“We Are On Fire”: Kentucky Governor Andy Beshear on Pandemic Surge Pushing Hospital Capacity to Brink by the Unvaccinated

Alexis McGill Johnson

[ Music ]

Female: Welcome to Conversations on Health C are with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health innovation, health policy, care delivery and the great minds
who are shaping the healthcare of the f u ture

This week Mark and Margaret speak with Democratic Kentucky
Governor A ndy Beshear on the raging surge of COVID - 19 f ueled by the
Delta variant. H e talks about deploying the National Guard to assist
hospitals at the breaking point . T he increased number of young
people getting sick a nd efforts by the GOP run legislature to block his
executive order powers , reversing his call for a mass mandate for kids
in school.

L ori Robertson also checks in , the Managing Editor of Fact C heck.org
looks at mis s tate ment s sp oken about health policy in the public
domain separating the fake from the facts . And w e end with a bright
idea that's improving health and well - b eing in everyday lives.

If you have comments, please email us at CHCRa [email protected] or
find us on Facebook, Twitter, Spotify or wherever you listen to
podcasts. You can also hear us by asking Alexa to play the program.
Now stay tuned for our interview with Kentucky Governor Andy
Beshear here on Conversations on Health Care.

Mark Masselli: We're speaking today with Kentucky Governor Andy Beshear , a
Democrat and 63rd G overnor of the Commonwealth. He previously
served as Kentucky's Attorney General .

Margaret Flinter: Governor Beshear has fought for the protection of the Afforda ble
Care Act and for Medicaid expansion. He's been issuing broad public health directives to stem the spread of COVID - 19 in his State , and
that's led to some legal challenges. Governor Beshear w elcome to
Conversations on H ealth care today.

Andy Beshear: Th ank you for having me.

Mark Masselli: Yeah, Governor, you know, the resurgence of COVID - 19 is really
causing havoc all across the country, but particularly in the S outh,
where many of the G overnors have aggressively sought to limit public
health measures, like mask wearing, for instance. But in fact, in your State , the State Supreme Court just upheld a challenge by the
Kentucky legislature, which sought to limit your executive powers in response to the pandemic. And it i s hard to believe that the judge
use d the word ‘ tyranny ’ to describe your mask mandate for K - 12
school children .

H ow's the court's decision impacting your overriding objective to keep
the population of Kentucky safe?

Alexis McGill Johnson

Andy Beshear: Well, it seems these days that name calling is not confined t o just
sum and tyranny now means I disagree with you. Listen from the very
start of this I was committed to doing the right thing , to follow ing the
science because at the end of the day, I care about the lives of my
people, a lot more than I care about my own personal popularity. And
so along the way, I've had to make difficult decisions.

Now it's everything from when we had to be healthy at home, to
when we previously had a mask mandate in Kentucky, to my decision
to require it in universal masking in publ ic and private schools , h ere as
we went back in the Commonwealth . And I did those knowing that
there would be backlash, but having the courage to just do the right
thing . A nd knowing what it is.

And in these instances, it's not just right versus wrong, and life versus
death. It's what works and what doesn't. If you have universal
masking when a class goes back, you can stay in - person, if you do not
wear masks, you end up with everybody in quarantine.

So I was willing to do the right thing and to push forwar d even with
the criticism out there. Now Supreme Court recently came out and
said, I'm not going to be able to carry the ball anymore, that these
tough decisions instead of being made by one individual that has a
little more latitude to do the unpopular th ing, if it's the right thing,
that they are going to be made by you know, legislature consisting of
over a 100 people, and maybe harder.

And that legislature has suggested before that they don't agree with
mask mandates, but I'm certainly going to push and do my best to
provide the education to show them that that is the only way right
now. Because as we're talking, I just got news that we have the third
highest number of cases in Kentucky than we have had at any time in
the pandemic. And that's with over 6 0% of adults in Kentucky having
at least one shot of vaccine. And today, we announced 65 deaths. We
were down to three a day I was looking forward to zeros , numerous
days in a row which I hadn't yet had the opportunity to see. So our
State and the South, w ill be the entire United State s is on fire with the
Delta variant. Now more than ever, we've got to make the right
decisions guided by public health to save lives.

