State has second highest number of new cases; 1/3 of hospitals critically short of staff; Beshear says Ky. in ‘uncharted territory’

Screenshot of KHN-adapted New York Times map; for interactive version, with local data, click here.

By Melissa Patrick and Al Cross
Kentucky Health News

As Kentucky hospitals struggle with enough beds and staff to care for Covid-19 patients, and the state recorded its second most coronavirus cases in one day, Gov. Andy Beshear said the state is in “uncharted territory.”

Beshear said Thursday that 32 of 96 of the state’s hospitals, exactly one-third, are reporting critical staffing shortages. He said hospitalizations have increased for 42 consecutive days, setting daily records the last five days.

“As horrible as last year’s surge was, and it was awful, we were never in a position where doctors worried they [would] need to choose between treating a patient who can’t breath because of Covid or treat a patient who’s bleeding out because of a car accident. That’s the strain our hospitals are under,” Beshear said at his weekly news conference.

The state reported 5,401 new cases of the coronavirus Thursday, 1,759, or 32.56 percent, among Kentuckians 18 and younger. Even before that report, the state’s 14-day infection rate was fourth in the nation, trailing Mississippi, Florida and Louisiana, according to The New York Times.

The percentage of Kentuckians testing positive for the virus in the last seven days set another record, 13.24%, and the state reported 27 more Covid-19 deaths, raising the seven-day average to 22 per day.

The state saw a similar surge last December and January. The difference between now and then, Beshear said, is that we know how to prevent it, how to make sure those hospital beds remain available for emergencies and routine care: “The difference between now in uncharted dangerous territory and before is we have the answer, they are the safe and effective vaccines.”

Kentucky hospitals reported 2,115 Covid-19 patients, 41 more than Wednesday, with 590 of them in intensive-care units and 345 of those on mechanical ventilation. All set new records. The share of ICU patients being ventilated has increased; in the first week of August, it averaged 40%; Thursday, it was 58%. The Lake Cumberland hospital region became the first to report that all its ICU beds are full; 40% are occupied by Covid patients.

Beshear played a video from Dr. Mohan Rao, a Baptist Health Madisonville surgeon, who encouraged Kentuckians to get vaccinated, reporting that 19 of the hospital’s 20 intensive-care beds are full, many of the beds are occupied by young people, and most of the patients on ventilators.

“I thought last year that we had seen the worst of it, especially with the introduction of vaccines,” Rao said. “And once we all got vaccinated, I thought that a lot of this would go away. Unfortunately, it’s come back and it’s come back pretty ugly, it’s come back with a vengeance.”

Thanks to an extension in federal funding, the Kentucky National Guard will provide a variety of services across the state to help combat the virus between Sept. 1 and Dec. 30, including helping hospitals in ways that will free up staff.

Also, the Federal Emergency Management Agency has approved the state’s request for additional emergency medical personnel and will provide 30 additional staff and 15 ambulances. The state still awaits approval for a “nurse strike team,” he said.

In addition, using money from the 2020 federal pandemic relief bill, the state is setting up four new sites to help the hardest-hit hospitals with testing. They will be in Danville, Corbin, Morehead and Pikeville.

The University of Kentucky has more Covid-19 patients than ever, 118. “This is more patients in the hospital than we had even last winter before we had a vaccine,” she said. “We’re just seeing more infections and more sick folks, and more young people as well,” Dr. Ashley Montgomery-Yates, UK HealthCare’s chief medical officer for inpatient and emergency services, said at a separate news conference. She also said they are seeing “a significant increase” in pregnant women with Covid.

Montgomery-Yates said this surge in patients has caused them to shift resources and to delay some elective surgeries, all while dealing with a nursing shortage that started long before Covid-19 ever hit and has only been exacerbated because of it. “And so now we are all existing in a world where we actually need more nurses, and we have less, and it’s hard. It’s hard on everybody,” she said.

UK also announced that beginning Sept. 1, it will require weekly Covid-19 testing for all faculty, staff and students on campus who are unvaccinated.

Legislature faces questions

Beshear’s ability to deal with the pandemic has been limited by the state Supreme Court decision that upheld, for now, the 30-day limit on governors’ emergency orders enacted by the 2021 General Assembly.

He said that if he still had the authority to do so, the 65 Covid-19 deaths reported yesterday, along with case numbers approaching 5,000 in one day, would have prompted him to impose another statewide mask mandate: “That would’ve been the trigger for me, if it was in my authority to put in a masking order for indoors across the state,” as the governor of Illinois did Thursday.

“Every other time we’ve been this high, we’ve done that and it’s worked,” Beshear said. “I can’t do that now, and I get that. I’ll provide all the information I can to the General Assembly and hopefully, they will make the best choice that they can. . . . But I’m begging you out there, put on that mask.”

Beshear and Republican leaders are negotiating how to dissolve that court ruling, which means Kentucky’s state of emergency related to the coronavirus will need to remain in effect until they tell Franklin Court Judge Phillip Shepherd how they want to proceed. Shepherd has asked them to come up with an agreed order within 10 days, Ryland Barton reports for Louisville’s WFPL.

Beshear said after an earlier event at Midway that he has now met with almost all Republican legislative leaders. He also said that the state school board’s emergency regulation requiring masks to be worn in school is not in legal jeopardy from the newly effective laws or the Supreme Court’s ruling.

Asked at his news conference why he wasn’t able to simply issue a 30-day order for a statewide mask mandate, the governor explained that the state of emergency needed to declare such a mandate would expire sometime before that. The Supreme Court’s decision will become final Sept. 10.

Being more careful

Beshear cancelled his appearance at the annual Kentucky Farm Bureau Country Ham Breakfast at the state fair, saying that he did so to model what needs to be done, especially after yesterday’s high case and death numbers.

In a video for the audience, he said, “I know this event was pre-planned, I know you’re doing your very best to stick by all of the safety protocols; folks, after today, please be as careful as you can. Our hospitals are overrun. And right now, the last thing we need to do is do things that make it more likely that we end up taking up a bed that somebody else may need.”

At his news conference, Beshear again made the case for the state school board’s mask rule, pointing to a North Carolina State University modeling study that showed without masks or regular testing, up to 90% of susceptible students may become infected by the end of this semester. The study demonstrated that, when used in combination, masks and testing can prevent 80% of new infections.

With the death of Jamie Kennedy, an assistant football coach and health teacher at Greenup County High School, who reportedly died from complications of Covid-19 on Wednesday, schools in the county have been shut down for the rest of the week with no virtual learning, Valarie Honeycutt Spears reports for the Lexington Herald-Leader.

“The number of students and staff who are positive and or quarantined has greatly impacted our ability to operate buses, kitchens and maintain classroom staffing,” Greenup County Schools Superintendent Traysea Moresea said in a message to families.

At least six other school districts in Kentucky have closed for various time periods this school year, several with no virtual learning, Honeycutt Spears reports.

Most of them are in Eastern Kentucky, which continues to have most of the counties with the highest infection rates over the last seven days. The statewide rate is 81.73 per 100,000 residents; counties with rates more than double that are Clay, 256.3; Bell, 205.2; Whitley, 205.2; Owsley, 194.1; LaRue, 175.6; and Jackson, 165.1.

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