To prevent hospitals from becoming overwhelmed with patients this fall and winter, Arkansas health officials Thursday emphasized the importance of getting a flu shot and taking steps -- such as wearing a mask -- that can prevent transmission of both the coronavirus and the flu.
State epidemiologist Jennifer Dillaha said only about half the people in Arkansas who should get the flu shot end up getting it each year -- a percentage the Department of Health hopes to increase this year.
"You don't want to get the flu and covid-19 at the same time," Dillaha said.
Also, she said, "flu vaccination can go a long way to keeping people out of the hospital, and we want to decrease the number of hospitalizations in Arkansas as much as possible because of the covid-19 pandemic."
Dillaha spoke as the state's count of coronavirus cases increased by 735, topping 47,000.
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The state's death toll from the virus, as tracked by the Department of Health, rose by seven, to 515.
The number of patients hospitalized with the virus fell by two, to 514, while the number of patients who were on ventilators increased by five, to 111.
The state's cumulative case count increased to 47,028.
The number of cases that were considered active rose by 21, to 6,958, as 707 Arkansans were newly classified as having recovered.
Although it had been increasing for six days, the number of active cases remained below the state's peak of 7,167 on July 20.
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At a news conference at the Health Department's headquarters in Little Rock, Health Secretary Jose Romero said he'd be comfortable opening schools to in-classroom instruction even if the virus keeps growing at the current rate.
Over a rolling seven-day period, the average number of cases added to the state's count each day dropped from 761 as of Wednesday to 753 as of Thursday.
That was down from a peak seven-day average of 817 new cases per day as of July 29.
"Right now, the numbers are not climbing significantly," he said. "I think we're fine to push forward with the plan to have in-school classes.
"We are keeping an eye on this daily and weekly and we'll make a decision if the numbers continue to rise significantly."
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Romero added that he hopes Gov. Asa Hutchinson's requirement for people to wear masks in public when they can't keep a safe distance from others will help slow the growth of the virus and that 200 antigen testing machines the state recently purchased will help the department respond to outbreaks.
Health Department spokesman Danyelle McNeill said the state has received all the machines and is expecting the kits needed to use them to arrive later this month.
Although top federal public health officials, along with the Arkansas chapter of the American Academy of Pediatrics, have called for delaying the start of in-person instruction in areas with high levels of transmission, Hutchinson and Education Secretary Johnny Key have said all schools must have options for on-site classes when the school year starts the week of Aug. 24.
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Key clarified Wednesday that means schools must offer on-site instruction every day when classes are normally held.
In consultation with the departments of Health and Education, however, schools can close school buildings in response to outbreaks.
"We want students in the classroom," Romero said Thursday. "We want to try to start school in a safe environment, with the ability to test appropriately, and that's why we're deploying these rapid antigen tests across the state.
"I think that at this time we are not going to change that. We are going to see whether there are significant outbreaks in schools. There will be cases sporadically within classes because some of these children are going to acquire their disease from the community, so we have to watch this very carefully."
Hutchinson, who usually leads the daily news conferences on the virus, was at a meeting of the Council of Governors at the Pentagon in Arlington, Va.
FLU CONCERNS
Rawle "Tony" Seupaul, the University of Arkansas for Medical Sciences' chief clinical officer and chairman of its emergency medicine department, said combining even the current level of virus hospitalizations with the flu season will be "quite a challenge."
He said the UAMS Medical Center is already almost at capacity. Just as they did earlier in the pandemic, hospitals would probably have to cut back on nonurgent procedures to free up space, causing them to lose revenue and forcing patients to put off needed care.
Since the symptoms of the flu and covid-19 are similar, hospitals would have to treat every patient with flu-like symptoms as if that person has the coronavirus, using up scarce protective medical gear.
"What we're all really concerned about is that if we have a coincident, either normal or worse than normal flu season, in terms of the number of hospitalizations, and we continue with a steady diet of coronavirus cases, hospital systems could get overwhelmed by that sheer volume," Seupaul said.
