Gov. Asa Hutchinson said Wednesday that hospitals and clinics will once again be able to perform some types of elective surgeries starting Monday, opening the door for surgical abortions to resume as long as the provider meets state requirements.
At his daily news conference on the coronavirus, Hutchinson also laid out a schedule for when he will announce decisions about whether and how restrictions on restaurants, fitness clubs, hair salons, places of worship and large events will be eased, starting May 4.
"We're going to be watching the data every day," Hutchinson said. "We're going to be working with the industry to see what kind of public health requirements and guidelines can be put in to place to give the consumers confidence.
"So we're not prejudging it. We want to be able to open up Arkansas back to business, but we're also going to take it a step at a time and study the data as we move to those decision points."
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The Republican governor last week set May 4 as a target to begin lifting some of the restrictions, which were established to slow the spread of the coronavirus, if the state meets criteria set out in the White House's "Guidelines for Opening Up America Again."
But he said at the time that he would follow the recommendation of a medical advisory board to begin allowing some elective procedures to resume even before that target date.
On Wednesday evening, the state's number of coronavirus cases included in the tally on a state website increased from the previous evening by 130, to 2,392, while the state's death toll from the virus rose by one, to 44.
The official case total still did not include all the cases associated with an outbreak at the Cummins Unit in Lincoln County.
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Department of Health Secretary Nate Smith said that, from Monday evening to Tuesday evening, the number of inmates who had tested positive there had increased by 11, to 681, and the number of cases among staff member had increased by four, to 14.
A state website listed the county as having only 512 cases on Wednesday evening.
Smith said cases from the prison outbreak are being added to the state total as information from laboratory reports are entered into a state database.
ALLOWED PROCEDURES
Under a new Health Department directive, hospitals and clinics will be able to resume performing elective surgeries on Monday that aren't expected to require overnight hospitalization, Smith said.
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The surgeries will still be prohibited for a patient who has symptoms of covid-19, the disease caused by the coronavirus, or has had contact within the past 14 days with someone who was infected with the virus.
Providers will also have to test the patient for the virus within 48 hours before the surgery, he said.
"Initially, we're going to encourage the facilities to start with a smaller volume and to build up and to make sure they have adequate supplies of" personal protective equipment, Smith said.
Smith said the new directive will allow some types of dental procedures.
Rural hospitals with fewer than 60 beds were exempt from the ban on elective procedures and won't be subject to the new requirements.
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The new rule will lift a prohibition, in place since April 4, that was designed to preserve hospital capacity and protective medical gear.
It prohibits routine office visits and any procedures that can be safely postponed.
The department cited that directive earlier this month when it ordered Little Rock Family Planning Services to stop performing all surgical abortions not necessary to protect the life or health the mother.
The order sparked a court fight, with the state winning the latest round on Wednesday when a federal appeals court dissolved a judge's temporary restraining order that had allowed abortions to resume.
American Civil Liberties Union of Arkansas interim Director Holly Dickson, who represents Little Rock Family Planning in its challenge of the Health Department order, said she didn't know yet whether the new Health Department requirements will pose a problem for the clinic.
"We've got to look at the language," she said.
The elective-procedure ban has meant less revenue for hospitals, which haven't seen the expected surge of coronavirus patients.
On Wednesday, 97 coronavirus patients were hospitalized, up from 86 on Tuesday but well short of the 1,000 that Arkansas officials once predicted the state would have at its peak of the pandemic.
The Arkansas Hospital Association is "very supportive" of easing the restrictions on elective procedures, Chief Executive Bo Ryall said.
Like Dickson, he said he wanted to see the details of the new directive.
"Hospitals are used to testing," he said. "They're used to screening patients, and I think they would comply with this in order to have a safe environment for patients to come in and receive procedures."
DECISION DATES
To slow the spread of the virus, Hutchinson has closed public school buildings; limited restaurants to takeout, drive-thru and delivery only; closed movie theaters, hair salons and other businesses; and prohibited indoor social gatherings of more than 10 people.
Before states begin easing such restrictions, the White House guidelines recommend that states meet certain criteria, including having a downward trend of new cases that are found each day or of a percentage of test results that are positive for two weeks.
Under the first phase of eased restrictions, the guidelines suggest that restaurants could open to indoor dining, and movie theaters, fitness clubs and other businesses could open as long as they took precautions, such as ensuring that customers maintain adequate distance from one another.
