Ashland hospital says surge in covid-19 cases has it full; feds allow indoor visitation at nursing homes without recent cases

By Al Cross Published September 21, 2020 CORONAVIRUS, FEATURED, HEALTH BUSINESS, HEALTH POLICY

King’s Daughters Hospital has 465 beds, making it one of Kentucky’s largest hospitals.
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By Al Cross
Kentucky Health News

As a smaller share of Kentuckians tested positive for the coronavirus, the hospital in Ashland reported that it had filled up from a surge of covid-19 cases.

Gov. Andy Beshear announced in a press release that 3.6 percent of Kentuckians who were tested for the virus in the last seven days turned up positive, “our lowest rate in months. When we asked for people to push off in-person classes in our schools until Sept. 28, it was so we could get our positivity rate down to a safer level.” A rate of 5% of more puts a state or locality in an official danger zone.

Beshear announced 777 more cases of the virus in the state, pushing the known total to 60,128. He said eight more Kentuckians had died of covid-19. “This is tough news today,” he said in the release. “It only took ten days for us to go from 1,000 deaths to over 1,100. This is why we’re working so hard to keep our case numbers down.”

In the Ashland area, “Covid is intensely surging in our communities,” Kristie Whitlatch, president and CEO of King’s Daughters Hospital, said in a Facebook post. “No longer can we say it is primarily impacting those with underlying health conditions or nursing-home residents. It is attacking babies, children, and healthy, active men and women who have no idea how they were exposed. We are also seeing difficult recoveries, many taking months to fully recover and some who have yet to fully recover and may see the impact for the rest of their lives. Our infectious-disease specialists and other medical professionals are very concerned.”

Whitlatch said the hospital has had 22 deaths related to covid-19, and this week discovered more than 120 new cases. “Our hospital is at capacity,” she wrote. “We are working to open a third nursing unit to care for covid patients. Multiple nursing units dedicated to one virus are unprecedented in our 120-year history. Many of these patients are very ill and many of our physicians, nurses and support team have been struck by the virus. I understand people have differing opinions, but we know for a fact it is dangerous and deadly because we live it every day. We must take this seriously.”

After advising the usual precautions, and telling people to “Stay at home as much as possible,” Whitlatch wrote, “I also ask for your prayers and/or words of encouragement for our heroes behind the masks. However, today I would add these heroes are not just our team members or other medical professionals. If you are wearing your mask and following the other guidelines you are our heroes too.”

Whitlatch did not say exactly how many covid-19 patients are in the hospital. The area has 214 fewer hospital beds than it did at the start of the pandemic, due to the April closure of Our Lady of Bellefonte Hospital in Russell.

Statewide, 500 people were hospitalized with covid-19, and 144 of them were in intensive care, according to the state’s daily report.

Nursing-home visits: The federal Centers for Medicare and Medicaid Services relaxed its covid-19 guidelines for long-term-care facilities, allowing visits at those that have gone 14 days without a case among residents or employees. Kentucky has been following a 28-day standard.

“Most nursing homes can allow indoor visits as long as there have been no new covid-19 infections in the past two weeks and the infection rate in the surrounding county is no more than 10%,” NPR reports. “But CMS recommends that nursing homes limit how many visitors a resident can have at one time, as well as limiting the number of visitors that can be in the facility at once.” The new rules also allow social activities and communal dining by residents, with social distancing and and mask wearing.

“Since March, family members have only been allowed to visit their loved ones for so-called compassionate care,” NPR reports. “This was interpreted strictly by many nursing homes to mean end-of-life situations. The new guidance from CMS expands the criteria to include residents who were living with their family before admission to the nursing home and are now struggling with the change in environment, residents who need family members to provide encouragement with eating or drinking, and residents experiencing emotional distress or crying more frequently. The guidance says this should not be regarded as an exhaustive list.”

In other related news Friday:

Of the 777 new coronavirus cases, 97 were in Kentuckians 18 or younger. Counties with more than 10 new cases were Jefferson, 146; Fayette, 116; Madison, 36; Daviess, 33; Warren, 30; Oldham, 26; Boone, 20; Union, 19; Hardin, 16; Henderson, 16; Laurel, 15; Kenton, 12; and Barren, Boyd and Mercer, 11 each.
Friday’s fatalities were an 85-year-old man from Bell County; a 96-year-old man from Christian County; a 96-year-old man from Fayette County; a 90-year-old woman from Greenup County; a 53-year-old man from Hopkins County; a 73-year-old woman from Laurel County; a 78-year-old woman from Pulaski County; and a 91-year-old woman from Scott County.
K-12 schools reported seven more cases, three students and four employees, raising the active-case totals to 340 and 165, respectively.
Colleges and universities reported 119 new cases among students, making for 1,098 active cases.
The University of Kentucky said it would randomly test students for the virus, following “a productive dialogue in which senior leaders engaged earlier in the week with Dr. Deborah Birx, the national coronavirus response coordinator,” who visited the campus and praised UK’s response. The tests will be free and will continue through the semester, which ends Nov. 24. Spokesman Jay Blanton said in an email that UK plans to test about 400 students in a first round of tests that it expects to be done by Wednesday. “We will follow up with students who do not comply and ask them to test,” he said. “If there is not compliance, ultimately, they are subject to sanctions in the student code, which generally range from education all the way to expulsion. But we have found that the vast majority of students have worked to comply with our testing and public-health protocols.”
UK also said it would require retesting of students living in residence halls, “as directed by the data” from sampling of dormitory wastewater for the virus.
The federal Centers for Disease Control and Prevention “reversed a heavily criticized guidance it issued last month about who should be tested for the novel coronavirus,” The Washington Post reports. “The agency updated its recommendation to call for testing anyone — including people without symptoms — who has been in close contact with someone diagnosed with covid-19, the disease caused by the virus.”
Beshear, his wife Britainy and their children, Will, 11 and Lila, 10, got their flu shots this week, along with Lt. Gov. Jacqueline Coleman, Health Commissioner Steven Stack and American Sign Language interpreter Virginia Moore. He “emphasized the importance of getting a flu shot this year to blunt the potential for what the medical community fears could be a ‘twindemic’ if seasonal flu outbreaks overwhelm health care systems already stretched thin by covid-19,” a press release said.