COVID Updates


STATE REPORT 01.03.2021
Issue 29

Missouri is in the red zone for cases, indicating 101 or more new cases per 100,000
population, with the 33rd highest rate in the country. Missouri is in the red zone for test
positivity, indicating a rate at or above 10.1%, with the 13th highest rate in the country.
• Missouri has seen stability in new cases and an increase in test positivity.
• The following three counties had the highest number of new cases over the last 3 weeks: 1. St.Louis County, 2. Jackson County, and 3. St. Charles County. These counties represent 37.2% of new cases in Missouri.
• 87% of all counties in Missouri have moderate or high levels of community transmission
(yellow, orange, or red zones), with 77% having high levels of community transmission (red zone).
• During the week of Dec 21 – Dec 27, 31% of nursing homes had at least one new resident
COVID-19 case, 43% had at least one new staff COVID-19 case, and 13% had at least one new resident
COVID-19 death.
• Missouri had 308 new cases per 100,000 population, compared to a national average of 413 per
• Current staff deployed from the federal government as assets to support the state response
are: 96 to support operations activities from FEMA and 5 to support operations activities from
• Between Dec 26 – Jan 1, on average, 268 patients with confirmed COVID-19 and 225 patients with
suspected COVID-19 were reported as newly admitted each day to hospitals in Missouri. This is a
minimal change in total new COVID-19 hospital admissions.
• As of Jan 2, 218,800 vaccine doses have been distributed to Missouri. 89,565 individuals have
received the first dose.
• Data reporting has been unstable for the past week, but hospital reporting has been stable and
the United States remains at a high plateau of 140-150,000 confirmed and suspected COVID admissions
per week and 120-125,000 total inpatients. Significant continued deterioration, from California
across the Sunbelt and up into the Southeast, Mid-Atlantic, and Northeast, despite low testing
rates during the holidays, suggests aggressive community spread.
• This fall/winter surge has been at nearly twice the rate of rise of cases as the spring and
summer surges. This acceleration suggests there may be a USA variant that has evolved here, in
addition to the UK variant that is already spreading in our communities and may be 50% more
transmissible. Aggressive mitigation must be used to match a more aggressive virus; without uniform
implementation of effective face masking (two or three ply and well-fitting) and strict social
distancing, epidemics could quickly worsen as these variants spread and become predominant.
• Messaging must be focused on proactive testing of those under 40 to prevent asymptomatic
silent spread to their household members and on a call to action for immediate testing and rapid
infusion of monoclonal antibodies for those at risk for severe disease. Every hospital should have
outpatient infusion sites immediately available to save lives.
• Strongly recommend the creation of young adult testing sites with BinaxNOW to encourage rapid

testing and, for those testing positive, immediate isolation and aggressive protection of
vulnerable household members.
• Do not delay the rapid immunization of those over 65 and vulnerable to severe disease;
recommend creation of high throughput vaccination sites with use of EMT personnel to monitor for
potential anaphylaxis and fully utilize nursing students. No vaccines should be in freezers but
should instead be put in arms now; active and aggressive immunization in the face of this surge
would save lives.
• Careful planning, efficient implementation, and transparent balanced messaging on the state’s
vaccination campaign are all critical to maintaining public confidence and maximizing vaccine
acceptance. Multiple states have launched vaccine-specific dashboards with regular updating of the
number of individuals vaccinated to date, as well as vaccine-related information and messaging;
these are a best practice. Michigan and Nebraska are excellent examples. Given persistent vaccine
hesitancy, continued active encouragement by the Governor, health officials, and community

influencers are needed; televised immunizations are potentially useful.
• New COVID hospital admissions (most reliable indicator during this time period) continue to be
at the highest levels. There is a significant amount of ongoing, undiagnosed asymptomatic
• Missourians must understand that virus levels are high in their communities. If they were
around people outside of their household during the holiday season, they must get tested.
• Along with the mask mandate, reducing indoor dining capacity to 25% and closing bars are
effective in decreasing transmission.
• Ensure all universities returning after winter break move to mandatory weekly testing of all
on and off campus students; begin planning now. Immediately identifying and removing asymptomatic
individuals will prevent community spread.
• When K-12 schools return, establish public health protocols to conduct active testing in
schools for teachers and students in districts with high positivity and cases. In accordance with

CDC guidelines, masks should be worn by students and teachers in K-12 schools.
• With the high percentage of COVID-positive LTCF staff, continue weekly testing of all staff
until residents and staff are fully vaccinated.
• Specific, detailed guidance on community mitigation measures can be found on the CDC website,

They spent 12 years solving a puzzle. It yielded the first COVID-19 vaccines.

Long before anyone knew of SARS-CoV-2, a small band of government and university scientists uncovered a prototypical key that unlocked life-saving immunizations (Kramer, 2020).

The SARS-CoV-2 spike protein, which allows the virus to break into cells, is a shapeshifter. By making it sit still, scientists uncovered a key to rapidly making coronavirus vaccines. This image is a false-colored, electron-density map acquired via cryogenic electron microscopy. (National Geographic, Kramer, 2020). For full article see link below:



The state of Missouri is currently working to vaccinate residents that fall under Phase 1A.

Phase1A Target

  1. Healthcare Workers
  2. Long-term Care Facility Residents and Staff

Phase1B Target

  1. High Risk Populations
  2. First Responders
  3. Essential Workers

Phase2 Target

  1. Populations at Increased Risk (Prisoners, Homeless, etc.)

Phase3 Target

  1. All Missouri Residents