The worse your case of Covid-19, the worse the 'brain fog' you are likely to suffer; disease has effect even in mild cases

Chart by The Economist shows levels of "brain fog" at different levels of Covid-19 seriousness.

Covid-19 is a new disease that is not fully understood, but new research by American and British scientists shows it causes problems with memory and concentration, often known as “brain fog,” even in mild cases.

The researchers teamed up with the BBC on the "Great British Intelligence Test," an online assessment billed to the public as a way to “test your cognitive strengths.” About 80,000 people "were asked to remember lists of numbers or locations on a chessboard to test their recall," The Economist reports. Other tests measured planning ability, verbal skills, problem-solving and the ability to manipulate information. "Questions about the virus, as well as about demographic factors such as age, ethnicity and socioeconomic status, were asked only after the test had ended."

The test showed that the more serious the disease, the greater the cognitive effect. "People ventilated for different respiratory diseases often face similar cognitive issues, but the performance of those with mild covid-19 symptoms suffered more than would be expected in the event of mild illness," The Economist reports. "Scientists are still unsure how exactly covid-19 is linked to cognitive impairment. . . . It remains unclear how long brain fog takes to clear, or if it does at all. That makes it difficult to estimate the lasting economic and social impact. And it reinforces worries that the health effects of Covid-19 will linger long after the pandemic is tamed."

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Covid-19 hospital, intensive-care and ventilator cases keep setting new records; positive-test rate also jumps to new high

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

By Melissa Patrick
Kentucky Health News

The metrics to measure the coronavirus pandemic continue to worsen, with Covid-19 hospitalizations and use of intensive-care units and ventilators at all-time highs. 

"The Delta variant continues to spread like wildfire," Gov. Andy Beshear said in a Facebook post. Kentucky still has the fourth highest infection rate over the last seven days, according to The New York Times.

Beshear added, "Two weapons can win this war. Number one, everybody's got to get vaccinated. This is still primarily unvaccinated folks either in the hospital or who spread it to someone who is vaccinated and is now in the hospital.

"The second one is masking; universal masking in our schools is a must, or we will get even worse from here. Everybody needs to be wearing a mask when they are outside of their home and indoors."

The state reported 4,548 new virus cases on Tuesday, the 10th largest daily total of the pandemic. The seven-day average went down 13, to 4,219, because last Tuesday had 90 more cases than today.

But the share of Kentuckians testing positive for the coronavirus in the past seven days increased 0.21 percentage points Tuesday, to 13.66%. That one-day increase equaled the total increase of the previous four days. 

The younger the age group, the greater the increase in cases during August. Among Tuesday's cases, 1,407, or 31%, were in Kentuckians 18 and under. 

Hospitals reported 2,274 Covid-19 patients, up 76 from Monday; 617 are in intensive care, up 2; and 406 are on mechanical ventilation, up 22. This is the first time the number of ventilated patients has gone above 400.

If all ventilated patients are in intensive care, 65.8 percent of Covid-19 ICU patients were ventilated on Tuesday, an indicator of how sick the Delta variant is making people. That is far above the average for the month, 50.6%, which is also about the average since Nov. 1.

Ventilator use forecasts deaths, the  lagging indicator of the pandemic. The state reported 23 more Covid-19 deaths Tuesday, bringing the death toll to 7,764. The daily average for the last week is 25.

The daily new-case rate for the last seven days is 89.42 per 100,000 people. Counties with rates more than double that rate are Owsley, 317.1; Clay, 264.9; Bell, 249.1; Whitley, 243.1; Perry, 214.6; Wolfe, 193.6; Leslie, 190.9; LaRue, 181.6; and Powell, 180.3.

Wolfe County schools will close next week due to a high number of cases, making the district at least the 20th to pause instruction in the academic year that recently began.

Again, the only county not in the state's red zone, for counties with 25 cases per 100,000, is Woodford County, the county with the highest vaccination rate.

The seven-day average of vaccinations in Kentucky is 13,902 doses per day, according to The Washington Post. That is 30 fewer than Monday. Only 48.5% of Kentuckians are fully vaccinated, 28th among the states.

"This is the worst the pandemic has been," Beshear said. "Please, at least take the same precautions you did earlier in Covid. Come on, folks. We've got to do this. Do the right thing. Love your neighbor as yourself. Protect one another."

The Kentucky General Assembly will make major decisions on dealing with the pandemic, since the state Supreme Court upheld several new laws it passed to limit the governor's emergency powers. 

Legislators have scheduled committee meetings this week to begin deciding what measures to take, anticipating a special session to enact such laws as early as next week.

Only Beshear can call a special session. He said Monday that he would like to do so before his declared state of emergency for the pandemic expires, which will happen when the court ruling becomes final Sept. 10.

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If you know someone who's taking, or thinking about taking, horse de-wormer to fight Covid-19, please pass this along to them

Cartoon by Nick Anderson

Demand is surging nationwide for ivermectin, an anti-parasitic drug typically used for livestock, based on unsubstantiated claims that it can help Covid-19 patients. How bad is it? A Las Vegas-area feed store is requiring customers to show a picture of themselves with their horse before they can buy it, and the Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institutes of Health have warned against using it to treat Covid-19.

This didn't start with ivermectin. It's largely a function of trust, or lack of it: in government, in science, and in the "elites" believed to control both. When Donald Trump, whom supporters saw as an outsider, cast doubt on top scientists from the beginning of the pandemic, it set the stage for supporters to doubt them when vaccines were released. Trump also advocated for untested Covid therapeutics such as hydroxychloroquine and publicly floated the notion of injecting disinfectants into the body to "clean" the lungs. Some followers listened; hydroxychloroquine prescriptions shot up 900% in 2020, leading to shortages for patients with autoimmune disease. And the day after Trump retweeted a viral video from America's Frontline Doctors claiming hydroxychloroquine cured Covid-19, poison-control centers in many states saw a significant rise in calls from people who had ingested bleach, Lysol and other household cleaners.

Part of the drugs' appeal is that both are FDA-approved to fight other human diseases. Ivermectin is used to treat parasites in animals and humans, but has a long history of being promoted as a panacea for everything from AIDS to autism. Last summer it became popular in Latin America and India for Covid treatment, mostly because doctors didn't have access to a vaccine and believed an experimental treatment was better than nothing.

But the science is inconclusive at best, and leading scientific bodies have said so. The studies ivermectin fans often cite are either far too limited in scale to draw conclusions (which the studies' authors acknowledged), or say ivermectin only shows a therapeutic effect at toxic doses, or are ethically suspect. One study was yanked from a peer-reviewed journal almost immediately because the paper contained unsubstantiated claims and promoted the authors' own ivermectin treatment.

In some cases, courts have forced hospitals to allow Covid-19 patients receive ivermectin. Why not just let them take it? It's not necessarily safe, for one thing: Some people are experiencing violent diarrhea and other side effects from taking it, especially those using the over-the-counter version meant for animals. And putting one's faith in ivermectin may dissuade people from seeking other experimental but approved treatments for Covid-19, such as monoclonal antibodies.

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Every metric to measure the pandemic in Kentucky is worse, and cases in children are rising; vaccination is up, but less than cases

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

By Melissa Patrick
Kentucky Health News

Kentucky reported more Covid-19 cases last week than in any other week during the pandemic, 29,456, and Gov. Andy Beshear said at this point the state is in "exponential growth," with no real end in sight.  

"We don't know where the peak is going to be yet and we ought to be concerned about that," he said at his weekly pandemic news conference. He said the peak will come when "we force it" with more masking and vaccinations.

Beshear said 27,505 vaccinations were given in the last three days, fewer than the number of new cases in that period.

Chart by The Washington Post based on Centers for Disease Control and Prevention data

The governor pleaded again for vaccination and concluded his hour-long news conference by saying, "All we have to do is care about each other . . . to put selflessness above selfishness." He called for "the vast majority of people who want to do the right thing" to talk with unvaccinated friends and family members.

"I need you to have that uncomfortable conversation, and I'm hearing from all over Kentucky from people who have done it," he said. "And it's really that risk of losing the friendship that oftentimes convinces that other person of how genuine you are."

The state also set records for Covid-19 hospitalizations, intensive-care-unit use and ventilators Monday, and Beshear said 58 of the state's 96 acute-care hospitals have critical staffing shortages, up from 50 on Friday.

