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Missouri issues public health warning for local governments to implement, plus travel advisory

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compiled by Brian Hauswirth and Ashley Byrd

Missouri’s governor has issued a statewide public health warning because of the continued increase in new COVID cases statewide. The Missouri Department of Health and Senior Services (DHSS) says there have been 27,358 new COVID cases in Missouri in the past week, which is an average of 3,908 new COVID cases per day.

The DHSS new COVID-19 advisory provides expectations for communities, with three action plans for counties based on positivity rates. Counties with a PCR 7-day positivity rate of 15 percent or above are advised to limit social group sizes to ten or less, and masks are advised in all offices and businesses where social distancing isn’t possible. In counties with a PCR 7-day positivity rate of 10 to 14 percent, counties are advised to limit social group sizes to 25 or less, and that offices and businesses with more than ten people should have masks. For counties with a PCR 7-day positivity rate of five to nine percent, social groups should maintain six feet of social distance.

READ 11-19-2020 Public Health Advisory

The advisory is simply that, however, a set of recommendations to counties and not an order, Missourinet confirmed with DHSS. The consequences of not complying are, as the White House Coronavirus Task Force describes, the exponential spread of the virus and the overburdening of health care systems.

Parson explained that this puts restrictions in the hands of mayors and counties instead of his office because he believes in local control, with “citizen input.”

“Government’s not going to mandate everything you need to do in your lives, nor do I want government to mandate, you don’t need that right now. You just need to take it upon ourselves to make tough decisions, wise decisions, and to slow the spread,” the governor said Thursday. “We don’t want to be like these other states around us. To be able to protect our economy, to be able to protect our lifestyle, we have to take action.”

The Parson administration has also issued a travel advisory for Thanksgiving, urging Missourians to minimize travel outside of the state and to wear a mask and practice social distancing.

 

Database of COVID-19 exposures in schools? Missouri NEA wants one.

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The Missouri National Education Association says the state should make a centralized system for the public to see information about COVID-19 exposures in K-12 and higher education schools. It has sent a letter to the Missouri Department of Elementary and Secondary Education calling on the agency to create one that would “regularly publish” the information and protect patient privacy.

Database of COVID-19 exposures in schools? Missouri NEA wants one.

President Phil Murray tells Missourinet his organization began a weekly report over the summer detailing some exposures within K-12 schools because he says some communities did not have accurate information. He says in a couple instances, people were told by their administrators not to talk about any positive cases that popped up. In other cases, he says schools were not reaching their entire audience through social media, the newspaper or the radio.

“The information was not widely distributed and if you weren’t listening on that particular day or you weren’t on social media, you probably weren’t going to get that report. And so, the districts were communicating with their local communities but they were not communicating with the community as a whole,” he says.

Murray says the association’s weekly report does not capture the true scope of exposure in schools and thinks the state could present a much more comprehensive picture.

“This is something that none of us have ever had to deal with and we are all kind of making it up as we go and we are trying to work together. We have been generally very happy with the things that DESE has been doing for our schools. We just came up with this idea and we would really like for them to continue this work,” he says. “Several districts are starting to do their own reporting and we are very grateful for that. Springfield Public Schools has a dashboard. We know that the Troy Public Schools has a dashboard as well. So, districts are starting to become a little more transparent. We are just looking for all that information to be in one place.”

Some schools started this week while others started a couple weeks ago. So why is the request being made now?

“There are several districts that have been in session now for a couple weeks,” Murray says. “And so what’s happening in those districts – that’s information we would like everybody to have as well. We are all in different places right now, but we are actually in the place where we’re starting to get some real hard information and we really think that’s information that should be shared.”

Murray says the database should include:

*The building or activity in which the exposure occurred
*The date of the incident
*The number of people exposed
*Actions the school district is taking to inform parents and staff
*Safety precautions the district is implementing to limit exposure and spread to others

The association, about 34,000 members strong, wants the state to require schools to report cases directly to the Missouri Department of Elementary and Secondary Education (DESE).

