Seven-day averages of new virus cases and covid-19 deaths in Kentucky reach new highs; Kavanaugh considers schools case

By Al Cross
Kentucky Health News

The pandemic set no daily records in Kentucky Friday, but the seven-day rolling averages of new coronavirus cases and covid-19 deaths hit new highs.

The state reported 3,614 new cases, raising its seven-day average to 3,232, beating the previous record of 3,119 set on Thanksgiving day, Nov. 26.

It confirmed another 25 deaths from covid-19, making a total of 2,039. The seven-day average of deaths is 24; the 14-day average is 19.8.

The averages are the best rough measurements of the pandemic, since they smooth out daily fluctuations, which can be large, especially on weekends.

The stabler numbers come from hospitals. Kentucky hospitals reported 1,792 covid-19 patients Friday, 18 fewer than the record set Thursday. Intensive-care units had 409 of those patients, 230 of whom were on ventilators.

As usual for a Friday, Gov. Andy Beshear didn't hold a briefing but issued a press release, encouraging Kentuckians to stay on guard as the first vaccinations, of frontline health workers and nursing-home residents and staff, approach.

“These vaccines are right around the corner. Within the next 10 days or so we might be giving out the first vaccines,” Beshear said in the release. “That means every loss of life and every extra infection that happens between now and then is entirely avoidable. So let’s fight harder than we ever have.”

For the first time, the Centers for Disease Control and Prevention is urging “universal mask use” anywhere outside the home. The CDC has long encouraged indoor masking when with people outside the household; in its latest Morbidity and Mortality Weekly Report, the CDC said the virus has entered “a phase of high-level transmission” and “consistent and correct” use of masks is essential. It recommended masking at home when a household member has been infected or potentially exposed to the virus.

Beshear's legal staff was busy Friday, responding to efforts to keep his ban on in-person schooling from applying to religious schools. They filed a brief with Supreme Court Justice Brett Kavanaugh, who may decide the issue this weekend.

Kavanaugh is the justice who hears emergency appeals from the U.S. Court of Appeals for the Sixth Circuit. Last weekend, three judges on that court threw out a district judge's injunction that would have allowed religious schools to reopen. Kavanaugh could stay the appeals-court order, pending review by the full Supreme Court, or kick the decision to the full court.

The case was brought by Danville Christian Academy and Attorney General Daniel Cameron. Sens. Mitch McConnell and Rand Paul joined 36 other Republican senators in filing a brief with the court supporting the position of the school and Cameron, a McConnell protege.

The 25 covid-19 deaths confirmed Friday were a 76-year-old Boone County man; a 69-year-old Caldwell County woman; an 84-year-old Christian County woman; a 70-year-old Crittenden County woman; a 70-year-old Elliott County man; a 74-year-old Franklin County man; a 72-year-old woman and two men, 74 and 87 from Greenup County; an 87-year-old Hopkins County man; two men, 67 and 71, from Jefferson County; two women, 40 and 64, and a man, 99, from Johnson County; a 55-year-old Lawrence County man; an 82-year-old Lewis County man; a woman, 73, and a man, 81, from Madison County; a 94-year-old Marion County man; a 97-year-old Marshall County woman; a 91-year-old Martin County woman; an 83-year-old McCracken County woman; a 77-year-old Monroe County woman; and an 85-year-old Muhlenberg County woman.

Counties with more than 10 new cases Friday were Jefferson, 576; Fayette, 351; Boone, 118; Kenton, 108; Warren, 102; Daviess, 100; Boyd, 86; Hardin, 68; Madison, 67; Boyle, 54; Oldham, 54; Bullitt, 53; Laurel, 51; McCracken, Pike and Pulaski, 50; Campbell, 48; Ohio, 46; Henderson, 45; Franklin, 42; Knox, 40; Christian, Graves and Hopkins, 39; Marion and Whitley, 38; Clark, Jessamine and Washington, 37; Scott, 35; Taylor, 34; Bell, Calloway Greenup and Shelby, 28; Marshall, 27; Johnson, 26; Caldwell, Hart and Simpson, 25; Lewis and Nelson, 24; Barren and Metcalfe, 23; Bath and Woodford, 22; Clay and Floyd, 21; Allen and Muhlenberg, 20; Anderson, 19; Bourbon and Letcher, 18; Pendleton, 17; Lawrence and Perry, 16; Adair, Lincoln and Mason, 15; Grant, Grayson, Green, Henry, Logan and Spencer, 14; Garrard, Harlan, Montgomery, Owen and Rockcastle, 13; and Bracken, 12.

In other coronavirus news Friday:

• The share of Kentuckians testing positive for the virus in the last seven days is 9.93 percent, a drop of 0.14 points from the record percentage set Wednesday.
• Congressional leaders reported progress in talks on a relief bill. "Compromise is within reach," Senate Majority Leader Mitch McConnell said.
• "Health-care advocates are raising concerns about logistical and ethical challenges that could complicate" coronavirus vaccinations of nursing-home residents and staff, report Christopher Rowland and Will Englund of The Washington Post.
• "Americans’ compliance with social distancing recommendations sank to new lows in October, according to a study that also documents a notable rise in risky behavior," reports Antonia Farzan of The Washington Post. "The Covid States Project, a coalition of researchers from Harvard, Rutgers, Northeastern and Northwestern universities, has surveyed more than 15,000 people each month between April and November . . . Their findings back the anecdotal observations of public-health experts who suggested that the dramatic surge in coronavirus infections that began in October was preceded by 'pandemic fatigue' and people letting their guard down."
• This fall, Kentucky ranked 16th in social distancing and 32nd in mask wearing; there was more difference among the states on distancing than masking.

