State ranks 14th in childhood trauma; a coalition called Bloom Kentucky has formed to seek statewide policies to change that

By Melissa Patrick
Kentucky Health News

A collaboration of 31 grantmaking organizations across Kentucky have launched an initiative to focus on statewide policy changes to prevent and lessen the impacts of childhood trauma, also called adverse childhood experiences, or ACEs.

Barry Allen, president and treasurer of The Gheens Foundation, one instigator of the Bloom Kentucky coalition, said it will move grant- making organizations from across the state out of their comfort zone and into actively advocating for policy changes to prevent and reduce ACEs. 

"Each of you and your organizations, through this initiative, are giving the current and future generations of the commonwealth's children and families reasons for hope," Allen said at the Aug. 4 announcement. 

ACEs are traumatic or stressful events that occur before age 18, such as abuse or neglect, substance-use issues in the household, or separation from a parent due to incarceration. More than one in five Kentucky children, 22%, have experienced at least two ACEs, ranking the state 14th in the nation.

ACEs can have lifelong effects on health and well-being. They are linked to chronic health problems, mental illness, substance-use problems in adulthood, and can limit education, job opportunities and earning potential. 

It's easy to think that the issues impacting ACEs are just too complex to tackle, but this coalition "absolutely rejects that notion," said Terry Brooks, executive director of Kentucky Youth Advocates, the backbone organization for the Bloom Kentucky initiative.  

"ACEs can have multi-generational impacts, which means we need holistic, multi-generational solutions," Brooks said in a news release. "Systemic policy change can influence every Kentucky community to foster opportunities for kids and families to flourish. We urge our state lawmakers to think upstream and prioritize policies and investments that prevent these traumatic experiences from happening in the first place." 

Brooks stressed that the work to get these policies in place will require persistence, saying that this is not a "microwave proposition," but instead a "crock-pot effort." The organizers said they would announce its policy priorities for the 2022 General Assembly this fall.

Bloom Kentucky honored three Kentucky leaders for their historic efforts to address ACEs: Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, for "pioneering this effort;" state Health Secretary Eric Friedlander, who was the first to "pound the pulpit" on this issue; and Sen. Max Wise, R-Campbellsville, chair of the Senate Education Committee, for his efforts to bring trauma informed care into schools after the 2018 Marshall County High School shootings. 

Wise said the issues that contribute to ACEs are not defined as rural or urban, but as "commonwealth issues," and said he was committed to working with Democratic lawmakers and Gov. Andy Beshear on policies around the School Safety Resiliency Act and ACEs.

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Community Health Days offering screenings and coronavirus vaccines in 32 Appalachian Ky. counties through November

The first Community Health Day was held in Hindman Friday, Aug. 6. (Photos by Melissa Slone, UK)

By Melissa Patrick

Kentucky Health News

HINDMAN, Ky. — The first of 96 University of Kentucky events to offer Covid-19 vaccines and other health screenings in 32 Kentucky counties resulted in seven more Kentuckians getting a vaccine. 

The three-hour Community Health Days event, which felt like a mini-health fair, was held at the June Buchanan Clinic in Hindman Friday, Aug. 6. The next one listed on the UK Center of Excellence in Rural Health website is Aug. 20 at Topmost Baptist Church, also in Knott County. The events will continue through November and will be added to an interactive website at www.kyruralhealth.org as they are scheduled.

Robin Hensley got a shot at the first Community Health
Day from the Kentucky River District Health Department.

Robin Hensley of Clay County, who was camping in the area, was one of the seven who got vaccinated. Hensley, a registered nurse, said she was initially against taking the vaccine because "it came out too soon," but after learning more about it, decided to get a shot. 

"I think it's important to to be respectful of others' opinions if they choose not to get it, but I also have studied it enough to know that now I'm comfortable with the decision to go ahead and take it," she said. 

The coronavirus vaccines were able to be developed, tested and given emergency-use authorization in less than a year because of previous research on related coronaviruses and new technology, and federal funding by Congress and the Trump administration.

Community Health Days are funded by a $3.3 million federal grant and sponsored by the UK rural-health center, Kentucky Homeplace, USA Drone Port and a network of community partners, according to a UK news release.

Screenshot, adapted, of interactive map available here.

At the request of the Health Resources and Services Administration, which made the grant, the program will also include clinics in West Virginia's Mingo and Wayne counties.

The clinics are being offered as the much more contagious Delta variant of the coronavirus surges across the state, with no real end in sight. They offer more than vaccinations.

Melissa Slone, research, interdisciplinary director at the UK center, said blood-pressure checks and screenings for diabetes and stroke risk at the events remind people to start thinking about and managing their chronic health conditions again after allowing them to worsen while vaccines were yet to come.

