State notches 2,708 increase in virus cases

Order for restaurants, bars to close by 11 p.m. extended

Registered nurse Carrie Perry records information from a driver in Wayne, W.Va., on Thursday, Dec. 31, 2020. The Wayne County Health Department was offering covid-19 vaccines for anyone 80 years of age or older at a drive-thru site.
Registered nurse Carrie Perry records information from a driver in Wayne, W.Va., on Thursday, Dec. 31, 2020. The Wayne County Health Department was offering covid-19 vaccines for anyone 80 years of age or older at a drive-thru site.

Arkansas' count of coronavirus cases grew Thursday by more than 2,700 as the number of patients hospitalized with the virus jumped to almost 1,200 -- setting a new high for the fourth day in a row.

The state's death toll from the virus, as tracked by the state Department of Health, rose by 39, to 3,676.

Also Thursday, the Health Department extended until Feb. 3 a requirement for bars and restaurants that sell alcohol to close by 11 p.m. as a way of limiting the spread of the virus.

The directive, which first took effect Nov. 20, had been set to expire Sunday.

"COVID-19 case numbers remain high and community spread is a significant concern, so we determined that extending the directive was necessary," Health Department spokesman Gavin Lesnick said in an email.

Violations are punishable by a fine of up to $500 and up to a month in jail.

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State Epidemiologist Jennifer Dillaha also said Thursday that the state had submitted its order for next week's shipments of the coronavirus vaccine, which will be designated almost exclusively for high-priority health care workers in outpatient settings.

Those will include enough doses to provide the initial shots to 18,525 people with the vaccine developed by Pfizer and BioNTech, and 28,200 with the Moderna vaccine.

While the Moderna vaccine has so far been designated for residents and workers in nursing homes and other long-term-care facilities, Dillaha said all but 9,000 of next week's Moderna doses will be shipped to pharmacies to be administered to health care workers in clinics and other outpatient settings.

The state will also receive 18,525 doses of the Pfizer vaccine to provide booster shots to people who received their first doses last week.

Gov. Asa Hutchinson said in a statement that the increase of 2,708 cases Thursday was "way too high" but noted that it was smaller than the record 3,204 cases that were added to the state's tallies the previous Thursday, Dec. 24.

He said he "spent the last day of 2020 working with our health department team on vaccine distribution."

"We are also working with our incredible hospitals on the best way to cover the increase in hospitalizations," the Republican governor said.

"Be safe this New Year's Eve."

The number of covid-19 patients in the state's hospitals rose by 21, to 1,195.

Numbers released by the Health Department on Thursday afternoon showed that, as of 2 p.m., those patients included 211 who were on ventilators, up from 205 Wednesday.

That tied the record of 211 virus patients that the Health Department's online dashboard indicated were on the breathing machines as of Nov. 30.

Later Thursday, however, a Health Department update indicated that the number of patients on ventilators had fallen slightly, to 209.

The number of covid-19 patients who were in intensive care units rose Thursday by 11, to 397.

That was still below the high of 407 ICU patients that were reported on the dashboard on Nov. 30.

ANOTHER SURGE FEARED

Thursday's increase in cases followed a spike of 3,184 Wednesday -- the state's second-highest one-day increase.

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Dillaha said the relatively smaller increase Thursday could indicate that "we are over the post-holiday catch up from the labs being closed" on Christmas and over the weekend.

"It's hard to say on a day-to-day basis what the ups and downs are attributed to," she said. "We have to look at the overall trend.

"Even so, the total cases remain very high."

She noted large new case totals in three counties -- 375 in Pulaski County, 310 in Washington County and 253 in Benton County.

Some people who were infected during Christmas gatherings might unwittingly spread the virus further during New Year's Eve celebrations, leading to a "surge upon a surge."

"I hope I'm wrong and that people will choose instead to not gather with other people on New Year's Eve, but I think that it's very likely that some people will do that," she said.

She said she'd encourage people not to gather with others outside their households.

People who do hold gatherings should keep the number of people to 10 or less, wear masks and stay at least six feet from non-household members, she said.

VACCINE PLANS

Next week will mark the first time a portion of the state's allocation of the Moderna vaccine will be designated for people who don't live or work in long-term-care facilities.

