Kentucky newspapers offer editorial comment on acceleration of the pandemic and the governor's response to it

Kentucky's recent surge in coronavirus cases and covid-19 hospitalizations, and the governor's latest emergency orders in response, has prompted editorial commentary from several newspapers.

"November feels eerily similar to April and May, when covid-19 cases weren’t as numerous but the virus was just as furious," said The Daily Independent of Ashland. "Whether or not you agree with him, Gov. Andy Beshear has proven he’s not simply out to collect votes. He won’t shy away from making an unpopular decision, but he genuinely seems to base his actions upon how many lives might be saved."

The paper added, "The local economy will suffer, but, ideally, fewer people will be infected with the virus — and fewer will die. . . . We must band together as a community once again, just as we did in April and May, and support local businesses. If it’s not currently in your routine to do so, make it part of your daily habits. Think local, eat local (carry-out) and shop local (with a mask)."

The State Journal of Frankfort also endorsed Beshear's orders: "We firmly believe the governor is taking the steps necessary to slow an overwhelming increase in coronavirus cases and deaths in nearly every corner of Kentucky.

Noting Republican U.S. Rep. Andy Barr's criticism of Beshear's latest orders, the newspaper said, "What we have been asked to do during the last eight months — limiting our contacts, practicing social distancing and wearing face masks in public — is not difficult or political. Instead of creating division, we expect our leaders to work together toward the common goal of crushing the coronavirus."

On Nov. 18, the day that Beshear ordered in-person schooling to stop as of Nov. 23, the Bowling Green Daily News said "We believe the appropriate path forward is to continue trusting school officials to do everything in their power to make classrooms and school buildings as safe as possible. Some virus cases among staff and students are inevitable, but until it is definitively shown that the school environment itself is actively worsening the spread, we believe it is in any community’s best interest to maintain in-person teaching options for those who wish to use them."

The editorial cited "the advice of educators and mental health experts who are nearly uniform in noting that many students are harmed socially and academically by a lack of in-person instruction. Not only that, but a recent study by the Prichard Committee for Academic Excellence, as described in a report in the Daily News, offers a new round of data illustrating the burdens that remote instruction places on many working families, such as difficulty scheduling child care and accessing reliable internet service."

The Daily News hasn't opined on Beshear's latest moves, but its reliably conservative editorial page has criticized his previous orders.

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Judge blocks Beshear ban on in-person religious schools

A federal judge issued an injunction Wednesday night that allows religious schools in Kentucky to continue in-person instruction, contrary to Gov. Andy Beshear's order last week that in-person schooling in the state stop in order to to prevent spread of the novel coronavirus.

“The governor has every right to impose some restrictions on all schools, religious and secular alike,” District Judge Greg Van Tatenhove wrote. “Social distancing, face masks, limits on class size, reporting requirements and other protocols may cost money and may be inconvenient for parents and students, but we give executives increased discretion in time of crisis. But in an effort to do the right thing to fight the virus, the governor cannot do the wrong thing by infringing protected values.”

Van Tatenhove exempted from Beshear's order "any religious private school in Kentucky that adheres to applicable social distancing and hygiene guidelines," saying that Danville Christian Academy and schools that joined its lawsuit were likely prevail if the lawsuit goes to trial. The school's attorneys had noted that the Boyle County Health Department said the school was following proper precautions.

Van Tatenhove wrote, "If social distancing is good enough for offices, colleges, and universities within the commonwealth, it is good enough for religious private K-12 schools that benefit from constitutional protection." He said "Danville Christian has presented evidence of the significance of in-person instruction" protected by the First Amendment, including the "prayer throughout the day" and weekly chapel services, and he knows "the role of daily in-person mentorship of religious values that occur in religious schools that is simply not as feasible in a virtual setting."

Beshear has appealed to the U.S. Court of Appeals for the Sixth Circuit and has asked it to stay the injunction, said his communications director, Crystal Staley.: "Let's be clear: lives are on the line, and everyone must do their part to defeat the virus."

The governor argued that his order applied equally to public and private schools, but Van Tatenhove said the Sixth Circuit court has said regulation of religious activities must follow "the least restrictive way."

The appeals court said that in a case involving Beshear's early-in-the-pandemic order against mass gatherings and his use of state police to put notices on cars of attendees at Maryville Baptist Church in  Bullitt County saying, in effect, that "their attendance at the drive-in service amounted to a criminal act." Actually, the service was held inside the church.

"Ultimately, the Sixth Circuit opted to enjoin enforcement of the orders only as they pertained to drive-in services," Van Tatenhove noted. "While Maryville Baptist does not decide this case, it is indicative of what might come. Maryville Baptist Church was motivated by a sincerely held belief that Christians should have the ability to meet in person. Similarly, Danville Christian is motivated by a 'sincerely held religious belief that it is called by God to have in-person religious and academic instruction for its students'," as the school argued.

Van Tatenhove also said the state hadn't explained why schools should be closed when other activities such as preschools are allowed to continue in-person activity. He also noted that Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said Nov. 19 that "for kids K-12, one of the safest places they can be, from our perspective, is to remain in school."