And I'll also say and we can talk about it. Our hospitals are bursting at
the seams. We have one that has a disaster plan in effect the disaster
plan people are being treated in their cars outside of them. So we're
calling in the National Guard to help where we're trying to take over
testing for some of them to free up staff. And we've asked FEMA for
help. So this is a time when we need strong leadership and I hope the
legislature will step up and make the right decisions.

Margaret Flinter : Well, Governor Beshear, we are sorry to hear this. It's of course,

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exactly what we're reading. The numbers don't lie. And while we can
talk about the fact that much of this was preventable, if we could
have gotten out there sooner getting people to be fully vaccinated ,
t he reality is you have to deal with what you have on the ground right
now.

Tell us more abou t the impact of this D elta surge on your State . How
is it affecting life in your State ? Share with us a little more about the
hospital situation , y ou've got hospitals and health cent er s, clinics all
over the State , h ow is it affecting the whole healthcare system in your
State ?

Andy Beshear: It's dire. And when they say this thing is aggressive , t hat's not a good
enough word for it. It's like an inferno. How quickly it escalates , cases
going from in April or early June in the hundreds to like, we have 4800
n ew cases today, more kids than ever before. It u sed to be about 11%
of our cases were kids, it's now 20 % plus. Remember, little kids don't
get tested t hat often. It's making people sicker from the very
beginning and we're losing younger people in their 30s and 40s ,
w ithout preexisting conditions.

We're seeing more breakthrough cases primarily with those that'll be
helped by the by the booster that the immunocompromised can
already get. But its impact on hospitals, especially hospitals in areas
with lower va ccination rates can't be under s tate d. Most of these
hospitals aren't used to helping higher acuity , sicker patients. Most of
them don't have that many ICU beds. And almost none of these
hospitals have pediatric ICU beds. And so we see the ICUs filled up , we
see operating rooms being turned into additional COVID wings . A nd
we see our healthcare heroes so tired.

St. Clair and Morehead is in their disaster mode where they can't take
any more emergencies and the ambulances are pretty much running
people to oth er hospitals . Pikeville Medical Centre as a triage tent
outside of the ER to push some to other places who might not need
an emergency care. Ephraim McDowell, which is a hospital where
people don't die because they're transferred to you know, higher
level trauma. Hospitals had seven pass away over the weekend. The ir
morgue only fits two. So we saw refrigerator trucks.

And I've declared this week Healthcare Heroes Appreciation Week
because they are so tired a nd they've gone through so much trauma.
And we've got to keep our healthcare staffing up at a time when so
many are saying I've already fought for too long. So this D elta variant
which you're right was entirely preventable i f people would have
gotten vaccinated to protect their families. It's having a maj or toll on
Kentucky and it's going to have a major toll on the entire country.
Because what we're learning is you can have a lot of your population
vaccinated. But with this D elta variant, you got to get close to all of

Alexis McGill Johnson

them vaccinate.

Mark Masselli: Gov er nor there, kids are going back to school now, without
vaccinations , without masks so virtually no protection against the
virus, leading to massive quarantines. And I believe you ’d like in this
scenario to throw in a giant chicken pox party only with a thir d
deadliest illness in the country.

I wonder if you could talk a little more about the dangers you see for
the State 's children s the teachers but also some of the strategies that
you're doing having to work around the General Assembly because I
know your a dministration is trying to educate and reach into all the
neighbo r hoods of Kentucky.

Andy Beshear: Well, this one i s real personal to me. I'm a dad of two middle school
children. One is 12 , Will is fully vaccinated. I broke down in tears when
he could get his first and his second shot. But my daughter , his sister,
is a year younger , is 11 a nd she can't get vaccinated yet. Thankfully,
they go to a school that chose universal masking. And then I stepped
up and required it because we had one school district Wa rren County
Public Schools that went back mask optional , t hey were one of the
first and in three days had over 700 Kids in quarantine, that rose to
1500 kids in quarantine . W hen I put in universal masking and they've
been there since that has been cut in h alf and is going down.

