Gov. Asa Hutchinson on Friday complained about delays that Arkansans have encountered in getting coronavirus test results back from commercial laboratories, as the number of cases added to the state's total exceeded 700 for the third day in a row.
Hutchinson said the average amount of time to get a test result has increased from 1.6 days in April to about 2.5 days so far in July.
"That's something that concerns us because we need quick results," Hutchinson said. "That helps us to manage the outbreak, to control it, to isolate people that need to be isolated."
The state's count of coronavirus cases rose Friday by 751, to 26,803.
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That was the third-highest number of cases added to the state's total in a single day. It followed increases of 734 on Wednesday and 806 on Thursday, which was the state's second-highest one-day increase and the first time the state had added more than 700 cases to its total for two days in a row.
Topping 400 for the first time, the number of Arkansans hospitalized with the virus rose by eight, to 402.
Eighty-four of the patients were on ventilators, up from 82 a day earlier.
The state's death toll from the virus, as tracked by the Department of Health, rose by four, to 313.
Meanwhile, the number of cases in the state that were considered active, meaning the person had tested positive and had not yet recovered, increased by 96, to 5,847, as 650 Arkansans were newly classified as having recovered.
That number of active cases has been increasing since Tuesday but remained below the peak of 6,394 on July 5.
The active cases Friday included 123 nursing-home residents and 584 prison or jail inmates, Health Secretary Nate Smith said.
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Hutchinson has said repeatedly that he wants President Donald Trump to invoke the Korean War-era Defense Production Act to ensure commercial laboratories can meet the demand for testing as the coronavirus surges in states across the South and Southwest.
"Our concern is the national shortage, because of the high-population states of Texas, of California, Arizona, Florida that have an increase in cases, that that pressure point on the six commercial labs that are all located outside of Arkansas will delay their response time and their ability to get testing results back to us," Hutchinson said.
He said the White House is "looking at that" and that he's "talking to them about utilizing the National Defense Production Act so that they can have a greater national program, working through the labs, to strengthen that supply chain."
One of the laboratories, LabCorp of Burlington, N.C., said Wednesday that its average time to deliver results had increased from one to two days to four to six days because of the increased demand and "constraints in the availability of supplies and equipment."
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Quest Diagnostics in Secaucus N.J., made a similar statement Monday, saying its average turnaround time for most patients had increased from three to five days to four to six days.
Both companies said they were working to expand their capacities to reduce the wait times.
Also on Friday, Little Rock School District Superintendent Michael Poore sent a letter to parents attempting to once again clarify what the district's policy on masks will be during the upcoming school year.
"I am providing additional language that I hope will relay our commitment to students and staff and reinforce messaging that masks 'will be required in areas where social distancing measures are difficult to maintain,'" Poore said in the letter. "As we plan for the school year we know we will have settings where social distancing will be a challenge -- buses, hallways, lunch rooms, and most classrooms. We can assure you that the safety and wellbeing of our students and staff remain our priority."
On Wednesday, the state-controlled district published a "frequently asked questions" document for employees that said, "When feasible, older children should wear face coverings within facilities. It is not required for children to wear a mask. Let the parent determine!"
In an interview Thursday, Poore said students would be "expected" to wear masks but stopped short of saying it would be a requirement.
"On the required aspect of things, it's that, I don't think we want to turn into a thing where I've required it, we turn this into discipline matters," Poore said Thursday. "That's the last thing we need."
If a student refuses to wear a mask, "we're going to work with that student so that they understand why they need to have their mask on, and we will work with the parent of anyone that does not want to wear a mask and talk to them about that," Poore said Thursday.
The district Friday also released a revised version of the "frequently asked questions" document that eliminated the statements indicating children would not be required to wear masks.
Poore said Thursday that those statements had been copied from a state website but didn't reflect what the district's policy will be.
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At his daily news conference on the pandemic, held Friday in De Queen, Hutchinson noted that the number of cases in the Health Department's central region, which includes Pulaski, Lonoke, Saline, Faulkner, Perry, Garland and Grant counties, grew 27% last week, the highest rate among the department's five regions.
In the northwest region, which is made up of 19 counties and previously had the highest rate of growth, the number of cases grew 17.9%, he said.
That was the third-highest rate behind the central and 14-county southeast region, where the number of cases grew 18.2%.
In the northwest region, "they tighten things up, they really pay attention and it starts looking better, going down a little bit, but now we've got the central region that is a concern," Hutchinson said.
The number of cases grew 9.9% in the northeast region, which has 18 counties, and 9.7% in the southwest region, which has 17 counties.
Smith also noted progress in De Queen, where the average number of new cases over a rolling seven-day period fell from a peak of 20 on June 17 to four as of Wednesday.
The department's medical director, Jose Romero, addressed the county's Hispanic population in Spanish.
"I want to let you know that this county has been the most affected with covid in the state, but there's also been great efforts being done to control covid in this state," he said, according to an interpreter.
Smith noted that Hispanics make up about a third of the county's population, but almost two-thirds of its coronavirus cases.
Many of those who have tested positive work at a Pilgrim's Pride poultry plant in the city.
As of Friday, 233 workers had tested positive, all but 17 of whom had recovered, according to a Health Department report.
Hutchinson said he met with the manager of the plant during lunch Friday and was impressed by its safety measures.
"They actually have a full-time staff superintendent that is responsible for covid education in the facility, teaching everybody there not just how to be safe in the work environment but also how to take that into the community," he said.
