By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Gov. Andy Beshear announced details of the first broad phase of his plan to re-open Kentucky’s economy in May, while saying child care, restaurants, and businesses that require increased human contact are not yet on the list of what will be allowed to open.

“I hope everybody also sees that these are cautious steps that are going to be done with strict compliance, and I would not be suggesting these if I did not think that we could not do them safely,” he said. “And if it proves that we can’t do any of them safely, it is always subject to pause.”

Beshear stressed that it’s important that the state not open up in such a way that it causes a second spike of cases, a common occurrence in pandemics.

Beshear went over a list of 10 rules that he said will apply to every group that is planning to reopen, including such things as continuing to allow telework when possible; opening gradually, in phases; doing daily onsite temperature checks; providing access to personal protective gear if needed; maintaining and enforcing social distancing; and making special accommodations for those who need it, such as those who do not have child care or who are over 60 with underlying health conditions.

He said it’s also important to have immediate testing of those who show up to work with a temperature, and systems for tracing contacts of those who test positive for the coronavirus.

The big day is May 11, when non-essential manufacturing, construction companies, and vehicle and vessel dealerships can open, Beshear said. Auto and boat dealers will be doing business differently, he said; for example, test drives will have to be done solo.

Professional services will be allowed to open, at half-staff, and pet grooming and boarding will be allowed to resume, but with no person-to-person contact.

Beshear also announced that horse racing will be allowed to open on May 11, starting at Churchill Downs — but with no fans. “This is one of the most detailed plans that we have seen,” he said.

On May 20, retail may re-open and churches may hold in-person services, both at reduced capacity. Beshear said they are working on details, and it will likely be a percentage of normal occupancy. He said they are also working with churches to make plans for things like Sunday school, and “All of this is contingent on being able to keep social distancing, on the type of cleaning that needs to occur.”

On May 25, “provided the virus is where we think it will be at that stage,” he said, social gatherings of 10 or fewer people will be allowed, with social distancing and masking where necessary.

“We want you to know that we think this is possible, but it is all contingent on all of us doing this right, on making sure that we don’t see a spike in the virus,” he said “But there is at least a light, I hope you see at the end of the tunnel where we can get together a little more.”

Barbers, salons, cosmetology businesses and similar services will also be allowed to open May 25.

Beshear said restaurant openings would have to come later, and the state is working with them to figure out how to they can open safely.

He said day-care centers will also not be allowed to open this month because they increase contacts to a level that can easily spread the virus: “We go from a controlled amount of contacts to almost exponential growth.”

He said gyms, movies, camp grounds, youth sports are also scheduled to open in the second phase. As for youth sports, he said he is hopeful some of these sports can resume in June or July, but “Public pools will not be in phase one or phase two.” He said summer camps will not open in phase one, and it will be hard to open them in phase two.

Beshear said the “healthy at home” approach and social distancing are still keys to defeating the virus, “so healthy-at-work doesn’t stop being healthy-at-home.”

Reopening plans also presume that testing will continue to increase, to keep better track of the virus. Asked why Kentucky lags in testing behind other states, particularly Tennessee, Beshear said one differences is that large health-care companies that are in Tennessee are doing almost all the testing, with only 5 percent done by the state. “With us, it’s over 30 percent.”

He said the state hopes to see more private-sector testing, to increase the state’s capacity much faster. He said the rates of infection seen in Kentucky’s testing are promising and compare well to other states.

By Al Cross
Kentucky Health News

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Projections of covid-19’s impact on Kentucky continue to bounce around, but one model has begun to estimate how individual counties will deal with the disease.

Those projections rely on data that is even more scant than the earlier models, but they are being updated frequently and are intended to be a guide to local and state officials in planning for the expected surge of covid-19 patients.

Statewide, that surge is expected to peak on April 24, according to the latest projection by the Institute for Health Metrics and Evaluation at the University of Washington. That is during the period that IHME predicts to be the peak for deaths, April 23-27, with 28 deaths per day.

The IHME projection of total deaths, which is based on patterns of deaths in other locations, has fluctuated widely. Its latest projection is that 933 Kentuckians will die of covid-19, about half the 1,750 it predicted a week earlier but about the same number it projected a week before that. When it estimated the higher figure, it projected 54 deaths per day at the peak, with approximately the same dates for the peak.

The model predicts that Kentucky’s health system is likely to have enough hospital beds, intensive-care beds and ventilators to handle the surge, but its projections have a wide range of possibilities, many of them exceeding capacity. Its projections are based on the assumption that social-distancing rules now in place will remain through May.

