CLAYTON — The numbers of infections, hospitalizations and deaths from the coronavirus continued to break records on Wednesday in Missouri and Illinois, and across the St. Louis area, as the pandemic raged into its ninth month.
After three days of near-exponential growth in admissions to area hospitals for COVID-19, St. Louis County Executive Sam Page’s administration was preparing to issue new restrictions on Thursday or Friday, according to a source with knowledge of the plans.
Page had warned on Monday that the county had a week or two to turn around its infection and hospitalization rates, but this week’s data from area hospitals demanded quicker action, the source said. The restrictions, which were still being worked out Wednesday, were likely to focus on reducing from 49 the maximum gathering size, and reducing occupancy for bars and restaurants from the current limit of 50%.
Page, a Democrat, was trying to coordinate announcements with St. Louis Mayor Lyda Krewson, another Democrat, and the leaders of surrounding counties, but it was not clear which entities would join a regional effort. St. Louis and St. Louis County already require face coverings, while surrounding areas do not.
Reducing maximum gathering sizes could also have an effect on winter sports that are played inside, such as basketball and hockey.
Despite the spread of a virus that has killed about 241,000 Americans, resistance to more restrictions was strong. St. Charles County Executive Steve Ehlmann, whose county has seen weeks of surging infection rates, said Wednesday in a radio interview that he did not intend to mandate face coverings, a measure the U.S. Centers for Disease Control and Prevention said Tuesday helps protect both mask wearers and those around them from coronavirus transmission.
“What we need to do is look at best practices,” Ehlmann, a Republican, told KMOX (1120 AM) radio host Mark Reardon. “Where are they really doing a good job? You know, I don’t know anywhere in the region where the numbers aren’t spiking. I don’t know anywhere in the state, I don’t know anywhere in Europe or anywhere else.”
He added, “You can only do so much, and then it just comes down to personal responsibility”
Page’s warning about tighter restrictions drew fire in comments from county residents read into the record at Tuesday’s County Council meeting. Some argued that because most of the people who become very sick are elderly or have preexisting health conditions, restrictions on younger, healthier people are not needed.
“Why do you insist on spreading fear and bullying the residents of St. Louis County?” one commenter asked.
In an interview on Wednesday, Councilman Mark Harder, R-7th District, said that “to penalize everybody because certain people chose not to heed warnings is somewhat irresponsible from a policy standpoint. We should have enough tracking data to know where the hot spots and vulnerable populations are.”
And Councilman Tim Fitch, R-3rd District, said he questioned whether it was wise to restrict business at restaurants and businesses in the county, tempting residents to travel to surrounding counties where the infection rates were even higher than in St. Louis County.
Hospital admissions spike
In the St. Louis area, new hospital admissions hit a single-day record of 120 on Wednesday, up from 114 on Tuesday, according to the St. Louis Metropolitan Pandemic Task Force. The seven-day moving average of hospital admissions rose to 99 from 91, also a record. And the seven-day moving average of hospitalizations rose to 572 from 546, a new seven-day moving average record.
The data comes from the four major health systems — BJC HealthCare, Mercy, SSM Health and St. Luke’s — that serve the region.
For perspective, task force commander Dr. Alex Garza for most of the summer had pointed about an average of 40 coronavirus admissions per day as being a danger zone. On Oct. 26, when the average was 52, he choked back tears.
In an interview on Wednesday, he said, “It’s tough for me to speculate on how much further this will go, given the current trajectory. … It has shocked my sense, seeing those large numbers. I would have never fathomed seeing those numbers if you’d asked me three weeks ago. But now it seems like I’m getting a new shock every day with the numbers that we see.”
He added, “I do know that unless we take some actions, it will continue as it is now, and probably get worse, but how much worse is hard to say.”
He said it wasn’t clear where the latest surge came from, other than it reached a tipping point.
“It’s not just here in St. Louis, it took off across the country. … I do think there is some contribution from people feeling relaxed and letting down their guard, maybe not social distancing enough, having informal gatherings that can cause some of these superspreader events. After a while, you build up so much virus in the community, it can take off on you.”
Garza said the bedrock of eliminating the disease — testing, tracing the contacts of positive people and quarantining people with exposure — has become ineffective because the virus has saturated the area.
Call for action
But there are actions that can be taken, he said. First, a mandatory masking policy across the region.
And he called for extreme limits on social gatherings similar to what went into effect in the United Kingdom on Nov. 5. He said “anybody that can work from home needs to work from home, nonessential things need to be eliminated” and there should be no group gatherings of more than 10 people, including weddings and funerals.
He did not advocate for a shutdown of the economy, which would hurt the most vulnerable people the most. “If we had systems where we could support the population financially with food and housing, then it would be much easier to say, ‘Let’s put a stop to most of the economy now,’ but we don’t.”
Garza said that in early October, residents of counties immediately surrounding St. Louis, such as Jefferson and St. Charles, made up a disproportionate share of the hospital admissions. That equalized more recently, but the task force hospitals have seen a surge from rural counties outside the metro area that now account for 15% of admissions.
He said it wasn’t clear yet how many of those patients had been transferred from outstate hospitals and how many came to the St. Louis area for medical care.
Illinois cases soar
Illinois public health officials on Wednesday reported 12,657 new cases of COVID-19, a record, and 145 new deaths caused by the coronavirus.
It was the highest death toll in Illinois since late May.
There have now been 523,840 cases and 10,434 coronavirus-related deaths in Illinois since the pandemic began.
Meanwhile, Missouri saw the number of COVID-19 cases climb by 4,071 and 24 additional deaths. The state has reported 220,768 cases and 3,323 deaths since the pandemic began.
The state also cited a record 2,157 hospitalizations, 102 above the previous mark set Tuesday. ICU capacity is down to 32% statewide, but just 28% in northwestern Missouri, 19% in the Kansas City area and 2% in sparsely populated northeast Missouri.
Missouri Hospital Association spokesman David Dillon said the ICU bed shortage is made worse because hospitals “are experiencing a staffing crisis after nine months of managing the disease.”
To staff ICUs, hospitals are taking steps such as hiring agency workers and moving staff from other areas of the hospital. Many hospitals also are postponing elective surgeries to keep bed space available for COVID-19 patients, Dillon said.
Adding to the problem is that patients who require skilled nursing care after hospitalization increasingly have nowhere to go because space in nursing facilities is limited.
“This is increasing hospitals’ length of stay for COVID-19 patients as hospitals work to identify where patients that cannot be discharged home can go for post-acute care,” Dillon said.
St. Louis County, the largest county in the metropolitan area, reported 642 cases and four additional deaths, bringing the total since the beginning of the pandemic to 37,658 cases and 904 deaths.
The Associated Press contributed to this report.
Updated at 7:45 p.m.
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