Achalasia: A Review of the Condition

Achalasia is a rare condition where the esophagus has trouble moving food and liquid to the stomach. If left untreated, it can become serious. Here’s an overview of the disorder. 

Causes and Risk Factors

Achalasia is a very rare disorder. Around 3,000 people are diagnosed each year in the United States. Doctors do not fully understand what causes the condition. A loss of nerve cells in the esophagus can cause achalasia. This could be a result of an infection or autoimmune response. In other very rare cases, an inherited genetic disorder can cause Achalasia. Though it is rare, this condition appears to affect middle-aged and older people the most. Additionally, people with immune disorders are at a higher risk for the disease. 

Symptoms of Achalasia

This condition is characterized by a few symptoms. These symptoms tend to appear gradually, worsening over time. They include dysphagia (inability to swallow), heartburn, regurgitation, chest pain, discomfort or pain after eating, coughing, and weight loss. It can cause considerable malnutrition and weight loss over a period of years, and is very serious if left untreated. 

Diagnosis

There are a few main tests used to diagnose Achalasia for people with issues swallowing. Doctors can use Esophageal Manometry to measure the muscle contractions in your esophagus during swallowing. It helps determine the force and coordination of your esophagus. This test can determine if you have Achalasia or another condition like Scleroderma. Another available test is an Upper Endoscopy, where your doctor examines your esophagus with an endoscope. They can also biopsy tissue during this test to determine if any other issues are present, like Barrett’s Esophagus. Additionally, doctors can take X-rays of your upper digestive system; in this case, you consume a liquid that coats your esophagus for better imaging of your esophagus. Sometimes, they may have you swallow a barium pill that they then track with an X-ray. 

Treatment and Prevention

Treatments for Achalasia involve both managing symptoms and altering esophagus function. Doctors can dilate your esophagus through balloon enteroscopy- they inflate a balloon attached to an endoscope in your esophagus to enlarge the opening. They often need to perform repeat procedures to maintain good dilation. Another treatment involved injecting Botox into the esophageal sphincter to relax the muscle. This option is best for people who are not good candidates for balloon dilation. 

There are a few surgical treatments available for severe cases. Heller Myotomy is a minimally-invasive endoscopic procedure that can help. Doctors cut the muscle at the end of the esophageal sphincter. This allows food and liquid to pass into the stomach more effectively. They may also pair this procedure with another called fundoplication. Here, they wrap the top of your stomach over the lower esophagus. This can prevent GERD from developing, which is a potential complication from the Heller Myotomy. 

Another potential treatment is POEM (Peroral Endoscopic Myotomy). During this procedure, doctors feed an endoscope into the esophagus and make an incision on the mucosa (lining). Then, they tunnel the endoscope through the mucosa to give access to the muscle below. Doctors then cut and partially remove the now exposed muscle beneath the mucosa. They complete the procedure by closing the incision. POEM helps to relieve tightness in the esophageal sphincter to allow for easier passage of food and liquids. 

Our experienced team at GHP has years of experience treating conditions including Achalasia. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Coronavirus Updates

November 25th, 2020

This is our thirty-seventh weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Vaccine and treatment progress
    • Drug companies Pfizer, Moderna and AstraZeneca have the leading COVID-19 vaccine candidates. Several others remain in development. Check out this vaccine tracker from the New York Times to see more about each potential vaccine’s progress. 
    • A recent analysis found that the Pfizer vaccine is 95% effective. It is expected to be the first COVID-19 vaccine to receive FDA authorization and anticipates delivering doses before the end of 2020. 
    • Check on this treatment tracker from the New York Times to see what treatments are being used and what level of effectiveness and safety each has. 
  • Coronavirus cases surge across the United States
    • Coronavirus cases continue to spike in the United States.
    • Kentucky and Indiana continue to see record-breaking coronavirus case numbers as well. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • Governor Beshear’s new restrictions to curb the spread of the coronavirus went into effect on Friday, November 20th and will remain in effect until December 13th. 
      • Restaurants and bars are not open for indoor food or beverage consumption. Carryout and delivery are encouraged as well as socially distance outdoor seating.
      • Private social gatherings are limited to up to eight people from a maximum of two households.
      • Gyms, fitness centers, pools, and other indoor recreation facilities are limited to a 33% capacity. Group classes, team practices and competitions are prohibited. Masks must be worn while exercising.
      • Venues, event spaces and theaters will be limited to 25 people per room. This applies to indoor weddings and funerals, but excludes in-person worship services, for which the Governor will provide recommendations Thursday.
      • Office-based businesses are limited to a 33% capacity for employees. All employees who are able to work from home must do so and all businesses that can close to the public must do so.
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
    • On November 13, Governor Holcomb issued an executive order effective through December 12th, detailing a color-coding system for counties in Indiana that details necessary steps to curb the spread of COVID-19. Read the executive order here and the county metrics and requirements here.  
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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November 19, 2020

This is our thirty-sixth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Vaccine and treatment progress
    • On Monday, November 16, biotechnology company Moderna announced significant early trial results for its coronavirus vaccine. The vaccine is 94.5% effective. 
    • On Monday, November 9, pharmaceutical company Pfizer announced positive early trial results for its coronavirus vaccine. An analysis found that the Pfizer vaccine was over 90% effective.
    • Several potential vaccines are in final testing phases. 12 are currently in Phase 3 trials. Check out this vaccine tracker from the New York Times to see more about each potential vaccine’s progress. 
    • Check on this treatment tracker from the New York Times to see what treatments are being used and what level of effectiveness and safety each has. 
  • Coronavirus cases surge across the United States
    • Coronavirus cases continue to spike in the United States.
    • Kentucky and Indiana continue to see record-breaking coronavirus case numbers as well. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • On Wednesday, November 18, Governor Beshear announced new restrictions to curb the spread of the coronavirus. 
      • All public and private K-12 schools will close to in-person instruction starting Monday through the end of the semester (The only exception is for elementary schools in counties outside a red zone, which can reopen on December 7 if the school follows guidelines).
      • Beginning Friday, November 20 and lasting until Dec. 13:
  • All restaurants and bars will close to indoor dining services. Outdoor dining is still allowed, with some limitations.
  • Gyms are limited to 33% capacity, and no group classes or indoor games are allowed. Masks are required.
  • Indoor gatherings should be limited to two families, not exceeding a total of eight people.
  • Attendance at weddings and funerals is limited to 25 people.
  • Professional services should have employees work from home when possible and limit their offices to 33% capacity.
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
    • On November 13, Governor Holcomb issued an executive order detailing a color-coding system for counties in Indiana that details necessary steps to curb the spread of COVID-19. Read the executive order here and the county metrics and requirements here.  
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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November 12, 2020

This is our thirty-fifth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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November 5, 2020

This is our thirty-fourth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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October 29, 2020

