Number of Ky. counties with high and medium Covid-19 risk tick up a bit; Beshear says it's likely due to 'post-Thanksgiving bump'

CDC map, adapted by Ky. Health News

By Melissa Patrick
Kentucky Health News

The number of Kentucky counties with high and medium risk of Covid-19 transmission on the latest Centers for Disease Control and Prevention map released Thursday were about the same as the week before, when they were higher than they had been for a while. 

At his weekly news conference Thursday, which was held before the map was released, Gov. Andy Beshear said recent increases in counties with high and medium transmission risk in the previous map,, and the increase in cases on Monday's weekly state report, were likely due to a "post-Thanksgiving bump." He said the pandemic in Kentucky still appears to be on a general plateau, but he expects cases will tick up for a few weeks before they come back down. 

"Here's the good news, though: It is nowhere near what we saw after each of these holidays the last couple of years," Beshear said. "This means Covid has fundamentally changed and our highs are going to be a lot lower and that's a very good thing for all of us." 

The latest risk map, which looks at both cases and hospital data to determine risk of transmissions, shows 12 Kentucky counties at high risk, up from 10 the week before. High-risk counties, shown in orange, were in Western Kentucky except for Bourbon, Nicholas and Pike counties. 

In high-risk counties, the CDC continues to recommend that you wear a well-fitting, high-quality mask in public indoor spaces, and if you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

Medium-risk counties, shown in yellow, numbered 44 this week, down from 48 on the previous map. These counties are found in several pockets across the state, mainly in the east and south. Again, barely a majority of the state's 120 counties (64) have a low risk of Covid-19 transmission, shown in green. 

If you live in a medium or high-risk county, the CDC advises those who are at high risk of getting very sick to wear a well-fitting mask when indoors and in public and to consider getting tested before having social contact with someone at high risk for getting very sick and consider wearing a mask when indoors when you are with them.

The CDC also has a transmission-level map that shows the level of virus spread in each county, at one of four levels. It shows 13 Kentucky counties with a moderate level of transmission and the rest have either substantial or high levels of transmission. This data is largely used by researchers and health-care facilities.

State officials have encouraged Kentuckians to use the other CDC map to guide their preventive measures.

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Epidemiologist says the dreaded triple-demic is here, with RSV, flu and Covid-19 cases all rising together

Centers for Disease Control and Prevention map

With national rates of influenza, Covid-19 and respiratory syncytial virus rising together, the "dreaded and much anticipated triple-demic is finally here," epidemiologist Katelyn Jetelina writes in her newsletter, Your Local Epidemiologist. 

RSV is a common virus that usually causes mild, cold-like symptoms. And while most people recover in a week or two, it can be serious for infants and older adults.

The weekly Centers for Disease Control and Prevention influenza-like illness (ILI) surveillance, which includes a tally of patients that go to the doctor with a fever and a cough and/or a sore throat is a general indication of the climate of respiratory health in the United States. The report does not include laboratory-confirmed flu cases. 

The ILI map for the week ending Nov. 26 shows that every state but four have a high or a very high ILI activity level. The CDC puts Kentucky's ILI activity level among the very highest. 

Jetelina writes of the national map, "This level is truly unprecedented; we’ve never seen such high levels of ILI activity at this time of year."

Hospitalizations for respiratory illness are also on the rise. CDC Director Rochelle Walensky said Monday, “Hospitalizations are the highest now than they have been in the past decade.” 

In Kentucky, Covid-19 hospitalizations increased for the second week in a row, taking a big jump in this week's Covid-19 report. Hospitals reported 383 Covid-19 patients Monday morning, an increase of 102 over the prior Monday. That same report showed that nearly 80% of the state's inpatient beds and 81% of its intensive-care beds were occupied. 

Jetelina points out that while ILI surveillance offers an overall view of respiratory illness in the U.S, surveillance for specific diseases also exist, but is imperfect. 

RSV: CDC data shows that RSV continues to rise, although we may be seeing the first signs of peaking on a national level, Jetelina reports. She adds that this is expected given that the positivity rate for RSV tests have already clearly peaked. 

Flu: "Flu cases are increasing and increasing fast," Jetelina writes. She notes that flu hospitalizations are lagged, but increasing. "We expect hospitalizations to continue to rise in weeks to come," she writes. 

Kentucky's latest flu report shows that flu activity in Kentucky continues to rise. In the week ending Nov. 26, the state confirmed 6,378 cases of the flu, up from 3,470 the prior week. So far, the total number of confirmed cases during this flu season is 15,909. 

