The number of people hospitalized with covid-19 in Arkansas fell for the second day in a row on Wednesday as the state's number of new cases indicated a continued slowdown in the virus's spread.
The state's death toll from the virus, as tracked by the Department of Health, rose by 26, to 6,565.
"These deaths are fellow Arkansans, neighbors, and friends, and they are mostly avoidable with the vaccine," Gov. Asa Hutchinson said in a tweet.
He said he would discuss "trends and the impact on schools" during a news conference today.
The number of people hospitalized in the state with covid-19, which reached a record high of 1,459 on Monday, fell Wednesday by 38, to 1,372.
That was just one more than the largest number of patients hospitalized in January during the state's winter surge.
[CORONAVIRUS: Click here for our complete coverage » arkansasonline.com/coronavirus]
The state's count of cases rose Wednesday by 2,685, an increase that was smaller by 255 than the one the previous Wednesday.
It was the third daily increase in a row, and the sixth in seven days, that was smaller than the one a week earlier.
After setting records for the previous three days, the number of virus patients who were on ventilators fell by two, to 326.
The number who were in intensive care, which reached a record high of 553 on Monday, fell for the second day in a row, going from 542 as of Tuesday to 524.
The number of intensive care beds statewide that were unoccupied, however, fell by two, to 15, reflecting an increase in non-covid-19 patients who were in intensive care.
Covid-19 patients made up 47% of all the state's intensive care patients as of Wednesday, down from 49% a day earlier.
After reaching a nearly seven-month high of 2,351 for the week ending Aug. 7, the average daily increase in the state's case count over a rolling seven-day period fell to 2,103 as of Wednesday.
With new cases exceeding recoveries and deaths, however, the number of cases in the state that were considered active rose by five, to 23,788, after falling the previous two days.
The number as of Wednesday was still down from a seven-month high of 25,735 that it reached Sunday.
State Epidemiologist Jennifer Dillaha said the decline in new cases could be the result of more people getting vaccinated and taking precautions such as wearing masks in public places.
She said she would "really love" the trend to continue.
"I'm a little skeptical because I have concerns that there may be spread with the new school year," Dillaha said. "Hopefully we can minimize it, but time will tell."
She said all the deaths reported Wednesday happened within the past month.
BEDS OPENED
Baptist Health as of Wednesday had opened 90 beds for covid-19 patients with money approved earlier this month by the Legislature's Joint Budget Committee, up from 87 a day earlier, health system spokeswoman Cara Wade said.
The beds open as of Wednesday comprised 50 regular beds and 12 intensive care unit beds at Baptist Health Medical Center-Little Rock, 16 ICU beds at Baptist Health-Fort Smith and 12 regular beds at Baptist Health-Van Buren.
"We are working to open the remaining 67 beds, including five ICU beds, in Fort Smith and Van Buren," Wade said in an email.
The committee approved spending $37.7 million in coronavirus relief funds to open and staff the 157 beds for 60 days.
At its 11 hospitals across the state, Wade said, Baptist Health had 282 covid-19 patients, including 57 who were being treated in the newly opened spaces.
The 282 patients included 110 who were in intensive care and 83 who were on ventilators. Wade said 88% of the covid-19 patients had not been fully vaccinated.
"ICU beds are extremely limited across our system and this varies hourly," Wade said.
The Joint Budget Committee has also approved spending $10.4 million for 43 beds at Unity Health-White County Medical Center in Searcy.
Hospital spokeswoman Brooke Pryor said Wednesday that the hospital was still working to hire nurses to staff the beds.
STATE RANKINGS
According to rankings Wednesday from the U.S. Centers for Disease Control and Prevention, Arkansas continued to have the country's fourth-highest number of new cases per capita, behind Mississippi, Louisiana and Florida, over a rolling seven-day period, with Mississippi overtaking Louisiana as the state with the highest rate.
Arkansas continued to have the second-highest number of new deaths per capita, after Louisiana.
Within Arkansas, Pulaski County had the most new cases, 347, followed by Benton County, which had 238, and Washington County, which had 191.
The state's cumulative count of cases rose to 425,551.
Dillaha said 15.1% of the state's coronavirus tests were positive during the seven-day span ending Tuesday, the same percentage that was initially reported for the week ending Monday.