Dillaha said the 68,800 doses of the vaccine that the state was allocated last week and this week, along with 9,000 additional doses next week, should be enough to provide the initial shots for people at those facilities.

As a result, the bulk of next week's Moderna allocation will go toward health care workers, who are also part of the highest-priority group to receive the vaccine.







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The state has initially designated its allocation of Pfizer vaccine for those workers.

So far, those doses have gone primarily to high-priority workers at hospitals, including general acute care, psychiatric, rehabilitation, long-term acute care and surgical hospitals.

Next week, the focus for the Pfizer and Moderna vaccine will shift to patient care workers in clinics and other outpatient settings.

That includes staff members at primary care and urgent care clinics, dental clinics, pharmacies, blood donation centers, dialysis centers and university health clinics, as well as school nurses, home health and private care aides, and hospice workers.

Shots will also be available for unvaccinated ambulance workers, Dillaha has said.

The Pfizer vaccine, which must be stored at minus-94 degrees Fahrenheit and has a minimum shipment size of 975 doses, will go to three hospitals and 12 pharmacies in 11 counties.

Those hospitals -- Northwest Medical Center in Bentonville, North Arkansas Regional Medical Center in Harrison and Baptist Health-Fort Smith -- and pharmacies, all of which have freezers that can store the vaccine at ultra-cold temperatures, will work with other pharmacies in their counties to administer the vaccines.

"They can refrigerate it, but it has to be used within five days, so they have to coordinate among themselves for that transfer so that the timing is right and the vaccine is not wasted, because once it's thawed, you can't re-freeze it," Dillaha said.

The pharmacies are Cornerstone Pharmacy, Don's Pharmacy, Kavanaugh Pharmacy and The Pharmacy at Wellington in Little Rock; Piggott Pharmacy; Woodsprings Pharmacy in Jonesboro; Village Health Mart Drug No. 1 in Hot Springs Village; Hyde Pharmacy in Paragould; Doctor's Orders Pharmacy No. 2 in Pine Bluff, Bryant Family Pharmacy; West Side Pharmacy in Benton; and Collier Drug in Fayetteville.

The Moderna vaccine will go to 140 pharmacies in the state's other 64 counties. That vaccine comes in shipments of as few as 100 doses and can be stored at normal freezer temperatures.

SCHOOL NURSES, AIDES

On its Facebook page, the Alma School District said four of its nurses received vaccinations Tuesday.

Superintendent David Woolly said five teaching assistants who work with students with disabilities also received the shots.

The doses were provided by Justin Boyd, owner of Coleman Pharmacy in Alma, who called the nurses and teaching assistants down to the pharmacy for the shots, Woolly said.

"It all worked out extremely well for them," Woolly said. "They were delighted. I appreciate Justin Boyd very much for stepping up and doing this. It's great that our school nurses are at the front of the line. I hope that's happening for school nurses across the state."

Dillaha said some community pharmacies received Pfizer shipments this week for hospitals that didn't need them.

For instance, some rehabilitation hospitals received the shots from an affiliated general acute care hospital and didn't need the vaccine from the pharmacy.

In those instances, pharmacies "could go ahead and administer the vaccine" to community health care workers, such as school nurses, Dillaha said.

"It didn't seem to make sense to just hold onto the vaccine until next week."

Whether a teaching assistant who works with disabled students should be eligible for the shot at this stage is "a gray area," she said.

"While they are not explicitly in one of the priority groups, we would not fault them for vaccinating them," she said.

Messages for Boyd, a Republican state representative from Fort Smith, were not returned as of late Thursday.

HOSPITAL WORKERS

As of Thursday morning, the state had received 92,625 doses of the Pfizer vaccine -- representing its first three weeks of shipments since the vaccine was issued an emergency use authorization by the U.S. Food and Drug Administration on Dec. 11.

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Pharmacies and other providers reported administering 24,302 of those doses as of Thursday morning, an increase of 1,629 from the number reported a day earlier, according to the Health Department.

Bonnie Ward, a spokeswoman for CHI St. Vincent Infirmary in Little Rock, said about 2,900 CHI employees had been vaccinated as of the end of the day Thursday.

