Frankfort paper names local health agency Newsmaker of Year

Franklin County Health Department staff pose for a photo taken by Deputy Director Brittany Parker.

The pandemic has been very hard on local health departments, which in many if not most cases haven't received the respect and recognition they deserve for bearing the extra workload and putting up with coronavirus skeptics who harass or abuse them. At least one got very prominent recognition at year's end, as The State Journal of Frankfort named the Franklin County Health Department its Newsmaker of the Year.

"It is because of their tireless efforts to keep the community healthy, while dealing with an increasingly hostile environment and constant threat of possible contamination," Harrison Wagner writes. "From organizing a way to administer tests and multiple doses of the vaccines, to creating informational materials about virus prevention, all while attempting to keep a healthy work-life balance and still perform their normal duties, the Franklin County Health Department has managed to weather the storm of the pandemic."

Health departments also enforce rules at workplaces, and "there were instances of hostility towards health environmentalists, or health inspectors, while they were enforcing safety guidelines at businesses," Wagner reports, quoting Director Judy Mattingly: “There were quite a few scary situations where their strict instructions from me were that if any business owner is hostile with you in any way, shape or form, that you are to leave immediately. There were situations at that time where our environmentalists were able to call our police partners or sheriff partners and be accompanied on those inspections.”

On the bright side, the pandemic has raised the profile of the department "and its other healthy-living initiatives," Wagner writes. "The staff has become closer as a result of working together at the testing and vaccination drive-thrus. Mattingly said this has led to Secret Santa gift exchanges and Friendsgivings, which has made the department more tightly knit."

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With positive-test rate a record and new cases a near-record, Beshear says Kentucky is in a surge from Omicron; cities lead

Demand for coronavirus tests was apparent Monday at a site
in Lexington. (Photo by Ryan Hermens, Lexington Herald-Leader)

By Melissa Patrick
and Al Cross
Kentucky Health News

After two days of high case numbers and a record-setting positive-test rate, Gov. Andy Beshear says Kentucky is in an Omicron-variant surge. 

"Folks, it’s clear Kentucky is now in a surge from Omicron. . . . This is the most contagious variant we’ve seen. Protect yourself and others: Get vaccinated and get a booster shot," Beshear wrote on Facebook.

Kentucky reported 5,530 new coronavirus cases Wednesday, the second largest daily number of new cases of the pandemic, beaten only by the 5,742 reported Jan. 6, 2021. The seven-day rolling average rose to 2,832, which is 15% higher than Tuesday and 29% higher than two weeks ago. 

The percentage of Kentuckians testing positive for the virus in the last seven days is the highest it's been since tests became widely available early in the pandemic: 14.46%, a 1.85-percentage-point increase from Tuesday.

The state's daily infection rate is 59.31 cases per 100,000 residents, up from 50.99 Tuesday. The New York Times ranks Kentucky's infection rate 28th among the states. The highest rate, 104 per 100,000, is in Wolfe County, population 6,562; the second and third highest rates are in Kentucky's most populous counties, Jefferson (93) and Fayette (80.5).

The three major Kentucky counties in the Cincinnati metropolitan area, Boone, Kenton and Campbell, are in the top 20, with rates of 75 to 64 per 100,000.

Officials in Louisville and Lexington sounded alarms yesterday as case levels and positive-test rates soared, and "Health officials said they expect to see an even higher rise in cases 10 to 14 days after any New Year's parties," Louisville's WDRB reports.

Louisville Metro officials reported an "alarming increase" in cases, raising Jefferson County's seven-day average of new cases to 1,742 per day. A week ago, it was 532. (Local and state reporting methodologies vary.)

The Lexington-Fayette County Health Department reported 494 new coronavirus cases Tuesday, well above the previous record of 451, the Lexington Herald-Leader reports.

The percentage of Jefferson County residents testing positive for the virus in the last seven days jumped to 19.5%, meaning that nearly one in five people who got tested were found to be infected with the virus. The figures do not include people who used in-home tests.

"This has really shattered the previous records," said Dr. Sarahbeth Hartlage, associate medical director for Louisville Metro Department of Health and Wellness.

Tests are in high demand, and in-home tests are in short supply. Hartlage advised, "If you wake up feeling poorly, the safest thing is just to assume that you are positive."

WDRB reports, "Area hospitals are also beginning to see an increase in Covid-19 patients. Dr. Steve Hester of Norton Healthcare said, as of Wednesday, his network of hospitals had 176," 80% of whom were unvaccinated for the virus. Eleven cases were children.

Chuck Anderson of Baptist Health said the state's largest hospital chain saw a "big jump" in Covid-19 patients this week, to 320. The system's peak last winter was 400, he said.

Kentucky hospitals reported 1,434 Covid-19 patients, an increase of 104 from Tuesday; 369 of them in intensive care (up 27); and 220 on mechanical ventilation (up 17). 

Eight of the state's 10 hospital readiness regions are using at least 90% of their intensive-care capacity, with seven above 96%.

Beshear said Monday that hospitals had not sent out any alarms regarding a shortage of beds or staff. President Biden's top health adviser, Dr. Anthony Fauci, has warned that even though the Omicron variant may cause less severe illness, an onslaught of new infections could overwhelm hospitals. 

One hospital that is already struggling to find beds for its patients is Wayne County Hospital in Monticello, Evelyn Schultz reports for WLEX-TV. Dr. Cory Ryan, its chief medical officer, told Schultz that they can't afford another spike in hospitalizations because they are already struggling to find beds.

"We're calling 30, 40 hospitals, and we're using referral hospitals we've never used in my 20 years," he said Tuesday. "We're sending patients to Ohio, and Tennessee, and hospitals we've never even thought about using."

Beshear said Monday that "the number one thing" Kentuckians can do to decrease hospitalizations is to get a Covid-19 vaccine and get boosted.

The state reported 21 more Covid-19 deaths Wednesday, bringing its pandemic death toll to 12,118. Over the last 14 days, the state has reported 30.4 deaths per day. The Times reported Tuesday that Kentucky's death rate since vaccines became widely available is fourth in the nation.

The state does not plan to issue any more pandemic reports until Monday.

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With Omicron, more effective masks should be worn, experts say

Chart from ShopMasks.com; click on it to elnarge.

"With another coronavirus variant racing across the U.S., once again health authorities are urging people to mask up indoors. Yes, you’ve heard it all before," Maria Godoy reports for NPR. "But given how contagious Omicron is, experts say, it’s seriously time to upgrade to an N95 or similar high-filtration respirator when you’re in public indoor spaces.

“Cloth masks are not going to cut it with omicron,” Linsey Marr, a researcher at Virginia Tech who studies how viruses transmit in the air, told NPR.

Omicron "spreads at least three times faster than Delta," Godoy notes. "One person is infecting at least three others at a time on average, based on data from other countries."

Robert Wachter, chair of the medicine at the University of California, San Francisco, told Godoy, “The kind of encounter that you could have had with prior versions of the virus that would have left you uninfected, there’s now a good chance you will get infected from it.”