Staley said that this is the second case in which Van Tatenhove "has refused to acknowledge the U.S. Supreme Court decision that found an action like this is both legal and constitutional."

Van Tatenhove wrote that Chief Justice John Roberts' controlling opinion in that 5-4 decision "is not dispositive in this case" because the factual and procedural circumstances are different. The Supreme Court merely declined to grant injunctive relief from a lower court's decision.

Attorney General Daniel Cameron, who joined the Danville school's lawsuit, said he was glad that the courts "have affirmed that the freedoms provided by our Constitution are stronger than the fears of the moment and cannot be case aside by the governor or any leader."

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Hospitalization figures again set new records, but poll suggests Kentuckians less likely to give thanks outside their households

Polling for The New York Times showed Kentuckians are generally less likely than their neighbors to have Thanksgiving dinner outside their household.

By Al Cross

Kentucky Health News

The covid-19 burden on Kentucky hospitals got heavier Wednesday, as the state began a long holiday weekend that officials and health-care workers worry will bring so many more infections that hospitals will be overrun.

Every data point on covid-19 cases from Kentucky hospitals was a new record: 1,734 patients, 409 of them in intensive care, and 216 of those on ventilators.

The state reported 3,408 new cases of the novel coronavirus, its fourth largest daily total. The higher numbers were 3,825 last Friday, 3,711 last Saturday and 3,649 last Thursday.

Kentucky's seven-day rolling average of new coronavirus cases, perhaps the best measure of the pandemic's course, is a new record: 3,087.

Gov. Andy Beshear announced 26 more deaths from covid-19, bringing the state's toll to 1,835. The dead by age, sex and county are listed below.

In a press release, Beshear again asked Kentuckians to follow preventive measures he has ordered and recommended during the holidays.

“Thanksgiving is one of my favorite holidays, and usually we get together with about 15 people,” Beshear said. “This year, we just can’t do that. I’m really disappointed, like all of us are, but protecting my parents, my kids, our neighbors and all of our health care workers has to come first. I’m grateful for all Kentuckians who are sacrificing this year to keep each other safe.”

There were at least two hopeful signs. The share of Kentuckians testing positive for the virus in the last seven days declined slightly for the third day, to 8.88 percent, and Kentuckians appeared more likely than people in neighboring states to follow official advice and not observe Thanksgiving with people outside their household, based on polling done for The New York Times Nov. 13-23.

The Times published a detailed, interactive map showing the share of people planning to eat Thanksgiving dinner with people outside their household. The findings are part of a "large number of interviews conducted by the global data and survey firm Dynata" at the paper's request, it said.

As their hospital beds fill up with covid-19 patients, the heads of U of L Health and Baptist Health gave a stern warning to the Louisville community in an open letter: "It is critically important that we take action now. Please, for the health and safety of yourself, your loved ones and your neighbors, wear a mask. Avoid gatherings — not just with strangers, but with extended family members. Don’t stand or be near people who don’t live with you. Wash your hands often.With Thanksgiving and the holidays coming, please celebrate responsibly in a scaled-back fashion that limits the virus’s spread."

The executives stressed that after eight months of fighting the virus, health-care workers in the region need their neighbors' help. "We are prepared to handle a surge of patients, but there is a limit," they said. "There will be a point when our hospitals will be too full to treat all of you with the virus and those with other medical needs "We are at a crossroads and desperately need your assistance with curbing the spread of the virus."

Beshear's release noted that getting one negative test days before a gathering "can’t guarantee that you won’t infect others at that event."

Last week, Beshear banned in-person schooling and indoor dining, and imposed other new restrictions in an effort to stop the recent surge in cases. The school order brought a lawsuit by the Danville Christian Academy and Attorney General Daniel Cameron, joined by other private schools, and some restaurants defied the inside-service ban and began losing their licenses as a result. U.S. District Judge Greg Van Tatenhove is expected to rule in the case soon.

Beshear also limited informal group gatherings to two households and no more than eight people, while acknowledging that it would be difficult if not impossible to enforce. Two families filed a lawsuit against Beshear Tuesday, saying the order “criminalized their family dinner.” One family includes seven children.

At his Tuesday briefing, the last before the holidays, Beshear called this claim “ridiculous,” “dumb,” and “a distraction,” and said, “Nobody’s saying a family of 10 can’t continue to live together and eat together,” he said. “What we’re saying is if one family wants to have another family over, it [should only] be two households.”

In other coronavirus news Wednesday:

• The latest covid-19 fatalities were a 60-year-old woman from Barren County; an 82-year-old Christian County man; a 94-year-old Daviess County woman; a 62-year-old Edmonson County man; an 87-year-old Floyd County man; a 91-year-old Hancock County woman; a 90-year-old Hardin County man; two women, 67 and 89, and three men, 62, 68 and 79, from Jefferson County; an 83-year-old Jessamine County man; a 61-year-old Lewis County woman; a 74-year-old woman and a 91-year-old man from Martin County; a 73-year-old McLean County woman; a 98-year-old woman and a 66-year-old man from Monroe County; an 84-year-old Ohio County man; two men, 79 and 87, from Oldham County; a 56-year-old Spencer County woman; and two women, 77 and 86, and a man, 77, from Warren County.
  