The department says schools are required to report the information to their local and state Health Departments. DESE spokesperson Mallory McGowin says the agencies are working to make this information available to the public. DESE says it has forwarded the association’s request to DHSS for review.

Copyright © 2020 · Missourinet

Missouri health department offers new guidance for nursing home visits

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UPDATED WITH NEW INFORMATION FROM DHSS

As part of the state’s reopening plan, Missouri will be giving long term care facilities much more flexibility to allow outdoor visits and visits through an open window or communal dining and group activities for residents who cannot leave their rooms.

According to DHSS, the long-term care facility guidance will be a “phased-in approach that will take into consideration many factors including the current status of COVID-19 in the community and current status of COVID-19 in the facility. In addition, other facility-specific guidance will likely be included in the reopening plan in line with guidance released from CMS.”   

“Since the underlying health conditions of residents in these facilities make them more vulnerable to COVID-19, the full reopening of all facilities will occur gradually and in phases. However, in order to allow facility residents a form of in-person visitation with family members and loved ones until a facility can fully reopen, the State will ease restrictions to allow for outside and window visitation at long-term care facilities assuming proper social distancing protocols and other criteria are being met.”

For instance, DHSS suggests a facility can consider visits if it has not had any COVID-19 staff or resident cases, or it has been two incubation periods (28 days total) since the last positive COVID-19 case acquired at the facility.

Outdoor visits are suggested for residents who do not have the virus or not suspected to have it or are recovered.

Social distancing and CDC-approved hygiene practices are still suggested.

Residents and patients in Missouri’s long-term care and skilled facilities have been some of the most vulnerable to COVID-19 and its spread. According to state health officials, 222 Missouri long-term care facilities have reported at least one case among staff or residents.

The state health department says Missouri ranks below national averages for cases per 1,000 residents, resident deaths and nursing staff cases per 1,000 residents. This was considered along with a 43 percent decrease in hospitalizations in Missouri since May 1 and increased testing rates.

 

CARES Act spending team hears the up-to-date coronavirus needs of Missouri agencies, businesses

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The informal advisory group appointed by Gov. Mike Parson heard a wish list from a series of state agency and organization leaders about how to spend CARES Act funding coming into the state.

State Treasurer Scott Fitzpatrick says Missouri has about $1.5 billion to work with after buying personal protective equipment for state health and frontline workers. As CARES Act money — and mandatory guidelines — come from the federal government, the team will recommend spending priorities to the governor.

Fitzpatrick says the panel is “still in information-gathering mode.’

The team met for more than four hours at the Capitol and remotely on Thursday. In the first hour, Missouri DHSS Director Randall Williams briefed the panel on the state’s approach to testing and how it could be paid for. Williams explained a three-pronged approach to add to current PCR (nasal swab sampling) infection tests given to individuals who ask for it.

  • “Boxed-in” approach:
    Williams says there will be outbreaks and each county needs to be ready to address those flare-ups by testing everyone involved.”We go in and test all the staff, all the residents because we know when this gets into congregated facilities, whether it be prisons or cruise ships or nursing homes or cruise ships, this tends to be very infectious,” Williams said. He said Medicare and Medicaid will pay for this testing and he wants health care facilities to seek this insurance rather than the state pay for it. State Budget Director Dan Haug says the state will reimburse large facilities and agencies through $135 million from coronavirus relief funds recently allocated for testing.
  • Community sampling:
    Williams says communities are asking DHSS to come in to do “snapshot” or random sampling to extrapolate from a small number what a larger number of cases might be. The department sampled 12 counties three weeks ago and found nine COVID-19 cases out of 3,000 tested. They are now testing in Buchanan and Andrew County. St. Louis County will be testing 5,000 people to be paid for locally. Other locations to be tested.
  • Sentinel testing:
    The health department picks areas of high morbidity and mortality or long-term care facilities to do periodic testing. Williams says there is a plan to put these in place around the state, in order to predict outbreaks before large-scale hospitalizations.