Hutchinson said he will announce a decision on any changes affecting restaurants on April 29; on fitness clubs on April 30; on beauty salons and barber shops on May 1; and on places of worship and "larger venues," such as sporting events, on May 4, the target date for any of the changes to take effect.
The state hasn't issued restrictions on places of worship but has advised them to limit person-to-person contact and allow people to keep a distance of 6 feet from one another.
Hutchinson cautioned that, whatever he decides, Arkansans will still be urged to take precautions such as staying 6 feet away from other people when in public and wearing a mask when that distance is not possible.
"Our life is not going to change in terms of our self-protection and our admonishment that if you're in a vulnerable population, you need to be careful," Hutchinson said.
CHANGES FEARED
Rep. Denise Garner, D-Fayetteville, a retired nurse practitioner who has advocated for more stringent measures, said she worries the state won't be ready to start easing restrictions on May 4.
She said the state needs to expand its testing and do more to educate the public about the virus's dangers. Everyone should be tested before they are allowed to return to work, she said.
"I'm still walking into grocery stores where employees aren't wearing masks, and that's frightening," she said. "I think we are seeing too many people that are not taking this seriously or don't understand the seriousness of the disease."
Little Rock Mayor Frank Scott Jr., whose request to Hutchinson for a stay-at-home order covering the city was rejected, said he's looking forward to hearing more from the economic recovery task force, appointed by Hutchinson last week to make recommendations on lifting restrictions.
If the task force, which includes state officials and representatives of several industry groups, recommends that restaurants open to dine-in service on May 4, the city will work to be prepared for that date, Scott said.
"I'm not sure that we will be, but we'll do all that we can to be ready with the prioritization of health and a balancing of our economy," he said. "What we want to do is be sure that when we open back up, that health is a priority, and also understanding the new normal of the business model."
Scott said he'll also share feedback with Hutchinson from the city's own covid-19 task force and its business community.
He said the city continues to review the need for its 9 p.m.-to-5 a.m. curfew and would likely scale it back when the state begins easing restrictions.
Within a week or two, he said, the city plans to unveil its own "rebuild the Rock" plan on "how we rest, restore and rebuild as a city."
"I always want to put the health, safety and welfare of the citizens first, but also understanding that we have to balance our economy to ensure that we have a sustainable Little Rock that we plan to rebuild to be stronger than ever," Scott said.
LATEST DEATHS
The latest deaths from the virus to be added to the state's tally were of people from Miller and Washington counties -- the first coronavirus deaths in those counties that have been reported, according to a state website.
Also, the Health Department said a death that had been listed Tuesday as having been that of a Howard County resident was actually of a Missouri resident who died in that county.
That death was removed from Arkansas' total and added to Missouri's, according to Arkansas' Health Department.
In addition to trying to contain prison outbreaks, the Health Department has been investigating outbreaks at dozens of nursing homes.
On Wednesday, the number of the state's nursing home residents who had tested positive increased by 35, to 178, from a day earlier, according to Health Department reports.
That included 19 more residents at The Lakes at Maumelle Health and Rehabilitation, bringing the total there who have tested positive to 30.
One 78-year-old resident of the home died last week.
At Briarwood Nursing and Rehabilitation Center in Little Rock, the nursing home with the state's biggest outbreak, the number of cases among residents grew from 39 to 47.
According to coroner's reports, that includes four residents who have died of the virus.
At Walnut Ridge Nursing and Rehabilitation Center, where one resident has died of the virus, the number of cases among residents grew from 29 to 34.
A resident at Harris Health and Rehab in Osceola and a worker at Rogers Health and Rehabilitation Center were also among those testing positive.
That brought the number of nursing homes where at least one worker or resident has tested positive from 29 to 31.
Two residents at Willowbend Healthcare and Rehabilitation in Marion are also among the state's eight nursing home residents who have died from the virus.
Meanwhile, the number of Arkansas health care workers who have tested positive increased on Wednesday by 13, to 262.
Among the state's hospitalized patients, the number who were on ventilators dropped by four to 23.
In Pulaski County, the number of cases increased by 14, to 414, from Tuesday evening to Wednesday evening.
Jefferson County had one new case, bringing its total to 147.
The totals didn't change in two other counties with more than 100 cases. Those were Crittenden County, which had 147 cases, and Garland County, which had 109.
Information for this article was contributed by Linda Satter of the Arkansas Democrat-Gazette.
A Section on 04/23/2020