• "Two more inmates have died from covid-19 in Kentucky state prisons, raising this years death toll in the system to 15 prisoners and two Department of Corrections employees," John Cheves reports for the Lexington Herald-Leader. Beshear has said that rampant community spread is responsible for the current surge of cases in Kentucky, noting that with prison employees coming and going in and out of the facilities every day, when case rates are so high, it is hard to contain it. Cheves reports that an analysis of state prison data ranks Kentucky 17th for per-capita inmate deaths during the pandemic.
• Counties with more than 10 new cases were Jefferson, 732; Fayette, 264; Kenton, 138; Boone, 116; Warren, 114; Hardin, 111; Madison, 100; Campbell, 69; Daviess, 69; Bullitt, 62; Christian, 61; Greenup, 52; Oldham, 48; Hopkins, 42; McCracken, 42; Pike, Scott and Wayne, 41; Magoffin, 40; Laurel 38; Franklin and Shelby, 35; Boyd, Clark and Muhlenberg, 32; Nelson, 31; Graves, Ohio and Pulaski, 29; Floyd, Henderson and Mercer, 28; Jessamine, 27; Carter and Whitley, 25; Knox, 23; Johnson, 22; Adair and Anderson, 20; Marshall, 19; Boyle and Calloway 18; Allen, Caldwell, Pendleton, Perry and Spencer, 17; Fleming, Grayson, Harrison, Rockcastle and Taylor, 16; Crittenden, Leslie and Logan, 14; Grant and Knott, 13; Clay, Garrard, Harlan and Woodford, 12; and Breathitt, Estill, Lee, Lincoln, Marion and Washington, 11.
  
• The state has issued guidelines for outdoor dining. The version posted by the Franklin County Health Department says tents qualify as outdoor seating if at least 50% of the perimeter is open and 6 feet of space is kept between customers at different tables; if two sides of the tent are not open, the tent is considered interior space and may not be used for seating until Dec. 14, under Beshear's order.
• The AstraZeneca coronavirus vaccine announced this week isn't proven yet, Hilda Bastian reports for Wired magazine: "The price of AstraZeneca’s shares actually dropped on the news, and an analysis from an investment bank concluded, 'We believe that this product will never be licensed in the U.S.' Over at Stat News, Anthony Fauci cautioned that we’ll need to see more data before coming to a conclusion. . . . Monday’s announcement did not present results from a single, large-scale, Phase 3 clinical trial, as was the case for earlier bulletins about the BNT-Pfizer and Moderna vaccines."
• Maggie Menderski of the Louisville Courier Journal tells the story of Demetrius Booker, a 40-year-old La Grange man, who spent 95 days in the hospital battling covid-19.

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Kentucky remains in most dangerous zone for virus cases and positive tests; White House calls for 'significant behavior change'

White House Coronavirus Task Force table; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

For the second week in a row, Kentucky is in the worst danger zone for both coronavirus cases and the share of Kentuckians who tested positive for the virus in the past seven days, according to this week's White House Coronavirus Task Force report. 

Kentucky has been in the red zone for case numbers, indicating 101 or more new cases per 100,000 people, every week since the Sept. 27 report, but this is only the second week it has been in the most dangerous zone for test positivity, meaning it has a rate above 10%.

Gov. Andy Beshear has noted several times that the state uses a different data stream than the White House, which results in a lower positive-test rate. The White House reports a 13% percent positivity rate in Kentucky. On Nov. 24, the state reported that rate to be 8.82%. 

As other states have surged even more, Kentucky's ranking in the White House report has fallen a bit. The latest report, which covers Saturday, Nov. 14, through Friday, Nov. 20, says Kentucky ranks 24th highest in the country for cases and 20th for positivity.

It says 92% of Kentucky's counties had a moderate or high level of community transmission, with 70% of them having high levels. That's up from 89% and 55%, respectively, in last week's report. 

It shows Kentucky with 433 new cases per 100,000 people. This number continues to show huge weekly increases. It was 344 per 100,000 in the prior week, and 274 per 100,000 the week before. The national average is 356 per 100,000.

In the state's Monday-to-Sunday reporting week, last week Kentucky had most cases ever: 20,514, up 22% from the week before. 

The number of counties in the White House red zone increased by 18, from 66 to 89; the orange zone number decreased by 11, from 24 to 13; and the yellow zone decreased by three, to 14. 

This week's report included a strong warning, saying the "aggressive, rapid, and expanding" spread of cases requires both "proactive, focused testing" to identify asymptomatic and pre-symptomatic individuals, combined with "significant behavior change of all Americans." 

Those behaviors include wearing a mask at all times in public, social distancing, significant reductions in public and private indoor capacity limits, and making sure that "every American understands the clear risks of ANY family or friend interactions outside of their immediate household indoors without masks." 

