Arkansas' count of coronavirus cases rose Tuesday by 1,476 -- the largest one-day increase in new cases in more than five months -- while the number of patients hospitalized with the virus topped 600 for the first time since Feb. 20.
The state reported an additional 15 covid-19 deaths, the most in a day since March 30, bringing the state's toll to 5,970.
"Today's report of 41 new hospitalizations should be of concern to unvaccinated Arkansans," Gov. Asa Hutchinson said in a tweet.
"98.3% of those hospitalized since January were not vaccinated."
The Republican governor spoke at noon to residents in Blytheville and in the evening in Forrest City as part of a series of meetings to encourage residents to get vaccinated.
In Blytheville, he cited the fast-spreading delta variant that first emerged in India and a low vaccination rate in Arkansas as reasons for the "dramatic" increase in the state's cases and hospitalizations over the past month.
He contrasted the 35% of residents in the state who were fully vaccinated as of Tuesday with the national rate of about 48%.
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"It's too low of a vaccination rate for Arkansas," Hutchinson said, adding that the rate in Mississippi County was even lower.
The U.S. Centers for Disease Control and Prevention put the county's rate at 25.2% as of Tuesday.
"The risk of the delta variant continuing throughout and creating more cases and more hospitalizations is much more significant when you have that low vaccination rate," Hutchinson said.
He said the approach of the 2021-22 school year in about a month adds urgency to the need for more people to get vaccinated.
During the previous school year, a statewide mandate was in effect for people to wear masks in most indoor public places.
Hutchinson lifted that mandate March 30.
Act 1002, signed by Hutchinson during this year's legislative session, will prohibit public schools and government entities from requiring masks when it takes effect July 28.
"As we look forward to school, there is one critical resource to make sure we have a good school year and that we don't have a surge in cases, and what is that? Everyone get vaccinated," Hutchinson said.
As of Thursday, 19.5% of Arkansans age 12-17 had received at least one vaccine dose and 13.5% had been fully vaccinated, according to a federal report.
Of the three vaccines that have been authorized in the United States, the Pfizer vaccine is allowed for people as young as 12, while the ones from Moderna and Johnson & Johnson are cleared only for people 18 and older.
The protocol for the Pfizer vaccine calls for people to be given two doses, spaced three weeks apart. The person isn't considered fully protected from the virus until two weeks after the second dose.
State Epidemiologist Jennifer Dillaha said the Arkansas Department of Health was working with the state Department of Education on guidelines for schools that will take into account guidance issued by the CDC last week as well as legislation passed in Arkansas during this year's session.
Those guidelines should be ready "very soon," possibly by the end of this week, she said.
The state's coronavirus numbers on Tuesday made her "increasingly worried about how things will go the rest of the summer, especially with school starting in a month," she said.
"I think that it's very likely we'll see spread in schools if we're not able to get our vaccination rates up for the older students and the staff and teachers and protect the younger students," Dillaha said.
"The delta variant is so contagious that I'm very concerned we'll have outbreaks in schools."
Meanwhile, she said, Hutchinson plans to hold a conference call Thursday, for the first time in months, with the "covid-19 winter task force" that he established in November to study ways of keeping hospitals from becoming overwhelmed amid a surge in cases that officials blamed in part on Halloween gatherings.
"I think we're going to have to think through what we will do around the state to minimize the hospitalizations from not just covid but for other conditions," she said.
She said it "remains to be seen" whether the number of covid-19 patients in the state's hospitals will surpass the levels reached in January, when it topped 1,300.
"The trend in the hospitalizations is what worries me the most because of the delayed care as a result of the pandemic," Dillaha said.
"People put off care for other illnesses, not just covid, that they need to be cared for, and if we have a lot of covid cases, then I think we'll have collateral effects of the potential of people who need care for non-covid-related conditions potentially not being able to receive it timely."
CASES SURGE
Excluding 2,932 cases that were added to Arkansas' count as part of a "data cleanup" on Feb. 28, the increase in cases on Tuesday was the largest in a single day since Feb. 5.
The average number of cases added to the state's count each day over a rolling seven-day period rose to 979, its highest level since Feb. 12.
With new cases outpacing recoveries, the number of cases in the state that were considered active rose by 879, to 8,134, the largest total since Feb. 17.
The increase in hospitalized patients brought the number to 606, its highest level since Feb. 19.
It was the eighth day in a row that the number had grown by double digits.
The number of virus patients who were on ventilators rose by four, to 98, its highest level since Feb. 26.
