Gov. Asa Hutchinson said Wednesday that he's reviewing recommendations from a group representing hundreds of pediatricians in the state, but he didn't give any indication that he will back down from urging schools statewide to open in-classroom instruction next month.
School "provides a wholesome atmosphere for the students," Hutchinson said. "It's a safe environment for them.
"We obviously need to have it safe for the teachers, but that's our goal, because whenever you start moving to a virtual environment, then every working parent has to scramble around for somebody to watch the child.
"If they're doing virtual at home, many times it takes a parent to help to guide the young child in that as well."
Hutchinson spoke as the state's count of coronavirus cases rose by 591, to 35,246.
The state's count of virus deaths rose by six, to 380, while the number of patients hospitalized with covid-19 fell by 14, to 474.
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The number of patients on ventilators fell by three, to 107.
While many school districts are planning to offer online options for students during the coming school year, Hutchinson and state Education Secretary Johnny Key have said they also expect them to have traditional classroom instruction, with the option to shift to online instruction as needed.
Classes are set to begin the week of Aug. 24.
In a statement Tuesday, the Arkansas chapter of the American Academy of Pediatrics said it "cannot support a statewide return-to-school decision for Arkansas in August."
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"While some counties may have extremely low rates of spread, others have growing numbers of positive cases or consistent positive test rates hovering around 30%, indicating that community spread is uncontrolled and testing is not yet sufficiently reaching all infected people," the group said.
Hutchinson said Wednesday that he had read the group's recommendations.
"A number of the things we have implemented, we have addressed," he said. "Others are ones that need to be discussed and see if they should be addressed."
Interim Health Secretary Jose Romero, a pediatric infectious disease specialist, added that children have "not been shown to be very effective in spreading the virus, and that's particularly in children under 10 years of age.
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"Newer data suggests that those children 10 and older may be more capable of spreading it, and similarly as you get into an adolescent, an older adolescent, like an adult," he said.
'AN ISSUE OF MATHEMATICS'
Gary Wheeler, president of the pediatrician group's Arkansas chapter, said the recommendations were developed and reviewed by its five-member executive committee in consultation with the national organization.
"They have seen our document and didn't have any disagreements with any of the things that are being said," Wheeler said. "What they do stress is that these are local decisions about how we accomplish these principles that we're trying to set forth."
Wheeler is the state Department of Health's former medical director and is a senior medical adviser to Romero.
Wheeler said one of the chapter's concerns is the amount of disruption the virus would cause for schools in areas with high rates of transmission.
"It's really an issue of mathematics," he said. "If you have very high rates of infection in the community, then a certain percent of the people who are infected in the community are going to wind up in school, either students or staff."
That in turn would trigger the isolation of the person who tested positive, the quarantine of people with whom they had been in contact, and questions from students, parents and local officials, he said.
"It's really, really a lot of work for the school and for the other health authorities that are involved in managing the case," he said.
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The pediatricians are also concerned that "not all school districts are created equal, and that the resources may not be available, particularly in the poor school districts or school districts with high minority attendance" to prepare for in-classroom instruction, he said.
"These are populations in the Hispanic, Black, and the Marshallese communities that have already been hit very hard by covid-19, and those districts may need even more support to get themselves prepared," Wheeler said.
The chapter, with more than 400 members, recommended opening schools only in counties that meet the White House guidelines for states on moving from one phase of reopening to the next.
Those call for a "downward trajectory" of cases or percentage of tests that are positive over a two-week period.
The group also recommended a mask requirement for all K-12 students and better guidance for schools on keeping space between students.
It also said the state should purchase protective equipment and cleaning supplies for schools and provide funding to update school ventilation systems.
Wheeler said the group met with state education and health officials Monday to discuss the recommendations.
He said the state Department of Education "has really been moving ahead on almost all of those issues," including helping school districts acquire protective gear and cleaning supplies.
"The issue of looking at individual districts in terms of opening times was the main area where there is some conflict," he said.
"We're hopeful that a month from now, every school district will be prepared, that the incidence of cases will have dropped and that it will be a good time for all kids to go back to school, but realistically that's probably not going to happen," Wheeler said.
