Arkansas' count of coronavirus cases rose Thursday by 1,794 -- the second-largest one-day increase since February -- while the number of covid-19 patients in the state's hospitals jumped to almost 300.
The state's death toll from the virus, as tracked by the Arkansas Department of Health, rose by four, to 11,600.
Except for the spike of 2,395 cases on Wednesday, the increase in cases Thursday was the largest in a single day since Feb. 12, during the state's first wave of infections from the omicron variant.
Growing for the second day in a row, the average daily increase in the state's case count over a rolling seven-day period rose to 1,096.
That was still short of the recent high of 1,102 -- the average reached Saturday, just before a dip likely caused by lower testing and reporting over the Fourth of July holiday weekend.
With new cases outpacing recoveries and deaths, the number of cases in the state that were considered active rose Thursday by 765, to 13,270, the first time it had been above 13,000 since Feb. 15.
State Epidemiologist Mike Cima said gatherings over the holiday weekend were likely contributing to the state's new case numbers, exacerbating an upward trend in new infections that began in late April.
"Any time that there's large gatherings individuals, especially when cases and transmission are high, you're going to have probably an acceleration of transmission associated with those," Cima said.
He said he didn't see any indication that the state's new cases were nearing a peak.
The number hospitalized, while still low compared with its level during previous surges of infection, is likely to continue rising along with the state's new cases, he said.
While some people test positive after being hospitalized for unrelated reasons, that doesn't completely account for the rising number of covid-19 patients in the state's hospitals, Cima said.
"I don't think that it's a coincidence that hospitalizations are going up with cases," he said.
"I think that there are still individuals who are becoming sick enough that they require hospitalization from their covid infection."
Rising for the fourth straight day, the number hospitalized rose Thursday by 22, to 299, its highest level since March 9.
The number who were on ventilators, which didn't change Wednesday, rose Thursday by one, to 12.
After rising by one on Wednesday, the number who were in intensive care grew by five, to 59, the largest number since March 21.
MAP UPDATED
Reflecting the state's growing numbers of new cases and hospital admissions, the number of Arkansas counties where the U.S. Centers for Disease Control and Prevention recommends people wear masks in indoor public places grew Thursday from 14 to 16, with some of the state's most populous counties joining the list.
As a result of an increase in weekly new cases, hospital admissions or both, the "covid-19 community level" rose from "low" or "medium" to "high" -- triggering the recommendation to wear masks -- in Pulaski, Faulkner, Saline, Lonoke, Johnson, Conway, Phillips, Perry and Woodruff counties under the latest update to a CDC map.
In Sebastian, Jefferson, Crawford, Hot Spring, Clark, Desha and Bradley counties, meanwhile, the level fell from high to medium or low.
The counties where masks were recommended under the latest map update represented about 33% of Arkansas' population, up from 18% under the previous weekly update.
The last time masks had been recommended in Pulaski County was March 9.
The level on Thursday remained low in Benton County and medium in Washington and Craighead counties.
Overall, the number of counties where the covid-19 level was listed as being low rose by two, to 25, under the latest map update. The number of counties listed as medium fell by four, to 38.
In counties with a medium covid-19 level, the CDC recommends people who are immunocompromised or at high risk of severe covid-19 talk to their health care providers about whether they should wear masks or take other precautions.
People in those counties also should consider wearing masks around people who have a high risk of severe illness, according to the CDC.
In counties with low covid-19 levels, the CDC doesn't have a recommendation about whether people should wear masks.
CASES BY COUNTY
Pulaski County had the most new cases, 282, on Thursday, followed by Washington County with 113 and Benton County with 103.
The state's cumulative count of cases since March 2020 rose to 873,261.
Also on Thursday, Cima said 992 vaccine doses had been administered to Arkansas children under age 5 since the shots became available to the new age group on June 20.
Including infants under 6 months of age, who remain ineligible for the vaccine, Arkansas has about 186,300 children under age 5, according to 2020 U.S. Census Bureau estimates.
The 992 Arkansas children ages 6 months to 4 years who have received doses represent less than 1% of that total number.
Even compared with children age 5-11, who became eligible for vaccination in November, the uptake among the youngest children has been low, Cima said.
"I'm holding out hope that maybe the Fourth of July weekend has delayed some reporting and that we'll see higher vaccinations [among children under 5] in the coming days and weeks, but it is really low," Cima said.
According to the CDC, 24% of Arkansas children age 5-11 had received at least one dose as of June 29, and 17.5% had been fully vaccinated.
Among Arkansans 12 and older, 76.9% had received at least one dose, and 63.1% had been fully vaccinated.
Cima said the low vaccination rate among young children could be because of fears about the vaccines as well as the perception that children are at low risk of severe illness from covid-19.
While children are generally at lower risk than adults, he said covid-19 poses a high risk of severe illness compared with other ailments that commonly affect children.
"It's not normal for children to become hospitalized or certainly die from infectious diseases," Cima said.
"That places a huge amount of importance on children and adolescents becoming vaccinated."
Nationally, nearly 300,000 children under 5 have received vaccinations in the two weeks since they became available.
That's a slower pace than for older groups. The White House said the slow uptake was expected for the eligible U.S. population of about 18 million kids.
A Kaiser Family Foundation survey conducted in April found that one in five parents of children under age 5 said they would get their child vaccinated right away once it was authorized, 38% said they would wait and see and nearly four in ten said they wouldn't get their children vaccinated at all or only if required.
Cima also said the Arkansas Health Department recently discovered that it had been inadvertently excluding some doses from the tally of vaccinations listed on the department's online dashboard of coronavirus information.
To correct the error, the update to the dashboard on Thursday included the addition of about 116,000 doses, he said.
The total number of doses administered listed on the dashboard rose by 116,694, to 4,227,864.
The number listed as having received at least one dose and the number fully vaccinated each rose by more than 20,000, while the number listed as having received a booster dose rose by more than 75,000.
Cima called vaccination "by far the most important thing that individuals can do to really protect themselves from covid-19."
"There's so much data out there that are supportive of vaccines at preventing severe outcomes from covid-19," he said.
Information for this article was contributed by The Associated Press.