Kentucky Health News added to the map specific percentages for Kentucky, bordering states and states often visited by Kentuckians.

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Dec. 15 is the deadline to sign up for federally subsidized health insurance; Kentucky enrollment is running behind last year's

By Melissa Patrick

Kentucky Health News

The deadline to enroll in federally subsidized health insurance for 2021 is fast approaching, with the last day Tuesday, Dec. 15 for coverage that starts Jan. 1.  

And while anyone already enrolled will automatically be re-enrolled in a 2021 marketplace plan, it is highly recommended that you check out other options to make sure your current plan still meets your needs. 

“It’s very important for individuals to update their applications, even if they were covered last year, so they can review the most current information on what savings are available and to find a plan that best meets their needs,” Kentucky Health Benefit Exchange Director Edith Slone said in a news release.  

Some things to consider when choosing coverage are whether the number of people in your household has changed, whether your income or medical needs have changed -- which is especially important this year because of the pandemic -- and whether the plan includes your providers or their formularies include your prescriptions.

Consumers are also encouraged to not only look at premium costs, but to also look at annual deductibles, which must be met before much of the coverage will kick in. 

And don't assume you can't afford coverage. The Cabinet for Health and Family Services says about 80 percent of Kentuckians who sign up on healthcare.gov will qualify for a tax credit or subsidy to reduce their monthly payments. 

Under the 2010 Patient Protection and Affordable Care Act, subsidies to offset premium costs are available on a sliding scale for people who earn between 100% and 400% of the federal poverty level. That range next year is $12,760 to $51,040 for an individual and $26,200 to $104,800 for a family of four, says Kaiser Health News, in an article that addresses how to choose a plan if you've had covid-19 and are worried about possible long-term complications.

Map shows Anthem marketplace plan availability by county.

In addition, many Kentuckians will have more choices this year, probably at a slightly higher cost, since Anthem Health Plans and CareSource both expanded their coverage areas, giving 94 of the state's 120 counties more than one company to choose from. This year, only 56 counties had two insurers on the healthcare.gov marketplace. 

Anthem is offering at least one of its 13 plans in all 120 counties in 2021, up from 93 in 2020. CareSource is offering all 12 of its plans in 94 counties, up from 83 in 2020.

Through the end of November, 2,939 fewer Kentuckians had enrolled on the federal exchange than at the same time last year. That was 12.2% less than at this time last year, but because of calendar procession, this year's tally had two fewer days, or 6.7% fewer. Nationally, more people had signed up compared to last November. 

Map shows CareSource plan counties in blue.

As of Nov. 28, Kentucky's enrollment on the federal exchange was 24,043, compared to 26,982 last year, according to the Centers for Medicaid and Medicare Services. None of these numbers reflect any automatic re-enrollments.

"We expected numbers would be less this year due to the pandemic," Susan Dunlap, spokeswoman for the health cabinet, said in an e-mail. " More are qualifying for presumptive-eligibility Medicaid coverage and traditional Medicaid coverage due to loss of income" in the coronavirus pandemic.

Another challenge may be a lack of awareness about the Affordable Care Act coverage on the marketplace, which is most widely known as Obamacare. The Kaiser Family Foundation reports that its polling found public awareness about the 10-year-old law is falling, compared to a decade ago.

"For example, 59% of the public knows the ACA offers subsidies for marketplace health plans, compared to 75% ten years ago," the foundation reports. "Among uninsured consumers today, understanding of ACA options and enrollment rules is more limited. Less than half (43%) know open enrollment is the time to sign up for marketplace plans; and 14% of uninsured individuals living in states that have expanded Medicaid eligibility under the ACA know about this expansion. KFF also finds many consumers are unsure about the current status of the ACA; as of this spring, just 22% of the uninsured know the law remains in effect. Uncertainty may result in part due to public debate and news coverage about a pending Supreme Court case to overturn the law." 

The health cabinet said it is reaching out to current and potential enrollees via direct mail, emails, phone calls, and community outreach events held by local Kynectors, who help people enroll.  

The foundation says the importance of health coverage is greater than ever because of the surge of new coronavirus infections, which can cost upwards of $10,000 for a mild-infection and tens of thousands of dollars for more severe cases. 

"At the very least, people with ACA-compliant private insurance are protected by out-of-pocket maximums, limiting how much enrollees must pay for a hospitalization. There is currently no guarantee that hospitals waive covid-19 treatment costs for uninsured patients, meaning those without coverage could be on the hook for large medical bills," the foundation reports.

It's important to not miss the Dec. 15 deadline because unless you qualify for a special enrollment period, you won't get another chance until next year. 

Where can I find help?

The state-based call center is available at 855-459-6328 to assist Kentuckians with questions about  where to go for coverage, answer questions and pre-screen for eligibility. The Healthcare.gov customer service center (800-318-2596) is also available 24 hours a day, seven days a week, excluding holidays.

Click here to find a Kynector, who can provide in-person help with applying for health coverage at no cost. Click here for information on how to assign an authorized representative to apply for or manage your benefits, Kynectors, and insurance agents, who can also help you sign up for benefits. 

Healthcare.gov provides a shopping tool to allow you to preview 2021 plans and estimated prices before you log in.

