Arkansas' count of coronavirus cases rose by 1,061 Saturday, setting a record for the number of cases added in a single day.
The state's cumulative case count increased to 27,864. The death toll from the virus, as tracked by the Department of Health, rose by six, to 319.
The number of Arkansans hospitalized with the virus increased by 10, to 412. Eighty-four of the patients were on ventilators, a number that hadn't changed from a day earlier.
"The record number of new cases is very concerning and may be the result of the July 4th celebrations," Gov. Asa Hutchinson said in a statement.
"Regardless, it is a reminder of the challenge we continue to face. As we dig deeper into the data, I will have further comments on Monday."
On Saturday, a spokesman for Hutchinson defended the lack of a statewide requirement for people to wear masks, a day after the chancellor of the University of Arkansas for Medical Sciences called for such a mandate.
"The Department of Health, in consultation with the Governor's office, issued statewide guidance strongly supporting the wearing of face coverings," the spokesman, Katie Beck, said in an email.
"The Governor also issued an executive order granting cities the authority to pass their own ordinances to mandate the wearing of face coverings and provided cities with a model ordinance to assist them. This will provide an additional tool through law enforcement to assist businesses in assuring compliance. The Governor will continue to consider effective options to control the spread."
Appearing on Arkansas PBS' "Arkansas Week" on Friday evening, UAMS Chancellor Cam Patterson said Hutchinson had "made it clear that everyone should be masking," but that the lack of a statewide mandate had created confusion.
"It's really difficult to make the case to somebody in a town like Little Rock that they need to wear a mask if there's a town 30 miles away where masking is not required," Patterson said. "It creates a situation in which people don't know what to believe."
Hutchinson has said a statewide mask mandate wouldn't be appropriate, noting that some of the state's 75 counties have few active cases.
Earlier this month, however, he issued an executive order allowing cities to adopt limited requirements for people to wear masks.
Rules issued by the Health Department require customers and employees to wear masks in certain types of businesses across the state, such as restaurants and hair salons.
The department has also issued guidance recommending that people wear masks in all places in which they could come within 6 feet of people who are not from their households.
State epidemiologist Jennifer Dillaha said 346 of the new cases were among prison or jail inmates.
That coincided with an increase of 488 cases among inmates at the Ouachita River Unit in Malvern, which brought the total number of inmates there who have tested positive to 1,161.
Such cases often don't show up in the state's overall tally until several days after tests are performed, after information from laboratory reports is entered into a state database.
The remaining increase of 715 cases among the state's non-incarcerated population "are of concern, because it's further indication of community spread," Dillaha said.
Coming a week after the Fourth of July, she said, some of the cases could have resulted from holiday gatherings.
According to the U.S. Centers for Disease Control and Prevention, people typically begin having symptoms of covid-19 four to five days after they are infected.
"I haven't heard reports of any particular events or situations that were problematic, but I think that when people are out and about and celebrating, there are more opportunities to engage in behaviors that put people at greater risk for being exposed," Dillaha said.
Saturday was the first time the number of cases had increased by more than 1,000 in a day.
Previously, the largest increase was 878 cases on July 2.
The increase Saturday continued a streak, beginning Wednesday, in which the state added more than 700 cases each day to its total.
The count rose by 734 Wednesday, 806 Thursday and 751 Friday.
Previously, the count had never increased by more than 700 on two consecutive days.
The percentage of the state's tests that are positive is also of concern, Dillaha said.
Of the 5,967 tests that were performed Friday, 630, or 10.6%, were positive.
The rate of positive tests was 10.9% Thursday and 9.2% Wednesday, she said.
Hutchinson has set 10% as a benchmark indication for whether the state's testing is adequate.
"We're having higher positivity rates, and we would like them to be lower, because that gives us an indication that we're testing enough," Dillaha said.
Noting that a surge in demand has caused delays in getting test results from commercial laboratories, she said it's important for people who have symptoms of covid-19 or who have been in contact with someone who has tested positive to quarantine themselves until they know whether they have the disease.
"If they get tested, they should presume they're positive until they get their results," Dillaha said. "Otherwise, if they presume they're negative, and they're going about their business, if they turn out to be positive, then they would have exposed a potentially large number of people."
Joe Thompson, chief executive of UAMS' Arkansas Center for Health Improvement, said on "Arkansas Week" that the state is "at risk of losing control" of the virus.
"We are seeing a 20[%]-30% increase in hospitalizations and ventilator use week over week," he said. "Testing more people does not cause more hospitalizations and more ventilator use.
"That's more people becoming sick and succumbing to the effects of this virus."
Patterson said on the TV program that the intensive-care unit at UAMS Medical Center is "completely full, and we know the number of cases is going to continue to increase over the coming weeks."
"At some point, while we may have the capacity across the entire state, we may have the resources across the entire state, to take care of every covid-19 infected patient, those resources are not necessarily going to be in the right place," Patterson said. "So as this progresses, we are going to see capacity constraints and limitations on our ability to provide care unless we effectively bend the curve soon."
He also said officials should prepare carefully for the return of students to classrooms in the coming school year.
"No place in the world has opened schools with a rising rate of infection," Patterson said. "So no matter what we do, we need to be prepared to be surprised, and we need to put as much effort into our plans to shut down schools right now as we're putting into opening them up, because inevitably we will have to shut down school systems once they've opened up if outbreaks occur in those school districts."
UAMS spokeswoman Leslie Taylor said Saturday that the hospital's intensive-care unit had 22 coronavirus patients, including 11 who were in the 52-bed unit.
She said the unit was on "ICU max" status.