The plant has "been part of the success story here in Sevier County," he said.
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The state's efforts to curb the growth of cases in its northwest corner have included inviting epidemiologists and other experts from the U.S. Centers for Disease Control and Prevention to study the spread of the virus among the Hispanic and Marshallese communities in Washington and Benton counties, which have the highest case totals in the state.
A report by those experts and Health Department staff, completed this week, recommends that the Health Department conduct testing and education campaigns at residential complexes with large numbers of cases, including repeated testing at complexes where the first round of testing turns up a high percentage of positive results.
The report also recommends repeated testing of household members of people who have tested positive; including Spanish-speaking and Marshallese-speaking staff members on testing and case investigation teams; and increasing the number of teams serving the Hispanic and Marshallese populations.
The Health Department "conducts COVID-19 case investigations and contact tracing and provides testing for the community including Hispanic and Marshallese populations; however, with only one Spanish-speaking and 8 Marshallese-speaking case investigators in Benton and Washington Counties, [the department] is unable to adequately respond to increasing case counts to address specific cultural and language barriers," the researchers said in the report.
Besides the Health Department, the report says "multiple other institutions and organizations are contributing to the COVID-19 response in NW Arkansas with limited coordination between these institutions."
It says the Health Department should improve the coordination of those efforts and work with members of the Hispanic and Marshallese communities on an education plan to encourage people to follow public health guidelines and eliminate the stigma and fears associated with testing.
"The Hispanic/Latinx community is apprehensive about testing for several reasons, including not being allowed to work if they are positive, fears of deportation, and the stigma of testing positive," the researchers wrote, describing the results of focus groups in Springdale. "There is also confusion and anxiety about testing, including what the multiple tests are for and fears that testing is painful."
Hispanics also "expressed confusion caused by inconsistent messages from authorities, changing guidance, and the reopening of the state," the researchers wrote.
Members of Marshallese focus groups, meanwhile, "reported anxiety over procedures and fears of mistreatment by health providers that existed prior to COVID-19."
"The Marshallese people are typically reluctant to seek medical care and tend to avoid hospitals as much as possible," the researchers wrote. "However, this situation is exacerbated by COVID-19, and likely reflects the high numbers of deaths among Marshallese."
Because Marshallese adults do not qualify for Medicaid, the cost of medical care is another barrier, the researchers wrote. Keeping a safe distance from other people is also difficult, they wrote.
"The Marshallese participants felt their friends and family were not willing to practice social distancing and explained that while some were following guidance, some would never follow it, and some were in the middle," the researchers wrote. "Marshallese also often live in large households, typically including extended family with one bathroom and one vehicle.
"Many Marshallese adults are employed at poultry processing facilities, where they work in close proximity to others and share activities like talking before and after work and during breaks, and sharing rides is likely."
Health Department spokesman Gavin Lesnick said in an email that the Health Department has "a dedicated outreach team in Northwest Arkansas" that includes 11 members who speak Marshallese and two who speak Spanish.
"This team works on testing, and it also does case investigation for Marshallese patients," Lesnick said.
He said the department also has five Spanish-speaking contact tracers on staff. Organizations such as Arkansas Blue Cross and Blue Shield and the University of Arkansas at Little Rock that have volunteered to help with the department's efforts have an additional six Spanish-speaking contact tracers, he said.
"Additionally, the agency has translation services available by phone and computer/phone/tablet or phone screen that have access to 220 different languages, including Marshallese, sign language, and Spanish sign language," Lesnick said.
The Health Department's contracts with General Dynamics Information Technology and the Arkansas Foundation for Medical Care to provide the state with 700 more contact tracers also call for those companies to "provide communication in multiple languages and accommodate special populations such as those who are homeless [and] those with cultural/health disparities."
Lesnick said the Health Department is reviewing the CDC report and will answer questions about it Monday.
The research team included two members of the Health Department staff and eight CDC staff members who visited Northwest Arkansas for three weeks in June and July at the request of the state agency.
Smith said Thursday that he had assigned Romero, the department's chief medical officer, and state epidemiologist Jennifer Dillaha to put together a group to "attempt to work through those recommendations and fully implement them."
"I'm very pleased that we've seen a downward trend in the northwest part of the state even since [the CDC researchers] arrived, but there's clearly more we can do, and I'd like to get as much value as we can out of the recommendations that they've given us," Smith said.
The cases added to the state's total Friday included 145 in Hot Spring County; 100 in Pulaski County; 54 in Benton County; 51 in Washington County; 42 in Sebastian County; 25 each in Faulkner and Pope counties; 23 in Jefferson County; and 21 in Yell County.
Smith said the state's count of cases among prison inmates increased by 149. Such increases sometimes reflect cases that were announced earlier but just added to the statewide total after information from laboratory reports was entered into a state database.
According to a Health Department report, two inmates and a worker tested positive at the Barbara Ester Unit in Pine Bluff.
One worker, who has since recovered, tested positive at the prison earlier.
Among workers in the poultry industry, the number of cases increased by 197, to 3,105, from Monday to Friday, according to Health Department reports.
The latest virus deaths added to the state's total included the 36th in Washington County, the sixth in Carroll County, the third in Ashley County and the second in Crawford County.
The state's deaths increased by three, to 80, among people age 45-64 and by one, to 217, among people 65 and older.