Healthinsurance.org also offers an Open Enrollment 2021 Guide.

The Kaiser Family Foundation also offers a Health Insurance Marketplace Calculator to provide estimates of health insurance premiums and subsidies for people purchasing insurance on their own on Healthcare.gov. It allows you to enter your income, age and family size to estimate your eligibility for subsidies and how much you should spend on health insurance. It will also allow you to see if you qualify for Medicaid.

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Washington Post story on nursing homes and the pandemic highlights the case of a Kentucky staffer who died of covid-19

A Kentucky example figures prominently in a national story about nursing homes, their staffs, their residents and families dealing with the pandemic.

"Burnout is stalking the country’s nursing homes," Will England's story begins. "Even as the coronavirus peaks yet again, remaining staffers are worn out, often fed up with the companies they work for, and yet many say they are holding on because their patients need them and have no one else to look out for them. Still, never far from their thoughts is the knowledge that they, too, could be felled by the disease. And unlike the ambulance drivers and hospital workers who have struggled to save lives during the pandemic, many say they feel no love from the outside world."

“The people in the community have no idea what we are going through,” Rebecca Rufial, a licensed vocational nurse in Paris, Texas, who works a 12-hour shift every night, in charge of two halls with 40 to 50 patients, helped by two nursing assistants, told the Post. “And no one cares, either.”

England writes, "A hospice nurse in Michigan who asked not to be identified so as not to jeopardize her current job, quit because she was angry at the way her employer had pressured her to return to work when she contracted the coronavirus herself. The nurse said she was shaken by the distress of the residents, and infuriated by the understaffing and emphasis on cutting costs at the nursing homes she visited. . . . And she hated to see nursing home companies exploit the dedication of their health-care workers. 'They really do take advantage of the culture of nursing, which is fairly meek,' she said.

"Dedication was all Michelle Thompson knew. She was a low-paid assistant responsible for dispensing medicines at a nursing home called Signature Healthcare at Summit Manor, in Columbia, Ky. Unmarried, 58 years old, a diabetic with high blood pressure, she was determined to carry on when the coronavirus entered the facility."

Her sister, Denise Carver, recalled, “It was just all scary at the beginning, Nobody knew what was going on.”

When Thompson volunteered to work with covid-19 patients, “We tried to talk her out of it,” said her mother, Marlene Iames. “She said, ‘No, these people need me, and it’s my job, and I’m going to try to help them. If I don’t do it, who else is going to do it?’”

England reports, "Thompson told her family that staffers hadn’t been provided with enough face masks or proper personal protective equipment. For a week or maybe two, she kept working. On April 17 she was running a fever, thought it was the flu and called in sick. Her supervisor accused her of slacking and, Carver said, told her to come in. Thompson refused. On April 18, she learned she had tested positive for the coronavirus. On April 21, she went to the hospital, where her kidneys failed and doctors put her on a ventilator. She died April 30. . . . Officials at the nursing home and at the Signature Healthcare headquarters in Louisville did not respond to repeated requests for comment." The company has more nursing homes in Kentucky than any other.

Summit Manor had 71 confirmed cases of the virus as of Nov. 1, with another 32 suspected, England reports: "Sixteen residents have died of the disease, as well as Thompson and another employee. Carver said it seems like everybody in Adair County, population 18,656, knew of someone who died at Summit Manor."

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Covid-19 hospitalizations in Ky. and U.S. at new highs; positive-test rate passes 10%; second highest day for new virus cases

State Department for Public Health map, with additional labels by Kentucky Health News

By Al Cross
Kentucky Health News

As the pandemic set more records in Kentucky and the nation, Gov. Andy Beshear announced allocations of the first doses of the first coronavirus vaccine expected to be approved.

The state reported 3,895 new cases of the virus Thursday, second only to the 4,151 it reported Tuesday, and 1,810 covid-19 patients in Kentucky hospitals, beating Wednesday's record of 1,768, an increase of 2.4 percent in one day.

Also, the share of Kentuckians testing positive for the virus in the last seven days is 10.07%, the highest since testing became widely available in May.

Beshear announced 34 more deaths from covid-19, following a record 37 on Wednesday and 35 on Tuesday. That total of 106 was the highest three-day figure yet. The seven-day rolling average of daily deaths, which has increased every day this week, is now 21. The state's death toll is 2,014.

"Today we’ve passed some tough milestones both in the country and here in Kentucky," Beshear said. "Today is the toughest day this country has ever seen in covid-19," from deaths and hospitalizations. "It ought to show us and tell us that it is more important right now now than ever that we do the right things to protect ourselves and those around us."

The good news, Beshear said, is "We believe that we could be vaccinating people here in Kentucky as early as December 15," starting with 38,000 doses for frontline health-care workers and residents of nursing homes. The vaccine will come from Pfizer Inc., which could get federal approval Dec 10.

Beshear announced that two-thirds of the state's first allocation of the vaccine will go to CVS and Walgreens, which have contracts with the federal government to vaccinate residents of long-term care facilities, and 12,675 doses will go to 11 hospitals selected for their locations and ability to provide ultra-cold storage needed for that vaccine.

Beshear said the two firms will handle logistics of nursing-home vaccinations, but "we believe and hope" that all 50,000 residents and staff can be vaccinated in the first eight weeks, as other shipments come to the state.

The initial shipment from Pfizer will be about one-third of what the state first expected, because of the company's supply-chain problems, and thus will not be enough to immunize all hospital workers or nursing-home residents and staff in the first round of vaccinations.

