven days by 104, to 1,022. That's the highest it has been since March 2.

Hospitalizations for Covid-19 also jumped, rising to 571, almost 10% more than Tuesday. Intensive-care units has 185 of those patients, and 83 of them were on mechanical ventilation.

The share of Kentuckians testing positive for the virus rose for the 32nd day in a row, to 8.29%. The state reported two more Covid-19 deaths, raising the total to 7,325.

Read more here: https://ift.tt/3jf8aDx

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McConnell will use campaign funds to run pro-vaccine ads

McConnell (Reuters photo by Joshua Roberts)

U.S. Sen. Mitch McConnell will use funds from his campaign to run 60-second advertisements on more than 100 radio stations in Kentucky to promote vaccination for the coronavirus, Reuters reports.

McConnell, the leader of Senate Republicans, has blamed misinformation for the low rate of vaccination among Americans, "which are fueling a rise in coronavirus cases, particularly in Republican-dominated states," Reuters notes.

"There is bad advice out there," he told Reuters. "Apparently you see that all over the place: people practicing medicine without a license, giving bad advice. And that bad advice should be ignored."

In Kentucky, the daily average of vaccinations is 28 percent higher in the last seven days than the previous seven, but remains below the level seen at the start of the month, and that was lower than June. Just under 52% of Kentuckians have received at least one dose of vaccine; the U.S. figure is 57%.

"Not enough people are vaccinated," said McConnell, 79. "So we're trying to get them to reconsider and get back on the path to get us to some level of herd immunity."

McConnell has promoted vaccinations since he was vaccinated in December, but has stopped short of criticizing other Republicans who have refused to say whether they've been vaccinated and "attacked the shots as unnecessary or dangerous," as Reuters puts it. But he endorsed recent remarks by Alabama Gov. Kay Ivey, who told reporters last week that it is "time to start blaming the unvaccinated folks" for the surge in cases, as well as criticizing people spreading misinformation about the vaccines.

Ivey wrote in The Washington Post that those "pushing fake news and conspiracy theories about this vaccine are reckless and causing great harm," adding that many of the unvaccinated are "being lied to."

McConnell, a native of Alabama, told Reuters, "I was encouraged by what the governor of Alabama said."

Reporter David Morgan of Reuters notes, "About 40% of Republicans are uncertain about the vaccine or are unwilling to be vaccinated, polling data published by the Morning Consult showed. That is more than double the 16% of Democrats who voiced those concerns."

Frank Luntz, a Republican pollster advising the Biden administration on vaccine persuasion, said he has been warning for months about politics being an obstacle to vaccination.

"The key here is to ensure that no one feels like they have to do it," Luntz told Morgan. "They have to want to do it. So, insulting them or mandating them won't work. Political messages won't work, unless you're Donald Trump. If Trump were to say to them: 'Hey, get the vaccine.' That would make a difference. But he doesn't do that. All he does is complain about the election."

Last week, Trump said, "People are refusing to take the vaccine because they don't trust (Biden's) administration, they don't trust the election results."

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Citing research, CDC recommends universal masking in schools, and in high-transmission areas indoors when away from home

State Dept. for Public Health map, relabeled by Ky. Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Federal officials offered new guidance Tuesday recommending that everyone in schools wear masks, even those who have been vaccinated; and that people living in areas with widespread transmission of the coronavirus wear masks indoors when away from home. 

Photo from USNews.com

Centers for Disease Control and Prevention  Director Rochelle Walensky said at a news conference that the new guidance was prompted by new research that found vaccinated people who contract the much more contagious Delta variant of the virus can spread it to others. "This new science is worrisome," she said. 

The guidance comes as the virus surge in Kentucky increased and school boards wrestled with the contentious masking issue -- and just one day after Gov. Andy Beshear announced the state's recommendations for in-school masking, which did not go as far as the CDC now has. 

The state recommended that unvaccinated students and staff wear masks in schools, and schools that want to "optimize safety" should require everyone to mask up. 

Beshear's guidance followed CDC recommendations earlier this month that said fully vaccinated people did not need to wear mask in schools. Not long after that announcement, the American Academy of Pediatrics called for everyone older than 2 to wear a mask, regardless of their vaccination status. 

A spokeswoman for the Kentucky Department of Education, Toni Konz Tatman, said the agency would review the CDC's latest guidance "in consultation with our partners at the Kentucky Department for Public Health, and will share it with our districts and families."

Mask requirements in Kentucky schools vary

On Monday, Lexington-Fayette County Public Health Commissioner Kraig Humbaugh recommended universal masking for staff and students in schools that have students under 12, because they are not yet eligible for vaccinations, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. 

Honeycutt Spears reports that 17 people signed up to speak at the county school board meeting Monday, mostly to oppose mask wearing and other restrictions in schools. The school board met with the health department Tuesday to discuss plans for the fall, WKYT-TV reports.

Jefferson County Public Schools Supt. Marty Pollio said he would recommend to his board Tuesday that it require universal masking, and WLKY-TV reported that four of the seven members agree with him.

The board of Frankfort Independent Schools, meeting Monday, accepted Supt. Houston Braber's recommendation to begin the school year with universal masking, Linda Younkin of The State Journal reports. Barber said he would revisit the issue every two weeks, with decisions based on data.