State Department for Public Health graph

He said more Kentucky children than ever are getting Covid-19, with cases among youth eight times higher than they were last August, going from 2,352 a year ago to more than 18,900 this month. Percentagewise, last August, 11.8% of Covid-19 cases in Kentucky were under 18; this month, it's 24.5%. 

"More kids are getting Covid right now than we ever thought imaginable," Beshear said. 

He said for months, youth and young adults between 10-19 have been getting Covid at a higher rate than other age groups. "These are our school-aged children," he emphasized.

Beshear spoke at length about the need for universal masking in Kentucky's schools, a question the legislature will now decide since the state Supreme Court upheld several laws that limit the governor's emergency powers. 

Senate President Robert Stivers said in an interview broadcast Sunday that he expects the legislature to let local school officials decide mask policy, perhaps within some guidelines.

Asked by Kentucky Health News what parameters would be acceptable for locals to make this decision, Beshear again stressed that universal masking is the "one right answer" but "If they won't do universal masking, but they say we will establish a metric by which if you hit a certain point, you have to and if you're under that you still can. If that's the best we can get,  I'll take it and we'll do the very best that we can from there to try to continue to educate."

Heather Antle, an instructional aide at Lee County Elementary School, died Sunday from Covid-19 and three other employees have been hospitalized from it, the Lexington Herald-Leader reports.

Daily numbers: Beshear reported 4,050 new cases on Saturday, 3,249 Sunday and 2,619 on Monday, with 752 of Monday's cases in people 18 and younger. That raised the seven-day rolling average to new records, but the rise from to Sunday to Monday was only four cases; the average is now 4,232 per day.

The percentage of Kentuckians testing positive for the virus in the past seven days is 13.45%, again the highest since testing became widely available in soring 2020. Beshear said everyone should be tested regularly, since the virus is so widespread and can be spread by people without symptoms.

Hospitals also continue to report record numbers, with 2,198 Covid-19 patients, 615 of them in intensive care and 361 of those on mechanical ventilation.

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

Beshear said 21 children are hospitalized with Covid-19, seven of them in intensive care and three on mechanical ventilation.      

Since Saturday, 56 more Covid-19 deaths have been recorded, with 25 reported on Monday and four of those being people in their 30s. The death toll is now 7,741.

Again, Beshear invited health-care professionals to tell the real stories of how Covid-19 is overwhelming their hospitals, with all of them asking Kentuckians to get vaccinated. 

"That’s the one thing you can do for our community," said Sherrie Mays, vice president and chief nursing officer for Baptist Health Corbin. "The other thing you can do for our community is pray for our patients, and pray for our staff and our physicians that they can be resilient during this pandemic and that we can get through it as quickly as possible."

He said the state has 115 intensive-care beds available and has had to provide ventilators to Advent Health in Manchester, after having done the same last week to TJ Samson Community Hospital in Glasgow.

The statewide new-case rate over the last seven days is 87.53 daily cases per 100,000 residents. Counties with rates more than double that rate are Owsley, 284.7; Clay, 246.9; Bell, 245.9; Whitley, 233.2; Perry, 200.8; Powell, 183.8; and Wolfe, 183.6.

The only county not in the state's red zone, for counties with 25 cases per 100,000, is Woodford County, the county with the highest vaccination rate.

State Department for Public Health graph, adapted and added to by Kentucky Health News

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McConnell keeps urging shots, but avoids comment on others' work and won't repeat that he has 'total' confidence in Fauci

McConnell spoke at the University of Kentucky as
Dr. Mark Newman, head of the hospital, listened. 

By Melissa Patrick and Al Cross
Kentucky Health News

At an event to announce a renewed four-year grant for the Center for Clinical and Translational Sciences at the University of Kentucky, U.S. Sen. Mitch McConnell first congratulated the center, noting that this award is "extremely difficult to get" and then spent the rest of his time talking about the need for more people to take the Covid-19 vaccine. 

"Honestly, my friends, it never occurred to me that we'd have a challenge getting people to take the vaccine, but that's where we are. Ninety percent of the people in the hospital are unvaccinated, we have a crisis of the unvaccinated. And so we're all I think perplexed as to how we tackle this problem. But clearly getting more and more Americans vaccinated is the only way to end it." 

He then went on to encourage people to collectively talk to their friends and relatives and encourage them to get vaccinated. 

Asked why he hasn't pushed back on some in his own party who have helped fuel skepticism about masks and vaccines, McConnell said it "wouldn't serve any purpose to start criticizing others" and said that he has been clear in letting people know what he thinks is the right thing to do, which is to get vaccinated.

McConnell said decisions about requiring employees to get vaccinated need to be left up to employers and school boards. "They can weigh the evidence, look at the effectiveness and make a decision," he said. 

Asked if he had had direct conversations with his fellow Republican lawmakers to nudge them to publicly support vaccinations, McConnell didn't answer directly but said he has been "quite vocal" about his opinions on this matter, so he thinks everybody knows how he feels about it.

In a later press conference at Millersburg, McConnell declined to repeat what he said on July 15, 2020, that he had "total" confidence in Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci has come under fresh attack by Sen. Rand Paul and others in recent months.

Asked the same question, his level of confidence in Fauci, McConnell replied, "Oh, look. I've said, Al, the same thing over and over and over for months. We know the vaccine works, we know this is largely a rising epidemic among the unvaccinated, and without getting into an argument about who's the best health-care adviser out there, it doesn't make any difference. We know the vaccine works, we know the people who are not vaccinated are the ones who are in the hospitals."

At UK, McConnell told reporters that "money is not the problem" when it comes to dealing with the pandemic, including the most recent surge in hospitalizations, pointing to the most recent $1.9 trillion rescue plan passed earlier this year. Instead, he said, "The reluctance of people to get vaccinated is the problem." 

This is the third time the UK center has received federal support for its research, now totaling $65.4 million since 2011. 

With a focus on Appalachia, the center provides support for all types of health research, including pilot funding, training and career development for the next generation of translational researchers, a full spectrum of research support services, community engagement resources, multidisciplinary mentors and connections to local and national research networks, a UK news release said. 

After the pandemic hit, the center established a Covid-19 biobank, launched pilot funding to address issues related to the virus and launched a "hugely successful" Johnson & Johnson vaccination trial that became the top enrolling site in the world for the final trial that led to the emergency-use authorization for the vaccine and paved the way for more Covid vaccine trials.  

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Coronavirus burning through low-vaccinated Breathitt County; 'It's like they're blind ... I don't understand,' local health official says

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Eastern Kentucky couple's deeply held resistance to coronavirus vaccines illustrate difficulty of getting enough people immunized

Kentucky Health News

One reason many Kentuckians are resistant to coronavirus vaccination is people like Josh Stacy.

“I feel there is more to it than just getting a shot,” Stacy told Brandon Roberts of Spectrum News. “The government doesn’t do anything with your best benefit in mind.”

Stacy's feelings about government are common in Kentucky. In a national poll, the state ranked second only to Minnesota in the percentage of people who said they weren't vaccinated or planning to be because they distrust government.

Tomi and Josh Stacy (Photo provided to Spectrum News)

Stacy also has reservations based on religion.

“I’m a Christian, and I also think that this is going to lead to other things,” he said. “I’m not saying this vaccine is the Mark of the Beast, but it can lead to that. It says in the Bible [the Mark of the Beast] will be placed in your right hand or forehead. We haven’t gotten that far yet, but it is leaning that way. You won’t be able to buy or sell anything without the mark.”

Roberts interviewed Stacy, a fellow Pike County native, to localize a story about another national survey that showed rural parents have more reservations about the vaccines than those in cities and suburbs. Stacy, 43, asked that his exact address and occupation not be reported, Roberts told Kentucky Health News.

Stacy "has lived and worked in the mountains of rural Eastern Kentucky his entire life," Roberts reports. "He and his wife, Tomi, are the parents of two daughters, ages 13 and 5. He said none of them have gotten or will get the vaccine. . . . Stacy’s doubts about the vaccine have only intensified recently, as his vaccinated mother and stepfather are currently battling Covid-19."