The 11 hospitals are in Paducah, Madisonville, Bowling Green, Louisville (3), Lexington (2), Edgewood, Corbin and Pikeville. Each will get a pallet of 975 doses, except the University of Kentucky hospital in Lexington and Norton Healthcare in Louisville will each get two pallets.

Each hospital will determine which employees will get vaccinated in the first round, based on their likelihood of exposure to the virus. "We are going to be spreading this out in future allocations," Beshear said. "Even if you’re not part of this very first shipment, it’s exciting there IS a shipment. … We need to be patient."

Schools: Beshear noted that all but seven of Kentucky's 120 counties are in the state's red zone, representing the highest level of infection, which means elementary schools in the other 113 will not be able to resume in-person instruction Monday. Beshear said he hoped that schools in the seven counties will open "on a lower-capacity basis." Those counties are Breckinridge, Crittenden, Green, Adair, Russell, Nicholas and Breathitt.

On Nov. 18, Beshear banned in-person schooling from Nov. 23 to Jan. 4, except for elementaries not in red-zone counties. He said the state is working on ways that "some form of in-person learning" can resume Jan. 4 in counties that are still red. He said schools would be required to have safeguards for employees, who are more vulnerable to the virus than students, and "meaningful" options for remote instruction.

Arethia Tilford was 57.

Beshear memorialized the life of Arethia Tilford of Louisville, who died of covid-19 at the age of 57 after 25 days in hospital. He said her husband, Mark, dropped her off at the emergency room and got a call from her shortly afterward saying she was being put on a ventilator. It was their final conversation.

Beshear said Mark Tilford called his wife "the most unselfish, charismatic person he had ever met . . . the most beautiful person, inside and out." An attendance clerk at Lincoln Elementary Performing Arts School, "She always said when you can't find the sunshine, be the sunshine," Beshear said. 

The 34 covid-19 deaths confirmed Thursday were a woman, 65, and two men, 63 and 69, from Barren County; a Bell County woman, 86; two Caldwell County women, 87 and 93; two Christian County women, 71 and 76; a Crittenden County man, 50; a Daviess County woman, 96; seven women, 65, 78, 87, 90, 94, 95 and 96, and two men, 81 and 93, from Fayette County; a 101-year-old Graves County woman; a Greenup County woman, 64; a Hickman County woman, 69; two Jefferson County women, 82 and 94; a Marion County man, 62; a McCracken County woman, 94; a Metcalfe County woman, 76; a 91-year-old woman and an 88-year-old man from Oldham County; two women, 74 and 92, and two men, 84 and 88, from Warren County; and a Woodford County man, 68.

In other coronavirus news Thursday:

• Of the 1,810 covid-19 patients in Kentucky hospitals, 415 are in intensive care and 240 of those are on ventilators, just short of records.
• Counties with more than 10 new cases were: Jefferson, 683; Fayette, 373; Hardin, 147; Kenton, 132; Boone, 110; McCracken, 103; Warren, 97; Daviess, 84; Madison, 81; Bullitt, 71; Perry, 65; Graves, 60; Campbell, 59; Greenup, 59; Christian, 54; Hart, 51; Nelson, 49; Ohio, 48; Calloway, 46; Oldham, Shelby and Whitley, 45; Laurel, 43; Mason, 41; Boyd and Clark, 40; Woodford, 39; Franklin, 35; Jessamine, 34; Hopkins, 33; Barren, 32; Henderson, 32; Lincoln, 31; Lewis, Meade and Mercer, 29; Clay and Muhlenberg, 27; Marion and Rowan, 26; Boyle and Pulaski, 25; Harlan and McCreary, 24; Grayson, 23; Bell and Taylor, 22; Carter and Pike, 21; Garrard, Montgomery, Rockcastle and Simpson, 20; Knox, 19; Scott, 18; Allen and Floyd, 17; Fleming, 16; Marshall, 15; Grant, Lawrence, Logan and Spencer, 14; Bourbon, Carroll, Powell and Wayne, 13; Anderson, Henry and Metcalfe, 12;  and Washington, 11.
• Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, told the U.S. Chamber of Commerce that he expects the next three months to be "the most difficult time in the public-health history of this nation," largely because of the pandemic's stress on the health-care system.

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More partners join campaign, mainly on social media, to encourage flu vaccinations to prevent a 'twindemic' with covid-19

The campaign to amplify the importance of all Kentuckians receiving a flu shot, particularly amid the coronavirus pandemic, has some new partners.

Aetna Better Health of Kentucky, Humana, WellCare of Kentucky and the Kentucky Hospital Association have joined the original partners – the Kentucky Medical Association, the Foundation for a Healthy Kentucky and Anthem Blue Cross and Blue Shield in Kentucky – in the “Raise Your Guard, KY: Focus on Flu” campaign for a special focus on flu vaccinations.

The campaign will be primarily centered on social media, with each organization promoting the benefits of flu vaccination. Last year, more than 27,408 cases of flu were reported in Kentucky, which resulted in 162 deaths.

KMA President Dale Toney said in a press release that his group and the foundation “worked together on a very successful campaign” a few years ago. Dr. Jeff Reynolds, Anthem's medical director, emphasized the importance of preventing a "twindemic" of flu and covid-19.

“We must all work to preserve our state’s hospitals and healthcare workers so they can be prepared for a potential influx of COVID-19 patients,” Reynolds said. “By encouraging everyone to get a flu vaccine, we can reduce the impact of influenza in Kentucky.”