PROGRESS TOUTED
The increase in the state's count of coronavirus cases on Wednesday was the first time in a week that the daily increase fell below 600.
But Hutchinson noted the number of the Health Department's tests that were performed Tuesday and reflected in the state's numbers was lower than usual, which he attributed to a data entry "challenge."
"Those will be entered, probably, in the coming days," he said.
A chart he displayed showed just 563 tests conducted Tuesday by the Health Department laboratory, compared with 1,775 a day earlier.
Health Department spokeswoman Danyelle McNeill said the lower number on Tuesday was the result of "a slowdown in data entry" caused by a "software glitch."
At his daily news conference on the pandemic, held Wednesday at Washington Regional Medical Center in Fayetteville, Hutchinson pointed to a chart showing a reduction in growth in new cases in the Health Department's northwest region, made up of 19 counties.
From a peak of 367 cases a day as of June 26, the average number of new cases in the region over a rolling seven-day period had fallen to 176 as of Tuesday.
"That is a success story, even though we still want it to come down lower as we get ready for school," Hutchinson said.
He said the change happened because "everybody here in Northwest Arkansas has worked together as a team."
"We've worn masks, we have done our contact tracing, we've done our social discipline, we understand what's at risk, and so everybody took it seriously and is trying to get the job done," he said.
The number of patients in the region hospitalized with the virus, which Hutchinson said was once worrying, had fallen from 159 on July 12 to 119 as of Wednesday.
On Monday, Hutchinson announced that he was sending 10 members of the Arkansas National Guard to help with case management at the Fayetteville hospital.
Washington Regional Chief Executive Larry Shackelford said the guard members are working in the hospital's call center and their help had allowed the hospital to return eight nurses to work in direct patient care.
"We understand they're going to be here for a time, for 30 days," Shackelford said. "Our hope during that time is we'll in fact see hospital volumes decrease and then we'll be able to pick that up."
He said that a week and a half ago, the hospital had an influx of coronavirus patients, with the number reaching 40, including 16 who were on ventilators.
"Our trends this week are better," he said. "As we have seen the number of positives in Washington County decrease, what we believe we're beginning to see now is a decrease of those sick patients that are coming."
At Mercy Hospital Northwest Arkansas in Rogers, the number of coronavirus patients began increasing in mid-May, peaking at 45 about two weeks ago, Eric Pianalto, the hospital's president, said.
Now the number is in the mid-20s, he said.
"We're very excited about that," Pianalto said.
WORKSITES, FAMILIES
In Washington County, Romero noted, 22% of the coronavirus tests that have been conducted have been positive, compared with about 8% of tests statewide.
He said 72% of the cases have been among people 44 and younger, "which points to the fact that these are individuals that are engaged in work and are acquiring the disease in the community or possibly spreading it at their worksites."
Statewide, 63% of the state's cases have been in that age group.
Romero also said almost 18% of Washington County's cases have been among children, which he said indicates the spread of the virus within families.
Statewide, 12% of Arkansas' cases have been among children.
Romero noted that the county has had 39 virus deaths, according to the Health Department's count.
Twenty-three, or about 60%, of the county's deaths were among its Marshallese population, he said. By contrast, Pacific Islanders, including the Marshellese, make up less than 3% of the county's population, according to census estimates.
LATEST CASES
The cases added to the state's total on Wednesday included 80 in Pulaski County, 46 in Benton County, 38 in Washington County, 33 in Craighead County, 30 each in Faulkner and Garland counties, 24 in Pope County and 22 in Crittenden County.
The state's count of cases among prison and jail inmates increased by seven, Romero said.
Such increases can reflect new cases as well as ones that were reported earlier but not immediately classified as being from a jail or prison.
The Health Department this week added the Omega Supervision Sanction Center in Malvern to its list of state lockups where outbreaks have occurred.
As of Wednesday, 22 inmates at the lockup for parole violators had tested positive, according to a Health Department report.
Statewide, the number of cases that were considered active fell Wednesday by 122, to 6,876, as 707 Arkansans were newly classified as having recovered.
