The state reached a record high of 1,155 hospitalized covid-19 patients, while the number of virus patients on ventilators matched a record of 201 set at the end of November, according to state Department of Health data released Monday.
In addition, 55 more Arkansans died from the virus -- just second to the record of 58 set Dec. 16 and repeated Dec. 21. The state's death toll hit 3,537 Monday.
"It will take a few days to know whether the increase in hospitalizations is the result of buildup after the long Christmas weekend," Gov. Asa Hutchinson said in a news release. "Regardless, the high number of cases continues to strain our health care system. Regretfully, we also have an additional 55 deaths in Arkansas from COVID-19. The importance of following guidance from the Department of Health cannot be overstated."
The state also added 1,651 new cases, bringing the cumulative total to 216,528. The record for a one-day increase was the 3,204 cases that were added Christmas Eve.
"One of the critical reasons we all need to do our part to stop the spread of covid-19 is to preserve limited health care resources," state Epidemiologist Jennifer Dillaha said. "We know that increased cases lead to increased hospitalizations, and today's numbers are a reminder that the system is strained."
While steps are being taken to optimize the available hospital and ICU beds in the state, Arkansans need to also do their part, Dillaha said.
"We can bring these numbers down by wearing face masks, maintaining social distance, washing our hands frequently and avoiding gatherings with people outside of our households," she said.
Dillaha said that if a surge in case numbers is coming from the Christmas holiday, it should be evident in the next seven to 10 days or more.
SHOTS BEING GIVEN
As of Monday morning, at least 20,730 vaccination initial doses had been administered in the state.
"It is important to note that there is a lag between a dose being administered and it being entered into our [computer] system, so the actual number is likely higher than that," Dillaha said.
Since Dec. 14, the state has received 43,875 doses of the Pfizer-BioNTech vaccine and 25,100 doses of the Moderna vaccine, Department of Health spokeswoman Danyelle McNeill said.
The state remains in Phase 1-A, which began with the vaccination of health care workers who care directly for covid-19 patients, then moved to the vaccination of staff and residents of long-term-care facilities.
On Saturday, emergency medical service personnel received their first dose of the vaccine at local health units in Arkadelphia, Star City and Paris, Dillaha said. Clinics for EMS workers were held Monday in Wynne and Mountain View, with vaccination clinics planned for Little Rock today and Fayetteville on Wednesday.
"We don't have a complete count on emergency workers, as many of them were vaccinated by area hospitals," Dillaha said. "As supply of the vaccine increases, they will be able to get vaccinated through one of the community-based pharmacies in the state that is participating in Phase 1-A."
St. Bernards Medical Center spokesman Mitchell Nail said the Jonesboro hospital has gone through two boxes of the Pfizer vaccine, amounting to about 2,300 doses.
Vaccinations there were put on hold over the holiday weekend, but will resume today, Nail said.
"The process has proven overwhelmingly positive. Because we've pulled in multiple departments to facilitate it, the sailing phrase 'All hands on deck' comes to mind," Nail said. "It speaks volumes to the team and family atmosphere at St. Bernards, and we all recognize this big push is the best way possible to end 2020."
CHI St. Vincent spokeswoman Bonnie Ward said about 2,200 vaccinations have been administered across its system.
"After briefly pausing our vaccination efforts over the Christmas holiday to give our vaccine administrators an opportunity to rest and reorganize, CHI St. Vincent has resumed COVID-19 vaccinations for health care workers at our hospitals," Ward said in an email. "The vaccination process has gone smoothly and after administering the first of two required doses to our prioritized health care workers, we continue vaccinations for the broader staff at our facilities."
Natalie Hardin, spokeswoman for Washington Regional Medical Center in Fayetteville, said about 1,800 doses had been given to its team members as of late Monday. The hospital has 1,290 doses remaining, she added.
Baptist Health System spokeswoman Margot Vogel said about 5,000 of the system's nearly 11,000 employees have been given shots.
"We will continue administering the first dose this week and next week as well as begin administering the second dose next week to those who are due for the second round," Vogel said.
Asked if any adverse reactions have been reported, Dillaha said a report from the U.S. Centers for Disease Control and Prevention is expected today.
Nail said the Jonesboro hospital has had a "limited number of small, allergic reactions" that have not required emergency care or hospitalization.
"Most of our recipients have experienced side effects similar to common vaccines, such as the influenza vaccine," Nail said. "The most common side effects include soreness at the injection site, malaise and muscle or joint aches. Less-common side effects include low-grade fevers."
