PUBLIC HEALTH HEARING: Dr. Jennifer Dillaha (left) testified.

COVID-19 patients who are younger and sicker than those hospitalized during the winter surge are on the verge of maxing out Arkansas hospitals, right as students prepare to go back to school.

That was the message doctors and hospital administrators gave lawmakers at the Public Health, Welfare and Labor Joint Committee Monday. The meeting came as Arkansas lawmakers prepare to reconvene in Little Rock Wednesday to consider allowing school boards to require students and staff to mask up.

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It’s a no-brainer for state epidemiologist Dr. Jennifer Dillaha, who told lawmakers we need to require masks in schools if we want to get children back to the classroom and keep them healthy. 

The delta variant of the virus, which accounts for 86% of Arkansas’s COVID infections, affects young people far more often than the alpha variant the state grappled with this past winter, Dillaha said. On Monday, 18.6% of COVID-19 cases in the state were in people 18 and under, and 11.2% were in children under 12 who aren’t yet eligible for the vaccine. Arkansas saw more children hospitalized for COVID-19 in July than it had at any point in the pandemic, significantly higher than back-to-school time last summer.

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Arkansas Children’s Hospital President and CEO Marcy Doderer told lawmakers that her patients are sicker now than the COVID patients they saw earlier in the pandemic, and while some have other health challenges, some of them were quite healthy before being hospitalized for COVID.

Monday’s numbers were bleak for Arkansans of all ages, with 81 more people in the hospital. The number of deaths, 42, was a record.

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As usual, Rep. Mary Bentley (R-Perryville) piped up throughout the meeting with wacky recommendations and conspiracy theories plucked from the misinformation vortex in which we all seem to be spinning. Rather than pushing vaccines, which she pointed out have only emergency authorization so far, Bentley said we should be treating COVID-19 patients with livestock dewormer and malaria medicine (neither of which has any FDA approval as a COVID treatment, emergency or otherwise).

A former nurse, Bentley also said children’s masks are contaminated with feces and urine, and that children who wear them can be stunted from lack of oxygen and too much carbon dioxide.

“It seems to me it would be more effective to eat healthy, get exercise and distance,  not try to put a mask on a little child who needs oxygen to grow,” Bentley said.

Dillaha didn’t address the filth issue, but pooh-poohed concerns about masked children’s oxygen intake, which she said is fine.

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Bentley was not the only anti-vaxer and anti-masker at the meeting, but her squad met plenty of resistance from other lawmakers who seemed more willing to heed experts’ advice. Sen. Cecile Bledsoe (R-Rogers) and Rep. Deborah Ferguson (D-West Memphis), for example, repeatedly teed Dillaha and hospital administrators up with questions clearly meant to showcase the benefits of vaccines and masks to a state full of people still reluctant to adopt such measures.

How many patients at Baptist Health for COVID are unvaccinated, Ferguson asked Baptist Health Senior Vice President Greg Crain. The answer is 85%

“It seems pretty clear to me the answer is to go get vaccinated,” Ferguson said.

“Would you please talk to us about the masks and whether they are effective?” Bledsoe asked Dillaha. “We’re having such a debate about that I thought you might add something that would convince us one way or the other.”

Dillaha cited studies from the U.K. and North Carolina that showed masks help reduce transmission a lot, including in schools. And that’s all the more important going into a new school year with the more infectious delta variant making the rounds, Dillaha said.

With the alpha strain of COVID, every person infected who wasn’t vaccinated or masked would infect an average two to three more people. With the delta variant, under those same conditions, an infected person will infect an average of eight new people.

Rep. Joe Cloud (R-Russellville) asked what kind of masks would be best. Masks comprising multiple layers of densely woven fabric can be nearly as effective as N95 medical-grade masks at blocking the droplets and particles that cause infection, protecting both the wearer of the masks and people around them, Dillaha said.

Is all this talk about masks as a preventive measure possibly misdirected when we should be focused on vaccines instead, Sen. Kim Hammer (R-Benton) asked.

Masks are more important now than they were when the alpha variant was predominant because even some vaccinated people are seeing breakthrough delta variants, Dillaha explained.

Even if students have to wear masks in schools, they may be going home to family members who don’t bother with such measures. Would a mask mandate in schools be just a drop in the bucket in the fight against COVID? Rep. John Payton (R-Wilburn) asked.

Vaccinations, masks and good hand hygiene will give us our best shot at keeping Arkansas students in school, which is where so many of them need to be for good mental health, Dillaha said. And while there was lots of confusion and different approaches to masking and school sports last year, Dillaha said students should mask up for games and practices, too.

Hammer further challenged the medical community’s advice, saying he believed messaging from the Centers for Disease Control and Prevention is being driven more by politics than by science, as evidenced by the number of times their recommendations have changed over the course of the pandemic.

“Who do we believe?” Hammer said.

Dillaha said she admired the CDC’s ability to be flexible and adjust their recommendations as the situation changes and new data becomes available.

Sen. Joyce Elliott (D-Little Rock) likened the CDC’s guidelines to a changing weather forecast, saying she was grateful they updated information as conditions changed.

Nurses are leaving the profession from burnout, or are finding higher paying opportunities elsewhere, and only about 3% of the state’s ICU beds are open and available, representatives from the Arkansas Hospital Association told lawmakers. Baptist Health is seeing more critical care patients this summer than they ever have,  Crain said.

Rep. Jim Dotson (R-Bentonville) offered a mixed blessing solution, suggesting that hospitals like Baptist Health and Arkansas Children’s Hospital that don’t require employees to be vaccinated will soon be able to hire unvaccinated nurses about to lose their jobs at Fort Smith’s Mercy Health or at Washington Regional, where vaccines will soon be mandatory.

What’s the best thing legislators can do to help, Sen. Clarke Tucker (D-Little Rock) asked.

“A head-on push to get Arkansas’s vaccination rate past the 41 percent where we sit today would be the best thing,” Doderer said.