Early research at the University of Hong Kong shows "Omicron multiplies 70 times faster inside human respiratory tract tissue than the delta variant does," NPR reports. "That study also found that Omicron reaches higher levels in respiratory tract tissue 48 hours after infection, compared with Delta."

Marr said, “That would suggest to me that maybe it reaches higher levels and then we spew out more [virus particles] if we’re infected,” Also, Omicron may be so contagious that it takes fewer viral particles to create an infection.

Also, "Virus particles from an infectious person can linger in the air indoors for minutes or even hours after they leave a room in some situations, says Dr. Abraar Karan, an infectious disease physician at Stanford University," Godoy reports.  Karan told her, “I think that people need to realize that transmission here can happen even when you’re not near somebody.”

Godoy says, "Given all this, you want a mask that means business when it comes to blocking viral particles. Unlike cloth masks, N95, KN95 and KF94 respirators are all made out of material with an electrostatic charge." That “pulls these particles in as they’re floating around and prevents you from inhaling those particles,” Karan told her. “And that really is key.”

Surgical masks also have an electrostatic charge, but they tend to fit loosely, "A snug fit — with no gaps around nose, cheeks or chin — 'really makes a big difference,' says Marr, who has studied mask efficacy," Godoy reports.

"KN95s tend to be a bit more comfortable than N95s, but counterfeits continue to be a problem. For safer shopping, check out a site like Project N95, a nonprofit that helps consumers find legitimate personal protective equipment. Or check the CDC’s site for advice on how to spot a counterfeit and a list of trusted sources for surgical N95s. For maximum protection, make sure your N95 fits snugly as well, creating a seal around your mouth and nose. The CDC explains what makes a good fit and how to test that yours is sealing well."

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Kentucky has had a high death rate from Covid-19 since vaccines became widely available; relatively low vaccination rate is a reason

New York Times graph, adapted by Kentucky Health News to highlight the state

Centers for Disease Control graph, adapted by Ky. Health News

Since vaccines for Covid-19 became widely available in April, Kentucky's death rate from the disease is fourth in the nation, partly due to its relatively low vaccination rate, according to The New York Times.

The vaccination rate, 54 percent of the state's population, is 33rd in the nation. That's for full vaccination, not including booster shots, which research shows are needed for strong protection from the highly contagious Omicron variant of the coronavirus that has become dominant in the U.S.

"States with lower vaccination rates tend to have had higher Covid-19 death rates, particularly from the most recent wave of Delta variant infections, which hit the South the hardest," the Times reports. "This all suggests that the change in who is dying from Covid-19 may be tied to which areas experienced the worst outbreaks of the Delta variant and who in those areas remains unvaccinated. Relaxed precautions in many areas may also play a role."

The Times found that Covid-19 death rates "fell in most counties across the country, and in about one in five counties, the death rate fell by more than half. But in about one in 10 counties, death rates have more than doubled."

That was true of some counties in Kentucky, especially in Appalachia, but the rates increased in most counties. Counties in which death rates decreased were Calloway, Carlisle, Clinton, Fayette, Fulton, Graves, Hancock, Hopkins, Kenton, Logan, Marshall, McLean, Ohio, Oldham, Russell, Todd, Washington and Woodford. The level of increase in many counties is difficult to discern from the Times map, below, and the newspaper does not link to its county-level data from state and local health agencies.

NYT map; Kentucky may seem worse than it is because it has so many counties. Click to enlarge.

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With few 5-to-11-year-olds vaccinated against Covid-19, public-health officials say kids will have to get sick to motivate parents

By Sarah Baird, The Goldenrod

Over the summer — during that fleeting window of time before the Delta variant hit when we believed Covid-19 might be evaporating into a gauzy nightmare of a memory — I interviewed a woman for a story who had lied about her 11-year-old son’s age in order to receive the Covid vaccine, which was then only approved for ages 12 and up.

Sarah Baird (NYT photo)

In my story for the Romper, the mom described the very involved lengths she and her husband went to in order to cook up a false birthday for their child:

"In Kamin’s case, the mental and logistical gymnastics did turn out to be, well, a lot. Kamin’s son’s birthday was in August, so they decided on a fake March birthday to tell the nurse at the medical clinic. (The thought process behind this? Turning the 3 on the vaccine card into an 8 later on would be relatively easy as to not muddle his long-term medical records.) What’s more, as a faux 12-year-old, her son was capable of — and expected to — tell the vaccine administrator his birthdate himself, so Kamin and her husband “drilled” him on his new, false birthday for days leading up to the event and in the car on the way to the appointment."

This astounded me. Is it even ethical? What does that teach the kid? But what confounds me even more is the overwhelming majority of parents in Central and Eastern Kentucky who are choosing not to vaccinate their children at all. This is evident when you look at the data for 5-to-11-year-olds, a group for whom a Covid vaccine was approved in late October, and see that most parents are foregoing the shots entirely for their kids as part of a worrying trend.

We’re looking at the data for fully vaccinated 5-to-11-year-olds as of Sunday, Dec. 26. There’s been quite a bit of reshuffling generally as to what “fully vaccinated” means in the wake of the Omicron variant and the third “booster” dose for adults, but for now — following the guidelines set by the Kentucky Department for Public Health — kids with two shots but no booster are considered completely vaccinated in this breakdown.

A few key takeaways from The Goldenrod's coverage area (Bracken, Harrison, Scott, Franklin, Anderson, Mercer, Boyle, Casey, Taylor, Green, Adair and Cumberland counties and those east of them in Kentucky):

• Only seven counties — Rowan, Franklin, Scott, Woodford, Fayette, Boyle and Jessamine — in the coverage area have a double-digit percentage of 5-to-11-year-olds who have been fully vaccinated. The rest are hovering well below 10 percent.
• Three counties in the area — Clinton, Martin and Robertson — have zero fully vaccinated 5-to-11-year-olds. (A handful have now received the first dose in each of these counties, which is somewhat heartening.)
• The number of fully vaccinated 5-to-11-year-olds in Leslie, Casey, Green, Owsley, Wolfe and Clay Counties is under 100 children, combined.
• Even in Perry County, where 92% (!) of people age 65-74 are fully vaccinated, only 3 percent of 5-to-11-year-olds have received both shots so far.

These astoundingly low vaccination rates coupled with Omicron knocking on the door in Kentucky means the potential for serious Covid outbreaks when in-person school restarts in January. For example, there are 1,315 kids enrolled across two elementary schools in McCreary County. With only 30 children from 5 to 11 fully vaccinated countywide, that’s a 2.2% vaccination rate for the students in these schools. (It’s even lower if a few of those vaccinated youngsters are either still in preschool, enrolled in private school or already in middle school.)

What do on-the-ground public-health workers think?

Despite several local school districts shuttering early for winter break due to spiking Covid numbers and the Omicron variant causing widespread infection among children nationally — there are currently 1,987 confirmed or suspected pediatric Covid-19 patients hospitalized across the country, according to The Washington Post — rural public-health officials across Central and Eastern Kentucky say there’s little interest in, or urgency from, parents when it comes to vaccinating their vulnerable 5-to-11-year-olds.

