Weekly COVID-19 Round-up - 12/16/21
River City Data No. 59
Things are in some ways calmer than they were last week regarding new cases, though rates remain very high in 2021 terms. Vaccinations are picking up just a little bit, but mainly in Missouri’s major cities, primarily focusing on third doses. The legal situation, and the utilization of non-pharmaceutical interventions as we look into the new year, continue to deteriorate. As a group, these three trends suggest that Missouri is in a poor position to manage the consequences of holiday gatherings and what seems like an increasingly likely Omicron-fueled surge in new cases over the next six weeks. - Chris
COVID-19 by the Numbers
Total cases in MO: 964,198 (+19,008 from last Thursday)
7-day average of new cases per day in MO: 2,715.43 (-87.57 from last Thursday)
Counties with the highest per capita rates (per 100,000) of new cases per day this past week:
Adair (120.15 per 100,000), Holt (109), Atchison (108.43), Gentry (105.03), Knox (94.01), and Harrison (83.5)
Total deaths in MO: 15,843 (+176 from last Thursday)
7-day average of new deaths per day in MO: 25.14 (+7.14 from last Thursday)
Percent of all Missourians initiating vaccination: at least 55% (+3% from last week)
Percent of all Missourians completing vaccination: at least 49% (+1% from last week)
Case and mortality numbers are current as of Wednesday, December 15th. Vaccination numbers are current as of Thursday, December 16th. Additional statistics, maps, and plots are available on my COVID-19 tracking site.
Trends in the Past Week
To begin with perhaps the best news - we have stopped seeing the steep increases in new case rates. As I wrote in last week’s newsletter, it was clear that we came out of Thanksgiving adding far more cases per day on average than we were accumulating before the holiday. We saw rates peak statewide at over 3,000 new cases per day earlier this week. This increase put our statewide seven-day average higher than this past summer’s wave.
The above plot contains a clear warning for us, however. Yes, we may have seen new case rates fall from this wave’s peak, but they have only fallen by perhaps 500 new cases per day. They also are not falling anymore. Most counties in Missouri have seen very little change over the past few days in their seven-day averages. Statewide, we are seeing just a slight bump that you can see at the tail end of the purple trend above.
Moreover, while I think it is reasonable to assume that at least some of these cases result from the Omicron variant, there is no evidence that it is anything close to the dominant strain. Nationally, the CDC estimates that it makes up perhaps 3% of new cases. In hard-hit New York, Omicron makes up 13%. So, before Missouri feels any significant impact from Omicron, we have already established new case rates near the highest they have been since early January 2021.
Regionally, the area of most significant concern continues to be Northwest Missouri, along with the greater Kansas City area and other pockets around Northern and Northeast Missouri.
Some good news - despite Northwestern Missouri’s very high rates, they are down quite a bit from last week. There have been significant drops in Gentry, Harrison, Nodaway, and Worth counties. That said, they are not falling back to their pre-winter 2021 baseline rates. This trend is part of the pattern we are generally seeing across Missouri right now.
Beyond cases, hospitalizations are rising as well. Statewide, hospitalizations started sticking up in early November. The pace of that increase appears to increase after Thanksgiving.
You can clearly see the most recent wave in St. Louis, where we have more up-to-date hospitalization trends. I continue to believe that this illustrates the general direction of cases in St. Louis over the entirety of the pandemic better than our actual case data, which were harmed by limited testing early in the pandemic (compare the plot below to the first plot above). We are only about 50 in-patients on average below our peak during the summer 2021 surge.
Hospitalization trends highlight another concern that I have. Even if Omicron does indeed cause more limited numbers of severe illnesses, which is a very big “if” that we are still unsure of, we may still be at significant risk. The variant’s increased transmissibility means that we are still at risk of dramatically stretching our already burned out overburdened health care providers. As Ed Yong lays out brilliantly today in The Atlantic, “the new variant poses a far graver threat at the collective level than the individual one.” Many more people mean many more seriously ill people, even if the ratio between the two changes for the better.
We have seen an uptick in the number of people getting vaccinated for the first time in Missouri. However, that increase is very modest and pales compared to the rate of people seeking third shots, according to the State’s vaccination dashboard. Moreover, the increase in vaccinations is concentrated in the St. Louis and Kansas City metropolitan areas.
I am glad that third shots are being administered. What we’re learning about Omicron suggests that these are key and that we need to stop thinking about them as optional boosters. Instead, these are essential aspects of maintaining the original efficacy of the vaccines. Those who remain wholly unvaccinated, however, are likely going to face significant risk, and we need to see the share of Missourians who have not yet received their first dose decline dramatically in the next few weeks.
Another concern is the rollback of mask mandates in St. Louis and Jackson counties and the following announcements that masking in schools will be dialed back in the new year. The aggressive actions of our Attorney General in Missouri are out of step with Americans as a whole, who remain very concerned about COVID-19, according to Morning Consult’s polling. Moreover, most Americans believe that vaccination requirements and non-pharmaceutical interventions like mask mandates are essential tools for managing the Omicron variant. They are correct but at odds with the prevailing opposition among Missouri’s politicians and what appears to be a vocal minority of our neighbors.
As they have been for much of the pandemic, local and state policymakers are abandoning schools. Left to their own devices, they are choosing to fail their students, faculty, and staff by promising to revisit mask mandates, end quarantines, and in some cases, stop providing parents with data about the risk their children face in schools. It is unconscionable and comes when we may see an increase in risk to children from the Omicron variant. Schools need to start leading, not because it is fair or even their job, but because no one else in Missouri will.