"Flying Blind": A Retrospective of the COVID-19 Pandemic in Kentucky

On March 6, 2020, a Kentucky resident from Lexington was tested for the novel coronavirus, COVID-19, and Gov. Andy Beshear declared a state of emergency.

The United States had been in a public emergency for more than a month.

Five days after the first case was reported in Kentucky, the World Health Organization officially declared COVID-19 a pandemic.

The NCAA canceled March Madness for “contributing to the spread” of the virus. The Metropolitan Museum of Art and the Museum of Modern Art have temporarily closed. NASCAR has suspended racing.

We had entered a time that Americans had not noticed since the flu epidemic of 1918. In other words, it was “uncharted territory,” Dr. Paul McKinney, interim dean of the University of Louisville and a professor in the School of Public Health and Health. Information Science, said in a September interview with The Lantern.

Over the next three years, about 2 million COVID-19 tests were conducted in Kentucky. More than 19,000 Kentuckians died.

Beshear has issued new orders, adding mass gatherings, final schools and releasing some prisoners at medical risk.

Some Republicans are now urging Kentuckians to make Beshear governor for a term, over his handling of the COVID-19 pandemic.

“Andy Beshear has let us down,” Republican candidate and state Attorney General Daniel Cameron said in an announcement. “He closed our prisons and opened our prisons. We can do better. “

A pro-Cameron PAC is running classified ads accusing a “criminal governor” of unleashing criminals on Kentuckians.

To help the electorate cope with criticism, The Lantern looks at the pandemic, a time of economic turmoil, changing policies, and widespread misinformation.

At first, the reaction to COVID-19 was “a brutal instrument,” said UofL’s McKinney, “because what can we do right now?

“We didn’t have any antiviral drugs to use, we didn’t have a vaccine,” he said. “We didn’t test well enough; We didn’t have enough (personal protective equipment) for everyone. Basically, we all had the ability to hint at the contacts of other exposed people and. . . Implement social distancing.

Tim Veno, executive director of a Kentucky nursing home and assisted living organization, agrees.

“We were kind of flying blind,” he said. We had no testing and no way of knowing who might or might not have had COVID. “

Until the science holds up, social mitigation is the only option.

In March 2020, Beshear, who had been governor for three months, issued recommendations and orders based on guidance from federal public health authorities, aimed at slowing the spread of the virus.

Almost as quickly, Attorney General Cameron began challenging some of the orders in court.

Not all of Beshear’s orders were restrictive. It simplified the procedure for out-of-state nurses to work in Kentucky, suspended evictions, and expanded eligibility for unemployment benefits.

The unemployment formula was temporarily defeated by the influx of programs, and others waited months for help. Meanwhile, the Louisville WDRB reported that Lt. Gov. Jacqueline Coleman texted the head of the Office of Unemployment Insurance to draw attention to his hairdresser application, as well as that of “friend of a friend. “Management claimed that there had been no abuse of power.

Beshear has also begun holding virtual press conferences, broadcast statewide, to share percentage data on the virus. Health experts welcomed the move, but it infuriated some of his political opponents.

And he encouraged Kentuckians to light up their homes green in memory of those who lost their lives to COVID-19.

When Beshear heard that schools would be closed for a few weeks, Spandana Pavuluri, a freshman at Louisville High School who is now 18, remembers thinking it would be “like an extended spring break. “Two weeks to catch up on homework, nothing more.

However, before the end of March, the virus shut down all public buildings in the United States, according to Education Week.

The prolonged isolation and loss of social connections at a pivotal time in his life “hit me like a truck,” Pavuluri said, calling it a “dark” time.

His room, where he studied, was a “place of. . . stress,” not relaxation.

The “truly social person” found herself very lonely, a sentiment echoed by other academics as part of the studies she helped conduct with the Kentucky Student Voice team.

In addition to school closures, in April 2020, Beshear halted elective surgeries so that medical and medical supplies could be contracted exclusively to combat COVID-19. It closed Natural Bridge and Cumberland Falls State Parks and suspended overnight stays at state parks.

