Another record week of cases; the most on a Sunday; and new highs for intensive care, ventilators and positive-test percentage

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

By Al Cross
Kentucky Health News

Kentucky recorded the most cases of the novel coronavirus on a Sunday, and the most in its official Monday-to-Sunday reporting week, Gov. Andy Beshear announced in a press release.

The 2,194 new cases made a total of 20,577 in the reporting week, in daily unadjusted totals. That was 22 percent more than the previous week's 16,832.

The seven-day rolling average of daily new cases is 2,940, more than two and a half times what it was just a month ago.

The state's daily report included other record highs: 389 covid-19 patients in intensive care, and 208 of them on ventilators. Total covid-19 hospitalizations in Kentucky totaled 1,533, 21 below the record set Friday.

The share of Kentuckians testing positive for the virus in the last seven days is 9.19%, one-hundredth of a percentage point above the record set Thursday.

Only three of Kentucky's 120 counties were not in the state's "red zone" for those with 25 or more daily cases per 100,000 residents in the last seven days.

Beshear again warned Kentuckians that they need to scale back Thanksgiving gatherings to keep covid-19 cases from overwhelming hospitals or spreading the virus to health-care workers, staff shortages being the greater threat.

“This upcoming holiday week is a special time for all of our families, and I know everyone wants to have a normal Thanksgiving after such a difficult year,” Beshear said. “If we have a major surge of covid-19 cases after Thanksgiving, our hospitals will simply not have the capacity to give everyone the care they need. Nothing is worth that risk.”

Beshear cited that risk last week in ordering a halt to in-person schooling and indoor restaurant dining, and limiting other indoor activities.

“I wish more than anything that we could go back to normal safely, but we can’t,” he said, asking Kentuckians to “keep gatherings small (eight people or fewer and two households at most), wear a mask, wash your hands, and stay six feet apart.” The state's guidance suggests:

• Having a small dinner with only people who live in your household
• Preparing traditional family recipes for family and neighbors, especially those at higher risk of severe illness from covid-19, and delivering them in a way that doesn’t involve contact with others
• Having a virtual dinner and sharing recipes with friends and family
• Shopping online rather than in person on the day after Thanksgiving or the next Monday
• Watching sports events, parades, and movies from home with only people who live in your household

Beshear said four more covid-19 deaths had been confirmed: a 69-year-old Allen County woman; a 78-year-old Daviess County man; an 88-year-old McCracken County man; and a 62-year-old Ohio County woman.

Counties with 10 or more new cases Sunday were: Jefferson, 515; Fayette, 301; Boone, 112; Kenton, 101; Greenup, 60; Campbell, 52; Madison, 48; Bullitt, 43; Hardin, 42; McCracken, 41; Boyle, 35; Warren, 33; Calloway, 32; Christian, 29; Floyd, 28; Scott, 24; Daviess, 23; Oldham, 22; Nelson, 20; Boyd, Graves and Pulaski, 19 each; Hopkins, 18; Carter and Lincoln, 17 each; Barren, Clay, Grant and Powell, 15 each; Garrard, Jessamine, Pike and Shelby, 13 each; Mason, Montgomery, Muhlenberg and Simpson, 12 each; Franklin, Harlan, Logan and Whitley, 11 each; and Carroll, Fleming, Grayson, Johnson and Laurel, 10 each.

In other coronavirus news Sunday:

• Kentucky's largest church continued to hold in-person services Sunday despite Beshear's request that they be suspended. Southeast Christian Church Senior Pastor Kyle Idleman told members that the decision was driven by concerns about members' mental health: "We have a lot of brothers and sisters who are really overwhelmed in this season. We have seen a dramatic increase in depression, anxiety, and loneliness and other mental health challenges that come when there's extended isolation and month after month of uncertainty. As some of you know, we've had a number of suicides connected to our church family. There's been a dramatic increase in those struggling with addictions. For those reasons, we want to keep our doors open during this season." Louisville's WDRB reports, "Southeast suspended in-person services for nearly four months, from mid-March until early July . . . Idleman estimates 70% of the church is participating online."
• The average healthy young person shouldn't expect to get a vaccine until 2021's second quarter, and maybe early in the third quarter, former Food and Drug Administration chief Scott Gottlieb on CBS's "Face the Nation." He said after vaccines are made available to health-care workers, first responders and other especially vulnerable people, he expects the FDA to authorize them for decreasingly younger age groups. He said achieving herd immunity won't require vaccinating 70% of the population because about 30% of Americans will have contracted the virus by spring. Asked about the claim of President Trump, who appointed him, that the U.S. wouldn't have had a vaccine for four years without Trump, Gottlieb said, "I don't think anybody was forced to do anything . . . Everyone recognized the urgency."
• Dolly Parton's $1 million gift for research at Vanderbilt University in Nashville sped work on the vaccine that Moderna announced last week. Vandy professor Mark Denison told The New York Times that the money “helped us develop the test that we used to first show that the Moderna vaccine was giving people a good immune response that might protect them.” Naji Abumrad, a physician and surgery professor whose friendship with Parton led to the donation, told The Washington Post, “Her work made it possible to expedite the science behind the testing. Without a doubt in my mind, her funding made the research toward the vaccine go 10 times faster than it would be without it.”

