Gov. Asa Hutchinson on Monday moved police, firefighters and other first responders to the front of the covid-19 vaccine line, breaking with the established, phased administration plan.
As the vaccine continues a slow rollout -- with only about one-third of the vaccine doses administered from the vials that landed in the state on Dec. 14 -- state Epidemiologist Dr. Jennifer Dillaha said in an interview Monday that the state Health Department has new resolve to make the vaccine plans and data more transparent and available to the public.
Dillaha spoke as the state's daily count of new cases was relatively low, at 1,306, but as the number of Arkansas covid-19 patients hospitalized, in intensive care units and on ventilators all reached record highs, according to data released by the Arkansas Department of Health.
The first responders, such as police and fire personnel, were initially in Phase 1B of the Health Department's vaccine distribution plan, as recommended by the U.S. Centers for Disease Control and Prevention, but Hutchinson moved the group to the initial phase.
When asked, Hutchinson did not give a reason for the change, but he said that the Vaccine Priority Plan will be covered today during his weekly covid-19 news conference.
Dillaha said in an interview that the Health Department is putting together a written plan this week for public release to detail the steps to vaccinate the entire state.
Hutchinson announced last week that the Health Department will begin releasing on the agency's website the number of vaccine doses received and shots administered.
"I think one of the frustrations is the public doesn't know what to expect very well. We would like to be able to do a better job of expectations," Dillaha said. "That is our goal is for this next week is to make our plans more transparent and put them in written form so that people will have a better idea of what to expect."
Dillaha said she knows that a lot of people "think they have been left out."
"They likely haven't been left out; they don't know where they fit in, and we want to better communicate that to the public," she said.
Dillaha said this will be a "really great week for us in immunizations for covid-19."
The state is still in Phase 1A of the vaccine distribution plan -- which includes health care workers, emergency medical service workers, residents and staff members of long-term care facilities, and now first responders.
"We have vaccines arriving in counties around the state to approximately 212 pharmacies and other locations so that we can make sure that our health care workers in Arkansas have the opportunity to get vaccinated," she said. "This effort is particularly focusing on health care workers who do not work in hospitals or in long-term care facilities. We want to start with the high-risk workers in the communities, certain priority groups, such as primary care, urgent care, home health and so forth."
Those administering the vaccines -- such as hospitals and pharmacies -- have 72 hours to report to state health officials the number of doses received and administered.
That three-day window leads to a lag in data, so it's difficult to tell exactly where the state is in its vaccination efforts, Dillaha said. Additionally, the Health Department is working with some vaccine administrators to help them transmit their data electronically.
"We can tell you how many health care professionals we have, but that doesn't really tell you how many people work in health care. That number has been a little more difficult to assess," she said. "What we were wanting to do is do an assessment of the hospitals and the pharmacies to see the folks that they're vaccinating, where are they on the priority list and how much vaccine they anticipate they need to finish the job."
The lag in reporting makes it difficult to predict when the state will progress to the next phase of vaccine distribution, but the hope is it will begin "in a few weeks," she said.
"We will continue the job until we see a drop-off in demand, and we'll move on to 1B," Dillaha said. "It's possible that we may finish 1A in some areas of the state before we finish 1A in other areas of the state. There may be an overlap in transition. There is probably more administered than what is shown because of the data lag."
The state has laid out three phases in its covid-19 vaccination plan. Phase 1B includes essential workers, such as teachers, day care workers, food industry workers, correctional employees, utility workers, truck drivers, essential government and infrastructure workers, and people who are 70 years or older.
Phase 1C is when some members of the general population will be vaccinated. It includes adults of any age with chronic health conditions, adults age 65 and older regardless of health status, and those who live in congregate settings.
"It's rolling," Dillaha said. "It's not stalled or sitting anywhere. I think the data lag is causing people to misperceive that the vaccine is not being deployed."
When it gets to the point of public dissemination, there will be "a lot more people" involved in getting the vaccine to the people -- and a lot more challenges, Dillaha said.
"We will need more vaccinators at that point -- assuming we have more vaccine. The more vaccinators we have, the more quickly we can get the population vaccinated," she said. "The limiting factor, of course, is the number of doses that we get each week."
As of now, more than 200 pharmacies are partnering with the Health Department to administer the vaccine. Many of those that are currently assisting with vaccinating long-term care facilities will likely help with the public rollout, Dillaha said.
"They will have very good experience in working out their process and flow. Some of them could do drive-thru clinics," she said. "If there's a need for us to supplement with assistance from the local health units or the National Guard or other entities, we can certainly do that. But it's all going to be dependent on how much the allocation that Arkansas gets increases. That's the limiting factor, not vaccinators."
Distributing the covid-19 vaccine to the rest of the public is quite different from flu vaccination clinics held in the past where hundreds of people stood in line to be vaccinated.
"Of course, in the current covid-19 pandemic, you don't really want people gathering in large groups, big lines, to do vaccinations. That could work against you in the spread of covid-19," Dillaha said. "Having a greater number of smaller venues works to prevent the spread of covid-19 and could actually work better in getting more people vaccinated. Because instead of having one main site in a county, such as at a local health unit, you could have many sites in the county."
As of Monday morning, 36,286 vaccine doses had been administered in the state, according to Health Department spokesman Gavin Lesnick.
Since Dec. 14, the state has received 92,625 doses of the Pfizer-BioNTech vaccine and 56,400 doses of the Moderna vaccine, according to Health Department data.
Of the Pfizer vaccine received, 26,693 doses -- or about 29% -- had been administered as of Monday. For the Moderna vaccine, 9,593 doses -- about 17% -- had been administered.
