Amid the surge in infections from the rapidly spreading omicron variant, the number of people hospitalized with covid-19 in Arkansas hit an all-time high Tuesday, surpassing the peak of almost 1,500 it reached during the summer last year.
Reflecting a slowdown in testing over the holiday weekend, however, the state's count of cases rose by 3,213, the second daily increase in a row that was smaller than the one a week earlier.
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The state's death toll from the virus, as tracked by the Department of Health, rose by 15, to 9,452.
"Today's report shows we are at the highest level of hospitalizations during the Pandemic," Gov. Asa Hutchinson said in a tweet.
He noted that the state had already taken steps to expand hospital capacity.
He said the state was "on target" to distribute 1.5 million at-home tests, purchased by the state last month, through local health units, public libraries and other organizations.
Health Department spokeswoman Danyelle McNeill said 393,120 of the tests that arrived in the state Friday were being distributed Tuesday.
More tests are expected to arrive later this week, she said.
Rising by double digits for the 19th day in a row, the number of people hospitalized in the state with covid-19 jumped Tuesday by 67, to 1,487.
The previous record, according to daily figures released by the Health Department, was the 1,459 covid-19 patients who were in the state's hospitals on Aug. 16, during the surge powered by the delta variant.
Since Sunday, the number has been above the peak of 1,371 it reached on Jan. 11 during last winter's surge.
The numbers of the state's virus patients who were on ventilators and in intensive care Tuesday, however, remained well below the levels they reached in the summer and last winter.
After rising the previous two days, the number who were on ventilators fell Tuesday by one, to 171.
The number who were in intensive care rose by 14, to 381.
The number on ventilators peaked at 388 during the summer surge last year and at 268 last winter.
The number who were in intensive care peaked at 558 during the summer and 458 in January 2021.
Dr. Jennifer Dillaha, the Health Department's chief medical officer, said the lower numbers of patients on ventilators and in intensive care compared with previous surges likely reflects, in part, the tendency of the omicron variant to cause severe illness less often than earlier strains of the virus.
Protection afforded by the vaccines is likely also keeping many of those who are hospitalized from needing intensive care, she said.
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Since Dec. 1, she said, people who were not fully vaccinated have accounted for 62.8% of the state's cases, 68.3% of its hospitalizations and 78.5% of its deaths from the virus.
Those who were fully vaccinated, but who had not received booster shots, represented 34.2% of the cases, 28.7% of the hospitalizations and 20% of the deaths.
People who had received boosters accounted for just 3% of the cases, 2.9% of the hospitalizations and 1.5% of the deaths.
According to the U.S. Centers for Disease Control and Prevention, 52% of Arkansans had been fully vaccinated as of Tuesday.
About 18% of the population had been fully vaccinated and received booster doses.
BEDS OPENED
In response to the rising number of covid-19 patients, the state last week allocated $50.1 million in American Rescue Plan Act funds to open 265 beds at 11 hospitals around the state.
McNeill said at least 89 of those beds had been opened as of Tuesday.
Those comprised 30 beds each at CHI St. Vincent Infirmary in Little Rock and CHI St. Vincent Hot Springs, 21 at St. Bernards Medical Center in Jonesboro and eight at Washington Regional Medical Center in Fayetteville.
Baptist Health also opened 35 beds Tuesday at its hospital in Van Buren with the help of federal funds, spokeswoman Cara Wade said in an email.
She said an additional 28 beds, including four intensive care unit beds, should be open at Baptist Health Medical Center-Conway by today, although "staffing is critical to being able to open these beds in a timely manner."
At its 11 hospitals around the state, Baptist Health had 312 covid-19 patients Tuesday, surpassing the previous record of 300 in August during the summer surge, Wade said.
The patients Tuesday included 88 who were in intensive care and 52 who were on ventilators.
"Baptist Health continues to care for more COVID-19 patients than any other healthcare system in the state," Wade wrote.
"In fact, today -- one in five patients statewide are being treated in a Baptist Health facility."