Read More

Another record week of cases; the most on a Sunday; and new highs for intensive care, ventilators and positive-test percentage

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

By Al Cross
Kentucky Health News

Kentucky recorded the most cases of the novel coronavirus on a Sunday, and the most in its official Monday-to-Sunday reporting week, Gov. Andy Beshear announced in a press release.

The 2,194 new cases made a total of 20,577 in the reporting week, in daily unadjusted totals. That was 22 percent more than the previous week's 16,832.

The seven-day rolling average of daily new cases is 2,940, more than two and a half times what it was just a month ago.

The state's daily report included other record highs: 389 covid-19 patients in intensive care, and 208 of them on ventilators. Total covid-19 hospitalizations in Kentucky totaled 1,533, 21 below the record set Friday.

The share of Kentuckians testing positive for the virus in the last seven days is 9.19%, one-hundredth of a percentage point above the record set Thursday.

Only three of Kentucky's 120 counties were not in the state's "red zone" for those with 25 or more daily cases per 100,000 residents in the last seven days.

Beshear again warned Kentuckians that they need to scale back Thanksgiving gatherings to keep covid-19 cases from overwhelming hospitals or spreading the virus to health-care workers, staff shortages being the greater threat.

“This upcoming holiday week is a special time for all of our families, and I know everyone wants to have a normal Thanksgiving after such a difficult year,” Beshear said. “If we have a major surge of covid-19 cases after Thanksgiving, our hospitals will simply not have the capacity to give everyone the care they need. Nothing is worth that risk.”

Beshear cited that risk last week in ordering a halt to in-person schooling and indoor restaurant dining, and limiting other indoor activities.

“I wish more than anything that we could go back to normal safely, but we can’t,” he said, asking Kentuckians to “keep gatherings small (eight people or fewer and two households at most), wear a mask, wash your hands, and stay six feet apart.” The state's guidance suggests:

• Having a small dinner with only people who live in your household
• Preparing traditional family recipes for family and neighbors, especially those at higher risk of severe illness from covid-19, and delivering them in a way that doesn’t involve contact with others
• Having a virtual dinner and sharing recipes with friends and family
• Shopping online rather than in person on the day after Thanksgiving or the next Monday
• Watching sports events, parades, and movies from home with only people who live in your household

Beshear said four more covid-19 deaths had been confirmed: a 69-year-old Allen County woman; a 78-year-old Daviess County man; an 88-year-old McCracken County man; and a 62-year-old Ohio County woman.

Counties with 10 or more new cases Sunday were: Jefferson, 515; Fayette, 301; Boone, 112; Kenton, 101; Greenup, 60; Campbell, 52; Madison, 48; Bullitt, 43; Hardin, 42; McCracken, 41; Boyle, 35; Warren, 33; Calloway, 32; Christian, 29; Floyd, 28; Scott, 24; Daviess, 23; Oldham, 22; Nelson, 20; Boyd, Graves and Pulaski, 19 each; Hopkins, 18; Carter and Lincoln, 17 each; Barren, Clay, Grant and Powell, 15 each; Garrard, Jessamine, Pike and Shelby, 13 each; Mason, Montgomery, Muhlenberg and Simpson, 12 each; Franklin, Harlan, Logan and Whitley, 11 each; and Carroll, Fleming, Grayson, Johnson and Laurel, 10 each.

In other coronavirus news Sunday:

