Missouri’s low vaccination rate fuels outbreak as state officials fight mask mandates

A sign warning of COVID-19 dangers remains in place Tuesday, June 15, 2021, outside the entryway of a state office building in Jefferson City, Mo. (AP Photo/David A. Lieb)

Low statewide vaccination rates have left Missouri residents exposed to the Delta variant of the coronavirus. Daily newly confirmed cases are on a trajectory to rise to numbers not seen since late 2020, while state officials continue to fight mask mandates. In the last week of July, Missouri had the country’s fourth-worst COVID-19 infection rate, with one out of every 360 people having been diagnosed with the virus.

CNN Medical Analyst Dr. Jonathan Reiner put the situation in blunt terms, warning, “In places like Missouri where ICUs are packed, you’re going to see a surprising amount of death.” The next few weeks and months will see an increase in deaths, as COVID-19 deaths have lagged spikes in cases by three to four weeks. Hospitalizations typically happen when a person has been sick for a week, and if a sick person dies it usually takes a couple of weeks after that. Reiner expressed frustration that the rise in deaths is preventable, “The vaccines we have work really well against this variant. It doesn’t need to be this way.”

Republican Governor Mike Parson has opposed emergency measures to curb the virus, claiming that data compilers include children under 12 in their vaccination statistics “to make the situation sound worse than it really is.” He denounced St. Louis County’s re-imposition of a mask mandate as “eroding [the] public trust.” Kansas City also instated a mask mandate effective July 28.

Parson argues that mask mandates should not be imposed since COVID-19 vaccines are freely available, yet scientists have released many studies showing that mask wearing helps curb the spread of the virus and must be implemented in coordination with a vaccination campaign.

Following Parson’s lead, Missouri Attorney General Eric S. Schmitt has filed a lawsuit against St. Louis County to get its mandate struck down. After only one day in effect, the St. Louis County Council voted to overturn the its mask mandate on July 27. County Executive Dr. Sam Page pushed back by declaring that the mandate remains in place, at least until Schmitt’s lawsuit gets resolved.

Meanwhile, experts are recommending that vaccines be mandated in certain regions. Professor of Medicine at George Washington University School of Medicine Dr. Gigi El-Bayoumi said, “In states where there are high vaccination rates, that are like 75 or above, it makes sense to loosen up the restrictions. In places where there are not, such as some of the Southern states, it makes sense” to mandate vaccination. National Institutes of Allergy and Infectious Disease director Dr. Anthony Fauci also supports local vaccine mandates: “We’re talking about life and death situation. We’ve lost 600,000 Americans already, and we’re still losing more people. There’ve been 4 million deaths worldwide. This is serious business.”

Only five Missouri regions have full vaccination rates above 40 percent: the counties of St. Louis, St. Charles, Boone, Franklin, and the city of Joplin in Jasper and Newton counties. However, the daily vaccination rate in St. Louis is dropping. St. Louis Hills Pharmacy reported that they currently administer 5-10 vaccinations each day. That’s down from 50 vaccinations a day in May. St. Louis County Executive Sam Page said that some zip codes have vaccination rates as low as rural Missouri areas. The highest county-infection rates are in the inner north suburbs, which has a high proportion of black residents. The infection rate there is 18 people per 100,000, nearly 3.5 times greater than the central portions of the county. Black residents are getting infected at a rate five times higher than white residents.

The virus is still ravaging southwest Missouri. At Osage Beach’s Lake Regional Hospital, 22 people have died from COVID-19 from July 1 to July 23. Back in May, no one had been admitted to the hospital for COVID-19. Dr. Harbaksh Sangha, Lake Regional’s chief medical officer told the Associated Press, “We’ve had a big-time Delta virus surge here. A lot of admissions, a lot of people who are very sick and are dying. … So as a human being it’s very frustrating, but as a physician, we just take care of whatever we get.” In the two counties around the city of Osage Beach , Camden and Miller, only 38.6 percent and 26.7 percent of residents respectively have begun the vaccination process.

Mercy Hospital in Springfield has 91 percent of its ICU patients on ventilators, with many of them in their 20s, 30s and 40s, as confirmed by Chief Administrative Officer Erik Frederick to CNN. He said that at last year’s peak only 40 to 50 percent of ICU patients were on ventilators. On July 12, there were 130 COVID-19 patients at Springfield’s Mercy Hospital, while CoxHealth had 125. Only 34.3 percent of people in Greene County, where Springfield is located, are fully vaccinated. Springfield area hospitals will require their employees to be fully vaccinated by late September.

On July 27, the St. Louis Metropolitan Pandemic Task Force warned that if cases keep rising in the area, St. Louis hospitals may be forced to start turning away patients. On that same day, nearly 500 people in Missouri were in an ICU due to COVID-19. The Missouri Department of Health and Senior Services (DHSS) had recorded 559,778 confirmed cases of COVID-19 that day. While the Missouri DHSS recommends that masks are worn indoors in businesses and schools, it does not recommend any mask mandates.

Speaking to KMOV 4, Dr. Clay Dunagan, interim head of the St. Louis Metropolitan Pandemic Task Force, expressed his fears of a fall surge in infections if more people do not get vaccinated. “We’re going to get to a point where we’ll really challenge health care resources,” he said. “I think what we learned in the first time through, particularly in the winter months, is we have enough ICU capacity and enough ventilators. We can manage what is coming our way. But it becomes such a dominant part of the health care enterprise, it makes it very difficult to deal with other health care challenges.”

The seven-day average for new hospitalizations in the area was 38 new cases a day as of July 13, most from people with the Delta variant. Under 45 percent of people in the region have received at least one vaccine dose, with the 18-45 age group making up the majority of the unvaccinated population.

Dr. Dunagan declared there’s been an increase in tests at official testing centers in recent weeks. Dr. Troy Dinkel, chief medical officer of Total Access Urgent Care, said that as of July 29 the 27 area locations are testing around 1,000 people a day and 150 tests daily, or 15 percent, were coming back positive. As of July 30, the Task Force reported 398 COVID-19 hospitalizations in four major area hospitals. “Getting up to the upper 300s, that’s a sign that things are really getting hectic,” said Dr. Dunagan. Ninety percent of these patients are unvaccinated.

Missouri’s official COVID-19 death toll now exceeds 10,400 but undercounting of pandemic deaths is no doubt widespread. Macon County coroner Brian Hayes, a Republican elected official and a partner of a funeral home, admitted this week that he has altered or omitted COVID-19 as the cause of death when there was a factual alternative that could be listed instead, when families requested it. “I won’t lie for them, it’s gotta be true, but I do what pleases the family,” he told the Kansas City Star.

Jefferson County, part of the St. Louis metropolitan area, reached red status for COVID-19 again for the first time since February. As of now, only seven counties in Missouri have a COVID-19 alert status below red. To show that mass vaccination is a vital part of control efforts, the Jefferson County Health Department released data that out of 69,997 residents vaccinated in the county, 46 have experienced a breakthrough COVID-19 infection, or 0.07 percent of the vaccinated population. Of those 46 breakthrough cases, four of them resulted in hospitalizations and three of them were asymptomatic. This is the first time Jefferson County has entered red status since vaccines became widely available, and the health department said their data shows the vaccine is effective at slowing the spread of COVID-19.