Last week, Boone County Schools said it would not mandate masks for students and staff, though they are recommended regardless of vaccination status. The school board said it reserved the right to change its mind based on the levels of infection in the school and community, Fox19 Now reports.

The Bowling Green Independent Schools and the surounding Warren County Pubic Schools will also not require masks for students, Aaron Mudd reports for the Bowling Green Daily News. Logan County Schools say likewise, though the county has a high infection rate and is only 40% vaccinated.

Statewide, just over half of Kentucky's population has received at least one dose of a vaccine. Vaccinations are picking up, rising to 7,579 per day over the last seven days. That's a 28% increase from the previous week, according to CDC data processed by The Washington Post.

Daily numbers keep rising

Vaccinations aren't rising as fast as cases of the virus. Kentucky reported 1,273 new cases Tuesday, the biggest daily number since Feb. 23, when the winter surge was winding down. That raised the seven-day average to 918, the highest since March 5. The positive-test rate is 8.11%, the highest since Feb. 5.

Kentucky hospitals reported 520 Covid-19 patients, the most since March 12; 175 are in intensive care and 83 of those are on mechanical ventilation.

The number of counties in Kentucky with transmission rates considered critical has been increasing daily; 28 of the 120 counties are in the "red zone," for counties with more than 25 daily cases per 100,000 residents over the last seven days.

Vaccines still offer much protection

While vaccinated people can get infected and spread the virus to others, many more infections are in unvaccinated people, Walensky said. 

"The highest spread of cases and severe outcomes is happening in places with low vaccination rates and among unvaccinated people," she said, making it more important than ever for people to get vaccinated.

The CDC eased masking rules in May, saying fully vaccinated people no longer needed to wear a mask in most settings. But the  new guidance says in areas of high transmission, fully vaccinated people do need to mask up. 

Walensky noted that the Delta variant only represented 1% of cases in May, but now represents at least 83% of them. The guidance issued in May was also made at a time when cases were dropping and more people were getting vaccinated. 

The CDC's latest guidance also recommends that community leaders encourage vaccination and mask-wearing to prevent further outbreaks in areas of substantial and high transmission. 

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Appalachian Food for Health, a diabetes prevention virtual program, is scheduled for from 10 a.m. to noon Friday

The second annual "Appalachian Food for Health" virtual event, focusing on diabetes prevention, is scheduled from 10 a.m. to noon Friday, July 30. Click here to register.

The event is hosted by Shaping Our Appalachian Region, the Foundation for A Healthy Kentucky, and the Community Farm Alliance. 

The virtual discussion will be led by Martha Yount and Jann Knappage, who will provide an overview of the Nutrition Education Program hosted by the University of Kentucky.

Attendees will also learn about eating and cooking healthy while on a budget from Sabrina McWhorter, lifestyle blogger and founder of Eat Wild Appalachia.

Following the presentations, there will be two breakout rooms highlighting policy and programming.

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Beshear strongly recommends in-school masking; coronavirus infections and Covid-19 cases in ICUs have doubled in 10 days

Kentucky Health News graph from initial, unadjusted daily reports; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear issued what he called "strong recommendations" Monday for all students and teachers not vaccinated against the coronavirus to wear masks during the upcoming school year, and said schools that want to "optimize safety" should have all students and employees wear masked. 

“If we truly want as many in-person classroom days [as possible], these are steps that school districts will need to take,” Beshear said at a news conference. He said school officials' decisions should be driven by "what gives us the best chance to have our kids in school the maximum number of days in the midst of a pandemic? That is it, folks; that should be our North Star." 

The mask guidance specifically pointed to children under 12 because they are not able to be vaccinated yet. Beshear said he expects vaccines will be available to them in the fall or winter. 

Asked if his recommendations will become mandates if the surge in virus cases continues, Beshear said that nothing is off of the table.  

"I'm not gonna take anything off the table when it comes to the health of our people," he said, adding that he expects school districts will do the right thing if there are outbreaks, as they have in the past. 

Asked about the politics of this decision, Beshear said, "This is a moment where we need the courage of some really great elected officials out there: superintendents, board members." Superintendents are chosen by school board members.

"We're not asking all that much when you look at keeping kids in school and protecting them, and we need the buy-in from those local school districts. . . .  And yes, that may mean that you've got to go through some tough school-board meetings, but it's the right thing to do. That's what you signed up for." 

Education Commissioner Jason Glass also called for the courage and leadership by educators to follow the governor's guidance: "We need to call again upon your professionalism and dedication to continue many of those same mitigation efforts from this past spring to keep our schools open and safe for in-person learning."

Ten days earlier, the state recommended that people who aren't fully vaccinated wear masks in schools, and that use of masks by everyone should be considered in schools that have students who can't be vaccinated, low vaccination rates, or "inability to monitor the vaccine status of students and/or teachers and staff."

Now, rather than talking about knowledge of vaccination status, the state has shifted to testing. It is offering a federally funded testing program for grades K-12. The voluntary program is being offered in partnership with the Centers for Disease Control and Prevention and it will be up to schools on how to use it.

