WHAT CITIES and TOWNS SHOULD KNOW DURING the COVID-19 PANDEMIC Joe Thompson, MD, MPH President and CEO, ACHI Professor, UAMS Colleges of Medicine and Public Health

WHAT CITIES AND TOWNS SHOULD KNOW DURING THE COVID-19 PANDEMIC Joe Thompson, MD, MPH President and CEO, ACHI Professor, UAMS Colleges of Medicine and Public Health

04.01.2021 COVID-19 IN THE UNITED STATES

At least 30,400,000 confirmed cases

At least 552,000 reported deaths

Sources: Washington Post and Johns Hopkins University, as of April 1, 2021. COVID-19 IN THE UNITED STATES: DAILY CASES

Source: New York Times, March 31, 2021 (using data from state, county and regional health department reports); www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html JHU COVID-19 DATA: NEW CASES SPREAD (MAR. 30)

Sources: Johns Hopkins Coronavirus Resource Center, March 31, 2021 Miami Spring Break 2021: Joe Raedle/Getty Images DAILY CONFIRMED NEW CASES, 7-DAY MOVING AVG

Source: Johns Hopkins University Coronavirus Research Center, www.coronavirus.jhu.edu/data/new-cases, retrieved March 31, 2021 COVID-19 IN ARKANSAS

As of March 31

Cumulative Cases: 330,398 Total Active Cases: 1,695

Hospitalized: 166 On Ventilators: 27

Daily Active Total Deaths: 5,626 Cases per 1K as of 3/31/21

Source: Arkansas Department of Health COVID-19 POSITIVE TESTS SINCE SEPTEMBER

Source: ACHI analysis of Arkansas Department of Health data.

COVID-19 HOSPITALIZATIONS IN ARK. PER DAY

1400

1300

1200 Total of “currently hospitalized”

1100 each day since Sept. 1, 2020

1000

900

800

700

600

500

400

300

200

100

0 9/1 9/8 9/15 9/22 9/29 10/6 10/13 10/20 10/27 11/3 11/10 11/17 11/24 12/1 12/8 12/15 12/22 12/29 1/5 1/12 1/19 1/26 2/2 2/9 2/16 2/23 3/2 3/9 3/16 3/23 3/30

Source: Arkansas Department of Health COVID-19 HOSPITALIZATIONS & DEATHS BY AGE

6,000 5,327 Cumulative numbers in Arkansas, 5,000 as of March 29, 2021 4,612 4,000 3,861 3,349 3,000 2,336 2,000 1,245 914 1,000 296 468 162 2 5 130 0 0-5 6-18 19-24 25-44 45-64 65-74 75+ Age Group Hospitalizations Deaths

Source: ACHI Analyses of Arkansas Department of Health data. All death data are provisional and subject to change based on further review by the Arkansas Department of Health. NEW REPORTED COVID-19 DEATHS IN AR PER DAY

30 28 27 26 25 25 24 22

20 19 18

15 15 14 14 14 14 14 13 13 12 12 12 12 12 11 10 10 10101010 10 10 10 9 8 7 7 7 7 6 6 6 5 5 5 4 4 3

0 * 3/1 3/2 3/3 3/4 3/5 3/6 3/7 3/8 3/9 2/15 2/16 2/17 2/18 2/19 2/20 2/21 2/22 2/23 2/24 2/25 2/26 2/27 2/28 3/10 3/11 3/12 3/13 3/14 3/15 3/16 3/17 3/18 3/19 3/20 3/21 3/22 3/23 3/24 3/25 3/26 3/27 3/28 3/29 3/30 3/31

* On Feb. 28, the Arkansas Department of Health conducted a data clean-up resulting in 174 deaths being removed due to reclassification or duplication. Source: Arkansas Department of Health

COVID-19 LONG-TERM EFFECTS o Organ damage o Heart o Lung o Brain o Blood Clots o Mood and fatigue issues o Many others still unknown

Source: Mayo Clinic, COVID-19 (coronavirus): Long-term effects. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351

CORONAVIRUS VARIANTS o Variants of concern and where they first emerged: o B.1.1.7 – U.K. o B.1.351 – South Africa o P. 1 – Brazil / B.1.1.248 – Japan (nearly identical) o B.1.427/B.1.429 – U.S. (California) o B.1.526 – U.S. (New York) o Appear to spread more easily o Study of the variant from U.K. suggested significantly higher death rate*

Sources: CDC, Arkansas Department of Health * BMJ 2021;372:n579 (R. Challen, et al. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study); Published March 10, 2021.

