A nonprofit publication of the Kentucky Center for Public Service Journalism

Clinicians suspected Kentucky’s first case of coronavirus, but patient didn’t qualify for testing

Crystal Miller, head of the health department serving Harrison County, at a press conference Saturday. Others, L to R: Gov. Andy Beshear; Health Commissioner Steven Stack; Harrison County Judge-Executive Alex Barnett; Cynthiana Mayor James Smith; and Mark Newman, head of UK HealthCare. (Photo from KHN)

By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky found its first case of the new coronavirus, in Harrison County, and Gov. Andy Beshear advised residents of the county Saturday to avoid crowds.

Beshear’s advice came on the same day that the U.S. Centers for Disease Control and Prevention recommended that all Americans over 60 or those with heart, lung or kidney disease avoid public gatherings. Seniors and people with underlying medical conditions are more vulnerable to the virus.

The governor said the patient had been treated at Harrison Memorial Hospital in Cynthiana, and the University of Kentucky said the patient is now in isolation at UK Chandler Hospital. Beshear said the patient was in serious condition but is improving. “There is no cause for fear at this time,” he said.

The hospital said the patient was treated for “flu-like symptoms” and when those didn’t subside, the patient was tested further but the state Department for Public Health “determined the patient did not qualify for testing” for the coronavirus. However, “due to the patient’s condition,” hospital clinicians admitted the patient “into a negative-pressure isolation room,” to prevent spread of any viruses. “From there, the patient was transferred to a tertiary care facility,” meaning UK.

State Health Commissioner Steven Stack said in an email to the Louisville Courier Journal Saturday night, “Like other states, Kentucky has been following the CDC guidelines for who and when to test. This individual was tested when CDC guidelines and clinician judgment determined testing was medically indicated.”

The Washington Post reports, “Even where test kits are available, many states are following strict criteria for who should be tested to avoid overwhelming their labs.”

Stack said earlier Saturday, “The state of Kentucky has all the test kits it needs to test everyone we need to test at this time.” With commercial laboratories soon doing tests, “We hope that very soon people will be able to seek routine medical care and get a test . . . just like they would for the flu.”

Harrison County (Map from Wikipedia)

State and local officials said they expect Harrison County to have more cases, and Beshear said the county’s schools would close for “at least a portion of a week if not a full week,” as health officials had recommended. “We would advise that public gatherings be delayed,” and that nursing homes be closed to visitors, he said.

“We are not advising the closing of any business,” Beshear said. “What we are suggesting is engaging on social distancing, trying to stay six feet apart, and then practicing good hygiene, practicing really, really good hygiene: washing your hands, washing them well, washing them a whole lot more than you might have a month ago, and making sure that if you are sick, anywhere in Kentucky but especially in Harrison County, do not go to work.”

The virus causes a disease that has been named covid-19, for “coronavirus disease 2019.” Symptoms may include fever, cough or shortness of breath, and may appear in as few as two days or as long as 14 days after exposure.

Health officials continue to stress that washing hands with soap and warm water for at least 20 seconds is the best way to prevent transmission of the virus because it is mainly transmitted by tiny droplets from sneezes and coughs. Other suggestions include:

• Only use alcohol-based hand sanitizer if soap and water are not available.

• Avoid touching your eyes, nose and mouth with unwashed hands.

• Avoid close contact with people who are sick.

• Stay home if you are sick; especially do not visit with seniors or people with chronic health conditions if you are sick.

• Cover your cough or sneeze with a tissue and then throw it away.

• Get a flu shot. There is no vaccine for the new coronavirus, but the flu vaccine can boost resistance to it.

• Clean and disinfect frequently touched objects and surfaces.

The U.S. Environmental Protection Agency has released a list of EPA-registered disinfectant products for use against the coronavirus. The EPA’s news release says coronaviruses are one of the easiest types of viruses to kill with the right disinfectant.

Role players include consumers, employers, Congress

Beshear said that the threat posed by the virus is still low, but that he declared a state of emergency Friday to make sure the state has access to all of the resources available to it. He and other officials advised calm.

“We’ve gotten through this just like this, or even worse, in the past,” said Dr. Steven Stack, commissioner of public health. He advised against general use of face masks, or hoarding them, which could leave health care short.

At UK HealthCare, “Supplies of personal protective equipment are exceedingly low, and many items are on backorder,” UK Executive Vice President for Medical Affairs Dr. Mark Newman told employees, asking them, “Please be frugal.”

Beshear said he has invoked, for preventive and related items, the state law against price gouging, and has asked Attorney General Daniel Cameron to enforce it. Cameron issued a call for residents to report cases of price gouging by calling his office’s consumer protection hotline, 1-888-432-9257.

Dr. Crystal Miller, director of the WEDCO District Health Department, based in Cynthiana, said employers should take preventive measures: “I urge you to be flexible in everything that you do; be creative,” she said. “If your employees are sick, please be flexible with them.”

Beshear has urged employers who don’t offer sick leave to grant it, to limit the spread of the virus. He said Saturday that the state will offer its employees more sick leave than they have accumulated.

The state recently started doing its own testing for the virus, with one positive result out of the 14 test done through midafternoon Saturday. The figures are updated at kycovid19.ky.gov.

U.S. Sen. Mitch McConnell announced Friday that Kentucky would receive at least $7 million to fight the coronavirus. This money is part of a special $8.3 billion appropriations bill President Trump signed that day. McConnell’s news release said the funding “will be provided to state officials who will determine how the resources will be distributed.”

Asked Thursday if any of the money could be used by health departments to help fund their efforts in controlling the virus, Beshear said, “I am committed before this legislature ends or through any other powers that I have in making sure that we have sufficient funding to meet the threat. . . . This shows how important our local health departments are, doesn’t it? We haven’t appreciated those as a state in far too long and I think this serves as a reminder about how absolutely critical they are.”

“The number of public health workers in Kentucky fell from 3,449 in 2012 to 2,269 last year,” Chris Kenning of the Courier Journal reports, citing the Kentucky Center for Economic Policy. “The strain is particularly acute in small, rural health departments.”

Medicaid beneficiaries, take note

Beshear said the state will not require pre-authorization for treatment of Medicaid patients “for anything related to coronavirus.” On Friday, he said Kentucky is fortunate to have expanded Medicaid, something it did during the administration of his father, Steve Beshear.

“I do believe that we are in a better place to address this than many states because of expanded Medicaid,” he said. “I don’t mention that because of my belief in expanded Medicaid, but it does mean that there is more access out there, that people will have less barriers to get service.”

Beshear said Kentuckians should be wary of scammers and con artists claiming to have a cure or a vaccine for the virus, and to be wary of e-mails pretending to be the CDC or other public-health organizations, and people claiming to raise money to develop a coronavirus vaccine or to help victims.

Newman said most patients with covid-19 will be treated in local hospitals or at home. Officials have voiced concern that the disease and the flu will overload hospitals, and that people congregating in clinics could spread the virus.

“If you are sick, try to use the telephone first,” Stack said, adding that people with a fever and a cough should “take Tylenol and stay home and rest.” He said those who are concerned but not sick should call the state’s covid-19 hotline, 1-800-722-5725.

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