“People are still afraid of [the vaccine] even if they get it,” says Kathy Slusher, a community health worker with Kentucky Homeplace in Bell County. “They are afraid to give it to their children. I think as more children get it, more people will come around.”

The Goldenrod's story is illustrated with
this notice of a school vaccination clinic.

But what the tipping point might be that will finally push that first, significant wave of families to get their elementary school-aged kids the vaccine remains to be seen in most counties.

Is it striking just the right chord with a public education campaign? Probably not.

Could it be setting up more vaccination sites with dedicated transportation? Doubtful, because public health officials are currently even willing to make house calls (seriously!) to deliver shots to kids.

Or will it come down to the most tragic possibility of all: Parents will have to watch children in their towns fall severely ill—and perhaps die—before they believe in the vaccine for their own offspring?

Greg Brewer of Gateway District Health Department, which serves Rowan, Bath, Menifee, Morgan and Elliot counties, thinks so. “I guess parents haven’t seen enough school-aged kids get sick around them. They just think it’s a runny nose, so it’s not enough to make them concerned and get the vaccine for their kids. That’s the only thing I can think of.”

When I asked if he thought parents were wholly against the vaccine, he said no. “I don’t think they’re antivaxxers, necessarily, but parents are so divided, and they’re just not concerned about their kids getting Covid. They’re going to have to see kids get really sick before they’ll get concerned.”

When I mused that parents might be scared of the vaccine, like Slusher suggested, Brewer didn’t miss a beat. “I don’t think people are scared, because if they were actually scared, they’d get the vaccine. Covid is a lot scarier.”

There was a sense of exasperation in his voice as he rattled off a fairly exhaustive list of ways local health departments in his region had tried to get the vaccine to community members, including those in the 5-11 age group: “We’re making vaccines available any way we can. We’ve talked to schools; set up clinics; we’ll come to your house to vaccinate your family; we’ll do anything you need us to do. We need kids to get the shot. It’s not going to cost you anything, all we need is your arm.”

The school-based vaccine clinic hosted last week in Menifee County, however, drew little participation. “The schools will do anything to get the shots to kids—they’ve been so good about helping with everything like masks and social distancing—but the people just won't do it,” Brewer said.

Health educator Shirley Roberson Daulton with the Lake Cumberland District Health Department agrees: “The urgency isn’t there. I feel like parents, as humans, sometimes listen to all of this misinformation out there. Also, because of events cancelling, we haven’t been able to be out in the community as much to tell people how important it is to get their kids vaccinated. But we’ve been trying to tell every family that comes into the clinic.”

Of course, just like the Anna Karenina principle — all happy families are alike; each unhappy family is unhappy in its own way — every Central and Eastern Kentucky county struggling with vaccination rates for its youngest eligible citizens has a unique set of hurdles, barriers and misbeliefs to counterbalance before rates among 5-11 year-olds start to climb.

How soon that will be—and how many people will have to face infection, illness or even death before that happens—remains to be seen.

The state health department says 16% of Kentucky children age 5 to 11 are vaccinated, and vaccines are available at primary-care providers and pharmacies in every county.

For a list of the 64 counties sorted by percentage of vaccination, go here.

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Health reporter writes 'Five things about Omicron that I want my friends and family to know'

Dan Diamond, a health reporter for The Washington Post, recently posted a Facebook thread about the Omicron variant of the coronavirus. It went viral, so he turned it into a story for the newspaper. He makes five points:

For the unvaccinated, Omicron might not be mild: "Reports of it being 'milder' appear mostly based on the generally mild breakthrough cases in vaccinated and previously infected people. If you've been vaccinated and boosted, there's reason to expect your omicron infection will lead to minimal symptoms. If you haven’t previously been infected, and you haven’t been vaccinated, there’s no reason yet to expect a 'mild' case." 

Daniel Ryan of Washington, D.C., wore a surgical mask
under a cloth mask early this year to provide greater
protection. (Washington Post photo by Sarah Voisin)

Brace yourself for a positive test: Omicron is one of the most contagious viruses ever found, so "Many, many people who are vaccinated or previously infected are going to test positive in the next few weeks . . . While earlier forms of the virus got stopped at your body’s front door if you were 'fully vaccinated' or previously infected, omicron can get inside. Still, vaccines and boosters hold the power to defang the worst consequences of omicron and fight off infections. It’s possible that some folks reading this have omicron right now and don’t know it because their immune system is doing such a good job containing the infection and the symptoms are small or nonexistent."

This variant is exactly what boosters are for: Booster shots of a vaccine bring "your antibodies back to a level where there are enough of them, like bouncers at a club, to often keep omicron from getting inside." They are one of the best defenses against the Omicron variant.

Hospitals will be pushed to their limits: New coronavirus cases are already setting records, and health experts say new records will keep getting set well into January. "Even if only a small percentage of those people need hospital care, it will tax a health system that is already straining under pandemic fatigue and treating cases linked to the older Delta variant. It’s also going to be a psychological blow after the past two years of fighting the pandemic, and businesses, families and others will surely be racing to adjust plans."

Upgrade your mask and think twice about taking risks. This month will be crucial. "The next month in America could rival the worst days of the pandemic, as a sheer wave of cases crashes into our country. Every expert I spoke to is cutting back on scheduled plans, and several urged: Don’t take risks that could land you in a doctor’s office or hospital emergency room at a moment when demand on our health-care system is going to surge. . . . I’m going to make sure I’ve always got a high-quality mask with me to navigate crowds and indoor spaces. Even if infections are inevitable, I don’t want to help omicron along, especially until we get more data in the coming weeks. And I don’t want to unwittingly get sick and carry an infection to family members this holiday season."

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At-home pill for Covid-19 is approved but supply is limited; Kentucky’s positive-test rate nears 10%

By Melissa Patrick
Kentucky Health News

The good news about the pandemic Wednesday was that the first antiviral pill to treat Covid-19 was granted emergency-use authorization. The bad news was that initially the supply will be limited at a time when demand is expected to soar. 

The Washington Post reports, "The Pfizer pill regimen could help meet some of that demand, but it is estimated there will be enough medication through the end of the year for only 180,000 patients, and it is unclear how many of those doses are destined for the United States." 

On Wednesday, the Food and Drug Administration authorized Pfizer's antiviral pill, Paxlovid, to treat mild-to-moderate Covid-19 in high-risk individuals 12 and older who weigh at least 88 pounds. This five-day treatment is the first antiviral Covid-19 pill authorized to be taken at home. The drug needs to be administered as soon as possible after diagnosis, and within five days of the start of symptoms.

“Today’s authorization introduces the first treatment for Covid-19 that is in the form of a pill that is taken orally — a major step forward in the fight against this global pandemic,”  Dr. Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research, said in the news release. “This authorization provides a new tool to combat Covid-19 at a crucial time in the pandemic as new variants emerge and promises to make antiviral treatment more accessible to patients who are at high risk for progression to severe Covid-19.”

"Last week, Pfizer released updated results that showed the treatment cut the risk of hospitalization or death by 89% if given to high-risk adults within a few days of their first symptoms. If given within the first five days of symptoms, the efficacy was similar: 88%," CNN reports.