Stacy told Roberts, “There is not a 100 percent guarantee you will not contract the virus even with the vaccine.” That is true, but unvaccinated people are about four times more likely to catch the virus, and about 10 times as likely to be hospitalized with Covid-19.

Stacy also said, “It’s not like chickenpox, tuberculosis, or anything like that. This virus is man-made, and I feel that the government and certain elites in this country are about population control.” U.S. intelligence agencies have ruled out the possibility that China developed the virus as a bioweapon, "but the agencies failed to reach consensus on the virus origin, according to key takeaways from a classified report delivered to President Biden," The Washington Post reports.

Stacy's concern about the Antichrist ("the beast" in the Book of Revelation) is common in many fundamentalist churches that regard the book as prophetic about modern times, and Kentucky is more religious than most states. "Stacy's faith . . . plays a significant role in his decision not to get the vaccine. Strong adherence to one’s religion is prevalent in rural America, but was not a factor the study considered," Roberts reports for Spectrum News, a service of cable-TV firm Charter Communications.

The study found that rural parents shared the same concerns as parents in cities and suburbs, but to greater degrees. They were 10 percentage points more likely than urban parents to say they were concerned that the vaccines have been tested enough (58% to 48%), nine points more likely to wonder whether the vaccines actually work (51% vs. 42%) and what long-term health effects they might cause (56% vs. 47%), and eight points more likely say they were concerned about how new the vaccine is (52% to 44%).

The survey was conducted online by researchers at Northeastern University, Harvard University, Rutgers University and Northwestern University June 9 through July 7 among 20,669 people, using quotas to reflect race, ethnicity, age, and gender in each state. The data were weighted using data for race, ethnicity, age, gender, education, and residency in urban, suburban or rural areas. It was funded by the National Science Foundation.

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Massie leads 'Freedom Rally' that includes man who says his wife, a UK hospital worker, will quit her job rather than get a shot

U.S. Rep. Thomas Massie, left, and state Rep. Josh Calloway
spoke at the rally. (Courier Journal photo by Scott Utterback)

Opponents of restrictions to fight the coronavirus pandemic, led by Fourth District U.S. Rep. Thomas Massie, rallied at the state Capitol Saturday. The "Freedom Rally" crowd included one man who said his wife, a nurse, is refusing her employer's requirement to get vaccinated and they may leave the state as a result.

"I want to get the masks off the kids," Joseph Mattingly of Lebanon told Munashe Kwangwari of Louisville's WLKY-TV.

Mattingly said his wife works at the University of Kentucky hospital, one of many that recently said employees would have to be vaccinated against the virus. "She's gonna be forced out with these mandates, but she's not going to take the shot. There's no reason she should have to take the shot. . . . If we have to, we'll move out of the state. I don't want to move. That's why we're here. We're willing to fight."

Morgan Watkins of the Courier Journal reports that Massie, a Republican, referred to masks as "face diapers" but acknowledged, "Covid is a serious disease," saying he has known people who died from it. "But there's another disease, another virus, in the state of Kentucky . . . the Beshear virus."

Massie said the original version was Steve Beshear, the Democratic governor's father, governor in 2007-2015, and the state caught the "Andy variant," symptoms of which include "loss of balance in your bank account" and confusion.

Beshear is seeking re-election in 2023, and one Republican, state Auditor Mike Harmon, has already declared for the nomination to face him. The auditor joined other officials in criticizing pandemic restrictions, Watkins reports: "Harmon specifically criticized so-called 'vaccine passports,' a buzzword that basically references some form of verification that a person has gotten vaccinated against Covid-19 and potentially might be required to work or enter restaurants in some places.

Watkins reports that Massie's statements were similar to those he has made. "In recent months, Massie has inaccurately claimed masks are ineffective and has questioned the Covid-19 vaccines' efficacy and necessity, despite medical and public-health professionals' consensus that the vaccines remain safe and effective, especially at preventing hospitalization and death," she reports.

Republican state Reps. Josh Calloway of Irvington, Savannah Maddox of Dry Ridge and Felicia Rabourn of Campbellsburg also spoke to "the crowd of at least 300," Watkins reports. Kwangwari's estimate was 600.

Beshear said in an interview broadcast Sunday on Lexington's WKYT-TV, "We don't have a tool other than vaccinations and masking that can stop this virus. . . . It doesn't impact anybody's liberty. . . . What we don't have is the liberty to spread a deadly virus to other people if we can prevent it."

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Stivers sees legislature returning mask-policy power to school districts, perhaps with guidelines based on status of pandemic

Sen. Robert Stivers (Image from WKYT-TV)

By Al Cross
Kentucky Health News

The Kentucky General Assembly may well let local school officials decide mask policy, rather than follow a state school-board regulation, Senate President Robert Stivers said in an interview broadcast Sunday.

Asked if the legislature would shift the authority for school mandates back to locals, Stivers said, "I can see that very seriously happening, because we've had certain school systems where you have had very successful responses without a mask mandate."

Local school officials "understand what needs to be done, whatever that may be, in their district . . . and do it in a responsible fashion," Stivers said on "Kentucky Newsmakers" on Lexington's WKYT-TV. But he said the legislature might require certain measures depending on the local status of the pandemic.

"You might see protocols that say, as long as you're at this stage, it is a local level, but if it gets above a certain area you have certain guidances that you have to follow," he said. 

The legislature has power to kill the emergency regulation that the Kentucky Board of Education issued Aug. 12, requiring all students and staff in public schools to wear face coverings for the rest of the school year.

On Aug. 10, Beshear, who appointed all members of the board, issued a broader mandate for all schools, saying so few districts had required masks that the threat of contagion and ability to maintain in-person instruction was in danger. He withdrew it after the state Supreme Court upheld laws limiting his emergency powers.

Now the Democratic governor and leaders of the Republican-controlled legislature are discussing a new legal framework for dealing with the pandemic, to be passed in a special legislative session Beshear would call.

When the state recorded 65 deaths Wednesday, the second most of the pandemic, Beshear said that if not for the court ruling, he would have reinstated the statewide mask mandate that he ended in June. Stivers quickly said there is little legislative support for such a broad mandate, and said likewise in the interview.

"If you're gonna do mandates of that nature, they really should be targeted, based on the positivity rate, other things of that nature," he said. "I think at this point in time we ought to be focusing on shots, behavior modification for those individuals who don't want to take the shots."

Only 48 percent of Kentuckians are fully vaccinated against the coronavirus, and resistance to vaccination is strongest in rural areas like Stivers' district: Whitley, Knox, Clay, Owsley, Lee and Wolfe counties.

Stivers has announced a campaign in his home Clay County with 30 local "influencers" urging people to get vaccinated, vaccination clinics at 13 public schools, drawings for cash prizes to be used for sports equipment in the schools with the highest vaccination rates, wrist bands that say "I took the shot" and coupons for free pizza. Stivers has suggested that the campaign could be used in other areas.

Some of Stivers' fellow Republicans have been openly skeptical of vaccinations and masking, and interviewer Bill Bryant told him some people have said politicians need to work as hard to inform people about vaccination as they do at getting elected.

Stivers replied, "Politicians have been somewhat tainted because they've seen this as more of a national political battle than as a local political battle." He said the state needs a vaccination campaign "that removes politicians" and uses more trusted messengers. 

"It would be better for leaders in their communities, be it doctors, be it religious leaders, educators, to step forward with the message," he said, adding later, "There's been a lot of misinformation."

Bryant noted that a pre-filed bill would ban employee vaccine mandates, but Stivers indicated little if any support for that, and implicitly endorsed the vaccine mandates issued recently by hospital chains. He said patients or their families could sue hospitals for "not requiring their people to have shots, knowing that they're dealing with a fragile population," and "Each business needs to look at their policy and set their policy based on what's prudent and reasonable."

Stivers said he expects a special session "at the appropriate time with a measured response," but said it should follow a quick session to redraw legislative districts to conform to the 2020 census, "so we can get that off the board and focus on covid policies and budgets."

The timing and agenda of special sessions is up to the governor, but with their partisan divide, Beshear and legislative leaders are expected to agree on much in advance, such as emergency certifications of health personnel.

The law upheld by the Supreme Court limits governors' emergency orders to 30 days, but Stivers said the legislature could "tier" that authority, allowing certain measures for 30 days, others for 45 days and allowing others to continue until January, when the regular legislative session will begin.