Kentucky Health News graph from state data; to enlarge, click on it.

Daily numbers: The recommendations come as every metric used to measure the coronavirus in Kentucky is worsening, including cases, positivity rate, hospitalizations, intensive care and ventilator use.  

The state reported 783 new virus cases Monday, bringing the seven-day rolling average to 886, more than double what it was 10 days ago. The share of Kentuckians testing positive for the virus is 7.89%. In the state's Monday-to-Sunday reporting weeks, those rates have risen four weeks in a row. 

Kentucky hospitals reported 486 patients with Covid-19, more than double the number of 12 days ago; 159 are in intensive care, a number that has more than doubled in 10 days; and 71 of those are on a ventilator, a number that has more than doubled in eight days.

Stack said since July 1, the weekly case numbers and positivity rate have quintupled and the hospitalizations, intensive care unit admissions and ventilator use have tripled. He said health-care providers are already exhausted and that from their view "This is entirely a preventable tragedy." since vaccines are available. 

Vaccinations: As virus cases have surged, vaccinations have increased, but only slightly. In the reporting week that ended Sunday, Kentucky averaged 6,766 vaccinations a day, 15% more than the week before, according to CDC data compiled by The Washington Post.

The state says 2.3 million Kentuckians have received at least one dose of a vaccine, 51.5% of the population; 45.3% have been fully vaccinated. Of those 12 and older, 60.4% have received at least one dose.

The lowest vaccination rates rates continue to be among Kentuckians under 50, with those 40-49 hovering at 52%. "We all need to do better," Beshear said. 

Stack displayed an updated version of a graph showing that unvaccinated Kentuckians are infected at a rate of 5:1 when compared to vaccinated people in Kentucky. 

State Dept. for Public Health graph shows cases declined as vaccinations increased, until the stronger Delta variant became dominant and caused infections in some people who had been vaccinated.

He also stressed the safety of the vaccines in the face of several myths: "Let me be very, very clear. There is no debate here, there's no two sides of the story here, there is fact, and there is fallacy . .. They do not damage your fertility . . . There are no magnets in these vaccines. . . .  Those persons peddling in those falsehoods are killing people, and it is a tragedy. These vaccines work. They are safe." 

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Somerset doctor says spread, strength of Delta variant mean it's too late to 'vax it or mask it'; both needed in high-spread areas

By Kevin Kavanagh

Republished from Infection Control Today

Dr. Jerome Adams, surgeon general in the Trump administration, said this month that the guidelines the Centers for Disease Control and Prevention issued in May on removing of masks were “premature” and “wrong.” Two years ago, most would not believe such a statement, but after the last year and a half, Adams’s statement is viewed by many as just another instance of misguided policy from the CDC. At issue was the May 14 policy reversal of no longer requiring vaccinated individuals to wear masks. The CDC stated it was based solely on science. However, many felt that this would open the door for no one to wear masks. Unfortunately, this is what appears to have happened.

Kevin Kavanagh, M.D.

Then came the Delta variant, virus which is up to 2.25 times as infectious as the wild type virus and has a higher replication rate producing 1,000 times more virons. In addition, it appears to be able to evade immunity. Israel reports vaccine efficacy has dropped to 64% in preventing symptomatic disease, down approximately 30 percentage points. Thus, there is concern that even vaccinated individuals can develop symptomatic diseases and may spread the virus. Most agree that the vaccines are effective in preventing deaths and hospitalizations, but even mild to moderate disease carries the risks of long Covid-19.

Thus, neither masks nor vaccinations will truly afford safety in areas where there is high viral spread. Each is a layer of armor and all need to do both until this virus dissipates.

The CDC and our federal response cause concern. In 2020, advisements on masking were reversed once asymptomatic spread was identified. In the public’s eye, this was held by many to be a sign of incompetence rather than evolving science. But since then, there have been a number of missteps in dealing with the coronavirus, SARS-CoV-2.

The rapidity of viral spread around the world, along with case reports from choirs, restaurants, and hospitals made an extremely strong case for aerosolization of SARS-CoV-2 -- so strong that 239 international scientists asked the World Health Organization and other public-health organizations on July 6, 2020, to recognize aerosolized spread of the virus. The National Academies of Science issued an expensive report on SARS-CoV-2 airborne transmission in October 2020. On Feb. 15, 2021, warnings were sent to the White House, CDC and the National Institutes of Health regarding SARS-CoV-2 aerosolization by 12 prominent infectious-disease authorities. Their letter called for strengthening of CDC guidelines for small-droplet spread with attention to the provision of respirators (N-95 masks) to workers and those exposed to SARS-CoV-2 aerosols.

But it took until May 6 for the CDC to recognize that airborne transmission can be a major spread of the virus. Ironically, a week later the CDC removed the masking requirement for those who are vaccinated, making the need for N-95 masks much less. Others are starting to follow former Surgeon General Adams’ advice. On July 19, 2021, the American Academy of Pediatrics recommended that all children over the age of 2, regardless of vaccination status, wear masks in schools this fall.