Merck has also requested emergency-use authorization for its antiviral pill, molnupiravir, but the FDA has not yet authorized the treatment. 

At a Saturday news conference, state Health Commissioner Steven Stack cautioned Kentuckians to not count on such treatments to protect them against Covid-19, pointing to an expected limited supply of the antiviral pills that will also come with restrictions. Instead, he said, the best plan to protect yourself against Covid-19 right now is to get a vaccine or booster as soon as you are eligible. 

So far, 2.7 million Kentuckians, or 62% of the total population, has received at least one dose of a vaccine; 2.4 million, or 54% of the total population, are fully vaccinated; and 788,022, or 18% of the total population, has been boosted. 

Daily report: Kentucky reported 2,913 more coronavirus cases Wednesday, raising the seven-day average  The share of Kentuckians testing positive for the virus in the last seven days continues to rise, to 9.61%. That's up from 9.33% Tuesday. 

Kentucky hospitals reported 1,210 Covid-19 patients; 327 of them in intensive care; and 185 on mechanical ventilation. 

Nine of the state's 10 hospital readiness regions are using at least 80% of their intensive care unit capacity, with six above 90%. 

The state's daily infection rate is 45.57 cases per 100,000 residents. Counties with rates more than double that rate were Wolfe, 129.7; and Lewis, 97.9. Kentucky's infection rate ranks 20th among the states, according to The New York Times. 

Ninety percent of the state's counties are red on the state infection map, for counties with more than 25 cases per 100,000 people, considered a high level of transmission. 

The state reported 36 more Covid-19 deaths, bringing its pandemic death toll to 11,918. 

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Experts urge respect, plain facts when talking to rural, conservative coronavirus vaccine skeptics

Rural Va. couple Everett and Kristin Jiles got Covid-19 in July, but only Kristin was vaccinated. After Everett had a much harder time recovering, the conservative Christian couple became crusaders for vaccination. Here, they talk about their story (AAMC video).

"Many people in rural and conservative areas remain frustratingly resistant to vaccination, challenging public health officials to come up with more convincing — and sensitive — approaches to promoting greater vaccine uptake," Beth Howard reports for the Association of American Medical Colleges. "It’s not enough to refute misinformation, experts say. To reach the vaccine-hesitant, public health officials urge a combination of approaches, from connecting with local physicians to having respectful conversations."

The problem is persistent: a recent University of Pittsburgh study shows that, although overall vaccine confidence rates have increased nationwide since the vaccines became available early this year, the same percentage of people who strongly opposed vaccination in January felt the same way in May. And even after adjusting for other factors like age, sex, race, employment status and education, people in very rural counties were 23 percent more likely to be vaccine hesitant than city dwellers.

Partisanship is also strongly correlated with attitudes toward coronavirus vaccination. "People in counties with the highest support for former President Donald Trump in the 2020 presidential election were 44% more likely to be vaccine hesitant," Howard reports. "Those living in a state with a Republican governor were 34% more likely to be hesitant than people living in a state with a Democratic governor."

Rural emergency medicine doctor Edwin Leap, who grew up in West Virginia, told Howard that the pandemic has exposed cultural rifts that go back generations. Because of that, mandates won't work, he said: "People in rural America are a culture. They tend to be fiercely independent ... The very last way you’ll get them to comply is by telling them they better do what’s right. They’re not going to have you tell them what to do."

Health and communications experts suggest the following approaches to increase rural coronavirus vaccination rates:

• Just provide the facts. Rural Americans resist mandates because they want to make their own decisions. So providing unbiased, basic information that will help them make an informed decision is the way to go.
• Leave politics at the door. The coronavirus has been deeply politicized, so it's important to avoid saying anything even remotely political in discussion vaccination. One expert told Howard that, if the subject of politics comes up, the best way to respond is something along the lines of "This virus does not care who you are or what you believe." That removes the discussion from politics and enables you to address the other person's concerns.
• Ally with community influencers. Rural Americans trust local health-care professionals much more than outsiders, so they're more likely to listen to fact-based vaccine recommendations from a community doctor, nurse, pharmacist or community health worker.
• Don't refute false claims about the vaccines. By bringing up misinformation, even if you do so to disprove it, you end up reinforcing the belief in the person's mind. So don't repeat falsehoods when providing vaccine information. "For instance, if someone says that vaccines give you Covid-19, you don’t have to say they don’t give you Covid-19," Howard reports. "Instead, provide an answer that addresses the vaccine’s overall safety — why and how they’re safe."
• Treat people with care and respect. Regardless of what someone believes, take their concerns seriously and treat them with respect. Don't talk down to people or make them feel judged or shamed.
• Be prepared to play the long game. It will likely take more than one conversation to change someone's mind about vaccination. When you're wrapping up a discussion about vaccination, "give them a call to action, such as offering additional resources to learn about the efficacy of the vaccine and inviting them to come back and talk about it more so that you can answer any other questions," Howard reports.

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Health-insurance companies' group makes 27 grants of up to $25,000 each to improve vaccination rates in Kentucky

The Clinton County News got a grant for four-color
ads spotlighting offices with 100% vaccination.

The Kentucky Association of Health Plans, which represents companies offering health insurance in Kentucky, has awarded 27 grants aimed at increasing acceptance of vaccines, especially those for Covid-19.

The grants of up to $25,000 will help various organizations "pursue efforts toward improving vaccination rates through outreach, communication, education, training, transportation, and/or support," KAHP said in a news release.

“For many months now, we have been partnering with various groups across the commonwealth and have had a lot of success in our vaccination efforts,” KAHP Executive Director Tom Stephens said. “We applied some of what we learned in that programming to launch a broader grant initiative that we think is quite impactful because we are really leveraging local organizations who know their communities best. It’s great to see so many different populations served. We certainly aren’t letting up because vaccines are the best defense against hospitalization and death.”

The Institute for Rural Journalism and Community Issues at the University of Kentucky, which publishes Kentucky Health News, obtained a $25,000 grant for the Kentucky Press Association to subsidize publication of special vaccination sections in newspapers that will be delivered to every household in some low-vaccination counties.

The Clinton County News received a grant that Editor-Publisher Alan Gibson said will be used for four-color advertising to recognize local employers that have 100 percent vaccination rates, modeled after the "house ad" that he ran about his own business.

Other grants have gone to the Lawrence County Health Department, the Lewis County Health Department, the Louisville Jefferson County Metro Government Department of Public Health and Wellness, Jefferson County Public Schools, St. Joseph Children's Home, Boulware Mission, Americana Community Center, Family Scholar House, Lexington Community Radio, Presbyterian Child Welfare Agency, Owensboro Health Twin Lakes Medical Center, Owensboro Health Muhlenberg Community Hospital, the Hopkinsville-Christian County NAACP, Appalachian Early Childhood Network, Mark 12 Ministries, the Kentucky Pharmacists Association, the Kentucky YMCA Youth Association, Maysville Community and Technical College, the Casey County Public Library, the University of Louisville, Presentation Academy, The People's Clinic, Operation Warm and the KCEOC Community Action Partnership, which serves 16 counties in Eastern and Central Kentucky.