• Kentucky's largest church continued to hold in-person services Sunday despite Beshear's request that they be suspended. Southeast Christian Church Senior Pastor Kyle Idleman told members that the decision was driven by concerns about members' mental health: "We have a lot of brothers and sisters who are really overwhelmed in this season. We have seen a dramatic increase in depression, anxiety, and loneliness and other mental health challenges that come when there's extended isolation and month after month of uncertainty. As some of you know, we've had a number of suicides connected to our church family. There's been a dramatic increase in those struggling with addictions. For those reasons, we want to keep our doors open during this season." Louisville's WDRB reports, "Southeast suspended in-person services for nearly four months, from mid-March until early July . . . Idleman estimates 70% of the church is participating online."
• The average healthy young person shouldn't expect to get a vaccine until 2021's second quarter, and maybe early in the third quarter, former Food and Drug Administration chief Scott Gottlieb on CBS's "Face the Nation." He said after vaccines are made available to health-care workers, first responders and other especially vulnerable people, he expects the FDA to authorize them for decreasingly younger age groups. He said achieving herd immunity won't require vaccinating 70% of the population because about 30% of Americans will have contracted the virus by spring. Asked about the claim of President Trump, who appointed him, that the U.S. wouldn't have had a vaccine for four years without Trump, Gottlieb said, "I don't think anybody was forced to do anything . . . Everyone recognized the urgency."
• Dolly Parton's $1 million gift for research at Vanderbilt University in Nashville sped work on the vaccine that Moderna announced last week. Vandy professor Mark Denison told The New York Times that the money “helped us develop the test that we used to first show that the Moderna vaccine was giving people a good immune response that might protect them.” Naji Abumrad, a physician and surgery professor whose friendship with Parton led to the donation, told The Washington Post, “Her work made it possible to expedite the science behind the testing. Without a doubt in my mind, her funding made the research toward the vaccine go 10 times faster than it would be without it.”

Read More

In south-central Kentucky, health workers and officials try to overcome coronavirus fatigue and politicization of the pandemic

Many in downtown Glasgow wear masks; many don't. (Courier Journal photo by Michael Clevenger)

Health officials are working "to convince a skeptical public in south-central Kentucky of the risk of catching the deadly virus racing through the region, taking lives and putting an ever-growing number of people in the hospital," Deborah Yetter of the Louisville Courier Journal reports after a trip to Glasgow, Tompkinsville and Bowling Green.

Brandon Dickey, chief nursing officer at T.J. Samson Community Hospital in Glasgow, "sees people daily ignoring precautions meant to slow the spread of the highly contagious coronavirus," Yetter reports. Dickey "believes the virus has sneaked up on rural communities including Barren County, where some people view it as a big-city problem."

"My perception is that people are tired of hearing about it," Dickey said. "It's been heavily politicized and people have mixed feelings about it. I wish people could come see the seriousness of it first-hand, because it is real."

Courtney Calloway's co-workers gave her 
flowers after she returned to work after a
bout with the virus. (Med Center Health photo)

"People still continue to think it’s a hoax or it's not going to happen to them," said Courtney Calloway, a Bowling Green nurse who contracted the virus in May while working on the covid-19 unit at Med Center Health. She told Yetter that she still suffers fatigue and joint pain, six months later, and she and her colleagues are "not really feeling the community is doing their part in a lot of ways."

Business people in Glasgow told Yetter that most people wear masks in the town of 14,000, "but those opposed to restrictions, including mask-wearing, are vocal about it, said Eddie Bruner ... who requires masks in his shop. . . . Outside Glasgow's downtown, some openly disregard the order by the governor to wear a facial covering in public. At one convenience store a reporter visited, neither several customers nor the worker at the cash register wore a mask; at another, a sign advised customers to wear a mask, but few, except two employees at the counter, did so."

Read More

State tells local health departments how to enforce Beshear's new restrictions; second highest day yet for coronavirus cases

Diagram illustrates possible misconceptions about vulnerability during gatherings.

By Al Cross
Kentucky Health News

As Kentucky reported the second-highest daily number of coronavirus cases Saturday, state officials scrambled to get local health departments to enforce Gov. Andy Beshear's new restrictions on businesses.

Beshear said in a news release and Facebook video that the 3,711 new cases continue a threat to “the health-care capacity in this state. That’s why we’re taking action and that's why we’re fighting back.”

The number of covid-19 patients under intensive care in Kentucky hospitals, and the number of those on ventilators, set new records, at 370 and 202, respectively. Total hospitalizations dropped by 40, to 1,514.

"We're worried we'll reach the point where there aren't enough doctors and nurses to help those who are sick," Beshear said. His office noted that the St. Elizabeth Health Care hospital in Fort Thomas is at capacity and moving intensive-care patients to other St. Elizabeth facilities.

To thwart the surge in cases, now in its sixth week, Beshear banned in-person schooling and indoor service in restaurants and bars, limited indoor gyms and recreation facilities to one-third capacity and limited sizes of gatherings, and requested that churches stop in-person worship.

“I know these steps are hard, but I want to thank the vast, vast, vast majority of individuals out there, and businesses out there – many that are hurt the most by these steps we’re taking – that are stepping up, agreeing and doing it right, knowing that the future of so many lives depends on it,” Beshear said.

“And there’s a light at the end of the tunnel, two effective vaccines; we’ve just got to get there. Let’s make sure that we work hard to protect one another, make sure our most vulnerable are there to get the vaccine. So mask up, follow these steps we’re taking the next three weeks and let’s stop this growth of the coronavirus.”

