Amid calls for Missouri order, some say problem is bigger than limited testing shows
The number of states without a universal stay-at-home order keeps getting smaller.
Tennessee became the latest to enact one on Thursday. The move by Republican Gov. Bill Lee followed pleas from Tennesseans, including many health care professionals, to help stem the spread of the coronavirus.
But Missouri Gov. Mike Parson, and about 10 other state leaders, continues to hold out. That’s despite the mounting calls for him to take action and eliminate the patchwork of county-by-county stay-at-home orders that blanket the state.
“Why are you not issuing a statewide stay at home order?” Jenny Tabb asked the governor during a Thursday Q&A on Twitter. “You say zero or few cases in a lot of counties. How much does this need to spread until you do something? Rural healthcare will not be able to handle an outbreak so do something now please.”
Parson replied that there’s already a statewide order, referencing his move March 23 that ordered people to avoid eating or drinking in restaurants and bars and prohibited gatherings of 10 or more.
“All options are on the table as we prepare to update that order,” he responded in a tweet. “The bottom line is that EVERYONE should stay home unless it’s ABSOLUTELY NECESSARY to get out.”
By the end of the day Thursday, Parson still hadn’t issued a statewide order.
“It’s important to understand, when you’re governor of the state of Missouri and you try to do a statewide order, our state is so diverse,” Parson said during his daily briefing. “Every segment of the state is different, and it’s very difficult to put a blanket order in place. Then when you start looking at the exceptions you’re going to do, and what essential businesses are, because they differ from whether you’re in a big urban area or a rural area.”
He said he and his staff were “going to figure out a solution to that,” and hoped to announce that on Friday.
But the calls for him to issue a statewide order continue to grow.
Timothy McBride, a health economist at Washington University in St. Louis and former chairman of Missouri’s Medicaid oversight committee, said uniformity is needed.
“As far as relying on current numbers we’re seeing in the state and feeling sanguine about not seeing it in every county, that shouldn’t make us feel that comfortable,” McBride said.
“First of all, we know there wasn’t sufficient testing, and that’s been problematic all along. So we really don’t know how many people really are symptomatic. We just know in the numbers that have been reported how many have been identified because they showed up sick.”
Parson regularly mentions that most Missouri counties still have few positive COVID-19 cases, and many have none at all.
But each day this week, the impact of the pandemic has grown across the state. By Thursday, Missouri’s cases had climbed to 1,834, a 16 percent increase from Wednesday. Rural areas across the state also saw more cases.
More than half of Missouri’s 114 counties now have confirmed cases. And a review of those that have no cases found that some counties had completed only a small number of tests — which is why many say the spread of the disease could be greater than the numbers now indicate.
Some health departments said that they didn’t know how many tests had been conducted because the state was only notifying them of tests that were positive.
The Dent County Health Center, located in southern Missouri, said on its Facebook page Thursday that it had tested 13 people with 12 testing negative and one pending.
Residents have questioned the Dent County numbers.
Wrote one person earlier this week: “But how many are coming in with a ton of the symptoms but no fever and not being tested?”
Added another: “All it takes is just one to spread it amongst a community like ours.”
And in Holt County, the sheriff’s department said Monday on Facebook that two people had been tested.
Krissy Prussman, the county’s health department administrator, said Thursday she couldn’t confirm the total number of tests conducted. But, she said, the county still had no positive case. She knows, however, that could soon change.
“Atchison has had one... Buchanan has had some,” she said. “We’re kind of surrounded right now. So I do feel like our time is coming, but we’re hanging in there. Hopefully, if we do get numbers, they still stay low.”
The county has no hospital, and tests are being conducted at Community Hospital-Fairfax in neighboring Atchison County as well as some area clinics, she said.
Prussman said more test kits have become available this week.
“I do think there are some that probably could be tested that we’re just asking to self-quarantine instead of actually testing,” she said. “Even though testing supplies are getting better, it’s not perfect. You kind of have to do your best at the ones that require it the most.”
When the Andrew County Health Department posted its update on Facebook on Tuesday that said “ZERO lab confirmed cases in Andrew County as of this morning,” someone asked: “How many from Andrew county been tested?”
The health department’s response: “We previously had shared that unfortunately the state is no longer reporting this information to us due to private labs and such being on board. All labs are required to push results to the state DHSS but that is not being shared on the local level.”
Audrain County is another with zero cases. But it’s not because of a lack of testing, said Sandra Hewlett, administrator of the county’s health department.
“We have four drive-throughs within 30 to 40 minutes of here,” Hewlett said Thursday. “Our local hospital is testing and now they are setting up a drive through.”
The central Missouri county of about 25,000 has tested 16 residents. Thirteen tests were negative and three are pending, she said.
One reason Audrain has been able to keep the cases at bay may be because they acted early, Hewlett said.
Health directors and lawmakers are waiting to see what Parson will do in coming days.
In a letter sent to Parson on Wednesday, Sen. Jill Schupp urged the governor to “listen to the counsel of Missouri’s medical professionals and issue a statewide stay at home order.”
Schupp, D-St. Louis, noted that last month the Missouri State Medical Association, the state’s largest association of physicians and surgeons, advised Parson to issue a statewide order. Without such an order, the group said that “COVID-19 patients will deplete the state’s available hospital beds, ventilators and precious personal protection equipment.”
Likewise, Schupp said, the Missouri Nurses Association, the Association of Missouri Nurse Practitioners and the Missouri Association of Nurse Anesthetists also urged Parson to issue a statewide order.
“These organizations are rightfully concerned that without a statewide stay-at-home order, Missouri’s health care system will soon be overwhelmed and unable to provide the level of care needed to treat the sick and save lives,” Schupp said.
Expecting various local officials to coordinate action across the state’s 114 counties without a uniform statewide order “has created a patchwork of differing policies,” she said.
“As a result, these disjointed directives have many Missourians questioning the seriousness of the pandemic.”
This story was originally published April 2, 2020 at 6:55 PM.