"We want people to get vaccinated," Slone said, "but if we can also help them with managing some of the other chronic diseases, then that's a win as well."  

Kentucky Homeplace, through its community health workers, can help people with a range of resources, whether medical, social, or environmental, like heating and air-conditioning assistance or housing needs. 

Twenty-two people were evaluated at the Hindman event, but only seven got the vaccine. 

Fran Feltner, director of the rural-health center, which is based in Hazard, said it's important to offer a range of screenings along with the coronavirus vaccines because it allows them to provide factual information about the vaccines and to answer any questions the participants may have about them, whether they choose to get vaccinated or not. 

Fran Feltner's magnets

For example, she said many people continue to think there is a microchip or a magnet in the vaccine, which is not true. To dispel that myth, she had a pack of magnets available to prove that wasn't true. 

"Our intent is to meet people where they are to work through barriers, alleviate fears, dispel myths, educate and assess any needs people may have that could be holding them back from being vaccinated," Feltner said in the news release.

Feltner said in the interview that the events are "about community members taking care of community members. The ultimate goal is to make sure that everybody has access to vaccine, whether it be the kids or the adults that need access to the vaccine. And sometimes, you bring it to them instead of them coming to you. . . . It's up to us as community members to make sure that people have the right information so that they can make the right decisions." 

Feltner said the Homeplace health workers, who know the people in their communities, have been instrumental in planning the events. She said some sites have had trouble finding local providers to administer vaccinations, and in those cases Walgreens has agreed to partner with them to give the vaccines.

Feltner wrapped up the interview by encouraging people who are hesitant to get a vaccine to seek out credible information about the vaccines and to then weigh their risk before deciding to get one or not. She said, "The more people we can get vaccinated, the more we can get back to a new normal." 

Click here for answers to frequently asked questions about the coronavirus and the vaccines.

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Chain with 11 Ky. nursing homes says it applies lessons learned in pandemic, stopping visits when an employee tests positive

Christian Health Center in Hopkinsville (Photos by Jennifer P. Brown)

Christian Care Communities, which operates 11 nursing homes in Kentucky, "is using what it learned to minimize the risk of a surge in Covid-19 cases — especially as a surge in the Delta variant suggests long-term care facilities may not have seen the last of the virus," Jennifer P. Brown and Julia Hunter report for Hopkinsville's online Hoptown Chronicle.

That means stopping regular visitation when employees test positive for the coronavirus, as they did at Christian Care homes in Hopkinsville, Louisville, Bowling Green, Midway and Corbin, Christian Care CEO Mary Lynn Spalding told the Chronicle.

When an employee at Christian Health Center in Hopkinsville tested positive, "The facility shifted immediately to scheduled, outdoor visits with masks required for residents and visitors. Those unable to leave their room must visit with family members through a window, using cellphones to speak."

The employee did not have contact with residents, but the visitation policy was changed after "devastating infections and deaths during earlier waves of the pandemic" at the nursing home, the Chronicle notes. "In 2020, 98 residents tested positive for the virus — which was nearly all of those living at Christian Health Center, Spalding previously told Hoptown Chronicle. Of those, 14 died of Covid-19."

Christian Care Communities CEO Mary Lynn Spalding and
Jason Armstrong, executive director of Christian Health Center

Spalding "believes it indicates how much skilled nursing facilities have learned about managing infectious disease during the pandemic," the Chronicle reports. She said, “I don’t know a positive way to say it, but we are really good at managing Covid and infectious disease. Not that we weren’t good before, but everyone is so well attuned to it now.”

The Hopkinsville home is testing employees and residents for the virus twice a week because Christian County has a high level of virus spread, as measured by new cases over the last seven days. "As of Thursday, no one else at the nursing home had tested positive," the Chronicle reports.

Spalding said, “If we don’t identify any additional positive cases, we will resume our normal indoor visitation in approximately two weeks.” She said the facilities in Louisville and Midway have returned to regular visitation after two weeks without any new cases, and Bowling Green and Corbin are on track to soon reopen to visitors.

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A six-week surge of the coronavirus has put Ky. about where it was six months ago, but then it was going down; now it's going up

Ky. Health News graph, based on initial, unadjusted daily reports; to enlarge, click on it.

By Al Cross

Kentucky Health News

Six weeks of the Delta variant have put the pandemic in Kentucky about where it was six months ago, but then it was coming off its biggest surge. Just how big the current surge will get is anybody's guess, because vaccinations are rising more slowly than new cases are increasing and the coronavirus is mutating.

