Northern Kentucky jail offers treatment and care after release as part of drug treatment for inmates who want it

Photo: Liz Dufour/The Enquirer

A jail in Northern Kentucky has embraced science-based research for inmates with addiction for inmates who want it since 2015, and now that program includes care after release, Terry DeMio reports for the Cincinnati Enquirer.

DeMio walks through what the Kenton County Detention Center in Independence offers inmates, while regularly reminding readers that while the program is not what standard incarceration looks like, "It is still a jail." 

"But it is rare for jails and prisons in the United States to offer a full continuum of treatment for inmates with addiction, and especially, to include medication – even though it is the standard of care," she writes. 

In 2015, the detention center hired Jason Merrick, a certified drug and alcohol addiction counselor with degrees in social work who was in recovery himself to a newly created role: addiction services director. Merrick designed the program around what addiction specialist consider best practices, DeMio reports. 

In 2018, the jail partnered with Hazelden Betty Ford Foundation in a program called Strong Start Comprehensive Opioid Response with 12 Steps and Reentry, which includes three months of treatment that includes opioid-use disorder medications, followed by three months of aftercare. 

DeMio reports that it appears to be working. Only 24% of those who completed both the jail and aftercare program have been rearrested and jailed after three years, said John Clancy, director of strategic partnerships at the Life Learning Center, a focal point of the aftercare program. That compares to 68% recidivism after three years nationally, according to the Department of Justice.

The program, which is voluntary, has evolved to include two deputy/counselors, two re-entry specialists, a population management specialist and three social-work interns from Northern Kentucky University.

The staff makeup is just what people with substance-use disorder need, says Lindsey Vuolo, vice president of health law and policy for the Partnership to End Addiction, a national nonprofit dedicated to transforming how the United States addresses addiction.

“It is really important for jails and prisons to include medical professionals and individuals with lived experiences when designing this type of program,” Vuolo told DeMio, citing research from the National Council for Behavioral Health.

And all along, the University of Kentucky Center on Drug and Alcohol Research tracks and evaluates the Kenton County treatment plan, DeMio reports.

DeMio reports how the Life Learning Center in Covington, which offers the aftercare, helps the former inmates. She notes that it offers a range of services that include helping the former inmates connect with health care providers who offer medication assisted therapies to providing job-readiness skills and job-finding help. 

She also notes that the center helps the former inmates find appropriate clothing for work, offers childcare, helps them find affordable dental care and offers an on-site location that will remove their tattoos for free. 

DeMio also walks through how the program is funded and how officials say it ultimately saves taxpayers money. 

She writes, "Here's how: A year of incarceration costs about $24,000 for one person. Almost every inmate in the treatment program is spared a conviction likely to yield an 18-month jail sentence. The inmate is jailed instead for 90 days – which yields 15 months not served. That 15 months would cost $30,000 if served in jail. Merrick's records show that about 450 graduates have gone through women's and men's programs each year. That's $13.5 million saved every year, he says. Beyond that: Without evidence-based treatment in jail, it's likely inmates with opioid use disorder will relapse after release. And if they don't overdose and die, it's likely they'll be arrested again and return for more jail stays." 

For Bethany Ball, associate director of Addiction Services, and her staff, it's not just about the dollars, DeMio reports.

"We are trying to address the areas that we see people struggling with consistently, especially those that aren’t always addressed: culture, mental health, trauma, childhood trauma," Ball told DeMio. "We are committed to not just saving lives, but helping to show that there is a life worth living and they are worthy of that life."

Read More

Pandemic metrics, still on way down, pass more milestones

State Dept. for Public Health map, relabeled by Ky. Health News; click on it to enlarge.

By Al Cross
Kentucky Health News

Measures of the pandemic passed more milestones in Kentucky Wednesday.

The percentage of Kentuckians testing positive for the coronavirus fell to 2.4%, the lowest level since testing for the virus became widely available just over a year ago.

The state reported 440 new cases of the virus, lowering the seven-day rolling average to 434 per day. It hasn't been that low since July 17, and has dropped for nine consecutive days.