One of the safeguards which was present in 2020 was the presence of civilian scientists on the White House Coronavirus Task Force. However, on January 20, President Biden dissolved his Covid-19 transition task force, removing non-governmental employees, including some who later signed the Feb. 15 letter.

Needless-to-say, early recognition of aerosolization would require the use of N-95 masks and make upgrading ventilation systems an imperative. Proper interventions require infrastructure changes and allocation of significant resources. We also need to implement a comprehensive system of genomic sequencing of viral specimens to track community spread. Throughout this pandemic testing has been woefully inadequate in the United States, unless of course you are a member of a professional sports team.

All of these advisements tend to mitigate the seriousness of SARS-CoV-2 and lessen the need for interventions. We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen. We need to treat respiratory pathogens with the same vigor and diligence we put forth to prevent water, surface and foodborne disease.

The advice that you’re safe if you “vax it OR mask it” no longer holds with the Delta variant. We must do both. We also need to be taking this virus seriously. We need to remember that many civilizations in the past have been brought down by infectious disease, and species have gone extinct. What separates mankind from the rest of the biosphere is our intelligence and ability to leverage science. If we do not do this, we are in no better position than a tadpole. Unfortunately, almost all of our leaders appear to be hoping the virus will miraculously disappear. This did not work last year, and it will not work in 2021.

Kevin Kavanagh of Somerset is a retired physician and founder of Health Watch USA.

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Here are answers to frequently asked questions about the coronavirus, the Covid-19 disease and the vaccines

MedPage Today illustration

By Melissa Patrick
Kentucky Health News

One of the many challenges facing Kentuckians who remain unvaccinated against the coronavirus is that they still have unanswered questions about vaccines, some based on facts and others based on myths. This story is an attempt to sort through some of those questions and to counter misinformation. 

This information is not only for the unvaccinated. Kentucky Health News encourages individuals who have already been vaccinated to use it as a resource when talking to their loved ones about getting vaccinated, since friends and family have proven to be highly influential in persuading them to do so.  

Covid-19 is no worse than the seasonal flu, right? Wrong. While influenza and Covid-19 are both contagious respiratory illnesses, they are caused by different viruses. Covid-19 appears to be more contagious and to spread more quickly, and is more deadly. Preliminary estimates from the Centers for Disease Control and Prevention are that the U.S. had 38 million flu cases and 22,000 deaths from it in the 2019-20 flu season, for a death rate of 0.06 percent. The U.S. has had nearly 34 million confirmed cases of the coronavirus and nearly 607,000 deaths from Covid-19, for a death rate of 1.79%. In Kentucky, there have been 473,503 cases and 7,308 deaths. a death rate of 1.54%.

Kids don't get it, do they? Yes, they do. Children can be infected with the virus, and can get sick from Covid-19 and spread the virus to others without knowing they have it. In Kentucky, 15.5% of cases have been in people under 20. Most children have mild symptoms or no symptoms, but some have become severely ill from the disease and a few have died. They can also get a rare but serious condition, Multisystem Inflammatory Syndrome in Children, that sometimes doesn't show up until weeks after the infection. Kentucky has had more than 50 reported cases, according to the CDC. The more contagious variant of the virus that recently became dominant seems to affect them more; the American Academy of Pediatrics and Children's Hospital Association's weekly Children and Covid-19 State Data Report says more than 23,500 child cases of Covid-19 were reported between July 8 and 15, nearly double what was reported in late June. 

These vaccines were developed very quickly; how can we be sure that they have been fully researched and proven? The vaccines were developed, tested and given emergency-use authorization in under a year, thanks to years of previous research on related coronaviruses. Researchers had also been working on the technology for years and the timing, and federal funding by Congress and the Trump administration allowed companies to run multiple trials at the same time, saving lots of time. Surgeon General Vivek Murthy said on Twitter, "There were no corners cut in making these vaccines, what was cut was actually red tape."

Chart from University of Kentucky College of Medicine; for a larger version, click on it.

Then why haven’t they been permanently licensed? There has always been a long, deliberate process at the Food and Drug Administration to fully approve a drug, involving a review of much more data over a longer time than is required for emergency use authorization. The FDA has until January to review the materials, but has said it expects to make a decision on full approval within two months. 

Why hasn't the military required them? It appears that they are waiting on the full approval of the vaccine by the FDA before doing so. At this time they are voluntary. The Army has directed commands to prepare to administer mandatory Covid-19 vaccines as early as Sept. 1, pending full approval of the FDA licensure, reports Army Times. The Navy also recently told sailors to expect a mandatory vaccination program as soon as final approval is granted.

Does this new type of vaccine change your DNA? "Covid-19 vaccines do not change or interact with your DNA in any way," the CDC says. The new types of vaccines deliver instructions "to our cells to start building protection against the virus that causes Covid-19." Johns Hopkins University says, "The messenger RNA from two of the first types of Covid-19 vaccines does enter cells, but not the nucleus of the cells where DNA resides. The mRNA does its job to cause the cell to make protein to stimulate the immune system, and then it quickly breaks down — without affecting your DNA." 

What are the issues with the Johnson & Johnson vaccine? Is it still recommended? In April 2021, the J & J (Janssen) single-dose vaccine was paused while the FDA and the CDC investigated a very small number of cases of blood clots in people who had received it, nearly all of them adult women younger than 50. The FDA and CDC recommended that administration of the vaccine could safely resume. 