This is our thirty-third weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Vaccine and treatment progress
    • Several potential vaccines are in final testing phases. 11 are currently in Phase 3 trials. Check out this vaccine tracker from the New York Times to see more about each potential vaccine’s progress. 
    • Check on this treatment tracker from the New York Times to see what treatments are being used and what level of effectiveness and safety each has. 
  • Coronavirus cases surge across the United States
    • Coronavirus cases have spiked in the United States recently, with record-breaking daily numbers for several consecutive days. Daily new cases are now exceeding previous highs from July, and continue to rise. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • On October 26, Governor Beshear issued new recommendations for counties in the red zone (25 or more average daily cases per 100,000 people). The recommendations are: 
      • Government offices that do not provide critical services should have their workers performing their duties virtually.
      • Employers should have employees who can work from home effectively work from home as much as possible.
      • Reduce in-person shopping and return to curbside pickup as much as possible.
      • Order takeout, avoid dining in at restaurants or bars.
      • Prioritize businesses that follow COVID-19 measures.
      • Do not host gatherings of any size.
      • Avoid nonessential activities outside the home.
      • Pause high-contact sports, minimize crowds at sporting events.
      • Follow all other COVID-19 mitigation efforts.
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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October 22, 2020

This is our thirty-second weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Vaccine and treatment progress
    • Several potential vaccines are in final testing phases. 11 are currently in Phase 3 trials. Check out this vaccine tracker from the New York Times to see more about each potential vaccine’s progress. 
    • Check on this treatment tracker from the New York Times to see what treatments are being used and what level of effectiveness and safety each has. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • On October 19, Governor Beshear signed an executive order that ends the statewide moratorium on disconnections for nonpayment on Nov. 6, but takes additional steps to help Kentuckians. The executive order designates $15 million in federal COVID-19 relief funds for the Healthy at Home Utility Relief Fund, which will provide relief for Kentuckians at risk of natural gas, water, wastewater or electric service disconnection. The order will also require utilities to create a payment plan for residential customers that runs no less than six months. It will continue to waive late fees on utility bills for residential customers through Dec. 31, 2020. Read the order here
    • On October 16, ​The Kentucky Department for Public Health announced a draft plan for distributing a coronavirus vaccine to local health departments and health care organizations. Read the plan draft here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
    • On October 20, the Indiana Department of Health issued a draft coronavirus vaccine distribution plan. You can read the plan draft here
    • On October 15, Governor Holcomb issued an extension of Stage 5 of reopening until November 14. Read the order here
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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October 15, 2020

This is our thirty-first weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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October 8, 2020

This is our thirtieth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Vaccine progress
    • Several potential vaccines are in final testing phases. 11 are currently in Phase 3 trials. Check out this vaccine tracker from the New York Times to see more about each potential vaccine’s progress. 
  • CDC updated its ‘How Coronavirus Spreads’ informational webpage 
    • The CDC recently acknowledged that the coronavirus can spread further than six feet in some instances. Here is an excerpt from their update: “Today’s update acknowledges the existence of some published reports showing limited, uncommon circumstances where people with COVID-19 infected others who were more than 6 feet away or shortly after the COVID-19-positive person left an area.  In these instances, transmission occurred in poorly ventilated and enclosed spaces that often involved activities that caused heavier breathing, like singing or exercise.  Such environments and activities may contribute to the buildup of virus-carrying particles.” You can read the full update here
    • See the How Coronavirus Spreads webpage here
  • White House coronavirus outbreak
    • On Thursday, October 1, President Trump announced he and First Lady Melania Trump tested positive for coronavirus. This came soon after a positive test for Hope Hicks, a political advisor for the president. 
    • Since then, at least seven other administration officials and 13 other people who had been in close contact with the president have tested positive. 
    • On Friday, October 2, President Trump was admitted to Walter Reed Hospital Bethesda, Maryland for monitoring and treatment for the coronavirus. He left the hospital and returned to the White House on Monday, October 5. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • On October 1, ​Governor Beshear and Dr. Stack announced guidance for Halloween. Read the guidelines here
    • On September 29, Governor Beshear announced that under a new Official Order from Transportation Secretary Jim Gray, the mail-in and drop box options for driver’s licenses were extended to licenses bearing an expiration date as late as Feb. 28, 2021, with all such renewals to be processed by March 31, 2021.
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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October 1, 2020

This is our twenty-ninth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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September 24, 2020

This is our twenty-eighth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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September 17, 2020

This is our twenty-seventh weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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September 10, 2020

This is our twenty-sixth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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September 3rd, 2020

This is our twenty-fifth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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August 27, 2020

This is our twenty-fourth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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August 20, 2020

This is our twenty-third weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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August 13, 2020

This is our twenty-second weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
  • Midwest
    • The Midwest continues to see a rise in coronavirus cases. 
  • Progress on vaccine research and testing
    • A number of potential coronavirus vaccines have advanced to later phases of testing. A few have started Phase III Efficacy Trials, in which vaccines are given to thousands of people and placebos are given to others, and researchers wait to see how many people given the vaccine get infected versus those given a placebo. 
    • One of these trials receiving the most press attention in the United States is being conducted by Moderna and the National Institutes of Health. The first Phase III trial began on July 27. Eventually, around 30,000 people will be enrolled in the trial. 
    • See an overview of all potential vaccines and their relative progress in this tracker by the New York Times. 
    • In the United States, the FDA previously released a statement in June that any vaccine would need to protect at least 50% of people to be considered effective. 
    • On August 11, the U.S. Department of Health and Human Services (HHS) and Department of Defense (DoD) announced an agreement with Moderna, Inc. to manufacture and deliver 100 million doses of the company’s COVID-19 vaccine candidate. Read more here
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
    • On August 11, allowed bars to reopen at 50% capacity and restaurants to increase capacity back to 50% for indoor dining. There will be an 11pm closing time mandated, with food and drink service having to end at 10pm. 
    • On August 10, recommended that school districts delay in-person learning until at least September 28. 
    • On August 6, extended the mask mandate for an additional 30 days. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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August 6, 2020

This is our twenty-first weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
    • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Midwest
    • The Midwest continues to see a rise in coronavirus cases, with Montana, Oklahoma, and Missouri experiencing some of the largest increases in percentages of infections in the past week or so. 
  • Progress on vaccine research and testing
    • A number of potential coronavirus vaccines have advanced to later phases of testing. A few have started Phase III Efficacy Trials, in which vaccines are given to thousands of people and placebos are given to others, and researchers wait to see how many people given the vaccine get infected versus those given a placebo. 
    • One of these trials receiving the most press attention in the United States is being conducted by Moderna and the National Institutes of Health. The first Phase III trial began on July 27. Eventually, around 30,000 people will be enrolled in the trial. 
    • See an overview of all potential vaccines and their relative progress in this tracker by the New York Times. 
    • In the United States, the FDA previously released a statement in June that any vaccine would need to protect at least 50% of people to be considered effective. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. See the full list here.
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On July 30, Governor Holcomb ordered all counties in Indiana to extend Stage 4.5 of reopening to August 27. He also extended the prohibition on residential rental property evictions and mortgage foreclosures. He additionally ordered that all public and private K-12 schools have all students, staff, faculty, volunteers, vendors, and visitors wear a face covering or shield when on school grounds or in school buildings and facilities. Read the order here
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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July 30, 2020

