Good afternoon, everyone. Thank you for joining me for our weekly COVID-19 update. I'm pleased to be joined today by Dr. Dillaha State epidemiologist from the Department of Health Dr. Jerrilyn Jones from the Department of Health. We have Troy Wells, CEO of Baptist Health Systems, who's also on our Winter COVID-19 Task Force. Then we have Dr. Ivy Pfeffer of the Department of Education. So we have some important items to cover today. And first, we just finished Thanksgiving. And even though it's over, I still want to express thanks for a couple of things today. First of all, I want to thank everyone in Arkansas who has cooperated and had a different kind of thanksgiving with a smaller gathering, really being careful to follow the health guidelines and to minimize the spread during the holiday season. We'll find out what our report card says a couple of weeks from now. But I know that so many worked hard to make sure that everyone was safe during the Thanksgiving holiday. Sadly, I really am thankful for our health care workers across Arkansas, we are entering our 10th month of this pandemic. And they started out under stress. And they've continued to under stress for this long period of time. And as we see our hospitalizations go up, I recognize what our hospital workers are doing to save lives, and to be diligent, and we're grateful for them. I'm also grateful today for the work that's being done on our vaccines. And I want everyone to know that while the pharmaceutical companies, the FDA, will be reviewing the vaccine protocols and making a decision on that. In the meantime, we're working hard in Arkansas, in terms of being ready for the vaccine distribution whenever it gets here. We're grateful to have Dr. Jose Romero, chairman of one of the key committees that he's meeting today with in terms of vaccine approval process. But in the end, we will make decisions here in Arkansas on a limited supply of the vaccine and how we prioritize that. And it's important for everyone to understand that when those vaccines come to Arkansas, that there will not be enough to cover even the top priority of category, which is the health care workers and those in the nursing home setting. And so it's going to be some time, we don't know that timeframe. But it'll be some time before we actually get the vaccine that's available for the general public. It is important that we build confidence in this and the FDA needs to build confidence as they go through this review process. I have talked to the HHS and Washington secretary, a czar, the FDA going through the processes as well as with those that are getting ready for the distribution. And even though they're waiting for the authorization, we know that it's being preposition so that once it is approved, we should have it in Arkansas within 24 hours. And so we're working to be ready for that. And then finally, I want to express my thanks to the winner COVID-19 task force that is really concentrated its efforts on the hospitalizations and how we can manage the hospital hospitalizations as a result of COVID in a more efficient manner and to maximize our space in the hospitals and be ready for the unknown future. And so the COVID taskforce is really focusing on that from a resource standpoint, and I appreciate their work. One of the things that they recommended very early on, they identified the challenge of non COVID patients moving out of the hospitals, that frees up space for everyone else. There had been a delay in the approval process. And so whether it's from an insurance company or from Medicare Advantage programs, I've issued a letter to you today that I've signed that I've sent to Secretary a czar, asking for them to expedite the waivers with the private carriers for Medicare Advantage so that we can move people out of the hospital when they're okay by their doctor to move out of the hospital setting to have that approval in a quicker fashion and not have to wait sometimes two or three days for that approval. We are working hard on that aspect of it. And before I have Troy Wells come, I want to show the first slide that really illustrates the need for coordination. These are the percent of occupied ICU beds in Arkansas that are used by COVID patients. Of course, ICU beds are regularly filled up with non COVID patients as well as the new need for COVID patients. This is by hospital region, as you can see statewide 37% of our ICU beds are used by COVID-19 patients. But if you look at the Southwest hospital region 57% are occupied by covid patients. And it varies by region. And so you can see, just in this one illustration how necessary it is to coordinate the placement of someone in a hospital, that they have adequate space for it. And so that sets the stage, I want to ask Troy wells, who's led the committee that looked at these hospital resources to comment on one of the ideas that was presented.
