Cases up; state gears for post-holiday surge

Overflow beds in works; crowd lid on tap

Gov. Asa Hutchinson, right, speaks during a covid-19 briefing, Tuesday, Dec. 22, 2020.
Gov. Asa Hutchinson, right, speaks during a covid-19 briefing, Tuesday, Dec. 22, 2020.

As the state reached a record of hospitalized covid-19 patients, Gov. Asa Hutchinson announced Tuesday that two facilities will be renovated within the next several weeks to house up to 124 virus patients, if hospitals around the state run out of room.

Hutchinson also announced that starting Jan. 2, indoor gatherings of 10 or more people -- with the exception of those covered through separate directives, such as churches, school sporting events and restaurants -- will require a plan to be submitted to state health authorities before the event.

The "alternative care sites" will be in Little Rock and Van Buren, and will cost about $7.4 million, Hutchinson said at a news conference Tuesday. He said it's hoped that the Federal Emergency Management Agency will pay 80% of the cost.

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"This is important because -- even though it's going to take some time to build this out -- we have to be ready for whatever comes in January," the governor said. "It is my hope that we will build this out, and we will not have to utilize those beds for covid patients, but it is prudent upon me, as governor, to make sure that we have that adequate space if the need arises."

The extra hospital space will include eight intensive care unit beds.

The J.A. Gilbreath Conference Center on the Baptist Health campus in Little Rock will be retrofitted to accommodate 50 general medical and low-acuity covid-19 patients, and is expected to be complete in four to six weeks.

The Baptist Health-Van Buren site will be revamped to accommodate 74 beds, including eight intensive care unit beds. The availability of the beds will be staggered, and the beds will be made available as the space is completed and staffing is available, said Baptist Health spokeswoman Cara Wade.

Troy Wells, Baptist Health's president and CEO, said at the news conference that the greatest benefit of these sites is their proximity to hospitals, which will make it easier to share ancillary and clinical services.

"It's one thing to find nurses -- which we still have to work on our plan to do that, and that's actively being worked on -- but it's another thing to provide pharmacy and respiratory care, nutrition and food services, environmental services, lab, imaging and diagnostic services," Wells said. "All those services being co-located with these expansions will really help us provide that much more easily, rather than trying to re-create that in an off-site location."

Hutchinson said the state's hospitals have been able to manage the current caseload, but he is concerned about the post-holiday cases.

"We don't know what the rest of December is going to be like. We don't know what January is going to be like because we don't know what Christmas is going to be like," he said.

On Dec. 3, Hutchinson announced that he had asked FEMA for 10 beds at the John L. McClellan Memorial Veterans Hospital in Little Rock for the state to use for non-veteran coronavirus patients. The governor said Tuesday that only two of the beds were in use.

The five medical/surgical beds and five intensive care beds cost $1.9 million over 30 days, with the state paying 25% of the cost and the federal government paying the rest.

Hutchinson said he is sure state residents are "trying" to minimize exposure during the holiday season.

"But if we're not successful, we're going to see another spike after Christmas, and we have to be prepared for it," Hutchinson said.

The alternate care sites will be managed by the COVIDComm system, which was activated last week to route covid patients to hospitals with available beds or acute care, Hutchinson said.

Hutchinson said the care sites were the idea of the winter task force that he appointed.

"They all support this and that partnership," he said.

Wells said the additional sites are not the only thing that the task force is considering to meet the challenges of covid-19 patient care.

"The winter task force will continue to look for other alternative care sites should the need arise," Wells said. "We think the opportunity that we're talking about today gives us some more runway, gives us some more capacity before we have to make any further decisions or recommendations on expansion around the state."

Baptist Health will lease the beds to the state, Wade said.

"Plans are underway to determine the best way to provide staffing to cover this additional patient capacity," Wade said.

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Baptist Health's chief financial officer, Brent Beaulieu, said in an interview after the meeting that many of the details in the arrangement are still being worked out, including the final design, operational cost and the billing.

"Baptist Health is working with the state of Arkansas as a community partner to help create additional pandemic-emergency inpatient bed capacity for the state," Beaulieu said. "We are leveraging our existing resources where possible so this additional capacity can be created in the most effective and efficient manner possible."

INDOOR VENUES

Hutchinson said the update to the original directive regarding indoor venues is necessary to "make sure they're safe."

The updated directive reduces the minimum limit of attendees from 100 down to 10 before the event requires approval beforehand from the state Department of Health.

"This does not mean that we cannot have indoor venues that are larger than 10 people," Hutchinson said. "It just simply means that you have to have a good plan approved by the Department of Health to make sure it's safe and that you have your distancing, you have your mask requirements, and the other things that are necessary to make sure that venue is safe."

