Arkansas' count of coronavirus cases rose by 448 Thursday, including a record increase of 444 among people who are not prison inmates.
The jump was the second time in less than a week that cases among the state's noninmate population increased by a record amount, coming after an increase of 400 such cases Saturday.
The jump came just a day after Gov. Asa Hutchinson announced that, starting Monday, the state will move to its second phase of lifting restrictions that were imposed to slow the virus's spread.
Almost half of the new cases were in Washington and Benton counties, with 93% of Washington County's 143 new cases coming from Springdale.
During a video meeting with the Rogers-Lowell Area Chamber of Commerce on Thursday, Hutchinson called on business owners to insist that their employees and customers wear masks, wash hands, observe social distancing and take other precautions.
"Please, please understand," the governor said. "This is an emergency."
The total count of cases in the state increased to 10,816. The total topped 10,000 just Tuesday.
The state's death toll from the virus, as tracked by the Department of Health, rose by six, to 171. The number of patients hospitalized also rose by six, to 187.
Forty-five of the hospitalized patients were on ventilators, down from 49 a day earlier.
The new cases included 78 in Benton County, 37 in Pulaski County, 13 in Carroll County, 12 in Faulkner County, 10 in Crittenden County and 10 in Pope County.
Amy Webb, a spokeswoman for the Department of Human Services, said three residents at the Harrisburg Juvenile Treatment Center have tested positive, making it the second of the state's four youth lockups where cases have been confirmed among residents.
Two workers at the Harrisburg facility have also tested positive, she said.
Webb said earlier this week that four residents and a worker at the Arkansas Juvenile Assessment and Treatment Center at Alexander had tested positive for the virus.
Since then, three more employees at the facility have tested positive, Webb said.
The state began testing all employees and residents at the lockups last week, after an employee at the Alexander facility was denied entrance to work because of a fever during a routine screening and later tested positive.
A handful of results at the Harrisburg facility and the Mansfield Juvenile Treatment Center were still pending, but the Mansfield site had no positive results, so far, Webb said Thursday afternoon.
None of the youths or staff members at the Dermott Juvenile Correctional Facility tested positive, she said.
Parents were notified of their children's test results by phone calls and with follow-up letters, she said.
Youths who test positive are moved away from other residents, and all residents who enter or leave the facilities get tested. Programs, such as therapy and other activities, are continuing for those who test positive, Webb added.
At the East Arkansas Regional Unit for adults near Brickeys, 92 inmates were listed in a Health Department report Thursday as having tested positive, up from the 89 cases that prison officials reported a day earlier.
Results from prison inmates often show up in the state's overall tally of cases several days after the tests, after information from laboratory reports is entered into a state database.
Two staff members at the prison were also listed as having active infections.
Although Arkansas' virus cases have been on the upswing since the state entered its first phase of relaxed restrictions on May 4, Hutchinson and Health Secretary Nate Smith have said interviews with people who have tested positive haven't shown that a large number of them had gone to businesses, such as restaurants and hair salons, that were allowed to reopen or expand their services during that phase.
Rather, the increase has been concentrated in Northwest Arkansas, with outbreaks occurring among Hispanics and workers in the poultry industry there and in other parts of the state.
"We've been seeing daily a high number of cases in Washington County, and a high proportion of them have been in the Latino community," Smith said. "We're not seeing any departure from that pattern."
Hispanics, who are 7.7% of the state's population, as of Monday made up 29% of the state's cases that were active, meaning the person had tested positive and had not yet recovered, and 24% of the state's hospitalized patients as of Tuesday, Smith said.
Clusters of cases have been found within households and neighborhoods as well as workplaces, he said.
A team of bilingual staff members from the U.S. Centers for Disease Control and Prevention is to arrive in Arkansas today "to help us to better understand the dynamics of transmission in the northwest part of the state, particularly in Washington and Benton counties, helping to understand this interplay between transmission in the home, in the community and in the workplace," Smith said.
He said the CDC will also help the Health Department "learn how to more effectively reach out to the Latino community with messages that will help them to protect themselves and others from covid-19 and to interrupt those chains of transmission."
TRIALS TO RESUME
Also Thursday, the Arkansas Supreme Court said in a per curiam order that jury trials will be allowed to resume, with some restrictions, on July 1.