In July, the FDA added a new warning about the J & J vaccine because it was linked to a rare neurological condition, Guillain-Barré syndrome. Preliminary research found 100 people, out of more than 13 million U.S. doses, who had developed the syndrome after receiving the vaccine; one died and 95 were hospitalized. The FDA said in a news release that after evaluating the information it has determined that “the known and potential benefits” of the vaccine “clearly outweigh the known and potential risks.”

What are the side effects? The most common side effects are pain, redness and swelling on the arm where you got the shot. Other side effects are tiredness, headache, muscle pain, chills, fever and nausea. Side effects after a second shot may be more intense. There have been two confirmed cases of the rare blood clot following the Moderna vaccine, out of 137 million doses.

Serious adverse reactions after a coronavirus vaccination are rare, says the CDC. Anaphylaxis, which can occur after any vaccination, is severe and has occurred in 2 to 5 people per million vaccinated in the U.S. Clinics keep people 15 minutes after the shot to make sure they don't have a reaction.

As of July 19, there have been 1,148 reports of myocarditis or pericarditis among people 30 and younger who received a coronavirus vaccine. Most cases have followed the Pfizer or Moderna vaccine, particularly in male adolescents and young adults. The CDC has confirmed 674 cases; almost 340 million doses have been given, mostly the two-dose vaccines.

Will I need a booster shot? Boosters are common for many viral infection because the vaccine effect may wane. There is concern that the vaccines won't offer sufficient protection against new variants and that high-risk individuals, including seniors, who have weaker immune systems, will need them, Medical News Today reports. The CDC and FDA say they are “prepared for booster doses if and when the science demonstrates that they are needed.”

I don't need a vaccine if I've already had the coronavirus, do I? The CDC recommends that those who have been infected with the virus should be vaccinated because we don't how long or strong the resulting immunity is. "While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of reinfection is low in the months after initial infection but may increase with time due to waning immunity," the CDC says. 

I got fully immunized, but then got infected. How did that happen? No vaccine is 100% effective, health officials say. The Pfizer and Moderna vaccines are about 95% effective in preventing Covid-19 in those without prior infections. The Johnson & Johnson vaccine has a 72% overall efficacy rate and an 86% efficacy against severe disease in the U.S. Research is still ongoing to determine the effectiveness of each vaccine against the Delta variant, but so far most studies show that they are protective, especially against severe illness and death. Healthline reports on a number of studies that support the effectiveness of the three approved vaccines against the Delta variant. 

A study published in the New England Journal of Medicine found that after two doses, the Pfizer vaccine was 88% effective against the highly contagious Delta variant, compared with 31% after one dose. Health officials told The Washington Post that the Moderna vaccine likely offers a similar level of support. Some small studies show that the J&J vaccine is effective against Delta and other variants, but a New York University study that has not been peer-reviewed, shows that it is far less effective against Delta other variants than earlier strains, Forbes reports.

Why are we hearing so much about the Delta variant? It is now by far the dominant strain in the U.S. and Kentucky, and is reported to be about 225 percent more transmissible than the original strain of the virus. 

Chart from UK College of Public Health; click it to enlarge.

People who are not fully vaccinated are most at risk from the Delta variant. Also, a low vaccination rate in a community creates an opportunity for local outbreaks that have the potential to overwhelm the health-care system. Unvaccinated people, those who work in the public, and those who are considered high-risk are encouraged to wear a mask in indoor spaces. Some health officials say everyone should be doing so, especially in places with rising rates of infection. Children under 12 have not been approved for a vaccine, so they are also considered high-risk.

It's important to remember that unvaccinated people are places for the virus to mutate even more, perhaps into even stronger variants. At Fort Bragg, N.C., Force Health Protection Officer Lt. Col. Owen Price, said on a podcast that we are "one mutation away from kind of rolling back down the hill." He added, "I know everybody is Covid-spent, everybody’s over it. But we have to get to a point where there’s no safe haven for the virus to go, and we’re only going to do that through vaccination — and if we don’t get there, we’re going to back-slide."

Can vaccines affect fertility? "The Covid-19 vaccine will not affect fertility," say physicians at Johns Hopkins University in Baltimore. They said the myth sprang from a false report on social media that the Pfizer and Moderna vaccines would affect not only the spike protein on the surface of the virus, but another spike protein that is involved in growth and attachment of the placenta in pregnancy. "The two spike proteins are completely different and distinct, and getting the Covid-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods," the doctors say. The CDC says, "There is currently no evidence that Covid-19 vaccination causes any problems with pregnancy, including the development of the placenta. In addition, there is no evidence that female or male fertility problems are a side effect of any vaccine, including Covid-19 vaccines."

What about microchips? There are no microchips or any kind of device in the vaccines, but this hasn't stopped about one in five people from thinking it's true. First and foremost, it is physically impossible; James Heathers of The Atlantic examined the notion in detail. A related myth is that the vaccine can make you magnetic. The CDC says, "Covid-19 vaccines do not contain ingredients that can produce an electromagnetic field at the site of your injection. All Covid-19 vaccines are free from metals." 