Stivers acknowledged that the public is "extremely divided" on how to tackle the pandemic, but he and Beshear agree on "We need to get shots. how we deal with things after the shots, there may be disagreement."

He said the 10-day limit on non-traditional instruction, which the legislature passed this year, "will have to be revisited" because school districts are already closing temporarily and shifting to NTI because of high case numbers.

Bryant said in introducing the interview that Stivers, "usually careful and deliberate, has handled things in that same cautious way" since the court ruling. House Speaker David Osborne used a similar tone in an email to Kentucky Health News on Wednesday.

"Moving forward, our caucus is going to continue to be deliberate and intentional in how we approach this pandemic," Osborne said, noting that House Joint Resolution 77 in the last session was passed after legislators "evaluated each executive order and emergency regulation issued by the administration to address the pandemic. Ultimately, we ratified the ones that evidence supported were necessary and good. It is our intent to work closely with the administration, hear their recommendations, and work with them as well as other stakeholders to set the policies."

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Most Kentucky faith communities still meet in person, many without requiring masks, and vaccination is a touchy subject

The Rev. Carol Harston leads Highland Baptist in Louisville in communion. (Photos by Bill Campbell)

By Bruce Maples and Melissa Patrick

Kentucky Health News

As the state and nation endure another surge of coronavirus cases, how are Kentucky houses of worship dealing with the pandemic? Has their approach changed from the spring to now? And what are they doing to encourage vaccination? Kentucky Health News reached out to a wide range of them to find out.

In our sampling of faith communities, and parent organizations if they have one, nearly all said the pandemic had taken them through stages, from a full shut-down that lasted months, with all worship services done virtually, to more recently offering in-person services that include a range of social distancing and masking requirements. 

The return to in-person services was prompted by a drop in case numbers and the arrival of vaccines, with all of the faith communities looking forward to the day when they could resume most of their normal activities.

But as the highly contagious Delta variant of the virus caused a spike in new cases, many of these same faith communities are moving back to the more cautionary stages that were seen early in the pandemic, with some again going fully masked. A few are moving back to a full shutdown.

"We were just beginning to get back and now we're going backwards again. . . . It's tightening back up," said Gwenda Bizzle, church secretary at First United Methodist Church in Clinton, near the Mississippi River. 

Commonalities across communities

We were struck by the similarity of responses to the pandemic among leaders of churches, synagogues and mosques, including looking to the Centers for Disease Control and Prevention and the governor's office for guidance, including virtual options for worship. 

They also adapted services to ensure the safety of their members by not passing offering plates, discouraging touch during "passing of the peace," limiting singing, and doing temperature checks. 

Some may be guided by the Kentucky Council of Churches, which meets regularly with the governor's office. It has issued a guide for healthy worship including many of these suggestions.

"We highly recommend that all of our membership listen to and speak to their congregations in accord with recommendations that are put out by the CDC and the doctors who are speaking as far as the help of the state, and and we highly recommended that all peoples be vaccinated that are eligible for it," said Melissa Holland, interim executive director at the council, which comprises 21 denominational organizations, primarily but not exclusively on the more moderate and liberal side of the Christian faith.

Highland music associate Austin Echols leads choir in an
anthem he wrote for returning to worship in the sanctuary.

Only one church in our sample had moved back to virtual-only services: Beaumont Presbyterian Church in Lexington, largely driven by the surge of the Delta variant and a positive-test rate that is the highest it's been since the state started widespread testing.  

"We're going to keep doing this until this surge starts heading in the right direction," said the pastor, the Rev. Stephen Fearing. He added, "Some people might say that we're being overly cautious right now. But we're trying to set the example. I think the church should be a moral example to folks and we really want to set the tone that way." 

Most churches said they provide masks, strongly encourage people to wear them and encourage social distancing, but said they had removed systems that placed six feet of distance between families and now say masks are optional, calling them a personal choice. 

"We are encouraging masks, but we are also saying it is your choice; you are grownups, you are adults," said Senior Minister Larry Wilson at Woodlawn Christian Church in Campbellsville. 

Pastor Vince Farrell at Journey Church of Hopkinsville said mask wearing "is your prerogative. You are welcome here with a mask. You are welcome here without a mask." 

Most of faith communities said such decisions were made by their elders, deacons or church councils, and some had boards or committees that included medical professionals from their membership to offer input.  

Innovative measures 

Some communities have found innovative ways to deal with the pandemic. 

Journey Church uses colored arm bands to indicate a person's level of social comfort. Farrell said 85% of his members use green bands, indicating they are comfortable with fist bumps and hand shakes; 12% use yellow, inviting talking but no touching; and 3% use red, which indicate they would rather not socialize. 

Woodlawn Christian is not enforcing social distancing in the same way it did at the beginning of the pandemic, Wilson said the Campbellsville church is keeping track of where its members are sitting, to help contact tracing if someone gets the virus. 

Pastor Mike Caudill of Hindman First Baptist Church said they recorded more than 20 choir songs while their choir members stood 10 to -12 feet apart and now use those recording during both virtual and regular services.

The Louisville-based Mid-Kentucky Presbytery offered $2,000 grants to churches to help them adapt to virtual worship.

The Chabad House congregation in Louisville made special booths for members so they could pray without risking their health. The prayer booths are transparent (from the waist up) so congregants can see others and feel a sense of community, yet still be protected. Another synagogue is doing funerals in person, but only at gravesides. 

Rev. Jim and Mary Helen England at Highland.

What about vaccinations?

Parent organizations, who do not oversee most of the congregations in Kentucky, offered a list of ways they encouraged people to get vaccinated.

They have encouraged congregations to sponsor vaccine clinics and several have done so, and pastors have been encouraged to mention "God's gift of the vaccines" in sermons.  

Others reported that pastors have made pastoral calls on individual families to inquire about vaccine status and encourage getting vaccinated, with one church in the Mid-Kentucky Presbytery achieving a 100% vaccination rate among its regular attendees.

Another congregation is providing rides or money for Uber or Lyft for members to reach vaccination sites. And one faith community said getting vaccinated is mentioned every week in announcements, and information posted on their web site.

But among the sampling of churches interviewed, few of them are preaching about vaccines from the pulpit. 

Wilson, of Campbellsville's Woodlawn, said he has been forthcoming with people about being fully vaccinated, but said that as a church body, "We have not encouraged nor discouraged anyone from being vaccinated."

"We do not speak about current culture issues that don't reflect biblical things," said Hopkinsville's Farrell. "So we focus on preaching Jesus and love for one another. And things [like] vaccinations unfortunately have been so politically charged that we don't bring that into our pulpit."

Some others approach the touchy subject very differently. 

"From the get-go I have been advocating, vocally, for the congregation to get vaccinated," said Fearing of Beaumont Presbyterian. "I've been encouraging them to encourage their co-workers and friends and families to get vaccinated. . . . And our leadership has also been very vocal about that. So it's not something we're afraid to bring up. We see it as a theological issue. Getting vaccinated is how we protect our neighbors. So that's what Jesus calls us to do. So for us, it's a no brainer."

Some take a gentler approach.

Caudill, of Hindman First Baptist, said he encourages his congregation to get vaccinated by telling them that he and many people that they know have gotten vaccinated, "So without telling people you've got to go get vaccinated, they receive encouragement."

Some said they encourage people one-on-one to get vaccinated, but not from the pulpit. 

"I personally have been very up-front with my recommendation for [the] vaccine," said Pastor David Grout of Florence United Methodist Church. "I have had a lot of private conversations with people, encouraging them to get them. I've tried to counter some of the misinformation that I think is out there about vaccines, but we have not had any kind of official stance or anything." 

The Rev. Alex Lockridge of First Baptist Church in Corbin said, “I do believe churches should be more supportive of the local experts and health-care professionals, and taking what they have taught us and sending it out to our people, using our platform to encourage people to do the right thing."

Some have poor compliance

Some churches that Kentucky Health News contacted did not return multiple calls for comment on their practices. But, in the videos of recent worship services from three Baptist churches that are posted online, none of the performers on stage wore masks as they sang for the first 20 minutes of the service. And, in the few shots of the congregations, only one person was seen wearing a mask, even as the congregations also sang and greeted one another with hugs and handshakes while standing close together.

