COVID-19 is hitting small Arkansas communities hard as less populous counties report higher per-capita case rates than populous areas.
Pulaski county and Washington county consistently lead the state in total cases, but as of Oct. 28, the 10 counties with the most cases per capita each have a total population of less than 40,000, according to ArkansasCovid.com analysis of Arkansas Department of Health data.
Jackson county leads the rest with 69.1 active cases per 10,000 residents, compared to the statewide average of 16.4 cases per 10,000 Arkansans.
Case totals have fallen significantly since the surge at the end of summer 2021, but healthcare workers in Arkansas are still facing difficulties from staffing shortages.
One nurse in the northeast region of the state, Elizabeth Lemke, said conditions were so bad she had to leave the medical field indefinitely.
In spring 2020, nursing didn’t require too much additional work to deal with the struggles of COVID-19, Lemke said in a phone interview. “But then so many people quit. But now you’re doing the job with a little extra with three people’s jobs…You can’t safely take care of anyone like that,” Lemke said.
After she quit, Lemke received calls from several medical facilities around the state looking to hire more nursing staff. “People were calling me from places I never applied to just cause I had a license,” Lemke said. “They’re going on the national registry and searching people that will come to work.”
The highly infectious delta variant is still spreading around the state despite a downward trend in cases, and the most cases-per-capita are being reported in Arkansas’ rural areas.
The ‘everybody knows each other’ charm of small towns drives the spread of the virus, according to Joshua Johnson, a recovering COVID-19 patient and resident of Mississippi county.
“If someone goes to work with COVID, they might spread it to five or six people, easily,” Johnson said in a phone interview. “And then they all go home and spread it to whoever they live with. And when everybody knows everybody, that spread is going to repeat itself across the neighborhood.”
Johnson said his case was traced back to a coworker who wasn’t showing symptoms when they were in contact, but tested positive for the virus days later.
“I see a lot of the same people every day, like just from around town and work, so if any one of us is contagious, it has a chance to spread across the whole community,” Johnson said.
The total death toll of COVID-19 in Arkansas recently exceeded 8,000 people, according to ADH data. The CDC continues to recommend booster shots as an effective means of protection against the virus. Specific guidelines for individuals seeking a booster shot are available at the department of health’s website.
Since the beginning of COVID-19, public schools have felt the strong force of the virus. High schools lost the ability to teach in-person during the 2019 and 2020 school year, provide their students with extracurricular activities, and give their students a real and full high school experience. Now that kids above the age of 12 are now eligible, with 5 to 11 year old’s soon to be on that list to receive a vaccine, there is hope that a return to a new normal is on the horizon.
Suki Highers, sociology teacher at Fayetteville High School and Justice of the Peace for Washington County District 11, has experienced COVID-19 firsthand, with her whole family having the virus despite being vaccinated. Highers understands and reinforces the importance of mask wearing at school every day.
“While some students seem to be very conscious about COVID precautions, as a whole, most don’t seem to care,” Highers said. “Every day I have to remind students how to wear a mask appropriately, sometimes multiple times in one class period. It is easy to tell who hasn’t been impacted by COVID in the classroom.”
The transition back to in-person classes has been tough on everyone, but there are obvious precautions that need to be taken for it to stay that way.
“Many students haven’t entered a classroom since March of 2020, and it is evident,” Highers said. “They struggle with basic skills, people skills, and are much more tied to their phones than they used to be.”
Fayetteville High School has a mask mandate and quarantine policy, along with Little Rock School District. Little Rock is the second largest school district in the state. Two weeks ago, Rogers and Fort Smith School Districts lifted their mask mandate, although mask wearing is “strongly encouraged.” The largest school district in the state, Springdale School District, ended their mask mandate back in September.
The districts without a mask mandate have comparably larger case numbers per 100 staff and students cumulative totals compared to Fayetteville. From calculations made with October 14 data provided by the Arkansas Department of Health, Springdale had 26.69 student cases per 1,000 cases, Rogers with 24.94, and Fort Smith with 30.78. while Fayetteville had 17.24 student cases per 1,000 and Little Rock with 14.85. Fayetteville and Little Rock’s numbers are almost cut in half compared to school districts without a mask mandate.
The common theme between Springdale, Rogers and Fort Smith is that there is no mask mandate, which can be seen as the cause for higher case numbers.
