Coronavirus infections appeared to be continuing to surge in Arkansas on Wednesday, with the count of cases rising by 1,459 and the number of covid-19 patients in hospitals rising for the 16th day in a row.
The state death toll from the virus, as tracked by the Department of Health, rose by 13, to 6,020.
"Our vaccination numbers are better this week, but hospitalizations and ventilator usage increased once again," Gov. Asa Hutchinson said in a tweet.
"The vaccines protect against the Delta Variant, and we need everyone to do their part. Get the shot today to protect yourself and those you care about."
The increase in cases was the state's third-largest in a single day since February.
It followed a spike of 1,875 cases on Tuesday, which was the largest one-day new case total since Feb. 4.
The number of covid-19 patients hospitalized in Arkansas, on ventilators and in intensive care all rose by double-digits, with the numbers on the breathing machines and in ICU units reaching their highest levels since late January.
The number of hospitalized grew by 33, to 848, its highest level since Feb. 3.
The number on ventilators rose by 25, to 156, the largest number since Jan. 27.
The number in intensive care grew by 21, to 334, its highest level since Jan. 26.
The average number of cases added in the state each day over a rolling seven-day period rose to 1,173, its highest level since Feb. 10.
With new cases outpacing recoveries, the number of cases that were considered active rose by 428, to 11,903, the largest number since Feb. 13.
"They're still moving in the wrong direction," state Epidemiologist Jennifer Dillaha said of the state's case numbers. "It's very concerning."
Based on numbers as of Tuesday, U.S. Centers for Disease Control and Prevention rankings on Wednesday continued to list Arkansas as the state with the most new cases per capita over a rolling seven-day period.
The 8,058 cases that were added to Arkansas' count during the week ending Tuesday translated to a rate of 267 per 100,000 residents.
Florida had the next-highest rate, 264.2 per 100,000 residents, followed by Missouri, with 244.6 per 100,000 residents.
The national rate was 79.4 cases per 100,000 residents.
In deaths per capita, Arkansas fell from being tied with Montana for having the highest rate Tuesday to roughly tying with Missouri for the fifth-highest rate as of Wednesday.
Arkansas' 37 deaths during the week ending Tuesday amounted to a rate of 1.2 per 100,000 residents.
Maine had the highest rate, 1.9 per 100,000 residents.
Also topping Arkansas in deaths per 100,000 residents were Montana with 1.6, Louisiana with 1.4 and New Mexico with 1.3.
The national rate was 0.5 deaths per 100,000 residents.
Health officials have blamed Arkansas' recent surge in cases on its low vaccination rate and the fast-spreading delta variant that first emerged in India and has become the dominant strain in the United States.
Dillaha said the virus has been spreading in summer camps, workplaces and gatherings such as weddings and funerals, among other settings.
Since Jan. 1, she said, just 3.4% of the state's cases, 4.6% of its covid-19 hospitalizations and 3% of its deaths from the virus have been the result of "breakthrough" infections of people who were fully vaccinated, meaning they tested positive at least two weeks after their final vaccine dose.
Recently, however, breakthrough infections have been on the rise.
In June, for instance, such infections accounted for 9% of the state's cases, 9.7% of its covid-19 hospitalizations and 8.6% its deaths from the virus.
So far this month, they have accounted for 12.5% of the cases, 12.3% of the hospitalizations and 15.6% of the deaths.
"It's really important for people to recognize that the more spread there is, the more transmission in the community, the more likely there is to going be breakthrough cases," Dillaha said.
She also noted that studies have shown the vaccines have lower effectiveness against the delta variant than other strains.
"There is this tendency for people to think of vaccinations as an all or none -- either it completely protects you, or it doesn't protect you at all, kind of like a light switch," Dillaha said.
"The better analogy I think is it works like a dimmer, that it reduces your risk for infection and also reduces your risk for severe disease if you have infection.
"How much it reduces it may depend on different things such as your health status, your age, but also it depends how much the virus is circulating in the community, and how much exposure you're getting."
Older Arkansans appear to be at a greater risk of such infections.
Among those age 65 and older, breakthrough infections have accounted for 8.4% of the state's cases, 6.8% of its hospitalizations from covid-19 and 3.3% of its deaths from the virus since January.
"Even healthy older adults do not respond as robustly to vaccines as younger adults," Dillaha said.
"In addition, the older we are, the more likely we are to have some sort of a chronic condition that would increase our risk for severe disease."
Despite the increase in breakthrough infections, she said the numbers show the vaccines are highly effective.
Putting the numbers another way, even so far this month, 87.5% of the covid-19 cases, 87.7% of the hospitalizations and 84.4% of the deaths have been among people who were not fully vaccinated.
"The take home message is the vaccines do a lot to reduce a person's risk for getting infected, and if they do get infected they do a lot to reduce a person's risk for having severe illness that results in either hospitalization or death," she said.
Still, she said she'd encourage even people who are fully vaccinated to take precautions such as wearing a mask in public places and practicing social distancing, "especially for people who are older and have underlying health conditions that increase their risk."
The more people are vaccinated, she said, the more the risk to older adults and people with chronic health conditions will be reduced.