"Not only will that strain our resources to care for those patients, but other patients."
If the July 17 projections from UAMS' Fay W. Boozman College of Public Health hold true, with covid-19 hospitalizations reaching 2,591 in late November, "it could be very crippling to the health care system, quite frankly of the United States, not just Little Rock or Arkansas," Seupaul said.
"I think we'd be a microcosm of what the rest of the United States would be like."
On the other hand, he said, if people take precautions such as practicing good hand hygiene and wearing a mask in public, it will reduce the spread of not just the coronavirus but also the flu, making the patient load more manageable.
"There is, potentially, light at the end of the tunnel, or a silver lining to all this," Seupaul said. "If we can inculturate these behaviors now, we might be in a good place."
During the 2017-18 flu season, which was Arkansas' deadliest in decades, at least 1,653 Arkansans were hospitalized at some point, including 187 during the week of March 3-10, 2018, McNeill said in an email.
She said the actual number was probably higher since "there are a few major hospitals that do not report" flu hospitalizations.
Since the first coronavirus case was discovered in the state March 11, a total of 3,168 Arkansans had been hospitalized with covid-19 as of Thursday.
Dillaha said the Health Department will have the flu vaccine available next month and will hold drive-thru vaccination clinics starting Sept. 21.
The shot will be available at schools the following week, she said.
"Even before then, many clinics and pharmacies will have flu vaccinations available, and we encourage all Arkansans to go ahead and get one whenever it's available," she said.
The vaccine is recommended for most people age 6 months or older, she said.
She encouraged parents to have their children get the shot during back-to-school doctor visits and also get them caught up on other immunizations recommended by the U.S. Centers for Disease Control and Prevention.
LATEST CASES
The state's latest coronavirus cases included 73 in Pulaski County, 69 in Craighead County, 62 in Sebastian County and 27 in Poinsett County.
Benton and Garland counties each had 24 new cases, and Crittenden and Mississippi counties each had 23.
Cases also rose by 22 in Greene County and by 21 in Saline County.
At Hot Springs Health and Rehabilitation Nursing Center, the number of residents who were listed in Health Department reports as having tested positive jumped by 52, to 66, from Tuesday to Wednesday.
A department report Wednesday also listed the nursing home as having 10 deaths from the virus, up from none Tuesday.
Among staff members at the home, the number of cases increased by 14, to 31.
"Recently we had residents test positive for Covid-19," the home said in a statement Thursday. "We are doing everything we can to ensure we stop the spread of this virus within our community which includes testing of all staff."
The nursing home said it had "strict proactive measures" in place and an isolation wing with dedicated staff to care for residents with covid-19.
"We are in very close communication with local and state health officials to ensure we are taking every appropriate step presently," the home said. "The safety and well-being of our residents and staff is our top priority and we are following the recommended preventative measures until this virus has been eradicated from our community."
Statewide, the number of virus cases among nursing home and assisted-living facility residents rose Thursday by 15, to 1,425, while the number of deaths among residents rose by 12, to 182.
Meanwhile, a report from the Pulaski County coroner's office indicates a patient infected during an outbreak at the Arkansas State Hospital in Little Rock died Monday at the UAMS Medical Center.
Deed Thurman, 66, was transferred from the state-run psychiatric hospital July 9 while in respiratory distress and tested positive for the virus the same day, according to the report.
According to court records, Thurman, who suffered from schizoaffective disorder, was committed to the hospital last year after being charged in Sebastian County with second-degree battery of a police officer and found mentally unfit to stand trial.
Since the first case was discovered at the State Hospital in April, a total of 33 patients and 53 staff members have tested positive.
A Health Department report didn't list any deaths at the hospital as of Thursday.
Information for this article was contributed by Eric Besson of the Arkansas Democrat-Gazette.