Kentucky reported 2,612 new cases of the virus Friday, the largest in one day since Jan. 30. That raised the seven-day rolling average of daily new cases by more than 100, to 1,820 per day. That's the highest since Feb. 10.

The average has increased 175 percent over the last two weeks, giving Kentucky the nation's 14th highest rate of increase, according to The New York Times.

Covid-19 hospitalizations and intensive-care cases continued to rise, to the point that more than 1,000 Kentuckians are likely to be hospitalized with the disease this weekend. Hospitals in the state reported 976 cases, 286 of them in intensive care and 121 of those on mechanical ventilation. The next report will be Monday.

Covid-19 deaths, a lagging indicator of the pandemic, are starting to creep up. The state reported six more Friday, raising Kentucky's toll to 7,372 and the seven-day average to 5.4, the highest since mid-June.

 

Gov. Andy Beshear said in a Facebook post, "Folks, we've got too much to lose. Let us never forget what we are fighting for. Do the right thing – get vaccinated and mask up when indoors."

The  percentage of Kentuckians testing positive for the virus increased for the 43rd day in a row, to 10.46%.

The daily new-case rate for the last seven days is 38.98 per 100,000 residents. Counties with rates more than double that rate are Clay, 114.9; Hart, 87.8; Webster, 82.8; Floyd, 82.3; Laurel, 81; and Carter, 78.4.

Vaccinations continued to creep up. According to the Centers for Disease Control and Prevention, 11,850 doses were reported Friday, raising the daily average over the last seven days to 10,196. It had not been above 10,000 since July 1.

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11 Ky. hospital systems to require vaccine as pandemic continues to surge; state has over 2,000 new cases for second day in a row

Health Commissioner Steven Stack drew red trendlines on this state Department for Public Health graph to show that the pandemic is accelerating in Kentucky more quickly now than it did last fall.

By Melissa Patrick

Kentucky Health News

Seeing their intensive-care units filling up with Covid-19 patients, 11 Kentucky hospital systems are requiring their staff to get vaccinated for the coronavirus, and Gov. Andy Beshear says other private employers should follow suit. 

“I think that other companies should follow the lead that we’re seeing here today . . . of doing everything they can, including what was announced here today, requirements to get people vaccinated,” Beshear said at his weekly news conference. “We’re going to support each and every one of them that do.”

Health Commissioner Steven Stack said the 11 health-care systems have about 75% of the state's hospital beds. Beshear said they had not reached out to every hospital in the state.

The systems are Appalachian Regional Healthcare, Baptist Health, CHI Saint Joseph Health, Ashland-based King’s Daughters Health System, Bowling Green-based Med Center Health, Norton Healthcare, Pikeville Medical Center, Morehead-based St. Claire Healthcare, St. Elizabeth Healthcare of Northern Kentucky, UK Healthcare and UofL Health. All were represented at the news conference; some had imposed the requirement already but most joined publicly on Thursday.

The number of Covid-19 patients in intensive care in Kentucky hospitals is four and a half times what it was a month ago. "Just a month ago I had three Covid patients and only one in the ICU," Pikeville CEO Donovan Blackburn said. "As of this morning, I had 43 [Covid] patients in the hospital. Over a third of them are in the ICU fighting for their life."

The vaccine mandate for health-care workers is supported by the Kentucky Hospital Association, the Kentucky Medical Association and the Kentucky Nurses Association, which said in a joint statement that they "support hospitals and health systems amending their existing vaccine policies to require Covid-19 vaccines for their health care employees. . . . Vaccination against Covid-19 is the best tool to prevent spread of the disease, protect patients and ensure the health and well-being of the hospital workforce and all Kentuckians."

Some employees at Baptist Health Hardin in Elizabethtown, a hospital the chain recently took over, staged a protest of the mandate. Beshear the "courageous" move by the hospitals will make him think again about a similar requirement for state-run hospitals.

Few long-term-care and senior-living facilities have mandated coronavirus vaccinations, though the state ranks low in immunization of those staffs. But associations representing the facilities issued a statement saying they are "expecting health-care workers to initiate" vaccinations no later than Sept. 15. 

Beshear also called for local leaders to do all they can to encourage people to get vaccinated, citing as an example Matt South, chair of Metcalfe County's industrial board, who closed an economic-development announcement with Beshear this week by promoting vaccination.

Beshear quoted South as saying: "I have two grandkids, one seven year old and one two year old, and they can't take this vaccine that's been provided for us. And that scares me. So please get the vaccine for my grandkids and for yours."