Versailles Republican, Rep. David Wood took issue with local health departments having to foot the bill for testing services, relying on local general CARES funding to the county to be allocated to them.

“Basically you have no plans of sending money down, even though they are doing your work and they are funded through you, you’re having them compete for the dollars that are sent to the county? I’ve made that point in budget committee numbers of times that if Health and Senior Services is receiving additional funds from COVID money, whatever pot it’s coming from and they are not passing on to the people doing the work, that to me is … (mumbled expletive).”

Unemployment, tourism, job training needs 

Chris Slinkard, Director at Missouri Division of Employment Security discussed the health of the state Unemployment Trust Fund.

“The trust fund at the beginning of this year was at almost $1.1 billion, the largest in state history,” he told the panel. “On May 18, 2020, the UI Trust Fund balance was $858 million; the majority what was given out has come from the U.S. CARES Act.”

Missouri Chamber of Commerce and Industry President and CEO Dan Mehan

Missouri Chamber of Commerce President Dan Mehan also spoke to the group, seeking more attention for the state’s apprenticeship and internship program for workers who may not get their jobs back.

“If you look at where we would prioritize, it’s about the testing and it’s about the people. It’s about the apprenticeship and internship approach that when people talk infrastructure, the term shovel-ready got kind of a bad connotation, we have shovels in the ground in these apprenticeship programs and they are working,” Mehan said.

Mehan also said that businesses opening up need some help by a temporary law.

“We sent a letter to the governor two days ago asking for a special session to consider lawsuit protection. There are a lot of employers out there that are fearful or reopening their doors for fears being sued for whatever possible reason even though they try to open responsibly, safely, with PPE and try to follow CDC guidelines, guidelines of the state and we’d just like to have some sort of temporary — not global — but temporary immunity from lawsuits that could occur from this. We’ve seen hundreds crop up around the country. The fear of lawsuits is going to hinder our recovery in a big way,” Mehan said.

Stephen Foutes, Director for the Missouri Division of Tourism reported losses compared to the normal brought in by sightseers and visitors.

“Approximately $2.16 billion in tourism-related spending has been lost from February 29 through May 9 of this year as compared to roughly the same time last year, ” Foutes said.

“Since early March both the tourism economy and the industry employment have plummeted,” he added.

One-third of the tourism industry in Missouri has filed for unemployment.

Zora Mulligan released information from a public and private college and university survey on how higher education institutions are trying to cope with budget cuts and the demands of creating online learning.

“If I have one big takeaway from this survey is that institutions worked really hard, as did students, to figure out ways to make this work this spring semester. But if this is to be a longer-term strategy, we’ve got a lot of additional investment that we’re going to need to make in terms of professional development, advising, infrastructure, student capacity, and then the larger broadband system in which this operates,” Mulligan summarized.

Department of Elementary and Secondary Education’s Jeff Falter agreed with Mulligan that broadband capacity across the state is a major problem.

“Districts report an estimated 23 percent of students are without internet access — or one out of every five students,” he told the panel.

Parson’s daily COVID-19 briefing, May 13, 2020 : Testing ramps up statewide

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Gov. Mike Parson with Jim Dumbauld, Senior Director for Logistics, Environmental Health and Safety, Facilities and Fleet, Quest Diagnostics and DHSS Director Randall Williams. Williams provides updated testing capability numbers and outlines the 4-part approach to COVID-19 testing in Missouri.

Total cases confirmed in Missouri: 10,142
Deaths: 542

Watch full briefing:

Gov. Parson COVID-19 briefing May 11, 2020 : “Good to be around everyday people”

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Cases in Missouri: 9,918

Total Deaths: 488

View full Missouri COVID-19 interactive map for today.

In Monday’s briefing, Gov. Parson says it was good to go home over the weekend and go out to eat at a restaurant and talk to the staff. He spoke of the “unintended consequences” of COVID-19, including domestic violence cases and people putting off their normal health care needs.