Some restaurants said they would defy Beshear's order. One was in Marshall County, where others said they might follow suit. During a special meeting of the county health board Saturday morning, officials said they unsure of their authority to enforce the order and had not received guidance they had requested from state officials, and expected to get it next week.

However, Beshear Communications Director Crystal Staley told Kentucky Health News in an email, "The Kentucky Department for Public Health issued enforcement guidance to the Marshall County Health Department this morning before the Board of Health meeting. We have communicated with two restaurants in Marshall County that had been open, but will now close."

Staley said the guidance was sent to all health departments.

Earlier, when asked if there would be enforcement action against a Grant County restaurant that was remaining open, Staley indicated that was up to local officials: "We thank the thousands of establishments that are following the orders to save lives and defeat this virus. . . . If an establishment violates the order, it is violating the rule of law, and all levels of government have a duty to take action."

The guidance says that when a health department receives a complaint about violation of an establishment it regulates, a staffer should visit the site to verify the complaint, and if valid, explain the requirements of the order. If compliance is not forthcoming, the establishment is to be given a "Notice to Cease Operation," and if it does not comply, the department should "proceed to suspend their food service permit" under a state regulation on public health hazards.

The Traveler's Lantern and Cafe in Trenton, in Todd County, also defied the order. County Health Director Jennifer Harris told the Todd County Standard, "I don't feel like we have a choice but to enforce. There is a process we are going to have to go through."

Richard Hayhoe, owner of Bean's Cafe in Dry Ridge, told Cincinnati's WCPO-TV that the order against restaurants was unfair, and customers should be able to dine inside if they think that is best for them: "Please, Frankfort, you don't need to tell everybody what they must and must not do."

Staley noted research that shows restaurants are major sources of virus transmission, and restrictions imposed by governors in other states.

Health Commissioner Steven Stack, a physician, said in the news release, “Kentucky, and much of the nation, is in a dangerous place right now. Stay home. Stay home with only your own household as much as possible. If you must leave your home, wear a mask every time you are in public and stay as physically far away from others as possible. This is necessary for you, your loved ones and the most vulnerable Kentuckians who depend on us all.”

Beshear reported 21 more deaths from covid-19, raising the state's toll to 1,783. He said one, a 58-year-old man in Barren County, worked in a long-term-care facility.

The other fatalities were three Jefferson County men, ages 43, 72 and 83; two Jefferson County women, 67 and 73; a Bullitt County man, 79; a Carter County man, 80; a Monroe County woman, 79; three Pike County women, 73, 75 and 90; an 80-year-old Pike County man; a 76-year-old and 91-year-old from Madison County, genders unspecified; two Jessamine County man, 86 and 90; a Lewis County man, 75; two McCracken County man, 87 and 92; and McLean County woman, 94.

Beshear took note of the high number of new cases, 171, in Oldham County, and may have had Marshall County on his mind, noting the 27 new cases there, much fewer than the others he noted.

All but three of the 120 counties were in the state's "red zone," because they have had more than 25 daily cases per 100,000 people over the past seven days. Two of the three counties had rates almost that high: Allen at 24.1 and Rockcastle at 24. Menifee County's rate was 15.5. The rate is 27 in Marshall County, 54.7 in Grant County and 77.4 in Oldham County.

Counties with more than 10 new cases on the state's daily report were: Jefferson, 573; Fayette, 268; Oldham, 171; Boyd, 159; Hardin, 139; Kenton, 118; Boone, 109; McCracken, 94; Warren, 86; Lee, 76; Campbell, 74; Nelson, 67; Christian, 62; Daviess, 55; Bullitt, 54; Madison, 53; Graves, 50; Calloway, 42; Logan, 40; Jessamine, 38; Shelby, 38; Clark, 37; Marion, 36; Pike, 36; Henderson, 34; Floyd, 33; Greenup, 33; Perry, 28; Marshall, 27; Hopkins, 26; Carter, 25; Knox, 25; Barren, 24; Boyle, 24; Franklin, Laurel, Pendleton, Powell, Pulaski and Taylor, 23 each; Grayson, 22; Green, Letcher, Mason, Muhlenberg and Simpson, 20; Whitley, 19; Hart and Ohio, 18 each; Magoffin, Montgomery and Woodford, 17; Grant and Harlan, 16; Fleming, LaRue and Rowan, 15 each; Meade, 14; Clay, Edmonson, Garrard, Johnson, Knott, Morgan and Union, 13; and Bath, Bell, Butler, Estill, Henry, McLean, Metcalfe, Washington and Wolfe, 11 each.

The percentage of Kentuckians testing positive for the coronavirus in the last seven days was 9.14 percent, the average for the last five days.