As Inside Medicine reported, for the first time during the pandemic, flu hospitalizations overtook Covid-19 hospitalizations last week. "This may be a one-off occurrence since Covid-19 hospitalizations are increasing now, too, but it is noteworthy," she writes. 

Jetelina adds that epidemiologist are hopeful that the U.S. flu season will follow what has happened in the Southern Hemisphere (Australia specifically) where there has been a high number of flu cases but a moderate level of hospitalizations. 

Covid-19: "Covid-19 is on the rise across the globe due to the combination of seasonal changes, behaviors changes, and the variant soup. In the U.S., all signs point to the beginning of a wave. For example, SARS-CoV-2 in wastewater is rapidly increasing across all regions," she writes. 

In Kentucky, the state Department for Public Health reported 5,751 new coronavirus cases last week, or an average of 821 per day. That's a nearly 49% jump over the week before, when the state reported 3,866 new cases. But that number that was 43% lower than the week before, indicating that Kentucky continues to be on a rough plateau. 

"One major concern is the rapid rise in hospitalizations among older adults, which has exponentially increased 28% in the past two weeks," Jetelina writes. "This is partly (or wholly) due to abysmal vaccination rates—only 1 in 3 adults over the age of 65+ have their fall Covid-19 booster. A public health failure. Without a recent booster, many people are technically vaccinated but not protected." 

Bottom line, she concludes, "This viral season is like no other. . . .  I’m especially concerned for hospital systems, kids under 5, and adults over the age of 65, as they are at highest risk." 

She adds, "There’s a lot we can do: mask, test before seeing loved ones, get that airflow moving, stay home when you’re sick. The least you can do for a healthy season is get a flu and fall Covid-19 booster. If you haven’t gotten one yet, it’s never too late." 

Jetelina is a California epidemiologist and biostatistician who says she writes the newsletter on Substack as a way to translate public-health science for everyday use, helping people to make evidence-based decisions. She is also a consultant to a number of organizations, including the CDC.

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Flu cases in Kentucky keep rising; at least one hospital system in the state saw more flu patients than Covid-19 patients last week

State Department for Public Health graph

By Melissa Patrick
Kentucky Health News

Influenza continues to slam Kentucky, with one hospital system saying last week's flu admissions were greater than Covid-19 admissions and another seeing about equal admissions of both. 

Last week, among all nine Baptist Health hospitals there were 155 flu admissions and 92 Covid-19 admissions, according to Kit Fullenlove, public relations director for Baptist Health. 

"Over our entire system, flu and Covid cases have been pretty much neck and neck until late this week," Fullenlove said in an e-mail.

One of the nine Baptist Health hospitals is in southern Indiana and is considered part of the Metro Louisville market; it accounted for 23 of the flu admissions and eight of the Covid-19 admissions. 

On Nov. 30, a spokesperson for UK HealthCare said the hospital had a total of 47 flu patients, with 41 of them adults and six of them children, and 45 adult Covid-19 patients and less than five pediatric Covid-19 patients. 

The hospitals are seeing fewer RSV patients. Baptist Health said it had fewer than 10 RSV admissions and UK HealthCare had a total of 24 such patients, 18 of them children and six of them adults.  

RSV, or respiratory syncytial virus, is a common virus that usually causes mild, cold-like symptoms. And while most people recover in a week or two, it can be serious for infants and older adults.

The state's latest flu report shows that flu activity in Kentucky continues to rise. In the week ending Nov. 19, the state confirmed 3,470 cases of the flu, up from 2,719 the prior week. So far, the total number of confirmed cases during this flu season is 9,531. Six Kentucky adults have died from the flu this season, which runs from October to May. 

Most of the cases have been in Kentuckians under the age of 20. 

Fullenlove added that the larger flu impact in the Baptist Health system is being seen in its emergency rooms and urgent care centers 

"For November, we saw a 10 percent increase in ER visits, with the bulk of those patients coming in with respiratory symptoms. In the last seven days, those numbers escalated about 20 percent," she said.

Further, she noted that in November, five of the Baptist Health hospitals hit an all-time high in the history of that hospital for the number of patients being seen in the ER in a single day: Corbin, Hardin, La Grange, Lexington and Louisville. 

"An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu," says the Centers for Disease Control and Prevention. "CDC recommends that everyone ages 6 months and older get a flu vaccine annually. Now is a good time to get vaccinated if you haven’t already." 

All 16 of Kentucky's health regions have confirmed flu cases, and nine of the 16 are reporting that their rates are increasing. 

Some of the counties with the highest cases in the week ending Nov. 19 were Allen, with 74; Boone, 92; Clark, 69; Fayette, 188; Hopkins, 72; Jefferson, 1,182; Jessamine, 81; Kenton, 149; Laurel, 81; Madison, 56; McCracken, 72; Pike,92; Warren, 132; and Whitley, 55.

