The number of Arkansans hospitalized with covid-19 fell back below 1,400 on Tuesday as the state's count of cases rose by 2,223.
The state death toll from the virus, as tracked by the Department of Health, rose by 45, to 6,749.
"The hospitalization reduction relieves some pressure on ICU capacity," Gov. Asa Hutchinson said in a tweet.
"Currently, all COVID patients have access as needed to ICU. We're working w/hospitals to expand capacity. It's difficult with limitations on nurse staffing, but I'm proud of the determination of our hospitals."
After rising the previous two days, the number of covid-19 patients in Arkansas hospitals fell by 44, to 1,367, its lowest level since Saturday.
That was down from the all-time high of 1,459, the number reached on Aug. 16, and smaller by four than its peak in January during the state's winter surge.
The number of virus patients on ventilators and in intensive care both fell from their record levels a day earlier.
The number on ventilators fell by six, to 343, while the number in intensive care fell by eight, to 550.
The number of intensive-care beds statewide that were unoccupied, however, fell by four, to 18, because of an increase in noncovid-19 patients.
Covid-19 patients made up just under half of the 1,103 patients across the state who were in intensive care as of Tuesday.
The increase in total cases was larger by 20 than the one the previous Tuesday.
As a result, the average daily increase in the state's case count over a rolling seven-day period rose slightly, to 2,228.
That was still down from the nearly seven-month high of 2,351 it reached the week ending Aug. 7.
After rising steeply from late June through early August, the average has fluctuated over the past couple weeks between about 2,100 and 2,300.
With recoveries and deaths outpacing new cases, the number of cases in the state that were considered active fell Tuesday by 448, to 23,128.
ICU BEDS SCARCE
Hutchinson began his weekly news conference at the state Capitol on Tuesday by saying he had been informed that "our ICU beds for covid patients are full in Arkansas right now."
"I share that because everybody should know the strain this is on our hospitals and the need to get our vaccinations, and how critical our bed space is," Hutchinson said.
"It fluctuates day by day but, right now because of the increased number of covid patients that need that type of ICU care, those beds are full right now."
Health Department Chief of Staff Renee Mallory said hospitals had reported to the state's COVIDComm system, which facilitates the transfer of covid-19 patients, that they did not have any ICU beds available for such patients.
Weekly Covid-19 Update Aug. 24
She said those beds are in rooms with negative air pressure to prevent airborne particles containing the virus from escaping.
The state still had some ICU beds available for non-covid-19 patients, she said.
"We have received word from one of our hospitals that they are going to open some additional ICU beds today, and then maybe later in the week," she said.
"They're trying to secure staffing."
Jeff Tabor, the program manager for the COVIDComm system, said after the news conference that none of the 48 hospitals that accept transfers through the system had available ICU beds for covid-19 patients from at least 7 a.m. until about 11:30 a.m. Tuesday.
As of Tuesday afternoon, he said one hospital, in southeastern Arkansas, had one or more ICU beds available to covid-19 patients.
Although Hutchinson called the situation unprecedented, Tabor said it's happened several times since July 29, which Tabor said at the time was the first time the state had no ICU beds available for covid-19 patients who needed to be transferred.
"It's an overnight to morning time problem, because as the days start, at 6 a.m., 7 a.m., physicians come in and they make their rounds, and they start discharging patients, and so then you see the green lights start coming on," Tabor said.
"Then, with that, they start getting filled right back up."
By comparison, in the winter, he didn't ever remember a time when hospitals had no ICU bed available for covid-19 patients.
"This surge is so much more difficult for us to place patients than the winter months, by far," Tabor said.
Over the past two weeks, Baptist Health has opened 113 hospital beds, including 33 ICU beds, for covid-19 patients with the help of federal coronavirus relief funds allocated by the state.
The extra beds that had been opened as of Tuesday included 12 intensive-care beds and 50 regular beds at Baptist Health Medical Center-Little Rock, 21 intensive-care beds at Baptist Health-Fort Smith and 30 regular hospital beds at Baptist Health-Van Buren.
Baptist Health spokeswoman Cara Wade said the health system planned to open the remaining 44 regular hospital beds in Van Buren today that will be funded under the agreement with the state.
The state has allotted $37.7 million in American Rescue Plan Act funds to open and staff the 157 beds for 60 days.
"Even with the completion of these beds, our state is in dire need of more critical care beds," Wade said in an email.
"We made the Arkansas Department of Health aware that Baptist Health will help beyond the 157 beds already committed."
She said Baptist Health planned to open an additional 18 ICU beds, including 15 dedicated for covid-19 patients, in North Little Rock and Fort Smith.
