The uptick in the growth of coronavirus cases in Arkansas continued Wednesday as the state's count rose by 2,327 -- topping the increase the day before as well as the one the previous Wednesday.
The state's death toll from the virus, as tracked by the Department of Health, rose by 34, to 2,786.
The number of patients hospitalized with the virus in the state fell by 17, to 1,064.
Those patients included 179 who were on ventilators, down from 182 a day earlier.
The number of cases that were considered active rose by 304 to a new high, 18,765, as new cases outpaced recoveries.
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"It's still worrisome that we're well over 2,000 new cases today, over 30 deaths and we still have well over 1,000 people in the hospital," state Epidemiologist Jennifer Dillaha said.
She said it was likely that cases resulting from Thanksgiving gatherings were continuing to contribute to the elevated numbers.
The numbers were released about 6 p.m., hours later than usual.
Gov. Asa Hutchinson cited "a delay in our computer system" as the reason for the holdup.
Earlier Wednesday, he met with government, business and education leaders for more than an hour at The Jones Center in Springdale in the second of a series of meetings he plans to hold around the state to discuss the state's response to covid-19.
Like his meeting in Benton on Tuesday, the one Wednesday was closed to the public and drew protesters opposed to public health mandates.
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"The discussions around health care, education, and business provided my team and me with valuable insight into the challenges that are being faced as a result of this virus," Hutchinson said in a statement afterward.
Hutchinson has said he will also deliver an address to the state at 7 p.m. today that will be broadcast on various media outlets.
Also Wednesday, an inmate from the East Arkansas Regional Unit near Brickeys died at CHI St. Vincent Hot Springs, where he had been undergoing treatment for covid-19-related symptoms, the state Department of Corrections announced.
The inmate was in his late 40s and serving a 150-year sentence for sexual assault, according to the department.
Department spokeswoman Cindy Murphy said he was the state's 50th prison inmate to die from the virus.
PRISON OUTBREAKS
Wednesday's increase in cases topped the 2,283 cases that were added Tuesday as well as the increase of 2,212 cases a week earlier, on Dec. 2.
At a record level since Friday, the average number of cases added to the state's tallies each day over a rolling seven-day period rose by more than 16, to 2,162.
The cases added to the state's tallies Wednesday included 1,757 that were confirmed through polymerase chain reaction, or PCR, tests.
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The other 570 were "probable" cases, which include those identified through less-sensitive antigen tests.
The state's cumulative count of cases rose to 176,652.
That comprised 152,369 confirmed cases and 24,283 probable ones.
Pulaski County had the most new cases on Wednesday, 276, followed by Benton County with 165, Washington County with 136, Craighead County with 125 and Garland County with 89.
Among prison and jail inmates, the Health Department's count of cases rose by 30.
Murphy said the number of cases among inmates grew by 15, to 769, at the Varner Unit in Lincoln County.
The Tucker Unit in Jefferson County and the McPherson Unit near Newport each had two new cases, while the East Arkansas Regional Unit near Brickeys, the East Central Arkansas Community Correction Center in West Memphis and Northeast Arkansas Community Correction Center in Osceola each had one new case.
Of those prisons, the Tucker Unit had the largest number of cases that were active, 55, followed by the McPherson Unit, which had 43; the East Arkansas Regional Unit, which had 30; and the Varner Unit, which had 22.
The state's death toll rose by 31, to 2,552, among confirmed cases and by three, to 234, among probable cases.
Among nursing home and assisted living facility residents, the state's count of virus deaths rose by 14, to 1,183.
The number of patients who have ever been hospitalized with the virus in the state rose by 98, to 9,675.
The number of virus patients who have ever been on a ventilator rose by eight, to 1,068.
Meanwhile, the Health Department reported that 11.2% of the state's PCR tests were positive in the seven-day span that ended Tuesday.
That was higher than the 11% that was initially reported for the seven days ending Monday.
However, the percentage for that period later rose to 11.6% as the state received more test results.
Hutchinson said he wants to keep the number below 10%.
The Health Department also reported that 20% of the state's antigen tests were positive in the seven-day period ending Tuesday, down slightly from 20.7% for the week ending Monday.
MANDATES PROTESTED
Hutchinson said he met with community leaders in Springdale at the recommendation of his winter covid-19 task force so he can learn from the communities and make better decisions.
Mayors, county judges, hospital administration and school superintendents discussed the need for more information and marketing related to the covid-19 vaccines, he said.
Outside The Jones Center, about a dozen people, including Benton County Justice of the Peace Carrie Perrien Smith, gathered without masks.