Civil trials may be conducted in whole or in part via videoconference. Criminal trials must be conducted in person, except that jury selection may be conducted via videoconference if the parties agree.
No more than 50 people should be in the courtroom, and those in attendance should wear masks and stay at least 6 feet apart. People should be screened for fever and other covid-19 symptoms, and have access to hand soap and hand sanitizer, the high court said.
"This order does not mandate the resumption of in-person proceedings, but rather lifts the suspension previously announced," the high court said. "Protection of the public from unnecessary risks will depend largely on the discretion of individual judges.
"Decisions shall be based on the growth rate of the virus in the area, the size of the venue in which court is conducted, the security measures necessary to conduct trials, the availability of personal protective equipment, and other relevant factors.
"As such, jury trials in some counties may resume in July, whereas most parts of Arkansas might not resume jury trials until September or later."
Justice Robin Wynne dissented.
"This is simply too soon in light of the rise in the number of COVID-19 cases in Arkansas in recent days," he wrote.
Along with jury trials, the high court began limiting in-person proceedings to all but the most essential cases in March. The court previously lifted most of its restrictions on hearings beginning May 18.
Ivy Pfeffer, deputy commissioner of the Arkansas Department of Education, spoke briefly at Hutchinson's news conference about the plan to return children to on-campus instruction in the fall.
Pfeffer said schools have plans to follow most of the same guidelines for limiting spread of the virus as businesses and venues in the state. That includes good hand hygiene, frequent cleaning of frequently touched surfaces, encouraging mask use when possible and keeping physical distance when possible.
Hutchinson said the plan for schools is a work in progress but emphasized that he wants children to return to classrooms in the fall.
Hutchinson opened the video meeting with the Rogers-Lowell Area Chamber of Commerce by citing Washington Regional Medical System's warning Wednesday that Northwest Arkansas faces a serious public health emergency, going from four being hospitalized in the region with covid-19 to more than 70 in less than a month.
He acknowledged that his loosening of restrictions and concern over rising hospitalizations seem to be at odds.
"We are dealing with two crises at the same time," he said.
There is a public health crisis and the economic aspects of that, he said.
He said he is counting on business leaders to act responsibility and to insist on responsible actions by their customers.
People have to make a living, Hutchinson said. In particular, he said, the poultry industry in Northwest Arkansas is critical to the national food supply.
"It's a confusing message to Northwest Arkansas with this spike in cases," the governor said.
But the risks of opening the economy are manageable if business owners take warnings like Washington Regional's seriously, he said.
"There was enormous national pressure when this began to have a shelter-in-place order," Hutchinson said. "We didn't do that, and, in hindsight, that proved to be the right decision."
Unemployment in Arkansas is 4% below the national average of 14%, he said, in large part because there was not a complete shutdown.
Randy Zook, president of the Arkansas State Chamber of Commerce, said during the meeting that the pandemic has lasted long enough to show that businesses that take the health threat seriously are doing better commercially than those that don't.
Customers notice businesses that enforce social distancing and patronize them, Zook said.
"The companies that do this will thrive," he said. "The ones that don't will be economic road kill. That's the plain truth of it."
He said one restaurant business, which he would not name, is enjoying record sales as word-of-mouth spreads that it is a safe place to go.
Nationally, he said, the economy has shown some recovery "but it's a 2-foot jump on an 8-foot ditch."
Chamber members asked the governor what it would take for him to place earlier restrictions back on businesses. He said hospitalizations getting anywhere near capacity would be the most important factor.
At his daily news conference on the pandemic, later Thursday, Hutchinson said he had spoken to hospital representatives who told them they have enough capacity to care for covid-19 patients as well as other types of patients.
"We continue to watch that," he said.
A coalition of Northwest Arkansas health care providers Thursday announced a "Safe and Strong" public education campaign aimed at stemming the surge in cases.
"Recognizing [that] the region's COVID-19 inpatient and outpatient numbers are rising, hospitals across Northwest Arkansas are currently prepared, have capacity and remain safe," the group said in a news release.
"However, if the spread continues at its current rate, health systems could become strained."
The campaign includes a Youtube video showing people wearing masks while going about daily activities. A message on the screen asks viewers to "keep up the habits that keep us safe."
