Claire White, 27, an intensive care unit nurse at Mercy Hospital Northwest Arkansas, used to care for one or two ICU patients a day. Now, as the delta variant of the coronavirus sweeps through the state, her workload has increased to three Covid patients a day, many of whom are on ventilators and need round-the-clock assistance.
While it was unusual to see patients under 60 in the ICU last year, this summer White has been caring regularly for patients in their 40s and 50s at the hospital in Rogers. She feels overwhelmed and exhausted, particularly because she knows this wave might not have occurred if more people had been vaccinated.
"Last year, most of us were just burnt out, because it was depressing and tragic," White said. "Now, it's still depressing and tragic, but it could've been avoided."
Covid-19 has roared back in Arkansas, causing record hospitalization numbers and dangerously low ICU bed counts in recent weeks. The state reported its biggest one-day increase in Covid-19 hospitalizations Monday, with 103 new admissions and just eight available ICU beds.
It's the largest resurgence in Covid cases since January as the state tallies more than 2,000 cases a day. Arkansas also has one of the lowest vaccination rates in the country — just 38 percent of its population has been fully vaccinated. The state reports a seven-day average of 19 Covid deaths, up by 64 percent from two weeks ago.
As in other Southern states where Covid-19 is resurgent, the vaccination rate in Arkansas is finally ticking upward: The seven-day daily average of first shots has more than doubled since early July.
But a modest increase in vaccinations may not be enough to slow the seemingly endless spread, state officials say.
'Who helps the helpers?'
Stephen Pennington, 34, president of the Arkansas Nurses Association, said many of his constituents feel similar to White.
"We are seeing an increased number of concerns from nurses about their own mental health," said Pennington, a registered nurse who works in Little Rock. "Who helps the helpers? Because that's at the point we're at right now."
Pennington hears from nurses, doctors, respiratory therapists and social workers who say they don't know how much longer they can continue to work with Covid patients.
"In the past month or two, we have seen nurses who have said: 'I am done with the profession. I am going to do something else,'" he said. "That hurts us, especially as a rural state, where we need as many nurses as we can get."
The increase in patients has worsened staff shortages in the state, Pennington said, adding that he hears from many people who say their hospitals could open more beds if they had the staffing to do it safely. Nurses are getting sick, too, but not from Covid-19 — from mental and physical exhaustion, he said.
"Here in Arkansas, we have the beds," he said. "We don't have the staff to staff the beds."
White said she has witnessed the high turnover rate firsthand.
"Any time I hear of someone leaving, I can't really blame them. It's just a hard place to work," she said. "I know I've never wanted to quit my job until now, but I don't want to because I've still got a job to do."
Delta is different
Dr. Gerry Jones, chief medical officer at CHI St. Vincent Infirmary, a large hospital in Little Rock, said the new wave is being driven largely by delta variant cases in unvaccinated people.
"Had we had a larger percentage of our population that was vaccinated, I don't know that I could say that it wouldn't have happened," he said, "but it might very well not have been as dramatic as it is."
He said he's grateful that the demand for vaccinations has grown. In early July, when Covid cases began to surge again, only about 34 percent of the state's population had been fully vaccinated.
"We have seen over the past three weeks a tremendous resurge in demand for the vaccine and really have seen our vaccinated numbers rise," he said.
Still, hospitalizations are increasing, with "no evidence" that they are slowing down, said Dr. Jennifer Dillaha, chief medical officer and medical director for immunization for the state Health Department.
Dillaha is worried that people in the state are underestimating the latest variant. "People are familiar with what happened in the past with previous variants," she said. The delta variant is more dangerous — other variants were less transmissible. Her department is working to make sure people have accurate information, know about monoclonal antibody treatments and understand the importance of wearing masks and getting vaccinated. The effort is not without challenges.
Gov. Asa Hutchinson, a Republican, signed a law in April that banned government entities from imposing mask mandates. A judge last week temporarily banned the state from enforcing the law, and as case numbers climbed in the state, Hutchinson said he regretted having signed it.
Jones said masking, along with vaccination and social distancing, will be the most effective way to stifle the newest outbreak in Arkansas and lighten the load on health care workers.
He commended the resilience of the state's health care workers while acknowledging that the current wave presents a mental challenge.
"These folks spent months climbing a mountain expecting that when they got to the top, they'd see a beautiful valley down below," he said. "And in fact, when they got to the top of the mountain, what they saw were more mountains. And that made it hard for them."