Case slowdown in state cues optimism and yet caution

Experts look to see if state can maintain infection drop

A nurse conducts a coronavirus test in August 2020 at the UAMS drive-thru screening site in Little Rock. More photos at arkansasonline.com/819test/. (Arkansas Democrat-Gazette/Stephen Swofford)
A nurse conducts a coronavirus test in August 2020 at the UAMS drive-thru screening site in Little Rock. More photos at arkansasonline.com/819test/. (Arkansas Democrat-Gazette/Stephen Swofford)

Public health experts say the decline in new covid-19 cases in the state is cause for cautious optimism but warn that those numbers could increase again as new, more contagious variants of the virus continue spreading across the country.

For the fourth day in a row, the number of new infections declined in Arkansas, with the Health Department reporting 637 cases Monday, down from 672 Sunday and 1,341 new cases Saturday.

Active cases in the state decreased by a little more than a thousand Monday to 15,320. On Sunday, active cases numbered 16,324.

“This is a ray of hope,” said Dr. Jennifer Dillaha, the state’s epidemiologist. “It is a hopeful sign we will keep trending downward.”

“We do possibly need to take it with a grain of salt, because we have weekly variations in new case numbers, so those can be higher toward the end of the week and lower at the beginning,” Dillaha said. “We try to look at the weekly average as opposed to putting a whole lot of stock on what happens on a single day.”

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Monday’s new infections “are nearly half as many new cases as last Monday,” Gov. Asa Hutchinson said in a statement. “This, as well as almost 90,000 doses of the covid-19 vaccine administered last week, provides us with hope as we continue to fight this pandemic.”

“Our united efforts as a state will help us get past this, but it takes everyone working together,” the governor said.

Deaths from covid-19 increased by 30, bringing the toll to 5,106 people in Arkansas.

Hospitalizations decreased by four to 777, according to the Health Department. Of those, 16 additional patients were placed on ventilators, bringing the total on ventilators as of Monday afternoon to 142.

The decline in hospitalizations is proportional to fewer cases but also could be attributed to more widespread use of monoclonal antibody treatments, Dillaha said. These treatments are given to high-risk patients who test positive and are shown to prevent serious cases of the virus.

St. Bernards Medical Center in Jonesboro has administered more than 700 monoclonal antibody infusions, “which have proven overwhelmingly effective in preventing covid hospitalizations,” Mitchell Nail, a spokesperson, said via email.

“We encourage any person experiencing covid symptoms to seek testing, because we only have a short window from the onset of symptoms to administer an infusion,” Nail said.

Such treatments must be administered to a patient within about a week of testing positive to be effective at preventing severe illness.

VARIANTS CONCERN

Even with the emergence of more promising data, Dillaha said it is too soon for Arkansans to relax safety measures such as wearing masks, avoiding large gatherings and social distancing.

She said the decrease in cases could be from fewer people traveling and more public awareness of the need to adhere to such guidelines so as not to overwhelm hospitals.

It is too soon to measure whether the covid-19 vaccines given out in the state are having any impact on transmissibility, Dillaha said.

“To relax [safety measures] now would be a very unfortunate step in the wrong direction,” Dillaha said, “because we have circulating around the world and now in the U.S. a few variants of the virus that causes covid-19 that are very concerning.”

She added: “These variants of interest are able to spread from person to person much more easily than current variants, and there is concern that with those variants circulating, we again will have a big surge, high hospitalization rates and more deaths.”

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The U.S. Centers for Disease Control and Prevention predicts that a more contagious strain of the coronavirus, detected in the United Kingdom in December, could become the dominant strain in the country by March.

There are 690 cases of that variant reported in 33 states, according to the latest data from the CDC.

Three cases of a variant that emerged in Brazil have been detected in two states, including Oklahoma, the CDC reported. Six cases of a variant that emerged in South Africa have also been found in three states.

So far, the new strains have not been detected in Arkansas, Dillaha said.

“I am not aware of anything being identified here, though it is possible they are here,” she said. “Our hope is that we can hold them off as much as possible.”

“We don’t want any of these variants from other geographic locations to move in on our state,” Dillaha said. “We may not be able to completely prevent it, but we should hold them off as long as possible.”

Dillaha said she is also concerned about reports out of South Africa that the use of the AstraZeneca-Oxford vaccine had been halted after clinical trial participants were not protected against the variant that emerged there.

She said that is the other reason to “move forward with caution.”

VACCINE ROLLOUT

Pharmacists, hospitals and other health care providers administered 1,946 covid-19 vaccinations Monday, bringing the total since the rollout in mid-December to 379,624, according to the Health Department.

That figure is about 68% of the 561,150 doses of the Pfizer-BioNTech and Moderna vaccines that the state has received.

An additional 45,325 initial doses are expected to arrive this week — 18,525 Pfizer shots and 26,800 Moderna shots, Dillaha said.

Most of the Pfizer vaccine will be delivered to hospitals, while the Moderna shorts will arrive at some 230 pharmacies across the state, Dillaha said.

CHI St. Vincent reopened its vaccination clinics at the Infirmary in Little Rock and CHI St. Vincent in Hot Springs on Monday after having to close those clinics because of vaccine shortages.

Those two clinics began administering second doses of the vaccine to nearly 2,000 people who received initial doses in January, Bonnie Ward, CHI St. Vincent communications director, said via email. Those second-dose vaccinations will conclude today.

CHI St. Vincent received additional trays of the Pfizer vaccine and will resume initial shots after contacting people who have already made an appointment.

“We would like to remind all those who have previously registered for the vaccine through CHI. St. Vincent to please be patient and wait to be contacted in order to schedule their vaccination,” Ward said.

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As St. Bernards in Jonesboro this week resumes first-dose vaccinations for people 70 and older, who make up a subgroup in the Phase 1B rollout, the health care group is working on contingency plans for inclement weather, said spokesperson Nail.

Last week, St. Bernards administered 2,800 doses, he said.

“Our biggest concern this week involves potential winter weather affecting communities in this age group,” Nail said. “We are prepared to vaccinate, however, regardless of weather.”

For the remainder of February, John Vinson, head of the Arkansas Pharmacists Association, which coordinates vaccine distribution efforts between local pharmacies and the Health Department, said processes are beginning to normalize as vaccine allocations have become more predictable.

Pharmacies for the most part can now forecast how many doses they will receive weekly and work through sometimes-long waitlists in a more regimented manner, he said.

“I feel really good about the fact that we have predictability now for the rest of February,” Vinson said. “Pharmacies are now regularly getting vaccines and know how many doses they are going to receive at a minimum.”

Vinson said it could take at least six weeks to complete the rollout of those who want a vaccine in the Phase 1B subgroups, which include individuals 70 and older and educators who work in schools, higher education and child care.

“The longer this goes on, the more questions we are getting from people who have anxiety about when they are next or who is next,” Vinson said. “It is hard to say, ‘I don’t know. I’m not sure. I’ll let you know when we know.’”

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