For much of October, there were so few new COVID-19 cases in Knox County that health director Lori Moots said she was beginning to hope the pandemic was almost over for her constituents.
The early September Knox County Corn Festival, she said, did not produce the dreaded spike in cases. And by October 8, the health department was able to report that there was only one active business in the province of 3,744 people.
That has all changed in the past two weeks.
On Friday, there were 54 active cases, 13 more than at any time since the first infections were identified in mid-June 2020.
“Going into Halloween, I had predicted that hopefully it would be out of here before the indoor sports kicked in,” Moots said Tuesday, “and it just broke out on Nov. 1.”
Knox County is an extreme example of what happened in the state in November.
The main culprit remains the Delta variant of the coronavirus, which hit the state in may and drove hospital admissions to near record levels as it peaked in august.
While political battles about mask mandates stayed warm, the Delta variant wave cooled. However, the daily average of new cases remained more than double its late May low of 396 per day.
At the end of October, the downward trend came to an end. The Ministry of Health and Senior Services has so far reported 21,190 new infections with the corona virus in November. The seven-day average of reported cases rose from 975 per day on Oct. 31 to 1,418 per day on Wednesday, an increase of more than 45 percent.
On Friday, the daily average exceeded the rate of the same day of the previous month for the first time since August 22.
Wednesday’s percentage remains less than half of the August 5 peak and less than a third of the pandemic’s peak on November 20, 2020.
The state’s health department reports 12,423 deaths among people with lab-confirmed cases of COVID-19, including 3,257 who have died since early May.
At least 10 people died every day from July 4 to October 22. The most deaths, 46, occurred on August 29. The highest single day death toll for the Missouri pandemic is 77, on Nov. 23 and Dec. 9. , 2020.
Over the past two weeks, hospitals in the state reported an average of about 1,000 admitted COVID-19 patients each day. While that’s well above the average of about 650 at the end of May, it’s down about 60 percent since mid-August.
Wastewater sampling, which can identify the variants and predict whether cases will increase, shows viral spread throughout the state is increasing. The early May program identified the arrival of the Delta variant in Branson.
“I think we’ll see a steady increase over a month or two, but probably not as bad as last year,” said Marc Johnson, a professor of molecular microbiology and immunology at the University of Missouri. Johnson’s lab analyzes wastewater samples for the state.
In late June, when the Delta variant rose sharply, Johnson accurately predicted daily cases would triple by the end of July.
The current rise in the number of cases is because vaccination against the coronavirus is now open to anyone over 5 years old and booster shots are available for many people who get vaccinated early in the year. The state report shows that 50.4 percent of all Missouri residents have completed vaccination.
On Tuesday, the Department of Health and Senior Services issued: a hotspot advice, the first in nearly a month, for seven counties in northwest Missouri. The list includes Buchanan County, home to St. Joseph, the largest city in the region.
Six of those provinces have already exceeded the October case totals.
The increase in northwest Missouri appears to be part of a broader regional trend, the consultancy said.
“Our neighboring states like Kansas, Nebraska, Iowa and Illinois also all have higher cases than Missouri, and many of our border counties in the northern part of the state appear to be disproportionately affected,” said Lisa Cox, a spokeswoman for a state health department. department, wrote in an email to The Independent.
The trend in cases has increased in almost all parts of the state. In the past week, 77 of the state’s 118 local health departments showed an increase in the number of cases from the previous week. Only 36 showed declining cases.
There are 26 local health departments where the infection rate per capita has exceeded the rate for the entire month of October. Only six local health jurisdictions exceeded the infection rate per capita in September in October.
Samples from 73 sewage systems, tested in the first week of November, showed 16 systems with increasing levels of coronavirus particles and 11 where the load was decreasing. Tests last week showed 29 increased and only five where the virus declined. For the rest, the trend was uncertain.
When viral loads increase 40 percent in a week, health officials can expect a 25 percent increase the following week, state health officials said in June.
Platte County, which borders the region mentioned in the advisory, has seen a 63 percent increase in the number of cases in the past seven days compared to the previous week.
“At this point, it is difficult to pinpoint an exact cause for the increase in cases,” said Aaron Smullin, spokesman for the Platte County Health Department, in an email. “We have no outbreak or event in common. Our current thought is because of Halloween activities. Last year around this time we saw a similar increase in cases.”
As of late October, nearly 22 percent of new cases statewide have been among children under the age of 18. A large proportion of Platte County cases are also among children, Smullin wrote.
The requirement to vaccinate children is a good one, he wrote.
“We have several clinics scheduled in Platte County, and they are fully booked very quickly,” he wrote. “We see a very high demand for pediatric COVID vaccine doses.”
The pattern of increasing cases in Missouri is seen in many states, Johnson said. The states that see the highest rate of increase, Johnson said, are the ones where cold autumn weather drives people indoors.
“If you look at the distribution across the country, what’s going on now has a lot more to do with your latitude than your vaccination rate,” Johnsons said.
Situation in Knox County
The small staff at the Knox County health department are working as hard as they can to keep up with the flow of new cases, Moots said.
“We worked Veterans Day and we split the caseload among three nurses for contact tracing,” Moots said. “We’re just doing it, hoping it’s about to get through this and slow down.”
The 54 active cases are equivalent to one person in 75 with COVID-19. Knox County has the third lowest population of the state’s counties.
If the same proportion of active cases occurred in Boone County, which has more than 180,000 people, it would be more than 2,450 active cases, or the equivalent of every infection reported since Sept. 17. The Columbia-Boone County Public Health and Human Services Department reported 334 active cases as of Tuesday afternoon.
In St. Louis County, the state’s largest population with nearly 1 million people, a similar ratio of active cases would be equal to all cases reported since Sept. 24.
Of the 68 cases identified by Knox County this month, 26 were among children under the age of 10. Moots said she started give warnings a few weeks ago via her department’s Facebook page that people should not assume that symptoms such as coughing or sneezing are the result of allergies or that childhood illness, such as coughing, vomiting or diarrhea, is the result of a cold or foodborne pathogens.
“We had some rainy weather and the alcoves went in,” said Moots. “All meals went in. There were no outdoor activities for the little boys. That’s where we really saw the explosion, from kindergarten through sixth grade.”
The high number of new cases reported by Moots’ department is not reflected in the health department’s report, which shows just 20 cases this month, and 17 in the past two weeks.
“The 17 cases we currently have include antigen and PCR testing, but it’s certainly possible they have a provider in the area that doesn’t report directly to DHSS as required,” Cox wrote in an email. “We are investigating it with the local health service.”
Moots said she was unaware of the discrepancy and was too busy to check the state report.
Vaccination coverage in Knox County is better than in much of rural Missouri. The county was 51st in vaccinations completed, with 38.1 percent vaccinated. But many of them are older residents of the county, Moots said.
It is difficult to convince many younger adults to take the picture.
“When it comes down to it, those 16- to 46-year-olds who would be in the hot zone just aren’t going to do it,” Moots said.
The childhood cases were generally mild, and monoclonal antibody treatments are readily available in the area to support adult cases, she said. The disease is generally not as severe as it was earlier in the pandemic.
She has personal experience with the disease in children.
“My 9-year-old was due to get his vaccine and got COVID last week,” Moots said. “That also interrupted my boosters.”