Missouri DHSS Director Randall Williams announces the state is getting about 600 rounds of Remdesivir to help treat patients with severe COVID-19 complications in order to reduce their chances of dying.

WATCH full briefing:

 

COVID-19 testing available for Missouri first responders, health care workers WITH symptoms

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From DHSS press release

The Missouri Department of Health and Senior Services is expediting COVID-19 testing and test results for some first responders and other public health and safety professionals by processing their specimens through the Missouri State Public Health Laboratory.

Missourians working in health care and public safety who have had close contact with suspected COVID-19 patients and subsequently experience symptoms such as fever, cough or shortness of breath are eligible, according to the department’s public statement today:

“The lab can provide test results within 24 hours of receiving the specimen — a faster rate than the 8-9 days of some commercial laboratories. This means front-line professionals who test negative and recover from symptoms may return to work sooner and continue providing critical services to fellow Missourians.”

For testing at the state laboratory, first responders must meet two criteria:

  • ·     Close contact with a suspected COVID-19 patient
  • ·       Symptoms such as fever, cough or shortness of breath

First responders who meet these criteria can ask their health care providers to call the 24-hour hotline at 877-435-8411 to request testing. If the patient is approved, the hotline representatives will assist with the PUI (person under investigation) form and send a copy to the Missouri State Public Health Laboratory. 

For more information, please see the Missouri Department of Health and Senior Services health update::https://health.mo.gov/emergencies/ert/alertsadvisories/pdf/update32320.pdf

Missouri leaders to address coronavirus control, health director meets with White House

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Dr. Randall Williams (courtesy Missouri Department of Health and Senior Services)

Missouri’s health director will testify Monday in Jefferson City before a newly-created state House committee related to the new coronavirus. House Speaker Elijah Haahr announced the formation of the committee Thursday, saying state Department of Health and Senior Services (DHSS) Director Dr. Randall Williams has briefed his office on the state’s response plan to protect Missourians’ health. Speaker Haahr says that the more information Missourians have, the better equipped the state will be to mitigate the virus’ spread.

Williams said in an agency statement released today, “Prior to the national health emergency being declared on January 31, our incident management team from DHSS had already begun daily meetings (on Jan. 27) as part of our normal preparedness and response duties. Part of our responsibilities also includes being an effective liaison to local public health departments who were briefed last week in Jefferson City with the latest information from federal partners.”

This week, Williams traveled to Washington, D.C. to meet with his counterparts from around the nation to discuss preparations across our country with the acting White House Chief of Staff Mick Mulvaney and the Secretary of Health and Human Services Alex Azar.”

“I am pleased that our efforts here in Missouri are strategically aligned with our federal and national partners.”

The Missouri State Public Health Laboratory has been approved by the CDC to begin providing testing. The test uses real-time reverse transcription-polymerase chain reaction to detect the virus which causes COVID-19, and it can provide same-day results.

“Our Missouri team has been working to educate and collaborate with a robust network of response organizations including the State Emergency Management Agency, all 16 State departments, the Missouri State Public Health Laboratory, clinicians, local public health departments, medical associations, hospital associations, airports, school nurses, student health departments at colleges, and others to provide timely and accurate information in preparation for the possibility of a future positive case,” Dr. Williams also said in the press statement.

Missouri DHSS has established a website at www.health.mo.gov/coronavirus to provide information and links to resources and education material on COVID-19.

 

Medical marijuana patients in Missouri can apply for the drug earlier than planned

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The Missouri Department of Health and Senior will take applications for patient and caregivers on June 28, six days ahead of the July 4 deadline.

Patients and caregivers must visit medicalmarijuana.mo.gov to apply or to preview the necessary information and forms. At this time, DHSS will accept physician certifications as an attachment to a patient’s application rather than directly from a physician. Certifications cannot be more than 30 days old.

Patient and caregiver registration fees are $25, and patient (in-home) cultivation registration fees are $100.

No medical marijuana facilities will be licensed until early 2020.