Louisville Blogs

The field hospital at the Kentucky Expo Center in Louisville has been ‘mothballed’, but could be reactivated in a week or less if Kentucky experiences a surge in cases of COVID-19, according to the Kentucky National Guard.

As other states experience surging cases of virus, Kentucky has so far maintained a “plateau,” meaning daily cases may go up or down, but average out over time.

Kentucky has averaged 221 new cases per day over the last week, according to the WFPL News Covid-19 tracker.

The number of people testing positive for COVID-19 in Kentucky remains low at 3.6% compared to the positivity rates seen in states including Arizona (24%), South Carolina (14%), Texas (14.4%) and Florida (16%), according to covidexiststrategy.org.

Taking a looking at available hospital space, Kentucky has 11,565 unoccupied hospital beds and 654 intensive care unit (ICU) beds as of July 1, according to data provided by the Kentucky Cabinet for Health and Family Services.

In total, there were 495 patients hospitalized with COVID-19 as of July 1. Seventy-three of those patients were in the ICU.

If the surges happening in other states, happens in Kentucky, Major Stephen Martin with the Kentucky National Guard said the field hospital at the state fairgrounds could be online in a week or less.

“So the alternate care facility at the Kentucky Fairgrounds and Expo Center is currently mothballed,” Martin said. “There are still beds there and everything is setup but we really just took the crews down and locked the doors.”

Martin said the decision to reopen the facility would be left to the Kentucky Health Cabinet and Gov. Andy Beshear.

As of July 1, Beshear said the state has seen 15,842 cases of coronavirus, 220 of which were reported on Wednesday.

So far, 572 people have died from COVID-19.

“Each one of these folks was special. Each one of them won’t get to see their friends, their neighbors, their kids and grandkids anymore,” said Beshear in a press release. “We cannot let this become the new normal. I’m heartbroken for these families.”

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Kentucky Gov. Andy Beshear has decreased the frequency of his coronavirus updates to once a week. Tuesday’s update comes a day after the state entered another phase of reopening, allowing bars, swimming pools and music venues to operate with fewer than 50 people.

Kentucky has not so far experienced the dramatic spike in cases seen in states including Arizona, Texas and Florida. Both Florida and Texas closed down bars Friday as a result. But the website COVID Exit Strategy flags Kentucky as “trending in the wrong direction,” having reported a 35% increase in new positive COVID cases over the last 14 days.

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Kentucky reopens bars, swimming pools and music venues on Monday, allowing crowds of up to 50 people to gather indoors after as the U.S. reports record cases of COVID-19.

Monday’s plans are the latest in a series of reopenings phased in by Kentucky Gov. Andy Beshear’s administration. Already, the state has opened restaurants, some child care programs, funerals and barbershops at limited capacities, among other businesses.

Experts in infectious diseases say it’s likely that relaxing guidelines has contributed to the growth in daily case numbers seen in dozens of states around the country. In turn, last Thursday, the U.S. reported 41,000 new cases of COVID-19 in a single day — a new record.

Kentucky has not so far experienced the dramatic spike in cases seen in states including Arizona, Texas and Florida.  Both Florida and Texas closed down bars Friday as a result.

Instead, the Commonwealth has maintained what Beshear often calls a “plateau,” which he says is an inelegant way to say that cases maybe be going up and down day-to-day, but overall the caseload appears to be averaging out.

As of last week, Kentucky’s seven-day average amounted to 182 newly reported cases per day, according to the WFPL News COVID-19 tracker.

Meanwhile, the rate of positive cases compared to the overall number of people tested in Kentucky has hovered between 2.5 and 4% over the last two weeks, which is better than many states currently experiencing spikes, according to covidexitstrategy.org.

Chief of Infectious Diseases at the Virginia Commonwealth University Dr. Gonzalo Bearman said the current numbers indicate Kentucky’s phased reopening guidelines have thus far helped limit the spread of the virus. However, Bearman warns that relaxing measures further will result in new infections.

“As we relax some of these preventative measures, there’s going to be an increase in cases,” Bearman said. “Particularly if, when these measures are relaxed, there is a lack of social distancing, a lack of the use of the face mask. That’s going to be a big problem.”

Kentucky Public Health Commissioner Dr. Steven Stack said it’s essential that people continue to practice good hygiene and follow social distancing guidelines as the state reopens.