So listen , one works universal masking that newest study that came
out cutting transmission by 80% with unvaccinated kids in poorly
ventilated classrooms for hours at a time you're right , i s like a giant
chicken pox party with third leading cause of death in America. I
mean, come on, we can't be allowing that to happen to our kids . And
keeping our kids safe isn’t some issue of personal liberty c ome on.
Our kids aren't our property, they are not an opportunity for us to
have our politi cal arguments, they are a solemn obligation.

And right now we require what we mandate 12 + vaccines by the time
you're in sixth grade , 30 p lus shots that are out there. And all we're
asking them to do is wear a piece of cloth over their face that helps
prev ent the spray and the spread. It was every education group that
supported the mandate I put into schools .

T he leader of the Kentucky superintendent Association, it was our
Kentucky Chamber of Commerce, which hadn't always been with me,
and the steps I've h ad to take because they are certain. And it's a fact
that if a ton of kids are quarantined, which they will be mask optional,
a ton of parents can't go to work. That's lesser productivity and has a
direct hit on the economy.

So right now, we still have, at least in public schools, the mandate in
place because our Board of Education courageously and unanimously,

Alexis McGill Johnson

passed an emergency regulation as well. But private schools, and
maybe in the future public schools won't have that mandate, in effect.
So what I'm doing is I'm trying to talk to every Superintendent ,
anybody that will listen to me . A gain, you might have a couple parents
that are upset with you now. But when their kids are quarantined, or
tested positive, they're going to be a whole lot more angry.

A nd with more kids suffering long term consequences I hope people
don't say, “W ell, you only have 21 kids in the pediatric ICU ” first that's
more than we've ever had. And second, we got kids in adult ICU that
we don't have in that count , b ecause we only hav e two pediatric ICU
units in the entire State . This ought to be a no brainer. And if I sound a
little frustrated about it, I am because my kids are the most important
thing in my life, and they ought to be for everybody else.

Margaret Flinter: Well, Govern or, we totally appreciate your frustration. And we'll be
talking about this one for a long time , try and understand how
something like immunizations went from being a very small minority
of people who opposed the m to where we are today.

But, you know, alo ng the way, we had to heard an awful lot as we
conducted vaccine campaigns. One of the arguments people put out
was, well, this wasn't a fully approved or authori z ed vaccine it was
still, you know, emergency use kind of in the experimental phase. B ut
that argument is over now too, right . T here's been the full
authorization of the vaccines . D o you think this is actually going to
make a difference in vaccine uptake in your State ? And what other
strategies are you and your team deploying to try and increase th at
vaccination rate? The numbers have been going up around the
country , b ut what else are you doing to try and get people to change
their minds and get vaccinated?

Andy Beshear: Well, full FDA approval should move a lot of people because you hear
a lot of people say it. I think in general, we have two groups of people
left that are unvaccinated. You have those that have been provided
misinformation. But believe it on a couple of topics that if we could
get the right information from someone they trust, tha t they'll get
vaccinated . Many are some that are just politically opposed to it, and
short of being ventilated themselves, at which time they will beg for
the vaccine (inaudible 00:13:21) that they will get it.

So for the groups that misinformation does ap pear to have created
skepticism, but maybe not lock them off. I think this concept that it
was rushed ought to now be settled , full FDA approval is a gold
standard. It's what the smallpox vaccine and chickenpox vaccine and
polio vaccine, all of which we ha ve taken and we are still here. But the
other thing that I would say is half the country has taken this vaccine,
at least one out of every two people that you come across h as taking
this vaccine. So if there's a problem with it, we'd know it by now.

Alexis McGill Johnson

And th e other two myths we got to directly debunk that it can make
your sterile entirely not true. But we've even had Kentucky leaders
that have been telling people that falsely , as well as a concept that if
you're pregnant, or you want to become pregnant, you s houldn't take
it , t he CDC ha s directly addressed that saying it's much more
dangerous to be unvaccinated and pregnant, then vaccinated . A nd
really across the country , I think it's rightful fear of the Delta variant
that's truly driving it.