This is our twentieth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of July 28, 52,942,145 total viral tests have been reported and 5,046,506 positive viral tests have been reported in the United States. This is a 10% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Midwest at risk of surge in cases
    • Kentucky, Indiana, Ohio, and Tennessee are showing warning signs of potential surges in coronavirus cases. Positive case numbers and positivity rates have been rising significantly in all three states over the past few weeks. 
    • Dr. Deborah Birx, White House coronavirus response coordinator, visited Kentucky on July 26 and recommended that the state close bars and reduce restaurant capacity to curb a potential surge. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On July 27, Governor Beshear announced new measures to curb a rising number of coronavirus cases in Kentucky. He announced that bars would close for two weeks starting July 28 and restaurant indoor capacity would be reduced to 25% of pre-pandemic capacity. He also recommended public and private schools avoid in-person instruction until the third week of August. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On July 24, Governor Holcomb issued a 30 day statewide mask order in effect starting July 27. All Indiana residents 8 and older are required to wear a face covering in indoor public spaces, outdoor public spaces where social distancing isn’t possible, and while using public transportation. Read the order here
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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July 23, 2020

This is our nineteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of July 22, 51,680,022 total viral tests have been reported and 4,878,379 positive viral tests have been reported in the United States. This is a 10% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Emerging research
    • There is emerging evidence that the coronavirus can spread through small particles in the air. These smaller particles, which can spread when people talk or breathe, were previously not thought to be the main method of transmission- larger respiratory droplets from coughs and sneezes were. This research may change recommendations and guidelines for masking and distancing in indoor spaces. Read more here
  • Increasing case numbers across the United States
    • The United States has seen coronavirus cases surge in recent weeks, with particularly high rates of increase in Southern and Western states including Florida, California, Arizona, and Texas. The seven day average of new cases across the United States stands just over 66,000.
  • Kentucky
    • Cases have started to rise significantly in Kentucky over the past two weeks, with the total case number growing past 24,000 and some of the highest single day case increases being recorded. 
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On July 20, the Kentucky Department of Public Health issued a new travel advisory that recommends a 14-day self-quarantine for travelers who went to any of eight states – Alabama, Arizona, Florida, Georgia, Idaho, Nevada, South Carolina and Texas – that were reporting a positive coronavirus testing rate equal to or greater than 15%. The advisory also includes Mississippi, which is quickly approaching a positive testing rate of 15%, and the U.S. Territory of Puerto Rico. Read more here
      • On July 20, the Cabinet for Health and Family Services issued a new order that pulls back on guidance covering social, non-commercial mass gatherings. On June 29, the original guidance was eased to allow for gatherings of 50 or fewer people. The new order returns the guidance to allow only for such gatherings of 10 or fewer people. The guidance, which does not apply to weddings, restaurants, retail or other public venues, went into effect on July 20 at 5 p.m. Read the order here
  • Indiana
    • Indiana has also started to see a rise in coronavirus cases after weeks of slow decline. 
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On July 16, Governor Holcomb ordered a continuation of Stage 4.5 of reopening Indiana (except for Elkhorn County) in light of increased coronavirus spread. This extension pushes Stage 5 to August 1. Read more here
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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July 16, 2020

This is our eighteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of July 14, 41,761,392 total viral tests have been reported and 3,754,729 positive viral tests have been reported in the United States. This is a 9% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Emerging research
    • There is emerging evidence that the coronavirus can spread through small particles in the air. These smaller particles, which can spread when people talk or breathe, were previously not thought to be the main method of transmission- larger respiratory droplets from coughs and sneezes were. This research may change recommendations and guidelines for masking and distancing in indoor spaces. Read more here
  • Increasing case numbers across the United States
    • The United States has seen coronavirus cases surge in recent weeks, with particularly high rates of increase in Southern and Western states including Florida, California, Arizona, and Texas. The seven day average of new cases across the United States stands just over 60,000, over three times higher than new case averages a month ago. 
  • Kentucky
    • Cases have started to rise significantly in Kentucky over the past week, with the total case number growing past 20,000 and some of the highest single day case increases. 
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On July 14, reminded Kentuckians that they can report noncompliance with coronavirus mandates through the reporting hotline at 833-KY SAFER (833-597-2337) or online at https://govstatus.egov.com/kysafer
      • On July 10, the Cabinet for Health and Family Services Department for Public Health issued an order related to health insurers and licensed clinician’s COVID-19 testing. Read the order here
      • On July 9, signed an executive order requiring Kentuckians to wear face coverings under several circumstances for the next 30 days. There are several exemptions to the order, including children who are 5 or younger and any person with a disability or a physical or mental impairment that prevents them from safely wearing a face covering. Read the order here
  • Indiana
    • Indiana has also started to see a rise in coronavirus cases after weeks of slow decline. 
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On July 8, issued a coronavirus screening guide for parents to use each day before school to help them decide if they need to keep their child/children home. Read the guide here
      • On July 7, issued guidance on when students, faculty, and staff can return to school after showing symptoms. 
      • Read documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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July 9, 2020

This is our seventeenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of July 9, 39,208,278 total viral tests have been reported and 3,487,780 positive viral tests have been reported in the United States. This is a 9% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Emerging research 
    • There is emerging evidence that the coronavirus can spread through small particles in the air. These smaller particles, which can spread when people talk or breathe, were previously not thought to be the main method of transmission- larger respiratory droplets from coughs and sneezes were. This research may change recommendations and guidelines for masking and distancing in indoor spaces. Read more here
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On June 30, ​announced that the deadline to apply for Pandemic-Electronic Benefits Transfer (P-EBT) has been extended until the end of August. P-EBT provides equivalent funding for meals that students would have been provided in school this spring without the closures due to COVID-19. Read more here.
      • On June 30, ​announced Kentuckians who are uninsured can apply for short-term coverage through Medicaid Presumptive Eligibility. Families can apply online at chfs.ky.gov or benefind.ky.gov, by contacting an application assistant at healthbenefitexchange.ky.gov or by calling 855-459-6328. Initial coverage ends two months after the application month, unless the person applies for regular Medicaid or Presumptive The state is extending Presumptive Eligibility benefits for three months for anyone who already applied and whose coverage was previously set to end June 30. Read more here
      • On June 30, announced the state has hired Ernst & Young to help begin immediately processing outstanding claims that resulted from the COVID-19 global pandemic. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On July 6, created a COVID-19 Screening Decision Tree for schools as they prepare to reopen. See the document here
      • On July 1, announced Indiana would delay its transition to stage 5 of reopening. Instead, starting on July 4 and continuing through July 17 (for all counties except Elkhart), Indiana will enter phase 4.5. Phase 4.5 is similar to phase 4, and is intended to pause reopening plans as coronavirus cases increase around the nation. Read the Executive Order here
      • See documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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July 2, 2020

