The impact of the coronavirus surge continued Monday as the state reported that 81 more Arkansas patients had been hospitalized with the virus -- the highest single-day increase since the pandemic began in March 2020, bringing the day's total to 1,220.
"We continue to see nearly all hospitalizations among the unvaccinated. Do your part to help," Gov. Asa Hutchinson said on Twitter. "Hospitals are full & the only remedy is for more Arkansans to be vaccinated."
The state's death toll from the virus, as tracked by the Department of Health, rose by 42, to 6,199. The last time at least 40 were reported in a day was in February.
The number of covid patients in hospital ICUs rose by 35 to 451 -- the highest number since it reached 458 on Jan. 11.
The number of virus patients who were on ventilators rose by 15 to 250 -- the highest number since mid-January.
After a weekend of four-digit case increases, the state's count of cases rose Monday by 844, for a cumulative total of 389,280 cases since the pandemic began.
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The number of cases in the state that were considered active fell by 816 to 18,922.
"The upswing in cases, including cases of the Delta variant, appears to be continuing and is of concern," Health Department spokeswoman Danyelle McNeill said in an email. "Hospitalizations and deaths also continue to increase across the state."
The number of available hospital beds in the state dropped by 31 to 1,752 on Monday, meaning that less than 20% of the total 8,832 beds are open for patients.
Many of the state's hospital leaders were called to speak at the joint Senate and House Committees on Public Health, Welfare and Labor on Monday afternoon about the pandemic's impact on the health care facilities.
"At Children's our team is tired, very tired," Marcy Doderer, president and chief executive officer of Arkansas Children's Hospital, said. "The pandemic is not just affecting them at work, but it follows them home. The vast majority of our team is young women with children. It compounds on the mental resilience. We are seeing nurses leave the industry faster than ever before. This is the first time I have seen it at this level. Nurses in the middle of their career" are leaving.
Children's Hospital spokeswoman Hilary DeMillo said later Monday that there are 19 covid-19 patients at the hospital's Little Rock location and two at the organization's Northwest Hospital in Springdale. Eight of those patients are in ICU and five are on vents.
None of the patients have been fully vaccinated, DeMillo said.
"We are stretched, but not at capacity," DeMillo said. "We will continue to make bed space through creative solutions, but face the biggest challenges with staffing, especially among nurses."
Arkansas Children's Hospital "constantly" monitors its census and has "clinical teams developing solutions to help us flex our facilities and staffing to take care of any child who needs us," DeMillo said.
"Any changes we make will be based on safety and children's best interests," she added.
Doderer said Children's Hospital is using an incentive program to hopefully attract more nurses.
"We are doing a talent acquisition and employee referral bonus," she said. "If someone who is leaving or is on staff encourages someone to join our team then you and the new hire get a bonus. We are encouraging our existing team members to bring back or bring along friends and colleagues into the health care profession."
Doderer told the group that the hospital is also seeing a large spike in respiratory syncytial virus, commonly known as RSV, among children.
"When children were isolated at home and masked we didn't really see this, but now we have a hospital full of sick children," she said.
State Rep. Mary Bentley, R-Perryville, asked state Epidemiologist Jennifer Dillaha if masks and isolation play a part in the increase of RSV by lowering their immunity.
"It didn't weaken their immune system," Dillaha said. "It's more likely they just didn't have time to be exposed to it yet."
Bo Ryall, president and CEO of the Arkansas Hospital Association, said Mercy, Washington Regional, Arkansas Children's Hospital, Conway Regional and the Arkansas Heart Hospital have all mentioned vaccine requirements for employees that could be implemented.
He added that hospitals in Arkansas are having to compete with one another, medical systems in other states and the traveling nurse industry in the midst of the pandemic.
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Ryall said the multiple state assistance that was there in the beginning of the pandemic isn't available because so many states are surging at the same time. He said most of the National Guard assistance is already being used by hospitals.
Greg Crain, senior vice president and administrator for Baptist Health Medical Center-Little Rock, said traveling nurses who were hired went somewhere else when their contract was up so they could earn a higher salary.
Crain said in his 26-year career he has never seen a staffing challenge like he has in the past 18 months of the pandemic.
Baptist Health spokeswoman Cara Wade said later Monday that there are 239 covid patients across the Baptist system with 88 of those in intensive care.
"The best defense continues to be getting the vaccine, wearing a mask and social distancing," Wade said. "Eighty-eight percent of our covid positive hospitalized patients are not fully vaccinated and 92.5% of our ICU covid patients are not fully vaccinated. The majority of our patients with covid continue to be under the age of 60. Ages range from 19 to 98."
Baptist's hospital beds are "extremely limited" and that can vary hourly, Wade said.
"In order to accommodate the increase, we have made adjustments such as opening additional critical care beds and converting some private rooms to semi-private rooms for noncritical covid patients," Wade said. "We are working on plans to open additional beds, but more important is finding the staff to support the beds."