Some churches around the state have been the sources of Covid-19 outbreaks. One organizational leader said they have provided guidance to churches, but have no way to make them comply, even though they have felt the deadly effects of the virus.

Another leader, Rev. John Odom of Mid-Kentucky Presbytery, shared this personal observation: “One of our congregations … chose to ignore our guidance, ignore the CDC guidelines. They kept worshipping in person, without masks, without social distancing, they kept singing. And last December, when infections spiked here in Kentucky, the church service became a super-spreader event for that congregation, and the pastor and several members ended up in the ICU, and the pastor actually died as a result of Covid infection. Which is a great sadness, but at the same time, God always tells us our actions have implications. We reap what we sow, right?”

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Isolation, closures and lethal drug supply likely contributed to the big increase in drug overdose deaths in Kentucky last year

The 49% increase in drug-overdose deaths in Kentucky in 2020 included a big jump among young people, Jasmine Demers reports for the Kentucky Center for Investigative Reporting. 

Her object example is Isabell Slusher, 24, who came close to being one of those overdoses. She said she started using heroin when she was 18. Last year, she was forced into isolation during the Covid-19 pandemic, and isolation is a dangerous place to be for someone with a substance-use disorder.

“As addicts, you already isolate yourself. And then when the pandemic hit, you’re then being forced to not be around your loved ones,” Slusher told Demers. “You do start to get lonely. What better thing to do than just lay around and get as high as you can get?”

Slusher said she became depressed and felt hopeless, adding, “Who would even know I was gone? Who would miss me?”

Slusher entered treatment last November, and hasn’t used drugs since, reports Demers, but she adds that that wasn't the case for everyone. 

"Young Kentuckians experienced the highest increase in drug overdose deaths last year, according to the state’s overdose fatality report released this month. The report showed increases in mortality across all age groups, and overdose deaths grew overall by 49%. But the jump for young people was much higher: 127 people aged 15-24, 90% more overdose deaths than the previous year," Demers reports. 

The exact cause for this increase in drug overdose deaths is not clear, but many have blamed the isolation of the pandemic.

“They’re already dealing with a lot of uncertainty and just figuring out life,” Julie Duvall, CEO of Adult and Teen Challenge of Kentucky, told Demers. “Their peer groups are so important to them and all of that has kind of been disrupted.”

Duvall added that drug use among young people can be misinterpreted as rebellion or behavioral issues instead of a deeper problem, and that people tell them that they start experimenting with drugs as a way to cope with life.

State records show that over the last five years, increases or decreases in overdose deaths have correlated with the number of people seeking emergency care, but in 2020 there were more deaths than emergency room visits, Demers reports. 

"In 2020, emergency department visits for nonfatal drug overdoses increased statewide by just 13%, compared to the 49% increase in total overdose deaths, according to the Kentucky Injury Prevention and Research Center. For young people, the discrepancy is even wider — emergency room visits increased by 10.5% while overdose deaths jumped by 90%," Demers writes. 

Duvall told Demers that her treatment program hasn’t seen an increase in admissions. “So, what that tells me is they’re suffering in isolation at home or wherever they are and not reaching out for help," she said. 

Another challenge has been restrictions and closures during the pandemic that have made finding recovery options even harder. 

Slusher told Demers she came into treatment through a court order after being arrested for violating her federal probation. The judge sent her to Adult and Teen Challenge of Kentucky.

“I think maybe if I didn’t get locked up that day, I know that I probably wouldn’t be here,” she said.

Courtney Duerksen, 24, who is in treatment with Slusher, told Demers that she also felt the impact of that isolation. But five months into recovery, Duerksen offered this advice for people with substance use disorders. 

“Make sure that you’re reaching out if you need help. Make sure you’re talking to someone,” she said. “Because that’s one thing that I didn’t do. I isolated to the fullest. And if I needed help, I didn’t call anyone.”

Another contributor to the increase in overdose deaths during the pandemic was the lethality of the drug supply, with fentanyl detected in 71% of the overdose deaths, Demers reports. 

Last year, 1,964 people died of a drug overdose in Kentucky, and about 29% of them were 35 to 44 years old. Kentucky had the third-highest increase of overdose deaths in the nation in 2020, according to the Centers for Disease Control and Prevention.

And it seems to be getting even worse this year, according to Dana Quesinberry, public health policy and program evaluator for the Kentucky Injury Prevention Research Center.

“There had been a hope … that once vaccines became available and we’re reintegrating our society that we would see a decline in overdose deaths, and we are not seeing that," she said. 

And while the data is important, Quesinberry told Demers that it's about more than just numbers.

“Every person who has died, every person who has had a non-fatal overdose, every person who has suffered with substance use disorder is somebody’s parent, somebody’s child, somebody’s brother, sister, coworker, neighbor,” she said. “That’s why prevention and harm reduction services and support for them are very important.”

Kentuckians can call 1-833-8KY-HELP (1-833-859-4357) to speak with a specialist about substance use treatment options and available resources. To find openings at addiction treatment facilities, you can also visit www.FindHelpNowKY.org.

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More than half of state's acute-care hospitals report critical staff shortages; 7-day average of new coronavirus cases sets a record

By Melissa Patrick and Al Cross
Kentucky Health News

Before celebrating the third and final batch of winners of the state's lottery for the vaccinated, Gov. Andy Beshear gave yet another grim pandemic report, saying 50 of the state's 96 acute-care hospitals report critical staff shortages.

"It's worse from a hospitalization standpoint and a hospital capacity standpoint than it's ever been for any reason," Beshear said at an event held to announce the lottery winners. "You are at more risk now if you are in a car accident or have a heart attack of not getting all the services you need than ever before."

The state continued to report record numbers of Covid-19 patients in hospitals and intensive care, and on mechanical ventilation, though the daily gains were mostly the lowest of the week. But 4,815 new cases of the coronavirus raised the seven-day average above 4,000 per day. It is 4,045, breaking the record of 4,002 set Jan. 12. 

Kentucky hospitals reported 2,129 Covid-19 patients, 592 in intensive care and 349 on ventilation. Beshear noted the latter record a sign of the seriousness of the pandemic, noting the state had delivered two ventilators to T.J. Samson Community Hospital in Glasgow because it had run out.

"People should rightfully be very scared of the Delta variant. . . . It is that serious. It is that aggressive," he said.

The seven-day infection rate set a new record Thursday and did again Friday, rising to 84.49 daily cases per 100,000 residents. Counties with rates more than double the statewide rate are Clay, 259.9; Bell, 226.1; Whitley, 215.1; Owsley, 197.4; LaRue, 175.6; and Perry, 171.9. The next six are Laurel, 166.6; Wolfe, 163.7; Jackson, 161.8; Grayson, 153.5; Breckinridge, 153.5; and Allen, 148.1.

The lowest rate, 25.1, is in Woodford County, which has the highest percentage of residents who have received at least one dose of vaccine, 72%.

Kentucky's infection rate ranks fifth in the nation, trailing Mississippi, Florida, Louisiana and Tennessee. Indiana and West Virginia are 15th and 16th; Missouri is 23rd, Virginia is 30th, Ohio is 34th and Illinois is 36th.

The percentage of Kentuckians testing positive for the virus was again the highest since testing became widely available last spring: 13.33%.

The state reported 18 more Covid-19 deaths, raising the seven-day average to 24 per day. One month ago, it was four per day.

Beshear reiterated several of the state's most recent efforts to provide relief to its hardest-hit hospitals, including use of the Kentucky National Guard in ways that free up hospital staff; Federal Emergency Management Agency emergency-medical strike teams arriving in Louisville, Prestonsburg and Somerset; a request to FEMA for nurse strike teams; and using money from the 2020 federal pandemic relief bill to set up four testing sites.

Beshear again called on Kentuckians to get vaccinated, and reiterated that it's time for a statewide mask mandate, a measure that would have to be imposed by the legislature because of last Saturday's state Supreme Court ruling upholding laws that limit the governor's emergency powers. 

"If we truly want to stop the surge and save lives . . . the legislature is going to need to do a statewide mask order," Beshear said, noting national projections of 100,000 more deaths, "half of which could be saved by universal masking That's 50,000 people across the United States; that's a pretty good reason to do it."

