State reports 790 new coronavirus cases, lower positive-test rate

Kentucky Health News graph, based on initial daily reports, which are adjusted slightly downward

By Al Cross
Kentucky Health News

After four days with more than 800 new coronavirus cases each day, Kentucky finally dipped below that figure, but not by much. Saturday's case count was 790.

That brought the seven-day rolling average down by five, to 710. Gov. Andy Beshear said 98 of the infections are in Kentuckians 18 and younger.

“It is critical that Kentuckians take the steps necessary to slow the spread of covid-19,” Beshear said in a press release. “We need everyone to keep gatherings to less than 10 people, wash your hands frequently, social distance and wear a mask.” 

Beshear did not attend the Kentucky Derby, where attendance was largely limited to people with connections to horses on the day's race card. “This Derby Day is very different for many reasons,” he said. “Kentuckians are battling inequities, injustice and a global health pandemic brought on by covid-19. For those who make your voice heard today, we are continuing to listen. For Kentuckians gathering today or over the holiday weekend, I ask you to please do so safely.”

The state's daily report said the share of Kentuckians testing positive for the virus dropped almost half a percentage point, to 4.22 percent.

The state Department for Public Health reported six more deaths from covid-19, raising its official death toll to 993. "Reporting from local health departments indicates the state already passed 1,000 deaths, reaching a total of at least 1,051 by Thursday," the Lexington Herald-Leader reported.

Beshear said, “Please light your homes and places of business up green tonight to show compassion for these Kentuckians and their families.”

The fatalities were 77-year-old man from Bell County; a 67-year-old man from Madison County; a 68-year-old woman from Marion County; a 72-year-old man from Nelson County; an 80-year-old man from Scott County; and a 59-year-old man from Todd County.

Counties with more than 10 new cases were Jefferson, 198; Warren, 99; Fayette, 73; Madison, 33; Daviess, 16; Kenton, 15; Laurel, 14; Hardin, 13; Boone, Lewis, Nelson, Oldham and Union, 12 each; Greenup and McCracken, 11 each; and Boyd and Henderson, 10 each.

The state reported 24 more coronavirus cases each among students and employees in K-12 schools, making for 324 active cases in students and 133 in employees. At colleges and universities, the official state list, which lags several days behind local reports, had were 52 more in students and nine in staff, making for active-case totals of 749 and 36, respectively.

In other covid-19 news Saturday:

• As Kentucky nears its 1,000th official covid-19 death, Bill Estep and Jack Brammer of the Lexington Herald-Leader report on the pain suffered by families of victims.
  
• The Nelson County Jail has had an outbreak of covid-19 cases. As of Aug. 29, last Saturday, 35 of the 119 inmates and 10 deputies had tested positive; most have been asymptomatic, Jailer Buck Snellen told the county Fiscal Court, reports The Kentucky Standard.
• Bardstown Independent Schools will begin in-person classes Tuesday, while offering the option of online learning. Supt. Ryan Clark cited "an encouraging decline" in coronavirus cases, The Kentucky Standard reports. Nelson County Schools still plan to start in-person classes Sept. 28.
• The Beechmont Neighborhood Association in Louisville is using a a $31,000 Community Challenge grant from AARP to create a more pedestrian-friendly main street, public-space seating and street lighting" to adapt to the pandemic, Nadia Ramlagan of Public News Service reports in KyForward. "In Lexington, residents and urban planners are also working to tailor the city’s open spaces for a pandemic future, and held a public webinar last week to discuss plans for local parks, trails and other public areas. . . . According to recommendations from the Centers for Disease Control and Prevention, outdoor spaces that allow people to remain six feet apart combined with mask-wearing is the most effective way to curb spread of the coronavirus."

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'Prostate cancer is to men as breast cancer is to women,' survivor writes for National Prostate Cancer Awareness Month

By Steve Ranson

Prostate cancer is to men as breast cancer is to women.

The second-leading cause of cancer deaths in men comes from a small gland located between the bladder and the penis. If not monitored or treated, prostate can be a killer. Likewise, the No. 2 cause of cancer deaths in women is breast cancer. So what’s the difference? Over the years, more awareness has been directed at breast cancer screening than with the prostate gland. Therefore, with September being Prostate Awareness Month, let’s put the spotlight on this type of cancer.

I’m one of those statistical males where prostate cancer will affect one out of nine men in their 60s. I began screening about every 18 months to two years when I was in my 50s, and then about every year to 18 months after I entered my 60s.