"Everyone around them needs to be fully vaccinated," she said.
According to Health Department figures, the number of covid-19 patients in state hospitals has grown every day this month except for July 5, when there was no change in the number compared with the day earlier.
The department reported that just 40 -- or about 3.4% -- of the 1,172 intensive care unit beds across the state were unoccupied on Wednesday.
Covid-19 patients made up almost 30% of the patients in the units.
In Mountain Home, Baxter Regional Medical Center said in a Facebook post that it had 32 covid-19 patients, up from four about a month ago and close to the number it had at the height of a previous upswing in November.
Seven of the patients on Wednesday were in intensive care, and three were on ventilators.
Of the covid-19 patients who have been admitted since March 1, 87.8% were not vaccinated, the hospital said.
The hospital also said it had 34 employees who were isolating at home with active covid-19 infections.
In an interview with a radio station KTLO, hospital CEO Ron Peterson said the hospital's total patient census, including noncovid-19 patients, was 25% to 35% higher than it was in December or January, and the number of patients coming into the emergency room was 30% to 35% higher.
"I've been on several phone calls just in the last couple days and talked to several administrators across the state, and it seems like every hospital in the state is about at full capacity," Peterson said.
"We have a hard time transferring patients, those type of things. The best thing people can do to help us out is to get vaccinated."
CHI St. Vincent hospitals in Arkansas have "seen a significant increase in hospital admissions related to COVID-19 over the past two weeks," the health system said in a statement.
"Despite that increase, our ministry remains prepared to effectively, safely and expertly deliver care for all patients at our care sites," the health system said.
It said it has only admitted one patient who was infected with the coronavirus after being fully vaccinated.
Arkansas Children's Hospital in Little Rock had 10 covid-19 patients on Wednesday, including four who were on ventilators, spokeswoman Hilary DeMillo said.
In Little Rock, virus cases led the First United Methodist Church Child Development Center to temporarily shut down, spokeswoman Lesley Andrews said Wednesday.
She said seven people, including staff members and children, tested positive for the virus over the past two weeks.
The center cares for about 228 children, from newborns to pre-kindergarten, and has about 60 employees.
"The center's No. 1 priority is to create a safe environment for its students and staff. Parents, employees, and our children have shown incredible resilience over the past year," Andrews said.
"When parents entrust the center with the care of their children, we understand that trust must be earned daily. The center and its board will continue to put every effort into keeping and maintaining that trust by putting safety and transparency first."
She said the center has maintained strict preventive measures.
"The board has implemented covid-19 policies focused on both prevention and mitigation of the spread of covid-19. These include mandatory masks for employees, temperature checks at check-in and throughout the day, regular hand washing and cleaning, and many other prevention measures," Andrews said. "The board regularly meets to evaluate the latest covid-19 guidance and best practices, often opting to leave in place more stringent guidelines as a precautionary measure."
The center also has held covid-19 training sessions, including a vaccination seminar. Vaccinations have been offered on site to employees.
The center works closely with the Health Department to ensure that, in the event of a positive case, contract tracing and any additional measures can be quickly implemented, Andrews said.
"We notify parents when a positive case has been confirmed," Andrews said. "We then contact all parents of children who have direct exposure to the Covid positive individual, then alert all parents after all affected families have been contacted."
The center's administration is currently evaluating its reopening date and will contact staff and parents of that decision by the end of the week, Andrews said.
CASES BY COUNTY
Dillaha said 13.5% of the state's coronavirus tests were positive during the seven-day span ending Tuesday, down slightly from the 13.6% that was initially reported for the week ending Monday.
Hutchinson has said he wants to keep the number below 10%.
Pulaski County had the most new cases on Wednesday, 243, followed by Washington County, which had 135, and Benton County, which had 96.
The state's cumulative count of cases rose to 368,466.
The number of people who have ever been hospitalized in the state with confirmed infections grew by 77, to 17,949.
The number who have ever been on a ventilator rose by 13, to 1,830.
Meanwhile, Health Department figures continued to indicate an uptick in vaccinations.
At 9,833, the increase in doses providers reported having administered, including second doses of the Pfizer and Moderna vaccines, was larger by more than 3,800 than the one a week earlier.
The average number of doses administered each day over a rolling seven-day period rose to 7,103, its highest level since the week ending May 29.
According to the CDC, the number of Arkansans who had received at least one vaccine dose rose Wednesday by 5,477. That was larger by more than 1,600 than the increase a week earlier.
The average daily increase in the number of Arkansans who had received at least one vaccine dose rose to 4,787, its highest level since the week ending April 29.
The increase on Wednesday brought the number to 1,338,218, or about 44.3% of the population, according to the CDC.
The number of Arkansans who were fully vaccinated rose by 2,487, to 1,072,166, or about 35.5% of the population.
Among the states and District of Columbia, Arkansas continued to rank 45th in the percentage of its residents who had received at least one dose and 49th, ahead of only Mississippi and Alabama, in the percentage who were fully vaccinated.
Nationally, 56.3% of people had received at least one dose, and 48.8% were fully vaccinated.
Information for this article was contributed by Jeannie Roberts of the Arkansas Democrat-Gazette.