The statewide rate of daily new cases fell to the lowest level since the state began reporting it in December: 6.66 cases per 100,000 residents. Counties with rates more than double the statewide rate were Webster, 33.1; Owen, 27.5; Union, 22.8, Adair, 20.8; Robertson, 20.3; Bath, 19.4; Montgomery, 18.3; Gallatin, 17.7; Harlan, 17.6; Rockcastle, 17.1; Whitley, 16.2; Laurel, 14.8; Powell, 13.9; Bourbon, 13.7; and Knox, 13.3.

Kentucky hospitals reported 349 Covid-19 patients, 109 of them in intensive care and 50 of those on ventilators. Those figures have also trended downward; the average hospital count in the past seven days has been 352; in the previous week it was 397, so the latest weekly average was a drop of 11.3 percent. 

Two hospital regions reported more than 80% of intensive-care beds in use: Lake Cumberland, 91%, and the easternmost region, from Lee to Pike counties, 82%. In the former region, 22% of ICU beds had Covid-19 patients; in the latter, only 6% did, about average for the state other than Lake Cumberland.

The state reported 19 more Covid-19 deaths, 16 from regular health-department reports and three from an ongoing audit of death certificates. Over the last two weeks, the state has averaged 7.3 deaths per day; in the previous two weeks, it was 9.3. The state's Covid-19 death toll is 6,744.

Read More

Chamber, UK school starting public-policy series with discussion of health differences and disparities between rural and urban Ky.

The health disparities between rural and urban Kentucky, and differences in health-care access and delivery, will be discussed in the first of a new series of public-policy webinars sponsored by the Kentucky Chamber of Commerce and the Martin School of Public Policy & Administration at the University of Kentucky.

The event, scheduled from noon to 1:30 p.m. ET Tuesday, June 8, will be a panel discussion with:

• Mark Birdwhistell, UK Health Care chief of staff and vice president for health services administration
• Larry Gray, president of Baptist Health Louisville and former president of Baptist Health Corbin
• State Sen. Ralph Alvarado of Winchester, chair of the Senate Health and Welfare Committee and a physician
• State Rep. Kim Moser of Taylor Mill, chair of the House Health and Family Services Committee and a former nurse

Chamber Senior Policy Analyst Charles Aull will moderate the discussion. He said it will include the opportunity for questions from participants. The webinar is free; to register, click here.

“We look forward to not only engaging in these roundtable discussions but also serving as a resource for policy-makers and other interested parties,” said Kate Shanks, vice president of public affairs at the Chamber and a Martin School graduate. “Our goal is that these sessions will lead to better understanding of these important issues and help develop Kentucky-specific solutions.”

Future programs in the series will address the rural-urban divides in education (July 15) and economic development (Aug. 10).

Read More

Beshear says Ky. data prove vaccines work; asks younger Kentuckians, who make up most new cases, to get vaccinated

Graphic by The Washington Post is updated daily.

By Melissa Patrick

Kentucky Health News

At his only announced pandemic press briefing of the week, Gov. Andy Beshear shared Kentucky data that shows how well coronavirus vaccines work, and again implored younger Kentuckians to go get one. 

First, he showed how deaths related to Covid-19 have plummeted since Kentuckians have been able to get vaccinated, falling from a high of 1,672 deaths in December, when the first vaccines became available to some, to only 56 in May, with less than a week left in the month. 

In March and April, of the people who tested positive for the virus in Kentucky, 97.5% were not vaccinated; of those who were hospitalized, 94.3% of them were not vaccinated; and of all the Covid-related deaths, 94.4% were not vaccinated, Beshear said. 

"These things work," he said. "Yes, they are not 100% effective, but when you look at these numbers, they are much more than 90% effective. Folks, these vaccines have earned an A, and we all ought to recognize that and take them. Those are incredible numbers that show just how effective the vaccines are." 

So far, 2,006,742 Kentuckians have received at least one dose of a vaccine, which amounts to 45% of the total population or 56% of the adult population. 

Beshear said he was proud to see an increase in the number of people who got a first dose of a vaccine last week, up nearly double from the prior week, to 74,553. 

He said 23,409 12- to 15-year-olds have received at least one dose of a vaccine since it became available to them, and "You want to keep that up."

Moderna announced today that its early trials show the vaccine is 100% effective for 12- to 17-year-olds and said it will seek emergency approval from the U.S. Food and Drug Administration to expand its use in teens. Currently, the Pfizer-BioNTech vaccine is the only one approved for that age group. 