This is our sixteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of July 1, 33,601,847 total viral tests have been reported and 3,194,381 positive viral tests have been reported in the United States. This is a 10% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On June 29, visitation resumed at assisted living and personal care homes, group activities (10 or fewer) in facilities, communal dining and off-site appointments. On July 15, visitation will resume in nursing homes and in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IIDs).
      • On June 24, Governor Beshear, Lieutenant Governor Jacqueline Coleman and Kevin Brown, interim commissioner of the Kentucky Department of Education, released initial guidance for Kentucky schools looking ahead to opening in the fall. Read the guidance here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On June 29, issued guidance and timelines for visitation in Long-term Care Facilities. Read the guidance here
      • On June 26, created an FAQ document regarding COVID-19 planning for schools and local health departments. Read the document here
      • See documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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June 25, 2020

This is our fifteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of June 23, 30,110,061 total viral tests have been reported and 2,874,748 positive viral tests have been reported in the United States. This is a 10% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On June 22, ​announced updated guidance beginning next week for many venues, including restaurants and bars. Read the requirements for restaurants and bars here. The new guidance also covers wedding venues and gatherings of 50 or fewer people. Read the requirements for gatherings of 50 or fewer people here
      • On June 18, ​announced the state would continue to expand in-person services to help Kentuckians resolve unemployment insurance claims. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On June 19, issued guidance on reducing indoor COVID-19 transmission through changing environmental factors. Read the guidance here
      • On June 18, updated guidance on making and wearing masks in public. Read the guidance here
      • See documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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June 18, 2020

This is our fourteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of June 16, 23,765,801 total viral tests have been reported and 2,523,345 positive viral tests have been reported in the United States. This is a 11% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On June 16, gave updated guidance on public pools and gatherings of up to 50 people. Read the pool guidance here and the guidance on gatherings here
      • On June 15, ​announced that Kentucky is currently performing mass testing of all inmates and staff members at the Kentucky Correctional Institute for Women (KCIW) in Shelby County. TThree staffers and 11 inmates recently tested positive for COVID-19. More than 270 of the facility’s 639 inmates have been tested thus far. Fortunately, no one from the facility has been hospitalized. Read more here
      • On June 15, announced that contact tracers will call people who may have been exposed from 1-844-KYTRACE (1-844-598-7223) to offer information and resources to keep them and others safe. Read more here
      • ​On June 10, announced churches, synagogues, mosques and other houses of worship can begin hosting congregants at 50% of their pre-pandemic capacities. Read the guidelines here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On June 15, updated the Specimen Submission and Collection Guidelines. See the updated guidelines here
      • On June 12, announced the beginning of Stage 4 of reopening Indiana. Stage 4 will span June 12-July 3. Read the Executive Order here
      • See documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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June 11, 2020

This is our thirteenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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June 4, 2020

This is our twelfth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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May 28, 2020

This is our eleventh weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of May 26, 15,183,888 total viral tests have been reported and 1,858,968 positive viral tests have been reported in the United States. This is a 12% positive rate. 
      • Viral tests tell you if you are currently infected. These differ from antibody blood tests; antibody tests check your blood by looking for antibodies, which show if you had a previous infection with the virus.
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On May 22, announced a new absentee ballot portal that is live online here. Voters in every county of the commonwealth can request a mail-in ballot for the June primary elections. The last day to apply for a ballot is June 15. The primary elections in Kentucky will be held on June 23.
      • On May 22, lifted the interstate travel ban. See the executive order here in English or here in Spanish. 
      • On May 21, provided an updated Healthy at Work schedule for June. See the full schedule here
      • On May 20, announced a $300 million award to city and county governments as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act. The CARES Act established the Coronavirus Relief Fund (CRF) to reimburse local governments for expenses incurred in response to the public health emergency caused by COVID-19. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On May 21, announced that Stage 3 of Indiana’s opening would begin on May 22 for most of the state; Cass, Lake, and Marion counties, the hardest hit areas of the state, will enter Stage 3 later on June 1. Read more about Stage 3 here
      • See documentation on Indiana’s 5 stages of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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May 21, 2020

This is our tenth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of May 19, 12,601,143 total viral tests have been reported and 1,699,375 positive viral tests have been reported in the United States. This is a 13% positive rate. 
      • Viral tests tell you if you currently are infected. 
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On May 19, announced that museums, outdoor attractions, aquariums, libraries and distilleries will be allowed to reopen with proper distancing and sanitization procedures in place starting June 8.
      • On May 18, announced the appointment of Mark Carter as executive adviser leading the contact tracing efforts in the Office of the Secretary of the Cabinet for Health and Family Services (CHFS). Learn more about contact tracing in a video here
      • On May 14, announced that groups of 10 or fewer may gather again starting May 22 and the travel ban will expire on May 22. Read more here
      • On May 13, announced the next step for health care reopening. Hospitals and care facilities can begin non-emergency surgeries and procedures at 50% of their pre-COVID-19-era patient volume beginning May 13. Facilities will determine their patient capacities starting May 27 as long as progress continues.​
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On May 18, issued COVID-19 Specimen Collection and Submission Guidelines for healthcare providers. Learn more here
      • See documentation on Indiana’s 5 phases of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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May 14, 2020

This is our ninth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of May 13, 10,217,573 total viral tests have been reported and 1,510,924 positive viral tests have been reported in the United States. That is a 15% positive rate. 
      • Viral tests tell you if you currently are infected. 
      • A single infected person may be tested multiple times, so the number of positive cases is not equal to the number of positive tests. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On May 7, announced that phase 2 of reopening the economy would start on May 22. Read more here
        • Phase 3 is planned to start on July 1. New Phase 2 reopening dates are now tentatively:
          • May 22 – Restaurants, with limited 33% capacity and outdoor seating
          • June 1 – Movie theaters, fitness centers
          • June 11 – Campgrounds, public and private
          • June 15 – Child care, with reduced capacity; and potentially low-touch and outdoor youth sports
      • On May 6, announced the beginning of Health Care reopening phase 2. This includes outpatient and ambulatory surgery and invasive procedures may resume. Read more here
      • On May 5, announced an aggressive testing plan for long-care facility staff and patients. Learn more here.
      • On May 4, announced a partnership with the Kentucky Chamber of Commerce and the Kentucky Distillers’ Association to get personal protective equipment (PPE) and hand sanitizer to small businesses as they prepare to reopen. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week:
      • On May 11, created an interactive map of public wifi locations in Indiana. See the map here
      • See documentation on Indiana’s 5 phases of reopening here
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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May 7, 2020