"Staffing is critical to being able to open these additional ICU beds in a timely manner," Wade said.
"We could potentially have the ICU beds open this week in Fort Smith and next week in North Little Rock."
Of the newly opened beds, 81 were full, including all of the new ICU beds.
At its 11 hospitals around the state, Baptist Health had 296 covid-19 patients as of Tuesday, including 140 who were in intensive care and 93 who were on ventilators, Wade said.
She said 88% of the patients had not been fully vaccinated.
The state also has allocated $10.4 million in American Rescue Plan Act funds for 43 beds, including nine ICU beds, for covid-19 patients at Unity Health-White County Medical Center in Searcy.
Unity Health spokeswoman Brooke Pryor said Tuesday the hospital was still working to hire staff for the beds.
She said it planned to open at least five of the beds on Sept. 7.
"We are working feverishly but the agency recruitment process is taking time," Pryor said in a text message.
Arkansas last week also submitted a request through the Emergency Management Assistance Compact for medical personnel from other states, LaTresha Woodruff, a spokeswoman for the Arkansas Department of Public Safety's Division of Emergency Management, said Tuesday.
She said Arkansas had not yet received a response to the request.
UAMS Medical Center had 58 covid-19 patients on Tuesday, including 27 in intensive care, 15 on ventilators and four on heart-lung bypass machines, spokeswoman Leslie Taylor said.
"More and more of the covid patients are in the ICU," Taylor said.
"That's very concerning because usually ICU patients are there for a few days, and especially if they're on ventilators or" heart-lung bypass machines.
She said nine of the 58 patients, all with health conditions besides covid-19, had been fully vaccinated.
With a few exceptions, such as for trauma and stroke, she said the hospital was not accepting transfers of patients from other hospitals.
At its hospitals in Little Rock and Springdale, Arkansas Children's had 23 covid-19 patients on Tuesday, spokeswoman Nicole Huddleston said.
She said about half the patients were in intensive care, and seven were on ventilators.
None of the patients had been fully vaccinated, even though 11 were at least 12 years old, making them eligible for the Pfizer vaccine.
At the news conference, Hutchinson displayed a graph showing that the average age of people hospitalized with covid-19 in Arkansas had fallen from 63.9 in December to 54.6 in July and August.
"With the delta variant, we're seeing more serious consequences in the younger ages," he said, adding that older people are also more likely to be vaccinated.
According to the U.S. Centers for Disease Control and Prevention, 83.3% of Arkansans age 65 and older had received at least one vaccine dose as of Monday, and 69.7% were fully vaccinated.
Among Arkansans age 18-64, 57.6% had received at least one dose, and 43.5% had been fully vaccinated.
Among children age 12-17, 40.5% had received at least one dose, and just 25% had been fully vaccinated.
Also on Tuesday, the Health Department reported that the number of active cases among public elementary and secondary school employees and students rose by 294, to 2,091, from Thursday to Monday.
Over the same period, the number of school districts or charter school systems with five or more active cases increased by 20, to 129.
That's out of the state's 262 total districts and open-enrollment charter school systems.
The Bentonville School District topped the Monday list with 88 active cases. Rogers followed with 74; Fort Smith with 70; Cabot and Springdale with 59 each; Little Rock with 56; and Marion School District with 43.
The Little Rock and Marion school districts are among the plaintiffs in a lawsuit challenging the constitutionality of a state law that prohibits government agencies -- including school districts -- from mandating that staff and students wear masks.
Enforcement of Act 1002 of 2021 has been stopped until the lawsuit is decided.
Private kindergarten-through-12th grade schools had 49 active cases as of Monday. Only Harding Academy, with seven cases, was identified.
Schools with fewer than five active cases weren't listed individually.
Most public schools started classes last week, if not earlier. Colleges and universities are getting underway as the month of August nears an end.
Between Thursday and Monday, the number of active cases at colleges and universities increased slightly from 233 to 247.
Thirteen campuses had 5 or more active covid cases, totaling 177. Campuses with fewer than five cases were not listed individually.
The University of Arkansas, Fayetteville had 37 active cases Monday, followed by 26 cases at the University of Central Arkansas and 19 at the University of Arkansas for Medical Sciences.
Arkansas school districts are in growing numbers posting to their websites or on social media information about their covid 19 cases and quarantines that is sometimes more current and more specific than the state Health Department reports can be.
For the period between 3 p.m. Monday and 3 p.m. Tuesday, the Little Rock School District logged nine new cases of covid 19. That was one employee and eight students at one district administrative site and five campuses. There were 62 individuals who were quarantined because of symptoms or exposure, including 19 at Southwest High and 21 at Don Roberts Elementary.