Beshear said if the Moderna vaccine is approved for this age group, it will help get them vaccinated before school starts in the fall. 

The weekly federal pandemic report for Kentucky shows its share of fully vaccinated people has dropped from 27th to 31st among the states in the last three weeks. Asked why, and what the state is doing about it, Beshear and Health Commissioner Steven Stack pointed to lack of second doses.

Stack said coming back for that second shot is "very important" in order to be fully protected and for it to last longer. He added that just because it looks like we are resuming normal activities, that doesn't mean you don't need to get that second shot. 

The Centers for Disease Control and Prevention says that as of May 21, 37% of Kentuckians are fully vaccinated. Nationwide, 50% of U.S. adults are fully vaccinated. 

Prisons: Beshear announced that the Department of Corrections and the Department of Juvenile Justice will resume in-person visitation the week of June 20. It has been stopped since the pandemic began. 

He said visitation will open by appointment to fully vaccinated family and friends of inmates. A state news release says available times will be published on the agencies' websites June 4. Beshear said 76% of adult inmates have been vaccinated, and vaccines will be offered to new inmates and those who originally declined one. 

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

Daily numbers: The share of Kentuckians testing positive for the virus in the last seven days is 2.52%. It hasn't been that low in almost a year.

Beshear announced 580 new cases of the virus, saying it was the lowest Tuesday number in three months. It lowered the seven-day rolling average by nine, to 456 down for the eighth straight day.

He said the highest new-case rate is still among 10 to 19-year-olds, closely followed by those 20-49. “Our incidence rate is much higher among younger Kentuckians than older Kentuckians,” he said. “It’s directly associated with . . . whether you’re vaccinated.”

The state reports that 81% of Kentuckians 65 and older have received at least one dose of a vaccine; 61% of people 50-64; 47% of people 40-49; 42% of people 30-39; and 31% of people 18-29. 

Kentucky has seen three straight weeks of declining cases and positive-test rates. Beshear called this yet more "real-world proof" of how effective these vaccines are. 

The statewide rate of daily new cases over the last seven days is 7.01 per 100,000 residents, down 0.42 from Monday and the lowest since the state began reporting the figure in December. Counties with rates more double the statewide rate are Owen, 27.5; Adair, 23.8; Bath, 22.9; Union, 21.9; Webster, 19.9; Rockcastle, 18; Montgomery, 16.7; Gallatin, 16.1; Bourbon, 15.2; Harlan, 14.8; Carroll, 14.8; Laurel, 14.3; Mason, 14.2; and Whitley, 14.2.

The state reported five more Covid-19 deaths, four from regular health-department reports and one from the ongoing audit of death certificates. The state's Covid-19 death toll is 6,725.

Kentucky hospitals reported 353 Covid-19 patients; 108 of them in intensive care and 49 of those on a ventilator. All hospital readiness regions are using less than 80% of their intensive-care beds. 

Beshear also acknowledged the loss of two people who he said had made an impact on his life, both of them to cancer. One was his Aunt Mary Ann Miller and the other was 9-year-old David Turner Jr., who advocated for childhood cancer research and early in the pandemic asked Kentuckians to wear a mask. 

In other pandemic news Tuesday: 