"Some organizations like the Newcomer Academy at Jefferson County Public Schools have already initiated programming, conducting vaccine outreach and a clinic for English as a Second Language families," the release says.

"In September, KAHP completed a Disney trip sweepstakes for 20 grand prize winners who received their shots during the month of September. In August, in partnership with Volunteers of America Mid-states, KAHP launched 'Take 1 for the Team,' a hyper-local, targeted vaccine outreach and incentive campaign in Clay County, which combines heavy digital advertising featuring local influencers like pastors, coaches, doctors, and others, as well as offers for free food, free drawings for cash prizes, a free professional wrestling match, and a competition between local schools for $6,000 in sports equipment.

"The program has steadily raised vaccination rates, and building on this success, the two organizations launched a parallel effort in the West End of Louisville called 'Healthy West Lou.' KAHP provided an unlimited ride wristband and $20 gift card to all individuals who received the vaccine at the Kentucky State Fair.

"In June, KAHP visited Mercer, Montgomery, Estill, Nicholas, and Rockcastle counties for a 'Hottest Concerts' ticket giveaway at county health departments. KAHP visited the Lee, Owsley, Breathitt, Magoffin, and Leslie County health departments and gave away $100 Visa gift cards to those who received the shot. KAHP also held a “Shots Across the Bluegrass” live broadcast and pop-up vaccination clinic tour with Kentucky Sports Radio, with stops in Barren, Green, McCracken, Clay, and Laurel counties. . . . 

"Kentucky’s Medicaid managed-care organizations and commercial insurers are reaching their members through digital and radio ads, robust cash incentives, transportation coordination, pop-up clinics, clinics staffed by bilingual personnel, homebound vaccination visits, text and email campaigns, yard signs, billboards, outbound calls to members prioritized by risk tier, personalized assistance from advocates with sign-ups and digital site navigation, direct mail, and follow-up on second dose appointments based on claims data."

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Biden to get free, at-home Covid-19 test to Americans in January; In Ky. Covid-19 metrics are high, but stable

By Melissa Patrick
Kentucky Health News

As health officials predict a "national surge" in Omicron cases, President Joe Biden on Tuesday announced plans to distribute a half-billion free, at-home Covid-19 tests and provide more help for strained hospitals.

Biden assured Americans that despite this latest surge of variant, the nation is more prepared that it was last March. 

"This is not March of 2020," he said. "Two hundred million people are fully vaccinated. We're prepared. We know more."

In Kentucky, 2.7 million Kentuckians, or 62% of the total population, have received at least one dose of a vaccine; 2.4 million, or 54% of the total population, are fully vaccinated; and 784,270 people, or 18% of the total population, have received booster shots  

Biden’s plan also aims to expand access to vaccination sites across the nation. The president told unvaccinated Americans that they have an obligation to get vaccinated, calling it a "patriotic duty" and "an obligation to your country." 

"If you're not fully vaccinated, you have good reason to be concerned" about the Omicron variant, he warned.

The federal government will start delivering the free, rapid Covid-19 tests to homes next month and a website will be set up for Americans to order them, according to a statement. 

Gov. Andy Beshear and Health Commissioner Steven Stack have both encouraged Kentuckians to do a rapid Covid-19 test at home or to go get tested just before attending indoor events or traveling this holiday season, but at-home tests are often scarce and are generally expensive, with one report finding  they cost upwards of $25 for a pack of two tests in some locations. 

The Centers for Disease Control and Prevention has reported that the Omicron variant now accounts for 73% of all new coronavirus cases in the United States. 

Kentucky reported 2,566 new coronavirus cases Tuesday, bringing the seven day average to 2,270, up one from Monday. Of today's cases, 19.6% of them are in people 18 or younger. 

The share of Kentuckians testing positive for the virus in the last seven days is 9.33%, up from 9.2% on Monday. 

Hospitals reported 1,205 Covid-19 patients, down one from Monday, with 328 in intensive care (up three) and 174 of them on mechanical ventilation (down two). 

Eight of the state's 10 hospital readiness regions are using at least 80% of their intensive care capacity, with six above 90%. The Barren River and Lake Cumberland regions are using the most, at 96.15% and 96.36% respectively. Northern Kentucky dropped from 100% to 92.86%. 

Biden's plan also increases support for hospitals in hard-hit areas to ensure that they will have the personnel, beds and supplies they need to face rising Omicron hospitalizations, which is largely occurring among the unvaccinated. 

Beshear said Monday that with the exception of a hospital hit by the biggest tornado that ravaged Western Kentucky last week, he had not heard of any Kentucky hospitals eliminating elective procedures at due to an influx of Covid-19 patients. 

The state's seven-day daily infection rate is 45.02 cases per 100,000 residents. Counties with rates more than double that rate were Wolfe, 137.7; Menifee, 107.9; Union, 101.3; Lewis, 101.2; Carroll, 94.1; and Trimble, 92.8. Kentucky's infection rate ranks 21st among the states and Washington, D.C., according to The New York Times. 

As we head into the holidays, 87.5% of the state's counties are in red on the state infection map, representing those with more than 25 daily cases per 100,000 people, considered a high level of transmission. 

The state reported 35 more Covid-19 deaths, bringing the pandemic death toll to 11,882. The seven-day death average is 29.

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As highly contagious Omicron variant becomes dominant in U.S., Beshear says Ky. cases will rise and he will watch hospitalizations

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

By Melissa Patrick

Kentucky Health News

Cases of the coronavirus cases and the share of Kentuckians testing positive for it remain on high plateaus, but Gov. Andy Beshear warns that these numbers will go up because of the highly contagious Omicron variant of the virus, which is now the predominant strain in the United States.

"Case numbers will go up," Beshear said at a Monday news conference. "We'll be watching hospitalizations real closely, that will end up being our major metric that we follow during Omicron. But given that it is more contagious, unless a whole lot of people go out there and get boosted and vaccinated for the first time, these case numbers are going to shoot up." 

Kentucky has reported 5,321 new coronavirus cases since Saturday, 1,215 of them on Monday. That brings the seven-day rolling average to 2,269, 6.3% above the average on Friday.

Beshear said he has not been alerted to any more counties with the Omicron variant, but  said, "Omicron is probably in every county by now." On Saturday, he announced that it had been identified in Kenton, Campbell, Fayette and Jefferson counties. 

The Centers for Disease Control and Prevention reported late Monday that the Omicron variant now accounts for 73% of coronavirus cases in the U.S.

At the start of Christmas week, Beshear encouraged everyone to get vaccinated for the virus or get a booster shot, and to take a Covid-19 test as close to any event as possible and to wear a mask when appropriate. 

The share of Kentuckians testing positive for the virus over the last seven days is 9.2%, essentially returning it to the peak it reached before this month's decline. It was 9.21% on Dec. 3. 

Covid-19 hospital cases are down 3.75% in the last week. Kentucky hospitals reported 1,206 Covid-19 patients, a decrease of 49 from Friday, 325 in intensive care (down four) and 176 on mechanical ventilation (down 19). 