The updated directive is effective Jan. 2 and will run through March 1.

"We want to be prepared for the first of the year and make this plan to give everybody an opportunity to make sure they can adjust toward that," Hutchinson said.

The directive covers indoor venues for "commercial, community, civic, public or leisure events," such as auditoriums, convention centers, movie theaters, museums, gymnasiums, auction houses, barns and exhibit halls.

Hutchinson said he wanted to make it clear that the directive does not cover residential homes, churches, retail stores, restaurants and bars or community or school-sponsored sports.

Health Secretary Jose Romero told the governor that additional staffing is not needed for the Department of Health to review the event plans.

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"A lot of the events have slowed down because of our increased cases," Hutchinson said.

The venue will be subject to Department of Health inspection, and the plan must include steps that will be taken to comply and enforce public health guidelines.

VACCINATIONS CONTINUE

Hutchinson said 12,969 health care workers in the state have been vaccinated against covid-19 since the state received its first shipment of the vaccine a week ago Monday.

The state has received allocations of 23,400 additional doses of the Pfizer-BioNTech vaccine and 17,700 more doses of the Moderna vaccine, Hutchinson said.

In its initial shipment last week, 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.

The Moderna vaccine was shipped to pharmacies in the state to begin vaccinations of staff members and residents of long-term-care facilities.

"Our vaccine roll-out has gone well. We have not had any major glitches," Romero said. "The uptake looks about right. Of the doses we received last week, about 51% have already been administered."

University of Arkansas for Medical Sciences spokeswoman Leslie Taylor said about 3,300 health care workers in that facility have been vaccinated so far.

"Most of our employees are very excited about the vaccine and want to receive it," Taylor said in an email. "There was a very long line this morning when the first clinic opened. Our employees understand how important vaccinations are in defeating COVID-19."

CHI St. Vincent Infirmary spokeswoman Bonnie Ward declined to give specific vaccination numbers but said in an email that the hospital completed the first round of vaccinations last week and had received a second shipment of the Pfizer vaccine Monday.

"At this point, our ministry has seen no adverse reactions to the vaccinations, and our staff is invigorated by this step forward, although they know there is still much work to do," Ward said. "The COVID-19 vaccine and PPE are designed to work together to help protect against the virus and we currently have no plans to limit the wearing of personal protective equipment at our facilities, even for those who have already received the vaccine."

Wade said the vaccinations of Baptist Health employees and health care workers has gone "incredibly well." The hospital system has administered 4,352 vaccinations so far, she said.

"We have approximately 3,000 doses of the vaccine to continue using with employees. We will provide employee vaccinations through Wednesday and then take off for the holiday and resume on Monday," Wade said. "Those getting the shot have been very excited, eager, and appreciative to receive the vaccine."

Romero said he wanted to stress to the health care providers in the long-term-care facilities that the vaccines "have been studied well.

"They have been shown to be safe and advantageous," he said. "I want you to consider receiving these vaccines sooner rather than later. We are continuing to follow the safety of these vaccines post-administration."

Hutchinson said everyone wants victory over this pandemic.

"There are two V's as a key to a victory over the pandemic and that is the vaccine -- which we're working hard on -- and secondly is vigilance," he said. "We hope that everybody will be vigilant during this Christmas season so that we can have victory and get to the vaccine."

BY THE NUMBERS

The state had 1,941 new covid-19 cases added Tuesday, bringing the cumulative total to 205,048.

The number of patients hospitalized with covid-19 in the state increased by 25 to a record 1,103. There were 353 covid-19 patients in ICUs, two more than the previous day.

Those patients included 173 who were on ventilators, down from 174.

The state's death toll from the virus, as tracked by the Department of Health, rose by 43, to 3,338.

"Very sadly, it is troubling to me that we have 43 additional deaths," Hutchinson said. "That number remains too high for us. I'm very concerned about that, but it's the result of increased cases and increased hospitalizations."

Of the state's inventory of 1,081 ventilators, 665 remain available for use -- 11 fewer than the previous day.

The number of hospital beds available for use dropped by 155, going from 2,330 to 2,175 Tuesday.

Available ICU beds increased to 51, an increase of two beds from the previous day. Out of the state's 1,154 critical care beds, about 4% were available Tuesday afternoon.

The number of cases that were considered active dropped by 179, to 21,979, as new cases outpaced recoveries.

The Health Department reported that the top counties for new cases were Pulaski County with 288; Washington County with 168; Benton County with 153; Saline County with 81; and White County with 75.

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