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Pandemic stress caused premature aging in teenagers' brains; long-term effect uncertain, but some parents say impact will last

Shutterstock photo

American teenagers' brains prematurely aged by three years during the pandemic due to the stress of lockdowns, a study has found.

The researchers found changes similar to those seen in "children who have faced chronic stress and adversity," reports Katherine Reynolds Lewis of The Washington Post. "The study, published Thursday in Biological Psychiatry: Global Open Science, was the first to compare scans of the physical structures of teenagers’ brains from before and after the pandemic started, and to document significant differences, said Ian Gotlib, lead author on the paper and a psychology professor at Stanford University."

Gotlib had pre-pandemic images because he and his colleagues started the work eight years ago, with the goal of "better understanding gender differences in depression rates among adolescents," Lewis reports. "The researchers recruited 220 children ages 9 to 13, with a plan to take MRI scans of their brains every two years."

Then the pandemic hit, interrupting the third set of scans, but presenting an opportunity. Gotlib said they knew teens had higher “levels of depression, anxiety and fearfulness” than “before the pandemic. But we knew nothing about the effects on their brains. We thought there might be effects similar to what you would find with early adversity; we just didn’t realize how strong they’d be.”

The researchers "compared MRI scans of a group of 128 children, half taken before and half at the end of the first year of the pandemic, the researchers found growth in the hippocampus and amygdala, brain areas that respectively control access to some memories and help regulate fear, stress and other emotions," Lewis reports. "They also found thinning of the tissues in the cortex, which is involved in executive functioning. These changes happen during normal adolescent development; however, the pandemic appeared to have accelerated the process, Gotlib said."

Premature aging of children’s brains can make them more vulnerable as adults "to depression, anxiety, addiction and other mental illnesses, they can raise the risk of cancer, diabetes, heart disease and other long-term negative outcomes," Lewis notes. "Prior research has found dramatically higher levels of anxiety, depression, suicidality and other mental illnesses in adolescents since the onset of the pandemic."

Gotlib said, “The takeaway for me is that there are serious issues with mental health and kids around the pandemic Just because the shutdown ended doesn’t mean we’re fine.”

Jason Chein, professor of psychology and neuroscience and the director of the Temple University Brain Research & Imaging Center, said the study is important but he "cautioned against making broad interpretations based on the changes the researchers observed," Lewis reports. "brain regions can show nonlinear patterns of growth, so simply seeing a thinner cortex or larger amygdala volume doesn’t necessarily indicate an older brain, he said."

But there are anecdotal examples. "Stacy Gittleman, 54, of West Bloomfield, Mich., saw the pandemic derail one of her children," Lewis writes. "An aspiring musical theater actor, he was a junior in high school when school and theater shut down." Gittleman said, “So much of how my son thrives depends on moving, acting, doing hands-on work and interacting with others. He spent much of his time in bed, which was very painful as parents to watch, as my son before the pandemic was so lively and social.”

While "managing his mental health will be a lifelong task, she said," her son's older siblings, now 24 and 26, weren't as affected by the pandemic. “In the long term, the adversity thrown at the feet of our teenagers I believe will make them stronger and more resilient,” she said.

"Other parents aren’t so sure," Lewis writes, quoting Meg Martin, 55, of Gaithersburg, Md., whose son intended to apply to a four-year residential college, but now feels unmotivated and disengaged from school after years of online and hybrid learning: “I really think the way his high-school years unfolded are going to have ripple effects for years to come.”

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Ashland hospital system, with 465 beds, is now part of UK

Main hospital of King's Daughters in Ashland

King's Daughters Hospital in Ashland is now fully incorporated into the University of Kentucky's health-care enterprise.

The hospital, one of Kentucky's largest and northeastern Kentucky's largest employer, became part of UK HealthCare Thursday, Dec. 1.

"UK and King’s Daughters have been working together for nearly two years," UK's Kristi Willett notes. "During this time, King’s Daughters has experienced significant growth in employees and revenues and has begun to build and expand important infrastructure to improve access and care for people in the region. In October 2022, the UK Board of Trustees approved plans for the KD to become part of UK."

Kristie Whitlatch remains president and CEO of King’s Daughters. "When the partnership was established, UK and King’s Daughters intentionally positioned King’s Daughters to keep its identity and continue to make decisions locally," Willett writes.

King's Daughters serves a 16-county region in Kentucky, Ohio and West Virginia and has more than 5,000 employees. "Its health system is comprised of two acute-care hospitals totaling 465 licensed beds; an integrated network of more than 600 physicians and advanced practitioners; more than 50 ambulatory centers and practice locations; a long-term care facility; medical transport company; and six urgent care centers," Willett reports.