Dr. Howard Shaps, WellCare's chief Kentucky medical officer, said, “To help protect against the flu, we encourage members to schedule their vaccination appointments as soon as possible. Since it can take two weeks after getting the vaccine for the antibodies that protect against the flu to fully develop, it’s best to get a flu vaccine as early in the season if possible.”

More on the campaign is available at RaiseYourGuardKY.org/Flu.

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37 reported dead today from covid-19, the state's deadliest day yet; Beshear notes White House report commends his actions

Kentucky Health News graph; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

This week's White House pandemic report praised Gov. Andy Beshear's latest orders to thwart the coronavirus, and said they will work "if compliance is high." If there was ever a time for that, it would be now, Beshear said after reporting the state's deadliest day from covid-19 and a rapidly rising positive-test rate.  

"The time we really need to be coming together and doing the right things is right now because the ramifications if we don't are the most severe of any time in the virus," Beshear said. adding later, "Now is the time where action is necessary; inaction is deadly."

At his Wednesday briefing, Beshear announced a record 37 additional deaths related to covid-19, bringing the state's death toll to 1,980. The previous high was 35, reported Tuesday. Six of the deaths were people under 60, he said. 

The share of Kentuckians testing positive for the virus in the past seven days is going up at an alarming rate. On Wednesday it hit 9.62%, the highest it's been since May when the state started testing more broadly. 

That shows "it's not more testing" that is driving case numbers, Beshear said. "It's more people who are getting the virus and more people who are spreading the virus."

He announced 3,601 new cases of the virus Wednesday, the state's sixth highest single day for cases. He said 1,768 people were in the hospital with covid-19; 427 of them in intensive care and 234 of those on ventilators. 

This week's White House Coronavirus Task Force report came with dire warnings, but it also came with praise for Beshear's Nov. 18 orders to slow the latest surge of cases, hospitalizations and deaths. 

"New orders put in place by the governor should result in rapid decrease in transmission if compliance is high," the report said. 

The orders include a ban on in-person schooling and indoor service in bars and restaurants, and tighter numerical limits on certain gatherings. All are controversial and several have been challenged in court.

The Democratic governor and his health commissioner both stressed that the Republican-led White House approves their rules. Beshear said the nation's foremost experts say Kentucky has "a winning game plan." 

"Sometimes we feel like this virus is being politicized and the steps that we take are being politicized," said Beshear. "Well, this is Donald Trump's White House, so if there are those in the state and different parties that disagree with me, they're disagreeing with Donald Trump's White House. 

"And if Donald Trump's White House agrees that . . . the plans that were put into place will work, that means that the public-health experts all know that this thing will work, if again, we all do our part."  

Health Commissioner Steven Stack, a physician, said he and Beshear review a "whole swath of information" in order to make the "best informed decisions we can, based on experts and good judgment." 

Stack said they and the Trump administration are "not agreeing on every single point, but agreeing on the vast majority of points. And so you're getting fairly similar guidance on most of the big topics from two very different administrations."

White House warnings: Stack added that this White House report used some of the "darkest language" it has used since it started issuing them.

"The covid risk to all Americans is at a historic high," the report said. "We are in a very dangerous place due to the current, extremely high covid baseline and limited hospital capacity; a further post-Thanksgiving surge will compromise covid patient care, as well as medical care overall."

The report called on officials to alert the public: "It must be made clear that if you are over 65 or have significant health conditions, you should not enter any indoor public spaces where anyone is unmasked due to the immediate risk to your health; you should have groceries and medications delivered."

Further, "If you are under 40, you need to assume you became infected during the Thanksgiving period if you gathered beyond your immediate household. Most likely, you will not have symptoms; however, you are dangerous to others and you must isolate away from anyone at increased risk for severe disease and get tested immediately.

"If you are over 65 or have significant medical conditions and you gathered outside of your immediate household, you are at a significant risk for serious covid infection; if you develop any symptoms, you must be tested immediately as the majority of therapeutics work best early in infection. . . . All states and all counties must flatten the curve now in order to sustain the health system for both covid and non-covid emergencies." 

Many of the Kentucky's hospitals are already being stretched thin, said Beshear, including King's Daughters Medical Center in Ashland, which is using one of its lobbies as an overflow area for the emergency department due to "near record patient volume," a hospital spokesman told WYMT.

The White House report again has Kentucky in the most dangerous zone for number of cases and the share of people who tested positive Nov. 21-27, ranking 23rd highest for cases and 16th highest for positive-test rate.

It says 68% of the state's 120 counties have high levels of community transmission and 68% have moderate levels. The number of counties in the White House red zone decreased by three from the previous week, to 81; the orange zone rose by six, to 19; and the yellow zone increased by one, to 15. 

The report says Kentucky had 437 new cases per 100,000 people, about the same as the last report, when that number was 433 per 100,000. The national average is 349 per 100,000.

Health experts have cautioned that reports that cover the Thanksgiving holiday could understate the status of the pandemic because there was less testing,

Stack noted research predicting that good compliance restrictions could prevent hundreds of covid-19 hospitalizations. The University of Louisville research, done first in the Louisville region, has been extended to the Bowling Green and Owensboro regions.

Beshear honored the life of Michael Rodriguez, who was a nurse at Norton Audubon Hospital in Louisville for 26 years. Rodriguez died at 67 from covid-19 on Nov. 20. He is survived by a brother, sister, a fiancé, and three nephews. 