Beshear said South is a registered Republican who was speaking to friends, with whom "it may be a hard conversation to have. These are folks that might change their opinion on him locally. But he stepped up and he made a statement on the biggest of stages in his community in a very personal way to push these vaccines. We need more leadership like this."

Daily numbers: The governor's pleas came as the state's rates of new coronavirus cases, Covid-19 hospitalizations and percentage of Kentuckians testing positive from the virus keep are surging. 

On Thursday, the state reported its second consecutive day of coronavirus cases above the 2,000 mark, 2,217, with 478, or 21.6 percent, of those in Kentuckians 18 and younger. Stack said early indications are that young people are more susceptible to the much stronger Delta variant. 

Nationwide, Covid-19 cases among children and teens are up 84% in one week, Stack said. Beshear said, "This ought to be setting up alarm bells, everybody. Kids are not proxies for political battle." 

Beshear said cases in Kentucky youth increased about fourfold between June and July, going from 1,197 to 4,165 in those 18 and younger and from 534 to 2,092 in those under 12, who aren't eligible for vaccines yet.

The rate for new cases over the last seven days is 36.06 per 100,000 residents. Counties with more than double that rate are Floyd, 83.5; Clay, 82.6; Hart, 81.1; Webster, 74; and Laurel, 73.3.

The share of Kentuckians testing positive for the virus in the last seven days is 10.27%. It has risen every day for six weeks.

Kentucky hospitals reported 939 Covid-19 patients Thursday, with 282 of them in intensive care and 108 of those on a ventilator. Between March 1 and Aug. 4, 92.3% of cases, 91.4% of hospitalizations, and 88.7% of deaths were in unvaccinated or partially vaccinated people, the state says. 

"Our beds and our ICU beds are full of unvaccinated individuals," said Hollie Harris Phillips, president and CEO of Appalachian Regional Healthcare.

On Thursday, two of the state's 10 hospital readiness regions were using at least 80% of their intensive-care beds: the easternmost region (from Lee to Pike counties) and Lake Cumberland, 84.6% and 93.3% respectively. 

Beshear said hospital capacity is a key metric he will use to determine any emergency mandates he might issue. He said the state must not let its hospitals be overrun with Covid-19 patients and keep others from getting care.

The state reported four new Covid-19 deaths on Thursday, bringing the toll to 7,366. 

Vaccinations: Kentuckians are getting vaccinated at a faster rate, though it pales in comparison to the number of new cases. Over the last seven days, the state has averaged 9,865 shots per day, 30% more than the previous seven days, according to Centers for Disease Control and Prevention data in The Washington Post. 

Still, only 46% of the state's population is fully vaccinated. Almost 53% of Kentuckians have received at least one dose of a vaccine; among those 18 and older, the rate is 64%. 

Stack again pointed out that public-health strategies to slow the spread of the virus continue to work, including masking, social distancing, hand hygiene, staying home when you are sick, and getting tested -- but the way to get back to our normal lives and not have to do these things is to get vaccinated. 

"Vaccines are the exit strategy," he said, adding, "We treat this virus casually and cavalierly at our own peril. We can't afford to do that. Getting vaccinated and getting all of us vaccinated is essential." 

He said the vaccines have been proven safe with immunization of nearly 1.6 billion people worldwide, but alluded to the possibility that continued spread could lead to a variant that could circumvent vaccines.

"We know for a fact, this virus is dangerous and becoming more dangerous the longer it has the opportunity to spread," he said. "When you look at the relative risks of the disease and the vaccines, there is no debate, there is no uncertainty. Being vaccinated is hands down the far better route for all of us." 

Beshear announced an incentive to encourage state Executive Branch employees to get vaccinated, giving them an extra vacation day for proof of getting at least one dose of a vaccine. The employees already get up to two hours off to get vaccinated, and time to recuperate from any side effects. 

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'Things will get worse before they get better, but we can fight this,' Beshear says as pandemic accelerates again in Kentucky

State Dept. for Public Health map, adapted by Ky. Health News; for a larger version, click on it.

By Melissa Patrick
Kentucky Health News

As the pandemic continues to surge in Kentucky because of the Delta variant of the coronavirus, every metric used to measure it is on the rise. 

The state reported 2,583 new cases of the coronavirus on Wednesday, with 512 of them in people under 19, or 20 percent of the cases. The daily number was the highest since Feb. 11. 

It raised the seven-day rolling average by more than 100, to 1,597 cases per day. That figure is now more than doubling every 10 days, faster than before, and the two-week rate of increase, 175%, is 14th in the nation.

"We are not moving in the right direction," Gov. Andy Beshear said with some understatement on a Facebook post to announce the rising numbers. "And remember, with more cases comes more death."

