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COVID cases spike again in Missouri as health officials watch for omicron strain

Jared Wilson, RN, and Andrea Wiese, RN, care for patients in the COVID-19 unit within the Progressive Care Unit at University Hospital.
Justin Kelley
MU Health Care
Jared Wilson, RN, and Andrea Wiese, RN, care for patients in the COVID-19 unit within the Progressive Care Unit at University Hospital.

A waning delta variant summer surge gave way to a spike of cases in November, as infections and hospitalizations rose amid concerns about a new coronavirus variant spreading out of South Africa.

The omicron variant hasn’t been detected in Missouri, but public health officials are watching. The first place it is likely to be detected is in the weekly wastewater sampling that found the delta variant in Branson’s wastewater at the beginning of May.

“Is this really going to be more transmissible? Is it going to make patients sicker?” Laura Morris, a family medicine physician and MU Health Care’s COVID-19 vaccine co-chair, said during a Monday briefing. “So far, that does not appear to be the case. But there are so few cases and not enough time has passed to really be able to say that for sure.”

While it hasn’t reached Missouri yet, the omicron variant is already having an impact on travel plans because of restrictions imposed by the U.S. and other countries. Gov. Mike Parson canceled a trade mission to Israel and Greece, scheduled for this week, after Israel banned all travel to the country on Saturday.

“We are postponing our trade mission because we want to respect the travel policies and practices enacted by the host countries,” Parson said in a news release.

The Department of Health and Senior Services reported 41,530 additional coronavirus infections in November, an 18.6% increase over cases reported in October. By the end of the month, the seven-day average of newly reported cases stood at 1,564 per day, more than 60% higher than the rate at the end of October.

The delta variant peak was just over 3,000 cases per day at the beginning of August.

The counties hit hardest in November are all in north Missouri, and four of the five with the highest infection rates for the month – Atchison, Gentry, Worth and Nodaway – are clustered in the northwest corner of the state. Three of those counties were the subject of the health department’s latest hotspot advisory, issued Nov. 16. The fifth, Knox County, is in the northeast.

Infection rates in those counties were four to six times higher than in October.

Hospitalizations are 29% higher than at the end of October, with 1,272 people being treated as inpatients compared to 986 at the beginning of the month. The high point for hospitalizations caused by the delta variant was 2,463 on Aug. 19.

After the delta variant arrived in May, it circulated for several weeks before it began having a major impact on the state. Branson straddles the line between Stone and Taney counties. Cases in those counties increased about 50% in May compared to April. They tripled in June as the variant took hold throughout southwest Missouri.

The delta variant's spread imparted essential lessons for how fast a more transmissible strain can spread, and detection through genomic sequencing and even PCR testing, which includes swabbing someone's nostrils to sample genetic material for the virus' presence, may make detection of the omicron variant slightly easier, Morris said.

"But the reality is that if this variant is going to spread and be similar to delta, that it will be there before we know it," Morris said.

Internal emails from the state's health department obtained by The Independent and the Documenting COVID-19 Project show that state officials were slow to react to the danger of the delta variant.

Marc Johnson, a virologist at MU who leads the wastewater surveillance program, was shocked at how fast delta spread.

Johnson and his team warned of delta’s spread as soon as the data showed it was taking over as the dominant strain. But information from wastewater testing did not translate to immediate action.

On internal calls with local health officials, the state cautioned against causing “mass hysteria or concern” about delta. The state’s first hotspot advisory of the pandemic, was not issued until July 19, came as Springfield officials were warning that the strain on southwest Missouri hospitals was likely to spread to other parts of the state.

On Monday, the department issued a news release to assure the public that it was ready to act when the omicron variant is detected.

“If the omicron variant emerges in Missouri, the public health community has the resources available to identify it through the state’s extensive partnerships and monitoring systems, as has been done with other emerging variants,” Director Donald Kauerauf said in the release. “Emerging COVID-19 variants can be highly unpredictable in the early stages, so the public needs to remain vigilant to prevent their risk of exposure.”

But the reality is that if this variant is going to spread and be similar to delta, that it will be there before we know it.
Laura Morris, a family medicine physician and MU Health Care’s COVID-19 vaccine co-chair

Some variants arrive but then disappear, depending on whether the mutations make it more likely to be transmitted. One of the first variants to cause worries, the beta variant detected in the United Kingdom, resulted in a brief outbreak, “but it fizzled,” Johnson wrote in a recent email to The Independent.

During November, the state health department made two big changes to the way it reports cases and deaths. The change added 10,706 infections to the total detected since the start of the pandemic, which stood at 906,993 — almost 15% of the state’s population — on Tuesday.

The state also added deaths among people who’s infections were identified by antigen testing or individuals who were identified through death certificates who had not been tested. That change recognized 2,771 deaths, many of which were already being reported by local health departments in their reports.

As of Tuesday, the department reported, 15,434 people have died of COVID-19, about 1.7% of those infected with the coronavirus.

Health officials are urging people who completed vaccination in the spring to get a booster shot and for the almost 40% of Missourians who have not had a shot to obtain it.

“Although we will learn more about the omicron variant in the coming weeks, I encourage all Missourians to make it their personal responsibility to take control of the COVID-19 threat and follow public health recommendations for vaccinations,” Kauerauf said in the release. “By getting vaccinated, we are doing our part to limit the impact of the current variants that are circulating in Missouri.”

With COVID cases rising in the last few weeks — before a known case of the Omicron variant has even been detected — Morris stressed that residents' choices still need to be made with the level of community spread in their area in mind. Getting vaccinated against COVID-19, whether for the first time or through a booster dose, is key to preventing serious disease, she said.

"I don't necessarily need someone to make a rule for me to be able to do the thing that's the smart thing for public health,” Morris said, “and I encourage others to do the same.”

Missouri Independentis part of States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence.

Rudi Keller covers the state budget, energy and state legislature as the Deputy Editor at The Missouri Independent.