An abnormal PSA or prostate-specific antigen found in the blood alerts physicians that prostate cancer may exist. During the past six years, my PSA slowly climbed from a 3.18 in 2014 to 6.36 in 2017. In 2019, the PSA more than doubled to 16.57, causing my general practitioner to refer me to an urologist. Other warning signs began to develop during the first seven months. I had frequent urges to urinate, but the stream was weak. Occasionally, blood would appear in my urine. Sometimes, I would stand over the toilet, straining to empty the bladder.

My urologist Dr. Brian Montgomery saw me in late August 2019 and quickly re-ordered another PSA. It returned with a score shy of 17.

“The higher the PSA, the more likely prostate cancer,” he said, reviewing the latest result with me.

A month later, Dr. Montgomery completed a core biopsy of the prostate by taking samples from 12 areas. When he presented the results to me two weeks later, I had the presence of cancer in two quadrants, the left base and left lateral apex. Dr. Montgomery’s attention focused on the left later apex, which measured the adenocarcinoma — cancer forming in mucus-secreting glands —up to 16 mm in its greatest dimension and occupying 95% of the surface area.

Furthermore, Dr. Montgomery said the pathologist issued a Gleason grading score of 8, which means I have a high-grade legion than can spread more quickly than scores half that.

The left base showed adenocarcinoma took up only 5%, but the Gleason score came in at 6. Based on my PSA, however, Dr. Montgomery said he expected to see the adenocarcinoma in more than two quadrants.

“It’s all statistics with many different results,” he said.

One test remained before Dr. Montgomery offered his final decision on treatment. A bone scan using criteria based on National Comprehensive Cancer Network guidelines determined if the cancer had spread beyond the prostate to another organ or the bones.

“If you’re metastatic, that basically means high risk,” he pointed out, “but your imagining shows it has not spread.”

Dr. Montgomery said I was very fortunate not to have the cancer in more than two quadrants. Statistically, he said the prognosis shows I have a good chance to beat this disease and there’s an 80% chance I will not have a reoccurrence of prostate cancer.

The treatment: Based on all the tests and the Gleason scores, I was deemed a good patient for receiving radiation treatments instead of having a radical prostatectomy where the prostate and surrounding tissues are removed.

The next step: Dr. Montgomery implanted three radioactive seeds into my prostate that would accurately guide radiation beams to not only the affected quadrants but also the entire prostate.

Dr. Gary E. Campbell, a radiation oncologist with more than 37 years experiences, oversaw the next step with me receiving 43 radiation treatments over three months. The last session on June 1 ended the numerous 128-mile round-trip journeys from my hometown to the center. Willing to answer any questions thrown at him, Dr. Campbell works with his team to develop a tailored plan for each patient.

“We want to take away the fear. It’s scary. Anybody would be scared,” Dr. Campbell said of patients facing radiation treatment.

As the treatments progress, patients begin to feel more relaxed and confident. Seeing and talking to the staff on each arrival seemed like the beginning of the popular television sitcom Cheers … where everyone know your name.

The 43 radiation treatments I received give a higher percentage of killing most cancer cells. Dr. Campbell said statistically, out of hundreds and hundreds of patients, he can tell how they will do with their treatment plans. Chemotherapy, however, is used for advanced prostate cancer and administered on the center’s main floor.

Dr. Campbell also said radiation will work on both the prostate and the tissues associated with the prostatectomy, and since The Carson Tahoe Cancer Center is an affiliate of Huntsman Cancer Institute at the University of Utah, he can access their physicians and findings to assist him developing a treatment plan on answering questions.

Based on his 30-plus years as an oncologist, he said the technology has improved, and the treatments are better tolerated by the patients and more successful because of the center’s multi-million dollar treatment machines.

“It’s kind of like the latest and greatest, and it’s very precise. We are able to push the radiation doses which is important,” he said.

With each 20- to 25-minute treatment, Dr. Campbell said his technicians shoot external radiation beams to the area that’s being treated.

Radiology technician Ellen Plewacki said every patient is treated according to information downloaded from a chart to a computer. For every session, the prostate cancer patient like me lies down on a table, and at a computer outside the treatment room, a technician guides the rays at different angles — nine to be exact — at both the affected quadrants and entire prostate.

“Most of the patients have the same setup and procedure,” she said. “It takes about 2 to 3 minutes to identify the internal anatomy needing treatment.”

Based on dose escalation studies, Dr. Campbell said a higher dose provides the best opportunity to eradicate the cancer.

