Arkansas saw 396 new covid-19 cases reported Monday to health officials, the lowest daily increase since early July when daily case counts dropped to the mid-200s.
By comparison, the state reported 646 cases the previous on Sept. 13, which was almost 300 fewer than the number reported two weeks ago.
Likewise, active cases in the state dropped to 15,004, a number not seen since July 26 when 14,627 active cases were reported.
"Our active COVID cases in Arkansas are at the lowest level since the end of July," Gov. Asa Hutchinson said in a social media post. "The seven-day rolling average of percent positivity is now below 10%, the goal I have pushed. Our vaccinations are not as high as we need, so let's not delay."
Since the pandemic began in spring 2020, there has been a total of 485,452 cases.
The state's death toll from the virus, as tracked by the Department of Health, rose by 37, to 7,482.
Covid-19 hospitalizations rose by 12, to 1,027, while those requiring ventilators remained the same at 289.
The number of patients in intensive care units fell by five, to 440. There were 70 ICU beds available in the state late Monday afternoon, an increase of 20 from Sunday, when 50 ICU beds were open.
"The lower case numbers show that Arkansas is following similar trends to the United Kingdom and India regarding their surges of the Delta variant, which began earlier than the surge in the US," Chief Medical Officer Dr. Jennifer Dillaha said in an email. "Our hospitalization trend tells us that our current surge of the Delta variant is not yet over."
Dillaha said she is still concerned about a winter surge because people stay inside more during colder weather and have more indoor gatherings.
"We tend to see more viral infections like flu and RSV [respiratory syncytial virus] during the winter, so we are concerned that we may see more COVID-19 as well," Dillaha said. "We are encouraging Arkansans to get vaccinated against the flu as well to help keep our communities healthy and reduce the strain on our health care system. In addition, it is possible that we will experience an additional surge of the Delta variant similar to what the UK has experienced."
Dillaha said a surge can be prevented if vaccinations increase and other precautions are taken, such as wearing masks and practicing social distancing.
"In addition, everyone with symptoms of respiratory illness should stay home from work or school and get tested," she said.
Dillaha said the rollout of vaccine booster shots to the general population will not start until Friday at the earliest.
Last week, an advisory committee of the U.S. Food and Drug Administration rejected a Pfizer proposal for covid-19 boosters across the board and instead recommended keeping the boosters to those who are 65 or older or are at high risk.
The FDA will take the recommendation under advisement and is expected to make its decision this week. The U.S. Centers for Disease Control and Prevention is also expected to issue guidance soon.
If the FDA accepts the committee's recommendation, then booster doses will not become available until the CDC's Advisory Committee on Immunization Practices makes its recommendations for administering the booster doses, Dillaha said.
If the Advisory Committee on Immunization Practices "recommends the Pfizer booster doses as authorized by the FDA, boosters will not be available until CDC accepts the ACIP recommendation, so boosters are expected to be available no sooner than Friday, Sept. 24," Dillaha said.
Arkansas has a sufficient amount of the Pfizer-BioNTech covid-19 vaccine across the state to meet the demand for booster doses, Dillaha said.
"Booster doses for Moderna and Janssen are not yet being considered and will not be available for the public at this time," she added. Janssen is the unit that makes Johnson & Johnson's vaccine.
The number of vaccine doses that Arkansas providers reported having administered, including second doses of the Pfizer and Moderna vaccines, rose by 2,596, to 2,843,435 on Monday.
The number of individuals 12 and over partially immunized fell by 629 on Monday, for a total of 302,732, or 11.9% of that group.
The number of individuals fully immunized increased by 1,587, to a total of 1,307,631, or 51.1% of that age range.
As of Monday, 17,998 third vaccine doses had been administered.
There were 43,059 vaccine doses administered in the past seven days, 5,685 fewer than the previous week, when a total of 48,744 doses were administered.
The Health Department does not base its percentage of people vaccinated on the state's total population, but on the total population of those 12 and older, which the department said is 2,557,248. Children under 12 can't be immunized under current federal authorization.
