In a further indication of the coronavirus's accelerating spread in Arkansas, the state's count of cases rose Wednesday by more than 800 for the second day in a row as the number of virus patients in the state's hospitals jumped back up to 300.
The state's death toll from the virus, as tracked by the Department of Health, rose by three, to 8,595.
"Increasing new & active cases are warning signs that a tougher winter is ahead," Gov. Asa Hutchinson said in a tweet.
"It's important we protect ourselves & our families while we celebrate the upcoming Thanksgiving season. First doses & booster doses are available across the Natural State for those who are eligible."
Topping the increase of 814 on Tuesday, the state's case count rose Wednesday by 828.
Other than those two days, the count hadn't risen by more than 800 on a single day since Oct. 9.
After falling to a nearly five-month low a day earlier, the number of people hospitalized with covid-19 in Arkansas jumped Wednesday by 24, to 300, its highest level in almost two weeks.
"It looks like we are at the beginning of a new surge," said Dr. Jennifer Dillaha, the Health Department's chief medical officer.
As people make plans for Thanksgiving next week, she said she would encourage people to "keep their gatherings small and limit them to situations, like in a home, where you can have good ventilation and people can spread out."
People should also take into account the vaccination status of those who will be attending, she said.
"I would encourage people who are not vaccinated to wear a mask as much as possible when they're visiting with other people," Dillaha said.
People who have symptoms of covid-19 should stay home, she said.
For others, taking a rapid, over-the-counter covid test before attending a gathering is a "great idea," she said.
In general, she said Arkansans should "use as many layers of protection as they can," including getting fully vaccinated, getting a booster shot at the appropriate time, wearing masks in public and avoiding crowded indoor spaces with poor ventilation.
Already at its highest level since the week ending Oct. 20, the average daily increase in the state's case count over a rolling-seven day period rose Wednesday to 554.
With new cases outpacing recoveries, the number of cases in the state that were considered active rose by 329, to 5,444, the largest total since Oct. 23.
HOSPITALIZATIONS
Wednesday was the first day the number of hospitalized covid-19 patients in the state had been at or above 300 since Nov. 4.
It was the largest single-day jump in the number hospitalized since Sept. 1, near the height of the state's summer surge, when the total number of covid-19 patients in the state's hospitals was more than four times larger than it was Wednesday.
Health Department officials said at the time that the increase of 101 patients on Sept. 1 was partly the result of an inaccurate number reported by the department a day earlier.
The rise Wednesday marked a change from the past several days, when the number of people hospitalized largely fell even as the state's new cases ticked up.
"This increase [in cases] has been going up long enough that now the hospitalizations are showing up as an increase as well," Dillaha said.
While the state's hospitals have adequate capacity now, she said, an increase in coronavirus patients, combined with a normal flu season, could stress the health care system this winter.
Rising for the fourth day in a row, the number of Arkansas virus patients who were on ventilators went from 63 as of Tuesday to 68.
The number who were in intensive care rose for the second-straight day, going from 122 as of Tuesday to 129.
The number of intensive care unit beds in the state's hospitals that were unoccupied, however, rose by nine, to 103, as a result of a drop in non-covid-19 patients who were in intensive care.
People with covid-19 made up almost 13% of the state's intensive care patients Wednesday, up from almost 12% a day earlier.
ESCALATING SPREAD
Initially sparked by infections during Halloween-related gatherings, Dillaha said the state's uptick in cases has escalated as the virus has spread among unvaccinated people in schools and other settings.
"Schools are dropping mask mandates, and I think we are seeing more people in the communities around the state who are not wearing masks," Dillaha said.
Also, she said, "There's more social gatherings, and people who are eligible for vaccination have low vaccination rates, and we need to get more people boosted.
"All of those things working together, I think, has given the virus an opportunity to increase its spread."
According to the Health Department's online coronavirus dashboard, about 60% of the state's active cases as of Wednesday were evenly split between children and teenagers up to age 18 and people ages 25-44.
The numbers translated to a rate of about 203 cases per 100,000 residents for each of those age groups.
The number of active cases per 100,000 residents was 183 for Arkansans ages 19-24, 155 for those age 45-64 and 148 for those age 65 and older.
For all age groups combined, the rate was 180 active cases per 100,000 residents.
Infections among people who had not been fully vaccinated accounted for almost 79% of the total, according to the dashboard.
Since Feb. 1, infections among the unvaccinated have made up about 86% of the state's cases, 88% of its covid-19 hospitalizations and 86% of its deaths from the virus.
CASES BY COUNTY
Benton County had the most new cases Wednesday with 104, followed by Pulaski County with 74 and Independence County with 39.
The state's cumulative count of cases rose to 521,553.
Dillaha said all of the deaths reported Wednesday happened within the past month.
She said 6.9% of the state's coronavirus tests were positive during the seven-day span ending Tuesday, up from the 6.8% that was initially reported for the week ending Monday and a recent low of 5.4% the week ending Oct. 23.
Hutchinson has said he wants to keep the percentage below 10%.
The number of people who have ever been hospitalized in the state with covid-19 rose by 19, to 28,021.
The number of the state's virus patients who have ever been on a ventilator with covid-19 rose by three, to 2,961.
VACCINATIONS DOWN
Meanwhile, at 12,116, the increase in the Health Department's tally of vaccine doses that had been administered was smaller by more than 600 than the one the previous Wednesday.
Third doses, including booster shots of the Pfizer and Moderna vaccines for people who received their second doses at least six months ago, accounted for almost 48% of the most recent increase.
The count of first doses rose by 4,445, which was up by 687 from the increase in first doses a week earlier.
The number of children ages 5-11 who had received first doses rose by 1,787.
That brought to 14,099 the total number of children in that age group who had received first doses since they became eligible for a low-dose version of the Pfizer vaccine earlier this month.
Falling for the second day in a row, the average number of total doses administered each day over a rolling seven-day period dropped to 9,817.
After falling a day earlier, the average for first doses rose to 3,395.
According to the U.S. Centers for Disease Control and Prevention, 59.4% of Arkansans had received at least one vaccine dose as of Wednesday, up from 59.3% a day earlier.
The percentage who had been fully vaccinated remained at 48.8%.
Of those who had been fully vaccinated, 17.1% had received a booster dose, up from 16.7% a day earlier.
Among the states and District of Columbia, Arkansas continued to rank 36th in the percentage of its residents who had received at least one vaccine dose and 44th, ahead of Louisiana, North Dakota, Mississippi, Alabama, Wyoming, Idaho and West Virginia, in the percentage who were fully vaccinated.
Nationally, 68.7% of people had received at least one dose, and 58.9% were fully vaccinated.
Of the fully vaccinated population nationally, 16.1% of people had received a booster dose.