Tuesday, June 2, 2020
Beshear says more time needed to detect a 'new bump' in virus cases; says Supreme Court upholds his orders on gatherings
 |
| Kentucky Health News chart shows upward two-week trendline slightly lowered by latest report. |
By Melissa Patrick
Kentucky Health News
As he announced 155 more cases of the novel coronavirus in Kentucky, Gov. Andy Beshear said he still wants more time to analyze the upward trend of recent days.
"It's going to take five, six, seven days to try to truly see if this was perhaps related to our testing in long-term care [where] we are seeing an escalation of cases," he said at his daily briefing. "We want to try to make reasonable determinations based on data and we simply don't have enough right now to suggest that there is a new bump right now."
Beshear said a week ago that the state had begun the long-forecast decline from a plateau of several weeks, but high numbers at the end of the week reversed the two-week trendline, a key metric for any epidemic. Tuesday's number of 155 cases was much lower than those on three of the last four days, which had 214 or more cases. But the two-week trend remained decidedly upward.
"I still believe that if we are not plateaued, we are decreasing, but the data is going to bear that out," Beshear said. "We are going to have to watch and see."
The governor did not give an update on long-term care facilities Tuesday, but the latest long-term care facility report, dated May 31, showed that 1,358 residents and 621 employees had tested positive for the virus in 124 facilities, and 250 residents and two employees had died from it.
Beshear reported an adjusted total of 10,185 cases of the virus in Kentucky, at least 3,275 of whom have recovered. He said 481 people are hospitalized with covid-19, including 85 in intensive care. The counties with the highest number of new cases Tuesday were Jefferson, 46; Franklin, 17; and Fayette and Warren, each with 10.
He said 253,585 tests for the virus have been done in Kentucky, bringing it into the top half of states. As he has reopened the state's economy, Beshear has encouraged Kentuckians to consider getting tested monthly, and more often if they have lots of contacts, to track the spread of the virus. "It helps us to restore our economy safely," he said.
Beshear also announced that have been three more deaths from covid-19, bringing the state's death toll to 442. The fatalities were a 69-year-old woman from Clay County, a 94-year-old man from Jefferson County and a 92-year-old man from Muhlenberg County.
“Let’s keep lighting our homes up green” in honor of the dead, Beshear said. “Let’s continue to ring our bells at 10 a.m. Let’s do it for those that we’ve lost from this and from senseless violence. Everybody that we’ve lost that should still be here deserves that same level of compassion.”
The first part of Beshear's briefing was spent on an update of the protests against police violence that have been going on in Louisville and across the state. He reiterated that black Kentuckians continue to be disproportionately affected by the virus, at a rate more than double their share of the state's population.
"Before what we are seeing in Louisville and around the country, this again was showing what inequality results in, which is death," he said. "We were seeing that because of inequalities that have lasted hundreds of years and absolutely exist in our health-care system. . . . This is not OK and we're going to do something about it."
Beshear said he would announce later this week an initial plan to address inequalities in health care, which will intend to "actually make change in the health of individuals."
“Just like in many ways it shouldn’t have had to take some terrible incidents around our country to wake people up or to get them to listen to the type of injustices that are occurring in our society, it shouldn’t take a one-in-every-100-year pandemic for us to see the same in health care," he said.
Beshear again cautioned protesters that the virus is still spreading, and asked them to do their best to be safe by wearing a mask, social distancing, and staying away from seniors and others vulnerable to the disease.
Switching to the courts and politics, Beshear noted that last Friday, the Supreme Court issued an order upholding the California governor's orders limiting mass gatherings in houses of worship, orders similar to those issued by Beshear and other governors. The vote was 5-4, with Chief Justice John Roberts joining the court's four liberals.
A Beshear news release noted that Roberts said state officials have broad latitude to protect public health. Roberts wrote, “Where those broad limits are not exceeded, they should not be subject to second-guessing by an ‘unelected federal judiciary,’ which lacks the background, competence, and expertise to assess public health and is not accountable to the people.”
Beshear said the ruling should resolve all current federal-court challenges to his emergency orders.
For additional information, including an up-to-date list of cases and deaths, as well as breakdowns of the virus by county, race and ethnicity, click here.