   

Some argue that Kentucky does not have a reliable estimate of the virus' spread because it depends on "convenience samples" from voluntary tests instead of statewide random testing. Beshear has argued that the state does so much testing that it has a pretty accurate picture of how many people have the virus, especially among those with symptoms. 

He was asked Tuesday about White House's recommendation for "proactive, focused testing" to catch the virus in people without symptoms, and the latest analysis from the University of Louisville's Co-immunity Project – which does random testing in Jefferson County, finding that the infection rate is now 10 times what it was two months ago and that the infection rate is nearly five times higher than the publicly reported number of cases.

Beshear said the state is doing a study with LabCorp, a large testing laboratory, "that is giving us data on how widespread that we think the virus is in Kentucky." He said Health Commissioner Steven Stack would talk about it next week. "It's got some different numbers than the co-immunity project, but it's also statewide."

The White House report also called for "strong Thanksgiving messaging" that encourages people to limit events to individuals in their household and to wear masks while indoors around high-risk and vulnerable people. In addition, it says to expand public-health messaging to all media platforms, to warn people about the risks of social gatherings and re-emphasize the need for masks and social distancing. 

The report also called on Kentucky to stay vigilant to protect nursing home residents and staff, ensuring that they have full testing capacity and are properly isolating those who test positive. It also calls on the state to ensure that all hospitals have expansion and contingency plans and up-to-date treatment protocols.

The report included a graph showing covid-19 hospitalizations by age and by week.

White House Coronavirus Task Force graph; for a larger version, click on it.

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Hospitalizations up 5% in one day; health-department workers afraid to enforce orders because of threats, abuse, Beshear says

Beshear showed a video of Katie Rogers, an advanced-practice registered nurse, asking Kentuckians to keep from spreading the virus at Thanksgiving in order to keep hospitals from being overwhelmed.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced a 5.4 percent jump in Kentucky's covid-19 hospitalizations Tuesday, making for another record high, while making a final plea for Kentuckians to keep their Thanksgiving gatherings small – and saying health-department workers are afraid to enforce his emergency orders because of abuse and threats. 

Beshear said covid-19 hospitalizations totaled 1,658, 85 more than Monday; 390 of them are in intensive care, and 207 of those are on a ventilator. 

The governor warns almost daily that a main reason Kentuckians need to stop spreading the novel coronavirus and bring case numbers down is to keep the state's health-care system from being overwhelmed – and there are already signs that that is beginning to happen. 

Beshear pointed to newspaper headlines across the state reporting that local hospitals were either at capacity or near capacity. 

The Albert B. Chandler Hospital at the University of Kentucky announced that it will close five of its 32 operating rooms to make room for an influx of covid-19 patients, whose number has jumped from about 30 in late October to 81 early Tuesday, notes Alex Acquisto of the Lexington Herald-Leader.

Beshear said the disease is beginning overwhelm the health-care capacity of the state and the region. "If we do not stop the exponential growth of cases, we will exceed our health-care capacity," he warned. "We will experience more loss and more death than we have to."

In the question session of his daily briefing, Beshear was quick to confirm that Kentucky's health-department workers are being targeted by death threats and doxxing – malicious posting of personal information online – over the enforcement of coronavirus orders, similar to episodes in other states. 

"It's going on every day, in every local health department, to every single worker," Beshear said. "It is awful and it is disgusting. Our local health department workers are scared. They're scared to release their local numbers, they're scared to do basic enforcement. They're people's neighbors, fighting for the lives of neighbors, and people treating them this way is unacceptable. It is not in accordance to our values. It's not in accordance to my faith. It is not Christian." 

Health departments been tasked with enforcing Beshear's mask mandate since July, and now they are being asked to enforce his new orders that include, among other things, banning indoor service in bars and restaurants. 

Some restaurants have refused to follow that mandate, forcing health departments to become involved, and in some cases suspending their food service permits. 

One such restaurant is Bean's Cafe and Bakery in Dry Ridge. Rachel Cheatham reports for the Grant County News that the bakery has decided to keep its dining room open, despite the order to close all indoor dining by 5 p.m. Nov. 20. Restaurants are allowed to provide outdoor seating, with some restrictions.

Bean's owner Richard Hayhoe told Cheatham, “It is our understanding that to defy an order like we have will bring out the situation to a head and make the governor’s office prove that they have the legal authority to strip business owners of their constitutionally protected ability to earn a living. These regulations are the political overreach of an office that is bent on controlling every aspect of life and taking away your ability to make your own decisions.”

A Bean's Facebook post said the restaurant had received a notice from the Northern Kentucky District Health Department that its food-service permit had been suspended. "We will remain open until it can be proven that this is unlawful for them to do in a court of law." The office of Grant County Attorney Stephen Bates II declined to comment other than to say the case will be a matter of public record. 

In London, Bill Estep of the Herald-Leader reports that the Laurel County Health Department planned to shut down Wingz 2.0, a restaurant that had not shut down its dining room. Janet Patton of the Herald-Leader reports that the Lexington health department has ordered closure of a coffee shop, Brewed, and suspended its permit, but its dining room remains open. 