"So what that means is we do still have a very limited number of beds in case one of our patients in house needed to go to the ICU, but we're at capacity," she said.
But even before the coronavirus pandemic, she said, it wasn't unusual for the intensive-care unit to be at capacity.
She said the hospital can house intensive-care patients in its post-anesthesia care unit and can convert additional space for intensive care.
"I think the chancellor's point was that we don't have infinite resources," she said.
Beck, Hutchinson's spokesman, also responded Saturday to a letter that Rep. Dan Sullivan, R-Jonesboro, sent to the Health Department on Friday and posted on Facebook.
In the letter, Sullivan said directives issued by the Health Department to control the spread of the coronavirus are invalid because they were not properly disseminated.
He said he didn't dispute Hutchinson's authority to issue executive orders in response to a public health emergency, but he argued that state agencies must follow the state's Administrative Procedure Act in promulgating rules.
The act requires agency rules to be approved by the Legislature's Joint Budget Committee or the Legislative Council, which meets when the Legislature is not in session.
Emergency rules, which go into effect for no more than 120 days, must be approved by the Legislative Council's executive subcommittee.
Sullivan also noted that the Wisconsin Supreme Court, siding with the Republican leaders of the Legislature in that state, in May struck down a stay-at-home order issued by the state health agency, ruling that the department had exceeded its authority.
"It is altogether proper in this season of rememberance of the Declaration of Independence that we take this opportunity to examine the basic function of our institutions of government and recall that they were designated in our best effort to preserve and protect the inalienable rights of the great people of the State of Arkansas," Sullivan said in the letter. "We must always remain vigilant in that endeavor, even, or perhaps especially, in times of crisis."
He said on Facebook that the letter was signed by 12 other Republican legislators: Reps. Josh Miller of Heber Springs, Mary Bentley of Perryville, Stephen Meeks of Greenbrier, Nelda Speaks of Mountain Home, Jimmy Gazaway of Paragould, Brandt Smith of Jonesboro and Joe Cloud of Russellville; and Sens. Terry Rice of Waldron, Mark Johnson of Ferndale, Kim Hammer of Benton, Gary Stubblefield of Branch and Ron Caldwell of Wynne.
Hutchinson endorsed Sen. John Cooper of Jonesboro in Sullivan's successful bid to unseat the senator during the Republican primary in March. Sullivan is unopposed for the seat during the November election.
The Republican governor's original emergency declaration on March 11 named the Health Department as the lead agency in charge of the state's response to the pandemic.
The most recent extension of the declaration requires all public and private gatherings, businesses and other organizations to adhere to directives and guidelines issued by Health Department Secretary Nate Smith.
The Arkansas Emergency Services Act of 1973 allows the governor, during an emergency, to issue "executive orders, proclamations, and rules and amend or rescind them." It says such orders have the force and effect of law.
Beck said the Health Department and Smith are "essential state government resources for responding to a global pandemic."
"The Governor has directed Dr. Smith to issue guidance and directives based on his expertise, and those directives have been made a part of the Governor's executive orders, giving them the force and effect of law for the duration of this emergency," she said.
"We stand by the authority Dr. Smith has used to issue directives aimed at stopping the spread of COVID-19 in Arkansas," Health Department spokesman Danyelle McNeill said in an email.
House Speaker Matthew Shepherd, R-El Dorado, said he's been looking into Sullivan's concerns and has also asked House staff members and the Bureau of Legislative Research to investigate the matter.
"Certainly nobody would want for anything to be done in a way that's contrary to the law, but at this point we're still looking into the issue," he said.
Senate President Pro Tempore Jim Hendren, R-Sulphur Springs, said he researched the issue when trying to determine whether a special session of the Legislature was needed to pass legislation giving businesses immunity from coronavirus-related lawsuits.
In the end, Hutchinson used his emergency authority to issue an executive order addressing the issue.
"It became pretty clear to me that the [emergency] law was designed for just such occasions as what we are experiencing," Hendren, who is Hutchinson's nephew, said.
Legislators could revisit the issue during the regular session next year "if there needs to be some refinement to the process," he said.
"There's 135 legislators and probably close to that many different opinions as to where the executive authority stops and the legislative authority begins," Hendren said.
VETERANS HOME DEATHS
A Health Department report Friday indicated that two residents of the state Veterans Home in Fayetteville died of the virus, the first such deaths among residents at the state's two nursing homes for veterans.
Buster McCall, the Fayetteville home's administrator, said one of the residents, who was in hospice care, died earlier this month and that the other died Wednesday.
He said the home tested all of its residents on June 12, and they were all found to be negative.
Later in the month, however, one resident was tested after a "temperature spike" was found during a routine check.
Since then, five residents, all living on the sixth floor, have tested positive along with three staff members, he said.
Residents who test positive are isolated in their rooms for at least 21 days and until they test negative on two days seven days apart, McCall said.
"They're handling it really well," McCall said. "You can just see them going back to their military discipline."
A Health Department report Friday listed the state's veterans home in North Little Rock as having two staff members and no residents who have tested positive.
The state's tally of cases increased by 326 in Hot Spring County; 112 in Washington County; 76 in Pulaski County; 61 in Benton County; and 59 in Sebastian County.
One of the deaths in the Health Department's count was the first recorded in Madison County. Two were in Pulaski County, bringing the death toll there to 65. Crittenden and Union counties each had one new death, bringing the total in each county to 14. Jefferson County also had one new death, raising its total to 29.
All of the deaths were among people 65 or older, bringing the total number of deaths in that age group to 223. The state's other deaths include 16 among people age 25-44 and 80 among people age 45-64.