With the end of radiation treatments almost three months ago, I have encountered side effects from swelling in the legs and ankles, urination and bowel-movement problems, restless nights and some tiredness — they should go away. In order to keep the prostate small and to fight any cancerous cells that may be lingering, I receive a Lupron shot every three months. My main complaint with the shot is how it causes hot and cold flashes and mood swings.

Both doctors, however, have repeatedly said the best indicator of how treatments worked is with another PSA … and with a score of 2 or below.

“I would anticipate your PSA will be extremely low,” Dr. Campbell predicted after I finished the treatments.

My first three-month checkup with Dr. Montgomery occurred in late August, and I had the opportunity to see my first PSA result. Bingo! The result came back as a negative .02, meaning there is no traceable sign of cancer left in the prostate.

“Just what I hoped for,” Dr. Montgomery said.

Steve Ranson is editor emeritus of the Lahontan Valley News in Fallon, Nev. He is a former president of the Nevada Press Association and the International Society of Weekly Newspaper Editors.

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It has come to this: ignore vaccines-in-animals drug industry PR & news

A long-haired male golden hamster (via Wikipedia & Creative Commons)

Earlier this week, a powerful opinion piece, “It Has Come To This:  Ignore the CDC,”  co-authored by former National Institutes of Health director Harold Varmus,  was published in the New York Times. That’s on the science side.

On the PR and journalism side, it has come to this:  ignore a lot of the news you hear about vaccine studies in animals.  We’ve written about excited news and PR about vaccine results in monkeys and mice.

This week it was breathless PR and copycat journalism about vaccine results in Syrian golden hamsters.

It all started with a Johnson & Johnson PR news release.

The Janssen Pharmaceutical Companies of Johnson & Johnson are working to develop a coronavirus vaccine.  They published data in a journal this week claiming that their vaccine “elicited an immune response as demonstrated by neutralizing antibodies and prevented severe clinical disease – including weight loss, pneumonia and mortality – in Syrian golden hamsters.

“This pre-clinical study further validates our confidence in our SARS-CoV-2 vaccine candidate,” said Paul Stoffels, M.D., Vice Chairman of the Executive Committee and Chief Scientific Officer, Johnson & Johnson.

Journalists – and the public they serve – may want to wait until the Phase 3 human trials, which are planned to start this month, are completed.

Or does that even matter anymore? You probably read that the FDA commissioner talked this week about possibly approving emergency use before trials are complete.

But journalists didn’t wait.  Journalists for CNBC, Reuters, Bloomberg, Yahoo.com, The Daily Mail (UK) and even some international TV news outlets all reported the Johnson & Johnson PR news release almost verbatim.  Most of these stories carried no independent perspective, just what J&J had to say about its vaccine.

So, yes, it has come to this.  For your own sanity and education, we advise news consumers to ignore vaccines-in-animal news and to ignore drug industry news reporting that is nothing more than stenography of drug industry PR.

Wikipedia/Creative Commons

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Study finds using electronic cigarettes can lead to 'substantially increased risk' for teens and young adults of developing covid-19

By Melissa Patrick

Kentucky Health News

Electronic cigarettes are linked to a "substantially increased risk" of covid-19 among teens and young adults, a new study says. 

“This study tells us pretty clearly that youth who are using vapes or are dual-using [e-cigarettes and cigarettes] are at elevated risk, and it’s not just a small increase in risk; it’s a big one,” the lead researcher, Dr. Shivani Mathur Gaiha, a postdoctoral researcher at Stanford University, said in a news release.

The study, published in the Journal of Adolescent Health, found that people from 13 to 24 who use e-cigarettes have a “substantially increased” risk of becoming infected with the coronavirus and exhibiting symptoms of covid-19, such as coughing, fever, tiredness, and difficulty breathing.

The researchers found that among young people who were tested for the coronavirus, those who used e-cigarettes were five to seven times more likely to be infected than those who did not. 

In Kentucky, 26.1 percent of high-school students use e-cigarettes frequently (on 20 or more of the 30 days before the survey) and 8.7% use e-cigs daily, according to the 2019 Youth Risk Behavior Survey. 

The findings prompted two Illinois Democrats, Senate Minority Whip Dick Durbin and Rep. Raja Krishnamoorthi, chair of the U.S. House Oversight and Reform Committee’s consumer subcommittee, to urge the Centers for Disease Control and Prevention to encourage college campuses to go tobacco-free, and that all such policies should include e-cigarettes, Beth Wang reports for Inside Health Policy. 