Another model, which Gov. Andy Beshear has used in simplified form at his daily briefings, projects a much later peak of stress on Kentucky hospitals, and a lower number of hospitalizations: 841, on June 7, if there is strict compliance with social-distancing rules. If there is poor compliance, it estimates a peak of 15,105 hospitalizations on June 23. That would be near system capacity, but the state is working on temporary field hospitals and other measures to increase capacity.

The model, developed and updated by a group of epidemiologists across the country, projects that with strict compliance, 2,000 Kentuckians would die of covid-19, and that with poor compliance, 16,000 would die. The latter number is 3,000 higher than it was a week ago.

The model has begun to project the county-by-county impact of covid-19, based on limited data. Here is an enlargement of its national map, focused on Kentucky, along with the map legend. The colors are based on poor compliance; most counties at high or moderate in that case are in a lower category under strict compliance. The model has, for each county, bell-curve charts like the one above.

In other covid-19 news Sunday:

Beshear announced that the Kroger Co. will begin a free program designed to test 20,000 Kentuckians for the virus over the next five weeks, beginning Monday in Frankfort. He said the Cincinnati-based grocer will provide medical staff, personal protective equipment an an online portal, KrogerHealth.com/covidtesting; the state will pay for test kits and shipping, and the Gravity Diagnostics lab of Covington will provide support to provide results in 48 hours.

The Kroger tests will be limited to health-care workers, first responders and people who are over 65 or a chronic health condition such as heart or lung disease, or an immune-lowering condition such as diabetes. Beshear said he hopes to announce more locations next week.

Beshear reported 134 new covid-19 cases, for a corrected total of 1,963, and three more deaths: a 72-year-old man in Jefferson County, a 74-year-old woman in Hopkins County and a 62-year-old man who lives in Pike County or is being cared for there. “We’re still not seeing the type of increases that we’re seeing in other states,” he said. “Still. we’re in that phase where the coronavirus is increasing . . . and we’ve got to do everything we can to stop it.”

Adair County led the list of new cases with 35, reflecting an outbreak at its only nursing home. Statewide, Beshear said, 19 more residents and 11 more employees of long-term-care facilities tested positive for the virus, and four more deaths had been identified as occurring in such facilities. The totals are 172 residents, 103 employees and 25 deaths. “This virus comes for the most vulnerable,” Beshear said.

The governor said 667 Kentuckians have hospitalized with covid-19 and 289 remain so. He said 256 have been in intensive care and 136 still are. He said at least 607 have recovered, and displayed a social-media post about a man going home from a Bowling Green hospital.

Beshear said African Americans account for 21.51 percent of cases in which race has been determined, about four-fifths of the total, which he called “really concerning data… There’s a lot more we should have done before now and unfortunately a lot of people in our society are paying for it.”

Four shipments of personal protective equipment for a group of Northern Kentucky hospitals were seized or redirected by the Federal Emergency Management Agency, according to Garren Colvin, CEO of St. Elizabeth Healthcare, The Washington Post reports: The first order, from Texas, was diverted to St. Louis at the demand of FEMA, Colvin wrote in an email. “In another case, a deposit had already been made for supplies from China when, Colvin wrote, “we were told that the order was canceled at the request of the U.S. Government.”

Colvin wrote U.S. Rep. John Yarmuth, D-Louisville, “and other lawmakers,” the Post reports. Yarmuth told the newspaper, “Stories from FEMA are contradicted by what we’re hearing on the ground, namely that they deny that they’re confiscating or redirecting PPE while they’re clearly commandeering it for their distribution system.” The Post story has several examples from other states; Gov. Andy Beshear has said he spends much of his time trying to find PPE.

Beshear said Saturday that some Kentucky manufacturers have helped by making PPE, especially face shields, but donations have been more help. Donations can be arranged by calling 833-GIVE-PPE or going to givePPE.ky.gov, or made by delivery to any of the 16 state police posts.

Health experts hope that social-distancing rules can be pulled back “at least in some ways, maybe next month,” in certain places, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN. “There’s an extraordinary risk of there being a rebound” if too much is relaxed too soon, he said.

Musician Sturgill Simpson, born and raised in Kentucky, said on Instagram that he had tested positive for the coronavirus on April 6 and would self-quarantine through April 19. He said his symptoms arose after a tour of Western Europe and the eastern U.S., which was ended due to the pandemic.