Read More

Sen. Rand Paul makes inaccurate remarks about virus, vaccines and 'naturally acquired' covid-19 disease, FactCheck finds

U.S. Sen. Rand Paul's Nov. 17 tweet

U.S. Sen. Rand Paul of Kentucky is being taken to task for a series of remarks he has made about the novel coronavirus, vaccines and immunity. FactCheck.org, a nonpartisan, independent unit of the Annenberg School of Communication at the University of Pennsylvania, found several inaccuracies in his statements.

Paul, an ophthalmologist, suggested on Twitter that “naturally acquired” immunity to the virus was better than that from a vaccine.

"But it’s not known how immunity from the two sources compares — and the entire point of a vaccine is to offer immunity without the risk of getting sick," Jessica McDonald reports for Fact Check. She writes:

Paul made his claim in a Nov. 17 tweet in which he listed interim efficacy figures from two ongoing vaccine clinical trials and then provided his own calculation of the “effectiveness” of natural infection with the coronavirus.

In a follow-up tweet, the Kentucky Republican shared a link to a New York Times article about a new unpublished study that found evidence of some immunity to the coronavirus in most people for at least six months. He commented: “Why does the left accept immune theory when it comes to vaccines, but not when discussing naturally acquired immunity?”

Paul, who has previously spread misinformation about childhood vaccines, has inaccurately argued during the covid-19 pandemic that parts of the U.S. have reached herd, or community, immunity because of pre-existing immunity to other coronaviruses. Herd immunity is when enough people in a population are immune to prevent spread of the disease.

Public-health experts, however, have said that threshold is still a ways off — and that allowing the virus to spread uncontrolled would lead to many needless deaths. A better approach, they say, is to stave off the spread of the virus until a vaccine is widely available.

A Paul spokesperson told us that the senator was not suggesting that immunity through natural infection with covid-19 is better than getting immunity from a vaccine, but rather, “highlighting research that says immunity is real.”

We were directed to subsequent tweets, including one in which Paul said he was not “arguing against vaccines” but that covid-19 patients “can celebrate immunity if lucky enough to survive,” as well as Paul’s support for alternative options to speed along access to covid-19 vaccines.

Still, the efficacy figure Paul provides for natural covid-19 infection isn’t accurate. And the juxtaposition of the numbers implies a kind of superiority of natural infection over vaccination — a dangerous notion, given that contracting the virus poses a serious risk.

As University of Florida biostatistician Natalie Dean pointed out in response to Paul’s tweet, “The key distinction is that vaccines are a safe way to achieve immunity. Getting sick with covid-19 is inherently unsafe. We would never ever tolerate a vaccine that carried even a fraction of the risks of natural infection.”

Bogus ‘efficacy’ figure

While Paul purports to offer a precise percentage for how “effective” natural infection is relative to vaccines, experts told us that the comparison is premature and faulty.

The efficacy figures for the vaccines come from interim results released in press releases by the two companies, Pfizer and Moderna, and refer to the ability of the vaccines to prevent symptomatic covid-19 infection in phase 3 trials. (The day after Paul’s tweet, Pfizer announced additional data reflective of the full trial, which showed 95% efficacy.) But the number for natural infection is a broad-strokes calculation Paul made based on reinfections.

“We don’t really know how many reinfections there have been,” virologist Angela Rasmussen said in a phone interview, adding that many reinfections have not been confirmed and that efficacy of naturally-acquired immunity “isn’t a thing.”

“It’s just really ridiculous to try to use the way that efficacy is calculated in clinical trials for vaccines and apply that to epi[demiologic] data across the entire population,” she said.

Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and a member of the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee, agreed.

“Clearly, there are people who can be reinfected. As a general rule, it’s usually more mild reinfection,” he told us. But, he added, “most people aren’t tested, so you don’t really know who’s getting reinfected and who isn’t.”

It’s true that reinfections so far appear to be rare, which bodes well both for a vaccine and for people who may have immunity as a result of infection. But no one knows yet how the immunity from each will compare.

Most vaccines do not offer quite as good protection from a pathogen as a natural infection will — but of course, a person has to survive or suffer through the infection to get that future protection, sidestepping the entire function of a vaccine. It’s therefore largely irrelevant whether or not vaccine immunity is superior to that from natural infection.

There are some instances in which a vaccine does elicit a better immune response. That’s the case for vaccines against human papillomavirus, or HPV; tetanus; Haemophilus influenzae type b; and pneumococcus.

Whether covid-19 will be one of them remains to be seen. Rasmussen said it was possible, but still hypothetical at this point. “We don’t really know. We only know that these vaccines typically induce levels of neutralizing antibody that are comparable to the higher levels of neutralizing antibody that’s been observed in convalescent patients,” she said, referring to the type of antibody that can prevent cells from becoming infected with the virus.

