Arkansas' first doses of the coronavirus vaccine continued to arrive at hospitals Tuesday as the state's death toll from the virus topped 3,000.
University of Arkansas for Medical Sciences Chancellor Cam Patterson said medical assistant Yolanda Emery was the first employee at UAMS Medical Center in Little Rock to receive the shot after the hospital received its first shipment Tuesday.
"Hip-hip-hooray," Patterson tweeted, along with a photo of him giving an elbow bump to Emery.
"It's not over yet but hopefully now we can see a light at the end of the tunnel," Patterson said in the tweet.
The shipments arrived as the number of people who have ever been hospitalized in the state with covid-19 passed the 10,000 mark, rising by 105, to 10,096.
The state's count of cases rose by 2,141 -- a bigger increase than the ones on the previous two days but slightly smaller than the 2,283 cases that were added a week earlier, on Dec. 8.
The state's death toll from the virus, as tracked by the state Department of Health, rose Tuesday by 26, to 3,016.
Of the state's initial allotment of 25,000 doses of the vaccine developed by Pfizer and BioNTech, UAMS Medical Center and Baptist Health Medical Center in Little Rock on Tuesday each received two trays, with each containing 975 doses.
Sixteen other hospitals, each with at least 1,000 employees, were to receive one tray each, as did the Health Department, which administered the first vaccination in the state to one of its nurse practitioners on Monday.
Other shipments were designated for pharmacies that were to deliver the vaccine to about 60 smaller hospitals.
During his weekly covid-19 news conference on Tuesday, Gov. Asa Hutchinson said state health officials should learn Friday when to expect more shipments of the vaccine and that that "should be a recurring process."
UAMS received its shipment at 9 a.m. Tuesday, said Robert Hopkins, division chief of internal medicine and chairman of the National Vaccine Advisory Committee.
Hopkins, who was among those who received a shot, said he was unsure of how many of his colleagues also had injections.
"Our goal is to vaccinate those who are providing care to patients who are potentially or actively infected first," Hopkins said. "Then we will spread out to support services for those areas."
In a news release, the hospital said its employees were prioritized "based on potential exposure and risk of transmitting the virus, with employees working in intensive care units, the Emergency Department, COVID testing sites and units with COVID-positive patients being given the first opportunity to receive the vaccine."
"This includes physicians, nurses, therapists and other health care workers along with transport, registration, environment services and nutrition services employees," the hospital said in the release.
"Other health care workers and students who work directly with patients will be offered the vaccine as additional quantities become available."
Baptist Health in Little Rock began administering the vaccine on Tuesday afternoon, "giving priority to employees and caregivers who work in covid units and support departments," spokeswoman Cara Wade said in an email.
The hospital is equipped to administer up to 500 vaccinations daily, Wade said.
"We are hoping to receive another shipment of vaccines in a week," she said.
Unity Health, which has its White County Medical Center and other campuses in Searcy, as well as a hospital in Newport, received its first allocation Tuesday morning, Roddy Lochala, chief medical officer, said.
Between 15 and 20 employees received vaccinations that afternoon, he said.
"We started with a dry run, or soft opening, of immunizing a few people," he said. "So far, so good. We have confirmed our processes were good, and we are ready to open up our vaccination for all of our associates."
Lochala said he expects up to 70 employees to be inoculated daily.
"But being mindful, we need to stagger different people in different departments," he said. "If we do everyone in all departments all at once, if there are some side effects, we don't want everyone down at once."
Sam Lynd, chief executive officer of NEA Baptist Memorial Hospital in Jonesboro, said his hospital received its shipment with 975 doses at 10 a.m. Monday.
[Video not showing up above? Click here to watch » https://www.youtube.com/watch?v=xbVodneGHEk]
"By 2:30 p.m., we had given our first dose to Dr. Steven Stroud, our infectious disease doctor who's been battling on the front lines over the last several months," Lynd, appearing via a video connection at Hutchinson's news conference, said.
He said the vaccine was then administered to nine other workers, including nurses in intensive care units for covid-19 patients as well as emergency room nurses, respiratory therapists and several physicians.
The hospital was planning to give the shot to 80 more workers Tuesday afternoon, then give it to 100 or more a day over the next several days, he said.
Lynd added that the hospital had administered monoclonal antibody treatments to just over 100 "high risk" patients over the past few weeks and that so far none had been hospitalized.
"We believe yesterday was a milestone and a turning point for our battle," he said. "Our staff are excited about what that means and that there's a light at the end of the tunnel."