NEW YORK TIMES VACCINE TRACKER

Updated March 31, 2021

Source: Coronavirus Vaccine Tracker, New York Times: nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html COVID-19 VACCINATION PROGRESS IN ARKANSAS

As of March 30, all Arkansans age 16 or older are eligible to receive the COVID-19 vaccine

Source: Arkansas Department of Health COVID-19 VACCINATION PROGRESS IN ARKANSAS

STATE FEDERAL PROGRAM PROGRAM As of March 31 Hospitals, state long-term care, and Retail (Walmart) & long-term care others since Dec. 14, 2020. (CVS, Walgreens) since Dec. 28, 2020. Received: Allocated: 1,755,140 280,130 Administered: Administered: 1,010,188 132,704 Percentage: Percentage: 57.6% 47.4%

Source: Arkansas Department of Health, https://www.healthy.arkansas.gov/programs-services/topics/covid-19-vaccination-plan

CDC GUIDANCE FOR FULLY VACCINATED PEOPLE o Fully vaccinated defined as: o 2 weeks after the second dose in a 2-dose series, OR o 2 weeks after a single dose vaccine o Fully vaccinated individuals can gather: o Indoors with other fully vaccinated people w/o masks o Indoors with unvaccinated people from 1 other household w/o masks, unless they or someone they live with is at high risk for severe illness o If exposed to someone with COVID-19, no need to isolate or get tested unless you develop symptoms o However, in group living settings, you should still stay away from others for 14 days and get tested, even with no symptoms

Source: Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html FULLY VACCINATED? WHAT HAS NOT CHANGED o Wear a mask, stay 6 feet apart, and avoid crowds: o In public o At gatherings with unvaccinated people from more than one household o When visiting with unvaccinated people at high risk o Continue to avoid medium- or large-sized gatherings o Delay domestic and international travel o Watch for COVID-19 symptoms, especially if around someone sick o If you develop symptoms, get tested and stay home o Continue to follow guidance at your workplace

Source: Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html

WHAT CAN YOU DO ONCE FULLY VACCINATED?

1) What are you doing? 2) Who will you be with?

o Is it indoors? o Will there be more than 10 people there? o If so, is there good ventilation? Will you be around many Will you be there for more than o o people you don’t know? one hour? o Is everyone vaccinated? o High intensity or involve shouting? o Are they following health guidelines?

Source: New York Times, Opinion: What Can You Do once You’re Vaccinated, Tara Haelle March 30, 2021. nytimes.com/interactive/2021/03/30/opinion/coronavirus-vaccine-risks.html WHAT CAN YOU DO ONCE FULLY VACCINATED?

3) Who is in your circle? 5) What is your health situation?

o Are there kids? o Do you have underlying health risks for COVID-19? o Are any adults in your circle or household not vaccinated? o If you get sick, can you afford to stop working and isolate? o Are any immune-compromised, or not vaccinated and high risk? o Will you have access to sick leave, testing and essential supplies if you get sick? 4) Where do you live or where will you be?

Finally …

How comfortable are you with the risk level in each of those five areas?

Source: New York Times, Opinion: What Can You Do once You’re Vaccinated, Tara Haelle March 30, 2021. nytimes.com/interactive/2021/03/30/opinion/coronavirus-vaccine-risks.html

COVID-19 RESTRICTIONS AND MASK MANDATES IN ALL 50 STATES

Source: New York Times, See Coronavirus Restrictions and Mask Mandates for All 50 States, March 31, 2021. nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html AR COVID-19 DIRECTIVES CHANGED TO GUIDANCE o Face coverings o Business and restaurant operations o Casinos, bar and club operations o Barber shops, cosmetology, spas, etc. o Gyms and Fitness Centers o Large indoor or outdoor venues o Elective medical procedures  Cities free to institute individual mask mandates

Source: Arkansas Department of Health, as of April 1, 2021 ACHI HEALTH POLICY BOARD CALL TO ACTION

The board calls on leaders across the state ― business owners, school board members, faith leaders & local elected officials ― to adopt strategies that maintain Arkansas Department of Health and CDC guidelines to help prevent the spread of COVID-19.

Specifically, termination of the state mask mandate should be replaced by local decisions to continue important efforts to minimize the spread of this disease, including mask mandates.

ACHI Health Policy Board Call to Action, April 1, 2021. ACHI HEALTH POLICY BOARD CALL TO ACTION o For businesses, faith-based organizations, and educational institutions:

o Continue to require masks (over nose and mouth) to protect patrons and employees

o Maintain signage and other reminders to ensure appropriate distancing o Keep spaces ventilated o Encourage employees to get vaccinated

ACHI Health Policy Board Call to Action, April 1, 2021. ACHI HEALTH POLICY BOARD CALL TO ACTION o For individuals: o Get vaccinated, and encourage others to do the same

o Wear a mask in public

o Wash your hands often with soap and water

o Maintain appropriate distance from others

o Avoid crowds

ACHI Health Policy Board Call to Action, April 1, 2021. 2021 COVID-19 STRATEGY

Action

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