When several Americans sued the state in defiance of Beshear’s restrictions on the interstate, Cameron officially sided with them. In another case, a federal ruling ruled that parts of the order were unconstitutional. Beshear picked her up before Memorial Day.

The state has banned visits to nursing homes in end-of-life cases. Leaders were concerned that visitors could spread COVID-19 to the most vulnerable.

“Of course, this has been devastating for some families,” Veno, president and CEO of LeadingAge Kentucky.

“After that, we mobilized very temporarily to establish remote communications, iPads and other connected devices so that we can immediately, at least, at a minimum, allow citizens and families to communicate over the internet,” Veno said. All very difficult decisions to make. “

Despite “some political repercussions” similar to those measures, Veno said, “in my opinion, this action has saved lives. “

After mass gatherings were suspended, some churches continued to hold in-person services, even though a religious revival in Hopkins County has been linked to at least 28 cases of the virus and two deaths.

A Bullitt County congregation met on Easter Sunday despite the order. The pastor discovered nails in the parking lot before the service. And attendees discovered notices posted by state police agents on their windshields asking them to quarantine.

Maryville Baptist Church in Bullitt County and Tabernacle Baptist Church in Nicholas sued Beshear. Attorney General Cameron joined the prosecution.

Two U. S. District Judges U. S. Centers for Disease Control ruled that Beshear’s ban on holding devotional gatherings was unconstitutional and that churches could simply celebrate in person while respecting precautions against the spread of the virus. But the U. S. Court of Appeals for the U. S. The U. S. Circuit Court for the Sixth Circuit disagreed and allowed the in-person restriction to continue. The appeals court blocked Beshear’s ban on drive-in movies.

Beshear agreed to allow places of worship to gather, but many chose to wait. The Rev. Kent Gilbert, pastor of the historic Union Church in Berea, told the Lexington Herald-Leader at the time, “No pastor needs to go back to church to celebrate the funeral. “

Todd Gray, executive director of the Kentucky Baptist Convention, told The Lantern that the denomination’s pastors and church leaders “make their own decisions” about protecting parishioners. “They were looking to be citizens who came forward in cooperation with the recommendations of the Centers for Disease Control. “and Frankfurt,” he said.

The theological confidence that Christians want to come together has also been factored into the return of some congregations to in-person meetings “as temporarily as possible,” Gray said.

He also believes that the state unfairly attacked churches during this period.

“While most Baptist churches in Kentucky tried to cooperate as much as they could with the governor’s recommendations,” Gray said, “most, if not all, felt that the governor had gone too far in particular targeting churches, while some businesses such as liquor retailers outlets remained open. “

In May 2020, angered by the mass lockdowns, protesters opposing COVID-19 restrictions hung Beshear in effigy at the state Capitol and marched to the governor’s mansion to call for his resignation.

Attached to the effigy was a sign with the words “sic semper tyrannis,” meaning “so to tyrants. “John Wilkes Booth said this after shooting President Abraham Lincoln in 1865.

Both Republicans and Democrats denounced those actions. Secretary of State Michael Adams, a Republican, tweeted at the time that “John Wilkes Booth’s words have no standing in Lincoln’s party. “

There have been other protests against lockdowns, social distancing and masking measures. Misinformation abounds, adding claims that the pandemic itself is a hoax.

The politicization of the pandemic has forced physical care staff to do their jobs, they said.

“It’s an incredible challenge for hospitals,” said Deborah Campbell, vice president of clinical strategy and transformation for the Kentucky Hospital Association.

In early 2021, when vaccines became available, Kentucky prioritized physical care staff and long-term care and assisted living facilities, followed by others over the age of 70, first responders, elementary and high schools, and child care staff.

Many, some fitness workers, have refused vaccination against the virus.

Once vaccinations were mandated through the Center for Medicare & Medicaid Services, those who refused vaccines may no longer show up at hospitals, Campbell said.