The winner of the third $1 million prize, Mary Mattingly of Louisville, Mattingly urged vaccination and expressed her appreciation via video because she was traveling. 

"I want to use this opportunity to encourage each of you to get the shot of hope," Mattingly said. "The vaccines cannot stop every case, but they can greatly reduce your chances of acquiring a serious, long term or fatal case of Covid-19."

The five Kentucky youth selected for full postsecondary-education scholarships are Marissa Herron of Mount Washington, Lillie Nielsen of Nicholasville, Jordan Ballard of Crestwood, Grider Burch of Lexington and Jaden Wattley of Louisville.

"The response we've had for this sweepstakes has been great," Beshear said, saying it generated hundreds of thousands of dollars worth of favorable publicity for the vaccines, which are the targets of misinformation. "I do think we're at the point where incentives can probably only do so much."

Beshear said 762,174 adults entered to win the three $1 million prizes and 47,544 youth entered to win the 15 scholarships. Since announcing the sweepstakes, 419,566 Kentuckians received a Covid-19 vaccine.

Daily vaccinations continued to increase. Today's report, reflecting yesterday's shots, says 16,410 doses were given, raising the seven-day average to 13,389 per day, the most in more than two months.

Chart by The Washington Post, adapted by Kentucky Health News; to enlarge, click on it.

In other pandemic news Friday:

• Franklin County Schools said they would close next week due to a rising number of virus cases, and will offer students non-traditional instruction and work.
• The Grayson County school board adjourned without finishing its business Thursday night "as tensions escalated and more audience members began speaking out of turn" about masks and other controversial subjects and "additional Leitchfield Police Department personnel responded," the Grayson County News-Gazette reports.
• Senate President Robert Stivers did a "Kentucky Newsmakers" interview about the newly powerful legislature's approach to the pandemic. It will air on Sunday 6 a.m. on WKYT-27 and 10 a.m. on The CW Lexington, digital channel 27.2.
• The University of Kentucky says it's not taken vaccine mandates off the table, even as it expands incentives for vaccination, WKYT reports. Starting next week, unvaccinated students and employees must be tested weekly.

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State has second highest number of new cases; 1/3 of hospitals critically short of staff; Beshear says Ky. in 'uncharted territory'

Screenshot of KHN-adapted New York Times map; for interactive version, with local data, click here.

By Melissa Patrick and Al Cross
Kentucky Health News

As Kentucky hospitals struggle with enough beds and staff to care for Covid-19 patients, and the state recorded its second most coronavirus cases in one day, Gov. Andy Beshear said the state is in "uncharted territory." 

Beshear said Thursday that 32 of 96 of the state's hospitals, exactly one-third, are reporting critical staffing shortages. He said hospitalizations have increased for 42 consecutive days, setting daily records the last five days. 

"As horrible as last year’s surge was, and it was awful, we were never in a position where doctors worried they [would] need to choose between treating a patient who can't breath because of Covid or treat a patient who’s bleeding out because of a car accident. That’s the strain our hospitals are under," Beshear said at his weekly news conference. 

The state reported 5,401 new cases of the coronavirus Thursday, 1,759, or 32.56 percent, among Kentuckians 18 and younger. Even before that report, the state's 14-day infection rate was fourth in the nation, trailing Mississippi, Florida and Louisiana, according to The New York Times.

The percentage of Kentuckians testing positive for the virus in the last seven days set another record, 13.24%, and the state reported 27 more Covid-19 deaths, raising the seven-day average to 22 per day.

The state saw a similar surge last December and January. The difference between now and then, Beshear said, is that we know how to prevent it, how to make sure those hospital beds remain available for emergencies and routine care: "The difference between now in uncharted dangerous territory and before is we have the answer, they are the safe and effective vaccines."

Kentucky hospitals reported 2,115 Covid-19 patients, 41 more than Wednesday, with 590 of them in intensive-care units and 345 of those on mechanical ventilation. All set new records. The share of ICU patients being ventilated has increased; in the first week of August, it averaged 40%; Thursday, it was 58%. The Lake Cumberland hospital region became the first to report that all its ICU beds are full; 40% are occupied by Covid patients.

Beshear played a video from Dr. Mohan Rao, a Baptist Health Madisonville surgeon, who encouraged Kentuckians to get vaccinated, reporting that 19 of the hospital's 20 intensive-care beds are full, many of the beds are occupied by young people, and most of the patients on ventilators. 

"I thought last year that we had seen the worst of it, especially with the introduction of vaccines," Rao said. "And once we all got vaccinated, I thought that a lot of this would go away. Unfortunately, it's come back and it's come back pretty ugly, it's come back with a vengeance." 

Thanks to an extension in federal funding, the Kentucky National Guard will provide a variety of services across the state to help combat the virus between Sept. 1 and Dec. 30, including helping hospitals in ways that will free up staff. 

Also, the Federal Emergency Management Agency has approved the state's request for additional emergency medical personnel and will provide 30 additional staff and 15 ambulances. The state still awaits approval for a "nurse strike team," he said.

In addition, using money from the 2020 federal pandemic relief bill, the state is setting up four new sites to help the hardest-hit hospitals with testing. They will be in Danville, Corbin, Morehead and Pikeville.

Legislature faces questions 

Beshear's ability to deal with the pandemic has been limited by the state Supreme Court decision that upheld, for now, the 30-day limit on governors' emergency orders enacted by the 2021 General Assembly.

He said that if he still had the authority to do so, the 65 Covid-19 deaths reported yesterday, along with case numbers approaching 5,000 in one day, would have prompted him to impose another statewide mask mandate.

“That would’ve been the trigger for me, if it was in my authority to put in a masking order for indoors across the state. Every other time we've been this high, we've done that and it's worked,” he said. “I can’t do that now, and I get that. I’ll provide all the information I can to the General Assembly and hopefully, they will make the best choice that they can. . . . But I’m begging you out there, put on that mask.”

Beshear and Republican leaders are negotiating how to dissolve that court ruling, which means Kentucky's state of emergency related to the coronavirus will need to remain in effect until they tell Franklin Court Judge Phillip Shepherd how they want to proceed. Shepherd has asked them to come up with an agreed order within 10 days, Ryland Barton reports for Louisville's WFPL.  

Beshear said after an event at Midway that he has now met with almost all Republican legislative leaders. He also said that the state school board's emergency regulation requiring masks to be worn in school is not in legal jeopardy from the newly effective laws or the Supreme Court's ruling.

Asked at his news conference why he wasn't able to simply issue a 30-day order for a statewide mask mandate, the governor explained that the state of emergency needed to declare such a mandate would expire sometime before that. The Supreme Court's decision will become final Sept. 10.

Being more careful

Beshear cancelled his appearance at the annual Kentucky Farm Bureau Country Ham Breakfast at the state fair, saying that he did so to model what needs to be done, especially after yesterday's high case and death numbers.

In a video for the audience, he said, "I know this event was pre-planned, I know you're doing your very best to stick by all of the safety protocols; folks, after today, please be as careful as you can. Our hospitals are overrun. And right now, the last thing we need to do is do things that make it more likely that we end up taking up a bed that somebody else may need."

At his news conference, Beshear again made the case for the state school board's mask rule, pointing to a North Carolina State University modeling study that showed without masks or regular testing, up to 90% of susceptible students may become infected by the end of this semester. The study demonstrated that, when used in combination, masks and testing can prevent 80% of new infections. 

With the death of Jamie Kennedy, an assistant football coach and health teacher at Greenup County High School, who reportedly died from complications of Covid-19 on Wednesday, schools in the county have been shut down for the rest of the week with no virtual learning, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. 

“The number of students and staff who are positive and or quarantined has greatly impacted our ability to operate buses, kitchens and maintain classroom staffing,” Greenup County Schools Superintendent Traysea Moresea said in a message to families.

At least six other school districts in Kentucky have closed for various time periods this school year, several with no virtual learning, Honeycutt Spears reports.

Most of them are in Eastern Kentucky, which continues to have most of the counties with the highest infection rates over the last seven days. The statewide rate is 81.73 per 100,000 residents; counties with rates more than double that are Clay, 256.3; Bell, 205.2; Whitley, 205.2; Owsley, 194.1; LaRue, 175.6; and Jackson, 165.1.