The North Little Rock School District reported that as of Tuesday, it had a total of 26 students and employees with who tested positive for covid 19 and 99 students and employees quarantined.
The Bentonville School District had 12 new positive cases among students on Tuesday and 56 students quarantined. Total cumulative cases for the district are 105 with a total of 270 currently quarantined.
The smaller Mountain Pine School District in Garland County reported on a social media video post that there were seven positive cases among students and 71 quarantined for exposure.
SHOTS AT GAMES
Education Secretary Johnny Key said the increase in active cases at public schools was "not unexpected," but he noted that no schools had made shifts to virtual instruction in response to virus cases or quarantines.
He said the department was working with the Arkansas Activities Association and the Health Department on plans to hold vaccination clinics at three or four "regional rivalry" high school football games across the state.
Hutchinson said at the news conference that he expects more businesses to implement vaccine requirements for their employees after the U.S. Food and Drug Administration's decision Monday giving full approval to the Pfizer vaccine.
He said he supports allowing businesses to choose whether to adopt such requirements but doesn't expect a need to change Act 977 of 2021, which prohibits state and local governments from requiring vaccinations.
Hutchinson also announced that the Health Department would be issuing a notice warning people not to take veterinary-grade ivermectin, an anti-parasitic drug, for the treatment of covid-19.
"Drugs intended for veterinary use are made with higher doses of the medication for use in large animals and can be highly toxic in humans," the department said in the notice posted to its website.
Taylor said the Arkansas Poison Center at UAMS' College of Pharmacy has received calls about 20 poisoning cases in adults this year related to veterinary-grade ivermectin, up from seven last year.
In 19 of the 20 cases, the person had taken the drug as a treatment for covid-19 or a protection from the virus, she said.
In their latest forecast report, released Tuesday, researchers with UAMS' Fay W. Boozman College of Public Health called covid-19 in Arkansas "a raging forest fire that will grow in size and strength."
They predicted the state will see a surge in cases five to 10 days after the start of the 2021-22 school year and after Labor Day weekend.
"If we have learned nothing else from the pandemic, COVID-19 loves a holiday party," the researchers wrote.
By Sept. 14, the report predicted new cases in Arkansas will top 4,500 a day, with the state's cumulative count of cases -- which stood at 438,465 as of Tuesday -- topping 530,000.
The state's death toll was projected to reach 7,017 by the end of August.
"If this forecast holds true, COVID-19 will have killed more Arkansans than all the wars in the 20th and 21st centuries," the researchers wrote.
According to CDC rankings on Tuesday, Arkansas had the country's seventh-highest number of new cases per capita during the week ending Monday, after Mississippi, Louisiana, Florida, Tennessee, South Carolina and Georgia.
Arkansas' number of deaths per capita during the week was the country's second-highest after Louisiana.
Within Arkansas, Pulaski County had the most new cases on Tuesday, 177, followed by Benton County, which had 176, and Washington County, which had 150.
The number of people who have ever been hospitalized in the state with confirmed infections rose by 174, to 20,797.
The number who have ever been on a ventilator rose by 20, to 2,124.
Meanwhile, at 10,950, the increase in vaccine doses that providers reported having administered, including second and third doses of the Pfizer and Moderna vaccines, was smaller by more than 1,700 than the one the previous Tuesday.
It was the sixth daily increase in the past seven days that was smaller than the one a week earlier.
The average number of doses administered each day over a rolling seven-day period fell to 9,575.
That was down from a nearly three-month high of 12,950, reached the week ending Aug. 9.
According to the CDC, the number of Arkansans of all ages who had received at least one vaccine dose rose Tuesday by 2,184, to 1,573,166, or about 52.1% of the state's population.
The number who had been fully vaccinated rose by 3,493, to 1,211,140, or about 40.1% of the population.
Among the states and District of Columbia, Arkansas ranked 36th in the percentage of its residents who had received at least one vaccine dose, up from 37th late last week.
In the percentage of its residents who were fully vaccinated, it ranked No. 46, ahead of West Virginia, Idaho, Wyoming, Mississippi and Alabama.
Also Tuesday, The Associated Press reported that a group of parents filed a lawsuit challenging the Cabot School District's decision to require masks.
The lawsuit argues the School Board did not have the authority to impose the requirement. A similar lawsuit was filed against a Northwest Arkansas school district last week.
More than 100 public school districts and charter schools have approved mask requirements after a judge issued a preliminary injunction against the state law banning mask mandates by government entities. The requirements cover more than half of the state's public school students.