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Study of 40 first-time fathers finds that fatherhood changed their brains in ways that could help them be better parents

Centers for Disease Control and Prevention photo

A growing body of research finds that children with engaged fathers do better on a range of outcomes, including physical health and cognitive performance, and a new study finds that fatherhood causes changes in the brain in ways that could influence their parenting, Darby Saxbe and Magdalena Martinez Garcia report for The Conversation, a platform for journalistic writing by academics.

Garcia, who works at the Instituto de Investigación Sanitaria Gregorio Marañón in Madrid, Spain, was the lead author on the study. Saxbe, of the University of Southern California in Los Angeles, contributed to the research.

Despite fathers' increasing participation in child care, they note, there is surprisingly little research about how fatherhood affects men, and even fewer studies focus on the brain and biological changes that might support fathering. Since pregnancy-related hormonal changes help explain why a new mother's brain might change, they explored whether fatherhood also reshapes the brains and bodies of men, in a study of first-time fathers in Spain and California.

Spanish researchers had scanned first-time mothers before conception and two months after delivery, and found that compared to childless women, "The new mothers’ brain volume was smaller, suggesting that key brain structures actually shrank in size across pregnancy and the early postpartum period," Saxbe and Garcia report. "The brain changes were so pronounced that an algorithm could easily differentiate the brain of a woman who had gone through a pregnancy from that of a woman with no children." They also found changes across the brain's gray matter, the layer that is rich in neurons, and changes in the cortex, which is linked to thinking about others, and the subcortex, which is linked to more primitive functions, including emotion and motivation.

The authors say experience-induced brain plasticity happens when you learn a new language or master a new musical instrument, and suggest that this could also happen with the new experience of caring for an infant. They note that there is a small, but growing body of research being done on this topic. 

To learn more about plasticity in new dads’ brains, the researchers studied 40 expectant fathers who were put into an MRI scanner twice: during their partner’s pregnancy, and after their baby was 6 months old. The study also included a control group of 17 childless men.

"We found several significant changes in the brains of fathers from prenatal to postpartum that did not emerge within the childless men we followed across the same time period," they report. "In both the Spanish and Californian samples, fathers’ brain changes appeared in regions of the cortex that contribute to visual processing, attention and empathy toward the baby." They offer the possibility that the brain plasticity in fathers may be tied to how much they interact with their baby, and say that raises the question of whether family policies that increase the amount of time a father can spend with their child during the early postpartum period could help to support the development of the fathering brain. 

"Spanish fathers, who, on average, have more generous paternity leaves than fathers have in the U.S., displayed more pronounced changes in brain regions that support goal-directed attention, which may help fathers attune to their infants’ cues, compared with Californian fathers," they write. However, men who show more remodeling of the brain and hormones may be more motivated to participate in hands-on care. The authors called for more research, noting that future studies with more detailed measures of postpartum caregiving can reveal more about parental brain plasticity in both men and women.

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As Dec. 10 anniversary of tornado disasters looms, and holidays also draw near, Kentucky's mental-health experts are on alert

Tornado damage in Mayfield reminded Brian Bowen of Iraq. (Photo by Brett Carlsen, Getty Images)

This story discusses suicide. Anyone who is having suicidal thoughts or sees a friend who they think needs help can call or text the Suicide and Crisis Lifeline at 9-8-8 for help and support.

By Sarah Ladd
Kentucky Lantern

Army veteran and crisis counselor Brian Bowen fought in an Iraq war zone.

But even the devastation he saw in combat didn’t compare to the leveling of Mayfield after an EF4 tornado going upwards of 200 miles an hour tore through Kentucky, destroying homes and killing dozens in December 2021.

Bowen, who lost his job at the Graves County Jail when the twister destroyed it, now runs a small support group in Marshall County through Project Recovery for those impacted by the storms.

Mental-health experts like Bowen expressed concern over the coming disaster anniversary, which they said could trigger mental health issues. As the Dec. 10 first anniversary approaches, it’s important for survivors to be aware of their moods and take care of their mental health.

In addition to his law enforcement background, Bowen has a degree in psychology and quickly saw the need for more mental-health services in the area. So, he joined Project Recovery, an organization that aims to help people recover from disasters. “I like helping people. I like counseling people,” he reasoned. “So, you know, why not?”

Bowen at work (Photo provided to Kentucky Lantern)

He quickly saw the mental health fallout was worse than he’d realized among his neighbors. He wasn’t immune, either.