Of the new cases reported Monday, 88% involved unvaccinated people while 90.2% of those hospitalized had not received the shots. About 84.2% of the active cases and 87.7% of the deaths involved unvaccinated people.
Total hospital beds in the state -- whether filled or vacant -- rose by 17, going from 8,851 on Sunday to 8,868 on Monday, according to Health Department data.
Available beds jumped by 40, to 2,111, meaning about 76.2% of the state's hospital beds are full.
The total of intensive care beds, filled or vacant, increased by seven, to 1,165. Seventy ICU beds were available Monday, which means that more than 94% of the special-care beds were full.
As of Monday, the University of Arkansas for Medical Sciences had 39 covid-19 patients, with 16 in the ICU. Of that number, 12 were vaccinated -- seven fully and five partially, said spokesperson Andrea Peel.
The medical center has three ICU units with 60 ICU beds, all of which are full, Peel said.
"We are seeing a relief from covid patients, but people are still needing ICU care for non-covid-related illness or injury," she said.
Conway Regional Health System spokeswoman Rebekah Fincher said the hospital had 37 covid-19 patients on Wednesday, but only had 15 as of Monday afternoon.
"In the last couple of weeks, we have seen a decrease in census as compared to August and earlier in September," Fincher said in an email. "The greatest need is for individuals to receive the vaccine. It is our best shot at defeating COVID-19."
St. Bernards Healthcare in Jonesboro has seen slight surges and dips over the past two weeks, said spokesman Mitchell Nail.
"We have 81 in-house patients at St. Bernards Medical Center; a 2.5 percent increase from this same time last week and a 4.7 percent decrease from two weeks ago," Nail said.
Of the 81 patients, 26 are in the ICU with 10 requiring ventilators, he said.
"The virus refuses to let up, and any relief has been fleeting," Nail said.
St. Bernards can accommodate up to 75 ICU patients, but fewer than 10 of those beds were available as of Monday.
"We need more people to get vaccinated. Our hospital has seen the virus claim 12 patients in the past four days alone, and we experienced a single-day record of COVID admissions--22" on one day last week, Nail said. "Caring for COVID patients forces healthcare workers to draw deeply from their wells of physical and mental health. Without a chance to replenish those wells, they will deplete soon."
As of Monday afternoon, the Baptist Health System had 234 covid-19 patients in its hospitals, with 107 in the ICU and 80 on ventilators. About 86% are not fully vaccinated, said spokeswoman Cara Wade.
Available hospital beds are "extremely limited" across the Baptist system, Wade said. There has been some relief in covid-19 hospitalizations, but officials are seeing more non-covid patients requiring hospitalization. The hospital system has 253 critical care beds, but 95% were occupied on Monday, she said.
"Staffing continues to be our greatest challenge. Baptist Health and most every hospital across the country are experiencing nursing shortages," Wade said. "The pandemic just highlights an already existing problem with the nursing shortage in the U.S. We are so proud of our health care workers who keep showing up day after day caring for some of the sickest patients in the state. Please remember to thank your health care workers and first responders for their sacrifices and hard work."
Bonnie Ward, marketing director for CHI St. Vincent, said in an email that St. Vincent hospitals continue to operate at a high level of capacity.
"While we have seen the number of patients requiring hospitalization for COVID-19 at our hospitals decline by a small degree, we would not describe that as relief at this point," Ward said. "We must all remain vigilant in order to protect ourselves and those around us while slowing the spread of the virus."
Chris Durney, a spokesman for the Central Arkansas Veterans Healthcare System, said in an email that there were 14 covid-19 patients in the hospital Monday, with nine in the ICU. About 67% were unvaccinated.
Durney said there were four "humanitarian" patients being treated under the Fourth Mission. Early in the pandemic, the state contracted with the Central Arkansas VA to have available five intensive care unit beds and five non-ICU beds for covid patients who are not veterans.
