After a brutal delta surge, COVID is waning in Kentucky. Is it too soon to celebrate?

Deborah Yetter Sarah Ladd
Louisville Courier Journal
Dr. Sherry Babbage-Melisizwe and her husband Loiso Melisizwe sit with their grandkids. 11-year-old, Chloe Sturgeon, is still to young to get a vaccine for COVID-19 but at 15, her sister Brooke Sturgeon, is vaccinated.
Oct. 24, 2021

After an onslaught of COVID-19 hospitalizations in recent months, Dr. Valerie Briones-Pryor welcomes a decline in cases at the University of Louisville Health hospitals where she works.

"It's much better in regards to COVID, much better," she said. "I feel like we can breathe."

After several months of soaring hospitalization rates statewide, rising deaths and hospital staffing shortages so acute that the Kentucky National Guard stepped in to help, COVID-19 cases and hospitalizations are falling.

The most recent COVID-19 wave involving the new, more contagious delta variant started around July — just as it appeared cases had eased — hitting unvaccinated individuals the hardest, including more younger adults.

"When this wave came, it was a lot of younger patients, not vaccinated," Briones-Pryor said. "They came in sicker and stayed longer."

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And while a decline in new cases is good news, public health officials say they're not ready to declare defeat of a virus that has overshadowed daily life in Kentucky since the first COVID-19 case was detected in March 2020.

Since then, Kentucky has experienced several waves of the virus, resulting in more than 734,000 cases and nearly 9,600 deaths.

"It's almost certain we will have another wave at some point, but hopefully, it won't be as bad as what we've just been through," said Dr. SaraBeth Hartlage, associate medical director for the Louisville health department. 

And Hartlage said such waves of COVID-19 can happen fast.

"It takes no time for the numbers to climb very high," she said. "It takes a very long time for them to crawl back down."

Still, officials say there are grounds for optimism.

More people are getting vaccinated, with the vaccines continuing to prove highly effective at preventing serious illness, hospitalization and death. Kentucky reports that 92% of hospitalizations and 82% of deaths from March 1 through Oct. 20 of this year were among people not vaccinated against COVID-19. 

Additional "booster" shots of vaccines are now widely available to those concerned about waning immunity from vaccines that first became available in December 2020.

And as early as  this week, a COVID-19 vaccine could be approved for children as young as 5, which public health officials and many parents say would be a huge benefit as schools work to stop the virus from spreading and keep kids in the classroom.

Currently, vaccines are approved only for children 12 or older.

Dr. Sherry Babbage Melisizwe, a U of L dental professor, said she is eagerly awaiting approval of vaccines for younger children because it means she will be able to get her younger granddaughter, Chloe Sturgeon, 11, vaccinated.

Chloe's older sister, Brooke Sturgeon, 15, is already vaccinated, Melisizwe said, and had no problems other than a temporary sore arm. Sherry Melisizwe and her husband, Loyiso Melisizwe, care for the two girls.

"I'm really happy, I'm excited — I don't like sick kids at home," said their grandmother, who became an early advocate for the COVID-19 vaccine through the family's church, St. Stephen, in Louisville. "I absolutely trust the vaccine."

Public health officials, some with young children of their own, welcome the vaccine for kids ages 5-11.

"I know there are some parents who are just itching to get their kids vaccinated," Hartlage said. "I have a 6-year-old who will be getting hers on the first day it's available."

Meanwhile, she said she thinks falling cases and basic precautions can ensure a fun Halloween for kids this year.

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Kentucky's rates of positive COVID-19 cases, which peaked at approximately 14% in September, had dropped to 5.08% by Friday. Public health officials say a positive rate of 5% or lower is their goal but are happy to see the decline.

"I think trick-or-treat outside is probably fine this year," Hartlage said before the weekend. "But you probably don't want to be at a crowded party where you don't know the vaccination status of everybody that's there with you."

Dr. Mark Burns, an infectious disease specialist with U of L's medical school, said another factor in falling COVID-19 case numbers may be vaccine mandates imposed by an increasing number of employers, including U of L Health, where he works.

"It would appear that some of the vaccine mandates by private companies have helped as well," Burns said at a recent news conference. "The more people get vaccinated, the better off we are all going to be."

Officials including Gov. Andy Beshear continue to urge basic precautions, including getting vaccinated and wearing a mask at most indoor settings.

"Let's not punt on the third down," Beshear said at a recent news briefing. "Let's not cheer and celebrate while we're still where we are."