This is our eighth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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April 30, 2020

This is our seventh weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

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April 23, 2020

This is our sixth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

  • Confirmed cases and deaths
  • Testing
    • As of April 22, 97 public health labs in the United States have the capacity to test for the coronavirus. 
    • As of April 22, 5,116 specimens have been tested by CDC labs and 405,105 specimens have been tested by US public health labs. 
  • National
    • On April 16, the White House issued the Guidelines for Opening Up America Again, a three-phased approach to guide re-opening the economy. The guidelines outline criteria for different phases of reopening and specific guidance for employers, individuals, and state governments. Read more here
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On April 20, advised educational institutions to remain closed to in-person instruction through the rest of the school year.
      • On April 17, discussed benchmarks Kentucky must meet to re-open the economy, reflecting federal guidance from the White House on April 16. Learn more here
      • On April 16, announced Kentucky is joining a regional state partnership with Wisconsin, Illinois, Minnesota, Michigan, Ohio, and Indiana to coordinate plans to reopen regional economies when the time is right. Read more here
      • On April 15, announced the first stage of the Co-Immunity Project, a testing regime that will focus on comprehensive testing, centered on antibodies and developing donor plasma resources, starting with healthcare workers. Read more here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week (see the full list here):
      • On April 16, announced Indiana is joining a regional state partnership with Wisconsin, Illinois, Minnesota, Michigan, Ohio, and Kentucky to coordinate plans to reopen regional economies when the time is right. 
      • A full resource guide for Indiana residents is available here. Recent public updates can be found here
  • Resource List

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April 16, 2020 Coronavirus Update

This is our sixth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

Quick Facts

  • Confirmed cases and deaths
  • Testing
    • As of April 14, 95 public health labs in the United States have the capacity to test for the coronavirus. 
    • As of April 15, 5,038 specimens have been tested by CDC labs and 316,889 specimens have been tested by US public health labs. 
  • National
    • Coronavirus stimulus payments to individuals have started to arrive as direct deposits in people’s bank accounts. Paper checks may take months to arrive for people who do not have bank account information on file with the IRS. 
      • On April 15, the IRS launched an online form that allows people to upload their bank account information so they can receive their stimulus payments more quickly. See the form here
      • The stimulus amounts are $1,200 for eligible individuals and $2,400 for eligible married couples filing jointly. Read more here for information on eligibility. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On April 12, announced a partnership with Kroger that will expand testing capability in Kentucky. Locations for drive-through testing will be announced throughout the next five weeks, with a goal to perform 20,000 additional tests in five weeks. Read more here
      • On April 9, expanded who is eligible for workers compensation if they are forced to quarantine to include grocery workers, child-care workers, and more. Read more here
      • On April 8, issued an Executive Order limiting the number of people allowed in stores that are open and limiting the number of shoppers per household to one adult. Read the order here
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week (see the full list here):
      • On April 15, launched a disaster program to give residents better access to food assistance. Read more here
      • A full resource guide for Indiana residents is available here
  • Resource List

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April 9, 2020 Coronavirus Update

This is our fifth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

Quick Facts

  • Confirmed cases and deaths
  • Testing
    • As of April 8, 95 public health labs in the United States have the capacity to test for the coronavirus. 
    • As of April 8, 4,925 specimens have been tested by CDC labs and 228,034 specimens have been tested by US public health labs. 
  • National
    • On April 3, the CDC issued guidance recommending wearing cloth face coverings in public areas like grocery stores and pharmacies, and in high-transmission areas. Read more here
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights from the past week (see the full list here):
      • On April 5, announced an agreement with Gravity Diagnostics that provides up to 2,000 tests per day in Kentucky. The tests will be reserved for the area outside the ‘golden triangle’ (Louisville, Lexington, and northern Kentucky) where there is less infrastructure for testing. 
      • On April 4, adopted CDC recommendations to wear cloth face coverings in public.
      • On April 2, recommended school systems extend suspensions of in-person instruction to at least May 1. 
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights from the past week (see the full list here):
      • On April 6, issued a new two week stay at home order. Read more here
      • A full resource guide for Indiana residents is available here
  • Resource List

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April 2, 2020 Coronavirus Update

This is our fourth weekly update regarding the coronavirus (COVID-19). Below, you will find updated facts and figures. 

Quick Facts

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March 26, 2020 Coronavirus Update

This is our third weekly update regarding the novel coronavirus (COVID-19). Below, you will find updated facts and figures. 

Quick Facts

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March 19, 2020 Coronavirus Update

This is our second weekly update regarding the novel coronavirus (COVID-19). Below, you will find updated facts and figures. 

Quick Facts

  • The coronavirus causing COVID-19 has now spread to 164 locations internationally (as of 3/18/20).
  • Confirmed cases and deaths
  • Testing: As of March 16, 89 public health labs in the United States have the capacity to test for the coronavirus. 
    • As of March 17, 4,255 specimens have been tested by CDC labs and 27,623 specimens have been tested by US public health labs. 
  • If you are sick with COVID-19 or think you may be, follow these steps
    • Stay home except to get medical care. Many people with mild symptoms will be able to recover at home. 
    • Call before going to get medical care. 
    • Avoid public transportation.
    • Separate yourself from others in your home. 
    • Limit contact with pets and animals.
    • Wear a facemask if you are sick. 
    • Cover coughs and sneezes. 
    • Clean your hands often. 
    • Clean high-touch surfaces every day. 
    • Monitor your symptoms and consult with a medical professional before receiving care. 
  • Kentucky
    • The state of Kentucky’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Beshear. Here are a few highlights (see the full list here):
      • By 5pm on March 18, all public-facing businesses that can’t comply with CDC guidelines for social distancing must cease in-person operations. 
      • Restaurants and bars were ordered to close by 5pm on March 16. Food and beverage services are now restricted to carry-out, delivery, and take-out only. 
      • Primary elections have been postponed until June 23, 2020. 
      • All community gatherings are recommended to cancel or postpone.
      • All school districts were recommended to close in-person classes beginning March 16. All schools have done so and many are using e-learning technologies to continue instruction. 
      • Businesses are recommended to use telecommuting options and encourage working from home. 
      • Hospitals are recommended to cease non-elective procedures. 
  • Indiana
    • The state of Indiana’s response to COVID-19 includes both guidelines for specific groups and Executive Orders from Governor Holcomb. Here are some highlights (see the full list here):
      • Per CDC recommendations, all events with 50 or more people are advised to cancel or postpone. 
      • Restaurants and bars have been ordered to cease in-person services. Take-out and deliver services can still be provided. 
      • School districts are recommended to close. Most school districts have closed in-person learning and many are using e-learning technologies to continue instruction.
      • Hospitals are recommended to cease elective procedures. 
      • State employees are encouraged to use telecommuting options as much as possible. 
  • Resource List

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March 12, 2020 Coronavirus Update

As healthcare professionals, Gastroenterology Health Partners has a responsibility to be a trusted resource on relevant health topics for our patients. We will be posting weekly updates about COVID-19 (coronavirus) from reputable sources.