Here in Kentucky , we have a lottery. We've made two millionaires, I
get to make another one on Friday. We're giving away full ride
scholarships to kids. I can't imagine a better thing for us to do to
encourage people to get vaccinated , but just a great thing to do in
gene ral. I get to give my next five out so I feel like Willy Wonka. This is
the third set of five kids that get their golden ticket.

We've got our MCOs are Managed Care Organi z ations Medicaid,
offering money though we're still not seeing a lot of people come
a round to that. So we're learning a lot about incentives right now. I
think what we're really going to see now that we have full FDA
approval is private sector mandates because this is their workforce,
and their workforce could be wiped out very quickly. Lo ok at Tyson
y ou know, Tyson Chicken you got their huge operations, and COVID
can spread and ravage a facility there. I remember because we had to
shut one down for a couple of days. That's a workforce that if you
want to protect it and remain productive, t hat that vaccine is really
necessary. I see that as the next big step t hat's going to boost
numbers.

Mark Masselli: I think you're absolutely right. We're speaking today with Kentucky
Governor A ndy Beshear . Governor, your father, former G overnor
Ste ve n Be shear joined us in 2013. And, you know, he spoke
eloquently about the reasons for the Affordable Care Act and the
Medicaid expansion, a rare position amongst Southern Governors.
And your predecessor, though, tried to dismantle much of those
gains. And you' ve really tried to correct that of course.

And I remember your father telling us that the ACA was not only good
health policy for Kentucky, but it was good economic policy. And the
same logic could really apply to vaccines. And I think you've said that
one hospitali z ation could cost hundreds of 1000s of dollars. And I'm
wondering as G overnor, you have to think about these things. Help
our listeners understand the economics of prevention and public
health measures , and why vaccines are truly the best hedge a gainst
both health and economic calamity ?

Andy Beshear: Well, first, let me say Steve Beshear is a great man, a great dad and
was a phenomenal G overnor. And him embracing the Affordable Care
Act and expanded Medicaid is one of the reasons that Kentucky a

Alexis McGill Johnson

S tate that was predicted to have one of the highest per capita death
rates in this pandemic has not , because access to health care is the
difference between life and death and expanded Medicaid is
absolutely necessary to expand access.

A nd let me say I was honoured to fight for that program . M y dad
instituted the Affordable Care Act as G overnor. And as Attorney
General, I was the co - lead with Xavier Becerra in fighting to protect it .
T he biggest legal victory of my life will be that ultimate Supreme
Court d ecision that i n part bears my name in the Commonwealth, that
preserve that legacy coverage for pre - existing conditions, expanded
Medicaid, you name it . A nd to be able to protect a little bit not just of
how incredible it is , b ut my father's legacy is somet hing that I will
forever be grateful for .

A ny State that hasn't expanded Medicaid absolutely needs to . A nd I
will say during this pandemic, we had to take additional steps. You
know, before the pandemic, I rescinded the Medicaid waivers that my
predecessor had done that would have kicked 100,000 people off
their health care. But we were at a point last summer, where African
American Kentuckians were dying at twice the rate that they make up
of our population, the reason was access to health care. And so we
le d a specific marketing campaign directly to that in our Hispanic
population to get folks signed up . A nd guess what being i ntentional
works . Sure, a lot of people tried to say free health care for one group
or the other , listen it was available for everyb ody. But now our death
rates line up with or are below our population numbers be ing
intentional works.

Now I know, the second part of your question was about the
economics of this. And eventually, I think our insurers and others are
going to come around an d you're going to see some major movement
there. To get your shot out, get your vaccine cost you $0 . F ederal
government is paying for it in general. And typically it costs your
insurer, your employer $0. And what that does is give you a really a
90 % plus c hance of never being in the hospital and not dying of COVID
a nd even better chance there.

Now, if you are unvaccinated, and you end up in the hospital, your bill
is likely going to get close to $100,000 i f not 30 , 60 , 90 ; a nd if you end
up intubated , o h my goodness. So your decision to not get vaccinated
causes huge costs to everyone's insurance plans , to your employers
will ultimately drive everybody's costs up.