"We're stronger together, even if we're apart," another message says.
The campaign also includes pictures with public health reminders in English, Spanish and Marshallese.
Martine Pollard, executive director of communications and public relations for Mercy Health System in Northwest Arkansas, said the campaign will advertise on English and Spanish language television and radio stations with public service announcements in Spanish and Marshallese by local officials, community leaders and others.
"We've done a significant amount of surge planning to prepare for the surge that we are in, and we are managing that right now, but we have to continue to adhere to those social distancing practices," she said.
The providers are working through the Northwest Arkansas Council, a business group.
Participating health organizations 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.
Springdale Mayor Doug Sprouse said the increase in cases in his city is "alarming." Although he said he usually pays more attention to hospitalizations, he noted that those are also on the increase.
"We are very concerned. We're urging people to take this very seriously," he said. "Our spike is here now, and it's a pretty significant spike."
He said he isn't worried about the state's shift to Phase 2 of its reopening plan Monday, noting that the Health Department hasn't found links between the rise in cases and easing of restrictions on businesses.
He also noted that Phase 2 will mainly just allow restaurants and other businesses to go from using 33% of their capacity to 66% while keeping other safety measures in place.
"Certainly our businesses and those things that open up need to open responsibly, and they need to continue to take all those precautions," he said.
Arkansans who recently died of covid-19 included a Jacksonville nursing home resident who survived the Spanish influenza pandemic of 1918 and a Crossett woman with two great-grandchildren.
Elsie Ferreira, 103, who lived at Woodland Hills Nursing Home and Rehabilitation, died Tuesday after testing positive for covid-19 on May 28.
Ferreira had a history of heart failure and atrial fibrillation, according to a Pulaski County coroner's report.
"I got a call from the nursing home that she had been diagnosed with covid, but they said she was asymptomatic," her daughter Nancy McCuen said. "The next day we got another call, and she had started developing symptoms. She lasted about a week and a half. She was a fighter."
McCuen said her mother was born in New Bedford, Mass., in 1918. She worked for 24 years as a final inspector of rubber goods at Acushnet Process Co. in Massachusetts, where she inspected products such as windshield wipers and gas masks.
"My dad and both my grandparents worked in the same industry, and that's how she got involved," McCuen said.
Ferreira was the mother of two, the grandmother of three and the great-grandmother of three.
She moved to Arkansas in 2008 to live with McCuen and her husband.
"She is just a sweet person, always had a smile on her face," McCuen said. "She never said anything negative about anybody. And she had this big, wonderful smile. She was in a lot of wonderful photographs because of that smile."
Ferreira was married to her husband, Frank, for 50 years before he died.
After her retirement, Ferreira spent her time crafting, crocheting and sewing her own clothing until glaucoma and macular degeneration took her eyesight.
"She loved to read, and she was a die-hard watcher of QVC. She loved that home shopping stuff," McCuen said. "Music was the highlight of her life. Frank Sinatra, Vince Gill. Willie Nelson. She was always listening to them and would sit in her chair clapping through the songs."
McCuen said she had not visited her mother since March 11 to lessen the threat of possible exposure to the virus.
"That's the sad part. I didn't get to see her," McCuen said. "Most family members can at least go to the window and be with their loved ones as they pass, but because of her eyesight, she wouldn't have seen us or known we were there."
A Health Department report Thursday said 26 residents at the nursing home had tested positive for the virus, including two who died.
Twenty-four workers at the home have also tested positive, according to the report.
Kay Brewer, 78, of Crossett, died Wednesday at CHI St. Vincent Infirmary in Little Rock from covid-19, according to a Pulaski County coroner's report.
She was admitted to the hospital on May 29, and diagnosed with covid-19 and metabolic encephalopathy. Brewer had a history of cerebrovascular disease.
Her brother, Dr. David Fredrick, said his sister was a "happily retired housewife" and the mother of one, grandmother to one and great-grandmother to two.
"She was a good mother, grandmother and wife," Fredrick said.
Information for this article was contributed by Ginny Monk and John Moritz of the Arkansas Democrat-Gazette; and by Alex Golden of the Northwest Arkansas Democrat-Gazette.