More covid-19 news for Tuesday:
- MedPage Editor in Chief Dr. Martin Makary of Johns Hopkins University talks about what the second wave of infections could look like, what vaccines and treatments in the pipeline are most exciting to him, and the value of wearing a mask, noting that the risk of airborne transmission is far greater than from the transmission of the virus through surfaces. "We're increasingly learning the value of wearing masks in a situation like this," he writes, "and I think it's powerful."
- White House coronavirus response coordinator Deborah Birx said the U.S. should not expect the coronavirus outbreak to wane over the summer, Politico reports.. "None of us can be lulled into this false sense of security that the cases may go down this summer," Birx said in a discussion with the German Marshall Fund president during the organization's Brussels Forum webcast. She added that American leaders are preparing actively for the possibility of finding and containing future outbreaks through contact tracing and proactive surveillance.
- About seven in 10 Americans say they would get a vaccine to protect against the coronavirus if it was free and available to everyone, according to a Washington Post-ABC News poll. This number was higher among Democrats than Republicans, 81% and 58% respectively, the Post reports.
- The University of Kentucky's College of Public Health and Gatton College of Business and Economics will hold a free webinar from noon to 1 p.m. June 3 to discuss research demonstrating that strong social-distancing measures imposed at the onset of the pandemic were effective in slowing disease transmission, thereby saving lives. Click here for more details.
- The Lexington Herald-Leader offers tips on how to stay safe at yard sales in the pandemic. Experts also tell the Herald-Leader in a separate article that playgrounds are not safe and can lead to the spread of the disease.
- A Lexington pharmaceutical company is developing a nasal spray to treat covid-19, Alex Acquisto reports for the Herald-Leader. The spray would be used on patients who've been diagnosed with the virus, but who "have not yet exhibited symptoms severe enough to require hospitalization," says the press release.
- The pandemic has resulted in the closing of more than 100 day centers for elderly adults and adults with disabilities in Kentucky, leaving about 9.500 individuals "suddenly cut off from the daily meals, health services, therapy and social activites they and their caregivers rely on," Deborah Yetter reports for the Louisville Courier Journal.
Writer worries about spread of virus in Central Ky. restaurants
I'm worried that almost none of the restaurants in Clark and Jessamine counties are following the guidelines for safe reopening of their dining rooms.
I just went to one of my favorite places for carryout, and there must have been 10-15 people crowded into a small space, many at a lunch counter not more than six inches apart (rather than the six feet required). None of the tables were closed off. There was a big jug of sanitizer on the counter, but no dispenser. You would have to handle it and unscrew the cap to use it. The condiment bottles and salt shakers were sitting out on the counter so everyone could handle them. And I was the only one wearing a mask. The cook wasn't. The server wasn't. Not one of the customers were. And none of the workers were wearing gloves.
This was the worst I've seen, but it's been almost as bad at other places. Is no one enforcing the public safety rules? I like to local, independent businesses, but they've been the worst. At least the big chains seem to make a bit more of an effort. Two that seem to be doing it right are Starbucks and Jimmy John's. But for the mom-and-pop places, it's like "the deadly virus is over because the governor has allowed us to reopen." It isn't.
We just passed the 100,000 dead mark in this country. Think about that -- 10,000 people a week in only about 10 weeks, or nearly twice as many as died in 10 years of the Vietnam war. I don't want to sound like an alarmist, but people, this is a crisis. If you can't do this right, the government is going to have to shut it all down again, and the gains we made in March and April through social distancing and business closures will have been for nothing.
I know people who have had this disease. I know people with relatives who have had it. Here in Clark County, the numbers have more than doubled in the past few days. Epidemiologists say it hasn't even come to rural America yet, but it's coming.
Randy Patrick is a reporter for the Winchester Sun. He posted this on his personal Facebook page. He posted the first comment: "I'll have to say, as much as I like the food at the place I got lunch at today and the guy who owns it, I won't be going back. He may not take this seriously, but I do."
60 Minutes promotes one hospital’s “promise of plasma”
I’m a bit late on this with only a few excuses. The birth of a new grandson. Computer problems. Living in the Minneapolis area and being focused on the death of George Floyd and the ensuing protests.
But this is worth addressing, even though a little late.
CBS 60 Minutes broadcast a story it called, “The Promise of Plasma,” about a trial of convalescent plasma at just one medical center in New Jersey.
