On the same day that a second type of covid-19 vaccine arrived in Arkansas, the state's death toll from the virus rose by 58, matching the record high increase set Dec. 16, according to state Department of Health data released Monday.
Gov. Asa Hutchinson said the state began receiving shipments of 5,900 doses of the Moderna vaccine, with additional shipments expected today and Wednesday.
In addition, a second shipment of the Pfizer-BioNTech vaccine, containing 18,575 doses, was received Monday. The first shipment of that vaccine came last week.
"While this news provides hope for many, it is a continued concern to see the loss of 58 additional Arkansans," Hutchinson said.
The state's cumulative count of cases rose by 1,457 to 203,107 while the number of active cases dropped by 843 to 22,158.
"We must steel our resolve to take every precaution to keep everyone safe," Hutchinson said.
Of the 58 deaths, 20 were the result of delayed reports. State Epidemiologist Jennifer Dillaha said the delayed reports were ones in which the coroner or medical examiner listed covid-19 as the cause on the death certificate, but the virus had not been confirmed by a lab test.
"These meet the Council of State and Territorial Epidemiologists definition of a covid-related death but can take longer to receive and process into our system," Dillaha said.
As of Monday morning, 7,597 vaccine doses were administered since the state received its first shipment last week, Dillaha said.
"There can be a lag between when the vaccine is administered and when it is entered into our system, so the actual number is likely higher than that," she added.
The Pfizer-BioNTech vaccine received emergency-use authorization from the U.S. Food and Drug Administration more than a week ago. In its initial shipment, the state received 25,250 doses, which were distributed to the largest hospitals as well as to five pharmacies that distributed them to about 50 smaller hospitals and Arkansas Children's Hospital in Little Rock.
The first recipients were health care workers who cared directly for covid-19 patients.
The second wave of the Pfizer vaccine went to 10 acute-care hospitals and three pharmacies, Dillaha said.
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"The pharmacies will use their shipments to vaccinate [workers in] acute care hospitals, surgical hospitals, behavioral health hospitals, long-term acute care hospitals and rehab hospitals that are not being vaccinated by an affiliated acute care hospital," she said. "Any remaining doses will be used for continued vaccination of health care workers in acute care hospitals. ADH also received part of the latest Pfizer shipment, and will use the vaccine for high-risk EMS workers."
NURSING HOMES
The Moderna vaccine -- which was approved Friday by the FDA for emergency use -- is being shipped to pharmacies that will use it to begin vaccinations of staff and residents at long-term care facilities, Dillaha said.
There are about 53,000 residents in the state's nursing homes, assisted living facilities, residential care facilities and the centers for those with significant developmental disabilities, according to data from the Arkansas Health Care Association.
Dillaha said there will eventually be enough of the vaccine to cover all the residents and staff.
"We may need to supplement with doses from the next allocation to vaccinate all residents and workers in long-term care," she said.
Rachel Bunch, executive director of the Arkansas Health Care Association, said Monday was a "very exciting start of a promising week."
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"We can start to see some light at the end of a long tunnel for our patients and staff," she said.
Since the first coronavirus patient was identified in March, 9,332 nursing home and long-term care facility residents and 6,911 employees have tested positive for the virus. Of that number, 1,392 residents and nine employees died from covid-19, according to a Health Department report released Monday.
The total covid-19 death toll stood at 3,295 Monday.
The vaccine will be administered in vaccination clinics on site at facilities over the coming weeks, Bunch said.
"Some started today and a couple of others are planned for later this week," she said.
The facilities that choose to utilize the federal partnership with CVS and Walgreens will begin receiving the vaccine next Monday.
"Pharmacies are working with facilities on scheduling, and it will take some time to work through logistics and planning to offer this to staff members who work different shifts," Bunch said.
The Arkansas Health Care Association is working with the Department of Health on prioritizing the vaccine administration to residents and staff of the facilities, Bunch said.
"We are starting with patients that are the most elderly and frail and the workers who care for them, then to other provider types," she said. "More doses should come to the state in future allocations that will be designated for long term care. Residents and employees will have a choice in whether or not to receive the vaccine. Facilities will follow typical consent processes as they do for flu shots and other treatment."
Bunch said that she is appreciative of Hutchinson and Health Department leadership for prioritizing the elderly patients and the workers who care for them.
"We hope that this is the first step to getting life back to some type of normalcy in long term care," she said. "We don't know a time frame yet on when visitation restrictions can be lifted and changes to community dining and activities will occur, but we feel confident that this is the first step."