But he stressed that hospital staff members remain busy caring for covid-19 patients and urged Arkansans to take precautions, such as wearing masks and practicing social distancing.
"Our ICU units remain full," he said. "For each one that we're able to move out of the unit, there's certainly one awaiting to be admitted."
The Health Department, which administered the shot to 10 employees Monday, gave it to 215 employees Tuesday, spokesman Gavin Lesnick said.
Health Secretary Jose Romero said he expects the state to receive about 25,000 more doses of the Pfizer vaccine next week.
He said he also expects the state to receive about 45,000 doses of a vaccine from Moderna next week that will be designated for nursing home workers and residents if it receives an emergency use authorization from the U.S. Food and Drug Administration.
TRANSFER SYSTEM READY
At his news conference, Hutchinson said the state was ready to implement a system, similar to the state's trauma system, to help match covid-19 patients to hospitals with available bed space and other resources.
Jerrilyn Jones, the Health Department's preparedness medical director, said the COVIDComm system would go live today.
"The primary responsibility of caring for covid patients will be at the facility where that patient presents," Jones said.
"However, if it turns out that that facility is unable to care for the covid patient because they are out of beds, there's no ICU when the patient really requires an ICU level of care, that is when this TraumaComm or COVIDComm system will be initiated."
Hutchinson announced Dec. 1 that the state would create the system, following a recommendation from his winter covid-19 task force.
He said it would cost about $70,000 a month and that the Health Department would be able to pay for it the first few months.
According to a slide Hutchinson displayed at his news conference Tuesday, the system involves a "clinical tool" used to assess a patient's needs and groups hospitals according to their ability to provide "complex ICU care."
"It will be an incredible tool that will help our hospitals utilize more efficiently their scarce resources and also benefit the patients because patients will go to the right hospital with the right level of care for them," Hutchinson said.
Hutchinson also said he was still considering tightening restrictions on indoor events in commercial venues, a possibility he first raised almost two weeks earlier.
He said the Health Department was conducting a 10-day "compliance blitz" to enforce its rules for businesses.
"We want to give that time to operate," Hutchinson said.
Since June 15, a Health Department directive has required events such as weddings, concerts and plays with more than 100 people to submit plans to the department for approval.
Romero said officials have discussed lowering the threshold so that organizers of events with more than 10 people would be required to submit plans.
Lesnick said the enforcement "blitz" started Dec. 7 "and included a focus on facilities that will likely see high volumes of customers in the weeks approaching the Christmas holiday."
"The purpose is to assist the facilities to understand the directives and how best to implement them," Lesnick said in an email. "If a business is identified as falling short, the goal is to educate the operators so that staff and employees are protected as much as possible.
"This has led to greater compliance with the directives, though we have not issued citations or fines as a part of this effort."
Also at the news conference, Corrections Secretary Solomon Graves said the state had administered 44,000 rapid antigen tests to prison employees, including 141 who tested positive, through a weekly regimen that started in October.
"While that may appear to some to be a small amount, within a congregate housing setting being able to get in front of the asymptomatic spread of the covid virus is an extremely important tool," he said.
He said the Department of Corrections will receive an allocation of 43,000 rapid antigen test kits from the Health Department, allowing it to continue the weekly testing through late February or early March.
He said he expects prison employees to begin receiving the vaccine in late January, with medical workers receiving the first doses.
Inmates should start receiving the vaccine in late February or early March, he said.
Romero later said, however, that an advisory committee to the U.S. Centers for Disease Control and Prevention hasn't yet made a recommendation on who should get the vaccine after health care workers and long-term care facility residents.
The group is expected to include "essential workers" such as teachers but not prison inmates, he said.
The Advisory Committee on Immunization Practices, led by Romero, is scheduled to vote on the issue Sunday, a day after voting on whether to recommend emergency authorization of the Moderna vaccine.
[DOCUMENT: State Health Department’s phased vaccination plan » arkansasonline.com/1216plan/]
HOSPITALIZATIONS RISE
The number of people hospitalized in the state with covid-19 rose Tuesday by 20, to 1,070.
Those patients included 190 who were on ventilators, up from 180 a day earlier.
The number of virus patients who have ever been on ventilators rose by four, to 1,099.
Over a rolling seven-day period, the average number of cases added to the state's tallies each day fell Tuesday by 20, to 2,125.
The cases added Tuesday included 1,236 that were confirmed through polymerase chain reaction, or PCR, tests.
The other 905 were "probable" cases, which include those identified through less-sensitive antigen tests.
The state's cumulative count of cases rose to 189,198.
That comprised 161,592 confirmed cases and 27,606 probable ones.