Last December, Baptist Health announced that two facilities in the state would be renovated -- with financial help from the state to foot the $7.4 million tab -- to house up to 124 virus patients if hospitals around the state run out of room.
"We are currently working on surge plans that could include these two facilities," Wade said.
The J.A. Gilbreath Conference Center on the Baptist Health campus in Little Rock was retrofitted to accommodate 50 general medical and low-acuity covid-19 patients.
The Baptist Health-Van Buren site was revamped to accommodate 74 beds, including eight intensive care unit beds.
While not currently housing patients, the two areas are being utilized to care for patients, Wade said.
"For example, J.A. Gilbreath Conference Center has been used to administer the covid vaccine and for monoclonal antibody infusion to treat covid-19 patients," she said.
Martine Pollard, spokeswoman for the Northwest Arkansas Health Care Community, a coalition of health care providers in that region, said in an email that hospitals reached an all-time high of covid-19 patients.
"Today we are caring for 165 hospitalized COVID-19 patients, 19 more patients than Friday. Today's high is a 13% increase from Friday, July 30, and almost a 600% increase in just over six weeks," Pollard said in a news release. "Prior to today our all-time high was Friday, caring for 146 patients. During the winter surge, our high was at the turn of the year with 140 patients."
The hospitals' youngest hospitalized covid-19 patient is under 12 with 39 being the average age of the hospitalized patients, according to the release.
More than 99% of the hospitalized patients are eligible to get the vaccine, but 95% are not vaccinated.
"While our hospital healthcare providers and workers continue to work closely together and are rising to the challenge of our increasing volumes, with quality, safety and service centered on all patients who come through our doors, caring for the overwhelming number of unvaccinated COVID-19 patients, who are 99%+ eligible to get the vaccine, that are filling our hospitals, with high acuity, coupled with record volumes of critical care patients is stretching all of our resources," Pollard said in the news release. "We are concerned about our people. It is a concern that is very real and is placing an extreme burden on our region's health care providers we rely upon to treat non-COVID-19-related illnesses and conditions, along with COVID-19."
VACCINATIONS
The number of vaccine doses that providers reported having administered, including second doses of the Pfizer and Moderna vaccines, rose by 3,609 to 2,355,920 on Monday.
Of the 2,892,770 total doses received by the state, 81.4% has been administered, the Health Department said.
The number of individuals 12 and over partially immunized increased by 1,712 on Monday to a total of 313,783.
The number of individuals fully immunized increased by 966 to a total of 1,062,687.
The recent uptick in vaccines in the past week has meant that the majority of the vaccine doses that were set to expire over the weekend were able to be used, McNeill, the Health Department spokeswoman, said.
Robert Ator, a retired National Guard colonel who runs the state's vaccination effort, said last week in an interview with National Public Radio that an estimated 80,000 doses of the vaccine would expire within a week's time because of the low vaccination rate.
According to Health Department data, a total of 67,778 vaccine doses were administered in the past week.
"The ADH encourages all eligible individuals to get fully vaccinated as this is the best way to protect yourself, your loved ones, and to reduce the spread of COVID-19 in our communities," McNeill said in an email. "Getting fully immunized can also help reduce the risk of becoming severely ill or hospitalized for those who may still contract COVID-19. Wearing masks and social distancing can help slow the spread and keep people out of the hospital."
The reasons for the recent hike in vaccinations are varied, McNeill said.
"The Delta variant is more transmissible and spreads more easily from person to person, so this variant being the dominant variant in Arkansas may be responsible for some Arkansans choosing to get vaccinated," McNeill said. "The Governor's Office, in partnership with the ADH, has held local COVID conversations, allowing for open dialogue between community members and state officials to address concerns and questions. The ADH has also worked diligently to ensure vaccines are readily available across the state, along with information and education regarding safety and efficacy, as well as vaccine clinic locations regularly updated on our website."
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 236 cases from 668 on July 24 to 904 on July 31.
The number known to have been caused by the alpha variant from the United Kingdom rose by 35, to 553.
The Health Department also reported an increase from 38 to 40 in the number of cases found to have been caused by the gamma variant from Brazil. The number known to have been caused by variants from California remained the same at 44.
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.
BY THE NUMBERS
There were 223 more new cases reported Monday than compared with the same day a week ago when 621 new cases were reported.
The cumulative total increased by 13,309 new cases, going from 375,971 on July 26 to 389,280 on Monday.
The state reported 18,922 active cases on Monday. That was 4,295 more active cases than the same day last week, when the state had 14,627 active cases.
Deaths in the past week totaled 122, bringing the cumulative total from 6,077 to 6,199. On July 26, the state reported 23 deaths, compared with 42 deaths on Monday.
There were 240 more covid-19 patients hospitalized on Monday compared with a week earlier, when 980 were hospitalized.
CASES BY COUNTY
Health Department data indicated that Pulaski County had the largest increase in total cases, with the count rising by 172.
Washington County had the next-largest increase, 73, followed by Benton County with 56.