Northwest Arkansas Democrat-Gazette
At 2,878, state logs 2nd-highest case rise in day
Toll up 27; hospitalizations fall; more vaccines on way
Arkansas’ count of coronavirus cases rose Friday by 2,878 — a smaller increase than the one the day before but still the second-highest one-day jump since the start of the pandemic.
The death toll from the virus, as tracked by the state Department of Health, rose by 27, to 3,139.
The number of patients hospitalized with covid-19 in the state fell by 11, to 1,073.
Those patients included 181 on ventilators, down from 188 a day earlier.
Meanwhile, Health Department spokesman Gavin Lesnick said the state expects to get 18,525 doses next week of the vaccine developed by Pfizer and BioNTech, down from the 25,350 it received this week.
State Epidemiologist Jennifer Dillaha said some of the larger state hospitals that received direct shipments of the vaccine this week will receive additional doses next week.
Other doses will go to ambulance workers and employees at high-risk jobs at rehabilitation hospitals, behavioral health hospitals, long-term acute care hospitals and surgical hospitals.
The state also is expecting about 51,000 doses next week of the Moderna vaccine, which was issued an emergency-use authorization Friday by the U.S. Food and Drug Administration.
Those doses will be administered in Arkansas to residents of nursing homes and other long-term care facilities, Dillaha said.
The increase in cases on Friday followed a record spike of 3,039 cases on Thursday.
For the second day in a row, the average number of cases added in the state each day over a rolling seven-day period set a record as it rose by 15, to 2,257.
“There continues to be a high level of spread throughout our communities, in both highly-populated areas and more rural areas,” Gov. Asa Hutchinson said in a statement. “We must remain diligent over the weekend and not relax in following the public health guidelines.”
He also said the number of coronavirus tests of Arkansans performed Thursday set a record. Those comprised 13,816 polymerase chain reaction, or PCR, tests and 5,262 antigen tests.
Dillaha reiterated her concern that the spread of the virus had begun to escalate from activities such as Christmas shopping and holiday gatherings.
“The numbers remain high, and I’m still very concerned about it,” Dillaha said.
She also called it worrisome that Pulaski County had 355 new cases, setting a one-day record.
Also, she said, “I’m still really concerned about the high number of people in the hospitals and those on the ventilators because those are the people most likely to die.”
At a record level since Thursday, the number of cases that were considered active rose by 733, to 22,392, as new cases continued to outpace recoveries.
SHOTS GIVEN
Hutchinson said in his weekly radio address Friday that more than 4,000 health care workers had been vaccinated since the first shipments of the Pfizer-BioNTech vaccine began arriving on Monday.
He said he expects the first Moderna shipments to arrive Tuesday.
“We are well on our way to vaccinating thousands of Arkansans, which is the only way we are ever going to beat this virus,” the governor said.
The Pfizer-BioNTech vaccine was delivered in batches of 975 doses to 18 hospitals and five community pharmacies that are distributing doses to smaller hospitals based on the number of front-line workers the smaller facilities need vaccinated.
Little Rock-based Baptist Health, which has nine acutecare hospitals in the state, had inoculated 3,008 employees as of Friday afternoon, Cara Wade, a spokeswoman, said via email.
All of the hospitals received direct shipments except for Baptist Health Medical Center-Conway, which obtained doses from a pharmacy. Wade said that site should have enough doses left “to continue shots through Monday.”
“Hopefully we will receive another shipment the early part of next week,” she said.
At St. Bernards Medical Center in Jonesboro, “just over 1,000 healthcare workers” have been vaccinated with the first dose of the Pfizer vaccine, Mitchell Nail, a spokesman, said in an email.
The Pfizer vaccine is administered in two doses, with the second shot given about three weeks after the first.
“We vaccinated nearly all of our frontline workers between Tuesday and Thursday,” he said. “Our workers have expressed an overwhelming eagerness to receive it, and the vaccine itself has proven as safe as we knew it to be.”
Starting on Thursday through today, Nail said St. Bernards is vaccinating “workers from additional tiers” who may not have as much direct access with covid patients.
He said the 75 remaining doses left at the end of the day Friday should be gone by Saturday afternoon.
“We know we will receive more vaccine doses but have not heard a specific number or a date they will arrive,” Nail said. “We anticipate a shipment sometime next week and eagerly await its arrival.”
UAMS Medical Center in Little Rock vaccinated about 1,350 personnel this week and is still administering doses to front-line employees, spokeswoman Leslie Taylor said.
“Everything is going smoothly,” she said. “No one has reported any adverse side effects.”
Mercy Hospital Northwest Arkansas in Rogers vaccinated 568 employees by the end of the day on Thursday, David Fortner, vice president of operations and pharmacy director, said in an email.