Thank you, Governor. Good afternoon, everyone. As I've said before, one of our most precious resources from a healthcare perspective is our ICU staff and our ICU beds. So we have worked really hard at trying to identify some solutions as to how we can make sure our Kansans don't go without care that they need, when they need it. And to do that at a statewide level, let me just briefly explain to you the challenge that we're trying to deal with on a given day, a patient may show up in an emergency department somewhere in our state, and the hospital that receives that patient can't provide the care that that patient needs. And so they have to begin this process of finding a location finding a hospital that can provide the level of care that specific patient needs. And that usually involves a lot of phone calls, you call one facility, they don't have room to call another one. And it's really a guessing game as to who may have the ability to care for a particular patient. So let me stop there and then talk about a resource that we have in the state that used for another purpose, we have something that's called trauma calm. And that was established with the trauma system several years ago in Arkansas. And you can think about it like demand matching, you have rules about certain types of trauma that's received in a hospital around the state. And it matches up with rules about which hospitals can care for those trauma patients across the state. And there's a facilitation process in between two hospitals that helps decide and facilitate that transfer to the appropriate place. So we started to explore how this system could be adapted and use for COVID-19 patients and transfers. So let me just explain basically how this works. The transferring facility that would be an EDI, perhaps somewhere in the state determines the status of a COVID-19 patient and what that patient needs, we would have to use a common, we call it a patient stratification tool. It's a common way of classifying these COVID-19 patients. And all the hospitals as well would be categorized based on the capabilities and resources that they have available to take care of patients. So you think about some of the higher level ICU facilities around the state and others that may not have ICU capacity at all, we have four different levels or categories of hospitals, we would then update the availability of those beds and resources periodically during the day, and really provide a view from hospitals perspective on where that capacity exists on an hour to hour a day to day basis, so that they would know which facilities are most likely able to care for those patients, then this trauma comm system, if you will, would then help facilitate COVID-19 patients to the most appropriate location just like we do with trauma patients today. So a patient today may be able to be cared for in a facility that's not in one the metropolitan areas, for example. And instead of just going immediately to Little Rock or Northwest Arkansas or jonesborough for care, there may be another community that could accommodate that patient. So we're really trying to match up patient needs with facility resources in real time, and provide a way to facilitate those transfers throughout the state. Now, let me just briefly talk about some of the benefits, it obviously cuts down on time and, and the number of phone calls required to move a patient to the right place, it better identifies in a standardized way what a particular patient may need, and then helps to prevent certain hospitals from being overwhelmed with patients from around the state that might be able to be cared for elsewhere. So we're really trying to maximize the use of those scarce resources, ICU beds in particular, and look at the whole state and take care of all of our patients in Arkansas. So I want to thank the subcommittee members for helping to work on this particularly Dr. Jones is here with us today is really done all the legwork, and this is a recommendation from the subcommittee to Governor Hutchinson. Thank you.
Thank you, Troy and I joined in thanking Dr. Jones, who will have the lead responsibility and implementing this change to our Trauma Com system and She's looked at it from a cost standpoint, as well as Stephanie Williams, the Chief of Staff of the Department of Health. And it's estimated that this will add about $70,000 in cost every month, because we're going to have to hire personnel, it takes some expertise, we estimate that it'll take two weeks to get this system in place. If we find the right personnel quickly for that Dr. Jones will have the lead and getting this done. And we look forward to being able to utilize this tool for the benefit of our hospitals, and the management of the COVID-19 patients. So Troy, thank you for the excellent presentation and the recommendation, we accept that recommendation, we will work to get that implemented. Now, let's go to the case statistics for today. If you'll go there, we're going to go through this fairly quickly. But I wanted to report that in the last 24 hours, we've had an additional 1950 cases, obviously, this is higher than yesterday, it is less than it was a week ago, the same time. But with the holidays, everything is a little bit out of kilter. And so we can't read too much into the fact that it is less than it was one week ago. If you look at our confirmed deaths, excuse me, the total additional deaths are 10 over the last 24 hours, which is a sad note after the Thanksgiving holidays, we have 11 additional hospitalized two which is down