As part of the Federal Long Term Care Facility Program, Walgreens has received 16,300 first-dose allocations of the vaccine and has administered about 7% -- or 1,084 doses -- as of Monday.
Under the same program, CVS received 8,400 allocations and has administered 3% -- or 240 doses.
"The Department of Health is working with CVS and Walgreens to make sure long-term care facilities in Arkansas get addressed in a timely manner," Dillaha said.
"If it turns out they're not getting addressed timely, then we're taking steps to move that forward," Dillaha said. "There have been some instances where local pharmacies have vaccinated the residents rather than wait for one of the other works."
Baptist Health has administered 7,345 doses of the vaccine across the hospital system since Dec. 15, said spokeswoman Cara Wade. On Monday, 645 of its health care workers in Little Rock and North Little Rock were vaccinated. For some, it was the second dose, she added.
"Vaccinations will vary by facility this week," Wade said. "Some facilities will continue to provide the first dose of the vaccine, and some have started providing the second dose of the vaccine."
St. Bernards Healthcare in Jonesboro will begin its second-dose vaccinations on Wednesday. The hospital has given about 3,000 shots so far, said spokesman Mitchell Nail.
"We're thankful front-line health care workers across our state are receiving those second doses this week, and we look forward to continuing this process for our region," Nail said.
CHI St. Vincent has administered about 3,000 vaccinations across its system, said spokeswoman Bonnie Ward. The hospital is expecting a shipment for its second-dose vaccinations this week.
The University of Arkansas for Medical Sciences has vaccinated about 4,000 of its employees with the first dose and has begun issuing its second dose, said spokeswoman Leslie Taylor.
BY THE NUMBERS
There were 1,296 covid-19 patients in hospitals Monday, breaking the previous record of 1,234 set Sunday.
Of those patients, 411 were in critical care units Monday, breaking the record of 407 set Nov. 30.
The number of patients on ventilators increased by 18, to 212, one higher than the record of 211 set Nov. 30.
The state's count of coronavirus cases grew Monday by 1,306 to a cumulative total of 234,781. The state's death toll from the virus rose by 51, to 3,800.
"Today's increase in hospitalizations and the 51 new deaths from COVID-19 are vivid reminders of how many families are hurting because of this pandemic," Hutchinson said in a statement. "Our health care system is stretched and the numbers are likely to increase more. Thanks to all who are doing everything they can to be safe."
Of the total number of cases, 207,898 are considered recovered.
The number of cases that were active dropped by 1,181, to 23,057.
The state reported that in a 24-hour period, 4,473 polymerase chain reaction tests and 439 antigen tests were given.
The number of people who have ever been hospitalized in the state with covid-19 rose by 111, to 11,625.
Pulaski County had the largest number of new cases, with 206, followed by Washington County, with 151; Benton County, with 117; Faulkner County, with 96; and Sebastian County, with 61.
The number of hospital beds available for use dropped by 140, going from 2,121 to 1,981 on Monday.
The total beds -- whether filled or vacant -- dropped by seven, from 8,902 to 8,895. (The total includes more than 300 in psychiatric or rehabilitation facilities that aren't for covid-19 care.)
That means that about 78% of the state's hospital beds are full.
There were 49 ICU beds available Monday out of the state's inventory of 1,155 critical care beds -- meaning more than 96% are full.
Martine Pollard, spokeswoman for the Northwest Arkansas Health Care Community, a coalition of Northwest Arkansas health care providers, said the northwest hospitals reached a record high on Monday with 128 patients in the region's covid-19 units.
"We have continued to manage the increased volume of patients within our own surge planning along with the regional surge plan," said Eric Pianalto, president of Mercy Hospital Northwest Arkansas. "We have plans for what happens if we exceed that capacity, which we will institute regionally if necessary."
Since covid-19 hit the state in March, all the Northwest Arkansas hospitals have come together to form the Northwest Arkansas Health Care Community.
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.
"While it is disappointing, we anticipated we'd likely see an increase of COVID-19 patient hospitalizations following the holidays," Larry Shackelford, president of Washington Regional Medical Center, said in an email. "We will continue to enact our individual phased surge plans, while closely monitoring if we need to go to the next phase."
Shackelford added that Northwest Arkansas and the nation still face hard times as hospitals continue to see a surge in the need for in-patient care.
"As we start this new year, we must hold on to the hope that with the COVID-19 vaccine the end may finally be in sight, while continuing to practice the public health guidelines that have been in place since spring 2020: wear a mask, wash your hands, watch your distance and avoid gatherings," he said.
Ward said that CHI St. Vincent continues to experience a "high level of capacity." The hospital's Hot Springs branch extended its emergency room capacity by installing a temporary facility.
"The temporary facility in Hot Springs, which will serve as an extension of the current emergency department, will be implemented on an as-needed basis," Ward said. "CHI St. Vincent Hot Springs staff remain diligent about immediately identifying any patient suspected of having covid-19 and isolating them from the rest of the patient population."
Wade said regular and ICU beds at Baptist Health are "extremely limited" across our system.
"And this varies hourly," Wade said. "It is not uncommon to run at or near capacity for ICU beds. Though availability is limited, we have managed to care for the patients who present to Baptist Health whether that is for covid-19 or other medical conditions."
Taylor said UAMS has expanded its ICU beds to 64 from the typical, pre-covid number of 52 beds.
"This morning we had about 40 regular beds available, but that fluctuates and changes throughout the day depending on admissions and discharges," Taylor said. "We have two ICU beds open, but that, too, changes."