In our health care facilities, we are closely following guidance from the CDC and local and state health departments to inform our healthcare practices and procedures. With such a rapidly-evolving situation, it’s important that evidence informs our decisions and behaviors. We all have a responsibility to make the best informed decisions possible:

  • Seek out trusted, evidence-based sources of information.
  • Follow appropriate guidelines based on your individual situation and context.
  • Help stop social stigma against Chinese and Asian Americans, people who have gone through proper quarantine protocols, healthcare workers, and others who may be experiencing discrimination based on group identity.

Quick Facts

  • COVID-19 is a respiratory disease caused by a novel coronavirus that was first detected in China at the end of 2019. The coronavirus causing COVID-19 has now spread to over 100 locations internationally.
  • Confirmed cases and deaths
  • Symptoms
    • Symptoms include fever, dry cough, and shortness of breath. These symptoms may appear 2-14 days after exposure to the virus.
  • How does it spread?
    • Public health officials believe the virus spreads mainly person-to-person through respiratory droplets and mostly between people in close contact with each other (around 6 feet). It may spread via surfaces, but this is not thought to be the primary method of transmission.
  • Who is at risk?
    • Early data from people in China who contracted COVID-19 shows that older adults and people with chronic medical conditions are at a higher risk of getting very sick from COVID-19.
  • Preventing illness
    • There is no vaccine to prevent COVID-19 currently. As such, avoiding exposure to the virus is the best way to prevent illness. You should clean your hands often, avoid close contact with sick people, stay home if you are sick, cover sneezes and coughs with a tissue or your elbow, clean and disinfect frequently touched surfaces, and wear a facemask if you are sick.
  • Steps to take if you are sick
    • If you are sick and think you may have been exposed to COVID-19, and develop a cough, fever, or difficulty breathing, contact your healthcare provider immediately.
    • In general, self-isolate at home and follow other prevention guidelines when you are sick to help prevent the spread of disease.
  • Testing for COVID-19
    • As of March 10, 78 state and local public health labs across 50 states in the United States have the capacity to test up to 75,000 people (using CDC lab kits, not including commercially-available kits).
  • Resource List

Colorectal Cancer Screening at 45

Colorectal cancer screening is a crucial step to identify cancer early and save lives. Previous medical guidance has dictated that screenings should start at age 50 in most cases. However, the American Cancer Society now endorses screenings starting at age 45. Gastro Health Partners endorses this approach as well. Here’s an overview of why screening is so important, and what your options are.

Colorectal Cancer

Colorectal cancer, sometimes called colon cancer, is cancer that occurs in the rectum or colon. Abnormal growths called polyps can grow in the colon or rectum and become cancerous. When this happens, cancers grow into the wall of the colon or rectum over time. They then have the potential to spread into lymph vessels or blood vessels and travel to other parts of the body.

Screening is important because it can prevent the development of colorectal cancer and more widespread cancer in the body. If caught early, colorectal cancer is often very treatable. For example, during a screening, precancerous polyps in the colon or rectum can be removed before they become cancerous. Screening is a life-saving preventative measure: in this case, there is a 90% survival rate when cancer is found and treated early on. It is also helpful because many people will not exhibit symptoms until their colorectal cancer has progressed significantly. Getting screened can help doctors catch and treat cancer before it develops or spreads significantly.

Who Should be Screened and When?

Screening is the key prevention strategy for all adults. Everyone should get a screening regularly at a certain point. As mentioned before, the previous guidance was most people should be screened starting at age 50. Now, guidance has shifted to starting at age 45.

Additionally, other factors can influence when and how often you should be screened. If your family has a history of colon cancer, if you have had polyps, or if you have an inflammatory bowel disease or some genetic disorders, you may need to be screened earlier and/or more often.

Types of Screening and How Often to Get Screened

There are a few main screening options. You should talk with your doctor to determine the best path for you. As alluded to, the colonoscopy is the gold standard for screenings. During a colonoscopy, your doctor is able to look at your entire colon and can remove polyps. You may only need a colonoscopy once every 10 years if you have a negative screening. Another screening option is a Flexible Sigmoidoscopy, which is performed every 5 years with negative screenings. The downside of this method is that it doesn’t give a full view of the colon like a colonoscopy does. Only the lower parts of the colon are viewable with this test.

There are also a few stool-based screenings available. With stool tests, you collect a stool sample at home and send it in to your doctor for analysis. This method does not identify abnormalities as effectively as a colonoscopy. Doctors may also pursue follow-up testing if they confirm a positive result. There are a few other screening options that may be available as well, like a Capsule Endoscopy or a CT Colonography. Your doctor will recommend the best option based on your specific case.

Getting screened for colorectal cancer is an extremely effective way to prevent cancer. Our experienced team at GHP has years of experience performing screenings. We can help establish the best plan of diagnosis and care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Featured press release: DHPA Supports USPSTF Recommendations to Begin CRC Screening at 45, Calls for More Research on Disparities in Communities of Color

The Digestive Health Physicians Association recently announced its support for the U.S. Preventive Services Task Force (USPSTF)’s draft recommendation to begin colorectal cancer screenings at age 45. Gastro Health Partners endorses these changes as well. Read more about the DHPA’s support for the changing guidance in this press release:

“Washington, DC – The Digestive Health Physicians Association (DHPA) voiced its support for a draft recommendation by the U.S. Preventive Services Task Force (USPSTF) that Americans begin screening for colorectal cancer at the age of 45, an update of 2016 guidelines that had recommended that adults without risk factors for CRC should begin screening at age 50 and continue periodically until 75.”

Click here to read the full press release

Actor Will Smith and His Colonoscopy

Actor Will Smith recently posted a vlog on his YouTube channel documenting the process of getting a colonoscopy. His video is a great up-close look at the process and why it is so important for everyone.

The Colonoscopy Video

Will uploaded the video on YouTube on November 6, 2019. Will Smith turned 50 in 2019 and his doctor advised him to get screened for colorectal cancer. The video starts with him asking his doctor about the logistics of the procedure. He also documents the effects of the colonoscopy prep, and shows footage of him entering the exam room on the day of the procedure. We also see Will after the procedure under lingering effects of anaesthetic. The video ends with Will’s doctor talking through the exam results with him.