but it's still an increase. That gives us a total of 1074 that's been hospitalized, six fewer on ventilators. And you can see the top counties there, which is fairly consistent with what we've seen in our top counties before. If you look at our testing, we had very high antigen testing that came back into play on Monday. And so we had 4365 antigen tests, which is one of the reasons we had higher numbers, our PCR test is 5261, which is lower than what we like to see it and I think in the coming days, you're going to see more PCR tests coming in, which probably indicates that you'll there'll be an increase in some of the numbers that we see in our positive cases. With that, let's look at it from a different fashion, which is the graphs. And the first one, you can see it from a comparative standpoint. The orange, of course, is our new confirmed cases, the probable cases on the antigens in the white. And you can see the balance that's there. And again, higher than yesterday, a little bit less than a week ago. The next one, you can see the trend line. And again, even though it's pointed in the right direction, I'm going to discount that because of the holidays skewing things. And so we'll wait and see how that develops. Next is, again, this is week by week comparison. And if you actually look at the last week, we had fewer than we had two weeks ago and fewer than last week. That's good news. But here again, I think I'm not gonna put a whole lot of emphasis on it because of the holiday season. And I think the next two weeks are going to be more telling than even the last week. This is the currently number hospitalized 1074. We've mentioned that which is a new all time high. This breaks it down by region in terms of the seven day rolling average of new confirmed and probable cases in Arkansas. And I do like whenever I see those trend lines going down from the northwest, down to really each of them. But let's wait and see as we get more information in the coming days when our PCR tests get back up to normal. And we get some of the results from our Thanksgiving weekend. That will be our grade. And we'll see how we do.
This is the growth rate by region. I just like to show once a week that Central Arkansas and Southeast Arkansas is growing at 7.5% in cases we Northwest dropped down to 6.6% in new cases from November 28 to November 28. Next we'll see the seven day rolling average of percent positive cases in Arkansas. And these are PCR tests. And this is more significant that you see what is it man it's about 10 days ago that we reach this peak About 11% in PCR test positivity that has dropped, I think that is a real drop in that positivity rate, even the last few days might increase a little bit. But we're teetering on the 10%. Hopefully, we can stay below that. The next one you'll this is, you know, the last day of the month for November. And so let's look at how we did in our testing 333,000 PCR tests during the month of November 333,000 is over 10% of the entire population of Arkansas tested in one month. And I recognize there could be some duplicates, that somebody might be tested twice. But we're actually going to try to narrow that down, but you have a margin of 33,000, you still are testing 10% of our population in one month. The next one, you'll see the antigen test, that we're so far exceeding the goals people utilizing it, it appears to be continued improvements in its accuracy. So it's much more reliable 59,000 antigen test in the month of November. And here is the cumulative total of percent positive PCR test. That's August to the present, which is very similar what I showed a moment ago. So let's go the next one. And I think that concludes that. So with that, let me shift to education. And it appears to me from the National commentary that there is a growing national recognition that our schools are important to stay open. And you see New York City, they've been as tight and restrictive as any state. And yet, they've opened up the schools in New York City again, you hear Dr. Fauci articulating the importance of schools. And so I'm, I'm pleased that were the hard work of our teachers and making sure our students schools can stay open. And sure, we have to switch to virtual from time to time. But school staying open is increasingly important for the education and well being of our students. And so the teachers are critical to this effort, we've had to rely upon subs, substitute teachers, we've had to rely upon additional staff, sometimes schools have had to close because of a shortage of staff and teachers. And so just as we did with the nurses, I'm pleased to say that the State Department of Education will be asking the Board of Education to waive the application fee of $75. And to expedite the applications of a new round of teachers that will be coming out of school this next semester. And hopefully, we'll be able to get them into the classroom and available for our schools in a much quicker fashion by and also with some assistance and incentive by waiving that application fee of $75. This is similar to what we did with the nurses. Someone raised a question well, many of the nurses that we covered it already applied for their application and paid their fee. I want to say that we will be refunding that application fee for those 800 nurses that had already paid that. So that will be fulfilling that commitment and expediting those nurses to get out there. But it's important to have the teachers available as well. With that, I'd like to have Dr. Ivy Pfeffer to explain that more fully.