Erica Duncan, spokeswoman for White County Medical Center-Unity Health in Searcy, said 800 shots have been given out of the 2,925 that hospital received.

"Distribution has gone smoothly," she said.

Martine Pollard, spokeswoman for the Northwest Arkansas Health Care Community, a coalition of health care providers, said the region's hospitals had administered close to 4,500 covid-19 vaccinations.

U.S. Department of Veterans Affairs hospitals in the state have received their own vaccine shipments.

Chris Durney, a spokesman for the Central Arkansas Veterans Healthcare System, said the hospital system began on Dec. 22 vaccinating its front-line health care workers and residents of its community living center.

The hospital received a second shipment of the Moderna vaccine on Dec. 29 and began vaccination of residents in its domiciliaries at the Eugene J. Towbin VA Medical Center in North Little Rock, Durney said.

"Later this week, we plan to begin offering vaccinations to veterans at our day treatment center in downtown Little Rock," he said.

Durney said all five of the intensive care unit beds at the John L. McClellan Memorial Veterans Hospital in Little Rock that were made available to help Arkansas handle its load of covid-19 patients were occupied with non-veterans Thursday.

The five regular medical/surgical beds were not in use, however.

"We have not received to date any requests for medical surgical humanitarian missions," Durney said, referring to the five regular beds. "We are honored to be able to bring excellent care to our non-veteran patients, and to help the state during this rising pandemic."

Duncan said Unity Health-White County Medical Center had 36 covid-19 positive patients as of Thursday.

"Our associates have gone above and beyond to meet the needs of our communities," Duncan said. "We are thankful for their hard work and dedication during this time."

PRISON OUTBREAKS

The cases added Thursday included 1,837 that were confirmed through polymerase chain reaction, or PCR tests.

The other 871 were "probable" cases, which include those identified through less-sensitive antigen tests.

The state's cumulative count of cases rose to 225,138.

That comprised 186,784 confirmed cases and 38,354 probable ones.

The number of cases that were considered active rose by 336, to 22,189, as 2,333 Arkansans were newly classified as having recovered.

Aside from Pulaski, Washington and Benton counties, the counties with the highest number of new cases were Craighead County, which had 116, and Sebastian County, which had 109.

Among prison and jail inmates, the Health Department's count of cases rose by 41.

Department of Corrections spokesman Cindy Murphy said the number of cases among inmates rose by 19, to 607, at the Tucker Unit in Jefferson County; by 15, to 338, at the Barbara Ester Unit in Pine Bluff; by four, to 454, at the Wrightsville Unit; and by three, to 1,530, at the Ouachita River Unit in Malvern.

The Ester Unit has the most cases that were active, 159, followed by the Tucker Unit, which had 81, and the Malvern lockup, which had 54.

The Wrightsville Unit had 11 active cases.

The department also said an inmate from the Tucker Unit died Thursday while being treated for covid-19 at Jefferson Regional Medical Center in Pine Bluff.

The inmate was in his early 70s and was serving a 20-year sentence for rape.

Statewide, the average number of cases added to tallies each day over a rolling seven-day period, fell Thursday by 71, to 1,999.

The death toll from the virus rose by 20, to 3,088, among confirmed cases and by 19, to 588, among probable cases.

Among nursing home and assisted living facility residents, the count of virus deaths rose by five, to 1,508.

The number of people who have ever been hospitalized in the state with covid-19 rose by 87, to 11,358.

The number of virus patients who have ever been on a ventilator with covid-19 rose by 11, to 1,223.

HOSPITAL CAPACITY

About 57.5% of the state's inventory of 1,091 ventilators were available for use Thursday, 22 fewer than the previous day.

The number of hospital beds available for use increased by 33, going from 1,968 to 2,001.

The total beds -- whether filled or vacant -- remained the same at 8,940. The total includes more than 300 in psychiatric or rehabilitation facilities that aren't for covid-19 care.

That means about 77.5% of the state's hospital beds are full.

The number of available critical care beds increased by six, to 56 Thursday.

Out of the state's 1,155 inventory of ICU beds, 95% are in use.

