Coronavirus cases appeared to be continuing to surge in Arkansas on Friday as the state's count of cases rose by 2,544 -- the second-largest one-day new case total since January.
After dipping slightly a day earlier, the number of patients hospitalized with covid-19 rose by 32, to 1,087, its highest level since Jan. 26.
The state death toll from the virus, as tracked by the Department of Health, rose by 13, to 6,123.
Meanwhile, despite a recent uptick in state vaccinations, 91,000 doses of the Pfizer vaccine that had not been administered were set to expire this weekend, according to the Health Department.
John Vinson, CEO of the Arkansas Pharmacists Association, said the doses, representing about half the state's inventory of Pfizer vaccine, can't be administered after today.
Pharmacists were instructed to hold any doses that were left after today and await further instructions from the Health Department, he said.
"I'm not surprised there's this many expiring, but I have been surprised at how strong the need is for building vaccine confidence and distrust of the vaccine in the mid-South," Vinson said.
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"That's definitely been a formidable challenge."
Except for a spike of 2,843 cases a day earlier, the new cases on Friday were the most in a single day in the state since Jan. 21.
Already at its highest level since the week that ended Jan. 27, the average daily increase in the state count over a rolling seven-day period rose to 1,829.
With new cases outpacing recoveries, the number of cases considered active rose to 18,541, the largest number since Jan. 24.
After rising to their highest levels since mid-January a day earlier, the number of virus patients on ventilators remained at 219, and the number in intensive care remained at 398.
EXPIRING DOSES
State Epidemiologist Jennifer Dillaha said the Health Department had been working to make sure pharmacists and other providers still have usable vaccine when the Pfizer doses expired.
Any doses that haven't been used by their expiration date will have to be discarded, she said.
"It doesn't make me happy to think about that," she said.
Arkansas and other states faced a similar situation last month, when millions of Johnson & Johnson doses, including tens of thousands in Arkansas, were set to expire.
The states received extra time to use those when the company announced June 10 that the shelf life had been extended by six weeks.
The U.S. Food and Drug Administration this week announced that the shelf life for Johnson & Johnson doses had been extended by another six weeks, allowing it to be stored for six months before it expires.
As of Friday, however, no extension had been announced for the Pfizer vaccine.
Arkansas has lost vaccine doses to expiration before in smaller amounts.
As of Monday, 10,015 doses had to be discarded because they hadn't been used by their expiration dates or too much time had elapsed since they were thawed, according to a Health Department report.
The approaching expiration of tens of thousands of more doses arrives despite an accelerated pace of vaccinations that has coincided with the sharp rise this month in new state cases and hospitalizations.
Although it fell by 694, to 8,938, as of Friday, the average number of vaccine doses administered each day over a rolling seven-day period was still up by 10% compared with the previous week and by 56% compared with the week before that.
At some pharmacies, the pace of vaccinations has more than doubled, Vinson said.
That happened at one pharmacy in southwest Arkansas after "some well-known citizens" in the community died from the virus, he said.
Data showing that the vast majority of hospitalizations and deaths in the state have been among the unvaccinated has "opened a lot of minds and a lot of hearts," he said.
OPTIONS EXPANDED
In Jonesboro, vaccinations given by St. Bernards Healthcare increased three- or four-fold over the past couple of weeks, with more people from the community as well as health system employees getting the shots, spokesman Mitchell Nail said.
"I think the delta variant has really sobered our situation," Nail said. "People have taken a hard look at what's going on around them."
An expansion in options for getting the shots also has contributed to the increase, he said.
Last week, St. Bernards began offering the shots by appointments at three primary care clinics and to walk-ins at two urgent care centers that are open seven days a week.
Next week, its dedicated vaccination clinic will move from the infusion center at St. Bernards Medical Center to a clinic a few blocks away.
St. Bernards will hold a number of clinics next month at schools within the Jonesboro and Nettleton school districts and at two Jonesboro churches.
He said the health system has spent more than $1 million on financial incentives for its own employees to get vaccinated. The percentage who have gotten the shots is "nearing 70%," he said.
Arkansas Heart Hospital in Little Rock on Friday became the latest Arkansas health care organization to announce a vaccination mandate for its employees.
Directors, executives, managers, advanced practice nurses, physicians and physician assistants must be fully vaccinated by Sept. 30, the hospital announced.
New employees, starting Sunday, will have to have at least one dose by their start date and be fully vaccinated within 30 days of employment.
Employees can be granted exemptions for religious or medical reasons.
"We cannot provide the best health care services possible if we do not first care for ourselves," CEO Bruce Murphy said in a news release.
Statewide, the number of doses that providers reported having administered, including second doses of the Pfizer and Moderna vaccines, rose Friday by 9,435, according to the Health Department.
It was the first daily increase in three weeks that was smaller than the one a week earlier. The previous Friday, July 23, the number rose by 14,294, which was the biggest one-day increase since May 14.
According to the U.S. Centers for Disease Control and Prevention, 46.6% of Arkansans had received at least one vaccine dose as of Friday, and 36.3% were fully vaccinated.
Among the states and District of Columbia, Arkansas ranks 42nd in the percentage of its residents who had received at least one vaccine dose.
It continues to rank 49th, ahead of only Mississippi and Alabama, in the percentage fully vaccinated.
Nationally, 57.4% of people had received at least one dose, and 49.5% were fully vaccinated.