Asked what level of enforcement defiant restaurants can expect, Beshear noted that the state Supreme Court recently ruled – in a case involving Bean's and other Northern Kentucky businesses – that he has legal authority to issue such orders, and offering indoor dining is a violation of the rule of law. 

"Our society can't move forward with people who openly violate the law if they don't like it," Beshear said. "Once the Kentucky Supreme Court has ruled, that's supposed to be it." 

Beshear noted that there has been a rush on testing in the last few days. He said that is a good thing, but cautioned that it is not safe to think a that negative covid-19 test means you can safely gather for Thanksgiving, because it can take time for an infection to show up on a test. The incubation period for the virus is 14 days. 

"A single [negative] test can't guarantee a safe Thanksgiving," pointing to a Time article that expands on this topic.

The state Department for Public Health has asked Kentuckians to avoid travel and only have dinner with people who live in their household, or at a maximum, people from two households (no more than eight people total).

 “Please keep your Thanksgiving celebration as small as you can," he said. 

Beshear reported 2,690 new coronavirus cases on Tuesday, bringing the state's seven-day rolling average down to 2,994, 1 percent below yesterday's average. He also reported 17 more covid-related deaths, bringing the state's death toll to 1,809.

The deaths were a 90-year-old woman from Calloway County; two women, 64 and 81, and a 52-year-old man from Daviess County; an 81-year-old Hardin County man; a 67-year-old Henry County man; an 86-year-old woman and five men, ages 64, 67, 75, 76 and 88, from Jefferson County; a 78-year-old Kenton County woman; a 60-year-old Martin County man; a 90-year-old McLean County woman; an 88-year-old Metcalfe County woman; and an 81-year-old Shelby County woman.

 

The share of Kentuckians testing positive for the virus in the past seven days remained under 9% for the second day in a row, after being above that threshold since Tuesday, Nov. 17. Today, it was 8.82%.

  

In other coronavirus news Tuesday:

• Counties with 10 or more new cases were Jefferson, 394; Fayette, 201; Hardin, 118; Madison, 80; Daviess, 73; McCracken, 72; Boone, 71; Warren, 70; Boyd, 65; Nelson, 54; Pike, 49; Kenton, 45; Graves, 43; Oldham, 39; Hopkins, 38; Bullitt, Jessamine, Laurel and Pulaski, 34 each; Montgomery, 33; Henderson and Shelby, 32 each; Marion, 31; Carter, Greenup and Mercer, 29 each; Scott, 27; Barren and Lincoln, 26 each ; Campbell, 25; Larue and Simpson, 23 each; Clark, Franklin and Johnson, 22 each; Christian, 21; Magoffin, Muhlenberg, Ohio and Pendleton, 20 each; Washington, 19; Calloway, 18; Lee, 17; Floyd, Marshall, Meade and Whitley, 16 each; Martin, 15; Clay, Harlan, Logan and Webster, 14 each ; Grant, 13; Boyle, Garrard, Harrison, Leslie, Monroe and Spencer, 12 each; Bell, Knox, Powell and Wayne, 11 each; Metcalfe, Rowan and Woodford, 10 each.
• In long-term care facilities, there are 1,572 active resident and 1,044 active staff cases, with 92 resident cases and 115 staff cases reported today. There are 1,173 resident deaths and seven staff deaths attributed to covid-19, with 18 resident cases reported today. 
• Beshear announced another death at the Thomson-Hood Veterans Center in Wilmore, bringing the total number of deaths in that facility to 28. He said the facility has gone 10 days without a new case and that none of the other three veteran facilities in the state have reported any cases. 
• Fifteen states are in Kentucky's travel advisory because they have a positive-test rate of 15% or higher. They are, from highest to lowest, Wyoming, South Dakota, Iowa, Idaho, Kansas, Pennsylvania, New Mexico, Missouri, Alabama, Utah, Montana, Arizona, Mississippi, Oregon and Ohio. Kentuckians who travel to these states are asked to isolate for two weeks upon return. The state also recommends a 14-day self-quarantine for anyone returning from any international travel.
• The U.S. Department of Labor has as abruptly ended Kentucky's extended unemployment insurance payments, which will result in extended benefit payments for 4,723 claimants to cease this weekend, according to a news release. Claimants who continue to be off work due to the pandemic may be eligible for Pandemic Unemployment Assistance through the end of the year. This also does not affect the ability of Kentuckians losing their jobs to qualify for traditional unemployment insurance, says the release. 
• "Some Americans downplaying the novel coronavirus insist improved treatments have made the virus far less deadly than last spring, but that’s a far too rosy take," writes Paige Winfield Cunningham of The Washington Post. "Better treatments are now available, but their impact isn’t nearly big enough to avoid an impending surge of deaths" as hospitals reach or exceed capacity. "While the case-fatality rate declined early in the pandemic, it hasn’t budged since the summer" from 1.7 percent.
• The New York Times provides a detailed, interactive map that shows the share of people eating Thanksgiving dinner with people outside their household. The findings are part of a "large number of interviews conducted by the global data and survey firm Dynata" at the request of Times. Nationwide, the survey found that only around 27% of Americans plan to dine with people outside their household.  
• Essential workers are likely to move ahead of adults 65 and older and people with high-risk medical conditions on the Centers for Disease Control and Prevention's priority list, coming after health care workers and those living in long-term care facilities, members of the Advisory Committee on Immunization Practices said on Monday, Stat reports. No formal vote has been taken. Stat writes that the intention is to bring "many people of color closer to the front of the vaccine priority line -- should they want to be vaccinated -- in recognition of the fact that the pandemic has disproportionately hit Black and Latino communities." Further, one expert notes that essential workers have less opportunity to social distance, compared to seniors and those with high-risk medical conditions.
• Matthew Glowicki with the Louisville Courier Journal tells the stories of grieving families who have lost a loved one to covid-19 as they prepare for the Thanksgiving holiday. 
• Local health departments in Eastern Kentucky release a report with their covid-19 numbers on Monday's; this week's report includes three deaths, WYMT reports. 
  
