Reopenings may not fit guidelines, but Beshear says plateau and other states’ trends forecast a decline in May; public data limited

State’s “epidemic curve” notes, and Kentucky Health News arrow emphasizes, that coronavirus cases with first symptoms in the last two weeks may not appear. The later the date, the more that is likely.
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As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky’s coronavirus cases remain at a plateau, and Gov. Andy Beshear said they may not show the two-week decline that federal guidelines say should precede reopening of some businesses — which he has scheduled to start in less than two weeks, on May 11.

Beshear’s first benchmark for reopening is “14 days where cases are decreasing,” but he has said that doesn’t mean a decline each day. His benchmarks follow the federal guidelines, which call for “Downward trajectory of documented cases within a 14-day period” or “Downward trajectory of positive tests as a percent of total tests within a 14-day period.” He gives new case numbers daily — there were 174 yesterday — but not the positive-test percentage.

Asked at his daily briefing Thursday if the state would see “a two-week decline” by May 11, he said, “The answer is maybe. We believe that we’ve been holding steady on overall numbers despite there being more testing, and that is with us now testing more people in populations such as long-term care facilities,” where cases are more prevalent.

“What I believe is that by doing a very gradual and phased re-opening with strict guidelines, that we can do it safely at a time that we know where the contagion isn’t increasing, that we are not on the increase,” he said. “And I believe that we will see that we are on the decrease in May.”

Beshear has generally scheduled reopenings for several days in May, while reserving the right to change the schedule. He indicated that his decisions are based in part on watching trends in other states.

“We have now been plateaued for about three weeks, and if we are running a couple of weeks behind other places, I think that they are seeing their numbers changing, changing gradually,” he said. “Again, we wouldn’t be doing it if we didn’t think it was safe — and everything is dependent on the virus.”

The only time-related graph the state has on its kycovid19.ky.gov website is an epidemic curve, showing the first onset of symptoms among people who have tested positive for the virus, and it notes, “Illnesses that began within the last two weeks may not be reported,” because of delays in reporting by laboratories.

The graph shows a peak of 177 cases on April 16, followed by 85, 59, 95 and 69 cases April 17-21. After that, the numbers are quite low; the virus has an incubation period as long as two weeks, so the more recent the daily number, the more likely it is to change.

Apparently referring to case numbers, Beshear said, “For about the past three weeks, we’ve been in generally the same area. That is good news when we look at something that would otherwise spread more quickly.”

But to limit the spread as normal activities resume, he said every business that plans to reopen must open in phases, allow for social distancing, make daily onsite temperature checks, enforce mask wearing, provide access to personal protection equipment, and make special accommodations for those who need it.

“These are things that allow us to start re-opening our economy, even in a time where we are facing a worldwide pandemic,” he said. “These are things that keep us healthy. Let’s buy into them, let’s not push back on them, let’s say that this is what it takes to make sure we can go back to work and not cause a spike in this virus, and that’s what we ought to want to do.”

He reiterated that day-care centers could not re-open and showed graphics of how doing so would greatly increase the numbers of contacts each person would have if they were allowed to, which he said greatly increases the risk of spreading the virus. Here are the graphics, in succession, also showing workplace interactions (click on them to enlarge):

Health Commissioner Steven Stack said it will not be possible to open public swimming pools in the early part of summer, and beyond that, it’s too early to say. Beshear added that this includes any communal pools, such as those in apartment complexes.

“There is just almost no way you can put together a whole bunch of kids and people at a public pool and not have folks socializing and violating the social distancing rules of greater than six feet,” he said.

The state’s quarterly budget report shows that due to the economic impact of the pandemic, Kentucky is facing a budget shortfall of upwards of $319 million to $496 million, and a Road Fund shortfall of up to $195 million, for the fiscal year that ends June 30. Beshear said all governors have urged Congress to provide relief to both states and local governments, and he discussed “some of the numbers” Thursday with Senate Majority Leader Mitch McConnell, who first rejected “revenue replacement” for states but now seems to have opened the door to it.

Beshear said, “He said he understood, and that there were more discussions going on in Washington D.C., but he heard me out.”

In other covid-19 news Thursday:

