Why are cases of COVID-19 rising in Cape and other questions about rodeo, university and current hospital capacity

Here we go again. After positive cases of COVID-19 receded following the imposition of a countywide mask order in early July, cases of coronavirus are back on the rise in Cape Girardeau County. Understating the results is that university students who reside in Cape Girardeau are not counted in Cape County numbers if their official residence is elsewhere.

As a matter of personal observation, I've been impressed with the university's serious approach to "protecting the nest," even if some students' sense of responsibility doesn't translate to off-campus. Case in point: as a downtown resident, I frequently walk across the campus. For the most part, I do not wear a mask while outside. Given the lack of crowding in rural Missouri -- even in Cape Girardeau -- there's no reason to wear one in the open air. Do I give other people a wide berth when we pass? Yes. But a mask in such cases is unnecessary.

When I get to the campus, however, everyone is wearing a mask, even outdoors, which is probably sensible as students are more likely to congregate as they see each other. To support them I put on my own mask. Why detract from the spirit of universal adoption the university has been able to foster?

Unfortunately, masking is not always so vigilantly followed off-campus. And I've witnessed off-campus student gatherings that are largely unmasked and crowded. Inevitably, infections will be transmitted. The challenge is keeping the exposures as controlled as possible while still holding classes -- or when interacting in churches, grocery stores and other shops -- where utmost precautions should rule.

My wife teaches at Southeast, and only a week in, she had her first communication from a student "with symptoms." The student explained that she would be staying away from class unless her test results returned negative. My wife reviewed where the student had been seated (in appropriate distance from others) and that all had worn masks throughout class. Ideally, the classroom would have better air circulation, but in general all precautions had been taken, and the possible case -- even if it turns into an actual positive case -- won't detract from moving forward. [Update: the result came back negative.]

We all owe a debt of gratitude to teachers and professors everywhere for their commitment to their students -- and to their institutions.

In-person classes make a huge difference in the joy -- and learning -- of students. I see it with my littlest ones, and I hear it from parents all around town. Teachers and professors: Thank you again for your dedication, your talents, your creativity and your courage.

Meanwhile, here are some updates from the Cape Girardeau County Public Heath Center. Answers provided by Maria Davis, health educator:

__Q: There are rumors that a number of positive COVID-19 cases have been traced to the Sikeston Rodeo, which took place the first week of August. Do you have any comments on that, including guidance about attending large events?__

A: We know of about 10 cases that attended the Sikeston Rodeo within two weeks prior to infection or positive COVID test. It is unknown if that is where these individuals were exposed, but at large gatherings the risk of transmission is high. It is possible the increase in cases in our area could be due to the second or third generation of transmission from this event.

When attending large events, wear a mask, avoid touching your face, make sure to take hand sanitizer with you, stay six feet away from others as much as possible, and, most importantly, stay home if you are sick.

__Q: How are positive cases with students and staff at Southeast Missouri State University being traced? Can you walk us through how County Health makes a decision to alert someone about a possible exposure?__

A: The CDC's definition for which county a reportable disease is counted is determined by where the individual physically lived most of the year. Therefore, not all of the SEMO students that test positive will be considered Cape County Cases. SEMO has created its own COVID case dashboard on their COVID website to keep the community informed of all cases at SEMO.

Alerting someone of a possible exposure is done on a case-by-case basis, depending on how long and how often the individual was exposed, whether or not both individuals were wearing masks, and the type of activities/event the exposure occurred.

__Q: After seeing positive cases initially decline after the imposition of a countywide mask order, cases have spiked again. What do you view as some of the reasons for that?__

A: As far as exposures, we still see mostly contacts to confirmed/ probable cases, but we are seeing an increase in travel and unknown cases as well. Travel seems to be less work and international travel and more summer vacation associated. Community exposure is increasing slightly (attended an event or mass gathering with a case).

Household contacts are still the number one exposure, but there is a significant increase in what we call non-household contacts, which is friends or family members that do not live in the household. The public needs to remember the guidelines should still be followed when around extended family and close friends. There is also concerning increases in long-term care facilities and healthcare-associated cases.

__Q: The Missouri Hospital Association regional dashboard, which lists hospitalizations in the various regions of Missouri, is lagging. Any insights?__

A: The MHA regional dashboard uses the new Tele Tracking system from HHS [the United States Department of Health and Human Services]. With a new system; a lag in data was expected. However, we hope this lag will decrease and see more accurate information than was previously reported.

__Q: What is the current status of capacity to handle COVID-19 cases at the local hospitals? According to the state's lagging tracking numbers, the Southeast region has grown slightly in hospitalizations, but is far from approaching maximum capacity.__

A: We are in frequent communications with both our local hospitals, and they are staying steady with a total of about 20-30 hospitalized between the two COVID Care Units, which includes individuals from other counties along with Cape County residents. One thing to note is as cases increase, you may not see an increase in hospitalization rates right away. With this disease, we see that as cases increase, you can expect an increase in hospitalizations 2-4 weeks after that initial increase. Also, those with severe illness are usually sick for long periods, and several of the Cape County hospitalized individuals were hospitalized for 30 days or more.

n

__Finally, it wasn't a response to one of my questions. But County Health posted a message answering questions about the cause of deaths ascribed to COVID-19 locally -- and in the United States. Here is the comment:__

"In response to the recent misinformation circulating about COVID-19 deaths, which claims only 6% of reported COVID-19 deaths truly died of COVID. The CDC states 6% of the reported deaths had only COVID listed as the cause of death on the death certificate. What this means is 94% had other comorbidities determined as the cause of death along with COVID-19. Comorbidities are NOT the same as preexisting conditions. The CDC defines comorbidities as more than one disease/condition is present in a person at the same time. The most common comorbidities of reported COVID deaths are pneumonia, adult respiratory distress syndrome, respiratory failure, hypertensive disease, cardiac arrest, and diabetes. To summarize, those that die from COVID-19 die because of what the virus does to the body."

n

In other words, no one should underestimate the seriousness of this disease. We can't just stop living and studying and working and shopping. But we should do all these things while being smart: wearing masks, keeping social distance, washing hands and staying home when sick.

Keep strong. And be safe. Several different vaccines continue to show promise in development and testing. Human ingenuity -- with God's help -- will eventually defeat this malady.

Jon K. Rust is publisher of the Southeast Missourian. This story originally posted online Wednesday morning, Sept. 2.