“It was extraordinarily painful. It was painful for the staff and for the hospital management,” Campbell said.

But in the end, Campbell said, the precautions saved lives. They also allowed hospitals to function better than if mitigation measures had not been implemented.

“Having fewer people in poor health means more staff are not in poor health and have to take care of patients in the hospital, which means they’ve gotten better care, which means they’ve had better outcomes,” he said.

However, fitness professionals are the most affected by people’s anger.

Some hospital visitors and even patients treated physical care in a “demoralizing” way, Campbell said.

They spat on them and cursed them.

“People have been threatened. Workplace violence is higher in our hospitals, especially visitation and restrictions on personal freedom,” Campbell said. “These restrictions on visitation were heartbreaking. But at some point. . . I think it was pretty transparent, which was the right thing to do.

LeadingAge’s Veno said that in his 20-year career in healthcare, “I’ve never noticed this kind of public backlash, anti-vaccine backlash like I saw with COVID. “

All of this contributed to fuel burnout and exacerbated an already worsening staffing crisis.

About 18% of businesses in Kentucky had to close their doors due to a mandate in 2020, according to the U. S. Bureau of Labor Statistics. U. S.

This is similar to the percentage nationally, which is around 19%.

The state designated staff as “essential” and “non-essential” so it could remain open with more flexibility. Grocery store employees, for example, were considered essential. Retail outlets for jewelry and clothing were “non-essential. “

Appointments remain a sore point for some. Cameron said he wanted Beshear to be “non-essential” on Election Day.

The Kentucky Economic Policy Center reported in May that the state lost 294,900 jobs in the first two months of the pandemic alone. Shops are permanently closed left and right. Thousands of people across the country closed their doors.

“In the three years since, Kentucky has seen a recovery,” Kentucky Policy said. He reported that Kentucky had 53,800 more jobs than before COVID-19 hit the state.

Cameron said in October that if he had been governor at the time, he would have closed small businesses and physical care spaces like chiropractic offices. He criticized what he called the “inconsistency” of Beshear’s decisions.

“There are a lot of small businesses right now that haven’t been able to recover,” Cameron said. “Many of them have closed their doors for good. “

Among other measures to stop the spread of COVID-19, Beshear closed restaurants to in-person traffic, suspended access to out-of-state state employees and halted criminal visits.

Beshear commuted the sentences of 1,870 medically vulnerable inmates who had been convicted of violent or sexual crimes.

Cameron and his allies have criticised Beshear’s pre-departure assessment. They cited knowledge from the Administrative Office of the Courts showing that approximately some of the 1,700 recipients on the move were charged with a crime in July 2023.

Republican state Rep. Kevin Bratcher of Louisville called for the figures to be updated from a 2021 report. In an Oct. 13 media crusade, Cameron, Bratcher and state Rep. Jason Nemes released the new figures and criticized Beshear. short-sighted decision” on the release of prisoners.

The Louisville Courier Journal and the Lexington Herald-Leader, however, reported that many of those repeat offenders would have been able to commit their alleged next crimes because their original sentences would have expired anyway at the time.

The Prison Policy Initiative, a Massachusetts-based national nonprofit that studies criminalization in the United States, reported in April that Kentucky’s overall population declined 13% between January 2020 and December 2021.

The national average is 15% over the same period.

Wanda Bertram, communications strategist at the Prison Policy Initiative, says the real mistake of Kentucky and the top states has been not releasing more prisoners, despite warnings that prisons would be “hotbeds for the spread of the coronavirus” and “endanger not only the people who are incarcerated and the other people who paint internally, but also all the net paintings that surround the prison.

Kentucky, like most states, continues to incarcerate other people for technical violations of probation and parole conditions, Bertram said.

“We’ve shown that mass incarceration likely added at least part of a million COVID cases nationally in the summer of 2020 alone,” Bertram said.

In 2021, criminal policy assigned scores to states based on their response to the pandemic of incarcerated populations.