Eight of the state's 10 hospital readiness regions reported using at least 80% of their intensive-care beds, with four of them above 90%. The Northern Region is still at 100% capacity. 

Beshear said as hospitals prepare for Omicron, they should reconfirm their relationships with nursing schools so that they can get their help if needed, as they did earlier in the pandemic. He also said it's important to find virtual ways to connect with some patients, to ensure that people who need care have access to it. 

The state's seven-day infection rate is 45 daily cases per 100,000 residents. Counties with rates more than double that rate were Robertson, 216.9; Wolfe, 119.8; Menifee ,114.5; Union, 109.3; Lewis, 103.3; and Trimble, 102.9. Kentucky's infection rate ranks 22nd among the states and Washington, D.C., according to The New York Times. 

Nearly 87% of the state's counties are in red on the state infection map, representing those with more than 25 daily cases per 100,000 people, considered a high level of transmission. 

Moderna announced today a booster dose of its Covid-19 vaccine protects against the Omicron variant. It said the dose, half as much as used in the shots for adults, raised antibody levels against Omicron by 37 times; a full-dose booster, recommended for people with weak immune systems, increased antibody levels by 83 times.

Pfizer-BioNTech said last week that its booster increased antibody levels by 25 times.

The CDC recommends either the Moderna or Pfizer Covid-19 vaccine, which are created with messenger RNA, unless the one-dose Johnson & Johnson vaccine is the only one available. 

According to state data, only 18% of the 2.4 million Kentuckians who are fully vaccinated have gotten their booster shot. Beshear said boosters are needed for protection against Omicron because it is one of the most contagious viruses ever identified and most monoclonal antibodies for Covid-19 don't work against it.

“The message here is pretty simple: Omicron is spreading faster than anything we’ve ever seen. It looks like it's one of the most contagious viruses in modern history,” he said. "Some of the therapeutics, the ways that we help you out, won't work on it. . . . But you know what does? being vaccinated and being boosted." 

Beshear specifically encouraged parents and guardians of school-age children to get them vaccinated. Only 15% of children 5-11, 45% of those 12-15, and 48% of those 16-17 have received at least one dose. 

"Omicron is going to be really hard on schools," Beshear said. "Those that have universal masking are going to be in the best shape. But those that have the highest percentage of kids that are vaccinated are also going to be in the best shape to stay in person."

The state reported 93 more Covid-19 deaths since Saturday, with 32 of them reported on Monday. That brings the pandemic death toll to 11,847. Beshear said one of the deaths was a 29-year-old in Franklin County and another, in Martin County, was 34. 

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Nations with mask policies had fewer Covid-19 deaths early on

Photo by David J. Phillip, Associated Press

Mask policies in various countries have been shown to reduce deaths from Covid-19, regardless of the role of vaccines.

A study published in the American Journal of Preventive Medicine looked at 44 countries in Asia and Europe to see how mask policies enacted at the beginning of the pandemic affected Covid-19 deaths. Countries included Greece, Germany, Korea, Italy, Sweden, Hong Kong and the United Kingdom, among others. Mask policies in the U.S. and Canada were not included in the study because they are made by states or provinces.

The study analyzed Covid-19 deaths from February 2020, when the first Covid-19 deaths were confirmed, and May 2020, and the point when some countries began lifting restrictions. It found that nations without mask policies had 288 deaths per million residents; those with policies had 48 per million.

Overall, deaths were “significantly lower” in countries that enforced mask policies, suggesting face coverings offered an additional layer of protection that “could prevent unnecessary Covid-19 deaths,” researchers said in a news release.

The findings also emphasize the important role face masks play in regions that still don’t have access to Covid-19 vaccines, researchers say, especially as more dangerous variants continue to emerge and spread. “Across variants, vaccines may reduce mortality but not necessarily morbidity, and face masks continue to protect against both,” said lead study investigator Dr. Sahar Motallebi of Lund University in Sweden. “So, we don’t have to choose between these two good policies of vaccination and face masks or substitute one for the other when we can and must do both in parallel.”

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Flu cases in Ky. more than double in a week; health officials encourage everyone 6 months and older to get a flu vaccine

Dept. for Public Health map shows flu cases by county; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

As influenza cases in Kentucky more than doubled in one week, health officials said it's not too late to get your flu vaccination. Flu season typically peaks in February, but runs through May. 

"So it is very important that people get their flu vaccine," said Brooke Hudspeth, chief practice officer at the University of Kentucky College of Pharmacy. "We know that flu vaccines work and they are very well tolerated. And they are a key way to help prevent complications that we see from the flu."

The latest weekly report from the state Department for Public Health shows that in the week ended Dec. 11, Kentucky counted 402 new flu cases, up from 195 the previous week prior, an increase of 106%. The state has recorded 695 cases this season. No flu-related deaths have been reported this year.

Fewer adults in Kentucky got a flu vaccine last season, but the state also saw a big drop in cases. During the same reporting week last year, Kentucky had only seven confirmed cases of the flu, and a total of 125 for the season. 

The drop was likely due to the strict public-health measures taken against Covid-19 at that time, such as masks and social distancing. 

According to the Centers for Disease Control and Prevention, the number of adults getting a flu vaccine in Kentucky dropped to 44.9% in the 2020-21 flu season, compared to 48.4% in the 2019-20 flu season.

Kentucky Department for Public Health graphic, click on it for a larger version.

A county-by-county report shows that Jefferson County, which has more than 750,000 people, had the highest number of cases, reporting  233 in the week ending Dec. 11. Other counties with the highest number of cases that week were Pike, 26; Warren, 22; Oldham, 20; Allen, 18; and Fayette, 18. 

Health Commissioner Steven Stack has repeatedly encouraged Kentuckians to get both a Covid-19 vaccination or booster and a flu vaccine.

 "With Covid-19 cases escalating and the added threat of circulating flu viruses, it is imperative that every Kentuckian take the essential steps to protect themselves, their loved ones and their communities," Stack said in a news release.

Hudspeth said it is safe to get both the Covid-19 vaccination and the flu shot at the same time, and it's important to get both, since having Covid-19 and the flu at the same time can increase a person's risk of  severe complications. 

“If you are vaccinated, you are less likely to get the flu and spread the flu to those at greatest risk for becoming dangerously ill, including young children, pregnant women, people 65 and older and those with underlying medical conditions," said Stack.  

At a Dec. 18 news conference, Stack said this year's flu vaccine should be quite effective because it contains the H3N2 strain, which is the one that is circulating. "So this year's vaccine should be very helpful," he said. 

Flu shots are recommended for everyone six months and older and are strongly encouraged for people who may be at higher risk for complications or negative consequences. 

Kentucky has a long way to go to get all of its adults vaccinated against the flu. 

A Foundation for a Healthy Kentucky poll, taken Aug. 4-Sept. 4, found that almost two-thirds of Kentucky adults said they are very or somewhat likely to get the vaccine by the end of the year; 28.4% said they were very unlikely to get the flu vaccine and 5.9% said they were somewhat unlikely to get it.

Kentucky's influenza level is considered to be regional, a classification that is applied when increases in flu cases have been confirmed in at least two, but fewer than half, of the state's 16 regions.