Where can I get more information? And how do I tell truth from deception? The Immunization Action Coalition provides a list of questions you should ask when evaluating health information online, such as the original source of the information and who manages it. The University of California-San Francisco offers tips on how to find credible sources of health information, including red flags to watch for, including outdated or anonymous information, possible conflicts of interest, one-sided or biased information, if there is a claim of a miracle or a secret cure, or if no evidence is cited.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Beshear honors health-care workers at Morehead

A screenshot of the crowd showed at least one masked person, at far left. (WKYT; click to enlarge)

Hundreds of front-line health-care workers gathered at St. Claire Regional Medical Center in Morehead Wednesday night to get thanks from Gov. Andy Beshear and others for their work during the pandemic.

“You all engaged in one of the most remarkable acts of heroism that I've ever seen,” Beshear said, speaking in the past tense – though he said the next day that the recent surge of coronavirus cases poses the prospect that the health-care system in some places could be overwhelmed.

Showing emotion, Beshear said, “The hardest thing I've ever done in my life is to read out the ages and the counties and the genders of those we lost over and over every day. But I showed up every day because I didn't want anybody else to have to do that. But you were sitting there holding their hands and you knew their names and you were going to talk to their family members. And that is something so special that we needed you for above and beyond your regular jobs. You are all super-heroes.”

The state no longer lists the age, sex and county of Kentuckians who die from Covid-19. Deaths are averaging fewer than four per day; two months ago, the average was about eight per day.

Dr. Steven Stack, who became state public-health commissioner about a month before the pandemic hit, told the workers, "Up until March last year, I would have been in an emergency department. I would have been on the front lines with all of you. So as much as this has been difficult and hard, and as much as I've had this incredible privilege to get to serve with and advise a governor and support a state, it does feel in a way like I've been on the sidelines throughout this. Because I would have been in the Emergency Department with all of you. So I want to thank you very much for what you have done.”

The local star at the event was Beshear's senior adviser, Rocky Adkins of Sandy Hook, who was a state representative in the area for many years before challenging Beshear in the 2019 gubernatorial primary. He tearfully thanked St. Claire employees for helping his father, then 84, survive Covid-19 last year.

“My father started his journey of whipping Covid at St Claire,” Adkins said. “If any of you are in this room that treated my father, thank you from the bottom of my heart because I want to report to you your good work. My father has fully recovered. My father is on a tractor. My father is plowing, disking, and raising a half-acre garden and doing it without any oxygen whatsoever. My father is healed because of your good work, and I appreciate that from the bottom of my heart.”

Nikita Gibbs, a registered nurse who has worked at the Morehead's coronavirus testing site every day received a "Service Above Self" award. “She has seen over a hundred thousand nostrils, and she is exposed herself almost 3,000 times to Covid-positive patients. We all know her as the girl and scrubs the wears cowboy boots.”

"Gibbs said the journey has been a difficult one," reports Karyn Czar of WUKY. "But like all her counterparts, one she felt called to do." She told Czar, “It was definitely pretty terrifying at first because I do have a four year[-old] now at home, and she's my pride and joy. So taking that home to her, I was definitely on edge about that. I just wanted to make sure that I help serve my community and the best way that I could.”

Gibbs and other health professionals told Czar that the best way you can thank them is by getting vaccinated. “I really encourage you to get vaccinated, because it is not just for you but the people around you and your loved ones … All my family is vaccinated,” Gibbs said. “I have strongly supported it. Every friend that I talk to, I strongly support getting it.”

Few masks were visible at the event. Beshear said at his press conference the next day that everyone wore a badge saying they had been vaccinated for the virus.

Information for this story was also gathered from WUKY and WKYT.

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130 rural health clinics in Kentucky will get federal money to increase confidence in safety of the coronavirus vaccines

The U.S. Department of Health and Human Services is sending $100 million to more than 1,980 rural health clinics for outreach efforts meant to increase locals' confidence in the safety of coronavirus vaccines, according to a press release. The list has 130 clinics in Kentucky.

David Bolt

Through the Rural Health Clinic Vaccine Confidence Program, clinics can publicize vaccination sites and partner with other public-health entities to create strategies to increase vaccine confidence. Clinics can also use the funding to improve health literacy on vaccines in general. "Compliance is governed by Health Resources and Services Administration rules and regulations, just like any other HRSA grant,” Kentucky Primary Care Association CEO David Bolt told Kentucky Health News.

"This funding is vitally important to Covid-19 vaccination efforts in local communities," Bolt said. "Trusted medical providers at our rural health clinics talk to their patients every day about the safety and effectiveness of the Covid-19 vaccines. Having additional resources will help them reach even more people and further address vaccine hesitancy issues at the community and neighborhood levels."

The funding, announced in May, is part of nearly $1 billion the American Rescue Plan Act authorized for three major programs strengthening pandemic response efforts in rural areas. In addition to the Rural Health Clinic Vaccine Confidence Program, HRSA is providing $460 million to more than 4,600 rural health clinics for coronavirus testing. Another $398 million will go to small rural hospitals for testing and mitigation.