The number of cases that were considered active fell by one, to 20,690, as 2,116 Arkansans were newly classified as having recovered.
Pulaski County had the largest number of new cases, 273, followed by Benton County with 172, Washington County with 137, Saline County with 97 and Craighead County with 96.
Among prison and jail inmates, the Health Department's count of cases rose by 12.
Corrections Department spokeswoman Cindy Murphy said the McPherson Unit near Newport and the Tucker Unit in Jefferson County each had two new cases.
That brought the number of inmates who have tested positive to 645 at the McPherson Unit and 295 at the Tucker Unit.
Of those cases, 25 at the McPherson Unit and 63 at the Tucker Unit were active as of Tuesday.
The state's death toll rose by 16, to 2,672, among confirmed cases and by 10, to 344, among probable cases.
Meanwhile, the Health Department reported that the percentage of the state's PCR tests that were positive over a rolling seven-day span fell from 11.2% as of Sunday to 10.5% as of Monday.
The percentage for a given day tends to increase as more test results are reported.
Hutchinson has said he wants to keep the percentage -- a gauge of whether a state's testing is adequate --below 10%.
"That is the biggest challenge for Arkansans and alert to them that the community has covid, and there's a high rate of positivity," the governor said Tuesday. "Hopefully we can get that down."
FEWER BEDS AVAILABLE
There were 13 fewer hospital beds available for new patients Tuesday, with the number dropping from 2,449 to 2,436.
Out of the state's 1,160 ICU beds, only 73 -- or just over 6% -- were available as of late Tuesday. The available ICU beds dropped from 81 the previous day.
There were 382 covid-19 patients in the critical care beds as of Tuesday afternoon, 10 more than the previous day.
The state's inventory of total beds -- whether filled or vacant -- increased by 20 more beds, to 8,944.
The total beds include a few hundred in psychiatric or rehabilitation facilities that are not used for covid-19 care.
About 73% of hospital beds are full.
The number of ventilators in the state's inventory increased by three, to 1,070. A total of 646 ventilators, about 60%, remain available for use, 24 less than the day before.
Total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- increased by 50 beds to 8,914 as of Tuesday evening.
The increase, according to Health Department data, can mainly be attributed to hospitals in the southeast region of the state, which added 62 beds while hospitals in the northwest dropped 13 beds.
Maximum flex bed capacity -- the number of beds at a hospital regardless of its ability to staff them -- dropped by 27 beds, going from 11,503 to 11,476.
The drop can be attributed to the southeast region redesignating 27 beds.
In Central Arkansas, Conway Regional Hospital recently expanded its non-covid bed capacity by moving some of its inpatient operations to the Conway Regional Rehabilitation Hospital.
"This is not a bed capacity issue for us," Matt Troup, president and CEO of Conway Regional, said in a statement. "This is about bed placement. Expanding our capacity for COVID patients and beds at CRMC means we will potentially displace non-COVID patients. This plan allows us to expand total beds to meet current and future needs of our community, centralize resources, put patients in the appropriate level of care, all while providing the best possible care."
BAR CASES
The number of covid-19 cases among people who said they recently visited bars has dropped in the month since Hutchinson announced a Health Department directive that instituted an 11 p.m. closing time for businesses that sell and allow consumption of alcoholic beverages.
The Health Department reports don't say how many people were reached by case investigators, so it isn't known what percentage of respondents visited a particular type of location. Instead, they give percentages of the total active case tally, including people who were not interviewed by case investigators.
"Case investigators ask positive patients about all those locations, and it's based on those responses," spokeswoman Danyelle McNeill said.
"It can't include people who don't respond or don't tell us where they went and it's focused on places people visited during the infectious period, not necessarily where they became infected."
According to the latest report, the highest percentage of active cases -- 13%, or 2,711 -- was traced to people who visited retail stores in the 14 days before diagnosis.
About 3% of active cases were people who said they visited restaurants, 3% said they had been to church and 2% said they had been to medical provider appointments. Those who said they visited bars, barbershops, day cares, hotels and gyms each accounted for less than 1% of the active cases.
The categories are not mutually exclusive and do not add up to the total number of cases because those with an active covid-19 infection may have gone multiple places.
Since Nov. 19, the day the directive was announced, the number of active cases among people who said they visited bars dropped from 0.2% to 0.1% -- or from 37 cases to 22.
The number of cases among people who said they visited barbershops or beauty salons dipped as well, going from 0.6% in November to 0.5% as of the latest report. Cases among people who said they had been to day cares began November at 0.7%, or 71 cases, and are now at 0.8%, or 181 cases.