• U.S. Sen. Rand Paul says he won't get a coronavirus vaccination until he sees that it would be more effective than the natural immunity he says he has from having been infected with the virus more than a year ago. Paul said on WABC Radio in New York, "Until they show me evidence that people who have already had the infection are dying in large numbers, or being hospitalized or getting very sick, I just made my own personal decision that I’m not getting vaccinated because I’ve already had the disease and I have natural immunity." Fox News notes, "The Centers for Disease Control and Prevention has encouraged people who have had Covid to get vaccinated because "experts do not yet know how long you are protected from getting sick again after recovering." Research says at least eight months, and the degree of immunity appears to increase with the severity of the case. Paul had a mild case.
• "The daily vaccination rate has sunk below where the United States needs to be to meet President Biden’s July 4 vaccination goals," Paige Winfield Cunningham reports for The Washington Post. "Yet Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said he thinks the targets will still be met. 'I believe we will attain' the president’s goal of having 70 percent of Americans vaccinated with at least one dose of a coronavirus vaccine, Fauci told my colleague Yasmeen Abutaleb during a Washington Post Live interview."
• The source of the virus remains a mystery, "but in recent months the idea that it emerged from the Wuhan Institute of Virology, once dismissed as a ridiculous conspiracy theory, has gained new credence. How and why did this happen?" Glenn Kessler of The Washington Post asks and answers.
• Experts generally believe that the pandemic has killed more people than accounted for in government lists of Covid-19 deaths, but estimates vary. Recently The Economist estimated that the global death toll is 10 million, three times the official counts; now the Institute for Health Metrics and Evaluation at the University of Washington estimates that there have been 6.9 million deaths, more than double the official toll. The estimated U.S. difference is smaller, 58% (574,043 official deaths, 905,289 estimated deaths).
• Why do we get coronavirus shots in the arm? Because the muscles there are good at picking up antigens in the vaccine that stimulate immune responses and are close to the lymph nodes, which have more immune cells that recognize the antigens "and start the immune process of creating antibodies," Purdue University professor Libby Richards writes for The Conversation. "Muscle tissue also tends to keep vaccine reactions localized. . . . Another consideration during vaccine administration is convenience and patient acceptability. Can you imagine taking down your pants at a mass vaccination clinic? Rolling up your sleeve is way easier and more preferred."

Read More

Places with more uninsured had more Covid-19 cases, deaths; Ky. did well; its Medicaid rolls grew more than all but 2 states'

Chart by Dustin Pugel, Kentucky Center for Economic Policy, click on it to enlarge.

By Melissa Patrick
Kentucky Health News

People living in communities with high rates of uninsured people were much more likely to get the coronavirus and to die from it than people living in communities with fewer uninsured people. 

That's according to a new Families USA report, "The Catastrophic Cost of Uninsurance: Covid-19 Cases and Deaths Closely Tied to America's Health Coverage Gaps," which found from the start of the pandemic through the end of August, every 10 percent increase in the proportion of a county's residents who lacked health insurance was associated with a 70% increase in coronavirus cases and a 48% increase in Covid-19 deaths. 

In that same period, the report found 30% of Kentucky's total coronavirus cases (14,580 of 48,396) and 23% of the state's Covid-19 deaths (217 of 933) were associated with gaps in health coverage. 

"It seems clear to me that coverage matters when it comes to getting and staying healthy and Covid-19 is no exception," said Dustin Pugel, policy analyst for the Kentucky Center for Economic Policy. "Kentucky moved really quickly, more so than our neighboring states, to make sure our folks were covered by a special Medicaid program when many lost their jobs and their health insurance with it. I can only imagine how much worse things might have been here if we had hundreds of thousands more without access to health care." 

Those changes helped give Kentucky the third highest percent increase in Medicaid enrollment of any state between February and November 2020, according to state Medicaid Commissioner Lisa Lee.

Conversely, in the percentage of Covid-19 cases and deaths associated with health-insurance coverage gaps, Kentucky ranked low: 40th among the states, according to Families USA.

Its report provides numbers for counties with more than 50 cases or deaths. Todd County, at 40%, had the highest share of total cases linked to health-insurance gaps. Campbell and Boone counties, at 21% each, were lowest. 

Fayette County, at 28%,  had the highest percent of total deaths linked to health insurance gaps. Oldham County, at 14%, had the lowest percent. 

"Kentucky has had more people covered than our neighboring states and has fared much better in terms of both Covid cases and deaths," said Emily Beauregard, executive director of Kentucky Voices for Health. 

Thirty percent of Kentucky's Covid-19 cases were linked to health coverage gaps compared to 48% in Tennessee, 42% in Virginia and 34% in West Virginia, 34% in Ohio, 41% in Indiana, 37% in Illinois and 44% in Missouri. Kentucky's Covid-related deaths that were linked to health coverage gaps were also lower than each of the surrounding states, according to the report. 

And while every state saw some increase in their Medicaid enrollment since the pandemic started,  

One of the reasons for Kentucky's low rate of uninsured residents -- 6.4% in 2019 -- is because the state expanded Medicaid to more low-income adults in 2013 under the Patient Protection and Affordable Care Act, which added about 450,000 people to the Medicaid rolls. Prior to the expansion, this program was limited to children, pregnant women, people with disabilities and people in nursing homes. 