Kentucky, like many others, earned an “F. “

“The Beshear commutations of 1,800 incarcerated people are a bright spot in what I would otherwise call a general public health failure when it comes to protecting incarcerated people and the communities surrounding prisons,” Bertram said.

Kentucky had the third-highest rate of COVID infections and deaths among prisoners between March 2020 and June 2021, according to the Marshall Project, which collaborated with The Associated Press to track it. According to the report, those numbers are underestimated because inconsistent testing has been conducted. in infections that are diagnosed, especially in the early stages.

During the 15 months, Kentucky recorded:

In the end, 8 Kentucky state prison workers died from COVID-19, the Department of Corrections announced earlier this month.

At the start of the 2020-21 school year, four states had mandated the opening of in-person schools, but in Kentucky, most schools were continuing with remote learning.

In November, a fatal “third wave” struck, and Beshear announced the closure of public and K-12 schools.

Danville Christian Academy and Cameron challenged the school’s closure order and won before U. S. District Judge Gregory Van Tatenhove. But the U. S. Court of Appeals for the Sixth Circuit upheld Beshear’s order, saying it treated all schools, or otherwise, equally.

The appeals court took note of one of Beshear’s justifications: “Kentucky leads the nation in young people living with family members other than their parents, adding grandparents and great-grandparents, who are particularly vulnerable” to the virus.

The U. S. Supreme Court declined to hear the case.

By early 2021, a year into the pandemic, most in Kentucky had returned to in-person learning.

Some studies suggest that school closures helped keep COVID-19 transmission lower than if doors had remained open, but children suffered from disruption to their education.

In 2021, researchers at Harvard Medical School found that while most children with COVID-19 were mildly symptomatic or even asymptomatic, they could still transmit the virus to others.

Many children experienced learning loss in remote and hybrid categories in 2020 and 2021 across the country, according to a 2022 study by Harvard University’s Center for Education Policy Research.

In Kentucky, reading and math skills declined during the pandemic when comparing 2018-2019 tests to 2021-2022 data.

At the time of the October report’s release, Education Commissioner Jason Glass said in a statement that “the COVID-19 pandemic has had a profound effect on our students and schools as they continue to recover from the disrupted learning that occurred over the next two years. “

Cameron said that if elected governor, he would put in place a “catch-up” plan that included mentoring systems to bring young people up to speed.

Looking back, Pavuluri, a freshman public policy major at Vanderbilt University, says that despite disruptions to her education, school closures and other restrictions were worth it.

Because her mother is a geriatrician and works with older adults, she felt more empathy for others at higher risk.

“So, for me, it’s been in my brain and COVID is anything that I feel like I’m taking very seriously,” she said. “I didn’t necessarily have someone very. . . immunocompromised in my family. (But) I think I actually sympathize with academics who do it.

“Obviously there’s . . . some negative facets of this experience,” he added, “but I think the only main negative facet would have been. . . waste someone. “

Kentucky is known to be one of the sickest states: ranked as the third unhealthiest state by Becker’s Hospital Review in January, ahead of West Virginia and Mississippi.

“Everyone had an explanation for why to expect that we would surely be devastated” by COVID, said UofL’s McKinney.

Kentuckians suffer from high rates of central diseases, diabetes, and cancer. And the state’s population is aging. All of those points mean that many Kentuckians entered the pandemic with at least one “comorbidity,” a pre-existing condition that puts them at higher risk for COVID-19 headaches and potentially death.

“Among our neighboring states, we were so much more than almost all of them,” McKinney said.

And yet, the CDC’s mortality data, covering only 2020 and 2021, shows that Kentucky’s death rate is lower than Tennessee and West Virginia’s, despite being higher than Indiana’s, Ohio’s, and Virginia’s.

McKinney credits the measures “implemented through leaders and the state” with saving lives in Kentucky.

A study published in April in the foreign medical journal The Lancet took age and fitness into account when comparing states and found that Kentucky’s death rate is lower than the national average after adjusting for comorbidities.