'A lot to look forward to'

In some ways, life is slowly returning to normal.

After months of remote instruction at home, most children have returned to school, though masks generally are required for in-person instruction.

In Jefferson County, a voluntary "test to stay" program allows kids exposed to someone with COVID-19 to stay in school rather than quarantine at home if the student tests negative. Jefferson County Public Schools adopted the program in October; the Archdiocese of Louisville also has adopted it for Catholic schools.

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Briones-Pryor said the program allowed her son, 8, to remain at his grade school after a classmate tested positive for COVID-19.

"I'm really happy we implemented that in our schools," she said.

High school and college sports events have resumed.

And activities are returning to downtown, including performances at the Kentucky Center by the Louisville Orchestra. "Waitress," a popular Broadway show, part of the PNC Broadway series, opens at the center in November.

And that means a return of evening hours for the Bristol Bar & Grille on Main Street near the Kentucky Center for people coming downtown for the shows.

"The business downtown really depends on everything around it, including people coming to work downtown and coming to the arts center, to museums," said T.J. Oakley, operations director for the restaurant. "We kind of feel like it's important for us to be part of that reopening."

Another sign people are venturing out and planning more social events: Oakley said the Bristol's catering and event business is picking up, including bookings for receptions and parties.

"We're excited about the upcoming year," Oakley said. "We think that there's a lot to look forward to."

Public health officials agree the coming year may look better but said not to underestimate COVID-19.

About 57% of the state's population is vaccinated, according to the state Department of Public Health, and many more need to be vaccinated to stop the spread and potential mutation of COVID-19 into something more contagious and dangerous, they say.

"Eventually, we will probably have another variant to deal with, and that's sort of what keeps me up at night," Hartlage said.

COVID vaccine rate still a concern

Lagging vaccine rates remain a concern for public health officials who are working to reach and convince the many Kentuckians who haven't gotten the vaccine.

While vaccine rates are edging up — in part, after people witnessed the severity of infection from the delta variant — they are still doing so more slowly than when vaccines were introduced 10 months ago.

Briones-Pryor said some of her hospitalized patients, including adults, were surprised by how severely ill they became with COVID-19.

"The disheartening thing with this wave is that we knew there was a vaccine out there," she said. "Had people just gotten it, maybe it wouldn't have been as bad as it was."

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In late May, Kentucky enjoyed a brief respite from COVID-19 and by early June, Beshear held a press conference announcing the end of the mandatory state mask mandate in most public venues.

But statewide vaccination rates stalled over the summer with just over half of the state's residents vaccinated.

And within weeks of Beshear lifting the mask rule, cases began to climb after the delta variant became the dominant strain.

The number of patients hospitalized in early summer had dropped to fewer than 200 patients a day in July. But that shot to 2,500 or more per day in September, overwhelming most of the state's hospitals.

New cases of COVID-19 infection reached more than 5,000 a day after dropping to a few hundred a day in May and June.

Soon public health officials were urging a return to masks in public. Beshear can no longer order them after lawmakers reduced his emergency powers during the 2021 legislative session.

Beshear continues to warn of the risk of another outbreak.

Avoiding it will come down to how many people get vaccinated, how many people survive COVID-19 and how the virus mutates, he said. 

"Some are predicting this or that," he said. "Those predictions have rarely been right. What is within our control, again: vaccines, wearing a mask when it's the right thing, getting the boosters." 

The 'escape' variant

Meanwhile public health officials are closely watching potential new variants, or mutations, of the virus, including one known as lamda and another called mu, named after letters in the Greek alphabet.

Burns said that those variants and some others are considered "of interest" by the U.S. Centers for Disease Control and Prevention but that so far they haven't shown a widespread impact.

A key concern for public health officials is that a variant will be able to possibly bypass, or escape, protections of the vaccine.

"I think we've been lucky so far that every variant has been vaccine sensitive," Hartlage said. "We have not had a true escape variant."

Briones-Pryor said the public likely will have to learn to live with COVID-19, though she hopes the risk will be greatly diminished by vaccines.

"COVID is not going away," she said. "We're going to have to deal with it in some aspects, just like we do with the flu."

Reach Deborah Yetter at dyetter@courier-journal.com. Find her on Twitter at @d_yetter. Support strong local journalism by subscribing today: www.courier-journal.com/subscribe. Reach health reporter Sarah Ladd at sladd@courier-journal.com. Follow her on Twitter at @ladd_sarah.