Some held up signs with messages such as "I have an immune system" and "Your corona mandates kill small businesses."
Kelly Thonell, 49, of Rogers said she was turned away at the door from the meeting. She held a double-sided sign that read "Masks don't work" on one side and "Asa works for we the people" on the other.
She said people should have the choice whether to wear masks and should focus on improving their immune systems.
"We understand [Hutchinson] is not a health expert and [Health Secretary Jose] Romero is not elected by the people," she said.
Smith said she planned to attend the meeting because she thought it was open to the public. She said businesses should decide whether they want to require masks.
VACCINE 'SUMMIT'
On Tuesday, Dillaha represented Arkansas at the White House vaccine "summit" featuring President Donald Trump, Vice President Mike Pence, government experts, state leaders and business executives.
She said she was encouraged by comments by the leaders of FedEx and UPS, which will be responsible for delivering the vaccine developed by Pfizer and BioNTech if it is granted an emergency use authorization by the U.S. Food and Drug Administration.
"They have these really well-developed logistical systems for tracking and monitoring things, and that's what we need for the distribution of the vaccine, so it raised my confidence in the ability of the distribution systems in our country to work," she said.
An FDA committee is scheduled to make a recommendation on Pfizer's request for the emergency use authorization at a meeting today.
The authorization, if granted, could come within days of the meeting, and Arkansas could receive its first doses of the vaccine next week, Dillaha said.
The state's initial allotment of about 25,000 doses will go primarily to hospital workers.
"My hope is that by vaccinating hospital workers, we'll be able to lessen some of the stress on the hospital system because they will have fewer employees out due to covid illness or covid quarantine, so that may help," she said.
"But the overall spread of the disease in the community, it will take us much longer to really have an impact. It's going to be important for large numbers of people to participate by getting vaccinated, so that we'll have fewer and fewer people who are vulnerable to the disease, and so that's going to take several months."
Elsewhere on the vaccine front, the University of Arkansas for Medical Sciences is participating in a clinical trial of a vaccine developed by Janssen, a pharmaceutical company owned by Johnson & Johnson.
The trial will involve some 40,000 participants globally who will be followed for two years after receiving a single injection, Kristine Patterson, an infectious disease specialist and associate professor at the UAMS College of Medicine, said Wednesday during an online covid-19 vaccine forum.
The trial is close to launching at UAMS and may start enrolling participants as soon as Monday.
"We are really excited to be able to participate in this," Patterson said. "We are looking forward to being able to enroll participants who are diverse populations, particularly elderly diverse."
Patterson said it does not matter if people have contracted or not contracted the coronavirus to participate.
"That is not one of the exclusionary criteria," she said.
SCHOOL SHIFTS
Citing "an increasing number of staff and students in a short period of time" who were required to quarantine because of their proximity to one or more people who tested positive, the Pulaski County Special School District announced Wednesday that College Station Elementary School and Maumelle Middle School would shift to virtual instruction for the remainder of the week.
"Although the actual number of positive cases for covid-19 are low, we want to ensure that all students and staff remain healthy and safe," the district said, adding that administrators will assess on Friday whether students can safely return to those campuses Monday.
The Jacksonville North Pulaski School District announced that varsity girls' basketball had been suspended until further notice after a player tested positive, resulting in 10 student athletes and two coaches having to quarantine.
In its daily coronavirus update, the Little Rock School District reported that eight students and three employees at several schools had tested positive in the 24-hour period ending at 3 p.m. Wednesday.
An additional 70 students and 19 employees were required to quarantine after being near someone who tested positive.
The University of Arkansas, Fayetteville, reported 29 new cases among students and employees since its last update on Monday.
The number of cases that were active grew from 62 to 80.
The University of Arkansas at Little Rock reported 13 active cases on campus as of Wednesday morning.
As of Tuesday, the University of Central Arkansas in Conway logged 388 cumulative positive tests since March 13, an increase from the 378 total positives UCA reported on Dec. 1.
BEDS INCREASE
Even with the addition of 26 more hospital beds to the state's inventory, the number of regular beds available for new patients dropped by 32, going from 2,267 to 2,235 on Wednesday, according to Health Department data.
The total beds -- whether filled or vacant -- increased from 8,927 to 8,953. The total beds include a few hundred in psychiatric or rehabilitation facilities that are not used for covid-19 care.
That means that 75% of the state's hospital beds are full.
Out of the state's 1,161 intensive-care beds, only 81 -- or 7% -- remained available. ICUs had 375 covid-19 patients as of Wednesday afternoon, 19 fewer than on Tuesday.