You’re going to hear a lot about convalescent plasma because the approach makes intuitive sense. But science needs to prove that things work. Intuition is not sufficient. And the 60 Minutes story did a pretty weak job of establishing the difference. (The Mayo Clinic explains convalescent plasma on its website.)
Here are some of the things that could have been improved in the 60 Minutes story.
- There are many clinical trials of convalescent plasma all over the US and all over the world. CBS referred to tests at “numerous hospitals” – which is a bit of an understatement. And the only one mentioned, the only one profiled by CBS, was one in New Jersey, which CBS notes is “just a 30-minute drive from midtown Manhattan,” where 60 Minutes is based. Perhaps that’s why CBS chose to shine its light only on one hospital.
- The tone of the piece was highly promotional. It referred to the hospital’s “breakneck battle” and “all out battle.” The segment’s title – “The promise of plasma” – is alluring alliteration. But “promising” was one of the words patients have told me they don’t need to hear in medical news stories.
- The only data – the only evidence – provided by 60 Minutes was what this one hospital told them: “So far, 31 of the 46 patients who received plasma in this study appear to have recovered more quickly than those who didn’t.” There are many holes in that statement and many questions left unanswered by CBS. And no data from all of the other clinical trials around the globe were presented.
- There was also no independent perspective in the story. All of the input came from one hospital and one research team. Nothing from anyone at any of the other clinical trial sites, no comment from the National Institutes of Health or the Food and Drug Administration. It was wonderful PR for the New Jersey hospital. It was not the best journalism for 60 Minutes viewers.
- Often it is what journalists allow interviewees to say – unchallenged – that is most concerning. That happened with this 60 Minutes story.
CBS quoted a researcher who is helping to lead the New Jersey hospital’s convalescent plasma trial. This is how the story ended.
CBS’ Bill Whitaker: Based on what you have seen so far, what does your gut tell you?
David Perlin, researcher: My gut says that this is going to work. The initial response of the patients is incredibly encouraging. But as a scientist, I’m trained to be cautious. And so right now this is our best approach, we are going to take it, we’ll be aggressive with it but we’ll see how patients respond.
Benjamin Mazer, MD, a physician who is very active on social media, tweeted:
If you’re a doctor who goes on TV to say that convalescent plasma for COVID19 still needs more evidence but you’ve seen great outcomes in the patients you gave it to…you know exactly what you’re doing.
The public is going to hear “this probably works.”
— Benjamin Mazer (@BenMazer) June 1, 2020
Another physician joined Mazer with pointed skepticism:
When the expected recovery rate is 98% no one can confidently say they “see” a difference. pic.twitter.com/ru1P1fp4YQ
— Mark Hoofnagle (@MarkHoofnagle) June 1, 2020
So, even though researcher Perlin made an attempt to remind himself to be cautious, he went ahead and called the experiment “our best approach.” Well you can’t say that it’s the best approach because you don’t know that. That is why you’re doing the trial. And CBS should have addressed that. They didn’t, and that’s the take home message they ended with.
An RN/paramedic on Twitter reflected on the impact of stories like this on viewers:
We have criticized 60 Minutes in the past. Just two examples:
60 Minutes piece on Kanzius cancer cure not worth 60 seconds
CBS proclaims ‘cancer breakthrough’ – doesn’t explain what FDA means by that term
As always, when we criticize, we try to do so constructively, pointing to ways in which a story could have been improved – often with little effort. We hope 60 Minutes pays attention.
Monday, June 1, 2020
214 new covid-19 cases reported Monday, keeping trendline up; protests spread virus; experts say key is 80% wearing masks
 |
| Kentucky Health News chart shows two-week trendline about where it was on Saturday: up. |
By Melissa Patrick
Kentucky Health News
Coronavirus cases showed a big drop on Sunday, but jumped again on Monday to a number similar to the elevated numbers seen near the end of last week. Prior to the elevation in numbers late last week, the state had seen a downward trend for almost two weeks.
“Kentucky has had 131 new positive cases with zero new deaths on Sunday and 214 new cases with eight new deaths on Monday,” Health Commissioner Steven Stack said in a news release. “We continue our efforts to expand testing, ramp up contact tracing and urge the public to practice social distancing and wear cloth face coverings to reduce the spread of covid-19.”