EMERGENCY DECLARATION
Citing the rise in covid-19 hospitalizations, Gov. Asa Hutchinson on Thursday reinstated the public health emergency he had allowed to expire at the end of May and said he would call a special session of the Legislature, likely next week, to consider granting an exemption to public schools from a state law's prohibition on government mask mandates.
The state House and Senate are each scheduled to convene in a committee of the whole on Tuesday to review the emergency declaration as called for in Act 403, signed by Hutchinson in March.
If a concurrent resolution to terminate the public health emergency is introduced, lawmakers will consider the resolution.
If a concurrent resolution to terminate the public health emergency isn't introduced, Senate President Pro Tempore Jimmy Hickey, R-Texarkana, said he would declare the statewide public health emergency would continue.
If a resolution terminating the emergency is passed, Hutchinson could veto it and the the Legislature could consider overriding the veto.
The emergency will expire 60 days from Thursday, unless the emergency is terminated at an earlier date, or it is approved for renewal by the Legislative Council.
Asked when the governor would issue the call for a special session and give the details of his proposed legislation, Hutchinson spokeswoman Shealyn Sowers said Friday in a written statement, "More information will be released Monday."
On Thursday, House Speaker Matthew Shepherd, R-El Dorado, said there would have to be some limits in proposed legislation that would grant school boards the authority to require the masks in schools, "if there is any possibility of having something to pass."
"I think that might include limiting how long it could be in place, requiring the school board to revisit the issue periodically," he said.
The Legislature is now in an extended recess of its regular session.
Hickey said the precedent for the Legislature meeting in a special session during an extended recess occurred in August 1977.
On its website, the Arkansas Center for Health Improvement on Friday began once again posting information on new cases within school district boundaries.
It said 100 districts had 50 or more new cases per 10,000 residents within the past two weeks, including 12 that had 100 or more new cases per 10,000 residents.
"Arkansas has lost control of the virus," the center's chief executive, Joe Thompson, said in a news release.
"With new COVID-19 cases and hospitalizations surging, and with parents preparing to send their children back to the classroom, ACHI believes it is important for local leaders and parents to be aware of the risk levels in their communities."
WORKERS NEEDED
In his executive order declaring the emergency, Hutchinson directed the Department of Public Safety's Division of Emergency Management to seek staffing assistance from other states through the Emergency Management Assistance Compact, a mutual aid network.
He also directed the Health Department to suspend rules that could slow the licensure of health care workers.
At his request, he said the federal government was sending a "surge response team" to Arkansas to evaluate ways to maximize hospital capacity.
The Health Department posted a list of rules on its website Friday that had been suspended pursuant to Hutchinson's order.
LaTresha Woodruff, a spokeswoman for the Emergency Management Division, said the division was working with the Health Department to prepare the request to the mutual aid network.
The request could be submitted next week, she said.
Jerrilyn Jones, the Health Department's preparedness medical director, said many health care workers left their jobs after Arkansas' winter covid-19 surge, leaving hospitals with "significant shortages."
"People are just tired," Jones, an emergency room physician, said. "It's been a very long haul, and incredibly stressful for health care workers, and I think that some of them just decided it's not worth it anymore, and so they've decided to do other things."
She said she expects the federal surge response team to arrive next week.
"I think they have a wealth of knowledge with respect to process and can make sure that we are checking off the appropriate boxes, so that when we do submit a request, they're not denied because we haven't done all the things we needed to do to submit them," she said.
For instance, she said the state could request assistance from federal teams of medical workers that are deployed during disasters.
"Right now, our biggest hole is people, and so when we talk about hospitals being full, it's not necessarily physical plants that are full, it's staff that are full," she said.
She said she hopes some retired health professionals will return to work to help fill some of the gaps.
But she said they may lack the motivation to do that now that "vast majority" of those being hospitalized are people who chose not to be vaccinated.
"I just know in talking to folks, given the frustration, I'm not sure there will be a ton of people jumping to put themselves potentially in harm's way for a situation that could have been avoided," Jones said.
On Friday, the state's COVIDComm system, which helps match covid-19 patients with hospitals, was still unable to find an intensive care bed for a patient whom a hospital had been trying to transfer since about 12:30 a.m. Thursday, Jeff Tabor, the system's program manager said.
Unlike on Thursday, he said some of the hospitals identified as being capable of accepting transfers of covid-19 patients had available ICU beds, but none of them was among those considered to have the capacity to care for the most severely ill patients.
In such cases, Jones said, the patient often stays "in the emergency department for far longer than they need to."
STATE RANKINGS
CDC rankings Friday continued to show Arkansas trailing only Louisiana and Florida in new cases per capita over a rolling seven-day period.
Arkansas also continued to have the second-highest number of new deaths per capita, after Nevada, over the previous seven days.
Within Arkansas, Pulaski County had the most new cases on Friday, 447, followed by Benton County, which had 225, and Washington County, which had 189.
Dillaha said 15.5% of state coronavirus tests were positive during the week that ended Thursday -- the highest percentage over a seven-day span since January.
Hutchinson has said he wants to keep the percentage below 10%.
The state's cumulative count of cases rose Friday to 385,113.
The number of people who have ever been hospitalized in the state with confirmed infections rose by 77, to 18,580.
The number who have ever been on a ventilator rose by seven, to 1,886.