The state reported 10 more Covid-19 deaths Wednesday, the highest daily total in eight weeks. Beshear said one of the deaths was a 21-year-old from Daviess County. The state's pandemic death toll is 7,362.  

Hospitalizations also continue to rise. Kentucky hospitals reported 889 Covid-19 patients, with 275 of them in intensive care and 100 of those on a ventilator. 

"This is serious," Beshear said. "The Delta variant is real and we have to be willing to do what it takes. Folks, you need to get vaccinated. Things will get worse before they get better, but we can fight this. We can reduce the loss and the damage if you're willing to get vaccinated." 

Also, the governor said Kentuckians need to be wearing masks indoors, regardless of their vaccination status.

The share of Kentuckians testing positive for the virus in the last seven days passed the 10% mark and is 10.08%. 

The rate of daily new cases in the last seven days is 34.39 per 100,000 residents. Counties with double that rate are Clay, 108.4; Hart, 76.6; Webster, 74.0; Laurel, 73.5; Floyd, 71.9; Carter, 68.2; and Metcalfe, 68.1.

The surge in cases appears to have sparked a lesser surge in vaccinations in Kentucky. Another 11,862 were reported Wednesday, making the average for the last seven days 9,803. It's been more than a month since the weekly average was that high; the last seven days saw 35% more shots than the previous seven, according to Centers for Disease Control and Prevention data processed by The Washington Post.

Statewide, 52.7% of the total population and 61.8% of the eligible population (12 and older) has received at least one dose of vaccine.

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Drug overdose deaths in Kentucky rose 49% in 2020; fentanyl and methamphetamine remained the biggest drivers of death

By Melissa Patrick
Kentucky Health News

Drug-overdose deaths in Kentucky rose 49% in 2020, according to the state's latest annual report. 

“In addition to the stress caused by the pandemic, we believe the increase in overdose deaths for 2020 is due to a rise in illicit fentanyl and its analogues within the drug supply. The problem is also exacerbated by the widespread availability of potent, inexpensive methamphetamine,” Van Ingram, Executive Director of the Kentucky Office of Drug Control Policy, said in a news release. 

The state recorded 1,964 overdose deaths in 2020, the highest number recorded to date.. That was 648 more than in 2019, when 1.316 were recorded. It is also 498 more overdose deaths than in 2017, when the state recorded its last record high for overdose deaths, 1,566. 

Knott County had the highest rate of fatal overdoses in 2020, 122 per 100,000 residents. It was followed by Clark, 104; Bourbon, 98.4; Henry, 88; and Garrard, 82.3. The report cautions that counties with fewer than 20 overdose deaths per year, as was the case in all but Clark County, are unstable and should be interpreted with caution. 

The report does not give rates for counties with fewer than 10 overdose deaths, so the report only includes 44 counties. That's up from 2019, when 29 counties had 10 or more overdose deaths, and up from 23 in 2018. 

Jefferson County, the state's most populous county, had the most resident overdose deaths of any county, 512, which was an increase from 319 in 2019. 

Toxicology reports show that fentanyl was involved in 1,393 of the overdose autopsies, or approximately 71% of all overdose deaths for the year. Acetylfentanyl, another version of the drug, was found in 502 of the cases. 

Heroin was involved in 191 of the 2020 overdose deaths, an increase from 166 in 2019. Also seeing increases from the prior year were morphine, detected in 504 cases; alprazolam, 237 cases; gabapentin, 390 cases; methamphetamine, 801 cases; and oxycodone, 198 cases. 

The age group in which Kentucky overdose deaths are most common continues to be 35-44. Next is 25-34, which ranked third in the 2019 report and traded places with the 45-54s in this year's report.

“Deaths attributed to overdose in 2020 are a somber reminder that the opioid epidemic continues to deeply impact our commonwealth  . . . Opioid response is complex and our success will be dependent on our willingness to unite in a shared responsibility to end the stigma and discrimination against substance use disorders and build an equitable system of care that engages and empowers individuals and their families to lead healthy, fulfilling lives," Health Secretary Eric Friedlander said in the release.

Data for the report was compiled with data from the Kentucky Office of the Medical Examiner, the Kentucky Injury Prevention & Research Center, and the Kentucky Office of Vital Statistics.

People who are struggling with drug abuse or who are concerned about a family member's substance use can search for treatment providers at www.findhelpnowky.org. The KY Help Call Center (1-833-859-4357) also provides information on treatment options an open slots among treatment providers. The Kentucky State Police has also launched the Angel Initiative, which allows anyone with a substance-use disorder seeking treatment to visit a KSP post where they are directed to treatment. 

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