Out of the state's 1,054 ventilators in inventory, 631 -- or 60% -- remained available, 30 fewer than the previous day.
The state's total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- increased by 143 beds to 8,923 as of Wednesday evening.
Maximum flex bed capacity -- the number of beds at the hospital regardless of the facility's ability to staff them -- increased by 299 beds to 11,503.
FATIGUE A WORRY
Dr. Gerry Jones, chief medical officer for CHI St. Vincent Infirmary, graduated medical school nearly 40 years ago -- at the very beginning of the HIV/AIDS epidemic.
The human immunodeficiency virus attacks the body's immune system and can lead to AIDS, acquired immunodeficiency syndrome.
Since the beginning of the AIDS epidemic, more than 76 million people have been infected with the HIV virus and about 33 million have died worldwide.
"I have never seen anything like this," Jones said, referring to the covid-19 pandemic. "Even the very early days of HIV -- which created profound changes in the way we deliver health care -- it never threatened to acutely overwhelm the system like it is in this pandemic. This is unprecedented."
In his office, Jones has a large bookshelf filled with tomes to which he typically turns when stumped by a medical problem.
"But I can't go to any of them to get a route to how to do this virus," he said. "It has been a real learning experience for all of us."
Every morning, Jones begins his day in the emergency room and then winds his way through different units, including the covid-19 unit.
"And every day I'm amazed at the resiliency of the nurses and doctors that care, not only for the covid patients, but for all the patients in the hospital," he said. "I'm incredibly proud."
Jones said it's important to CHI St. Vincent hospital leadership that they are as transparent as possible with the employees on the front lines.
"We send out a lot of informational emails," he said. "One of the lessons we learned in the early days of the pandemic is that the information vacuum will get filled. We wanted it to be filled with appropriate information."
Jones said he worries about health care workers developing pandemic fatigue -- or contracting the virus.
According to the latest Health Department data, health care workers comprise 8% of the total covid-19 cases.
"We're now going into about nine months of this," Jones said. "We just have to keep up our standards and not drop our guard in order to keep ourselves as safe as we can."
The medical staff at St. Vincent's, like hospitals everywhere, are stretched to the limit working overtime and filling in for colleagues on quarantine.
"In any difficult situation there are folks that are really to be admired, real heroes," Jones said. "The people that come to the hospitals every day and put themselves in personal risk to care for the very sickest patients in the state of Arkansas, we can't thank those people enough."
Maintaining staffing at adequate levels, which was difficult before the pandemic, is even more pronounced now, Jones said.
"We're constantly looking at where we are. We don't have a big untapped pool to go out and hire people," he said. "The bigger question is: 'How can we keep our people here safe?' We have a large number of our staff that go out on quarantine because of exposure. That's really hurtful to us, so we focus on keeping those folks safe."
St. Vincent leadership huddles twice a day, Jones said.
"We look at exactly where we are at this moment, to see what changes, what shifts, we need to make to accommodate what's in front of us," he said.
Jones and other hospital leaders in the state also meet weekly with the Arkansas Hospital Association to talk about challenges and brainstorm solutions.
If there is anything positive to come from the pandemic, Jones said, it has been the once-competitive hospital industry joining forces to combat the virus and meet its unprecedented challenges.
"We've learned how to work together in a way we never have before," he said. "I know that if we find ourselves in a bad situation, I have no concerns that I couldn't pick up the phone and call the folks at Baptist, the folks at UAMS, Children's, the Heart Hospital and tell them what's going on. They would be ready to help us."
Jones added that the state and the Health Department have been "great partners."
The lessons learned in health-care management as well as medical treatments during the pandemic will make an indelible mark, Jones said.
In the early days of the pandemic, the general belief was that the earlier a patient was intubated and placed on a ventilator, the safer they would be, he said.
"Time has shown that was not the appropriate strategy," Jones said. "Now we work very hard to keep that patient off the ventilator. We know if we can, the prognosis will be better."
St. Vincent as well as numerous hospitals around the state are now offering antibody infusion treatments and continually exploring other strategies.
"Also, any improvement that we can make in efficiency helps us," Jones said. "If we're able to get a person better and get them home a day earlier, those cumulative efficiencies amount to the same thing as being able to find more staff."
Masking, hand hygiene and social distancing "absolutely work to reduce transmission of the virus," Jones said.
"This is true particularly during the holiday season," he said. "This year is different than any other year that any of us have been through. Don't underestimate the risks that are involved. Take this seriously and do the things we know are effective."
Information for this article was contributed by Lara Farrar of the Arkansas Democrat-Gazette.