Since the pandemic, the Beshear administration  launched a campaign to get more Black and Hispanic residents enrolled in health coverage as a way to reduce racial disparities in health.

 

It also adopted a broad presumptive eligibility option, which is temporary, time-limited Medicaid coverage that allows the state to get people into the program quickly and before the full Medicaid application is completed. 

Data from Lee's presentation at the May 20th Medicaid Oversight and Advisory Committee shows in March 2020, Kentucky had nearly 1.4 million people (1,383,005) in the Medicaid program, with 2,573 of them signed up through presumptive eligibility. 

By April 2021, that number had increased to nearly 1.7 million people (1,667,628), with 131,833 of them signed up through presumptive eligibility.  

Of the newly enrolled, Lee said 52,797 of them are children and most are between the ages of 18-65 who qualified because of Medicaid expansion. 

"This increase in enrollment reflects changes in our economy," said Lee. " Individuals have lost their jobs or they have reduced incomes." 

Lee added that Kentucky has qualified for a 6.2% increase in what the federal government reimburses for Medicaid since the pandemic hit and this has allowed the state to stay within it's budget during the public health emergency. 

And as Kentuckians get back into the workforce, Lee and Beauregard both noted that Kentuckians who no longer qualify for Medicaid should look for coverage on the federal exchange since the Biden administration has extended a special open enrollment period to Aug. 15. The special enrollment period includes enhanced premium subsidies, also known as tax credits, to help offset the cost of the health plans and also makes more people eligible for the subsides. 

Lee said the state has been doing outreach to those who enrolled presumptively to help them complete that full Medicaid application that would move them over to the traditional Medicaid program. And if they no longer qualify for Medicaid, they work to help them gain coverage through the federal marketplace, commonly called Obamacare. 

The Families USA report says it will use the findings from this report to ask one fundamental question, "If everyone in America had health insurance, how many people who contracted Covid-19 could have been spared, and how many who died might still be with us today?" 

As of May 24, there have been at least 456,053 total cases of the coronavirus in Kentucky and 6,720 deaths, according to the state's daily report.  

Read More

Kentucky's 7-day average of daily new coronavirus cases below 500 for first time in 10 months; positive-test rate keeps falling

By Melissa Patrick
Kentucky Health News

Kentucky's seven-day average of new coronavirus cases dropped below 500 Thursday, for the first time in 10 months, and its positive-test rate is among the lowest since testing became widely available. 

The state reported 575 new cases, with 23% (133) in people 18 and under. The seven-day average for cases is 489. The last time it was under 500 was July 18, at 447; the next day, 979 new cases raised it by 100. That was the start of a long-term increase that peaked in January; the seven-day average on Jan. 12 was 4,002.

Nationwide, the seven-day average for cases is also on a decline. It was 30,206 on May 19, according to The New York Times. 

The rate of new cases over the last seven days was 8.05 per 100,000 people,. Each day since May 6, the rate has dropped to the lowest since the state began reporting it in December.

Rockcastle, Owen and Webster counties, with more than 25 cases per 100,000, are the only Kentucky counties that remain in the red zone, which is considered a "critical" level. Other counties with rates more than double the statewide rate were Adair, 23.1; Union, 21.9; Henderson, 19.9; Grayson, 18.4; Bourbon, 17.3; Taylor, 17.2; Knox, 16.5; Estill, 16.2; Powell, 16.2; Lewis, 16.1; and Gallatin, 16.1.

The share of Kentuckians testing positive for the virus is 2.70%, the lowest it's been in the past seven days and among the lowest since testing became widely available in May. 

Kentucky hospitals reported 357 Covid-19 patients, the lowest number since April 5; 104 of them were in intensive care, and 44 of those were on a ventilator. Only one hospital readiness region is using at least 80% of its intensive care unit beds: Lake Cumberland, at 93%. The state's daily report shows 20% of those beds are being used by Covid-19 patients. 

The state reported 15 more Covid-19 deaths, 13 of them from health department reports and two of them from an ongoing audit of death certificates. 

The state's vaccine dashboard shows 1,945,674 Kentuckians have received at least one dose of a vaccine. That's 44% of the state's population and 55% of its adult population. Go to vaccines.gov/search/ to find a vaccine site.