"Our in-patient numbers have decreased significantly since the high-water mark two weeks ago, but have remained stable and under 18 in-patients since," Durney said. "We continue to plan and react well to the pandemic and feel that we're in good position to provide excellent care to all of our patients. Our supplies are good and the Emergency Operations Center is meeting three days per week to work through any issues that may come up. Our greatest need right now is for all Veterans, caregivers, and family to get both the COVID-19 and flu vaccines, both offered at our Little Rock and North Little Rock campuses."
The University of Arkansas, Fayetteville saw a decrease in its active coronavirus infections over a five-day period that ended Sunday, according to university data.
Cases dipped to 89 from 94 five days previously.
The decrease reported on UA's website Monday was the first update posted since Wednesday of last week.
The university typically has provided updates three times per week, on Mondays, Wednesdays and Fridays. But spokesman John Thomas said in an email Monday that no update took place on Friday because of "computer problems."
Last fall, the university and other colleges limited attendance to football games to allow for social distancing. This year, stadiums on college campuses have returned to normal capacity.
On Sept. 11, students and fans packed Donald W. Reynolds Razorback Stadium to cheer the Razorback football team to a victory over the Texas Longhorns. Attendance was listed at 74,531.
Active cases of covid-19 at UA increased the week after the Texas game. If UA had posted an update last Friday, it would have shown 112 active cases, up from a total of 78 cases posted a week earlier.
But UA has not released any information linking the game to an increased case count. On Saturday, UA again hosted a home football game, with a listed attendance of 66,311.
Covid-19 symptoms can emerge two to 14 days after exposure to the coronavirus, according to the CDC.
The most recent total of 89 active cases included 82 student infections.
LR SCHOOL CASES
The Little Rock School District reported seven new cases of covid-19 and 32 individuals quarantined in the 24-hour period that began at 3 p.m. Sunday and ended at 3 p.m. Monday. The capital city district reports on new cases and quarantines every weekday and once on weekends.
The Arkansas Division of Elementary and Secondary Education on Monday reported no short-term transitions of classes, schools or districts to remote, online instruction because of covid-19 outbreaks.
To date, the state has had 90,779 covid-19 cases in patients from newborn to 18 years old, according to Health Department data.
Of that number, 829 required hospitalization, and 110 were admitted to the ICU.
The state has reported 3,853 cases in children under a year old; 10,762 cases in children 1-4 years old; 28,338 cases in children 5-11 years old; and 47,826 cases in children 12-18 years old.
About 97% of patients between 12-18 years old were unvaccinated.
About 11.5% of the 12-18-year-old population in Arkansas are partially vaccinated while 36.4% are fully vaccinated.
On Monday, the state had 4,132 current active cases among patients from newborn to 18 years old.
VARIANTS OF CONCERN
According to a Health Department report released Monday, the number of cases in Arkansas found to have been caused by the delta variant, which first emerged in India, rose by 794, from 4,889 on Sept. 13 to 5,683 on Monday.
The number known to have been caused by the alpha variant from the United Kingdom rose by five, to 776.
The number of cases found to have been caused by the gamma variant from Brazil remain unchanged at 59.
The total number of cases caused by such variants is unknown because only a small percentage of specimens are sent to laboratories for the genomic sequencing used to determine the strain of the virus.
The Health Department reported 4,291 covid-19 tests Monday, comprising 3,814 PCR and 477 antigen tests.
Monday's total is lower than recently reported figures, such as 7,573 on Sunday and 4,592 on Sept. 13.
A total of 74,791 tests -- 62,809 PCR and 11,982 antigen -- were reported within the past seven days. The previous week, Sept. 6 through Sept. 12, saw 67,793 tests, with 56,369 of them PCR and 11,424 antigen.
CASES BY COUNTY
Health Department data indicated that Craighead County had the largest number of new cases, rising by 40.
Garland County had the next-largest increase, 39, followed by Benton County with 32.
Information for this article was contributed by Jaime Adame and Cynthia Howell of the Arkansas Democrat-Gazette.