Thank you, Governor. We do have 29 active modifications right now in our schools. So we have had 29 different instances where schools have had to modify some type of weather or grade level buildings or their district to remote learning. And that is down from previous weeks and 10 of those started this week. But every time we look at these modifications, more often than not, it is staffing issues to do to quarantines that are the main driver when districts have to pivot to remote learning. And because of that, as the governor stated we are going to be seeking approval from the State Board of Education to waive the $75 license application fee. This will be for first time licensees in Arkansas. These licenses would be issued to those who are completing program of studies so often times new teachers, it could also be a teacher coming into the state. Through reciprocity, the teachers will still have to have their background checks. And they will still have to complete the central registry child maltreatment. So those things will stay in place. But this will allow us to be able to expedite the paperwork for these teachers to go ahead and get their licenses. In some cases, there may be vacancies that they can fill it the semester. In other cases, they may take on the role of substitute teachers. But when we look at the similar period over last year, so we'll ask the waiver to be from December 1 through April 1 of next year. If you look at that same time period last year, we had about 500 new licensees at that time. So this really is a significant opportunity for us to be able to more quickly get new teachers able to be in the classroom able to be employed and able to provide a little bit of relief to our schools who might need that additional personnel. We also so for information where we've got the contact information there for our Office of educator licensure, new teachers will be referred for licensure from their ad prep program. reciprocity, candidates can contact us for the paperwork. And that way we can be sure to follow through on expediting the, all the necessary information. We also want to just take a minute to give you our first step date from our engaged Arkansas campaign. If you remember, a couple of months ago, we began this strategy in partnership with our education renewal zones and with graduation Alliance. And the strategy is really focused on two things. Number one, being able to find students who maybe did not return to school this fall, but also helping us to engage or re engage students who, because they're at heart at home learning remotely, may not be as engaged as they had been in the past. So we currently have 110 districts who have opted in to engage Arkansas. And currently student outreach and support is underway for almost 5000 students in efforts to reengage them in their district's current instruction and learning environment. 74% of the students have agreed to act to receive academic coaching. And that is taking place. And the early data is showing that families really do have a willingness to partner to take advantage of any opportunity to get their students some extra support. Most are reporting that their students are struggling, especially in reading and math. And so what we want to do is continue to work with graduation Alliance to really unpack all of the details around that, to then supply the information back to the school so that they can understand what's going on with their students who are learning remotely. So all of these things work together, in supportive as students trying to keep everyone at school for the maximum amount of time as safe as possible. Thank you.
Thank you, Dr. Pfeffer. And with that, we'll turn it over to questions and have Dr. Dillaha here and Dr. Jones and Troy and I'll defer questions they may as needed. But with that we'll start with the questions.
You mentioned, the supply of vaccine is not going to be enough to cover the high priority group entirely traditionally, how are they going to be prioritized within that group?
We're still working on that. And we're also we're actually going to give another assignment to our Winter COVID Task Force. We got some really key people in the healthcare industry there and we want to get their insights on this as well. I had a conversation with Dr. Romero about this today. And while you know right now, maybe our allocation is 25,000 vaccines well, and just we might have over 60,000 Hospital and health care workers. And, and so you can see some decisions had to be made. Now that number of 25,000. I expect that very well could change in the coming weeks. We're they're still trying to figure some of this out. The first one is going to be the Pfizer there's going to be some that's going to prefer majorna if that's approved because it's easier to store. So some of that is going to be information that we still have to gather before we can make those final decisions. Those are state decisions as to how the vaccines are allocated within our state. We want to wait and get the guidance from our CDC Advisory Committee. And then we'll make decisions from there.
It's alarming to see the numbers of the percentages, at least in their in southwest Arkansas, I guess what's the difference in the hospitalization just set up in that region than maybe some of the other regions in the state.
Dr. Jones, do you want to take that on?
So there is a difference in the raw numbers of hospital or ICU beds in the different regions, obviously, our bigger metropolitan areas have bigger hospitals and less they have bigger ICU with more beds, and so the percentage would be smaller there. Another thing that I like to mention is that, um, I see us are not all created equal. And what is put into an ICU say, in a smaller rural hospital might be something that's applicable to be managed on the floor and some of our larger hospitals. And so that number is probably due in large part because of the raw numbers, but it can also be due because due to the type of patient that's being put there,
What kind of additional strain does that sort of put on more rural areas of the state?