• • The 174 new cases brought the state’s total to 4,708. Beshear said there had been five more deaths, for a total of 240. They were of a 77-year-old man from Bath County, a 93-year-old woman from Daviess County, a 71-year-old woman from Jefferson County and a 97-year-old woman and a 66-year-old man from Grayson County.
  • The counties with the highest number of new cases are Jefferson, with 27; Kenton, with 27; Warren, with 19; and Boone, with 13.
  • Two deaths were reported in the state’s nursing homes, bringing that total up to 121 resident deaths and one staff death. Deaths in long-term-care facilities now account for 51 percent of the state’s total. In all, 727 residents and 307 staffers in nursing homes have tested positive for the virus in 74 facilities. Click here for a list of the affected facilities with the number of residents and staffers affected in each of them.
  • Rosedale Green nursing home in Covington is a covid-19 hotspot. Julia Fair of the Cincinnati Enquirer reports in detail on what health departments and St. Elizabeth Healthcare are doing to reduce coronavirus infections, including a plan to separate residents based on exposure and symptoms, increased testing, additional clinical supports, more personal protective equipment and doing a deep clean. As of Wednesday, the facility had reported 54 residents and 22 staff who had tested positive, and 14 resident deaths.
  • Beshear said everyone in the Green River Correctional Complex in Central City would be tested by Friday. The Lexington Herald-Leader reports that there have been 64 confirmed cases of the virus in the facility and two people have died from it, according to the Muhlenberg County Health Department.
  • Josh Benton, deputy secretary of the Cabinet for Education and Workforce Development, said e-mails will be sent today or tomorrow to 9,000 Kentuckians who need to submit identity documents to get their unemployment benefits. He said some of the nearly 28,000 March claims that have not been processed yet have to do with employer-separation issues.
  • Beshear urged people to sign up for open slots at testing sites, and added one to the list: Jessamine County, next Tuesday through Friday. Click here for a list of all of the state’s drive-through testing sites.
  • The Kentucky National Guard will do a statewide flyover on Friday to honor health-care workers and essential personnel, part of a nationwide event called Operation American Resolve. It will touch Frankfort, Lexington, Pikeville, Bowling Green, Owensboro and Louisville. The Courier Journal has the schedule.
  • Stack announced that Kentucky’s hospitals will now use the Battelle Critical Care Decontamination System that uses “vapor phase hydrogen peroxide” to decominate N95 respirator asks for up to 20 reuses without degrading filter performance.
  • Norton Healthcare specialists are researching experimental therapies to treat patients with covid-19, including medications to kill the virus or prevent it from growing; to help stop the body’s immune response that results in increased damage to otherwise healthy organs; and to improve immunity; and research that looks at the benefits of “convalescent plasma” in treating covid-19 patients, according to a hospital news release.
  • The release says 21 critically ill Norton patients have received convalescent plasma, which comes from a fully recovered covid-19 patient, and researchers say they are seeing “very encouraging results,” with six patients having recovered and gone home. Click here to learn more about how to donate blood plasma.
  • As part of a pilot program, Beshear announced that the more than 600,000 Kentuckians who participate in the Supplemental Nutrition Assistance Program, formerly called food stamps, will now be able to use their benefit cards online via Amazon and Walmart.
  • Big cities and major urban areas have seen the greatest number of coronavirus deaths, but a new Kaiser Family Foundation analysis finds the growth rate is now higher in rural areas. The report includes an interactive map that shows the per-capita number of coronavirus cases and deaths across metropolitan and non-metro counties.
  • The KFF analysis found that in the two-weeks ending April 27, non-metro counties saw a 125% increase in coronavirus cases (from 51 to 115 per 100,000 people) and a 169% increase in deaths (from 1.6 to 4.4 deaths per 100,000). Metro counties saw a 68% increase in cases (from 195 to 328 per 100,000) and a 113% increase in deaths (from 8 to 17 deaths per 100,000).
  • The Medicaid and CHIP Payment and Access Commission, a non-partisan group that analyzes policy and data makes recommendations, again told Health and Human Services Secretary Alex Azar that funds from the Coronavirus Aid Relief and Economic Security (CARES) Act are not providing sufficient help to health-care providers who serve Medicaid beneficiaries, and thus could do permanent damage to the nation’s health-care safety net. Click here to see the letter.
  • Housing authorities in more than 100 Kentucky towns will get about $12.6 million from the CARES Act, says a news release from Senate Majority Leader Mitch McConnell, which lists the recipients and says the money “will be used to support prevention and preparation services for their residents, for responding to the coronavirus pandemic in public housing, and supporting the health and safety of assisted individuals and families.”
  • A long list of African American faith and civil-rights leaders in Kentucky joined a statement issued by such leaders around the nation “encouraging communities to stay at home in states where stay at home orders are being lifted until there is evidence that it is safe.” African Americans have been disproportionately affected by covid-19; their death rate from it in Kentucky is about double their share of population in the state.
  • The Kentucky Distillers’ Association and the Kentucky Chamber of Commerce are partnering to help business make sure they have enough hand sanitizer needed to protect Kentuckians as businesses, a chamber news release says. Click here if you are a Kentucky business in need of hand sanitizer, to find out where to get it.
  • A Versailles-area winery is “putting the words of the man who told them to partially shut down to good use,” John McGary reports for The Woodford Sun. Wildside Winery’s first varietal is named Six Feet Petite, and bears Beshear’s familiar admonition “Y’all can’t be doing that” under an illustration of male and female silhouettes separated by a two-way arrow. Co-owner Elisha Holt told McGary that most buyers get two bottles, one to save for conversation pieces in the future. The wine “came out of the barrel last week, and Monday Holt said they’d already sold a third of it,” McGary writes.
  • The University of Kentucky‘s Chinese partners have donated 15,000 pieces of personal protective equipment to the university, says a UK news release.