Vogel said the Baptist Health system has had "very minor adverse reactions."
"The most common thing people who have had the shot are saying is that the injection hurt less than the flu shot, but they had a sore arm at the site of the injection several hours later," she said.
Ward said CHI St. Vincent has seen few minor reactions to the vaccine among its staff.
"Throughout all of 2020, our health care staff has proven they truly are our health care heroes and we're now optimistically looking forward to a brighter 2021," Ward said. "We must all, however, remain vigilant and continue to practice public health guidance to stem the spread of COVID-19, including social distancing, regular hand washing and wearing masks."
BY THE NUMBERS
The number of cases that were considered active dropped by 623 to 20,831 on Monday.
The cases added to the state's tallies included 889 that were confirmed through polymerase chain reaction, or PCR, tests.
The other 762 were "probable" cases, which include those identified through less-sensitive antigen tests.
The state reported that in a 24-hour period, 4,382PCR tests and 2,272 antigen tests were given.
The PCR testing numbers were considerably lower over the holiday weekend than reported the previous Monday, when 9,178 PCR tests were reported.
"This is likely due to a decrease in available testing beginning on the Christmas Eve holiday and continuing through the weekend. In addition, some labs were closed," Dillaha said.
In the past seven days, 61,654 PCR tests and 18,780 antigen tests have been administered.
Even with the low holiday numbers, the previous seven days -- from Dec. 15 to Dec. 21 -- saw higher total testing numbers, with 78,375 PCR and 22,558 antigen tests performed.
The number of people who have ever been hospitalized in the state with covid-19 rose by 53, to 11,062.
The number of virus patients who have ever been on a ventilator rose by eight, to 1,188.
PRISON CASES
Nearly 200 new coronavirus cases were reported across 11 prisons in the state Monday, said Arkansas Department of Corrections communications director Cindy Murphy.
Of the 195 new cases, the highest number of new infections were reported at the Barbara Ester Unit, which had 48. The facility, west of Pine Bluff, had 116 active cases as of Monday, Murphy said.
There were 41 new cases reported at the Ouachita River Correctional Unit, 28 at the East Central Community Correction Center, 26 at the Southwest Arkansas Community Correction Center, and 22 at the Central Arkansas Community Correction Center.
Eleven new cases were reported at the Omega Unit, along with seven at the East Arkansas Regional Unit, five at the Varner Unit, four at the Northeast Arkansas Community Correction Center, two at the Grimes Unit and one at the McPherson Unit.
The Health Department had a different count of cases among prison and jail inmates, saying the cases rose by 22.
COUNTY DATA
Pulaski County had the largest number of new cases, 266, followed by Benton County with 139, Washington County with 131, Faulkner County with 110 and Saline County with 91.
Those counties are also among the ones with the most active cases, with 2,565 in Pulaski County, 1,732 in Benton County, 1,724 in Washington County, 923 in Craighead County and 919 in Faulkner County.
According to a map released Monday by the Health Department, Fulton County, with a population of about 12,200, showed the highest 14-day rolling average of positive tests at 26.1%.
Fulton County had administered 5,358 tests since the beginning of the pandemic, according to Health Department data.
Other counties with the highest rates included Searcy County at 24.2%, Bradley County at 22.9%, Desha County at 21.9% and Lafayette County at 21.3%.
There were only four counties in the state that had a positivity rate below 10%: Chicot County at 9.7%, Franklin County at 9.6%, St. Francis County at 9.5% and Logan County at 9.5%.
HOSPITAL BEDS
There were 378 covid-19 patients in ICUs, three less than the previous day. Out of the state's 1,154 critical-care beds, 56 are available, six fewer than Sunday.
That means that more than 95% of the state's ICU beds are filled.
"Our patient census is high starting this week. As a regional referral hospital, St. Bernards Medical Center routinely accepts patients from a 23-county swath," Nail said. "Our ability to accept those patients, however, has proven more challenging as available bed numbers -- notably ICU beds -- have dwindled across the country. Providers are examining whatever way they can to create additional capacity without compromising the quality and integrity of their care."
Nail said the hospital is also beginning to see hospitalizations from the flu.
"These cases are not unsurprising, and we expect them to increase heading into January," Nail said. "They do, however, represent an additional challenge for hospitals with already heavy patient volumes."
Vogel, Baptist Health System's spokeswoman, did not give a count of available beds, but said there are about 1,200 hospital beds in the system, with about 200 of those being ICU beds.