So obviously, if they're, there's, if they're putting things that can be taken care of, on the floor, and other places in their ICU that could comment or be a marker of perhaps the comfort level of physicians that are taking care of patients in the hospital. And so that would be something we would definitely look at in terms of needing to decompress, or how we would how we would factor that in in terms of whether or not patients need to be moved. But I want to emphasize that the primary responsibility is our goal is for the patient that presents to hospital a wherever hospital a is that they are taking care of at that facility. So if it is humanly possible for them to take care of that patient, that's what we want to do. That's gonna save resources, that's going to save a lot of things.
In terms of resources, you know, staffing, how does that kind of stretch the staff a little thinner, especially down there in that southwest region?
So you know, the hospitals that are down there, and their CEOs and their leadership are looking at that very carefully. And obviously, they're already making ratio adjustments or things like that, that they need to do in order to try to kind of preserve the sanity of their staff for nothing else, but to make sure patients are still cared for in a safe manner. So that a lot of that decision making is made at local hospital level because they are going to have the best knowledge of what their providers can do.
Any other questions
About the trauma system, I was wondering since it seems like patients can... their condition contained rapidly with coronavirus. Is there any danger that somebody could be in a kind of lower level facility and then all of a sudden at the higher level of care?
Well, the important part of that is the evaluation by Trauma Com whenever they make the initial assignment. And that's why you need to have the right level of expertise for it. But should you add anything to that doctor?
So unlike trauma that has multiple years of experience in terms of knowing what different injury patterns required, what level of care hospitals, this is something that we're still kind of working out with COVID. Obviously, this has been around for less than a year in terms of dealing with the fallout of the disease. And so what we've done is that there are different scoring models, clinical scoring models that we would put into a protocol to use to kind of try and predict what type of care the patient would need. And again, that is why the clinical piece of being able to consult with an expert goes into how these patients are moved with trauma as opposed to with trauma calm now, what happens because we have all of those years of experience and all of those that knowledge and research on different injury patterns, trauma calm and the medics that answer the phone there can essentially determine what level hospital is needed based on injury patterns based on what the American College of Surgeons has said for the committee on trauma. All of these things have kind of been put in place for trauma because we don't have that with COVID that is Where the clinical piece comes in. And that consultation comes in and we discuss with the sending provider kind of different clinical markers such as respiratory rate, what are the sets, you know, and things like that. And there are a few scoring systems that are been put out there and been internally validated. Again, the data is still evolving. I will say that, but recently published in the annals of emergency medicine, one that basically looks at that and looks at looks at different clinical markers as a predictive tool as to who would decompensate in 24 hours. Again, that is something like emergency physicians look at for that initial triage, it doesn't speak to what happens on the floor. And obviously, you're not going to be able to predict all of that, I guess, is what I'm trying to say. So we're doing the best we can with the clinical markers and the things that have been put out there. And that's what we'll use in terms of making those decisions, those initial transfer decisions. For me,
The ambulance personnel and whoever brings transfers these patients through the via the Trauma Com. Do they have enough of the higher level PP that they will need to transfer no covid patients?
Yes, ma'am. I have not heard that there has been a problem with PP necessary PP in terms of N95, and things like that for EMS personnel. That has not been brought to my awareness. My understand is that they do. They have now wheat since COVID began, we ensured that they had those kinds of things.
Let's go remotely here. Is there any questions? Yeah.
Governor this is Andrew with AP. Had a couple of questions for you. At the outset, you talked about kind of the report card you're going to be watching for to see how things went over Thanksgiving. Want to see if you can kind of elaborate on how are you measuring the effectiveness of the restrictions you have in place including the earlier the earlier closing time for bars and restaurants, and whether, whether additional steps would need to be taken if they're kind of what's one of the factors you're going to be looking at to determine if there need to be other steps. And later on down the road, also was wondering, do you envision the state's restrictions being lifted, lifted? Once... Once the vaccine is widely available to the general public? It kind of is that the marker for that?