  

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Sales pitches for Medicare Advantage don't tell the whole story

Joe Namath is perhaps the most familiar spokesperson for Medicare Advantage plans.

By Trudy Lieberman
Community Health News Service

It seems nothing ever changes when it comes to hawking insurance to fill gaps in Medicare coverage. The fervent sales pitches, the misinformation, and the incomplete and deceptive information continue to proliferate.

For the last several weeks I’ve heard ad after ad urging older viewers to call 800 numbers to learn about the latest and greatest Medicare Advantage (MA) plans. Retired football star Joe Namath says you need to “get everything you’re entitled to.” Namath rattles off a bunch of extra benefits MA plans offer – dental, vision, hearing, prescription drug coverage – “all at no extra cost.” He urges viewers to “call the number on your screen now. It’s free.”

These are new benefits the government has let private insurers sell in hope of getting more seniors to leave traditional Medicare for a privatized system. By transferring more costs to seniors, the government saves taxpayers money.

Another commercial promises “free eyeglasses and free rides,” presumably to doctors’ offices. Yet another tells viewers they “may qualify” to get $144 added back to their Social Security benefits. The Medicare Part B premium for 2021 is $148.50, which is, presumably, what the commercial promises to save those who choose the privatized system.

I suspected those ads were misleading and deceptive come-ons, designed to persuade listeners to call. So I made some calls. The 800 numbers lead to an insurance brokerage firm or agency that apparently has a network of licensed agents located around the country. Callers are asked to give their ZIP code and then are transferred to an agent who can give the “free benefits” review.

I have heard close to 100 Medicare sales pitches over the years and know that those free consultations are meant to result in a sale, whether or not the senior needs the insurance or is really getting a better plan.

Seldom is there talk about making sure people are covered for the huge amounts doctors and hospitals sometimes charge and Medicare doesn’t cover. What are the trade-offs, for example, between buying an MA plan, which pays those charges after you satisfy a large out-of-pocket maximum ($6,700 per person next year) or buying a traditional Medigap insurance supplement Plan G, which covers those charges right away? A couple with Medicare Advantage could pay as much as $13,400 a year before their plan would pay for anything!

With so many choices, what’s a consumer to do? I rang up Bonnie Burns, one of the best Medicare consumer advocates in the country, for advice.

“It’s just too complicated,” she said. “No wonder people throw up their hands. That’s why people sign up for an Advantage plan with little or no premium and find out what the costs really are as they use benefits through the year.” She added, “It would be so much easier if Medicare Advantage plans and drug plans were standardized so people could figure this out.”

Congress could do that, but hasn't, resulting in today’s chaotic marketplace. Congress wanted to allow every insurer in the universe to throw something out there so the companies could make money and could entice more people to leave traditional Medicare. The goal was to reduce taxpayer costs, all the while side-stepping any action to control run-away medical costs.

Congress did standardize Medigap policies in the early 1990s because that market was as chaotic and misleading then as the MA market is today. I like to think of that action as the high-water mark of consumer protection, and I have no illusions that anything like it will happen again anytime soon.

One final bit of crucial advice is missing in today’s ads. Even after you enroll in an MA plan, perhaps enticed by a few dollars in savings for a pair of glasses, you can return to traditional Medicare in the future. But in all but four states (New York, Connecticut, Massachusetts, and Maine) state laws prohibit you from buying a Medigap plan without an insurer scrutinizing your health status.

If you have developed a pre-existing condition, you may be ineligible for a Medigap policy. I’ve met many people over the years who bought an Advantage plan, got sick, and needed to go to out of network for treatment. They learned the hard way they were shut out of the Medigap market for good.

What choices have you made for covering Medicare gaps? Write Trudy at trudy.lieberman@gmail.com.

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Studies forecast new restrictions could save lives, reduce hospitalizations; Beshear warns hospitals at 'tipping point'

University of Louisville graph, relabeled by Ky. Health News; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

A new study shows that compliance with Kentucky's new emergency orders to thwart the coronavirus could save up to 1,000 lives in the Louisville region, and presumably have similar results across Kentucky.