Even as Kentucky maintains its plateau, surrounding states are seeing cases trending upwards. Ohio reported 900 new coronavirus cases last Thursday – the highest level seen since April, according to the Columbus Dispatch.

NPR reports daily cases are also increasing in West Virginia, Tennessee, Arkansas and Missouri.

Last week demonstrated how infections can cross state lines when Kentucky public health officials warned a cluster of travelers who visited Myrtle Beach tested positive for the virus after returning to the state.

“State lines, as we all know, our porous. We come and go and that’s certainly a risk for increasing the rate of transmission and cases in Kentucky,” Bearman said.

In recent weeks, the average age of people who are infected with the virus has also trended downward, suggesting that younger people are not adhering to public health guidelines as well as they were before states began to reopen.

Bearman said that younger people are less likely to die from the virus, but they can transmit the virus to others who are more vulnerable, including older people and those with compromised immune systems.

Kentucky Derby

The record numbers of cases seen across the U.S. in the last week have prompted officials to cancel large events including Riot Fest in Chicago and the National Tractor Pulling Championship in Ohio. But in Kentucky, Churchill Downs Racetrack announced plans to hold the Kentucky Derby and Oaks in the first week of September.

The track, which can seat more than 150,000, will limit the venue capacity to reduce the crowd density, and restrict general admission ticket holders to the infield, though track president Kevin Flanery would not say how many people would be allowed into the stadium.

The Derby has traditionally attracted people from all over the world to attend the races, drink Kentucky bourbon and enjoy nights out in the city. Even with health guidelines in place, Bearman said this year’s Derby has the potential to become a “super-spreader event,” similar to what happened at Mardi Gras this year.

“I can’t see how that number of spectators could socially distance and somehow I just can’t imagine how everyone is going to be wearing a face mask, so there is a high risk,” Bearman said.

Beshear has said Kentuckians can expect the derby will look very different this year.

“The changes made to this year’s Derby will help to protect the health and safety of every Kentuckian, which is my main priority,” he said.

Still, Bearman warns the pandemic is “far from over” and expects the country will see a second wave of virus this winter.

He said officials should especially keep an eye the number of hospitalizations.

“I think if you have increasing cases and ongoing transmissions, particularly with increased hospitalizations and hospitals becoming overburdened, you have to rethink the current strategy,” Bearman said.

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After three months of closures, child care centers have reopened in Kentucky with a full slate of new safety guidelines.

There are temperature checks. Groups are capped at 10 kids. Playground time is staggered. The “lost and found” bin has been eliminated. Toys are sanitized between use. Field trips are canceled.

Adult staffers must be masked, unless they’re six feet away from another person. That’s consistent with the “universal masking” plank of the state’s plan to reopen the economy.

But for children, masking rules are looser.

The American Academy of Pediatrics and Centers for Disease Control recommend children 2 and older wear masks in public when social distancing is difficult. In daycare, “when feasible staff members and older children should wear face coverings within the facility,” according to CDC guidelines.

But Kentucky is recommending against masks for children 5 and younger. For children older than 5, masks in child care centers are recommended — but still not required.

State guidelines say the masking age is older than federal guidelines because children 5 and under face “increased risks of suffocation and strangulation.”

But experts and child specialists suggested the state guidelines have as much to do with the practical realities of caring for children as settled science about viral transmission.

Children And COVID

Although children are rarely debilitated by COVID-19 — only a single person under the age of 30 has died from COVID-19 in Kentucky — research is mixed on the extent to which kids transmit the virus.

“The risk of transmission among a group of children, based off of the data, does appear to be lower than the risk among even young adults, adults and older individuals,” said Annabelle de St. Maurice, assistant professor of pediatrics and infectious disease expert at UCLA.

There are also reports of a possible link between COVID and pediatric multisystem inflammatory syndrome (PMIS, or MIS-C), a very rare but serious disease that might explain several deaths among children who tested positive for the new coronavirus. Research is ongoing, and experts emphasize it’s premature to draw sweeping conclusions.

De St. Maurice said it’s important to do “whatever we can do” to prevent transmission in group settings. That includes familiar advice, such as keeping sick kids home, practicing hand hygiene and social distancing, and wearing masks. De St. Maurice encourages schools to promote masks “as much as possible.”