“I’ve seen buildings burned out and blown up. I’d seen vehicles turned upside down and on fire,” he said. “I’ve seen all that stuff. And I remember, to this day, when I started driving around Mayfield the next day (after the tornadoes), I was like: ‘I have never seen anything like this before.’ It was totally worse than any war zone I’ve ever seen.”

Seeing the devastation all around him “affected me very heavily and mentally and cognitively,” he said.

Some of Bowen’s clients have already noted the changing weather to him, the cycles of warm and cold.

“That’s the exact same kind of environment that we had last year, so a lot of them are pretty scared,” he told the Kentucky Lantern. “First thing they tell me is: ‘Is it going to happen again?’ All I can say is, ‘I don’t know.’”

Bowen can’t control the weather, but he’s focused on getting his clients to meditate, practice mindfulness or listen to calming music or sounds like the chirp of crickets or a running creek.

Leah Fondaw is a licensed clinical social worker and the vice president of clinical services at Four Rivers Behavioral Health, a nonprofit that serves West Kentucky. She said there is concern as Dec. 10 approaches despite the healing that has happened over the last months.

“Anniversaries can be a triggering event,” she said. She’s prepared postcards for distribution on the anniversary that offer advice for coping with trauma such as focusing on deep breathing, practicing mindfulness and finding someone to talk to — whether it’s a therapist, friend or even a stranger.

“Some people might not feel comfortable talking to a therapist, but they might feel comfortable talking to friends or family,” Fondaw said. “And then other people might not feel comfortable sharing with their family but they might feel more comfortable sharing with a stranger. I know that sounds funny, but sometimes that person like a therapist is kind of on the outside, (and) it’s easier to talk to for some people.”

Dr. Eric Russ

Dr. Eric Russ, executive director of the Kentucky Psychological Association and a clinician with the Louisville Psychotherapy Group, said there isn’t a ton of research into disaster anniversary reactions, but “what we know is that folks who struggle with reactions to a traumatic event, so whether that’s PTSD, or depression or anxiety or substance use, tend to have kind of a surge in their symptoms.”

A 2012 study at Princeton University found that even five years after the deadly Hurricane Katrina that killed almost 2,000 people, survivors still experienced mental-health challenges. Study author Christina Paxson said at the time, “I think the lesson for treatment of mental health conditions is don’t think it’s over after a year. It isn’t.”

In her study of 532 low-income mothers, she found that after four years, 33% experienced post-traumatic stress symptoms and 30% still experienced psychological distress.

Marcie Timmerman, executive director for Kentucky’s chapter of Mental Health of America, said there is an “upward trend of interpersonal domestic violence, murder-suicides and suicides” in the aftermath of disasters like last December’s tornadoes, particularly in the first three years.

“The emotional blowback takes a while,” Timmerman said. “You’re kind of in that emergency mode for a while … until the basic needs are met. And for some people, unfortunately, that emergency mode doesn’t cease at the end of the year. So that adds a lot of extra stress.”

As the tornado anniversary and the holiday season approach, it’s important to surround yourself with community, these experts say.

“If you’re somebody who has been struggling with suicidality as part of your recovery, it would be a time where you want to do some extra planning for yourself about how to take care of yourself,” Russ said, “about how you want to spend the day or the week and what resources you can draw on to get yourself some extra support.”

Fondaw, who has also worked as a grief counselor and compared the tornado recovery to the grieving process, agreed. Pay attention to the day, she said, and don’t ignore it.

“I always felt like for . . . anniversaries of a loved one’s death, it was so important to plan something positive for that day,” she said, “plan something that was meaningful, something that would help you with the emotions of that day.”

Tornado survivors — and their friends — can be on the lookout for these suicide warning signs, Timmerman said:

• Any change in mood or attitude, either positive or negative.
• Giving away prized possessions or discussing giving away belongings or pets.
• Discussing where their children would live if they were gone.
• Discussing death by suicide.

Be careful not to assume someone who reached out for help before will do it again, Timmerman said, adding, “Our largest rate of loss of folks by suicide is in, like, three to six months after they’ve seen a provider. So we want to make sure we’re continuing that follow-up support as friends and family members.”

And, she said, asking someone specifically if they’re having thoughts of ending their life is not a harmful question. In fact, if someone is feeling suicidal, they will likely feel relief that someone is seeing and acknowledging their pain.

Anyone who is having suicidal thoughts or sees a friend who they think needs help can call or text the Suicide and Crisis Lifeline at 9-8-8 for help and support.

The lifeline is also a good resource even if thoughts haven’t progressed as far as suicidal ideation, Russ said: “In general, people wait too long to reach out for help.”

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