Department for Public Health map,
adapted by Kentucky Health News

As he made perhaps his strongest plea yet for compliance, Health Commissioner Steven Stack went over two University of Louisville studies that forecast deaths and hospitalization trends in Jefferson County and the 14 other counties in the Louisville hospital region, based on differing levels of compliance.

One study projects that by mid-January, a high level of compliance would prevent about 1,000 deaths in the 15 counties and low compliance would still prevent more than 500 deaths. 

The study also forecasts 1,689 active hospitalizations in mid-January with little to no compliance, up from about 350 now. High compliance would limit the increase about 100 hospitalizations, the study predicts.

"This is substantial," Stack said. "Those measures, if they're followed, could have a profound impact and could really change the trajectory of this, and completely avert the crisis of health-care staffing and the harm that is caused to other people without covid who aren't able to get care because covid fills the hospitals, consumes all the resources and also causes health-care workers to go out sick. " 

Stack noted that for three weeks, the state had recommendations in place that public-health officials said would have brought down Kentucky's infection rates if they had been followed. Stack said Kentucky health officials were "asking, urging, begging, pleading, trying to persuade with facts and figures, and also appeals to people's better angels" to try to get people to comply, but it didn't work.  

"And as a result, because we can't stand by idling and let Kentuckians who can't otherwise protect themselves who are vulnerable, pay with their lives, literally. . . . The additional measures became necessary," he said. "And if we were just to comply fully with the mask mandate, that alone probably would help to contain this virus and get us back to reopening all these different things that are now shuttered. So ultimately, it's the public's choice, how we're going to respond." 

Stack called on local leaders and individuals to step up and do their part to improve compliance  in their communities. He also urged Kentuckians to not celebrate Thanksgiving with anyone who is not in their households, calling it an "assured recipe for disaster."

"This is really important. This is a defining moment. And we're gonna have a dark winter if we don't pull it together," he said. "And we want to lift as many of these restrictions as fast as we can, as soon as we can feel more confident that it won't be paid for with large-scale loss of human life and harm to other people who need medical and hospital care who don't have covid." 

Last week, Beshear banned in-person schooling and indoor service in bars and restaurants, limited indoor gyms and recreation facilities to one-third capacity, with no group classes; placed a limit of 25 people in all venues, event spaces and theatres; limited professional spaces to one-third capacity along with a call for them to allow people to work at home or to close altogether if at all possible; and limited sizes of gatherings to eight people from a maximum of two families. Beshear also asked churches to stop in-person worship. In addition, the mask mandate remains in effect. 

The second study Stack discussed looked at compliance with the mask mandate in Jefferson County. It found that men aged 19 to 44 were the least likely to wear a mask. Researchers who observed 191 public areas found that men made up 82% of unmasked staff and 75% of unmasked visitors, and more than half of the incorrectly masked visitors.  

The study also compared mask compliance in small, medium and large public areas and found that compliance was worst in small areas; 35% of such areas had at least one unmasked visitor, compared to 23% in medium-sized areas and 14% in large areas. Large areas had the highest rate of at least one visitor wearing their mask incorrectly, 61%. 

Daily data, threat to hospitals: Beshear announced 2,135 new cases of the coronavirus, another record for a Monday, a day that is typically low because of limited laboratory work on weekends. This follows the highest week for cases yet, up 22 percent from the week before.

"With what we're going to see happening over Thanksgiving, we're headed to an even darker place than we are right now," Beshear said. "That's why we're taking the steps that we're taking, to put up a fight against a virus that wants to take those we love. And it's our job to fight for those individuals. " 

The share of Kentuckians testing positive for the virus in the past seven days dropped a bit, to 8.97%. It had been above 9% since Tuesday, Nov. 17.

The state reported another day of highs for covid-19 hospitalizations and intensive-care-unit beds: 1,573 and 391, respectively. Of the ICU patients, 203 were on ventilators.

Beshear was asked if Kentucky hospitals have enough specialists to operate the ventilators around the clock for an extended period of time if they reach or extend beyond capacity, a worry in some other states.

"We talk about running out of staff before we run out of beds," he said. "We think it’s the same with ventilators." He said that if ventilator staff go out sick, hospitals "have to start bringing in people who don’t do it on a daily basis and our outcomes aren’t as good."

Beshear again warned that if cases continue to escalate, the state's health-care system will become overwhelmed, and said it is at "a tipping point." He asked Kentuckians whether they were willing to make sacrifices to ensure everyone has access to care when and if they need it, and said:

"We're taking action before we hit the point of no return, because that point is close, folks. If we don't take action now, what we're talking about will happen. Taking action before Thanksgiving is critical to make sure that the surge that we all expect to see afterwards, [to] make sure that we're as ready for it as we can [be]."

Beshear pointed to examples in other states as cases surge across the nation. He said New York has had to reopen a field hospital, the Mayo Clinic's Wisconsin hospitals have been forced to put beds in lobbies and a parking garage because they have exceeded capacity, and 22% of hospitals nationwide say they will face a critical staff shortage in the next week.

Because this surge is happening all across the nation, Beshear warned,  "There's nobody coming to help us. When our Kentucky providers run out, there's no one coming to our aid. We have to protect ourselves and the threat is so very real." 

