With local Covid numbers up, not wearing masks means vulnerable are at greater risk

There's a battle taking place in the national media about the meaning of dramatically rising Covid-19 cases but decreasing deaths. Will significant spikes in hospitalizations in some metro areas translate to more fatalities? In a few weeks we'll know more. But for now, the national trend lines for fatalities and hospitalizations are largely flat (after being downward for many weeks). Some of the reasons offered are that expanded testing is finding more cases, milder cases and earlier cases; the typical Covid-19 patient is now younger; and hospitals have learned how to treat better.

In Cape County, we're seeing a worrying explosion of cases. And yet, they are disproportionately among those 20-29 years old, who are among the least at risk for serious complications. Across the state, of more than 26,200 who have been lab-confirmed positive for the disease, only five under 30 have died.

Still, with more of the virus in the community, the more likely it is that it will be transmitted to someone who is at greater risk. This is a critical reason why face coverings should be worn in public where social distancing is not possible, especially where the elderly and vulnerable go, including at grocery stores, churches and shopping areas.

Questions about these trend lines on a local basis were put to Maria Davis, health educator with the Cape Girardeau County Public Health Center. Here are her replies.

__Q: For a while, data has shown positive local Covid-19 cases in a sharp spike up while the rate for hospitalizations and deaths are down. How are these diverging trend lines explained?__

A: The increase has been significant among young adults ages 18-29. These individuals are usually healthier and less likely to have severe illness due to Covid-19. Therefore, cases are increasing, but the hospitalization rate and mortality rate are decreasing.

__Q: What are the local hospitalization statistics by age?__

A: For Cape County residents, no cases younger than the 40-49 age group have needed hospitalization. There has been one case in the 40-49 group; two in 50-59. Two in 60-69. Nine in 70-79, and three in 80+. The three deaths have been 70-and-above.

__Q: Do you expect to see an increase in local hospitalizations soon?__

A: With an increase in cases, there is a higher risk for our vulnerable population to become infected. Therefore, we could see an increase in local hospitalizations as a result. There are some things that we as a community can do to prevent this, and the primary thing is to wear a mask and stay six feet away from anyone vulnerable.

__Q: If the mortality rate is lower than originally thought and there is not a concern for hospital capacity, why should those without comorbidities not go about life more like normal?__

A: Across the country, the mortality rate is lowering, but the average age of those infected is also lower. The mortality rates have not changed for our vulnerable age groups. Thus far we feel our community has done a pretty good job protecting those that are vulnerable. However, with the virus seeing substantial spread in the community, we worry that [it will spread] to the vulnerable. By wearing a mask and physically distancing, especially for those more susceptible and in public (where it is unknown if you come into contact with vulnerable individuals), we can continue to protect our community. The preventive measures that are the most effective are the ones that protect others. We ask people to do the right thing and protect each other.

__Q: The County Public Health Center has started to list venues and times where individuals may have been exposed, because the center has found it "impossible to notify all contacts of the patient" in some cases. How should the general public use this information? Should people be keeping a journal of where they go each day?__

A: It is encouraged anyone who was potentially exposed to watch for signs and symptoms of Covid-19. If you start to experience any symptoms, call a local healthcare provider to determine if you need testing. We also strongly encourage these individuals to be extra cautious and either maintain six feet physical distance or wear a mask when within six feet of non-household contacts.

__Q: Why isn't more information being shared about these potentially broad exposures? For example, whether the exposure was from a staff member or a customer?__

A: We do everything we can to protect their identity and private medical information while also protecting the public. If we know the times of when the unmasked positive individual was at a facility, we share those times. However, if they are unable to provide us with that information, we share the date and location.

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On a final note, while hospitalizations remain steady -- but not spiking -- in Cape Girardeau and southeast Missouri, that is not the trend line for the state as a whole, which is among the reasons St. Louis and Kansas City have implemented new requirements to wear face coverings in public. In Cape County, the health department's emergency order still stands. It encourages masks but does not require them. [Editor's note: Since the publication of this column online, the Cape Girardeau County Public Health Center has mandated face coverings in all public spaces, effective Monday, July 13.]

Please remember: A major reason to wear face coverings is that they help prevent transmission, which will allow us to keep more of the economy open. Unfortunately, several states and towns have had to pause or reverse plans to re-open their economies due to rising virus numbers leading to greater hospitalizations. We don't want to be one of them.

Masks may be inconvenient. And, they need not be worn in places it doesn't make sense. But taking personal responsibility now will help everyone.

Jon K. Rust is publisher of the Southeast Missourian. This column originally posted online Friday morning, July 10.