 

“College-age tobacco users are at heightened risk of contracting the virus, and they will spread it,” the legislators wrote. “Young people are increasingly driving the spread of covid-19, and that will only increase with reopened college campuses if appropriate public health precautions are not strictly implemented.”

The latest Kentucky report shows 710 college and university students and 27 staff have active cases of the virus and that 1,417 students and 60 staff have ever testing positive for it. Those numbers are almost certainly under-reported.

The legislators noted that most college students are already unable to legally purchase tobacco products, since Congress raised the tobacco-purchasing age from 18 to 21 in December, Wang reports. 

In a letter to state Health Commissioner Steven Stack, the Coalition for a Smoke-Free Tomorrow walks through the known risks from covid-19 associated with smoking. 

The letter says the CDC has identified smokers as a group of people at higher risk for severe illness from covid-19 if they contract the disease, and the World Health Organization has found that "smokers are more likely to develop severe disease with covid-10, compared to non-smokers." 

The letter expands on how smoking harms the lungs, how tobacco weakens the immune system, how smoking is the major cause of a list of underlying health conditions, like heart disease and diabetes, and that a growing body of evidence shows that vaping can harm lung health. 

"While it is not yet clear if smoking can increase the likelihood of contracting the disease, evidence confirms that smokers are more susceptible to severe symptoms if they do contract covid-19," says the letter, signed by Ben Chandler, the coalition's chair and CEO of the Foundation for a Healthy Kentucky.

Kentucky adults who want to quit smoking can call the state's free quit-tobacco line, 1-800-QUIT-NOW (784-8669).

Teens who want to quit vaping can use a program called "My Life, My Quit," a free service for minors. The program includes live support by phone, text or online chat. 

Participants can join by texting START MY QUIT to 855-891-9989 or going to MyLifeMyQuit.com. Teens are eligible for up to five calls with an experienced and trained Quit Coach. The program does not provide nicotine replacement therapy. 

Here are other resources for teens looking to quit: 

• Truth Initiative text message program: Text DITCHJUUL to 88709 or visit https://truthinitiative.org/research-resources/quitting-smoking-vaping/quitting-e-cigarettes 
• Not On Tobacco (NOT), a 10-week, voluntary program for small groups of teens aged 14-19: https://www.lung.org/quit-smoking/helping-teens-quit/not-on-tobacco 
• Become a Smoke-Free Teen: Quit Vaping explains tools to help you quit and how to use them, from the U.S. Department of Health and Human Services: https://teen.smokefree.gov/

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Coronairus cases top 800 for fourth straight day; as another surge threatens, Beshear urges people to follow the rules and be careful

Department for Public Health map, labeled by Kentucky Health News; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced 809 new cases of the novel coronavirus Friday, the first time Kentucky has seen four days in a row with more than 800 new cases each day. And his announcement of 11 more deaths made this week's death count the highest yet, 66 since Sunday. 

Beshear again implored Kentuckians to keep their social gatherings small and follow public-health guidelines as the state heads into the Labor Day weekend and the running of the 146th Kentucky Derby -- without fans at Churchill Downs, but perhaps at many Derby parties. 

Kentucky has been on an elevated, rough plateau of cases for several weeks, and it got there following a surge after the last big holiday, July 4.

“I know this is a big weekend: Derby weekend, even though it’s September, and Labor Day weekend,” Beshear said in a news release. “Traditionally, we’d get together with a lot of people over this weekend. This year, I need you to do it a little differently. Just this one time, probably in your entire life, please keep your gatherings small, 10 people or fewer.”

Today's new cases created new records. The state's unadjusted seven-day total of daily new cases is 5,006, the first seven-day period above 5,000 cases. The seven-day rolling average is 715. 

The good news continues to be that the share of Kentuckians testing positive in the last seven days continues to be under 5 percent, a key threshold for suppressing the virus. Today's positive test rate is 4.70%. It has remained under 5% for 10 days. 

Of today's new cases, Beshear reported that 98 are age 18 and younger, and of those, eight were 5 and under. The youngest was a 2-month-old baby from Jefferson County.

“We’re trying to keep our businesses open and get our economy to bounce back,” said Beshear. “We’re going to get our kids back in school later this month. We’re trying to get high school sports up and going and keep them going. So we really need you to help us on all the other things like wearing a mask, washing your hands frequently and social distancing.”