In an open letter, hospitals and health departments in the Paducah area pleaded with the public to wear masks, wash hands frequently, and practice social distancing. “We’re under some pretty significant stress right now,” Murray-Calloway County Hospital CEO Jerry Penner told Murray's WKMS. “Our resources are getting tight and our beds are filling. . .. We’re getting ready to go into a significant holiday when people normally get together. Now all of a sudden we’re asking people to wear masks and in some cases, the governor is asking them not to have large groups at home. We can only imagine the two weeks after Thanksgiving, we’re gonna have another potential blossom of a number of cases. We just need everyone’s help to think about what they’re doing.

Beshear shared a video of health-care workers asking Americans to wear a mask, and his news release noted a recent study in Kansas from the U.S. Centers for Disease Control and Prevention that shows on average, counties that mandated mask-wearing saw a 6% reduction in cases; in contrast, the counties that opted out saw a 100% increase in cases.

The governor announced five new deaths from covid-19, bringing the state's death toll to 1,792: a 73-year-old Fayette County woman, a 73-year-old Harlan County man, a 77-year-old Webster County man and two McCracken County men, 85 and 88.

Beshear honored the life of LaTasha Benton of Lexington, who died of complications from covid-19 at only 43. Beshear said Benton was a key member of the Lexington community, who worked on issues such as tenants’ rights, affordable housing and criminal justice reform.

Benton was featured in a New York Times series about people who have died of covid-19. In the article, her mother, Stephanie Pace, said that even after two kidney transplants, two strokes and two hip replacements, she never complained, saying, "She was my little bionic girl." Beshear said she tested positive for the virus at the end of October and died on Nov. 6. She is survived by her son, Daniel, her two brothers and her mother. 

"LaTasha, we are so sorry, and we grieve with your family," Beshear said. "I will wear my mask for you and I hope everybody else does, too." 

In other coronavirus news Monday:

• Counties with 10 or more new cases were Jefferson, 435; Fayette, 260; Madison, 110; Boone, 85; Kenton, 77; McCracken, 68; Warren, 54; Campbell, 39; Oldham, 38; Greenup, 32; Jessamine, 30; Daviess, 28; Graves, 26; Calloway, 25; Franklin, 24; Whitley, 23; Bullitt, 22; Montgomery, 22; Boyd, Logan and Powell, 21 each; Barren, Floyd and Shelby, 20 each; Henderson, 19; Pulaski, 18; Magoffin and Scott, 17; Caldwell 16 Grayson, 15; Breathitt, Muhlenberg, Owsley, Simpson and Spencer, 14 each; Boyle, 13; Bell, Carter, Hardin, Laurel and Mercer, 12 each; Garrard, Hopkins, McCreary and Russell, 11 each; Harlan, Letcher, Morgan and Taylor, 10 each.
• In long-term care, there were 6,065 active cases in residents and 5,437 among staff, with 138 new resident and 135 new staff cases reported Monday. Beshear said 37 more new resident deaths and one new staff death had been confirmed, bringing the toll attributed to covid in these facilities to 1,155 residents and seven staff.
• Beshear said 15 inmates have died from complications from covid-19, including two from the Kentucky State Reformatory who died this weekend. Two corrections employees have died from covid-19. 
• The college and university report shows 813 students and nine staff tested positive for the virus in the past 14 days. 
• More than 1,000 Kentucky parents, nine religious schools filed a brief supporting a lawsuit by Danville Christian Academy and Attorney General Daniel Cameron against Beshear's order to stop all schools from holding in-person classes. At a Monday hearing, "The judge said both sides made good arguments," WKYT reported. 
• Kentucky funeral homes are divided about Beshear's limit of 25 people in a room, Kristen Shanahan reports for Louisville's WDRB.
• Drugmaker AstraZeneca  announced in a news release that clinical trials show its coronavirus vaccine is 90% effective in preventing covid-19 in one of the dosing regimens tested and less effective in another, the Associated Press reports. The vaccine is also reported to be cheaper and easier to store since it does not require ultra-cold storage, so it may become the vaccine of choice for the developing world. Earlier this month, Pfizer and Moderna reported that their late-stage trials showed their vaccines were almost 95% effective. Both of these vaccines require special storage. The Lexington Herald-Leader explores what it means for a vaccine to be over 90% effective. 
• The first two vaccines for the virus have been developed with a revolutionary kind of genetic technology, report Grace Schneider and Deborah Yetter of the Courier Journal after interviewing University of Louisville physician and researcher Jon Klein, who participated in one of the clinical trials. "He said if the Pfizer and Moderna vaccines win approval and prove successful, it would be a stunning turnaround time for development of a vaccine. Prior to that, the mumps vaccine held the record as the fastest developed — and it took several years. Still, Klein warned the vaccines won't be available in time to prevent what he sees as a pending covid-19 catastrophe, with rates soaring across the United States, as well as many parts of the world."
• Yetter also takes a deep dive into the struggles facing the state's nursing homes and senior living sites as they continue to get slammed with the virus, and no end in site as long as rampant community spread continues.

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