The number of people who have ever been hospitalized in the state with confirmed infections rose by 132, to 20,285.
[Interactive Arkansas map not showing up above? Click here to see it: arkansasonline.com/arvirus]
The number who have ever been on a ventilator rose by six, to 2,057.
NURSING HOME CASES
A Health Department report released earlier this week shows that 110 nursing homes and assisted living facilities in the state had had at least one new covid-19 case within the past two weeks.
That was down three from a week earlier, when 113 facilities had at least one case.
There were a total of 484 cases, with the majority, 295, coming from staff members.
The cases are on the rise, growing from 415 a week earlier.
Rachel E. Bunch, executive director of the Arkansas Health Care Association and Arkansas Assisted Living Association, said the nursing homes recently began offering monoclonal antibodies in both an injectable and intravenous form for symptomatic covid-19 patients.
"What we're hearing back from our facilities is that in lots and lots of cases these people are not having to go to the hospital now," Bunch said.
"We're able to offer this treatment that seems to be really alleviating their symptoms and keeping them out of the hospital. That's something that I'm really proud of our efforts on, and I'm glad that we're able to do that."
The organization is also now partnering with pharmacies that send "strike teams" into the nursing homes experiencing outbreaks to join forces with the nursing staffs and care for the patients.
The partnership is keeping patients out of already-overloaded hospitals, Bunch said.
The state's nursing homes are also now streamlining their outbreak containment, Bunch said. When a covid-19 case is identified, a facility temporarily pauses visitation until it completes outbreak testing.
"They pause visitation until they can identify if there are other cases in the facility," Bunch said. "If the worker who is positive worked with a number of residents, they start in those areas first."
"The way that they're doing the outbreak testing, then following up to open up again, that's happening much faster now and keeping more homes open for visitation, which is what we want to see," she added.
According to the Health Department report, 37 homes had five or more new cases, up 11 homes from a week ago.
Nine of the facilities had 10 or more cases, the same as a week earlier.
Van Buren Healthcare and Rehabilitation Center in Van Buren had the most, 36, up from 21 cases, followed by Barnes Healthcare in Lonoke, 20; Spring Creek Health and Rehabilitation in Cabot, 19; St. John's Place of Arkansas in Fordyce, 17; Greene Acres Nursing Home in Paragould, 14; Lakewood Therapy and Living Center in Hot Springs, 14; Somerset Senior Living in Yellville, 14; Sherwood Nursing and Rehabilitation in Sherwood, 10; and The Waters of Rogers in Rogers, 10.
VACCINATION REQUIREMENT
Bunch said her organization had "mixed emotions" about President Joe Biden's announcement on Wednesday that nursing home staffs will be required to be vaccinated in order for those facilities to continue receiving federal Medicare and Medicaid funding.
"We're waiting on details, and we have a lot of questions," Bunch said. "We don't have all the details about when and how this will be effective."
The federal Centers for Medicare and Medicaid Services said it expected to issue rules outlining the requirement next month.
Bunch said vaccines have kept residents from becoming as sick from covid-19 as they once did, but she had concerns about requiring employees to get vaccinated.
"There are some employees who have opted not to receive the vaccines at this time," she said. "We're concerned about what pressures that will put on an already-stressed workforce situation."
Martha Deaver, president of Arkansas Advocates for Nursing Home Residents, said Biden's announcement was welcome news, adding it will "save thousands of our most frail and vulnerable citizens from harm or death."
"Nursing home residents have the right to be safe in their homes. CMS considers their room to be their homes. That is why nursing home residents are not called patients," Deaver said. "They have the same rights that you and I have in our home. Just as you and I would not allow someone to walk into our home with a coronavirus, nursing home residents have the same right. That right can no longer be denied."
Mark Parkinson, president and chief executive officer of the American Health Care Association and National Center for Assisted Living, said in a statement that nursing homes shouldn't be singled out.
"Vaccination mandates for health care personnel should be applied to all health care settings," he said. "Without this, nursing homes face a disastrous workforce challenge."
DASHBOARD DISPUTE
Bunch's group also issued a news release Wednesday warning that a dashboard launched Monday by the Arkansas Center for Health Improvement has "unverified" and "sensationalized" statistics about the state's nursing homes.