After almost two weeks with no day higher than 166 new cases, Kentucky's numbers jumped to 283 last Friday and 247 on Saturday. Gov. Andy Beshear said Saturday that those numbers were driven by increased testing in long-term care facilities, but no explanation was given for today's increase.
The counties with the highest number of new coronavirus cases on Sunday were Jefferson, 27; Kenton, 17; Fayette, 16; and three counties with 14, including Boone, Oldham and Warren.
Monday, the most new cases were in Jefferson, 54; Fayette, 30; Allen, 21; Warren, 19; and Boone and Shelby, both with nine.
The state has reported 10,046 cases of the novel coronavirus, with 457 people currently hospitalized with covid-19, including 90 in intensive care. At least 3,232 have recovered. The number of reported deaths stands at 439.
The deaths include an 84-year-old woman from Campbell County; an 82-year-old woman from Gallatin County; a 98-year-old woman from Grayson County; three Jefferson County men, aged 33, 53 and 75; a 90-year-old woman from Kenton County; and an 88-year-old man from Logan County.
Beshear did not hold his daily news conference today, having already held one to address the weekend protest against police violence in Louisville that resulted in a death.
At the end of that briefing, Beshear asked protesters to wear masks, practice social distancing if possible, and avoid contact with seniors and those with underlying health conditions.
The state provides additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity: for Sunday’s information, click here; for Monday’s information, click here. The daily nursing home report was last updated Saturday, May 30.
Other covid-19 news Monday:
- Public-health officials say that protests could lead to a surge of coronavirus cases, Route Fifty reports. “There’s going to be a lot of issues coming out of what’s happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings,” former Food and Drug Administration commissioner Scott Gottlieb said Sunday on CBS's "Face the Nation."
- Dr. Kevin Kavanagh of Somerset, founder of HealthWatchUSA, a group focused on preventing infection in health care, writes in Infection Control Today about why the public should wear masks during the pandemic, reporting that "new modeling is reported to show that if over 80% of the public wears a mask, the epidemic will markedly decrease."
- The University of Louisville Trager Institute offers a weekly online covid-19 information session. The next one is 10 to 11 a.m. EST Tuesday, June 2, with the topic "Restaurants are Up for the Reopening Challenge." Click here for the Zoom link and here for more information.
- Fewer Americans are concerned about necessary medical trips exposing them to the virus, according to a Gallup poll taken May 14-24. The poll found that 64 percent of U.S. adults are very concerned or moderately concerned about exposure to the virus at a doctor's office or a hospital. This is a 20-point drop from the March 28-April 6 poll. It also found that the number of U.S. adults who are not concerned about medical trips has more than doubled, from 16% to 37%. The poll found that men are less concerned than women (55% and 70%), and Republicans are much less concerned than Democrats (58% and 19%).
- An epidemiologist and evolutionary biologist at the University of Chicago, Sarah Cobey, tells reporters at The Washington Post, "The virus is here to stay. The question is, how do we live with it safely?" William Wan and Carolyn Y. Johnson write, "Even after a vaccine is discovered, and deployed, the coronavirus will likely remain for decades to come," like measles, HIV and chickenpox. They write that combating the virus will require long-range thinking, as well as "time, money and, most of all, political will."
- According to a Washington Post-ABC News poll, nearly six in 10 Americans say the pandemic has had a severe economic toll on their communities, and 57% of them say trying to control the spread of the virus is more important than restarting the economy (favored by 37%). By party, 81% of Democrats say controlling the virus is more important than restarting the economy, 59% of independents; and 27% of Republicans, reports the Post.
- Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, talked with Stat about covid-19 reopenings, vaccines and more, with a copy of the transcript included in the article.
Sunday, May 31, 2020
5 winning ways for kids burn energy
Could your kids power the electrical grid, if you could only figure out how to tap that energy? Someday, all the hours spent cooped up at home will be a memory, not a daily reality. But if your children are bouncing off the walls with schools and day care still closed and summer coming, here are five active ideas to safely channel their energy. Pandemic or not, preschoolers benefit from active play throughout the day, and children ages 6 to 17 should rack up at least 60 minutes of activity daily, according to the Centers for Disease Control and Prevention. And since regular activity boosts health and lifts mood, everyone stands to benefit.