She said 56% of the 312 patients, including 61% of those in intensive care and 67% of those on ventilators, had not been vaccinated.
"In addition, the majority of these patients have other comorbidities contributing to their hospitalization," Wade said.
She said 25% of the 312 covid-19 patients had been fully vaccinated but had not received booster doses.
"Ages of those hospitalized today are across the spectrum from 18 to 90-plus," Wade said. "However, the majority of our COVID-19 patients are between the ages of 60 and 80."
She said it can be difficult to determine how many patients were admitted "with" rather than "for" covid-19.
"The factors contributing to hospitalization are complex and nuanced, and there is no simple way to attribute a hospitalization to COVID-19 when there are other diagnoses involved," Wade said.
"For example, we have seen an increase in 'incidental' positive tests in patients who are admitted to have a baby. This is certainly a challenge for hospitals across the country to quantify. In general, our medical staff feels confident that a majority of our hospitalizations are 'for' COVID."
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She said 473 of the health system's 11,000 employees were off work for reasons related to covid-19.
Although "hospital beds and staffing are extremely limited," the health system hasn't had to cut back on elective procedures, she said.
"Of course, those choices always remain an option to create hospital capacity in the future," Wade said.
STAFFING CONCERNS
The University of Arkansas for Medical Sciences Medical Center in Little Rock had 73 covid-19 patients Tuesday, which was up by one from a day earlier but down from a record 82 Friday, spokeswoman Leslie Taylor said.
Previously, the hospital's all-time high for covid-19 patients was 80 during the summer surge.
"Today, our bed capacity actually looks pretty good," Taylor said.
But she said the large number of covid-19 patients, combined with employees who were out for reasons related to the virus, was straining the hospital's staffing.
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"We have a lot of patients that show up to the emergency department with covid, so that stresses the staffing capacity there," Taylor said.
She said 627 of UAMS' 11,000 employees had not been cleared to work for reasons related to covid-19, including 371 who are health care workers.
Those included 303 total employees, 195 of whom are health care workers, who had tested positive for covid-19.
The hospital hasn't stopped performing elective procedures, she said.
"We're just trying to keep an eye on the schedule, and so if there's a procedure that doesn't have to be done right away, we're trying to schedule those out a little bit," Taylor said.
She said 26 of the hospital's 73 covid-19 patients Tuesday had been fully vaccinated.
Of all 73, 20%-30% were initially admitted for reasons unrelated to covid-19 but were found, through routine testing performed on all patients, to be infected with the virus.
St. Bernards Medical Center had 111 covid-19 patients Tuesday, surpassing the previous record of 108 Saturday. Previously, the hospital's all-time high was 104 last winter.
The patients Tuesday included 21 who were in intensive care and eight who were on ventilators.
While the number in intensive care was low compared with previous surges, "we're finding a real challenge in terms of caring for the influx of [medical/surgical] patients, so those who are not as critically ill, but still needing hospitalization," spokesman Mitchell Nail said.
About 6% of St. Bernards Healthcare's 4,100 employees were out for reasons related to covid-19, he said.
The expansion funded by the American Rescue Plan Act funds has been "incredibly helpful," he said.
With the help of six members of the Arkansas National Guard, he said the hospital Saturday opened a drive-thru clinic for rapid covid-19 tests.
Starting this week, the clinic is open from 8 a.m.-11 a.m. Monday through Friday, Nail said.
He said people who are unvaccinated made up about 60% of the hospital's covid-19 patients who were in regular hospital beds or in intensive care.
Of those were on ventilators, however, about 85% had not been fully vaccinated.
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"It's just important for people to know that even if a breakthrough infection occurs, that that scale -- the vaccine helps them from going further down that," Nail said.
Arkansas Children's had a record 41 covid-19 patients at its hospitals in Little Rock and Springdale on Tuesday, and the main campus in Little Rock had 244 employees who were off work for reasons related to the virus, spokeswoman Hilary DeMillo said in an email.