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Rep. Andy Barr writes about bill, named for his late wife, to spur research into the heart ailment that killed her in June 2020

The late Carol Barr with her husband and daughters Eleanor and Mary Clay.

By U.S. Rep. Andy Barr

Though every holiday season without my wife Carol will be difficult, this year I am comforted by the fact that her legacy will be enshrined through the Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act, which passed the U.S. House of Representatives on Wednesday.

The CAROL Act makes historic investments in treatments for valvular heart disease to close the gaps in understanding about what risk factors make valvular heart disease a potentially life-threatening condition.

On June 16, 2020, my and my two daughter’s lives changed forever when my wife and best friend Carol unexpectedly passed away at 39 years old from sudden cardiac arrest. The medical examiner and Carol’s doctors told us that her fatal heart attack was likely brought on by a ventricular arrhythmia.

At a young age, Carol had been diagnosed with an underlying condition called mitral valve prolapse (MVP), or floppy valve syndrome—a typically benign condition that results in sudden cardiac death in only .2% of cases.

What factors placed Carol in the 0.2% versus the 99.8% category? In my discussions with top cardiologists, medical experts, researchers, and advocates following Carol’s passing, I learned the extent to which the medical community seriously lacked answers to this critical question. So, I decided to take action and introduce the CAROL Act, to better equip our medical community with the resources needed to develop predictive models, inform communities, and possibly save the lives of other loved ones.

Specifically, the CAROL Act authorizes a grant program administered by the National Heart, Lung, and Blood Institute, to support research on valvular heart disease, including MVP. This legislation martials the full power of 21st-century medical innovation and encourages the utilization of technological imaging and precision medicine to generate data on individuals with valvular heart disease. It is through this research that we can help identify Americans at high risk of sudden cardiac death from valvular heart disease and develop prediction models for high-risk patients, enabling interventions and treatment plans to keep these patients healthy throughout their lives.

Additionally, the CAROL Act will instruct the Centers for Disease Control and Prevention to increase public awareness regarding symptoms of valvular heart disease and effective strategies for preventing sudden cardiac death.

This week, the CAROL Act, which has earned 179 bipartisan cosponsors, passed the U.S. House of Representatives. My friend and fellow Kentuckian, Sen. Mitch McConnell and Arizona Sen, Kyrsten Sinema, whose sister also passed away from valvular heart disease, are leading the companion bill to the CAROL Act in the Senate.

We are rapidly approaching the finish line of this legislation becoming law. No matter what, Carol Barr’s greatest legacy will always be our two beautiful daughters, Eleanor and Mary Clay. Now, through the CAROL Act, her legacy also offers an element of hope that countless families will not have to experience the tragedy that has so profoundly impacted ours.

Andy Barr is a Republican representing the Sixth Congressional District.

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Every Covid-19 indicator in Kentucky is up; hospital cases rose 52% in last month; but vaccinations are outpacing new cases

Ky. Health News graph (virus cases based on initial, unadjusted reports); click on it to enlarge.

By Melissa Patrick
Kentucky Health News

As every metric used to measure the coronavirus in Kentucky kept rising over the weekend, the good news is that the number of Kentuckians getting newly vaccinated was much more than the number of new cases. 

"We are seeing more vaccinations over this last weekend than we have seen in a long time and at every state of the vaccination process," Gov. Andy Beshear said at his weekly pandemic press conference.

The number of cases reported in Kentucky during the Monday-through-Sunday reporting week is the highest it's been in nine weeks, at 15,875. "We are certainly not headed in the right direction," Beshear said.

The state reported 4,891 new cases of the virus since Saturday, raising the seven-day rolling average to 2,345 per day, up 15% from Friday's average.

But over the weekend, Beshear said, 15,117 Kentuckians received a first dose of a vaccine -- more than three times the number of new cases. He said 18,189 became fully vaccinated and 45,137 got a booster shot. So far, 2.7 million Kentuckians, or 61% of the total population, has received at least one dose of a vaccine. 

Beshear urged Kentuckians in their 40s to get their vaccinated, noting that 12 of the deaths reported since Saturday were in that age group, 68% of which have received at least one dose of a vaccine.

Of Monday's cases, 23% are in people 18 and younger. 

So far, Beshear said no cases of the Omicron variant have been reported in Kentucky, but "it would almost be surprising if it was not here." So far, the variant has been detected in at least 18 states, The New York Times reports. 

The share of Kentuckians testing positive for the virus in the past seven days is 9.13%. This weekly rate has increased steadily for five weeks. It has plateaued lately, perhaps because more people have been getting tested.

The state's seven-day infection rate is 47.96 daily cases per 100,000 residents, up from 41.73 on Friday. Counties with rates more than double that rate were Cumberland, 133.9; Powell, 126; Robertson, 108.4; Lawrence, 100.7; and McLean, 96.2. The state's red zone, for more than 25 daily cases per 100,000 residents, considered a high level of transmission, includes 110 of the 120 counties. The remaining 10 counties are in the orange zone, for more than 10 to 25 cases, considered substantial transmission. 

Beshear said these increases are largely driven by the highly contagious Delta variant, waning immunity and people's behaviors. "With that much Covid heading into the holidays, we need to be careful," he said. 

He offered several tips to stay safe, including encouraging eligible Kentuckians to get vaccinated or to get their Covid-19 booster shot as soon as possible; to not attend a gathering if you are sick; to wear a mask indoors; and to keep attendance numbers at at gatherings low. 

Beshear also advised schools and all businesses where people are in close contact to require masks, and said it's time for communities and businesses to "double-down" on encouraging vaccinations. He no longer has authority to impose mask mandates, because the legislature took that power from him.

Kentucky hospitals reported 1,077 Covid-19 patients Monday, up 105 from Friday; 310 of them in intensive care (up 26); and 168 on mechanical ventilation (up 12). In the last month, hospital cases are up 52%.

Beshear displayed graphs showing all of the hospital numbers are rising, but said there are no immediate concerns that hospitals could be overwhelmed. 

"Everybody has overall concern because of where staffing is and and seeing cases starting to go back up  and hospitalizations," he said, "but no one is sounding the alarm yet." 

Seven of the state's 10 hospital readiness regions are using more than 80% of their intensive-care beds, with six of them over 90%. 

The state reported 198 more deaths since Saturday, with 63 of them reported Monday. The pandemic death toll is now 11,289. Since Saturday, 17 of the deaths were in people under 50, and one of them was 23. 

In other pandemic news Monday: 

The University of Kentucky now has 90% of its campus community either partially or fully vaccinated, says a letter from President Eli Capilouto. That includes 87% of students, 97% of faculty, 93% of staff, and 93% of UK HealthCare. 

Capilouto urged Kentuckians to get a booster and flu shot, and noted that UK HealthCare has opened a Covid-19 vaccination clinic for children 5-17 at 245 Fountain Court in Lexington. 

He noted that despite courts' blockage of President Biden's vaccination mandate for facilities that receive payments from the Centers for Medicare and Medicaid Services (virtually all of them), Covid-19 vaccines remain mandatory for UK HealthCare employees, unless they have an exemption. 