Among the data points noted by the Center for Health Improvement in a news release announcing the dashboard, which is based on information reported by the homes to the Centers for Medicare and Medicaid Services:
• Of the 222 facilities that reported information, only 27% had at least 75% of their personnel fully vaccinated as of Aug. 1.
• An average of 61% of workers at the facilities had been fully vaccinated, which was in line with the national average of 60%.
• Ten facilities reported that more than 50% of their residents infected with covid-19 had died.
The center's news release also noted that some facilities had high percentages of residents and staff members who were vaccinated.
For instance, it said Colonel Glenn Health and Rehab in Little Rock reported 95% of its residents and 96% of its health care personnel were fully vaccinated as of Aug. 1.
"The dashboard misrepresents facts and sensationalizes the pandemic at a time when healthcare workers need our support the most," Bunch said in her group's news release.
"The ACHI dashboard numbers fail to emphasize the date that vaccines were made available to [long-term care] facilities. Accordingly, they fail to tell the story of the before and after vaccine availability, and how successful they are in preventing serious illness and death in this population. If the goal of the website is transparency, isn't that something to emphasize?"
She said the dashboard fails to identify residents who were already infected with the virus when they were admitted to the homes.
"Facilities stepped up and created COVID-19 units to admit individuals with the virus that had to be discharged from the hospital to free up valuable hospital beds," she said.
She said the site implies that all nursing home cases were the result of employees' infections or failure to vaccinate.
"ACHI should help spread the reach of CDC and ADH guidelines instead of attacking nursing homes regarding vaccination rates that already surpass the national average and are the best in the region," Bunch said.
"This is only one piece of the puzzle, and all nursing home staff are required to utilize masks, enforce mask usage with most visitors, and abide by physical distancing requirements when possible."
Joe Thompson, the Center for Health Improvement's president, said his group didn't change any of the data reported by the homes, "but has provided a consumer-friendly access point for Arkansas citizens."
"ACHI provided a copy of the dashboard to the Arkansas Health Care Association one week prior to publishing and offered and continues to offer options to submit corrections," Thompson said in an email.
He said the data does not include information on whether a resident was already infected with covid-19 before being admitted to a nursing home.
"Regardless, if this statement is true, then the vaccination rates of health care workers would be even more important," he said.
He said weekly reports to the Centers for Medicare and Medicaid Services are a requirement for payment to the nursing homes and that Bunch's organization can submit corrections.
"For people with loved ones in nursing homes, or for those families considering placing a loved one in such a facility, we believe this is important information to share," Thompson said.
PSYCHIATRIC FACILITIES
Nine behavioral health facilities had 77 covid-19 cases in the past 14 days, according to another Health Department report released this week.
Birch Tree Communities, a mental health facility in Benton, had the highest number of cases, 29, with 13 of its staff members and 16 residents testing positive within the past 14 days.
Perimeter Behavioral Health of Forrest City had 19 cases, with three among staff members and 16 among patients, followed by Pinnacle Point Hospital in Little Rock, which had 12 cases, including nine among staff members and three among patients; Perimeter Behavioral Hospital of West Memphis, with six cases, including five among staff members and one among patients; and Rivendell Behavioral Health Services in Benton, with four cases, all staff members.
All other facilities had three or fewer cases, according to the Health Department report.
VACCINATIONS DOWN
At 10,415, the increase on Wednesday in vaccine doses that providers statewide reported having administered, including second doses of the Pfizer and Moderna vaccines, was smaller by 900 than the one a week earlier.
After rising the previous two days, the average number of doses administered each day over a rolling seven-day period fell to 11,155.
Dillaha said the Health Department didn't yet have numbers on how many of the doses were third doses of the Pfizer and Moderna vaccines administered to people with compromised immune systems as authorized last week by the U.S. Food and Drug Administration.
According to the CDC, the number of Arkansans who had received at least one vaccine dose rose by 7,139, to 1,544,867, representing about 51.2% of the state's population.
The number who had been fully vaccinated rose by 6,488, to 1,177,462, or about 39% of the population.
Among the states and District of Columbia, Arkansas moved from being No. 38 in the percentage of its residents who had received at least one vaccine dose as of Tuesday to being essentially tied with Missouri for having the 37th-highest percentage.
Arkansas continued to rank 46th, ahead of Louisiana, Idaho, Wyoming, Mississippi and Alabama, in the percentage of its residents who were fully vaccinated.