If the school district does not openly care about the safety of their students, then the students will not care about their peers and the chance of getting COVID.
“I’m not sure cases are as low as what has been reported,” Highers said. “Many students won’t get tested for fear of being quarantined.”
It is a scary thought to think you might have COVID, but getting tested and being quarantined if you are positive is how we stop the spread and prevent cases from rising.
Masks are a simple and effective way to reduce the spread of COVID-19 and that has been the case since the virus first came to the United States. With case numbers and deaths from COVID rising each day, it is disheartening that mask-wearing has lost its importance to some people.
“Our school board has been very COVID conscious, but I believe that the mandate will be lifted this school year if case numbers remain low,” Highers said. “While it would be a relief to stop policing masks, I would worry about bringing it home again.”
In our data, we are comparing the number of individuals vaccinated in Arkansas to the amount of Positive COVID cases. We took a look at the year 2021 and gathered data from January 2021 through October 25, 2021 across the entire state of Arkansas.
January: 278,539 New Doses given and 65,826 Positive COVID Cases.
February: 320,175 New Doses given and 25,921 Positive COVID Cases.
March: 515,159 New Doses given and 7,889 Positive COVID Cases
April: 568,093 New Doses given and 5,116 Positive COVID Cases.
May: 268,480 New Doses given and 5,413 Positive COVID Cases
June:154,863 New Doses given and 7,935 Positive COVID Cases
July: 210,834 New Doses given and 36,367 Positive COVID Cases
August: 351,556 New Doses given and 64,455 Positive COVID Cases
September: 212,281 New Doses given and 40,296 Positive COVID Cases
October:162,214 New Doses given and 13,472 Positive COVID Cases
As we can see from the data, right after the holidays in January we had the biggest spike in Positive COVID Cases for the year 2021. The next big spike came in July into August right as many were going back to school and finishing up summer travel. Now, Positive COVID Cases are slowly decreasing but will be interesting to see what happens as we go into the holidays again. In December 2020 the Delta Variant also emerged in the U.S. which most likely lead to the spike in January 2021.
Analyzing the Data in correlation with New Doses given, April had the highest amount of doses given and also had the lowest amount of Positive COVID Cases in the month. With that being said, we can conclude that receiving vaccines does help in the number of COVID cases and would be in our best interest to continue to get them to protect our community. Right around this time in April the vaccine became available to more individuals which is why it could have increased so dramatically.
COVID 19, what we thought was just an extra week added onto our spring break in March of 2020 is still affecting us drastically. Not only did it extend from just an extra week but it is now October 2021, 19 months later and we are continuing to have spikes in cases. We have been through major shutdowns where only essential businesses have been open and now we are slowly opening back up with some businesses still mandating masks.
On October 4th, 2021 The Arkansas Democrat- Gazette posted a 4 minute podcast. Within this podcast they started it out by talking about the COVID cases finally falling below 10,000. Not only is this a big milestone but they fear that some individuals may not get vaccinated because it is going down. Another thing to prepare for would be the fact that during the winter there is typically a higher amount of sickness.
Alyssa Arnold, a local Registered Nurse at Willow Creek Women’s Hospital and now a Travel Nurse agreed with our data when she said, “We saw a pretty good spike when the delta variant hit but now the cases have continued to decrease.” Arnold works in the Labor and Delivery Department and we wondered how cases have been among pregnant women. Arnold said, “When the delta variant surfaced a few months ago we definitely saw an increase in the cases. While it is recommended for pregnant women to receive that vaccine many are skeptical, and rightly so… Over the last few weeks, it seems as if we have been seeing a decrease in cases though and I think this is due to more women getting vaccinated during their third trimester.”
Rebecca, an ICU Nurse was asked how she has seen cases be affected since the increase in the vaccination rate. She said, “We saw an initial decrease in cases after the vaccine became available to the public but then there was another surge. I work in an intensive care unit and over 90% of patients admitted to the icu in the past 6 months have been unvaccinated, and that number holds true nationwide.” We asked Rebecca if she thought there would continue to be a spike in COVID cases every few months? She said, “Probably. I think we will likely have a spike in cases after the holidays, and there are some new variants circulating that could cause problems. I’m not an epidemiologist, though – it’s important to understand that while nurses are respected health professionals, we don’t have the answers to questions like this. Any insight I can offer is purely anecdotal and we should be looking to scientists who specialize in community health and epidemiology for authoritative information.”