She said four of the hospitalized patients were in intensive care, including three who were on ventilators.
Of the 41 patients, she said, five had been fully vaccinated, and one had been partially vaccinated.
More than half of the 41 patients were at least 5 years old, making them eligible for vaccination.
Also Tuesday, the Arkansas National Guard announced that three soldiers from the Camp Robinson Installation Support Unit, including two heavy equipment operators, had been mobilized to assist with burial operations at the Arkansas State Veterans Cemetery in North Little Rock "due to cemetery staff affected by Covid-19."
The Guardsmen's orders are for 10 days, although that could be "extended or curtailed as conditions warrant," the Guard said in a news release.
NEW CASES
While high compared with typical daily increases before the current surge, the increase in cases Tuesday was less than half the size of the one the previous Tuesday.
After hitting an all-time high of 9,122 the week ending Sunday, the average daily increase over a rolling seven-day period fell Tuesday to 8,309.
The number of cases that were considered active, which reached a record 96,379 Sunday, fell Tuesday by 4,373, to 88,938, as recoveries and deaths outpaced new cases.
Dillaha said the downturn in cases Tuesday may have been at least in part because of the holiday and snowy weather in parts of the state over the weekend.
But she said she was encouraged that the percentage of tests in the state that have been positive has declined slightly.
Over the seven-day span ending Monday, the percentage was 33.2%, which was down from 33.6% the week ending Sunday and a record 33.7% on the seven days ending Saturday and Friday.
"They're not continuing to go up, so maybe that's a hopeful sign that we may be getting to near the peak of the current spike," she said.
Even after the state's new cases peak, however, hospitalizations will likely continue to increase for at least another week, she said.
She said Arkansans should get vaccinated and boosted if they haven't already, wear masks in public, avoid crowds of unmasked people and stay home when they're sick.
"Even though the omicron variant appears to cause milder illness compared to the delta variant, for many people, it is not mild illness. It's serious illness," Dillaha said.
"They miss work. They can spread it to people who will have severe illness."
She added that the long-term effects of covid-19 on people, even when they have mild symptoms initially, aren't yet fully known.
"We are beginning to see evidence now that people who have been diagnosed with covid later end up with a higher rate of new diagnoses of diabetes in both children and adults, so that's just an example," Dillaha said. "We don't know yet what the long-term compilations are."
CASES BY COUNTY
Pulaski County had the most new cases with 475 Tuesday, followed by Benton County with 448 and Washington County with 294.
The state's cumulative count of cases rose to 687,989.
Dillaha said all of the deaths reported Tuesday occurred within the past month.
The number of people who have ever been hospitalized in the state with covid-19 grew Tuesday by 11, to 31,062.
The number of the state's virus patients who have ever been on ventilators rose by one, to 3,238.
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VACCINATIONS DOWN
As with the case numbers, the state's vaccination numbers were down after the holiday weekend.
The Health Department's tally of vaccine doses that had been administered rose by 5,496, which was smaller by more than 2,300 than the increase the previous Tuesday.
Booster shots made up almost 50% of the most recent increase.
The count of first doses rose by 1,747, which was down by more than 800 from the increase in first doses a week earlier.
The average number of total doses administered each day over a rolling seven-day period fell to 6,741, which was down from more than 7,900 a day the previous week and more than 12,000 a day in early December.
The average for first doses fell to 2,181.
According to the CDC, 64% of Arkansans had received at least one vaccine dose as of Tuesday.
Of those who had been fully vaccinated, 34.6% had received booster doses.
Among the states and District of Columbia, Arkansas ranked 37th in the percentage of its population who had received at least one dose.
It was roughly tied with Tennessee for 44th, ahead of Georgia, Louisiana, Mississippi, Alabama, Wyoming and Idaho, in the percentage who were fully vaccinated.
Nationally, 75.1% of people had received at least one dose, and 63% were fully vaccinated.
Of the fully vaccinated population nationally, 38.7% had received booster doses.