As of 3:20 p.m. Friday, “Mercy has about 300 doses left to administer,” Fortner said, adding that that figure does not take into account the extra doses that have been found in some vials.
“It’s difficult to predict precisely, but we believe we’ll give all doses by early next week,” Fortner said.
At Unity Health’s White County Medical Center in Searcy, 484 injections have been given since receiving one shipment of 975 doses earlier in the week, Brooke Pryor, Unity Health’s marketing director, said.
“Administering the vaccine has gone more smoothly,” Pryor said. “So we’ve been able to vaccinate more employees in a shorter period of time.”
CHI St. Vincent Infirmary in Little Rock declined to provide specific numbers of employees who have received the Pfizer injection, but said vaccinations “are progressing smoothly as the hospital roughly doubles the number of our frontline, critical care staff receiving the vaccine each day,” Bonnie Ward, CHI St. Vincent communications director, said.
“At the current pace, all of our staff prioritized as first tier now have been vaccinated,” Ward said in an emailed statement.
NEXT WEEK’S SHIPMENTS
In addition to general, acute-care hospitals, the state’s first allocation of the Pfizer-BioNTech vaccine included doses for workers at the State Hospital in Little Rock and at the Health Department’s local health units.
Dillaha said the initial goal is to vaccinate the highest-risk employees at those institutions.
Next week, the vaccine will be available to workers at other types of hospitals because “some of them have covid patients themselves, so we want to protect health care workers providing direct care to patients who have covid 19.
“We also want to preserve the staffing capacity of these hospitals so that they can receive the transfer of medically stable patients out of the acutecare hospitals that need to be transferred.”
Lesnick said 10 acute care hospitals will receive direct shipments next week.
Three pharmacies will distribute the vaccine to one additional acute-care hospital, along with four surgical hospitals, 10 behavioral health hospitals, five long-term acute-care hospitals and 13 rehabilitation hospitals.
The Health Department also will receive additional vaccine that it will administer to emergency medical workers.
The initial allocation of the
Moderna vaccine, which will be distributed through pharmacies, should be enough to vaccinate all of the residents and workers at nursing homes, as well as at least some of those at assisted-living facilities and centers for people with significant intellectual disabilities who are willing to take the shot.
Rachel Bunch, executive director of the Arkansas Health Care Association, said this week that the long-term care facilities have an estimated 53,000 residents and employees.
Most of those are in nursing homes, which have the highest priority for the Moderna vaccine. Lesnick has said nursing homes have 33,000 to 34,000 residents and employees.
Dillaha has said that future shipments of the Moderna vaccine could be used for health care workers once the longterm care facility residents and workers have been vaccinated.
The state’s plan calls for the vaccine to go first to health care workers and long-term care facility residents and workers before moving on to other priority groups.
The tentative plan calls for the next group in line to be “essential workers,” such as teachers and prison employees, followed by people age 65 or older or adults with chronic health conditions.
The makeup of the priority groups could change depending on the recommendations of a U.S. Centers for Disease Control and Prevention advisory committee led by Health Secretary Jose Romero, which is scheduled to make recommendations Sunday.
RULE ISSUED
Also on Friday, the Arkansas Insurance Department issued an emergency rule prohibiting insurance plans from requiring prior authorization before patients can be transferred from hospitals to nursing homes, rehabilitation facilities or other post-acute care facilities.
The rule, which was approved by the Legislative Council on Friday, applies to individual and employer-based plans regulated by the department, as well as Medicaid managed-care companies and the plans covering teachers and state employees.
So-called self-funded plans in which employers, rather than insurance companies, are responsible for health care costs are regulated by the U.S. Department of Labor and aren’t subject to the emergency rule.
An Insurance Department directive in April already prohibited insurers from requiring prior authorization for covid-19 treatment.
Arkansas Hospital Association Chief Executive Officer Bo Ryall said earlier this month that the association wanted the directive extended to all types of patients to help free up space in hospitals.
Insurance Department spokeswoman Jennifer Bruce said Friday that many insurers had already been waiving prior authorization for all types of patients.
“I think this is just kind of a failsafe as the numbers keep rising and as the hospitals near capacity. We just want to remove any potential burdens on the system that we can.”
The department said it doesn’t plan to extend the rule after it expires in 120 days.
In a Nov. 24 letter, Hutchinson asked U.S. Health and Human Services Secretary Alex Azar to direct insurers to waive prior authorization requirements for Medicare beneficiaries in managed care plans, saying the requirements had created “unnecessary delays in transitioning Medicare beneficiaries through the health care system.”
Azar hadn’t responded to the letter as of Friday, Hutchinson spokesman Katie Beck said.