The final individual interviewed is Page Newberry, Family Practice APRN at NWA Family Medicine and Obstetrics. We first asked, from your best knowledge on COVID, do you think there will continue to be a spike in COVID cases every few months? Newberry said, “I think they will occasionally spike. Usually after large gatherings, social events, Christmas time, and spring break time. After we take precautions, I think there will be an occasional spike but I don’t think it will be anything like the beginning of the pandemic.” The final question asked was, April had the highest amount of New Doses and also the lowest amount of Positive COVID cases. Do you think those have a correlation to each other? She said, “I think that’s a direct correlation and not a coincidence just due to the large amount of people getting vaccinated. I think that’s just proof that vaccines aren’t perfect but they do work.”
The vaccination gap between white people and minority populations is closing as vaccine accessibility increases suffice minority groups’ experienced healthcare and COVID-related disparities throughout the pandemic.
“Minorities tend to have a higher ratio of their populations working in service-related jobs,” Mark Williams, Ph.D., dean of the UAMS Fay W. Boozman College of Public Health, said. “As such, they could not isolate at home as more white-collar related workers. And white-collar related jobs tend to be more white than Black, Hispanic or any other minority.”
Service-industry jobs are high-exposure and invite virus transmission due to their social and in-person nature. Moreover, service-industry jobs rarely offer health insurance, which decreased the possibility of employees visiting a physician, Williams said.
“Also, it’s come to light more recently, from some sociological studies that have been done is that having health insurance plays a big part in whether or not someone is vaccinated,” Williams said. “And part of the reason for that is because people tend to rely on their primary physicians for advice on getting vaccinated and oftentimes get vaccinated at their physician’s office.”
However, some of the jobs that were originally COVID-transmission hubs are now requiring vaccinations. Meat-processing companies such as Tyson enforced vaccinations among their employees, particularly affecting the Hispanic population in northwest Arkansas, Williams said. In fact, the vaccination rate of Hispanic individuals has exceeded the white vaccination rate in Washington county- the home of Tyson. Other companies, such as Walmart, have instilled employer-mandated vaccinations, as well.
“They’re simply being given no choice if they want to keep their employment,” Williams said.
Furthermore, state-based community groups and UAMS have provided on-site vaccination clinics to specifically reach Hispanic and Marshallese populations in northwest Arkansas and other populations in the Arkansas Delta, Williams said.
A solid level of trust is important in providing COVID-related information, education and vaccinations, Zac Brown, the assistant director of communications at Pat Walker Health Center, said. A lack of insurance or distrust in the healthcare system can discourage people from visiting physicians or offices. Rather, specific institutions, that minority groups trust, have found success bringing COVID-related resources to their communities. For example, some African American communities have utilized churches as vaccination sites, Brown explained.
Translation-based outreach has increased the accessibility of COVID-related resources, too. In northwest Arkansas, the Northwest Arkansas Council has paired with the state health department to provide educational and promotional COVID-vaccine information in Spanish, Marshallese and other languages, Brown said. When dispersing information, reaching diverse communities goes beyond simple translation efforts because the information provided in English must be culturally-sound, as well.
“We are always getting and sharing information, but we are also working with the local agencies, healthcare providers, and sharing information about the vaccines,” said Margarita Solorzano, the executive director of Hispanic Women’s Organization of Arkansas.
“Also, making sure that the communications that any of these agencies, either at a state level or local level, are culturally and linguistically appropriate for the immigrant and Latino community.”
The Hispanic Women’s Organization of Arkansas, which is located in Springdale, Arkansas, is a part of the Latino task force at the state level that reviews COVID-related information and daily statistics to reach the Spanish-speaking community, Solorzano said.
Though COVID cases have dropped over the past few months, the mortality rates have been high. Increased mortality rates may be influencing the increase in vaccination rates, too, Williams said.
“It’s something to say that people are simply realizing how serious the pandemic is,” Williams said.
Skye Harris, a healthy, happy 18-year-old Rogers native, was enjoying a vacation in June when her head began hurting and she started feeling like she had a cold. On her way to the drug store, she collapsed, seized and lost her ability to speak and walk. In that moment, her life changed completely.
After returning home from the trip, Harris visited emergency rooms six or seven times, eventually testing positive for COVID-19 and being diagnosed with functional neurological disorder.