Beginning Sept. 1, the University of Kentucky will require weekly Covid-19 testing for all faculty, staff and students on campus who are unvaccinated.

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Morehead hospital is so desperate for staff that it may put coronavirus-positive nurses back to work, in its Covid-19 units

Drs. Adam Howard and William Melahn (St. Claire photo)

St. Claire Regional Medical Center in Morehead is so desperate for staff that it may bring back to work nurses who have tested positive for the coronavirus, and assign them to care for patients with Covid-19, Dr. William Melahn, the hospital's chief medical officer, said in a radio interview.

"If things get much worse, Melahn says St. Claire's will have to bring back nurses who have tested positive for Covid just to keep things running," Sheena Goodyear reports for the Canadian Broadcasting Corp.

"Yes, we have a plan for that, actually," and it's approved by the state Department for Public Health, Melahn told CBC's Peter Armstrong. "If we have Covid-positive staff who are … feeling well, that we can use them in Covid-only units. We have two Covid-only units that we can do that with, and that's certainly on the table already. I don't think we're doing it today, but it's on the table."

"We've hired two nurses in six weeks," Melahn said. "And nobody can find [nurses]. There's a really big hospital up the road about 100 miles from us. They are short 200 nurses."

Asked if there are nurses or doctors or hospital staff that could come from other parts of the U.S. to help, Melahn said, "What we're finding is everyone around is going through the same thing. That doesn't mean that all hope is lost. This week we declared, actually, an official disaster, and that allows us to make some flexible changes. We're a health system, so we have a system of rural clinics around us. We've already pulled all those nurses and some of those doctors in."

Sperling's Best Places map

Melahn noted that the hospital will be one of five in Kentucky to get help from the National Guard, a step Gov. Andy Beshear announced Monday. He said Thursday that the hospital "is in disaster mode."

The hospital's Covid-19 patient count has exploded. "Thirty-one days ago, we had one in-patient with Covid," Melahn said. "We usually take care of a total of 75 in-patients per day, all told. This afternoon, I have 67 Covid inpatients."

He said that's due to low vaccination rates in the area, which are driven by bad information. "We are not upset at our patients," he said. "We're upset about the disinformation or misinformation that's out there that really fills them with fear. What we have observed is this is a pandemic driven by fear. I mean, these people are afraid of being vaccinated."

Armstrong asked Melahn, "Do you have hope? Do you have a sense how to get to a brighter, better day?" Melahn replied, "Usually, in an infectious-disease pandemic, the more rapidly it rolls out, the more rapidly it falls off. So … if you want to call that a positive, that's something that we're looking forward to."

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Today: 65 deaths, 2nd worst day of pandemic; 4,849 new cases, third highest; hospital and positive-test numbers hit new highs

State Department for Public Health table, adapted by Kentucky Health News; for a larger version, click on it. Some hospitals have staffing shortages, so not all beds are available.

By Al Cross

Kentucky Health News

A huge spike in Covid-19 deaths was just one of the fast-worsening numbers of the coronavirus pandemic in Kentucky Thursday.

The state reported 65 deaths, the second most of any day in the pandemic; 4,849 new cases of the virus, the third highest; a record number of Covid-19 patients in hospitals, and the highest valid percentage yet of Kentuckians testing positive for the virus in the last seven days.

The deaths reported Thursday far exceeded numbers of recent weeks. Deaths are not reported immediately, and go through a confirmation process. Gov. Andy Beshear said in a video that 57 of the 65 deaths occurred in August.

In the two weeks ended Wednesday, the state averaged 10.5 deaths per day. The average is now 14, and the seven-day average is 19.7. The numbers prompted one of the most urgent Facebook videos yet from Beshear.

"We are seeing and will see significant death moving forward, but we can do something about it," the governor said. "You know, there's a saying, when you can do something to stop devastation and you don't, that saying is about Nero fiddling while Rome burns. I'm sure there are some that would say it's Nero's individual liberty to just fiddle while everything burns down, but I think you got a responsibility to protect the people around them. So folks, get vaccinated, wear a mask, avoid large indoor gatherings. protect yourself, protect your family."

Beshear's pleas for vaccination have gone largely unheeded in the last three months. Daily vaccinations have generally increased in the last few weeks, as the threat from the virus has increased, but are still far below the levels seen in early spring, and they pale in comparison to pace of the pandemic.

"We had fewer people vaccinated during this report than we had come down with Covid," Beshear said. Today's number of vaccine doses will be reported tomorrow; yesterday, 12,294 doses were given.

The 4,849 new virus cases raised the state's seven-day average to 3,829 per day. Thursday's number ranked behind only Jan. 6 and 7, when 5,742 and 4,911 new cases were reported. Then, about 12 percent of cases were in Kentuckians 18 and younger; they are more susceptible to the Delta variant of the virus, so now are a much bigger share of cases; their share Thursday was 31.3%.

"Today's Covid report is heartbreaking. . . . more kids testing positive now than ever before," Beshear said. "Our hospitals are overrun." 

Kentucky hospitals reported 2,074 Covid-19 patients, 60 more than Wednesday, but the number in intensive-care units fell by 40, to 549, and the number of ICU patients on ventilators remained the same, 338.

Five of the state's 10 hospital regions reported more than 80% of their ICU beds occupied; the Barren River region had the highest percentage being used for Covid-19 patients, 44%. The effective capacity is not as large as the reports indicate, because some beds are not staffed due to staffing shortages.

The University of Kentucky shut down five of its 42 operating rooms due to its Covid-19 patient load, mainly to make sure beds are staffed and the Chandler Medical Center can continue to fill its role as a major trauma center. Baptist Health Richmond stopped elective procedures for at least two weeks.

The percentage of Kentuckians testing positive for the virus in the last seven days is 13.16%, the highest since testing became readily available.

Kentucky retained the nation's fifth highest infection rate over the last 14 days, as reported by The New York Times. States with higher rates are Mississippi, Louisiana, Florida and Tennessee. The rate on the state's daily report was 79.65 per 100,000 residents; counties with rates more than double that rate were Clay, 245.5; Bell, 191.5; Whitley, 188.7; Owsley, 174.7; Jackson, 167.2; and Magoffin, 160.9. All are in Eastern Kentucky. The next six counties are LaRue, 156.8; Laurel, 153.2; Taylor, 149.1; Allen, 141.4;
Breckinridge, 138.1; and Carroll, 137.1.

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Early exposure to tobacco smoke may speed the aging process

Early exposure to tobacco smoke, firsthand and secondhand, may make your body age more quickly, a European study suggests. The study in the journal Environment International builds on earlier findings that environmental factors during pregnancy and early childhood can change a child’s metabolism and physiology, sometimes in irreversible ways.

 

Researchers with the Barcelona Institute for Global Health found that smoking during pregnancy and exposure to smoke in early childhood were associated in a small way with a faster aging process, measured by changes in the DNA of 1,173 children aged 6 to 11 in a sample taken across Europe, and additional samples from 83 pregnancies and 103 infants.

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UofL Health-Jewish Hospital team is second in U.S. to implant a new type of artificial heart; Indiana man 'doing well' after 5 days

The University of Louisville announced Wednesday that UofL Health-Jewish Hospital had implanted a new type of artificial heart in a Southern Indiana man, making it the second U.S. hospital to implant the French-made device.

Mark Slaughter, M.D. (University of Louisville photo)

The heart was implanted Aug. 20 by a surgical team led by Dr. Mark Slaughter, the lead cardiothoracic surgeon at the hospital and chair of cardiovascular and thoracic surgery in the U of L School of Medicine. "The recipient, whose identity is being withheld upon request . . . is doing well," a U of L news release said.

The Aeson heart "serves as a bridge to transplant for patients with end-stage biventricular heart failure – heart disease affecting both left and right sides of the heart – allowing more time for the patient to receive a permanent heart organ transplant," the release said. "The new device is designed to solve the limitations of left-ventricular assist devices, which pump blood in just one chamber, by pumping blood in both heart chambers."

It also has sensors that detect blood pressure and position and adapt blood output accordingly, and has an external power supply, the release said: "The device is medically approved in Europe, where approximately 20 devices have been implanted. The first Aeson artificial heart in North America was implanted in July at Duke University," in a 39-year-old man from North Carolina.

