As the number of covid-19 patients in Arkansas hospitals continued to climb Monday, a top public health official said she'd recommend even people who are vaccinated to wear masks in public or when around people whose vaccination status is unknown.
"Of course, the more spread there is, the more exposure people who are fully vaccinated get," state Epidemiologist Jennifer Dillaha said.
"I'm encouraging people who are fully vaccinated to go ahead and wear a mask when they're out in public or when they're around large groups of people where they don't know who's vaccinated or who's not, because they still could be exposed and develop mild disease."
The number of covid-19 patients in Arkansas' hospitals rose Monday by 20, to 281, its highest level since March 10.
The 90 cases that were added to the state's tallies, however, were a slightly smaller increase than the one the previous Monday.
After two days in which the state didn't report any new covid-19 deaths, the toll rose Monday by two, to 5,876.
"We continue to see increasing hospitalizations due to COVID-19 in Arkansas," Gov. Asa Hutchinson said in a tweet.
"Vaccine doses are available throughout the state, and they continue to be effective at slowing the spread of this virus and preventing hospitalizations."
Dillaha's suggestion on masks differs from U.S. Centers for Disease Control and Prevention guidance, issued in May, that said people who have been fully vaccinated don't need to wear masks in most indoor and outdoor settings.
A few days after the guidance was issued, the state Department of Health revised its own mask guidance to reflect the CDC's recommendations.
Dillaha said she doesn't wear a mask when she's in her own office at the Health Department but has started wearing one when she's in more public areas of the building.
She said she continues to wear a mask when she goes to the grocery store.
"When someone goes to the grocery store, they're likely to be around a lot of people who are not vaccinated and not wearing masks, for example, so wearing a mask, in a sense, shows respect for the workers there, because they don't know who's vaccinated or not," Dillaha said.
The mask "could also be protective for the wearer," she said.
"We have a certain amount of breakthrough cases among people who are fully vaccinated, and it does no harm for someone in such a situation like that to go ahead and wear a mask," she said.
She said her view on masks is "related to what we're seeing now and the increased concern that I have now about the delta variant," which first emerged in India.
"We're seeing more data come out of other countries, such as the United Kingdom, where the delta variant has quickly become the dominant variant," Dillaha said.
In Arkansas, the number of cases identified as having been caused by the variant increased last week by five, to 32, according to a Health Department report released Monday.
The actual number of cases caused by such variants is unknown, however, because only a small percentage are tested to determine that.
Dillaha emphasized that the vaccines are highly effective at keeping people from getting sick from covid-19 and "about 99% effective in keeping people out of the hospital if they get covid-19."
She said last week that 85 people in Arkansas had been hospitalized with confirmed covid-19 infections after being fully vaccinated as of Friday.
That was about 1% of the 6,748 people who had been hospitalized with the virus since the state's first vaccine doses were administered, on Dec. 14.
MORE IN HOSPITALS
Monday was the seventh day in a row when the number of covid-19 patients in the state's hospitals went up and the second straight increase that was in the double-digits.
The number of those patients who were in intensive care rose by eight, to 134, its highest level since March 9.
After reaching its highest level since March 12 a day earlier, however, the number who were on ventilators fell by one, to 63.
Of the covid-19 patients admitted to hospitals May 28 through Saturday, 30% were ages 65 and older, Dillaha said.
People age 49-64 accounted for 31.3%, while those age 25-48 made up 32.9%, she said.
About 5.8% were people age 8 to 24.
By contrast, people age 65 and older made up 55.6% of those hospitalized Nov. 20-Dec. 20, she said.
During that period, just 14.5% of the hospitalizations were of people age 25-48, and 25.5% were of people age 49-64.
About 4.5% of the hospitalizations during that period were of people age 8-24.
Dillaha said the reason for the decrease in the percentage of those hospitalized who are 65 and older is most likely that group's higher vaccination rate.
According to a federal report, 64.7% of Arkansans' senior citizens were fully vaccinated as of Thursday.
That compared with 35.2% of those age 18-64 and just 9.4% of those age 12-17.
The increased availability of monoclonal antibody treatments might also be helping to keep older people out of the hospital, Dillaha said.
According to the Health Department's weekly report on variants, the total number of cases identified as having been caused by variants of interest or concern increased last week by 22, to 392.
That included an increase from 275 to 287 in the number of cases found to have been caused by the alpha variant from the United Kingdom.
The number of cases known to have been caused by the kappa variant from India increased by seven to nine.
Cases known to have been caused by the alpha variant had resulted in 17 hospitalizations and four deaths as of Saturday.
Out of all 287 alpha variant cases, 26 were "breakthrough" infections of people who had been fully vaccinated.
Known delta variant cases had resulted in four hospitalizations and one death.
Cases known to have been caused by the gamma variant from Brazil had resulted in four hospitalizations and no deaths.
Five of the 32 delta variant cases were breakthrough infections and two of the state's 22 known gamma variant cases were breakthrough infections.
The increase in the state's case count on Monday was smaller by 13 than the one a week earlier.
As a result, the average daily increase in cases over a rolling seven-day period fell slightly, to 233.
That was still up from an average of 225 cases a day the previous week, but down from a nearly three-month high of 247 a day during the seven-day span ending Wednesday.
Meanwhile, the number of vaccine doses that Arkansas health care providers reported having administered, including second doses of the Pfizer and Moderna vaccines, rose by 1,550, according to Health Department figures.
That was down by just over 200 from the increase the previous Monday.
After rising a day earlier, the average number of doses administered each day over a rolling-seven day period fell to 5,081.
That was still up from a recent low of 4,773 doses a day the week ending June 6, but down from a peak of more than 23,000 a day in early April.
According to the CDC, 41.2% of Arkansans of all ages had received at least one vaccine dose as of Monday, including 33.4% who were fully vaccinated.
Among the states and District of Columbia, Arkansas ranked 45th in the percentage of its residents who had received at least one vaccine dose and 49th, ahead of only Alabama and Mississippi, in the percentage who were fully vaccinated.
Nationally, 53.4% of people had received at least one vaccine dose, and 45.2% were fully vaccinated.
ACTIVE CASES FALL
The cases that were added to Arkansas' tallies on Monday included 78 that were confirmed through polymerase chain reaction, or PCR, tests.
The other 12 were "probable" cases, which include those identified through less-sensitive antigen tests.
The state's cumulative count of cases rose to 345,695.
That comprised 269,532 confirmed cases and 76,163 probable ones.
With recoveries outpacing new cases, the number of cases that were considered active fell by 145, to 2,319.
Pulaski County had the most new cases, 17, followed by Washington County, which had nine, and Hot Spring County, which had six.
The Health Department didn't report any new cases among prison and jail inmates.
The state's death toll rose by two, to 4,665, among confirmed cases and remained at 1,211 among probable cases.
Among nursing home and assisted living facility residents, the count of virus deaths remained at 2,091.
The number of people who have ever been hospitalized with confirmed infections in the state grew by 21, to 16,704.
The number who have ever been on a ventilator rose by one, to 1,705.