Well, first of all, I'd love to have the restrictions lifted as soon as possible. I recognize that they're burdensome, recognize that people don't like to have mask mandate that's in place. And so we want to lift these just as soon as we can you ask on the first part of the question as to what what triggers additional action in the future? Well, I've I've asked the, the COVID-19, winner task force to answer that question as well. And it's a hard one, in terms of what triggers the need for additional hospital space, or what triggers at what level are we push where we have to do more in terms of, of restrictions or other actions. And so that's something that's a continued evaluation point. You know, from my standpoint, hospitalizations and our capacity to manage the health care of our citizens citizens, both in terms of routine illnesses and COVID is a critical factor. And that's one of the things that we'll continue to look at. I as governor, I always wish I had better data. I wish I knew exactly the source of every positive case. So I could say, here it is, there's a problem, we can address it there. But the data is not that good. It's much of it is human data. You know, we have good some good information as to where they've been in the last 48 hours. But it's not always clear as to where that case came from. And so those are hard judgments to make. And that's why I've always said let's don't put economic restrictions on people and and restrict their ability to make a living unless we have good data and understand the consequences of it. Next question.
Govenror,tThis is David Ramsey with the Arkansas nonprofit News Network. You've spoken about how adept hospitals are and making adjustments in terms of ICU capacity. But specifically in terms of staff resources, are we reaching a hard limit just in terms of having the critical care staff necessary to treat everyone in ICU? And in response to those challenges, and I think Dr. Jones began to speak to this. Our hospitals in the state are beginning to change staffing ratios. How, how widespread is that, for example, you know, an ICU nurse seeing three patients instead of two? Is that something that we're gonna see more of? And I guess, is that a concern in terms of what that means for for outcomes?
It's a very good question, David, I've asked Troy Wells, if he would take that on.
I'm not aware of anywhere in the state where there have been modifications to staffing ratios. With or without COVID. They're always days where somebody doesn't show up to work, or you're short staffed and ratios get thrown off a little bit. And so that does I mean, there's gonna be a day when that happens. And there are places where that happens from time to time. But as far as making a formal and permanent adjustment to staffing ratios, I've not heard of that happening. I think, to answer the other part of the question, in terms of flexibility and what hospitals are doing. You know, I mentioned here a week or so ago that we were expanding our ICU capacity in January, we had to begin planning for staffing back when we began construction. So back in the summer, we started lining up more contract help to come in at that January timeframe, when we knew we were going to need to expand and open more beds. So I'm hopeful that as people have started look at their surge plans, and their expansion plans that they're making a staffing plan for that as well. And it may well mean that a nurse who's used to working in this area has to be retrained to work in this area. And we stopped doing less of this so that we can accommodate more of that. So we have to have a lot of flexibility. And we've got to work hard at training and identifying people that can be flexible.
And just to be clear, is that something you see in the coming weeks in terms of a change to staffing ratio starting to happen at at hospitals?
Well, we obviously don't want to ever do that. But there may be times in the future where that's where that's necessary to care for patients. And so it's important that we supportive nurses. And remember, there's other things we can do to then just add more nurses, we can bring in people to help a nurse expand her ability to care for more patients. So we've got a lot of different ways that we can help expand care and take care of more patients.
Next question.
Governor, this is Alex with CHANNEL SEVEN. Seeing that we've known that hospital capacity could be an issue since last spring, why are we just now getting this trauma system put in place? And my second question is, how do you plan on reimbursing the nursing licensure fees?
How do we reimburse that nursing licensing fee? Alex?
Yeah. Howare you planning on reversing that?
Well, those who have paid the fee will be refunded the amount that they paid. And so the nursing board will know who's paid the fee. And of course, it's it's a timeframe, it's for this, this window of applicants, and they will be refunded it. So it's a process that they'll be working on. If you want additional information, we can get our nursing board to speak to you on it, as well as Stephanie here. Did you have anything else to add? Stephanie? All right. And then the first part of the question was, why didn't we start the trauma con issue sooner? The answer is I didn't have my winter covid taskforce that made that recommendation. And probably the answer is that they were managing it without that necessity very well. And what we saw were regional partnerships. And so within the regions, they were managing it, and that was sufficient. But as we continue to get more cases and more hospitalizations, we recognize the need for a statewide management system. So it's part of the knowledge base that you gain whenever you go through a pandemic and the experience that you have with our hospitals.