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FactCheck: Origin of the novel coronavirus remains unclear, but U.S. Sen. Rand Paul overstates the case for the Chinese lab

By Lori Robertson and Jessica McDonald

FactCheck.org

At a July 20 U,S. Senate hearing, Republican Sen. Rand Paul and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, once again had a testy exchange over whether the U.S. funded gain-of-function research in China, with each man accusing the other of “lying.”

Gain-of-function research is defined by the U.S. government generally as aiming to “increase the ability of infectious agents to cause disease by enhancing its pathogenicity or by increasing its transmissibility.”

Paul also suggested that the research was tied to “4 million people dying around the world” from Covid-19, but then backed off the implication, saying, “No one’s saying those viruses” studied in the paper in question “caused it.”

Fauci and Paul sparred at a Senate committee hearing.

Most of the exchange was like a flashback to the clash between the two men at a May 11 Senate hearing, which we’ve written about. But the senator also made a false claim about theories on the origins of the SARS-CoV-2 virus, which causes Covid-19.

Paul said that “all the evidence is pointing that it came from the lab,” but there is no evidence linking the novel coronavirus to a lab — only speculation. As we’ve explained, many scientists with expertise in coronaviruses consider a lab escape unlikely and a natural spillover of the virus from an animal to a human the most likely scenario, based on the data we have so far. Several of those scientists summarized their reasoning in a July 7 paper, which has not yet been peer-reviewed.

We’ll recap here what we’ve written about the contention between Paul and Fauci. For more, we refer readers to our two stories on these topics: “The Wuhan Lab and the Gain-of-Function Disagreement” and “The Facts – and Gaps – on the Origin of the Coronavirus.”

Gain-of-Function

As we wrote in May, there’s no dispute that some U.S. funding went to China’s Wuhan Institute of Virology. The disagreement is over whether the research the lab conducted with the money was gain-of-function research.

Nearly $600,000 from a National Institutes of Health grant to the U.S.-based EcoHealth Alliance went to the Wuhan lab, a collaborator on the six-year project to study the risk of the future emergence of coronaviruses from bats. The grant was canceled in April 2020.

The NIH, EcoHealth Alliance and the lead researcher in Wuhan all say the experiments weren’t gain-of-function, and there’s no evidence that Fauci lied to Congress, as Paul asserted in the July 20 hearing, given that the NIH unequivocally backs up Fauci’s statement that the grant-backed research “was judged by qualified staff up and down the chain as not being gain-of-function.”

In a May 19 statement, NIH Director Dr. Francis S. Collins said that “neither NIH nor NIAID have ever approved any grant that would have supported ‘gain-of-function’ research on coronaviruses that would have increased their transmissibility or lethality for humans.”

Scientists have differing opinions on what counts as gain-of-function research, however, and which experiments would yield valuable insights into pathogens and how to combat them, and which are not worth the risks.

Paul cited Richard Ebright, a professor of chemistry and chemical biology at Rutgers University and a critic of gain-of-function research, who disagrees with the NIH. Ebright has said that the EcoHealth-Wuhan lab research “was — unequivocally — gain-of-function research.” And Paul cited a 2017 paper, published in the journal PLOS Pathogens, partly thanks to funding from that EcoHealth Alliance grant.

The paper was published shortly before the U.S. government lifted a three-year pause on gain-of-function research “that may be reasonably anticipated to confer attributes to influenza, MERS, or SARS viruses such that the virus would have enhanced pathogenicity and/or transmissibility in mammals via the respiratory route,” per the White House’s 2014 announcement.

On July 20, Paul addressed Fauci: "This research matches, indeed epitomizes the definition of gain-of-function research, done entirely in Wuhan, for which there was supposed to be a federal pause. Dr. Fauci, knowing that it is a crime to lie to Congress, do you wish to retract your statement of May 11th, where you claimed that the NIH never funded gain-of-function research in Wuhan?"

Fauci replied, "Senator Paul, I have never lied before the Congress, and I do not retract that statement. This paper that you were referring to was judged by qualified staff up and down the chain as not being gain-of-function."

Again, the NIH says the EcoHealth grant didn’t fund gain-of-function research. “No dispensation was needed as no gain-of-function research was being conducted,” a spokesman for EcoHealth told us.

The 2017 paper, authored primarily by Wuhan Institute of Virology researchers including Shi Zhengli, determined that bat coronaviruses in a cave in Yunnan, China, had “all of the building blocks” of the SARS coronavirus, which caused an outbreak in 2003. Shi is famous for her work tracking down the origins of the SARS epidemic.

The authors “speculate that the direct ancestor” of the SARS virus may have been a result of recombination — or the natural combining of genetic material — of precursors of these bat coronaviruses. And the authors found that the bat coronaviruses had the potential for direct transmission to humans.

A few of their experiments combined different elements of viruses to better understand what’s required to infect human cells. Specifically, the 2017 research used the backbone of WIV1, a bat SARS-like virus reported in 2013, and swapped in the spike protein of two newly identified bat coronaviruses to see if they, like WIV1, can use the human ACE2 receptor to enter human cells. The researchers found that both chimeric viruses could use ACE2 to infect and replicate in human cells in culture. (The researchers attempted to make six other chimeric viruses, but when put into monkey cells the viral constructs did not replicate.)