Beshear said, “The director of Norton Audubon Hospital, Randy Hamilton, said he’d never seen anything like the hospital after Michael’s passing – he had made such a positive impact on everyone. From those who cleaned the hospital, to the nurses, doctors and patients – everyone was devastated by this loss. Today we mask up in honor of Michael, his family, and his incredible team members at Norton Audubon who are mourning this devastating loss, but still showing up each day to care for our people.”

In other covid-19 news Wednesday: 

• Today's deaths were an Allen County man, 61; a woman, 80, and men 49 and 94 from Boone County; a Campbell County man, 82; a woman, 90, and four men, 48, 61, 62 and 93, from Daviess County; a woman, 86, and men 74 and 86 from Fayette County; a Floyd County woman, 62; Franklin County women 71 and 90; a Graves County man, 84; a Grayson County woman, 70; a Hardin County man, 58; a Henderson County woman, 46; a Hopkins County man, 88; a man, 87, and women 83 and 96 from Jefferson County; Jessamine County men 67, 74 and 90; two women, 81 and 82, and a man, 85, from Kenton County; two McLean County women, 61; a Monroe County woman, 95; a Montgomery County woman, 59; an Ohio County man, 85; a Trigg County man, 82; and a Warren County man, 46.
• Counties with 10 or more new cases were Jefferson, 686; Fayette, 219; Boone, 145; Hardin, 138; Kenton, 118; Warren, 103; Madison, 96; Daviess, 91; Laurel, 76; Bullitt, 71; Campbell, 69; Marion, 67; Clay, 56; McCracken, 55; Oldham, 50; Nelson, 49; Boyd, 48; Boyle, Christian and Pike, 46; Scott, 45; Jessamine, 41; Henderson, 40; Franklin and Whitley, 37; Perry, 36; Hart and Hopkins, 35; Lincoln, 34; Greenup, 33; Pulaski, 32; Barren, 30; Taylor, 29; Graves and Rowan, 28; Calloway and Grant, 27; Clark, Montgomery and Shelby, 24; Gallatin, 22; Washington, 21; Anderson and Magoffin, 20; Simpson, 19; Floyd and Woodford, 17; Knox, Lawrence and Rockcastle, 16; Bell, Bourbon and Johnson, 15; Adair, Edmonson, Logan, Marshall, Pendleton and Todd, 14; Carter, Garrard, Leslie, Ohio and Webster, 13; Harlan and Lewis, 12; Monroe, 11; and Bath, Clinton, Grayson, Russell and Union, 10.
• In long-term care, the state reported 2,145 active cases among residents and 1,143 among staff, with 141 new resident cases and 87 new staff cases. There have been 1,274 resident deaths and seven staff deaths, with 16 resident deaths confirmed today.
• Beshear said 379 of the new cases were Kentuckians 18 and under. 
• J. Michael Brown, Beshear's cabinet secretary, said 2,706 inmates and 425 corrections staff have had the virus, and that 310 inmates and 82 staff are still active cases. He said 19 inmates have died of covid-19, including two conformed today, and two staff members. 
• The Centers for Disease Control and Prevention now says a two-week coronavirus quarantine can be shortened to 10 days, or even seven. While the CDC continues to recommend a 14-day quarantine for people exposed to the virus, it is now offering two other "acceptable alternatives" as a way to increase compliance, especially among the working public. 
• The first option would end the quarantine 10 days after exposure for who have no symptoms and have not been tested. "CDC officials said research shows there’s anywhere between a 1% to 12% “residual risk” that someone remains infected after a 10-day quarantine period has ended, “an acceptable risk for many," reports Katie Camero of McClatchy Newspapers.
• The second option would end the quarantine after seven days, but only if that person tested negative and had no symptoms. "This alternative . . . carries a 5% to 10% risk that the person is still positive after a 7-day quarantine period," Camero writes.
• Asked about the recommendations, Beshear said state officials are reviewing them and he hopes to have a decision by Thursday on whether the state will change its quarantine guidance. 
• The CDC also issued new holiday travel guidance that urges Americans to stay home, and to get tested one to three days before their trip—and to not travel if the result is positive—and again three to five days after if they do travel. In addition, they recommend reducing non-essential activities for a full week after travel or for 10 days if not tested. The guidance cautions that "testing does not eliminate all risk, but it can help make travel safer." And for 14 days after travel, social distance, wear a mask, practice good hand hygiene, avoid being around people who are at increased risk of severe illness and monitor for any symptoms of the virus. 
• Brewed, a Lexington coffee shop that defied Beshear's bam on indoor service, was ordered to close by a circuit judge Tuesday, Jeremy Chisenhall reports for the Herald-Leader. Beshear said the coffee shop since ceased operations. 
• Billy Kobin of the Louisville Courier Journal explores several perspectives about re-opening schools to in-person learning, noting that the issue is far from settled. For now, Beshear's executive order has shut down elementary schools to in-person learning until Dec. 7, and then only if they are in a county with lower community spread, and the upper grades are closed to in-person learning until Jan. 4. 
• The Kentucky Blood Center is searching for people who have recovered from covid-19 to donate plasma, WDRB reports. 
• WKYT offers a report that shows where coronavirus cases increased the most in November, noting that the number of cases more than doubled in 25 of the state's 120 counties. 
• USA Today answers questions about coronavirus vaccines, and offers an online form for you to ask anything they haven't addressed.
• A vaccine may still be months away for children, NPR reports.
• The World Health Organization has tightened its mask guidelines, telling people who live in areas with high community spread to wear their mask at all times in stores, workplaces and schools with low ventilation -- and when you can't physically distance by at least three feet in enclosed areas, even at home. It adds that health care workers should wear N95 masks when caring for covid-19 patients, The Hill reports.
• Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, told ABC News that Kentucky not only faces logistical challenges to distribute coronavirus vaccines, but also challenges around trust, which makes it even more important to make sure trusted sources are chosen to be the messengers for immunization.