Now there's going to be a point where these insurance plans just like
if you're a smoker, you c urrently have different costs are going to say
if you refuse to get vaccinated, we can't carry that huge bill. So I think
that's going to be another mover that you're going to see . B ut let's
bring it down to a human level , i f you're unvaccinated, and you e nd

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up taking up a hospital bed, and our hospitals are bursting at the
seams. And we have an accident with a bus o f school children , a bus
of adults and that’s where mo re of those people die. That's it , more of
them die. It shouldn't. Your friend who has a heart attack dies and
shouldn't . A cause have a choice to not get vaccinated, land s you in
the hospital, when that bed would otherwise be open. There is an
economic cost. But there's a huge personal cost to o where your
decision could take somebody else's l ife and not just from COVID.

Margaret Flinter: Well, Governor, all compelling stories and observations and this idea
of there simply not being enough beds is very real in your State and
around the country. But I think what we've also seen is there may be
b eds, and there may simply not be enough ICU nurses and intensivist s
to staff those beds . A nd we've talked about some of the reasons the
exhaustion from, you know, a solid, you know, 20 plus months of this .

I wonder, and I really appreciate your designation of the Healthcare
Heroes Weekend , I'm sure all the health care workers in your State
appreciate it. What other strategies are you looking at in terms of
keeping a workforce in place to be able to manage this . I t's just, it's
not going to go away soon. The people that are there today may not
be able to carry this burden indefinitely into the future. Are you
looking at training other kinds of workers? Are you bringing in
healthcare professionals from around the country? What are your
university and academic medical cent er s and other groups doing to
try and help you meet the incredible needs so that where there's a
bed, there's also a well prepared ICU nurse or intensivist s , to take care
of people.

Andy Beshear: W ell you are right and it’s probably not going away in the immediate
term. But I really think it's important that everybody hears that we
could defeat this thing tomorrow, simply by going to your drugstore,
your grocery store, your local health department and getting
vaccinated. And if everybody got va ccinated tomorrow, we could
substantially end this whole thing. It's right there in front of us a nd
the ability for us to win .

In Kentucky t his has taken more lives than any two are now I think,
three wars that we have been through, put together. Think abo ut
that. If you were in the midst of a war, and you could win tomorrow,
right , just by going to your drugstore, you would do it.

So you're a 1,000% right, in that it's not actual beds , i t's our ability to
staff it. And so we're trying to do a couple things . Yes , f irst, we're
trying to show our appreciation and give a second win to the Warriors
on the frontline. We're also trying to amplify them. We're sending
National Guard strike teams to the hardest hit hospitals to try to take
over any non - medical functi on that we can free up more people to
staff beds and help people out. We've requested help from FEMA,

Alexis McGill Johnson

and they're going to bring in more ambulance units because we're
running short on our ability to help in emergencies because of the
transfer of patients , we've asked for nurse strike teams, we get this is
happening in so many other State s .

R ight now we're working on a way where we can move in and take
over the testing that all these hospitals do because that frees up more
people to ultimately help out.

I wa nt to make sure the number one we say the number one thing we
can do to preserve healthcare capacity is get vaccinated. Number two
is to wear a mask.

Mark Masselli: We're speaking today with Kentucky Governor A ndy Beshear . You can
learn more about his lea dership and his efforts to address the
pandemic in his State by going to www.covid19.ky.gov . You can also
follow him on Twitter @G ovAndyBeshear.

Governor t hank you so much for the example , y ou're setting , the
coura ge of your convictions , for your efforts to ensure that all of your
State residents have health coverage and for taking the time for
joining us on Conversations on Health Care.

Andy Beshear: Well, thank you and we always end our updates with a simple phra se ,
“ We will get through this and we will get through this together. ” And
e verybody go get vaccinated.

Margaret Flinter: E verybody go get vaccinated.

[Music]

Mark Masselli: At C onversations on Health Care we want our audience to be truly in
the know when i t comes to the facts about healthcare reform and
policy . Lori R obertson is an award winning journalist and Managing
Editor of F act C heck .org a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in U . S . politics.
L o ri , what have you got for us this week?