After topping 200 over the weekend for the first time since February, the number of virus patients who were in intensive care rose by 27, to 240, its highest level since Feb. 18.
Based on data through Monday, CDC rankings updated Tuesday showed Arkansas overtaking Missouri as the state with the most new cases per 100,000 residents over a rolling seven-day period.
Arkansas' 5,648 cases during the week ending Monday translated to a rate of 187.2 per 100,000 residents.
Missouri's rate was 174 per 100,000 residents.
Florida had the next-highest rate, at 126.5 per 100,000 residents.
With 35 virus deaths reported during the week, Arkansas ranked just behind Missouri as the state with the most deaths per 100,000 residents during the period.
Arkansas' number translated to a rate of 1.2 per 100,000 residents.
Missouri's was 1.6 per 100,000 residents.
Citing the increase in cases in the two states, the Chicago Department of Public Health on Tuesday issued an advisory recommending that unvaccinated travelers from Arkansas and Missouri obtain a negative covid-19 test no more than 72 hours before arriving in the city or quarantine for 10 days after arrival.
In Washington and Benton counties, the number of hospitalized covid-19 patients has doubled, to 58 as of Tuesday, in just over three weeks, a coalition of health care providers said in a statement.
"The last time we had volumes in the 50s was in February 2021 during the decline of our winter surge," the providers said. "The vast majority of today's COVID-19 hospitalizations are people who have not been vaccinated."
The coalition includes Washington Regional Medical System, Mercy Health System, Northwest Health System, Arkansas Children's Northwest, the Veterans Health Care System of the Ozarks, UAMS Northwest and Community Clinic.
Pulaski County had the most new cases on Tuesday, 215, followed by Benton County, which had 182, and Washington County, which had 146.
Dillaha said 13.8% of the state's coronavirus tests were positive over a rolling seven-day period as of Monday. That was down slightly from the 14.1% that was initially reported for the seven days ending Sunday and 14.7% for the week ending Thursday.
Hutchinson has said he wants to keep the rate below 10%.
All of the deaths reported Tuesday happened within the past month, Dillaha said.
The number of people who have ever been hospitalized with confirmed infections in the state rose Tuesday by 118, to 17,479.
The number who have ever been on a ventilator rose by 12, to 1,773.
RURAL GAP
At the Blytheville event, Hutchinson said the vaccination rates are higher in Arkansas cities than in surrounding rural areas.
"We do better in our cities versus our counties, but guess where those in our county, and Mississippi County, shop, or where they buy groceries, or where they go to school?" Hutchinson said. "We're interacting with them from church to all the other activities. We need to get everybody vaccinated throughout the area."
He said pastors are a "trusted source" who can play an important role in encouraging vaccinations.
Some have done that, even holding vaccination clinics at their churches, but "you have some that are saying just the opposite from the pulpit, and shame on them, because you could be leading someone to death," Hutchinson said.
"You could be leading someone to die if you tell them, 'Don't get a vaccine.'"
Dillaha said the virus has been spreading in summer camps, places of worship, long-term care facilities and during family gatherings.
"The thing they all have in common are people not vaccinated who are not wearing masks and social distancing," she said.
Of the 74,247 cases identified in Arkansas since Jan. 25, 2,572 -- or about 3.5% -- were the result of "breakthrough" infections, meaning they occurred at least two weeks after a person's final vaccine dose, Health Department spokeswoman Danyelle McNeill said.
Such breakthrough infections had led to 69 hospitalizations and eight deaths, representing 1.7% of 4,068 people who had been hospitalized with covid-19 and 1.5% of the 522 people who died from the virus since Jan. 25, she said.
Health Department figures on Tuesday continued to show an uptick in the state's vaccinations since the Fourth of July weekend.
At 5,551, the increase in the number of doses that providers reported administering, including second doses of the Pfizer and Moderna vaccines, was almost 3,600 more than the increase a week earlier.
The average number of doses administered each day over a rolling seven-day period rose to 4,785.
That was still down from an average of more than 5,700 a day just before the holiday weekend, however.
According to the CDC, the number of Arkansans who had received at least one vaccine dose rose Tuesday by 1,429, to 1,300,846, representing 43.1% of the state's population.
The number who had been fully vaccinated rose by 819, to 1,055,646.
Among the states and District of Columbia, Arkansas continued to rank 45th in the percentage of its residents who had received at least one vaccine dose and 49th, just ahead of Mississippi and Alabama, in the percentage who had been fully vaccinated.