Beyond Kentucky, new guidelines for international air travel now require all travelers two years of age or older who are returning to the U.S. to show proof of a negative Covid-19 viral test performed within one day of departure, to get tested three to five days after they return, and to self-isolate and get tested if they develop symptoms. All unvaccinated travelers are advised to quarantine for seven days.

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Aleria Companies and bankrupt Trinity HealthShare told to pay $4.7 million in Lexington class-action lawsuit that is still going on

"A purported health care cost-sharing company . . . has lost a class-action lawsuit resulting in a nearly $4.7 million judgment" in U.S. District Court at Lexington, reports Jeremy Chisenhall of the Lexington Herald-Leader. 

After representatives of The Aliera Companies "failed to appear in court multiple times, according to records, Senior Judge Joseph M. Hood "declared that the company should have been subjected to Kentucky insurance laws because their claims of selling health care sharing ministry plans were inadequate," Chisenhall reports. "Members in health care sharing ministries share medical expenses among themselves. Health-care sharing ministry plans aren’t subject to the same regulations as insurance, but they have to meet strict requirements. Aliera didn’t meet those requirements, Hood ruled."

Jay Prather, one of the plaintiffs' attorneys, said “Aliera and its partners have taken advantage of hundreds of Kentuckians, many of whom trusted the company because it professed Christian beliefs. “Aliera’s customers sought affordable healthcare coverage to protect their families in times of need. But when those times of need came, Aliera was more likely to shut the door in the face of its own customers. This ruling by Judge Hood is the first step in helping those families recover what they have lost.”

"Aliera created, marketed, sold and administered health care plans for Unity HealthShare and Trinity HealthShare, companies that were purported to be health-care sharing ministries, according to the lawsuit. Unity HealthShare later rebranded itself as OneShare Health, according to court records," Chisenhall reports. "Hood sided with the victims that purchased a plan while Aleria was partnered with Trinity. Assuming each policyholder would elect to receive the higher payout of those two options, Hood reached an aggregate judgment of $4.7 million, according to court records. Trinity has since filed for bankruptcy, according to court records."

The lawsuit continues because Hood's ruling applies only to policies sold through Trinity. Attorneys for the plaintiffs said Aleria sold plans to "hundreds, if not thousands, of Kentucky residents" and kept 84 percent of their payments. Conversely, insurance companies are required to pay out 80% of the premiums they received, but the law doesn't apply to health care cost-sharing companies.

Aleria denies that it was a health care cost-sharing company. It said in a court filing, “It is a for-profit entity that contracted with Unity and then Trinity (through its subsidiaries) to market memberships in their sharing programs and to create processes to facilitate member-to-member sharing of medical expenses. Aliera has created a system that is designed to afford members the ability to consent to their contributions being shared on a real-time, case-by-case basis with other members as their needs arise. But, as previously noted, all members are informed that their requests for sharing payments may not be met — there are no payment guarantees or indemnification.”

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Legislature will again be asked to let local governments pass tobacco-regulation ordinances, aimed at preventing youth use

By Melissa Patrick
Kentucky Health News

Kentucky lawmakers can expect another bill to be filed in January to give local governments the ability to regulate tobacco products, touted as a another tool in the box to limit young people's use of the products, advocates said on a training webinar Wednesday. 

The Foundation for a Healthy Kentucky "Health for a Change" webinar provided education on the potential impacts of local tobacco control in anticipation of 2022 legislation that would restore local control over the marketing, sale and distribution of tobacco products. 

Sen. Paul Hornback

Republican Sen. Paul Hornback of Shelbyville said on a recorded video that he supports repealing the law, adopted in 1996 after lobbying by tobacco-product manufacturers, that stripped local communities of the power to regulate the sale, marketing and distribution of such products. 

"As a father, grandfather, lawmaker, tobacco farmer, I'm outraged at the the marketing tactics that have been used to attract our youth, leading to more than one in four Kentucky high schoolers using e- cigarettes. . . . Please join me today in support of repealing the old law and restoring local control to our communities and protecting our youth," Hornback said. 

He added, "Restoring these options does not create a mandate to pass laws, it only gives communities that are ready the opportunity to enact their own protections." Hornback announced in June that he will not run for reelection in 2022. 

Mahak Kalra, chief policy and advocacy officer for Kentucky Youth Advocates, applauded the General Assembly for its efforts to curb youth use of tobacco products: passing a statewide tobacco-free school policy, increasing tobacco taxes and raising the legal minimum age to buy tobacco products to 21.

"The commonwealth is trying to continue to build off this legislative momentum," Kalra said. "Everyone from policymakers to advocates to educators to parents need to be involved in this effort from keeping tobacco products away from our children and we hope that you alongside of your alongside your network of advocates will join us in this effort." 

Sen. Julie Raque Adams, R-Louisville, who sponsored a local-control bill in the 2021 session, said at the Kentucky Voices for Health annual meeting that it will be hard for such a bill to gain traction during a session in which the legislature must pass a state budget. "We're going to have to fight to get some airtime on that issue," she said. "We only have so much bandwidth."

Kalra said that while tobacco products are evolving, the tobacco industry's tactics to get products into the hands of youth have remained the same since the 1960s and that every effort should be made to minimize youth exposure to these products. 

"The reality is that nearly 90% of tobacco users first try a tobacco product by age 18. But if they did not start using nicotine by age 26, they are unlikely to never start," she said. 

Allison Adams, vice president for policy at the health foundation, painted a picture of youth use of tobacco in Kentucky. She said nearly 30% of high schoolers report using any tobacco product and 19.7% of middle schoolers are using some sort of tobacco product, the highest rate among the 11 states surveyed. 

Adams said that among current high school users of electronic cigarettes, 43.6% use vapes frequently (20 or more days in past 30 days) and 27.6% use them daily, indicating a strong dependence on nicotine among our youth that will ultimately result in 119,000 Kentuckians to die prematurely from tobacco use. 

Foundation for Healthy Kentucky graphic

"Time is of the essence to add more tools to our toolbox," Adams said. "We can't express enough the urgency of the issue to stop the nicotine addiction that we are experiencing and seeing in Kentucky amongst our youth."

Katherine Morrison, a youth advocate from McCracken County, said vaping is a real problem in her school and that many youth who would never consider smoking traditional cigarettes will use electronic cigarettes because of their flavors and lack of an offensive smell. 

If the 1996 law is repealed, local communities would have the option to enact ordinances to keep children from being exposed to the products, such as buffer zones for sales of vaping products near schools, requiring products to be under a counter rather than point-of-sale locations, and restricting advertising on marquees or store windows, said Shannon Smith of the American Heart Association. She said local communities would still not be able to raise taxes on tobacco or vape products. 

Prestonsburg Mayor Les Stapleton said he supports legislation that allows local control because communities know what works best for them. He said some will be more willing to enforce stricter measures than others.

Smith promoted the Nix the Next campaign, which seeks support for repealing the 1996 law. The Kentucky Youth Advocates webpage for the campaign includes information on ways to contact legislators about the issue.

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