Pick a card
Annelieke Rietsema, an employee health coach and fitness specialist at Newton-Wellesley Hospital, suggests this simple strategy. Take a pack of playing cards and assign different exercises to each suit. For example, hearts could be jumping jacks or bear crawl; diamonds could be burpees or somersaults (if you have room); spades could be mountain climbers or cat-cow; clubs could be knee pushups or squats. Now shuffle or mix up the cards (face down), then start going through the deck. Kids do the number of each exercise on cards numbered 2 to 9. They do 10 of an exercise if a card is an ace, jack, queen, or king. So, a jack of hearts in the spades suit could equal 10 mountain climbers. For an exercise without discrete repetitive movements, like the bear crawl, try assigning a number of seconds based on the card selected (a five of hearts equals five seconds of bear crawl).
Children can do the shuffling and assign exercise choices, even picking simpler or harder exercises depending on age or ability.
Top of the hour
Five-minute or 10-minute energy burns at the top of each hour may help keep the peace. Have kids set a timer and choose easy exercises: running in place, jumping jacks, skipping rope, practicing sit-ups and squats. Children can compete with each other or with friends — from one week to the next, is it getting easier to do certain exercises? Can you do more than you could before?
Creature moves
Challenge younger children to think up and enact the moves of animals and other creatures: waddle like a duck, small hops like a bunny, giant hops like a kangaroo, slither like a snake, jump high like a frog, crawl-walk like a bear, inch forward like a turtle, waggle-dance like a honeybee, flap arms like a bird, crawl sideways like a crab, and so on. Set up indoor races for the quieter moves (crab, duck, snake) and occasional outdoor races for louder critters, to see who reaches the finish line in the least and most time. Extra points for unusual choices.
Personal best
Record how long a child can hop or balance on one foot or the number of push-ups, sit-ups, jumping jacks, or other exercises a child can do in a row. Practice three times a week and track the results once weekly.
Teens and some younger children may enjoy setting goals and logging progress in virtual races. The Healthy Kids Virtual Running Series for children in pre-K to grade 8 has a state-by-state locator to find local races. Many charities are encouraging people of all ages to raise money while walking, running, biking — or even dancing — in virtual events.
Yoga and fitness classes online
Two engaging options are Cosmic Kids, which combines yoga and storytelling into a calming, enjoyable workout for many children, and Go Noodle, which has high-energy video or app games to get kids moving and silly costumes to amuse them. Or you can find free online options, or sample classes available through local gyms, recreation centers, or YMCAs. Be sure to screen fitness videos aimed at children, to check if they are appropriate for your child.
Whatever you choose to help children burn energy, do give a thought to your neighbors. Quieter exercises are best if you live above someone, and mixing in safe outdoor time is good for everyone, parents included. If there’s enough room to move freely while maintaining safe distances, a game of tag or soccer, a bike ride, or just a run, skip, or kangaroo-hop to the end of each block could be fun.
The post 5 winning ways for kids burn energy appeared first on Harvard Health Blog.
Saturday, May 30, 2020
Virus cases are elevated for 2nd straight day in Ky., but Beshear attributes pattern to heavy testing in long-term-care facilities
 |
| Anonymous cell-phone tracking gauges mobility as the economy reopens. Selected counties' numbers are shown; all are available on an interactive map from The Washington Post, with a story; click here. |
 |
| Kentucky Health News chart shows two-week trendline of cases is up. |
Beshear reported 247 new cases Saturday, following 283 on Friday after almost two weeks with no day higher than 166. “We have been reviewing the data from yesterday, and nearly half of the new cases were from long-term care, accounting for more than 37 percent,” he said in a press release. “Another 9% of cases were from congregate care settings, mainly the federal prison in Lexington.”
He said Saturday’s data were still being reviewed, but he said the pattern to see if the pattern “is largely a result of our expansive testing initiative in long-term care facilities.” Such facilities have accounted for about 58% of Kentucky's covid-19 deaths.
As usual, he asked Kentuckians to light their homes, places of business and places of worship green, symbolizing compassion for the victims, and added, “In light of the events of the last couple days, compassion is something we need to have on full display.”
The state has additional information, including updated lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity, here.
