• Missouri is in the red zone for cases, indicating 101 or more new cases per 100,000 population, with the 17th highest rate in
the country. Missouri is in the red zone for test positivity, indicating a rate at or above 10.1%, with the 7th highest rate in the
• 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 33.8% of new cases in Missouri.
• 98% of all counties in Missouri have moderate or high levels of community transmission (yellow, orange, or red zones), with
97% having high levels of community transmission (red zone).
• During the week of Nov 2 – Nov 8, 45% had at least one new staff COVID-19 case, 27% of nursing homes had at least one new
resident COVID-19 case, and 8% had at least one new resident COVID-19 death.
• Missouri had 485 new cases per 100,000 population, compared to a national average of 294 per 100,000.
• Current staff deployed from the federal government as assets to support the state response are: 78 to support operations
activities from FEMA and 5 to support operations activities from ASPR.
• The federal government has supported surge testing in Columbia, Cape Giradeau, Branson, and Lee’s Summit.
• Between Nov 7 – Nov 13, on average, 296 patients with confirmed COVID-19 and 250 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.
• Referring to the national profiles in the back of the packet, there is now aggressive, unrelenting, expanding broad
community spread across the country, reaching most counties, without evidence of improvement but rather, further
deterioration. Current mitigation efforts are inadequate and must be increased to flatten the curve to sustain the health
system for both COVID and non-COVID emergencies.
• The spread in Missouri is exponential and unyielding with hospitalizations increasing week over week. Increases from the
past two weeks correlate with Halloween and related activities. With Thanksgiving and upcoming holidays, Missourians
must understand the COVID-19 situation statewide.
• Serious messaging and action are needed from the state leadership; recommending Missourians wear masks in public
settings communicates the current risk level.
• With all counties in the red zone and over 50% of nursing homes with at least one positive staff member, mitigation and
messaging needs to be further strengthened as other states have done. Effective practices to decrease transmission in
public spaces include limiting restaurant indoor capacity to less than 25% and limiting bar hours until cases and test
positivity decrease to the yellow zone.
• As previously noted, proactive testing must be part of the mitigation efforts inclusive of mask wearing, physical distancing,
hand hygiene, and immediate isolation, contact tracing, and quarantine. Start testing to identify and isolate asymptomatic
silent spreaders– those who are have the virus, feel fine, and are unknowingly spreading it. Incentivize people under 40
years to get tested.
• Conduct active testing in school for teachers and students where cases are increasing. In accordance with CDC guidelines,
masks must be worn by students and teachers in K-12 schools. Consider pausing extracurricular school activities, even
though athletics are not transmission risks, as the surrounding activities are where transmission is occurring.
• We have updated the new hospital admissions graphs to include breakdown by age group. Within the past week, there has
been an over 30% increase in new admissions, with most of these in among people over 40 years but across all age groups.
Increases in new admissions and changing proportions of age groups will be important to triangulate with cases and
percent positivity to increase proactive mitigation efforts.
• On university campuses, students are letting their guards down with Thanksgiving break less than a week away. Message to
students to continue their mitigation actions on and off campus to protect others and themselves. If they are going home,
they should follow CDC holiday guidelines for protective behaviors.
• Continuously monitor testing and contact tracing capacity in all counties to ensure rapid turnaround of test results (within
48 hours) and that all cases are immediately isolated and full contact tracing is conducted (within 72 hours of testing).
• Stay vigilant with regard to spread among nursing home staff and residents. Ensure all nursing homes, assisted living, and
elderly care sites have full testing capacity and are isolating positive staff and residents.
• Ensure all hospitals, including rural hospitals, have access to antivirals, antibodies, PPE, and ventilators. Work through FEMA
to secure supplies when stocks of less than a week’s supply is confirmed.
• Specific, detailed guidance on community mitigation measures can be found on the CDC website.