• Missouri is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 19th
highest rate in the country. Missouri is in the red zone for test positivity, indicating a rate at or above 10.1%,
with the 10th highest rate in the country.
• Missouri has seen an increase 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 28.9% of new cases in Missouri.
• 91% of all counties in Missouri have moderate or high levels of community transmission (yellow, orange, or red
zones), with 76% having high levels of community transmission (red zone).
• During the week of Oct 19 – Oct 25, 23% of nursing homes had at least one new resident COVID-19 case, 38%
had at least one new staff COVID-19 case, and 6% had at least one new resident COVID-19 death.
• Missouri had 257 new cases per 100,000 population, compared to a national average of 165 per 100,000.
• Current staff deployed from the federal government as assets to support the state response are: 67 to support
operations activities from FEMA; 5 to support operations activities from ASPR; 17 to support medical activities
from VA; and 3 to support operations activities from VA.
• The federal government has supported surge testing in Columbia, Cape Giradeau, Branson, and Lee’s Summit.
• Between Oct 24 – Oct 30, on average, 182 patients with confirmed COVID-19 and 217 patients with suspected
COVID-19 were reported as newly admitted each day to hospitals in Missouri. An average of greater than 95% of
hospitals reported either new confirmed or new suspected COVID patients each day during this period.
• As you can see from the time sequence of maps at the back of your packet, there is a continued increase in
cases, hospitalizations, and fatalities nationally, spreading southward from the coldest climates as the
population moves indoors and cases increase exponentially. These maps demonstrate the previous impact of
comprehensive mitigation efforts when implemented effectively in many areas and that partial or incomplete
mitigation leads to prolonged community spread, hospitalizations, and increased fatalities.
• With unrelenting spread and increasing new hospital admissions, refocus efforts on finding asymptomatic
sources of spread.
• Prioritize the use of Abbot BinaxNOW:
• Implement weekly sentinel surveillance among specific populations to provide detailed trend data on
where the virus is and direct mitigation efforts. Target populations should include healthcare workers,
K-12 teachers, prison staff, and first responders.
• Find asymptomatic cases to stop the source of spread; primarily test those younger than 40 years old.
• In areas with low positivity, confirm positives with RT-PCR testing. Realign contact tracing staff to support new
testing approaches. Visualize integrated surveillance data on dashboard so community can see local virus
• Effective practices to decrease transmission in public spaces include limiting restaurant indoor capacity to less
than 50% and restricting hours until cases and test positivity decrease.
• Review testing at universities; if universities have not been testing all students (on and off campus) weekly,
then work with them to implement weekly testing protocols. Investigate if there is ongoing transmission in
university towns; mitigation behaviors may be eroding in university towns.
• Messages to community for basic actions that they should take now:
• Do not gather without a mask with individuals living outside of your household.
• Always wear a mask in public places.
• Stop gatherings beyond immediate household until cases and test positivity decrease significantly.
• In accordance with CDC guidelines, masks must be worn by students and teachers in K-12 schools.
• Work with hospitals, chambers of commerce, and others to create and communicate PSAs on taking smart
actions to stay open, including targeted messages to rural communities.
• Ensure all hospitals, including rural hospitals, have access to antivirals, antibodies, PPE, and ventilators.
• Specific, detailed guidance on community mitigation measures can be found on the CDC website.


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