Based on the performance of the shingles vaccine, Offit speculated that some of the later-arriving vaccine candidates that include powerful adjuvants, or chemicals that are added to vaccines to boost the immune response, such as those from Sanofi-GSK or Novavax, might be better than natural infection.

Immunity unknowns

For both the vaccine and natural infection, important questions about covid-19 immunity remain.

“We do know that most people who get covid-19 do develop some kind of measurable antibody response, but we don’t know what that really means in terms of protection against either reinfection or whether you will mount protective immune responses upon a re-exposure,” said Rasmussen.

As a result, public health officials have cautioned that for now, even if people have previously contracted covid-19, individuals should still follow the standard recommendations.

The Centers for Disease Control and Prevention, for example, advises all people, including those who have recovered from covid-19, to continue to physically distance, wear masks, wash their hands and avoid crowds.

Similarly, the CDC notes that it doesn’t yet know “if or when” it will stop recommending masks or physical distancing after vaccination.

This is in contrast to Paul’s assertion that people “can celebrate immunity.” In a Nov. 12 interview on Fox News, Paul used similar language and advocated that people drop these precautions.

“We have 11 million people in our country who’ve already had covid. We should tell them to celebrate,” he said. “We should tell them to throw away their masks, go to restaurants, live again, because these people are now immune.”

A huge question is how durable immunity will be. Although the study Paul highlighted suggests that most people will be protected for at least six months — and might mean they are protected against severe disease for many years — it’s still not definitive, and doesn’t mean that those timeframes will apply to everyone.

Shane Crotty, an immunologist at the La Jolla Institute for Immunology and one of the senior authors of the paper, noted on Twitter that the team observed a wide range of immune responses in people, including a lack of a measurable response in some people.

“That led us to speculate,” he said, quoting his manuscript, that “‘it may be expected that at least a fraction of the SARS-CoV-2-infected population with particularly low immune memory would be susceptible to re-infection relatively quickly.’”

The CDC, notably, has said that people who have had covid-19 may still benefit from a coronavirus vaccine. And some experts envision a future in which multiple vaccines are on the table for everyone.

“It strikes me as not unlikely that we will learn what the duration of protection is and people will need — whether naturally infected or vaccinated — to have booster shots over some period of time, once a year, once every two years, once every five years,” Barry Bloom, an immunologist and global health expert at Harvard’s T.H. Chan School of Public Health, said in a press call.

Why naturally acquired herd immunity is a bad idea

In his tweet about the new immunity study, Paul also suggested that Democrats were somehow denying realities about immunity from natural infection.

“Why does the left accept immune theory when it comes to vaccines, but not when discussing naturally acquired immunity?” he asked.

Scientists, however, objected to Paul’s characterization.

“I don’t think anybody’s dismissing [immunity following natural infection]. I think what people are saying is, it’s a bad idea as a strategy for dealing with infection,” said Offit, who noted that 30% to 40% of the population could be considered at high risk for covid-19.

Both Offit and Rasmussen also pointed out that historically, there isn’t a lot of precedent for building herd immunity through natural infection.

“People were getting smallpox for millennia,” Rasmussen said, and “the herd immunity threshold was never really reached.”

The much safer way of getting to herd immunity is to use a vaccine instead, especially when multiple candidates are on the horizon.

“Trying to achieve herd immunity [without a vaccine] would result in hundreds of thousands more — if not millions — of unnecessary deaths and debilitating illness for millions more,” Rasmussen said. “So I think it’s not really right to talk about vaccine-induced herd immunity versus naturally-acquired herd immunity without mentioning the fact that one of them has a very, very large price tag in human lives and quality of life attached to it.”

Read More

Kentucky sets new records for coronavirus cases, covid-19 hospitalizations and patients in intensive care

Kentucky Health News graph; virus case numbers are from initial, unadjusted daily reports

By Al Cross
Kentucky Health News

New cases of the novel coronavirus, hospitalizations for its disease and the number of covid-19 patients in intensive care all hit new highs Friday.

New cases totaled 3,825, beating the previous record, set the day before, by 176. The seven-day rolling average of new cases is 2,775. The share of Kentuckians testing positive for the virus in the last seven days is 9.15 percent.

Kentucky hospitals reported 1,554 covid-19 patients, 366 of them in intensive care, both records, and 188 of those on ventilators.

"It is shattering records over and over until we stop it," Gov. Andy Beshear said in a press release. "That’s why we are taking action – we have to. We’ve got more than 10,000 students quarantined right now just based on the last two weeks alone. We’ve got to do so much better."

Beshear has ordered public and private schools to end in-person instruction until at last Dec. 7, and at 5 p.m. Friday a set of new restrictions took effect, including a ban on in-person dining. 