Hey, Governor, this is Josh White with KAIT. You had mentioned that New York was reopening schools and I wanted to make sure that we pointed out that is that middle school and high school students are not going back. Um, is that a is that something that you will look at here or that we should look out here? I know that the dem Gazette showed that 400 less public schools cases dropped last week because of Thanksgiving break. So it's almost as if we've seen this somewhat work any any Any idea to look to do that over the next three weeks before we hit Christmas break?
First of all, Thanks for pointing out that distinction. You're right. And so I made note of your comment there, in terms of New York schools, in terms of how it's working in Arkansas, you know, I'm glad that we have the option of going virtual, if the cases or the staffing is not sufficient. And so that system has worked well, in terms of flexibility. I'm glad that they're able to go back into in classroom instruction, whenever the circumstances allow it. And in by and large, the vast majority continue to have that ability for in classroom instruction. So hopefully, we can stick with that I think the most important thing is what is best for the children. And that is what there is a growing recognition nationally, and here in the state of Arkansas as to the consequences for children the adverse consequences for children, when they don't have access to the classroom instruction. And the and so we recognize the importance of it grateful for the teachers and what they're doing. And and much of the recognition comes from the experience of the teachers. But we all will continue to have that virtual option, as needed. Dr. Pfeffer Did you have anything to add to that?
And just a couple of things to add, when we look at the importance of in person learning, and there are some cases where states are prioritizing younger students, students with disabilities to be on site. And in some ways, it's a little bit easier for older students to manage a virtual schedule. However, anytime students are remote learners for long periods of time, there are some great challenges that exists. And over the next few weeks, we'll go deeper into the engaging Arkansas data. But some of the things I think that we really need to focus on and point out is right now our 12th grade students are the most at risk, according to this data, for dropping out and for not re engaging. And that's concerning to all of us. And these students have obligations outside of high school, they also are taking care of their siblings and younger children in the household oftentimes. So when we close off the option for them to be in person learning, we are putting them at greater risks. We also need to acknowledge the fact that we still have districts that do not have sufficient technology for every student to be a remote learner. I got a message from a superintendent the other day in a very small school district still waiting on 280 Chromebooks. And I think they're in a school with, you know, just less than 500 students. So when you think about those statistics, and you think about how that would eliminate learning options for those students, we need to do what we can do in order to keep students engaged in learning and at school to the extent possible, and provide parents with options. If students do need to be at home.
Governor, hi it's Neal Glader at KZNG and hot springs, just a clarification on the vaccines, please. And I recognize it may be a moving target. But the you mentioned the 25,000 initial doses. He said the two dose regimen mean that's enough to care for 12,500 health care or other top priority workers. And then the follow up is to have you had an indication of when the next shipment will be?
No, that's still preliminary. They in part of it, it depends upon what's the production like between now and the time you get the emergency use authorization. So I think the final amount of our allocation is still yet to be determined. It is to be noted that our allocation early on was higher. And it's actually been reduced some but I'm hopeful that it will come up, come back up. And and we got to remember that you're going to have two different types of vaccines at least presuming that they do get the FDA approval. Dr. delahaye did you have anything to add to that?
So it's important to know that the hypothetical 25,000 doses that we get, we can all use, we don't have to set any aside for the second dose regimen. Those doses are being set aside at the federal level and will be shipped at the appropriate interval. So any doses that we receive, we will want to be used right away to get as many people vaccinated as soon as possible.
Thank you, Dr. Dillaha. Next question.
This is Zuzanna with Ozarks at Large on KUAF. I have a question regarding an article that was published in Bloomberg last week, it showed a map based on some Census Bureau data and a survey, it showed that 50% of adults living in households are not current on their rent or mortgage in Arkansas, and they will likely face eviction. And just wondering if you're having any conversations about that on the state level? And if so, what are those conversations besides the Fresh Start Program, which will not be enough to help nearly everybody who needs financial assistance, especially as the CDC moratorium runs out in about four weeks?