Is that gain-of-function? Again, there are different definitions and opinions on that. We reached out to the NIH asking for a more detailed explanation of why the 2017 paper didn’t meet its definition, and we’ll update this story if we get a response.

Dr. Stanley Perlman, a professor of microbiology and immunology at the University of Iowa who studies coronaviruses, told us that in the type of research conducted under the EcoHealth grant “these viruses are almost always attenuated,” meaning weakened. He also said that making a virus that could infect human cells in a lab doesn’t mean the virus is more infectious for humans. Viruses adapt to the cell culture, he said, and may grow well in a cell culture but then not actually infect animals very well.

For her part, Shi told The New York Times in June that her lab had never conducted experiments “that enhance the virulence of viruses.”

Origins of SARS-CoV-2

In the July 20 hearing, Paul, again tied the U.S. funding of the Wuhan lab to the origin of the SARS-CoV-2 pandemic, and after the hearing, the hashtag #FauciLiedPeopleDied began trending on Twitter. But as Fauci correctly said, there’s no evidence the lab had a coronavirus that could possibly be manipulated enough to lead to the SARS-CoV-2 virus, according to several experts. Paul then said he wasn’t implying that.

Here’s part of that exchange:

Paul: "It’s a dance, and you’re dancing around this because you’re trying to obscure responsibility for 4 million people dying around the world from a pandemic."

Fauci: "I have to … well, now you’re getting into something. If the point that you are making is that the grant that was funded as a sub award from EcoHealth to Wuhan created SARS-CoV-2, that’s where you were getting. Let me finish. …"

Paul: "We don’t know if it didn’t come from the lab, but all the evidence is pointing that it came from the lab, and there will be responsibility for those who funded the lab, including yourself. …"

Fauci: "I totally resent the lie that you are now propagating, senator, because if you look at the viruses that were used in the experiments that were given in the annual reports that were published in the literature, it is molecularly impossible."

Paul: "No one’s saying those viruses caused it. No one is … We’re saying they are gain-of-function viruses, because they were animal viruses that became more transmissible in human and you funded it. And you won’t admit the truth. …"

Fauci: "And you are implying that what we did was responsible for the deaths of individuals. I totally resent that."

Paul: "It could have been. It could have been."

Fauci: "And if anybody is lying here, Senator, it is you."

There’s no evidence that the Wuhan laboratory, with or without funding from an NIH grant, created SARS-CoV-2.

Many scientists remain open to a lab escape of a natural virus, but fewer entertain the notion that SARS-CoV-2 was engineered. While this cannot be ruled out entirely, multiple coronavirus experts view this as implausible. And the only way SARS-CoV-2 could have come from the lab, whether manipulated or a naturally occurring virus, is if the Wuhan lab was in possession of a virus much more similar to SARS-CoV-2 than the coronaviruses that have been identified.

Robert F. Garry, a virologist at Tulane University School of Medicine, told us a coronavirus would have to be “at least 99%” similar to SARS-CoV-2 and “probably” 99.9% similar “to make that kind of switch in the lab at all.”

“There’s just no evidence,” he said, that the Wuhan Institute of Virology “had anything close to that.”

Shi announced in late January 2020 that a bat virus the lab named RaTG13 shares 96.2% of its genome with SARS-CoV-2, which is the highest percentage of any known virus. But experts say speculation that RaTG13 could have been changed to become SARS-CoV-2 is misplaced.

That’s because RaTG13’s genome still differs from SARS-CoV-2 by more than 1,000 nucleotides. “RaTG13 is too divergent to be this ancestral virus,” David Robertson, the head of viral genomics and bioinformatics at the University of Glasgow, told us.

Shi says there is only a genome sequence for RaTG13 anyway — live virus was never isolated from the sample.

Notably, other teams have subsequently found three other bat viruses that are more closely related to SARS-CoV-2 than RaTG13 when factoring in viral recombination — although they, too, are not precursors to the virus.

Paul claimed: “We don’t know if it didn’t come from the lab, but all the evidence is pointing that it came from the lab.” That’s not the case.

“On lab-leak, there’s no evidence that SARS-CoV-2 escaped from a lab other than the coincidence of the Wuhan Institute of Virology being there,” Robertson told us.

Many scientists who study coronaviruses say what data we do have points to a natural spillover as the likely origin, given the presence of similar viruses circulating in bats, the links of many of the first COVID-19 cases to animal markets in Wuhan and past spillover events with other coronaviruses. But without identification of a near-identical virus in a bat or other animal, scientists cannot be completely certain.

FactCheck.org is a nonpartisan, nonprofit that monitors the factual accuracy of what is said by major U.S. political players. It is a project of the Annenberg Public Policy Center of the University of Pennsylvania. The APPC was established by publisher and philanthropist Walter Annenberg to create a community of scholars to address public-policy issues. FactCheck's Covid-19/Vaccination Project is funded by the Robert Wood Johnson Foundation; it says the foundation has no control over editorial decisions, and the conclusions it reaches "do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about Covid-19 and vaccines, while decreasing the impact of misinformation."

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