“We’ve got new restrictions in place to help us slow down this speeding train and prevent avoidable death,” Beshear said. “Remember, your decisions are going to be what determines how many people live or die. Do your part.” 

Beshear's executive orders also affect bars, social gatherings, indoor fitness and recreation centers, theaters, other venues and professional services.

The governor reported 20 more covid-19 deaths, raising the state's toll to 1,762: A 74-year-old woman and a 68-year-old man from Boone County; a 54-year-old Boyd County man; an 88-year-old Campbell County woman; two 85-year-old Fayette County men; two women, 74 and 90, and an 82-year-old man from Hardin County; four women, 69, 86, 87 and 91, and two men, 80 and 92, from Jefferson County; a 77-year-old woman from Johnson County; a 93-year-old Marshall County woman; a 93-year-old Nelson County man; a 71-year-old Pike County man; and a 72-year-old Washington County woman.

Bean's Cafe and Bakery, one of three to sue

Coronavirus infection rates; for a larger map, click on it.

Lee County, with only 7,000 people, reported 98 new cases, making its average daily case rate over the last seven days by far the state's highest. The county has been the scene of outbreaks at a nursing home and a privately operated state prison, and there are signs that the outbreak is spreading to adjoining counties of Owsley and Powell; they also have very high infection rates.

 

Counties with more than 10 new cases Friday were: Jefferson, 668; Fayette, 297; Boyd, 185; Boone, 123; Kenton, 119; Lee, 98; Daviess, 88; Hardin, 85; Warren, 84; Oldham, 81; McCracken, 76; Campbell, 62; Franklin, 60; Bullitt, 55; Madison, 54; Jessamine, 52; Pike, 52; Hopkins, 50; Graves, Laurel and Powell, 46 each; Nelson, 45; Clay, 44; Logan, 40; Greenup, 39; Pulaski, 38; Knox, 36; Clark, 34; Boyle and Whitley, 33 each; Floyd, 32; Shelby, 31; Caldwell and Scott, 26 each; Elliott, 25; Bell and Henderson, 24 each; Adair and Christian, 23 each; Anderson, Lincoln and Marion, 22 each; Barren and Muhlenberg, 21 each; Woodford, 20; Knott, Letcher, Russell, Taylor and Washington, 19 each; Lawrence and Spencer, 18 each; LaRue and Simpson, 17 each; Carter. Harlan and Perry, 16 each; Garrard and Grayson, 15; Casey, Fleming, Grant and Rowan, 14 each; Hart, Henry, Marshall, Mercer, Montgomery and Wayne, 13; Allen, Harrison, Monroe, Morgan, Ohio and Union, 12 each.

In other covid-19 news Friday:

• Danville Christian Academy filed suit to remain open, alleging that Beshear's order to stop in-person instruction violates its religious freedom.

Read More

Kentucky kids improve on some health measures, but many counties lag far behind; pandemic reveals a wealth of disparities

By Melissa Patrick
Kentucky Health News

When it comes to the health of Kentucky's children, which make up about one-fourth of the state's population, the good news is that most have health insurance, fewer teens are getting pregnant, and fewer of the state's women are smoking during pregnancy. The bad news is that the percentage of babies born at a low birth weight has inched up, and many chronic problems pose obstacles to children's well-being.

That's the upshot of the annual Kentucky Kids Count County Data Book, released Nov. 17 by Kentucky Youth Advocates and the Kentucky State Data Center at the University of Louisville. It's part of the 30th annual release of Kids Count, a nationwide initiative of the Annie E. Casey Foundation to track the status of children in the United States. The Data Book provides information on the overall well-being of children in each county, through 17 measures in four areas: economic security, education, community strengths, and health and family.

The report says Kentucky showed improvement in 11 of the 17 measures of child health, made no progress on three and declined on three. 

It shows fewer pregnant women in Kentucky are smoking during pregnancy, dropping from 20.4% in 2011 to 17.8% in 2016-18. But that's still nearly triple the national rate of 6.5%, according to America's Health Rankings.

In some counties, though, this problem is much worse, and got more so between 2016 and 2018. Eighteen counties had rates of 30% or more, led by Owsley County, with 45.3%, the only one with a rate over 40%. Also, 23 counties reported higher rates in 2018 than 2016. This problem correlates closely with income; Owsley is one of the nation's poorest counties; Oldham County, one of Kentucky's wealthiest, had the lowest rate, 9%.

Smoking during pregnancy increases the risk of health problems for developing babies, including birth before full term, low birthweight, and birth defects of the mouth and lip. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome, according to the Centers for Disease Control and Prevention. 

Kids Count map; for a larger version, click on it.

Another measures that worsened in the latest report was the number of low-birthweight babies. The March of Dimes says babies born with low birthweight are more likely to have certain health conditions later in life, including diabetes, heart disease, high blood pressure, intellectual and developmental disabilities, metabolic syndrome and obesity.  

