Only eight intensive care unit beds were available in the state Monday and the hospitalization of covid-19 patients jumped by 103 to 1,376, the largest daily increase and total since the pandemic began.
The number of covid-19 patients in ICUs reached its highest level yet as it rose by 26 to 509 and the number of virus patients on ventilators broke a daily record, rising by 25 to 286.
"Today's report shows some very startling numbers," Gov. Asa Hutchinson said on Twitter on Monday. "We saw the largest single-day increase in hospitalizations and have eclipsed our previous high of COVID hospitalizations. There are currently only eight ICU beds available in the state. Vaccinations reduce hospitalizations."
Those eight intensive care unit beds are all that is available for any patient, not just those suffering with covid-19.
The number of ICU beds available fell by nine beds from Sunday when there were 17 ICU beds available.
Those in the state hospitalized with the virus grew from 1,273 on Sunday to 1,376 on Monday, a contrast with a slight dip of 17 on Friday.
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"This tells us that the virus is spreading rapidly," said Meg Mirivel, Health Department spokeswoman. "People are getting very sick with it and our hospital systems are strained."
The state's death toll from the virus, as tracked by the Department of Health, rose by 21, to 6,322.
There were 995 new covid-19 cases on Monday -- the first time in the past seven days that the daily increase has been below 1,000, but still higher than it was Monday a week ago when the number of new cases reported was 844.
The number of cases in the state that were considered active rose 1,106 to 22,815.
HOSPITAL BEDS
Total hospital beds in the state -- whether filled or vacant -- dropped by 122, going from 8,797 on Sunday to 8,675 on Monday, according to Health Department data.
The total critical care beds, filled or vacant, dropped 43 to 1,129. With only eight ICU beds available, that means that more than 99% of the special-care beds are full.
Mirivel said it's not uncommon for the number of total beds to drop.
"There are so many factors that go into hospital bed numbers," she said. "Those 43 ICU beds were likely repurposed for other uses. The numbers also depend on being able to staff the beds."
Available beds dropped by 78 to 1,590, meaning about 82% of the state's hospital beds are full.
Unsuccessfully attempts were made to get further information from the Arkansas Hospital Association about the crisis hospitals are experiencing.
In an email late Monday, Ashley Warren, the organization's director of communications, said she forwarded the information requests to "our executive team" and "they will respond as they are able."
The University of Arkansas for Medical Sciences is full, spokeswoman Leslie Taylor said. The academic medical center is caring for 68 covid-19 patients with 27 in intensive care. Sixteen of those patients are on ventilators and four are on heart-lung bypass machines known as ECMO.
Taylor said they have 64 ICU beds and all are full.
"If a patient comes to UAMS and needs intensive care, or is a surgery patient at UAMS who needs intensive care, we will care for them and provide the level of care they need in another area until an ICU bed becomes available," Taylor said. "We also have the ability to add more ICU beds if we have to."
The virus is limiting the hospital's ability to accept transfers from other hospitals, Taylor added.
UAMS has already increased its ICU beds by 12 and has opened three covid-19 units.
"If necessary we can add more beds. However, staffing is our limiting factor," Taylor said. "We are extremely grateful to our heath care workers who are working overtime and taking extra shifts to help patients get through this."
They are also seeing more patients in UAMS' drive-thru covid-19 testing facility.
"The number of patients there has increased exponentially since the Delta variant became the dominant variant in our state," Taylor said. "Prior to that our numbers had dropped below 100 a day and now we are seeing 400-600 a day in the drive-thru."
The patients at UAMS are also skewing younger than those seen during the first virus surges, Taylor said.
"Last year and early this year, the covid-19 patients we saw were primarily older people, most over 65 years of age," Taylor said. "The average age of our patients now is 40 and we are seeing many patients in their 20s and 30s."
Mirivel, the Health Department spokeswoman, said there are now more active cases in young people who are 18 and under than the previous two surges.
On Aug. 13, 2020, 12% of the cases were 18 and under. On Jan. 11 that number grew to 14% and today 20% of the cases are in young people who are 18 and under, Mirivel said.
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Bonnie Ward, director of marketing and communications at CHI St. Vincent, said in an email that the average age of patients requiring hospitalization at their facilities around the state are "notably younger than our ministry experienced throughout the winter," with the approximate age range being 25 to 44 years old.
CHI St. Vincent hospitals continue to see growing numbers of covid-19 patients, Ward said.
The hospital would not release specific numbers when asked.
"At present, hospitals within our healing ministry are operating near or at capacity as we care for patients both those with Covid-19 and other critical care needs," Ward said.
Chris Durney, a spokesman for the Central Arkansas Veterans Health Care System, said the system has 11 patients in its Medical Intensive Care Unit.
