While still low, Cape Girardeau numbers bump back up. Here's why

Today's column is mainly a Q&A with Maria Davis, health educator with the Cape Girardeau County Public Health Center.

__Q: After a period of a couple weeks with no confirmed new cases most days, there is a new bump in Cape County. Do public health officials have any insights regarding the new cases?__

A: "We are continuing to see community spread, and with an increase in testing and reopening, there will be an increase in case numbers."

__Q: Are there any similarities or linkages to the new cases?__

A: "Yes, household members and/or work contacts."

__Q: Are you concerned about the uptick? Or are the numbers so small in aggregate that the bump is not material?__

Data from USAfacts.org

A: "We are, of course, concerned about any increases in cases, but it was not unexpected as we reopen the state. The virus is not gone, and we learned through our seroprevalence study that 99% of the population is still at risk for infection. Cape County residents need to continue to practice social distancing and wear masks in public to help us decrease the number of new cases."

Data from USAfacts.org

__Q: In the county's briefings, the number of infections from "close contact" or "unknown" are growing. Can you speak to what contact tracing is indicating about both of these categories?__

A: "The goal of contact tracing is to identify potential new cases and ask these individuals to quarantine whether they have been in contact with cases that were classified as close contact or unknown exposure. What we are learning is that household contacts and work contacts are more likely to become infected. Unknown cases are classified as such because we cannot identify a confirmed case they came into contact with, and they have no recent history of travel."

__Q: If "unknown," what are the concerns about how people are contracting the disease?__

A: "Our concerns with unknown exposures are more than likely, they were not following the guidelines to prevent the spread of the virus, or those they are in close contact with are not following the guidelines."

__Q: Crowded pools and pool bars at the Lake of the Ozarks received a lot of attention this week. In Cape Girardeau, some establishments are packing customers in, too. What is your guidance for people in Southeast Missouri regarding crowded spaces? Does it make a difference if the space is indoors or outdoors?__

A: "The virus mainly spreads when an infected person talks, coughs or sneezes, and close contact of those droplets emitted can occur if you are inside or outside. For this reason, Cape County residents need to stay at least 6 feet apart from non-household contacts and wear a mask when unable to socially distance."

__Q: The CDC has said swimming is OK under certain conditions. What is your guidance? Should "healthy" people have any concerns about swimming?__

A: "There is no evidence that the virus can be spread through pool water and is unlikely if the pool is properly operated and the water is disinfected. However, the virus can still spread between individuals above the water and outside of the pool if they come into close contact. Therefore, social distancing from non-household contacts is recommended inside and outside of the pool. The virus can also spread on surfaces outside of the pool and should be disinfected frequently. We want people to enjoy summer activities, but extra precautions are necessary to protect themselves and their loved ones."

__Q: Free testing will be provided next week to anyone who wants to take a test to determine if he or she has active Covid-19. Why should people take this test even if they don't have symptoms? Are there any age groups that you particularly hope take the test?__

A: "On June 5 the Missouri Department of Health and Senior Services, along with the Missouri National Guard, will be conducting a mass testing event at Arena Park from 7 a.m. to 7 p.m. for any Missouri resident that wants to be tested. People can be asymptomatic but still infected with the virus and spreading it to others. Therefore, we would like as many residents to be tested as possible regardless of their age so we can isolate them and decrease the number of people they infect. Please note, a negative result from this test does not mean that you cannot become infected the following day; therefore, the guidelines should still be followed."

__Q: Whom should people contact to sign up for the free test?__

A: "Online preregistration is highly encouraged at www.health.mo.gov/communitytest, which will allow for the testing event to run efficiently for patients. Those without access to online preregistration can call the Missouri COVID-19 hotline for registration assistance at (877) 435-8411."

__Q: Vulnerable people -- the elderly and those with comorbidities -- need to take utmost precautions because the virus is still out there. But given the low prevalence of coronavirus in this area, in conjunction with a low fatality rate for those under 65-years old who contract it, why shouldn't those not in a danger group go about as normal? If they don't interact with the vulnerable, why should they wear masks, social distance or do anything out of the ordinary?__

A: "The recommendations stand for everyone, even those that may not have direct contact with a vulnerable person because your close contacts or their contacts can expose vulnerable people. No one lives in a bubble; what we do affects those around us. Therefore, it is everyone's responsibility to protect the vulnerable population. Also, the virus can spread to vulnerable individuals through the surfaces we touch."

Thanks Maria for the information.

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Our country has polarized around precautions such as wearing masks, social distancing and how fast to open the economy. But taking prudent precautions enables a more effective reopening. Wearing a mask is not giving up on American freedom. But it is certainly unkind if you don't wear one in places with others who are vulnerable. That includes shopping. (Thankfully, some stores have established dedicated shopping times for the most vulnerable.)

Is a face covering convenient? No. But it's not an incredible burden either.

It isn't necessary to wear a mask in an uncrowded area or where there is appropriate social distance, and some people are quick to condemn others for not always having a mask on outside the home. That's extreme and counterproductive, too. Being outside with housemates and walking and exercising in the open air are good to do. And walking past someone outside without close contact is virtually no risk to either person: mask or no mask. Understanding the risks around dining out -- and managing them -- also presents little concern in our area where the prevalence of the virus is currently so low. (If the number of active cases goes up dramatically; that would change.) Eating out in smaller groups -- preferably with those you're with regularly -- is still recommended.

The hard truth is that the statistics and projections around this disease continue to change as more is learned about it, and its mortality rate continues to drop from what was predicted earlier. Though it can sicken anyone, it has mainly proved to threaten people over age 65 and those with underlying chronic health conditions.

According to a recent Wall Street Journal column by John Delaney, who was a Democrat candidate for president last year, "This virus disproportionately harms older Americans. It is estimated that upward of 50% of deaths have been in nursing homes. Roughly 30% have been people over 65 not in nursing homes, and the other 20% is everyone else, according to Centers for Disease Control and Prevention data. That means roughly 3% of all nursing-home residents have died of Covid-19, versus 0.06% of people over 65 not in nursing homes and 0.01% of the rest of the population. If we separated the generally healthy population under 65 from the medically vulnerable under 65 the numbers would be even more stark."

In Southeast Missouri, we're certainly seeing similar statistics with nearly all fatalities involving the elderly, usually tied to congregant living in retirement homes.

Meanwhile, the lockdown -- needed originally while we learned more, particularly as Europe and New York were hammered -- has been devastating to our economy and to the health of millions of people shut inside and away from their jobs and schools, and the psychological toll continues to rise. Most Americans, absent a personal experience with the virus, are showing through their actions (as tracked by smartphone mobility) that they are finished with staying at home. They are ready to go about their business and see friends.

Opening the economy and getting back to work is vital, and those counseling against it are out of touch. But wouldn't it be better if we could open up the economy, socialize and be prudent at the same time? By being careful about how we interact with others? By staying away from large crowds? By wearing masks while shopping -- for at least a few months more -- as we see the effects of opening up? By taking care of the most vulnerable, including upholding stringent precautions around nursing homes?

Our case numbers in Cape Girardeau County, even with the recent slight bump, remain low. Let's keep them there.

Jon K. Rust is publisher of the Southeast Missourian.