In 2016-18, 8.9% of Kentucky babies were born with a low birthweight, defined as less than 5.5 pounds. That was up very slightly from 8.8% in 2011-13. Again, those rates varied across the state with 58 of the 120 counties showing an increase, and 30 counties with rates higher than 10%. Carlisle County had the lowest rate, 5.6%, and Martin and Union counties had the highest, 12.7%. 

Kids Count map; for a larger version, click on it.

Kentucky continues to make improvements when it comes to teen births. It declined to 28.2 teen births per 1,000 females age 15-19 in 2016-18. That was 30% less than the 40.4 rate recorded five years ago. That said, it's still about two-thirds higher than the national rate of 17 births per 1,000. 

This measure also shows great differences among counties, ranging from a low of 7.5 teen births per 1,000 in Oldham County to a high of 67.3 in Powell County.

Seven counties had higher teen pregnancy rates in 2016-18 than in 2011-13: Lincoln (52.1 teen births per 1,000 females 15-19 in 2016-18); Nicholas (46.9); Edmonson (35.1); Elliott (57.3); Harrison  (44.2); Hickman (29.1); and Breckinridge (36.1). 

Other key findings about Kentucky's children in the report include:

• Fewer children were living in poverty before the pandemic began, an improvement of 25.5% in 2013 to 22.3% in 2018; 107 of the state's 120 counties improved.
• 96.3% of Kentucky children have health insurance, and all 120 counties showed improvements in that. The report notes that disparities still exist when it comes to coverage, with only 91% of Latinx youth covered. 
• The number of children in foster care increased from 37.2 per 1,000 children ages 0-17 to 51.1 per 1,000; the number of children exiting foster care to reunite with their families dropped from 41% in 2012-14 to 37% in 2017-19. 
• The percentage of public-school kindergarteners who meet readiness-to-learn standards worsened in 78 of the state's 120 counties from the 2014-15 school year to 2019-20. Statewide, only about half of kindergarteners enter school ready to learn. 
• Because the K-PREP tests were not administered in Kentucky public schools during Spring 2020 due to the pandemic, this year's Data Book did not include the reading and math proficiency indicators. Instead it provided information on the proportion of students with an Individualized Education Plan due to having a disability and the percentage of students experiencing homelessness, which was 15% and 3% respectively.
• In a measure made more important by the pandemic, Kentucky ranks 40th in broadband access with 30% of students, and 35% of students of color, lacking adequate technology at home. 

This year's report also examines the impacts of what it calls "the dual pandemics" of covid-19 and systemic racial injustice on children and families. 

The report points to the disparities around case and death rates among Latinx and Black Kentuckians; the challenges that children with special needs face with remote learning; the challenges for children who are being raised by grandparents, who are at higher risk for the virus because of their age;  and the fact that children in low-income families are more likely to have parents with low-wage jobs that put their families at higher risk of contracting the virus, while being much less likely to have paid sick leave if they get ill. 

"The covid-19 pandemic reminds us once again that opportunities differ based on where you live, your family’s earnings, and the color of your skin," says the report. 

It lays out a plan of action to create "strong, equitable recovery" for all Kentuckians that includes responding to the impacts of trauma, prioritizing mental health supports, addressing the issues of low-wage workers, especially among families of color; strengthening access to health coverage and care for communities of color, bridging the digital divide for employment, education and health, prioritizing closing the gaps in educational achievement that has been exacerbated by the pandemic; and ensuring that families can meet their basic needs until the economy recovers. 

“The dual pandemics have shown us that the status quo was not working for many Kentucky kids and their families," Terry Brooks, executive director of Kentucky Youth Advocates, said in a news release. "We must use this opportunity to rethink and rebuild our systems in a way that achieves the vision of Kentucky being the best place in American to be young, regardless of the color of your skin, your zip code, or income level.”

The Louisville Courier Journal published five op-eds this week from people whose work is directly affected by the issues addressed in the Data Book. Click here for one that offers an overview of the data; click here for one that addresses child care; click here for one that addresses parental incarceration; click here for one that addresses health inequity, especially among Latinx populations; and click here for one that addresses the digital divide. 

The 2020 Kentucky County Data Book was made possible with support from the Casey Foundation and other sponsors, including Passport Health Plan by Molina Healthcare; Kosair Charities; Avesis Essential Benefits; and Mountain Comprehensive Care Center. 

The Kids Count Data Center provides easy access to county and school district data for about 100 indicators and allows the user to rank states, counties and school districts; to create customized profiles of the data; to generate customized maps; and to embed maps and graphs in websites or blogs. Click here to see your county's profile. 

Read More