PRISON OUTBREAKS
The cases added to the state’s tallies comprised 1,922 that were confirmed through PCR tests and 956 “probable” cases, which include those identified through antigen tests.
The cumulative count of cases rose to 197,421. That comprised 167,434 confirmed cases and 29,987 probable ones.
In addition to Pulaski County, the counties with the largest number of new cases were Washington County, which had 237, Benton County, which had 230, Craighead County, which had 118, and Pope County, which had 109.
Among prison and jail inmates, the Health Department’s count of cases rose by 58.
Department of Corrections spokeswoman Cindy Murphy said the number of cases among inmates grew by 46, to 434, at the Tucker Unit in Jefferson County; by six, to 651, at the Grimes Unit near Newport; by four, to 1,472, at the Ouachita River Unit in Malvern, and by two, to 28, at the East Central Arkansas Community Correction Center in West Memphis.
The Benton Unit, East Arkansas Regional Unit near Brickeys and the Barbara Ester Unit in Pine Bluff also each had one new case.
Among those prisons, the Tucker Unit had the largest number of cases that were active, 201, followed by the Grimes Unit, which had 188.
The state’s death toll rose by 21, to 2,776, among confirmed cases and by six, to 363, among probable cases.
Among nursing home and assisted living facility residents, the state’s count of virus deaths rose by 10, to 1,350.
The number of people who have ever been hospitalized in the state with covid-19 rose by 73, to 10,430.
The number of virus patients who have ever been on a ventilator grew by seven, to 1,132.
Meanwhile, the Health Department reported that 11.4% of the PCR tests of Arkansans over a rolling seven-day span were positive as of Thursday.
That was up slightly from the 11.2% of tests that the department initially reported were positive during the week that ended Wednesday.
The percentage for that period later rose to 12% as more test results were reported.
Hutchinson has said he wants to keep the percentage — a gauge of whether a state’s testing is adequate — below 10%.
The percentage over a rolling seven-day period was above that target for most of November and all of this month so far.
The percentage of antigen tests that were positive over seven days rose from 21.3% during the week that ended Wednesday to 21.5% as of
Thursday.
ICU BEDS SCARCE
As of 2 p.m. Friday, hospitals reported 37 available intensive-care beds out of 1,154 in the state, according to the Health Department. That is a 42% drop from the 64 ICU beds available Thursday and a record low according to the department’s daily reports.
There were 368 covid-19 patients in ICU beds, eight less than the previous day.
Of the 75 ICU beds in north-central Arkansas, one was vacant as of Friday afternoon. In the Central Arkansas metro region, which includes Little Rock, only three ICU beds out of 450 were open. In southwest Arkansas, 10 out of 140 total ICU beds were not occupied, according to the Health Department.
The total number of hospital beds increased to 2,194 on Friday, up from 2,126 the day before, according to the Health Department.
Out of an inventory of 1,072 ventilators, 676 are available for use. As of Friday afternoon, covid patients were using 181 ventilators, the Health Department said.
UAMS Medical Center is at “maximum capacity,” Taylor, the UAMS spokesperson, said.
“We have about 25 open hospital beds,” she said, adding that the hospital “has a good supply of ventilators.”
Thirteen out of the 41 positive covid patients at UAMS are in the ICU, Taylor said.
“We are always watching the numbers and working to balance staffing with bed capacity as needed,” she said. “Staffing continues to be a challenge.”
At Baptist Health Medical Center in Little Rock, available ICU beds “are extremely limited,” Wade, the hospital’s director of corporate communications, said, adding that the number of ICU patients only continues to increase.
She said Baptist’s Little Rock hospital will add 16 ICU beds that should be ready in January.
“Those will help if we need additional capacity,” she said.
St. Bernards Medical Center in Jonesboro has available beds “despite most regular and ICU beds being occupied,” Nail, the hospital spokesperson, said.
“We anticipate scaling up soon to accommodate upcoming hospitalization projections,” he said.
The hospital “still has ample ventilators, even though … usage has crept up in recent weeks,” Nail said.
Staffing remains an issue at St. Bernards because of absences related to positive cases and employee quarantines from probable close contacts.
“We haven’t seen as many team members out recently with the virus, but the number remains higher than we wish to see,” Nail said.
Ward, the CHI St. Vincent’s director of marketing and communication, declined to provide specific numbers in terms of capacity but said each of CHI St. Vincent’s facilities “has a pandemic or surge capacity plan that we continuously review with our emergency preparedness coordinators and can quickly enact if required.”
“While this year is certainly unique, we have always had to adjust staffing to match both the needs and numbers of patients we care for,” Ward said. “We continue to do so at this time.”