Friday's deaths were a 61-year-old man from Barren County; an 88-year-old woman from Carroll County; an 82-year-old man from Clinton County; an 82-year-old woman from Hardin County; two men, 72 and 77, from Jefferson County; a 77-year-old woman from Kenton County; a 67-year-old woman from Marion County; a 75-year-old man from Owsley County; a 79-year-old woman from Rockcastle County; and a 64-year-old woman from Warren County.

“I know how much we all want to see our families and friends for this holiday, but for one year, we need to prioritize making sure every person we care about is around to celebrate with us next year,” said  Beshear. “We have already lost so many Kentuckians, and I don’t want that loss to be even greater. It will be if we have a spike in cases.”

Beshear also extended several health-related executive orders today, including his mask mandate and an order that allows pharmacists to dispense 30-day refills. 

Counties with more than 10 new cases Friday were Jefferson, 249; Fayette, 56; Pulaski, 36; Daviess, 26; Madison, 23; Warren, 22; Union, 21; Henderson, 20; Laurel, 16; Boone, 15; Greenup, 14; Kenton, 14; Grayson, 13; Bullitt, 12; Nelson, 12; Hardin, 11; and Shelby, 11.

Hospitalizations for covid-19 in Kentucky remained stable, at 574, with 132 of them in intensive care. Each figure was up six from Thursday.

In long-term-care facilities, 51 more residents and four more employees were found to be infected. At least 310 facilities statewide have had at least one case, and there active cases among 585 residents and 352 employees.

In K-12 schools, the daily report showed 27 new cases among students, raising the active-case total to 300. Seven more employees were added to the case list, making 109 active cases. The total cases reported so far are 459 students and 128 employees.

At Kentucky colleges and universities, the state added 51 more students and four more employees to its list, making active-case totals of 710 and 27, respectively. The report was incomplete, or not up to date, or both; for example, no new cases were reported at the University of Kentucky, but the Lexington-Fayette County Health Department, which reports on a different schedule, reported 111 new cases, 50 of them at UK. The state report said UK has 390 active cases, but UK's own site, which had date through Tuesday, Sept. 1, said it had 459 active cases.

UK has started testing wastewater from dormitories to detect infection by the virus. "Increasing levels in wastewater could be an early indicator of an outbreak or increased prevalence," UK President Eli Capilouto said in a campus-wide email.

In other covid-19 news Friday:

• The Christian County Board of Education voted 4-1 to approve Supt. Chris Brentzel's recommendation that in-person classes begin Tuesday, while allowing students to opt out of it, Hoptown Chronicle reports: "Elementary school students will be on a traditional schedule and attend in-person classes five days a week. Middle- and high-schoolers will be on a hybrid schedule. They will be in class two days and have virtual learning the remainder of the week."
• "The pandemic has heightened stress and upset routines" so much that "physicians and researchers are seeing signs it is doing deep damage to people’s sleep," The Washington Post reports. “Coronasomnia,” as some experts call it, could "have profound public-health ramifications — creating a massive new population of chronic insomniacs grappling with declines in productivity, shorter fuses and increased risks of hypertension, depression and other health problems."
• The Louisville Courier Journal reports on what happens to public health when a city has "uncontrolled spread" of the coronavirus. Dr. Sarah Moyer, the city's chief health officer, told Grace Schneider that like a wildfire, extinguishing the spread is nearly impossible "after we have the wildfire going." Louisville Metro's public health officials encourage people who have tested positive for the virus to go ahead and do their own contact tracing by  alerting those they were within six feet of for at least 15 minutes in the days before they began to feel symptoms. 
• The Courier Journal's Deborah Yetter tells the story of covid-19 from the perspective of people who have recovered: the administrator of a nursing home that had a big covid-19 outbreak in May that resulted in the loss of 16 residents and one staff member to the disease; a nurse who works on a covid-19 ward; and a physician. Dr. Briones-Prior of U of L Health told Yetter that she is seeing whole families affected by the disease, instead of just the frail and elderly: "It gets into the household, and the whole household gets it."
• University of Louisville Physicians offer tips on how to increase your activity during the pandemic, saying that adding an extra 2,000 steps a day and reducing calories by 100 a day will help you achieve an energy balance that can stop weight gain. 

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Hospitals invest in interventions and public education to fight heart disease, which is the number-one killer of Kentuckians

https://www.lanereport.com/130324/2020/09/hospital-tech-takes-on-kentuckys-top-killer/?utm_source=Faster%20Lane%20Newsletter&utm_medium=Email&utm_campaign=

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906 new coronavirus cases make for state's third highest day, pushing total above 50,000; 10 more deaths bring toll to 976

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