Kentucky reopens bars, swimming pools and music venues on Monday, allowing crowds of up to 50 people to gather indoors as the U.S. reports record cases of COVID-19.
Monday's plans are the latest in a series of reopenings phased in by Kentucky Gov. Andy Beshear's administration. Already, the state has opened restaurants, some child care programs, funerals and barbershops at limited capacities, among other businesses.
Experts in infectious diseases say it's likely that relaxing guidelines has contributed to the growth in daily case numbers seen in dozens of states around the country. In turn, last Thursday, the U.S. reported 41,000 new cases of COVID-19 in a single day — a new record.
Kentucky has not so far experienced the dramatic spike in cases seen in states including Arizona, Texas and Florida. Both Florida and Texas closed down bars Friday as a result.
Instead, the Commonwealth has maintained what Beshear often calls a "plateau," which he says is an inelegant way to say that cases maybe be going up and down day-to-day, but overall the caseload appears to be averaging out.
As of last week, Kentucky's seven-day average amounted to 182 newly reported cases per day, according to the WFPL News COVID-19 tracker.
Meanwhile, the rate of positive cases compared to the overall number of people tested in Kentucky has hovered between 2.5 and 4% over the last two weeks, which is better than many states currently experiencing spikes, according to covidexitstrategy.org.
Chief of Infectious Diseases at the Virginia Commonwealth University Dr. Gonzalo Bearman said the current numbers indicate Kentucky's phased reopening guidelines have thus far helped limit the spread of the virus. However, Bearman warns that relaxing measures further will result in new infections.
"As we relax some of these preventative measures, there's going to be an increase in cases," Bearman said. "Particularly if, when these measures are relaxed, there is a lack of social distancing, a lack of the use of the face mask. That's going to be a big problem."
Kentucky Public Health Commissioner Dr. Steven Stack said it's essential that people continue to practice good hygiene and follow social distancing guidelines as the state reopens.
Even as Kentucky maintains its plateau, surrounding states are seeing cases trending upwards. Ohio reported 900 new coronavirus cases last Thursday – the highest level seen since April, according to the Columbus Dispatch.
NPR reports daily cases are also increasing in West Virginia, Tennessee, Arkansas and Missouri.
Last week demonstrated how infections can cross state lines when Kentucky public health officials warned a cluster of travelers who visited Myrtle Beach tested positive for the virus after returning to the state.
"State lines, as we all know, our porous. We come and go and that's certainly a risk for increasing the rate of transmission and cases in Kentucky," Bearman said.
In recent weeks, the average age of people who are infected with the virus has also trended downward, suggesting that younger people are not adhering to public health guidelines as well as they were before states began to reopen.
Bearman said that younger people are less likely to die from the virus, but they can transmit the virus to others who are more vulnerable, including older people and those with compromised immune systems.
The record numbers of cases seen across the U.S. in the last week have prompted officials to cancel large events including Riot Fest in Chicago and the National Tractor Pulling Championship in Ohio. But in Kentucky, Churchill Downs Racetrack announced plans to hold the Kentucky Derby and Oaks in the first week of September.
The track, which can seat more than 150,000, will limit the venue capacity to reduce the crowd density, and restrict general admission ticket holders to the infield, though track president Kevin Flanery would not say how many people would be allowed into the stadium.
The Derby has traditionally attracted people from all over the world to attend the races, drink Kentucky bourbon and enjoy nights out in the city. Even with health guidelines in place, Bearman said this year's Derby has the potential to become a “super-spreader event,” similar to what happened at Mardi Gras this year.
"I can't see how that number of spectators could socially distance and somehow I just can't imagine how everyone is going to be wearing a face mask, so there is a high risk," Bearman said.
Beshear has said Kentuckians can expect the derby will look very different this year.
"The changes made to this year's Derby will help to protect the health and safety of every Kentuckian, which is my main priority," he said.
Still, Bearman warns the pandemic is "far from over" and expects the country will see a second wave of virus this winter.
He said officials should especially keep an eye the number of hospitalizations.
"I think if you have increasing cases and ongoing transmissions, particularly with increased hospitalizations and hospitals becoming overburdened, you have to rethink the current strategy," Bearman said.