Skye Harris gets an EEG, a test which measures electrical impulses in the brain, at Arkansas Children’s Hospital in Little Rock in September.
“Basically, whenever I get overstimulated or excited my body takes it out physically,” Harris said. “And that can look like I pass out, lose my ability to speak, have —they’re not seizures, but it looks like a seizure, it’s like a convulsion. Oh, I also lose my vision sometimes, and I have a lot of weakness on the right side of my body. So I walk with a cane a lot. And they think it’s because of COVID, because they used to only see five or six cases of this in teenage girls a year. Now, each hospital is seeing five or six cases a week.”
For many who live through COVID-19, the story doesn’t end when they leave the hospital or their at-home quarantine ends. The pandemic has led to a second health crisis of so-called “long COVID,” although recent discoveries might provide some hope to long-haulers.
Long-term COVID, also known as post-acute sequelae SARS-CoV-2 infection or PASC, can cause COVID-19 survivors to experience lingering or new symptoms that negatively impact their lives for weeks or months after infection. These can include symptoms similar to active infection or additional ailments like neurologic, lung and heart disorders. Preliminary evidence suggests that those with PASC, also known as long-haulers, might be more likely to develop autoimmune diseases and postural orthostatic tachycardia syndrome (POTS), a condition that affects blood circulation and heart rate.
Researchers led by Destin Groff, Ashley Sun and Dr. Anna Ssentongo found the median (IQR) rate of those experiencing symptoms six months after infection was 54% when they performed a literature review of 57 studies comprising more than 250,000 COVID-19 survivors. The review was published Oct. in JAMA Open, the American Medical Association’s open access medical journal.
The most common symptoms identified were neurological disorders including difficulty concentrating and memory problems, lung function issues and abnormalities on lung scans, fatigue and muscle weakness and mental health disorders like anxiety and depression.
After her diagnosis, Harris lost the ability to drive and had to close down the food truck she operated in Northwest Arkansas because of her illness. She has made countless visits to specialists and participates in physical therapy and cognitive behavioral therapy twice a week.
Skye Harris uses an antigravity treadmill to work on endurance and motor skills in physical therapy at UAMS Northwest in Fayetteville in October.
Researchers at the University of Arkansas for Medical Sciences, led by Dr. John Arthur, recently made progress toward understanding what causes PASC. They think some survivor’s bodies overproduce an antibody that attacks ACE 2, a protein on the surface of many cells, and leads to the buildup of a hormone that causes the immune system to attack the body. No other known virus triggers this antibody, Arthur said.
Aurthur has been moved by the stories of COVID long-haulers whose lives have been devastated by the illness, and it has spurred his passion for the research, he said. Although the best way to avoid getting PASC is to protect oneself from getting COVID through vaccination and masking, there is hope for those currently suffering, Arthur said. The team hopes to begin treatment trials soon that could help reduce levels of the harmful antibody in patients. Long-haulers interested in participating can register at arresearch.org.
“One of the main messages I’m trying to get out is that things are going to get better for people. I know that a lot of people are really impacted by this, and some of them are feeling sort of desperate, but things are going to get better.”
Donn Seidholz, a retired private airline executive from Omaha, Nebraska, is living proof that things can improve. After contracting COVID-19 in summer 2020, Seidholz struggled with debilitating fatigue that would come on suddenly, brain fog that made it impossible to complete simple tasks, and a lingering loss of taste and smell, he said.
The illness was devastating for the former professional baseball player who was used to working out five days a week and was passionate about eating and cooking. After about a year of visiting many doctors who had few answers, and focusing on living a healthy lifestyle, Seidholz said his symptoms cleared up on their own.
“It just takes time and it feels like it’s never going away when you’re going through it,” Seidholz said. “But it does gradually get better. I mean, I just last night made chicken piccata, and actually, it tasted very good. And I could tell what I was eating and you know, six months ago, there’s no freakin way I could have done that.”
With no known cure for functional neurological disorder, Harris knows her disability will likely last years or a lifetime, she said. But Harris is staying positive and focusing on the good her illness has brought into her life, including the kindness of strangers, a new understanding of accessibility issues and an increased appreciation for what she has.
“It’s honestly made me a lot stronger person, so I’m not I’m not too mad about it,” Harris said. “You know, there are things that hold me back. But there’s also things that push me forward. So I’m not going to stop my life for something that can also push me forward.”