"Our Emergency Operations Center meets twice daily to assess the situation and to make operational adjustments as needed. For now, some elective surgical procedures have been curtailed," Durney said. "We base capacity decisions on staffing to ensure every patient receives the best care possible. One advantage of the Little Rock VA is that it is a large facility that has been retrofitted for negative air throughout. Another advantage is, if necessary, we can immediately call upon our sister VA hospitals in other states for relief staff and additional beds."
REGIONAL HOSPITALS
The total bed capacity -- hospital beds that can be staffed whether or not they are occupied -- was at 8,823 on Monday, according to Health Department data.
The maximum flex bed capacity, the number of beds at the hospital regardless of the facility's ability to staff them, was at 11,400.
The metro region of the state had the largest number of covid-positive admissions at 435, followed by the southwest region with 242; the northwest region with 191; the northeast region with 175; the Arkansas Valley with 143; the north central region with 118; and the southeast region with 72.
Hospitals in the metro region saw the highest number of covid-patients in the ICU with 196, followed by the southwest region with 88; the northwest region with 84; Arkansas Valley with 46; northeast region with 45; north central with 35; and the southeast region with 21.
The St. Bernards Healthcare System in Jonesboro -- which is in the northeast region and includes Jonesboro and Pocahontas locations as well as CrossRidge Community Hospital in Wynne -- increased its covid-19 patient load by nearly 12% over the weekend, spokesman Mitchell Nail said.
The system is now caring for 77 patients with covid-19, including 22 in intensive care, 11 of whom are on a ventilator.
The average age of St. Bernards' covid-19 patients fell by eight years from the initial peak in 2020 and the beginning of 2021, from 63 to 55. The biggest percentage increase came from the 30- to 49-year-old age group, Nail said.
"Capacity is certainly a challenge, and our rising covid numbers have forced us to revisit our surge plan. We routinely run high Emergency Department volumes, and patients needing admittance often see longer than normal wait times; simply based on our bed status," Nail said. "Our goal is to make sure they get the care they need that protects them and every person around them, especially if it involves a potential covid diagnosis."
St. Bernards' "Hospital at Home" program is alleviating the capacity somewhat, Nail added. Covid-19 patients are able to be admitted, monitored and treated from their own homes under the program.
"Obviously these patients do not require intensive care services, but they still need care on an inpatient level," Nail said. "There's a strict eligibility requirement for the Hospital at Home service, and we have had at least two covid patients meet those requirements and use it. I only expect it to grow in demand."
UNVACCINATED PATIENTS
The number of vaccine doses that providers reported having administered, including second doses of the Pfizer and Moderna vaccines, rose by 5,115 to 2,446,573.
Of the 3,035,260 total doses received by the state, 80.6% has been administered, according to Health Department data.
A total of 90,653 vaccine doses were administered in the past week -- 26,459 more than the total administered for the week of July 26 through Aug. 1.
The number of individuals 12 and over partially immunized increased by 1,581 on Monday to a total of 338,728 or 13.2% of that age group.
The number of individuals fully immunized increased by 1,781 to a total of 1,096,947 or 42.9% of that age group.
The Health Department does not base its percentage vaccinated on the state's total population, but on the total population of those 12 and older, which the department said is 2,557,248.
Taylor said about 90% of hospitalized UAMS covid-19 patients are unvaccinated.
"The other 10 percent who are fully vaccinated are patients who are immune compromised or have underlying health conditions," she said. "We are seeing more patients getting vaccinated in our on-campus clinics and we hope that trend continues."
Ward said that more than 99% of the CHI St. Vincent covid-19 patients are not vaccinated.
"CHI St. Vincent strongly encourages members of the public to get vaccinated against COVID-19. All available vaccines provide extremely strong protection against severe COVID-19 infection, including the current Delta Variant impacting our communities, and significantly reduce the likelihood of hospitalization or death," Ward said. "Regular, thorough hand washing, social distancing and wearing a mask also remain effective tools to help stem the spread of COVID-19."
Nail said that about 87% of St. Bernards' covid-19 patients were not fully vaccinated.
Durney said the Central Arkansas Veterans Healthcare System is continuing to offer vaccinations at its Little Rock and North Little Rock medical centers as well as through its mobile vaccination teams.
"We must stress the COVID-19 vaccines currently in use in the United States offer good protection against the virus. This indicates that full vaccination can prevent unnecessary deaths and hospitalization," Durney said. "With this in mind, it is concerning that less than 50% of our enrolled Veterans are fully vaccinated."
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 660, from 904 on July 31 to 1,564 on Aug. 7.
The number known to have been caused by the alpha variant from the United Kingdom rose by 55, to 608.
The Health Department also reported an increase from 40 to 43 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.
CASES BY COUNTY
Health Department data indicated that Pulaski County had the largest increase in total cases, with the count rising by 163.
Craighead County had the next-largest increase, 83, followed by Sebastian County with 62.