"Our bed availability fluctuates daily and sometimes hourly, and we adjust to meet whatever the needs are," Vogel said in an email. "So far we have been successful in staying ahead of the curve so that we are able to provide care to all patients who present to Baptist Health whether that is for COVID-19 or other medical conditions."
Vogel said the Baptist Health system continues to be concerned about its health care workers during this period of such high patient census.
"Baptist Health's priority is to make sure our staff is getting the rest they need and that we are retaining all of these amazing health care professionals," Vogel said. "In spite of the mental and physical fatigue from the last nine months, they continue to amaze every day. It has been a long nine months since the start of the pandemic, and our staff in so many roles has really come through for the people of Arkansas. It is not an overstatement to call them heroes. They are amazing health care providers, and the teams are taking great care of our patients regardless of the circumstances."
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Ward declined to give capacity and availability numbers for CHI St. Vincent.
"CHI St. Vincent continues to operate at a high level of capacity, but remains prepared to provide critical care to those in need within our community," Ward said in an email. "The holiday season typically corresponds to a higher than usual volume of patients and that is true this year as well in addition to the number of patients hospitalized with COVID-19."
If necessary, Ward said, each of the facilities has a pandemic or surge capacity plan that the hospital system continuously reviews.
"We have also learned a great deal over 2020 and the COVID-19 pandemic that has allowed us to better prepare for additional surges of patients," Ward said.
Statewide, there were 104 fewer hospital beds available for use Monday, going from 2,406 to 2,302.
The total beds -- whether filled or vacant -- increased by four, going from 8,943 to 8,947. (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.
Total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- increased by four beds to 8,917. The additional bed capacity was attributed to hospitals in the southwest region.
Maximum flex bed capacity -- the number of hospital beds regardless of ability to staff them -- remained 11,484.
Martine Pollard, spokeswoman for the Northwest Arkansas Health Care Community, a coalition of health care providers, said in an email that there are 108 covid-19 patients in the region's hospitals.
The Northwest region's hospitals had 477 patients admitted for non-covid medical needs. Those hospitals had 47 ventilators in use and 108 ICU beds filled -- seven more than Sunday -- by both patients with covid-19 and those with other medical needs.
The Northwest Arkansas Health Care Community was formed to address the pandemic. Members include Community Clinic, Washington Regional Medical System, Mercy Health System, Northwest Health System, Arkansas Children's Northwest, the Veterans Health Care System of the Ozarks and the University of Arkansas for Medical Sciences Northwest.
SCHOOL CASES
Schools across Arkansas have 2,702 active coronavirus cases, down from the nearly 3,500 reported the previous week, the Health Department said Monday in its biweekly schools report.
There are 118 districts with five or more cases. Districts with fewer than five cases are not identified for privacy issues, but the numbers are included in the total.
In its report Wednesday, the Health Department logged 3,447 active cases.
The Little Rock School District ranks first with 93 cases, followed by Springdale with 90, the Bentonville district with 86 and the Rogers School District with 84. All the other districts had fewer than 50 active cases as of Monday, according to the Health Department.
According to the Little Rock district's daily report, there were 11 new covid-19 cases and eight people considered to be in quarantine on Monday.
Three staff members at Fulbright Elementary tested positive in the 24-hour period beginning at 3 p.m. Sunday. Hall High School, Carver Magnet Elementary, Pulaski Heights Elementary, Rockefeller Elementary and the district's Student Registration Office reported one new case each among staff members.
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Three new positive cases emerged among students in the Little Rock School District: one attending Central High School virtually, one attending Forest Heights STEM Academy virtually and one at Washington Elementary.
There were no new instructional shifts because of covid-19 infections as of Monday, Arkansas Division of Elementary and Secondary Education Chief of Staff Gina Windle said. Many schools are on break, she said.
Active cases at colleges and universities dropped to 333, down from the 386 logged in the Health Department's Dec. 23 report.
The University of Arkansas, Fayetteville was at the top with 86 cases, followed by the University of Central Arkansas with 27 and Arkansas Tech University with 21.
UA-Fayetteville reported 64 active cases on its website Monday. University tallies of active cases are sometimes different than those of the Health Department because of variances in reporting parameters and the timing of data collection.
Arkansas State University-Newport had 13 cases at its Jonesboro campus, and the University of Arkansas at Little Rock had 13 cases.
Harding University in Searcy and the University of Arkansas, Fort Smith had 10 active cases each. Arkansas State University in Jonesboro had nine active cases.