We are having conversations and we have put our freshstart funds in place. I had the first conversation about how those been allocated distributed. What's the demand for those? What's the balance that's remaining? And And then secondly, we're waiting on the Congress to determine what's the next round of relief, there should be a stimulus package, I hope they can reach agreement on that. And I'm sure that part of that will be looking at the issue of rental assistance. I've always believed that the most important thing is the rental assistance. Because otherwise, the debt doesn't go away. And it just puts the renter further and further behind. And it just puts off the inevitable action by the landlord. And so the assistance is the most important thing. That's what we've emphasized in Arkansas. And we'll continue to look at that.
But odds are that unless there's a something from Congress, there's really not many options.
Beyond Congress? There's limited state funds that are available for that we've used up most of our cares Act funding. There's there's always a potential that additional general revenue could be put into that. But that's something that would probably have to be addressed down the road and legislative session.
This is Susan at K Rk. We recently ran a story where ADH employees acknowledge that COVID-19 cases specifically test results are being missed by the state and they couldn't give exact numbers saying it could be hundreds, it could be thousands. Is this something that you're aware of? And is there anything being done to shore up those holes? And then also off of that the fax machine reporting was brought to question Is that something that's being looked at at the state as well?
Dr. Cima, I'm going to ask him to respond to that he's with the Department of Health, does a great job on our statistics. And while he's coming, what was the last part of the question?
Um, the part about fax machines being how the majority of COVID test results are blocked by the state?
Well, let me answer that, first that I saw some critical story about the Department of Health that they're still using fax machines. The challenge is not within the Department of Health, the challenge is in some of our provider, some of the reports that come in from labs, or from other clinicians that, fax it in. And so we have to have that capacity. we're responding to what is out there and the waves, some people still communicate, we would like everyone to go electronic. We certainly push for that. And that would be helpful to us.
Thank you, Governor, thank you for that question. So let me clarify about the missing the missed cases. Really what is happening is that there is a delay in which we get those reports oftentimes from commercial labs, we noted this months ago in July, when we have a large number of cases as well as, as recently that sometimes that there are cases that for one reason or another, there is a certain lag between the time that a specimen is collected from the time that it is reported to us. Unfortunately, there is not much that we can do on the department side if it's taking seven days, 14 days, 21 days for a clinical lab to submit results to us. So I just want to clarify that part about missing results. Also about fax machines, as the governor noted, you know, we still use fax machine. Every health department in this country uses fax machines. Actually, there was a New York Times article a couple months ago that really highlights The importance of moving to electronic reporting, especially for infectious diseases like COVID-19. So we recognize that there are issues related to fax machines. We're working diligently to move as many providers as we possibly can to some form of electronic reporting. We have been extremely successful in doing that for many of our our providers.
Thank you.
Governor, it's Brent rains with 4029 News. Maybe I'll be the last one. Quickly. Do you have any idea as far as the number of new teachers, that could be you have any numbers that we could be talking about the fees can be waived?
And based on the number that and license, and for the first time, a year ago, it was about 400 new teachers and around 100 by reciprocity, so you know, potentially 500 and teachers if the pattern holds similar to last year, and we would love for it to be more. But that's our estimate at this time.
The last question, we'll come back to the table.
The trauma deal is gonna be an extra 70,000 per month.
Yes.
What's the funding stream?
Well, that the first initial months can be absorbed within the Department of Health budget. As we prove it successful, we might have to add additional funding to it. But right now, it's manageable within the budget.
Is this something that is going to be a more long-term thing, I mean, obviously, when you know, vaccines get here, there may not be as much of a need, but will there still be a use for it beyond COVID?
We'll wait and see what the application is. Obviously, its mission is primarily trauma, traditional trauma patients. So that mission will continue as to whether we learned from this that there might be some other benefit. We'll wait and see. Leslie.
...people to receive the vaccine includes you as governor, will you be taking one of those vaccines that are coming in? Are you going to wait?
Well, it is very important that the public understand that I have confidence in the vaccine, and the FDA approval process. And whenever it's my turn and allocation, and I would certainly be willing and interested in taking the vaccine. In terms of priorities, the priority would be health care workers. The priority would be those in the nursing homes, and I certainly want those to be taken care of first. Thank you all very much.