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Kentucky sees worst coronavirus day yet, with more than 4,000 new cases, 35 deaths and other record metrics of misery

From Gov. Andy Beshear's Twitter page

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear announced record numbers for almost every metric the state uses to measure the coronavirus pandemic Tuesday, calling it "a terrible day." 

"No way to sugarcoat it," Beshear said at his daily briefing. "Today is the very worst day that we have had for reporting on the spread of the coronavirus and it is the deadliest day that we have had. This is exponential growth. . . . If we don’t all do our part, if we try to be the exception, then slowing down this thing won’t work and we will lose a lot more Kentuckians we love and care about.”

Beshear announced record highs for new coronavirus cases, covid-19 deaths, hospitalizations, patients in intensive care and on ventilators, and the highest percentage of Kentuckians testing positive for the virus since the testing became widely available in May: 9.59%.

The governor reported 4,151 new cases of the virus, well beyond the previous record of 3,870, set on Thanksgiving.  

The new record of 35 deaths brought the state's covid-19 death toll to 1,943. The previous single-day high was 33, set Nov. 17.

The number of covid-19 patients in Kentucky hospitals hit a high of 1,777, with 441 in intensive care and 241 of those on a ventilator. And while covid-19 patients' share of beds in the state's hospitals remained the same as Monday, 21%, their percentage of ICU beds increased to 32%, from 30%, and their share on ventilators increased to 41% from 38%. 

“Covid is spreading like wildfire, taking record numbers of people from us, infecting record numbers of people out there,” Beshear said. "That's why we're fighting back. That's why we're trying to be aggressive and not wait for it to overwhelm us, but to try to stem this third wave just like we stopped the first two and not surrender and accept unacceptable fatalities." 

On Nov. 18, Beshear imposed new restrictions, including bans on in-person schooling and indoor service in bars and restaurants, and tighter numerical limits on at-home social gatherings. All have been controversial.

“We do believe right now that the steps that we’ve taken are absolutely necessary,” Beshear said. "And maybe today’s report will convince those out there who disagree.”

Mark Carter, who leads the state's contact-tracing program, said it has shifted to a strategy of mitigation instead of containment because the virus is so widespread. He said tracers are are only contacting patients who test positive for the virus, and instructing them to inform their close contacts.

“We’re being overwhelmed in terms of our disease investigation and contact tracing efforts," Carter said. "I think that is in part because we haven't had the level of compliance that we need to have with public health recommendations around masking and social distancing, and so forth.

"But we can turn that around, we can make a difference with that by taking our individual personal responsibility to heart knowing that we're protecting our loved ones and friends and family and, and we're just being good citizens. And we can we can turn that around." 

Community spread is also taking a toll on nursing homes. The state reported 2,251 active cases among residents and 1,193 among staff, with 173 new resident cases and 109 new staff cases reported today. Beshear said at least 57 long-term-care facilities have 15 or more active cases. Nursing home residents and staff have accounted for 65% of the state's covid-19 deaths.

"Our community response isn't where it needs to be," Beshear said. "Whether or not people in long-term-care facilities get covid is about what we do in our daily lives, the decisions we make and whether or not we do what it takes to prevent it from spreading to those around us."

Beshear reported that another veteran at the state's Thomson-Hood Veterans Center in Wilmore, who was previously listed as recovered, had died, bringing the center's death toll from the virus to 31. He said there is currently two active cases in the center and no new cases have been reported for 18 days. 

He also announced that the veteran who was the first active case at Western Kentucky Veterans Center in Hanson had died. In addition, he said a 37-year-old inmate from the Lee Adjustment Center, a privately operated state prison, had died from covid-19. 

Both Carter and Beshear made urgent pleas for more federal money. 

"Essentially all of our disease investigation and contact-tracing effort across the commonwealth has been funded by the federal CARES Act," Carter said. "We're required to have spent that funding by December 30. We desperately need either an extension of that date or additional funding, or both in order to take this program into 2021 and get us through the months that we need to get through 'til we reach the point where we have a widely available vaccine." 

Speaking more broadly, Beshear said that without any more federal relief funds there won't be any additional relief for restaurants and bars, for additional unemployment aid, for local governments, for eviction relief, or for contact tracing and the state's testing efforts: "Everything stops at the end of December unless we get a new act of Congress."

A bipartisan group of lawmakers outlined a $908 billion relief proposal Tuesday as an attempt to jump-start negotiations so that they can pass relief before the holidays, Andrea Noble reports for Route Fifty. Senate Majority Leader Mitch McConnell said there was "no reason" that Congress can't pass one by the end of the year, the Lexington Herald-Leader reports.

Bruce Gadansky

Beshear honored the life of Bruce Gadansky, who died of covid-19 at the age of 76, leaving behind his wife Mickey, two sons and five grandchildren. 

“As Bruce passed on, his wife and son were left to say their goodbyes, urge him on to a better tomorrow, through a phone held to his ear by a nurse," said Beshear. " That is what covid does to our loved ones." 