There were 397 covid-19 patients in ICU beds, 11 more than the previous day.

The state's total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- remained the same at 8,894.

Maximum flex bed capacity -- the number of hospital beds regardless of ability to staff them -- also remained the same at 11,428.

The majority of the 1,195 covid-19 patients hospitalized -- 387 -- were in hospitals in the metropolitan region of the state followed by 198 in the southwest, 160 in the northeast, 143 in the Arkansas Valley, 128 in the northwest, 114 in the north-central and 65 in the southeast.

Metro region hospitals also had 158 patients in ICU followed by 72 in the southwest, 56 in the northwest, 36 in the Arkansas Valley, 32 in the northeast, 28 in the north-central and 14 in the southeast.

The hospitals with the highest number of patients on ventilators were in the metropolitan region with 87, followed by the southwest with 34, northwest with 25, Arkansas Valley with 23, northeast with 19, north-central with 18 and southeast with three.

BAPTIST HEALTH

To carve out more patient-care beds, Little Rock-based Baptist Health's hospitals have converted some covid-positive patient rooms to double occupancy, expanded its emergency department capacity, added medical-surgery beds and are expanding ICU capacity, said spokeswoman Margot Vogel.

The hospital system has also increased the number of negative-pressure rooms that are designed to prevent air from flowing out of rooms with contagious patients.

"Our facilities management department has done an absolutely amazing job in converting rooms for negative pressure going all the way back to March," Vogel said.

Vogel declined to say how many of the system's 1,200 regular beds and 200 ICU beds were available.

"Our bed availability fluctuates daily and sometimes hourly, and we adjust to meet whatever the needs are," Vogel said. "So far we have been successful in staying ahead of the curve so that we are able to provide care to all patients who present to Baptist Health."

The hospital system is taking a "very proactive" approach to planning for the continued increase in covid-19 patients, Vogel said.

The hospital partnered with CHI St. Vincent to open a center to administer monoclonal antibody infusion of bamlanivimab for covid-positive patients and is assessing the options of expanding the clinic's days and hours of operations.

"We added 70 ventilators for the system with more on order," Vogel said. "We have been prepared and never stopped looking toward the future to analyze what we need to do to maintain our preparedness rather than be reactive to the situation."

Baptist Health has also maintained a "very refined" visitor policy to prevent the transmission of the virus within the health care setting.

"The policy is working, and there are no plans to change at this time, especially right now as the numbers continue to increase," Vogel said.

During December, the Baptist Health system has cared for an average of 200-plus covid-19 patients per day, Vogel said, adding that about 300-500 people per day come through the Little Rock campus's covid-19 testing station.

"Baptist Health has tested over 81,000 people in our drive-thru testing sites, with 32,000 of those being in Little Rock, and our call centers have answered over 50,000 covid-related calls," Vogel said.

The hospital system has not had to delay any health care services or elective surgeries for non-covid patients, Vogel said.

The system's health care workers are tired, Vogel said.

"And we are concerned about them," she said. "It has been a long 10 months for health care professionals, and we are continually working to make sure our caregivers are being taken care of as much as they are taking care of the community."

Baptist Health changed its personal time off policy so that employees can carry over vacation days into 2021. The hospital also paid for all the employees' health insurance premiums on the last payday of 2020 to give an added end-of-the-year bonus.

"Employee morale is important during these times of such a high patient census and all that goes along with battling a pandemic on the front lines," Vogel said. "In spite of all the challenges, our employees continue to show up and amaze every day. These heroes have come through for Arkansas in the state's time of need."

But the best way for anyone to show support to the health care workers on the front lines is to follow U.S. Centers for Disease Control and Prevention guidelines in reducing the spread of the virus by wearing masks, keeping a distance from others and taking the vaccine when offered, Vogel said.

"It is very important that everyone in Arkansas take these prevention measures seriously and do their part to protect themselves and others to fight this pandemic," Vogel said.

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Coronavirus daily updates and cumulative covid-19 cases in Arkansas

CORRECTION: On its Facebook page, the Alma School District said district nurses received covid-19 vaccinations Tuesday. An earlier version of this story incorrectly described when the post said the vaccinations were given.

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