Hot spots of COVID-19 cases continue to spread across northern and southwest Missouri, sparking concerns that the virus — especially a more dangerous variant — will reach more vulnerable populations in the St. Louis and Kansas City areas.
Average daily cases across the state have increased to almost 600 from around 400 a day at the beginning of June, driven mainly by big upticks in outstate Missouri. With that growth, Missouri ranks third among all states for the most cases per 100,000 residents in the last seven days, according to The New York Times nationwide tracker.
Among counties with a population of more than 10,000, the same data shows four Missouri counties in the top 12 for most new cases in the U.S. — Linn and Livingston counties in northern Missouri, and Webster and Taney counties in southwest Missouri.
At the start of June, Linn and Livingston counties (and also nearby Putnam with fewer than 10,000 people) led the nation in most new cases per capita, reporting even more cases than the state’s most populous cities. A few areas in southwest Missouri also showed troublesome signs.
Last week, more counties in the two regions moved toward red.
Nathan Koffarnus, assistant chief of disease control with the Missouri Department of Health and Senior Services, sounded the alarm at last week’s meeting of the Missouri Advisory Committee on Equitable COVID Vaccine Distribution.
“I’ve seen it brewing. I’ve been concerned about it for a couple of weeks now, and yesterday’s data update really kind of jumped off the page,” Koffarnus told the group, which includes members of health care organizations and advocacy groups. “It’s a pretty sizable jump in such a short period of time.”
Chariton, Grundy, Caldwell and Macon counties saw jumps in the north; while Greene, Webster, Laclede, Newton and the city of Joplin joined Polk and Taney counties with increasing cases in the southwest.
The southwest includes the state’s third-largest city of Springfield, as well as Joplin and Branson.
“The population in southwest Missouri is quite a bit higher than in north Missouri,” Koffarnus said. “When it hits here, it’s going to be worse, and I think it’s already happening.”
‘Get in front of this’
Greene County, which includes Springfield, reported 375 new cases in the past seven days — the most in the state. St. Louis city, with a population roughly the same as Greene County’s, had 74 new cases over the same period. Taney County, home to Branson, saw 88 new cases.
During the last two weeks of May, Greene County posted an average of 32.6 new cases per day. Just two weeks later, the daily average nearly doubled to 62.3.
Koffarnus told the committee that he sees the spread happening in areas along U.S. Highway 36, which runs east and west across northern Missouri, as well as along U.S. Highway 65, which runs north and south.
The same is happening along Interstate 44, which cuts diagonally through southwest Missouri and up to St. Louis.
He advised the group to “get in front of this” by considering how their residents interact with surrounding counties as far as work, shopping and recreation.
“Can we head some of this off before it jumps communities and really establishes itself down the road?” Koffarnus said.
To help, the state health department last week made available a “COVID Hot Spot Map” that updates daily and shows counties with the most new cases per capita in the past 14 days, as well as the highest percentage of positive coronavirus test results.
The maps are available on a “blind site,” meaning users must know the web address to find it on the internet.
Koffarnus blamed the upticks on the increasing presence of the Delta variant — which emerged in India and is shown to be more transmissible and cause more serious illness — along with low vaccination rates.
He cautioned that other Missouri counties and cities also have cases of the variant and similarly low vaccination rates. They could be just as vulnerable.
“We can see flare-ups and outbreaks in any part of the state,” he said.
Everyone at risk
At a meeting of public health leaders earlier this month, Andrew Miller of Deloitte Consulting, hired by the state to help with vaccination data, provided additional cautions about Missouri’s hot spots.
Miller pointed out that while northern Missouri has high rates of unvaccinated people, it is not home to the state’s most vulnerable residents in terms of poverty, medical comorbidities and minority populations.
“I’m looking specifically inside the I-435 corridor of Kansas City,” he said.
“I’m looking at the northwest pie wedge coming along I-70 and the Mississippi corridors in St. Louis city. I’m looking at the overhanging bootheel region … these are things we really need to pay attention to because those areas inherently have more vulnerability than this (north) region, yet we are still seeing this outbreak in this location.”
Scott Allen, administrator of the Webster County Health Unit, asked if it was OK to share the hot spot maps and other reports on the site with the public.
Adam Crumbliss, who directs state’s public health division, said the state didn’t want to create “mass hysteria or concern.”
But he added, “It is not something we would say is secret or closed record. We ask that if you do share it, that it’s done in an appropriate and thoughtful context of what our public health situation is.”
To date, the state health department has not released public health notices or guidance regarding troublesome hot spots. Health officials did not respond Wednesday to a request for comment about their level of concern and next steps.
Allen, reached by phone this week, said a month ago Webster County had 21 active COVID-19 cases, now it has 102. It has seen the 10th highest rate of new cases over the past week in the U.S.
“I’m OK with our county residents being alarmed. They should be. We have a significant issue in Webster County,” Allen said. “I want them to know we need their help in being more vigilant.”
Hospitalizations for COVID-19 are increasing in Joplin, Springfield and Columbia (which sees patients from northern Missouri), according to hospitalization data collected by St. Louis University sociologist Chris Prener.
Koffarnus said last week that about 5% of COVID cases in Missouri involve the Delta variant. State health officials late Wednesday issued a press release saying that wastewater surveillance shows the variant on the rise across the state. The variant is projected to become dominant worldwide.
Dr. Hilary Babcock, an infectious disease specialist for BJC HealthCare in St. Louis, said counties are seeing an increase in patients hospitalized because of the variant. Patients are mainly younger adults who opted against vaccination because earlier strains of the virus hit the elderly the hardest.
“If this Delta variant gets a foothold, it will just spread through the unvaccinated population and then put everyone at risk,” Babcock said.
While overall vaccination rates in the St. Louis area are higher than other parts of the state, there are pockets of residents that have low vaccination rates because of mistrust of government and health officials, she warned.
“It’s not like we have a solid wall between us and other parts of the state,” Babcock said. “Disease that is spreading in other counties means that people who go to those counties, or come from those counties to our counties, can bring coronavirus with them.”