Kentucky’s unadjusted COVID-19 death rate between January 2020 and July 2022 was 472 deaths per 100,000 people, above the national average. However, after adjusting for age and comorbidities, the rate of 341 deaths per 100,000 population is lower than the national rate. of 372.

The state with the lowest adjusted death rate is Hawaii (147 per 100,000 population). The highest, Arizona (581 per 100,000).

In April 2020, professors at the University of Kentucky’s Gatton College of Business and Economics published a study estimating that the state’s situation would have been worse if social distancing measures had been implemented from the start.

The U. K. did not send those researchers to The Lantern for this story. At the time, they estimated that Kentucky would have recorded 45,000 cases as of April 25, 2020, if the state hadn’t closed communal businesses like gyms and restaurants. . Instead, the state had about 4,000.

The researchers estimated that a month into the pandemic, those moves saved about 2,000 lives.

A more comprehensive study by the Royal Society of London tested the efficacy of non-pharmaceutical interventions (NPIs) such as social distancing and mask-wearing during the COVID-19 pandemic around the world.

The August 2023 report shows that social methods such as mask-wearing and physical distancing reduce the spread of the virus. However, scientists have found that this is especially true when potent variants such as Delta and Omicron, which are effective at evading protective barriers, do not spread.

“Could they. . . Could they ease restrictions more quickly?allow us to return to normal life more quickly?It’s a tough call,” McKinney said. You have to do it a little by ear. And again, you’re looking to get it wrong in the aspect of overprotecting human life.

“In hindsight, everything is clearer,” he added.

“I think under the leadership of the public health commissioner (Dr. Steven Stack) and the governor, who worked intensively together to implement the policy, the main fears are the preservation of lives,” McKinney said.

“The freedom of others is very important. But if you’re dead, you can’t be free,” he said. “So if you keep life going first and then. . . You’re worried about the point of rigor in life. “the controls you’ll want to implement later. I think that was the overall plan: to be as strict as possible to hopefully prevent the spread of the virus.

Kentucky’s reaction to COVID-19 hasn’t been perfect, experts say, and the state may be well informed for the future.

For example, Kentucky needs more surveillance of viruses that are breathed, automated data reporting, and well-maintained stocks of personal protective equipment.

The ability to temporarily produce vaccines will also allow the government to rely less on social mitigation measures, McKinney said.

Kentucky, and the country, will want to avoid complacency, McKinney said. While we “hope” there won’t be another pandemic in the near future, “there are no guarantees. “

Kentucky also wants to rebuild its physical care workforce. The pandemic has “imposed” physical care staff “beyond imagination,” Veno told LeadingAge. And the staffing disruptions this has caused continue.

KSVT’s Pavuluri said leaders want to keep in mind that academics want social connections, mentorship and relationships. Many missed it while learning NTI and will want it in the next public fitness crisis, he said.

And while the COVID-19 emergency years are over, “staffing is still a huge issue,” said Campbell of the State Hospital Association.

“We’re incredibly involved as hospitals and hospital agreements in the pursuit of building the pipeline and retaining the one we have,” he said.

Before the pandemic hit, she says, the trajectory of the aging nursing workforce was already worrisome. Then we had COVID, which led to burnout. “

If we look to the future, the climate update is a concern.

“Global warming will affect . . . much of the disease transmission,” McKinney said. “If the winter weather that wipes out the mosquito population every year didn’t, they survived, thrived, and carried something akin to malaria. . . During this entire period, it would be. . . A wonderful concern, of course, for the nation. “

COVID-19 is increasingly becoming an annual flu-like nuisance, public fitness experts said. People will get sick, but the science exists to control big waves.

For now, many services continue to follow universal precautions, such as dressing in private protective equipment, in case of outbreaks. They also use detection equipment to keep the spread low.

“Make no mistake about it,” said LeadingAge’s Veno. We’re still dealing with COVID and will for some time. “

Jamie Lucke and McKenna Horsley contributed to this story.

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by Sarah Ladd, Kentucky Lantern October 18, 2023