During the procedure, doctors actually found a polyp and removed it. Polyps are pre-cancerous lesions that are common in the colon. They removed the polyp and sent it to biopsy, where it was determined to be a tubular adenoma, a benign type of polyp that has the potential to become cancerous.

Will’s doctor speaks about her gratefulness that he was a compliant patient who took her recommendation for screening. She explains that the type and location of polyp Will had could have made it virtually unnoticeable if he hadn’t gotten screened; it is likely that by the time he started to show symptoms, it would have spread to other parts of his body. The video ends with his doctor talking through all of this and recommending a follow-up screening in the next two or three years, since he had a polyp. You can watch the video here.

A History of Celebrities Raising Awareness of Screenings

Will isn’t the first celebrity to publicize their own experience with a screening. Back in 2000, Katie Couric got a colonoscopy on the Today show to raise awareness on the importance of colon cancer screenings. Her husband had died of colon cancer in 1998. She went on to co-found the National Colorectal Cancer Research Alliance. In 2018, Couric also accompanied TV host Jimmy Kimmel through the colonoscopy process on his show.

The impact of celebrity promotion of screenings may be significant. In the year following Katie Couric’s Today show colonoscopy, there was a significant increase in screenings in the United States. A study from 2003 found that colonoscopy utilization rates increased in two large data sets following Katie’s promotion.  The first data set found an increase in the number of colonoscopies performed per month from 15 to 18.01. Additionally, analysis of the second data set, which was comprised of adults in a managed care organization, found that colonoscopies increased from 1.3 per 1000 people per month to 1.8 per 1000. This finding of increased screenings is called the Katie Couric Effect.

The Importance of Destigmatizing Colonoscopies

This video is important in a lot of ways. Having a celebrity share their experience with colon cancer screening can impact a lot of people and save many lives. As of the writing of this blog post, over 3.2 million people have watched the video.

Many people are uncomfortable with the idea of a colonoscopy, and avoid screenings for far too long. In particular, the idea of having an endoscope enter your body through your anus and the bowel prep associated with the procedure are barriers for some people. This is a problem, because screenings are extremely effective: colon cancer is the second leading cause of cancer-related death in the US and the survival rate for early detection of colon cancer is around 92%. Clearly, screenings save lives.

Our experienced team at GHP has years of experience performing colorectal cancer screenings. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Remembering Chadwick Boseman and the Importance of Colon Cancer Screening

The loss of Chadwick Boseman on Friday, August 28th came as a tragic surprise to the world. Only 43 years old, the actor, writer, and director had made a name for himself through his leading portrayals of American heroes such as Jackie Robinson in 42 (2013), James Brown in Get On Up (2014), and Thurgood Marshall in Thurgood (2017). His most iconic role was that of superhero T’Challa in Black Panther (2018). This role cemented his place in the Marvel franchise and the hearts and minds of people worldwide. Boseman’s cause of death was colon cancer, of which he had privately fought for four years prior.

This form of cancer is the third most commonly diagnosed and second most likely cause of death in men and women. Boseman’s death serves as a moving testament to our own mortality and the silent struggles many face. It also is a reminder to practice preemptive measures against this aggressive form of cancer. 

About Chadwick

Chadwick Boseman was born in 1976 in Anderson, South Carolina. He attended Howard University, where he pursued the dream of becoming a director. After graduating, he moved to New York City, where he wrote and directed plays, teaching acting on the side. It was only once he was cast in a recurring role on ABC’s “Lincoln Heights” that he began to consider a career as an actor.

On a whim, he moved to Los Angeles, acting in a number of roles before his breakout lead as Jackie Robinson in 42. Brian Helgeland, the writer of 42, noticed Boseman’s talent and stage presence immediately. “It’s the way he carries himself, his stillness — you just have that feeling that you’re around a strong person…” In the following years, Boseman continued to gain widespread acclaim, earning MTV Movie Award’s “Best Hero” title in 2018 and the top award of Outstanding Performance at the 2019 SAG Awards. Indeed, it felt as though Boseman’s career was just beginning.

Colon Cancer Screenings

Chadwick Boseman’s untimely death shines a light on the very serious risks of colon cancer. According to the Colon Cancer Coalition, one in 24 people develop colon cancer, with an equal risk in males and females. There are often no signs or symptoms associated with the onset of the disease. Therefore, diagnosis can be late, worsening chances of remission. A lot of people are only diagnosed through routine screenings, which doctors recommend to begin at 45 years of age. Many people fail to follow through with these recommendations. According to The National Colorectal Round Table, “if 80% of the eligible population was screened at the age of 50, the number of colorectal cancer-related deaths could be cut by 230,000.” Thus, following through with basic preventative measures can drastically reduce incidence.

Prevention

Prevention can begin at any age. Regular exercise, good diet, not smoking, and limiting processed foods/red meats can reduce the risk of developing colon cancer. Colon cancer does run in the family. Those with relatives who have had it have a 2 to 3 times higher chance of developing the disease.

You can dramatically reduce the risk of developing colon cancer. Educate yourself on personal risks and stay up-to-date with colon cancer screenings. For more information on colon cancer prevention and screenings in Kentucky and Southern Indiana, you can schedule an appointment with a gastroenterologist at Gastro Health Partners. Contact an office near you today for details.

Featured article: Colon cancer screening should start at 45, government panel recommends

Colon cancer screening guidelines are changing, and starting screenings earlier will help save lives. Gastro Health Partners fully endorses these changes. Read more about the changing guidelines in this featured article from NBC News:

Colon cancer screening should start at 45, government panel recommends

Screening for colorectal cancer should start at age 45, five years earlier than is currently recommended, according to draft guidelines from the U.S. Preventive Services Task Force.

The update was prompted by recent studies showing the rate of colorectal cancer rising in younger people, according to the draft, published Tuesday.

Click here to read the full article…

 

Chronic Diarrhea: What You Should Know

Chronic diarrhea can be caused by a variety of things, including infections, GI disorders, food intolerance, and a reaction to medication. Let’s take a closer look at the condition.

Causes and Risk Factors

Diarrhea is chronic when it occurs three or more times per day for more than two weeks. It has several potential causes. Infection is one main cause. This infection can be parasitic, and from parasites like Giardia or Cyclospora. Infection can also be bacterial, from bacteria like Salmonella and E. coli. Some viral infections cause chronic diarrhea too, like some rhinoviruses and rotoviruses.

Outside of infections, there are several other potential causes. Pancreatic disorders like pancreatitis and cystic fibrosis can be a cause. GI diseases like Chrohn’s and IBS can cause diarrhea as well. Intolerance to foods can be at play too- lactose intolerance and fructose malabsorption are two examples. Additionally, some medications like laxatives and antibiotics can cause chronic diarrhea.