BY THE NUMBERS
The number of patients hospitalized with covid-19 in the state increased by 21 to 1,078. There were 351 patients with the virus in intensive care units, nine more than the previous day.
Those patients included 174 who were on ventilators, four more than a day earlier.
The state reported that in a 24-hour period, 9,178 polymerase chain reaction, or PCR, tests and 1,013 antigen tests were given.
The seven-day rolling average is 11,196 for PCR tests and 3,223 for antigen tests.
"Testing often goes down early in the week because there is not as much availability on the weekends," Dillaha said. "Today's tests are a little bit higher than we reported on the previous two Mondays, but very close to the same figure."
On Dec. 7, the state reported 9,009 PCR and 687 antigen tests. On Dec. 14, there were 9,244 PCR and 925 antigen tests reported.
So far in December, results from 255,005 PCR tests and 55,309 antigen tests have been reported in Arkansas.
PCR tests are more accurate, but antigen tests give quicker results.
The cases added to the state's tallies included 1,069 that were confirmed through PCR tests.
The other 388 were "probable" cases, which include those identified through the less-sensitive antigen tests.
Of the new cases, two were attributed to correctional facilities.
Monday's count of new cases was the highest reported for that day of the week. The previous high for a Monday was 1,355 on Dec. 14.
The number of active cases increased by 1,467 in a week's time -- from 20,691 on Dec. 14 to 22,158 on Monday.
In the past seven days, a total of 16,050 new covid-19 cases were reported and 305 more Arkansans lost their lives to the virus.
Of the 10,191 tests reported Monday, 1,457 -- or 14.29% -- were positive.
Dillaha said she was concerned about the high positivity rate in the state because the rate indicates significant community spread.
"And that needs to be a serious concern for Arkansans. The numbers tell us that there is a risk of catching or spreading covid-19 across all parts of the state," she said. "Each of us has to do our part to stop this virus, starting with wearing a face covering, maintaining social distancing, washing hands frequently and avoiding gatherings with people outside of your household."
HOSPITAL BEDS
There were 142 more hospital beds available for use on Monday, going from 2,188 to 2,330.
The total beds -- whether filled or vacant -- increased by 28, going from 8,983 to 9,011. (The total includes more than 300 in psychiatric or rehabilitation facilities that aren't for covid-19 care.)
That means that about 74% of the state's hospital beds are full.
Available ICU beds, increased by one to 49. Out of the 1,154 critical care beds, 4.2% were available Monday afternoon. The state hit an all-time low on Friday when only 37 -- or 3% -- of the state's ICU beds were available.
There were 351 covid-19 patients in ICU beds, nine more than the previous day.
Total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- increased by 26 beds to 8,981. The additional bed capacity was attributed to hospitals in the northwest region.
Maximum flex bed capacity -- the number of hospital beds regardless of ability to staff them -- increased by 30 to 11,484. The additional bed space was attributed to hospitals in the Arkansas Valley region.
COUNTY DATA
The Health Department reported that the top counties for new cases were Pulaski County with 200; Benton County with 138; Washington County with 101; Craighead County with 93; and Faulkner County with 69.
Those counties are also among the ones with the most active cases, with 2,629 in Pulaski County, 1,844 in Washington County, 1,666 in Benton County, 991 in Craighead County and 916 in Faulkner County.
According to a map graphic released Monday by the Health Department, Bradley County, with a population of about 10,800, showed the highest 14-day rolling average percent of positive tests at 25.6%.
Bradley County had administered 7,898 tests since the beginning of the pandemic, according to Health Department data.
Other counties with the highest rates included Fulton County at 24.3%, Jackson County at 23.2%, Searcy County at 22.8% and White County at 21.9%.
There were only eight counties in the state that had a positivity rate below 10%: Logan County at 9.9%, Izard County at 9.8%, Lafayette County at 9.8%, Scott County at 9.6%, Chicot County at 9%, Nevada County at 8.2%, Hot Spring County at 7.2% and Little River County at 5.9%.
Pulaski County has the highest cumulative total of covid-19 cases -- at 21,867 -- since the pandemic began in March. Following is Washington County at 19,555, Benton County at 15,826, Craighead County at 9,191 and Sebastian County at 8,672.
Only 24 out of the state's 75 counties have had fewer than 1,000 covid-19 cases as of Monday.
Only seven of the counties have had more than 100 deaths since the pandemic began. They include Pulaski County at 351, Benton County at 238, Washington County at 211, Sebastian County at 142, Garland County at 137, Jefferson County at 123 and Craighead County at 121.
Information for this article was contributed by Andy Davis of the Arkansas Democrat-Gazette.