In other pandemic news Thursday:

• Counties with 10 or more new cases were Jefferson, 147; Fayette, 22; Boone, 21; Kenton, 19; Campbell, 17; Johnson, 15; Laurel and Pulaski, 13; Clark, 12; Adair and Floyd, 11; and McCracken, 10.
• 
  

Read More

As Covid-19 metrics slowly trend down, we can talk about the end of the pandemic, but that's a somewhat fuzzy concept

WebMD image

For more than a year, people have pondered when the coronavirus pandemic would be over. 

A firm answer to that question depends on many factors, but several key metrics used to measure the pandemic suggest that it could be time to have that conversation, Joel Achenbach writes for The Washington Post. 

New coronavirus infections in the United States have dropped to their lowest rate since mid-September, and if trends continue, they will soon be lower than in nearly 11 months, Achenbach notes. 

Also, nearly half of adults have had at least one dose of a coronavirus vaccine that has proven remarkably effective at preventing severe illness and death. In a separate Post article, Paige Winfield Cunningham reports positive trends in three key metrics: new cases, hospitalizations and deaths. 

On Monday, May 17, Cunningham reported that average daily deaths in the U.S. had fallen 16.5% in the previous week, and are now below 580 per day; average daily hospitalizations fell 12.6%; and average daily cases fell 19.2%, with fewer than 35,000 new cases being diagnosed each day.

In Kentucky during the same week, the 7-day average of hospitalizations fell 3.5% and the weekly average of new cases dropped 12%. Death reporting in Kentucky can be slow due to delays at local health departments; the reported-death average in the state rose slightly last week.

Centers for Disease Control and Prevention models show that cases are likely to decline sharply in July. 

"We are doing extremely well in the U.S. and are well on our way of moving past the pandemic," Monica Gandhi, professor of medicine at the University of California at San Francisco, told Cunningham. 

That said, some experts say the metrics are still too high and that it is too early to declare victory. They include CDC Director Rochelle Walensky, who told a congressional subcommittee Thursday that the nation has made "extraordinary progress" but the virus has "sent us too many curveballs" to say the pandemic is over or will soon be over. "Today, I’m cautiously optimistic," she said.

Washington Post graph; to enlarge, click on it.

Carlos Del Rio, a professor of medicine at Emory University, told the Post's Cunningham that his goal is to see new cases drop below 20,000 per day and daily deaths fall under 100. He said it is concerning that daily vaccinations are sloping downward.

In the last week, vaccinations in Kentucky numbered 27% less than the previous seven days. Cunningham reports that last week, the U.S. saw an 11% decrease in the number of vaccine doses administered, compared to the week before.

Experts often say we are in a race between the vaccines and the variants -- mutations of the virus that are more contagious or more deadly. 

That means "pandemics start quickly and end slowly," Achenbach writes. He notes that infectious-disease experts have been clear that the virus is unlikely to be eradicated and that some measures to fight it, like booster vaccines and wearing masks in the winter, could remain part of our lives. 

“Covid-19 as a pandemic will end,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Achenbach. “But it won’t end uniformly throughout the world for obvious reasons, because many countries will not have capabilities to make it end. But as a pandemic, or as a countrywide epidemic, it absolutely will end in this country.”

Fauci added that achieving this will depend on getting at least 70% of adults vaccinated and if this happens by the fall, he said, "I think we're going to get out of the epidemic stage and much more into the control stage." 

Achenbach wraps up his article by noting five "caveats that cloud this sunny outlook:" polling that shows a significant number of people don't want a vaccine; the possibility that mutations could erode vaccine efficacy; experts anticipate a fifth wave of the virus this winter; the U.S. is not truly safe from the virus until the whole planet is; and it is still not known exactly how many people need to have been vaccinated or have had the disease to create herd immunity, which creates significant protection for those who are unwilling or unable to get vaccinated. 

Helen Branswell of Stat takes another approach to this topic, exploring how some scientists look to the past to see the future when they consider how this pandemic will end.

"The truth of the matter is that pandemics always end. And to date vaccines have never played a significant role in ending them," she writes, adding, "That doesn’t mean vaccines aren’t playing a critical role this time. Far fewer people will die from Covid-19 because of them."

She reports that past pandemics didn't end because the viruses went away, but because their viruses underwent a transition, and became endemic, or common. And the big, unanswerable question when it comes to this coronavirus is, "When will that happen?" 

Read More