Lori Robertson: A new study found there was no negative effect on sperm levels in
men after receiving the COVID - 19 vaccines. But social media posts
have made the baseless claim that vaccinated men “ are effectively
st erile. ” Experts say there is no evidence that the vaccines cause
infertility in men. And there are new data that further rebut the
online claims. In a study published June 17th, in the Journal of the
American Medical Association, researchers at the Univers ity of Miami
reported that they found no significant decreases in sperm
measurements among a group of healthy men before and after
receipt of a COVID - 19 vaccine . T he team collected samples of 45 men
18 and older before receiving either the Pfizer Bio NT ech or M oderna
vaccine a nd again more than 70 days after receiving their second

Alexis McGill Johnson

dose . T he researchers measured volume concentration and the total
amount of moving sperm and found no declines post vaccination.
Researchers at a hospital in Israel have reported s imilar findings in a
study that has not yet been peer reviewed.

The Society for Male Reproduction and Urology , and the Society for
the Study of Male Reproduction issued a joint State ment in January,
saying “ COVID - 19 vaccines should be offered to men desiri ng fertility
similar to men not desiring fertility when they meet criteria for
vaccination. ” Experts say a fever could affect a man's fertility for
upwards of three months. But that's any fever, not something unique
to a fever following vaccination. And t hat's my fact check for this
week. I'm L ori Robertson Managing Editor of FactCheck .org

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at th e University of Pennsylvania. If you have a fact that you'd
like checked, email us at C HCR adio .com we'll have F act C heck.org ’s
Lori Robertso n , check it out for you here on C onversations on H ealth
C are.

[Music]

Each week C onversations highlights a bright ide a about how to make
wellness a part of our communities and everyday lives. Danielle Tudor
had a revelation a few years ago waking up on the cold floor of a jail
cell, she could ask for help for her drug and alcohol addiction or she
could die. She chose the former . T u d or then launch ed not only on her
own recovery journey, but on a broader quest to develop tools that
c ould help all people grappling with addiction recovery to avoid
relapse, which is so common, especially in the early days of sobriety .
S he real i z ed that there needed to be more readily accessible tools for
those in recovery to stay connected to their treatment goals b eyond
the 12 - step meetings and the talk therapy sessions .

Danielle Tudor : I am in long term recovery. And I went through a four wee k in - patient
treatment program, where at the end of that four week program all I
received was a piece of paper that listed an enormous amount of
things I'm supposed to do on a daily and weekly basis for the rest of
my life to stay in recovery. And I knew t hat building something on our
cell phones that are with us 24/7 would be a way to bridge that gap
and keep people accountable through an app to those activities.

Margaret Flinter: So she founded WE connect a relapse prevention mobile application
that can be downloaded on a smartphone. The platform is designed
to keep people engaged in their recovery plan u sing daily reminders
and a reward system for when you perform the tasks that are
essential to recovery .

Alexis McGill Johnson

Danielle Tudor: T he individual are able to input th ose activities into the app a nd when
it comes time for that activity t o start, you simply check into it. You
see at the top of the app, how you're earning your incentives. And
either way this incentive program is proven to show keeps people
accountable to checking into those activities on the go.

Margaret Flinter: And the digital platform also allows everyone who's connected to the
person's health care ecosystem to see in real - time when one might be
at higher risk for relapse .

Danielle Tudor: W e have train ed peer recovery support specialists. And they get to
leverage a tool that we developed called a data dashboard, where
they can see in an instance if someone needs additional support or
outreach. So it really allows for this connection of support 24/7 and
visibility so that when someone needs that added support in real -
time .

Margaret Fl inter: S ince the pandemic hit Tudor says the WE connect platform has been
a lifeline for those in recovery.

Danielle Tudor: Actually, when the pandemic hit, immediately my hea rt went out for
w ow, none of us have support meetings to go to any more in - person.
So we immediately stood up with a set of partners, these mutual aid
meetings that are online that are led by certified peers. And within
just a couple months, over 200,000 p eople joined from all State s and
several countries.

Margaret Flinter: W Ec onnect a downloadable app designed by people in recovery for
people in recovery to help maintain sobriety with a support system in
the palm of their hand, staying connected to a care team and avoiding
relapse. Now that's a bright idea.

[ Music ]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health .

[Music]

Female : Conversations on Health Care is recorded at WESU at Wesleyan
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