Under new safety guidelines for school re-opening in Kentucky, students first grade and above will be required to wear masks in school if six-foot distancing isn’t possible. Masks will also be required on the bus.

Masks are widely believed to be an important part of viral containment. In Hong Kong, one of the most densely populated metro areas in the world, just five people have died of COVID-19 out of 7.5 million residents, according to Hong Kong’s government. Experts cite social distancing and universal mask-wearing.

But when or if children should don masks is more complicated.

The benefits of child mask-wearing are straightforward. But so are the risks: young children are less able to remove their mask in an emergency, and they’re also more likely to touch and contaminate their masks.

“In the youngest children, trying to put a mask on them all day, that mask is probably going to get wet and gross, and they’re going to play with it and take it off, and someone’s going to need to put it back on them,” said Kristina Bryant, professor of pediatrics at the University of Louisville and the hospital epidemiologist at Norton Children’s Hospital.

“I think that’s part of the rationale driving the recommendations for daycare: How practical is it to keep a mask on a 2- or 3-year-old all day long?”

Practicality was a major concern for state officials. “In Kentucky, we chose to recommend that children ages 5 and older wear masks because they are likely more able to comply,” said Susan Dunlap, spokesperson for the Kentucky Cabinet for Health and Family Services.

Still, there are reasons to encourage able, younger children to wear masks. If children infected with COVID-19 are presymptomatic or asymptomatic, they might unknowingly spread the virus through child care facilities or schools, jeopardizing the staff and their own families.

Some states have already seen issues after child care facilities re-opened. In Texas, where there never was a mask requirement for child care centers, Gov. Greg Abbott ordered new rules after a spike of new COVID cases linked to child care.

Norton Children’s Hospital recommends children 2 and older wear masks in public when social distancing isn’t possible. So does the Kentucky Children’s Hospital, in Lexington.

“The CDC recommended from two years and up, everyone should be wearing a mask as much as possible in a public setting, especially at the hospital,” said Jenna Cook, a child life specialist at the Kentucky Children’s Hospital.

State rules and recommendations are important because mask-wearing needs to be universal — above 80% of the population, as one study suggested — in order to be effective.

“The 4-year-old wearing a mask protects other people; the mask doesn’t protect the 4-year-old,” said Bryant. “It only works if everybody for whom it’s safe wears it.”

Judgment Call For Younger Children

The disagreement centers on what ages can safely wear masks. Experts agree children under 2 should not wear masks. “Babies can’t take the mask off themselves. If they’re overheating or can’t breathe, they don’t have a moment to take it off themselves,” said Ashley Rapske, a child life specialist at Kentucky Children’s Hospital. She’s a health care professional who provides emotional support and coordinates activities with children and their families.

The development of older kids ranges more widely than younger ones. A 5-year-old, for instance, might face similar risks with masks depending on their needs.

Eric Friedlander, secretary of the Kentucky Cabinet for Health and Family Services, has advised children to wear masks as they are able. Still, he acknowledged, “it’s a judgment call on a child’s developmental ability.”

Child care operators can recommend mask usage for children ages 2-5 “as long as the child is developmentally able to comply and it is not felt to be a safety risk to the child,” Dunlap added.

Steven Stack, commissioner of the state’s public health department, believes such a recommendation would not go against the guidelines but would set an even higher bar, according to Dunlap.

“We know children get infected with COVID-19. And, it seems very likely that they are able to transmit the disease to others,” Dunlap said. “Unfortunately, we don’t know how effective they are as transmitters when compared with older persons.”

Another challenge is that Americans have no history of wearing face coverings in public and are developing mask norms in real-time. When adults balk at wearing a mask, children often pick up a signal, experts advise.

Cook and Rapske outlined simple steps for parents to familiarize their children with masks, including modeling mask-wearing, teaching children how to put on and take off a mask, wearing masks around the home as practice, and using the masks as part of creative play such as on stuffed animals or action figures.

To combat the stigma, signs around Norton Children’s Hospital are appealing to kids directly: “Superkids, like superheroes, wear masks.”

“Kids aren’t used to wearing masks,” Bryant said. “But kids know superheroes, and superheroes wear masks.”

The post CDC Recommends Younger Kids Wear Masks; Kentucky Says It Depends appeared first on Kentucky Center for Investigative Reporting.

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