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St. Louis-area virus cases rise, worrying health officials who fear delta variant

St. Louis Post-Dispatch - 7/9/2021

Jul. 9—ST. LOUIS — After dropping for months, the area's coronavirus caseload is back on the rise, worrying health officials who for weeks have been watching the virus surge in other parts of the state.

Dr. Faisal Khan, director of the St. Louis County Department of Public Health, said the county's seven-day average of new COVID-19 cases rose 30% over the past week, and he expects that the number will continue to climb.

"All the signs point in that direction," Khan said. "There is no other logical outcome from the patterns that we are seeing emerge right now."

An outbreak in Missouri's southwest, around Springfield and Joplin, has clogged hospitals and sent case rates soaring, driven by the more infectious delta variant. Health officials there have called in health care workers from other states and a surge response team from the federal government. Officials across the St. Louis region are urging residents to get vaccinated in order to prevent a rise here.

On average in St. Louis and St. Louis, St. Charles, Franklin and Jefferson counties, about 46% of residents have gotten at least one vaccine dose, according to state data. And the pace of vaccinations statewide has slowed significantly. At a peak in mid-April, 50,000 Missourians were getting vaccinated each day, on average. As of Thursday, that number had dropped to 7,000.

Vermont, Massachusetts and Hawaii lead the nation, each having more than 70% of their residents vaccinated with at least one dose, according to data from the Centers for Disease Control and Prevention.

The national rate is 55%, and Missouri ranks 38th, at 45%.

St. Louis acting health director, Dr. Fredrick Echols, said the city has seen a slight increase in cases in recent weeks but is worried given the low vaccination rates in the area.

Seeking to build trust

There is still a lot of distrust between some residents and the health care entities in the region, Echols said. In the coming weeks, building trust with residents who are hesitant about getting vaccinated and having one-on-one conversations about their concerns will be key.

"We don't want the community to have a false sense of security," Echols said. "Because what's happening in Greene County or in the Bootheel of the state of Missouri could easily happen in the city of St. Louis."

Dr. Clay Dunagan, BJC HealthCare's chief clinical officer and an infectious disease expert at Washington University, said that the overall numbers of virus patients are still well below the peak seen in late 2020, but the trajectory is worrisome.

BJC was treating 110 COVID-19 patients as of Thursday — more than double the number in early June, when the COVID census hit a low point in the mid-40s.

The St. Louis Metropolitan Pandemic Task Force reported a total of 188 confirmed virus patients across area BJC, Mercy, SSM Health and St. Luke's Hospital facilities — significantly below the peak of 962 reported on Dec. 1 — but still a 100% increase from 93 on June 9. Task force data lags two days.

"The only way out of this pattern, right now, is for people to get vaccinated," Dunagan said.

"There's just no getting around it," he said. "If you're not vaccinated, you're at relatively high risk."

Since July 1, St. Louis and St. Louis County have recommended that all residents, including the vaccinated, wear a mask when indoors around other individuals whose vaccination status is unknown.

Echols said the city will have ongoing conversations about public health measures, but for the time being, it is focused on education efforts around the virus and the vaccines.

'Brick wall ... of complacency'

The St. Louis County health department, Khan said, is not considering any additional public health restrictions. But Khan urged vaccinations and testing. If residents believe they may be ill, even with a cold, and even if they are vaccinated against COVID-19, they should get tested for the virus. Testing rates have also fallen in recent months, which he said is cause for concern.

"We're running into a brick wall, it seems, of complacency, and just a refusal to accept that we are still in the middle of this pandemic," Khan said.

Dr. Stephen Liang, an associate professor of medicine at Washington University and an infectious diseases and emergency medicine physician at Barnes-Jewish Hospital, said the city and county's recommendation seems "very reasonable," especially as cases rise locally. Residents should be especially cautious in indoor, poorly ventilated areas.

Liang, who was vaccinated in December, said he is comfortable without a mask outdoors or in indoor areas where he knows people are vaccinated. But he still wears a mask in public places such as grocery stores.

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(c)2021 the St. Louis Post-Dispatch

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