Symptoms of Chronic Diarrhea

As previously mentioned, diarrhea becomes chronic if it occurs three or more times per day for two or more weeks. Diarrhea is characterized by loose, watery stools that occur often more frequently than usual. Other symptoms include abdominal pain, abdominal cramps, bloating, nausea, blood or mucus in stool, and a fever. It also dehydrates you over time. If left untreated, this can be very dangerous. You should always see a doctor for chronic diarrhea.

Diagnosis

Chronic diarrhea itself is simple to diagnose, based on the definition outlined above. When you see a doctor for chronic diarrhea, they will work to diagnose the underlying cause. Depending on your symptoms, medical history, medications, the results of a physical exam, and other factors, they will select the appropriate testing measures. Stool samples can be tested to help identify if parasites, bacteria, or viruses are a cause. Your doctor may also want to do a blood test. If initial testing does not reveal a cause, your doctor may order an x-ray or endoscopy.

Chronic Diarrhea Treatment and Prevention

The cause of the condition dictates its treatment. With any case of diarrhea, fluid replacement is key. You should consume fluids and salts to replace those lost through diarrhea, unless otherwise ordered by your doctor. Some fruit juices and soup can be good options here. If liquids are upsetting your stomach, your doctor may recommend an IV to help rehydrate you.

Diarrhea caused by infection can often be treated with antibiotics or other medications. Your doctor will prescribe the proper medication for you depending on your case. If infection isn’t the cause, it will likely take more time to determine the underlying cause and therefore appropriate treatment. Conditions like IBS, Chrohn’s, fructose malabsorption, and Ulcerative Colitis all have their own treatment approaches. Your doctor will work with you to determine the best treatment options depending on the underlying cause.

Preventing chronic diarrhea involves mitigating risk factors for its various causes. To avoid infections that cause diarrhea, always drink safe, clean, properly-treated water. You should also use good food handling techniques, and practice good hand hygiene after using the bathroom and around food. If some foods trigger diarrhea for you, narrow down what they are and avoid them if possible.

Our experienced team at GHP has years of experience treating GI conditions like chronic diarrhea. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

What is Esophageal Manometry?

Esophageal Manometry is a test that helps doctors measure the force and coordination of your esophagus. Here’s what you need to know about the test.

When it is used

Esophageal Manometry tests whether your esophagus is working correctly. Your esophagus is a smooth muscular tube that pushes food and liquid from the mouth to the stomach. Every time you swallow, your esophagus contracts and helps move everything to your stomach. Your esophagus can have trouble functioning correctly if you have certain disorders.

There are a few scenarios in which this test may be used. If your primary symptoms are pain while swallowing or a difficulty swallowing, your doctor will likely recommend other testing (like an Upper Endoscopy). Your doctor may recommend you undergo Esophageal Manometry if you present symptoms that could be due to an esophageal disorder. These disorders include Scleroderma, Achalasia, and diffuse esophageal spasms. Additionally, if your doctor is considering surgery to treat your GERD, esophageal manometry can help diagnose Achalasia or Scleroderma, both of which can’t be treated surgically. Also, if you are experiencing chest pain unrelated to your heart and are unresponsive to GERD treatment, this test can help identify the cause of the pain.

Preparing for Esophageal Manometry

You should not eat or drink during the 6 hours before the test. This is because an empty stomach helps your doctor perform the safest and most effective test. Additionally, you should discuss any medications you are taking with your doctor. Some medications can affect esophageal pressure, and should be discontinued before the test.

During the test

You will not be under a general anaesthetic during the testing. However, a topical anaesthetic will be used in your nose and a numbing spray will be used in your throat. Your doctor will pass a thin tube (catheter) through one of your nostrils and down into your esophagus. You may gag briefly as this happens. Once the catheter is placed, you may be asked to lie on your back. Next, you will swallow small sips of water as directed by your doctor. The catheter will help measure the pressure your esophagus exerts as you do this. You will need to breathe slowly and smoothly during the test, remaining still and following your doctor’s instructions. The test takes around 30 minutes in total.

After the test

Following the test, there are a few mild symptoms you may experience. These include a sore throat, a nosebleed, and a stuffy nose. These should resolve in a few hours. You can immediately resume normal activities after your testing, unless your doctor tells you otherwise. If you experience any lasting or unusual symptoms, contact your doctor.

Side effects from Esophageal Manometry are very rare. These include aspiration, an irregular heartbeat, and perforation of the esophagus.

Our experienced team at GHP has years of experience performing Esophageal Manometry. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Bile Duct Diseases: An Introduction

Bile ducts are tubes that primarily carry bile from the liver and gallbladder to the small intestine to help digest fats.

Several diseases in the bile ducts can prevent proper bile duct functioning. Read along to find out more.

Bile duct disease

There are several bile duct diseases that can occur. Gallstones are one common issue for bile ducts. These form when deposits of digestive fluid harden in the gallbladder. They can cause inflammation, increasing pressure in the gallbladder and potentially blocking a bile duct. Another common bile duct condition is cholangitis, which is inflammation in the bile duct system. This is often caused by a bacterial infection.

Bile ducts can also have strictures (narrowing). In other cases, they can leak. Cancer can also occur in the bile ducts. Bile duct cancer is rare and aggressive. Additionally, some infants are born with a condition called biliary atresia, in which bile ducts are scarred and blocked. This causes a buildup of bile in the liver and can damage it.

Symptoms of Bile Duct Diseases

Bile duct diseases tend to have some of a group of symptoms. These include abdominal pain, nausea, vomiting, itchy skin, fever, chills, weight loss, loss of appetite, and jaundice. Pain may occur in the upper abdomen and radiate to the back in some cases. Depending on the disease, these symptoms can be at differing levels of severity and present in varied ways. The progression the disease also influences the severity and types of symptoms.

Diagnosis

Doctors diagnose bile duct diseases in a few different ways. Bilirubin blood testing can identify high levels of bilirubin in your bloodstream and can diagnose jaundice. Doctors can perform an Endoscopic Retrograde Cholangiopancreatogram (ERCP) to diagnose diseases. In an ERCP, they can inject contrast dye to help image your bile ducts during an x-ray. They can also perform an Endoscopic Ultrasound (EUS) to examine your bile ducts and make a diagnosis.

Treatment

Treatments vary depending on the type of bile duct disease. ERCP, in addition to helping with diagnosis, can help treat disease. Doctors can pass tools through the endoscope during an ERCP and open blocked ducts, remove or break up gallstones, insert stents, and even remove tumors. Doctors can also help drain bile during an EUS by inserting a stent to help drain into the small intestine or stomach. One other emerging treatment involves using Radiofrequency Ablation for palliative care to treat the symptoms of bile duct cancer. This can be a way to manage pain for long-term cases of cancer.

Surgery may also be necessary in some cases. For example, with patients who have bile duct cancer, surgery can help to remove tumors. If tumors are very large, doctors may need to remove the liver and perform a liver transplant.

Our experienced team at GHP has years of experience treating conditions including bile duct diseases. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.