Beshear said Gadansky was a U.S. Navy veteran who served in Vietnam, was a deputy sheriff in Oldham County for 10 years and championed causes for the elderly during his time as vice-president of operations for the Louisville Better Business Bureau. He had also been a volunteer for St. Matthews Baseball.

“What we must stress here is that Bruce and Mickey tried to do it all right," Beshear said. "They barely left the house in nine months and they always wore a mask. But that’s the thing about masks – it takes all of us wearing them correctly to protect one another. If we do, we can prevent the loss of individuals like Bruce, and the heartbreak of his family who is now mourning." 

In other covid-19 news Tuesday: 

• Tuesday's deaths were a 70-year-old Boyd County man; a 75-year-old Calloway County man; an 82-year-old Christian County man; a 96-year-old Daviess County woman; a 95-year-old Graves County woman; two women, 79 and 86, and two men, 57 and 66, from Grayson County; a 93-year-old Henderson County woman; an 87-year-old Hopkins County man; six women, 61, 64, 76, 77, 77 and 80, and seven men, ages 62, 64, 64, 66, 72, 73 and 94, from Jefferson County; a 62-year-old Jessamine County woman; a 76-year-old Kenton County man; a 79-year-old Marshall County woman; a 66-year-old Mason County woman; two men, 59 and 64, from McCracken County; a woman, 88, and a man, 64, from Monroe County; a 65-year-old Montgomery County man; a 93-year-old Robertson County woman; and an 82-year-old Union County man.
• Counties with 10 or more new cases were: Jefferson, 700; Fayette, 238; McCracken, 172; Warren, 148; Kenton, 126; Hardin, 120; Daviess, 119; Boone, 102; Madison, 97; Laurel, 89; Oldham, 80; Campbell, 73; Christian, 72; Hopkins, 67; Marion, 62; Bullitt, 61; Lincoln, 56; Nelson, 55; Hart, 54; Pike, 51; Montgomery, 50; Carter and Clay, 49; Barren and Graves, 48; Pulaski, 44; Greenup, 41; Magoffin, 39; Marshall, 38; Rowan and Woodford, 36; Whitley, 35; Jessamine, 34; Boyle, 32; Floyd, 31; Ohio, 30; Bell and Henderson, 29; Franklin, 28; Knox and Washington, 27; Clark, Johnson and Logan, 26; Harlan, 25; Anderson, Boyd, Mercer, Rockcastle and Taylor, 23; Lawrence, 22; Garrard, 21; Adair and Scott, 20; Calloway, 18; Grant, Larue and Simpson, 17; Monroe, Perry and Shelby, 16; Bracken and Jackson, 15; Edmonson, Muhlenberg and Pendleton, 14; Grayson and Harrison, 13; Livingston and Mason, 11; and Butler, Letcher, Martin, Union and Wayne, 10.
• Beshear said 2,650 restaurants and bars have applied for the Food and Beverage Relief Fund, for a total of $25.6 million in assistance. The state has already approved applications for $1.7 million. To apply, click here. Beshear said he expects bars and restaurants will be able to resume indoor service on Dec. 14 as planned.
• As cases continue to surge in Kentucky, Beshear encouraged Kentuckians to get tested. Click here to find a location near you. 
• The Healthy at Home Utility Relief Fund still has about $11 million in it that must be dolled out before Dec. 30. “Eligible households can receive a one-time $500 benefit towards their water and or wastewater bills and $400 towards their natural gas or utility bills,” said Beshear. Households who have an income up to 200% of the federal poverty line and have been economically impacted due by covid-19 can apply through their local Community Action office. Click here to find your local office, as well as a list of required documentation, or call 800-456-3452. 
• Food and Drug Administration Commissioner Stephen Hahn told McClatchy Newspapers on Tuesday that the FDA will not automatically authorize emergency use of coronavirus vaccines before completing a rigorous independent review. “The urgency of the situation is a pressure that I think is substantial on all of us,” he said in the phone interview. “Our career staff recognize that and are working with great speed. But also we’ve maintained a commitment to using data and science, and we will continue to do that.”
• The coronavirus may have been spreading in America as early as December 2019, according to a Centers for Disease Control and Prevention study that found coronavirus antibodies in 106 of the 7,389 blood samples from routine blood donations to the American Red Cross between Dec. 13, 2019 and Jan. 17, 2020, the Herald-Leader reports. However, the researchers also said they wondered if the detection of antibodies in these samples indicates a past coronavirus infection, or that of another pathogen in the coronavirus family, such as the common cold. They also say "widespread community transmission was not likely until late February." 
• In a decision released Monday, Attorney General Daniel Cameron said Kentuckians who report people or businesses to the state for failing to comply with its pandemic restrictions should not be granted anonymity, John Cheves reports for the Herald-Leader. The ruling was made against the Labor Cabinet in an appeal under the state Open Records Act. "In a letter to Cameron, the cabinet warned that publicly identifying tipsters 'will have a chilling effect on citizens’ good-faith reporting of non-compliance with public health orders,' especially if their names are posted online by Beshear’s critics," Cheves writes. 
• Dalton Godbey of Louisville's WDRB looks at why state and local coronavirus and covid-19 statistics don't always match up. 
• The director of the Laurel County Health Department told Phil Pendleton of WYMT that he expects a surge of coronavirus cases in mid-December. Health leaders told him most of their contact tracing points to the virus being spread in household gatherings.

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