The release noted past pioneering cardiac efforts at U of L and Jewish, which the university took over in 2019 "to preserve its storied organ-transplant program," notes Deborah Yetter of the Courier Journal. "On July 2, 2001, U of L cardiothoracic surgeon Laman Gray led the surgical team that implanted the first self-contained artificial heart in the United States at Jewish Hospital," the release said. "The AbioCor artificial heart was implanted into Robert Tools, who lived five months on the device. The UofL surgical team also performed the first heart transplant in Kentucky at Jewish Hospital in 1984."

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In southeastern Kentucky's Covid-19 hotspot, health-care providers try to fight misinformation without confrontation

By Jamie Lucke
Kentucky Health News

Martin Huff of WYGE Christian Radio in London says he never shied from vaccines before. He gets an annual flu shot and has been vaccinated against shingles.

Martin and Joyce Huff (Photo provided)

Covid-19 was different.

“There was so much propaganda and talk, you didn’t know what to do. People don’t know what to do.”

Huff was concerned that the vaccines had only emergency authorization from the Food and Drug Administration. “I just waited. I just waited too late, to be honest with you.”

In early July, he was diagnosed with Covid-19 and received monoclonal antibodies which, like the vaccines at the time, have emergency FDA authorization. (The antibodies must be administered soon after symptoms begin, so don’t wait to get tested.)

The virus more severely infected his wife, Joyce Huff, a nurse and supervisor at a hospital in Cincinnati.

“My wife was a no-vaxxer. She said, ‘I’m not a no-vaxxer anymore.’ It makes a believer out of you,” Huff said by telephone on Aug. 16. He said he plans to get the vaccine, but must wait 90 days after receiving the antibodies.

Ky. Health News chart; color reflects county vaccination rate

Baptist Health Corbin, where Huff was treated, serves counties with low vaccination rates and high infection rates.

Four of the seven Kentucky counties with the highest incidence of coronavirus for the week ending Aug. 24 – Bell, Clay, Laurel and Whitley – are in the hospital’s immediate eight-county service area.

Just one of every three residents of those counties had at least one dose of the vaccine, compared with more than half of all Kentuckians. (Children under 12 are not yet eligible to be vaccinated.)

Fueled by the more contagious Delta strain, this surge is striking younger unvaccinated adults and children, amid growing evidence that Delta is also making people sicker.

Clay County is suffering Kentucky’s highest infection rate, and one of the nation’s highest: 194.5 per 100,000 residents, more than two and a half times the state rate of 76.9.

Corbin is the seat of Whitley County, which had 167.4 cases per 100,000, third highest in the state.

London is the seat of Laurel County, where there were 153.9 cases per 100,000, seventh highest.

Kentucky Health News talked to four people on the front lines in this hotspot about their race against the deadly virus and the endless stream of misinformation that gives it an edge.

What do they say to people, who like Huff, are understandably confused and hesitant?

Spoiler alert: Their unanimous advice is to get the vaccine. Or, as Huff says, “If you know you can keep yourself from dying, you should.”

The doctor

“It frustrates me that this disease has become political, because disease has no politics,” says Dr. Shelley Bundy Stanko, chief medical officer at CHI Saint Joseph London and medical director of the Laurel County Health Department.

She tries to reassure patients that the vaccine is safe and necessary by being “very fact based” and conveying “very strongly that I think it’s best for them. I’ve had lots of long conversations about it over the last six to eight months.”  

Shelley Bundy Stanko, M.D.

Some of the unvaccinated are waiting to gather more information, and do eventually decide to get the shots. Others – probably the majority – are “sort of shutting down and not absorbing the information. It’s heartbreaking. Whether because of personal biases or politics, they have stopped listening to the medical facts.”

She’s not giving up. “Confrontation does not help. Keep the door open. Let me talk this through with you.”

She assures her patients and coworkers that the 4.8 billion doses administered worldwide provide ample proof. “We know they’re safe; we know they help.”

To patients who point out that even vaccinated people can get and spread the virus, she explains that vaccinated people become infected much less often, don’t get as sick, and recover faster.

On Aug. 17, the 150-bed London hospital was caring for the most Covid patients ever and had its highest percentage yet in intensive care and on ventilators. Even in intermediate care, Covid patients require more hands-on attention; the virus leaves them too fatigued to even feed themselves or walk to the bathroom at a time when London has not been spared from the nationwide shortage of nurses.

The rise in Covid hospitalizations is jeopardizing other patients. Stanko said it has become “extremely difficult” to find a hospital for patients who need to be transferred for specialty care, despite an effective coordination system among Kentucky hospitals.

Stanko, her husband and their three children are all vaccinated and wearing masks in indoor public places. Masking in schools is an important tool, just like booster seats and seatbelts, for keeping children safe, she said: “Even imperfectly applied,” masks on kids produce benefits and are “worth it.”

She urges people to research the facts rather than relying on “a neighbor, social media account or television channel.”

“I’m a person of faith. . . . Those of us who can be vaccinated should do it for our neighbors.”

The nurse and the chaplain

Jasmine Whitaker, a registered nurse at Baptist Health Corbin, has had nightmares about struggling into her protective gear while a monitor keeps dinging a warning that one of her patients is nosediving.

Caring for Covid patients, “you have this anxiety constantly. It doesn’t just go away when you get to the parking lot.”

Eighteen months into the pandemic, she’s coming to terms with a new wave of disease and death, one that could have been avoided, if only enough people had gotten the vaccine.

“I think sometimes you do feel, not angry, but upset, because it’s so simple to help stop the spread of Covid,” she said. “We’re aware that vaccines have side effects, but so do your daily medications. Health-care workers just had a lot of hope that more people would get the vaccine. So you kind of feel let down.”

Baptist Health Corbin has 273 beds.

Her colleague, the Rev. Alice Tremaine, advance-care planning coordinator and a chaplain at the Corbin hospital, shares her disappointment at being “back at square one.”

“I think a lot of people think only in terms of their risk for dying of Covid. I’m hearing reports about younger people, healthier people getting permanent lung damage. A lot of people are living with really serious long-term side effects from having had Covid, needing a lung transplant when they’re young, a drastic life change in their 30s.”

Both women see families struggle with decisions when loved ones will never be able to breathe naturally again and are unaware and unable to decide for themselves. “Especially if they’re younger,” Whitaker says, “they haven’t had those kinds of conversations with family about what they would want.”

Tremaine says she sees Covid compounding the guilt and shame that people often feel in response to any premature or preventable sickness or death. “It’s become such a divisive topic. You cannot prevent the spread of Covid 100 percent. Some precautions you can take are very simple and easy, like getting vaccinated, wearing masks or social distancing. When people have failed to do that, I think there’s an extra layer of regret or even anger with each other when family members disagree about what should have been done.”

The hospital administrator

“People have asked, ‘what can we do?’ We appreciate the food and cards. But what health-care workers need more than anything is for people to get vaccinated,” says Anthony Powers, president of Baptist Health Corbin.

The largest hospital between Lexington and Knoxville is vaccinating more people – almost 100 a day vs. “in the teens five or six weeks ago,” Powers says, but the uptick is not enough to defeat the Delta strain.

“For the first time, we’re seeing kids who are sick with Covid.” The hospital has transferred two patients to Kentucky Children’s Hospital in Lexington.

Nurses are working extra shifts. The emergency room is treating record numbers, not just for Covid but people who are sick because they deferred care during the pandemic. Patients who need to be transferred for specialized or higher-level care must wait longer in the ER because other hospitals are full.

What Powers is not seeing is admissions of vaccinated people. Only two of the hundreds who have been hospitalized in Corbin for Covid have been vaccinated.

A clinic staffed by three retired nurses is infusing about 20 outpatients a day with monoclonal antibodies, the experimental treatment that then-President Trump received.

“We’ve not had anybody say no to monoclonal antibodies because it’s experimental.” Yet, there is great resistance to vaccination, which is not.

“Some pushback” has greeted the mandate that all hospital employees be fully vaccinated by the end of October or be tested at least once a week, Powers said.

“If one of our health-care workers brought it in, there could be grave consequences for patients and their families,” Powers said. “We’re a place of healing. We also want to be role models.”

Bottom line, he says: “We’ve got to get more people vaccinated.”

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