As reported previously, Gov. Mike Parson and the Missouri Department of Health and Senior Services have identified two key metrics that they feel counties should use to determine the risk of COVID spread and to guide policy decisions by local officials. 

“Positivity Rate” trended up a bit over the past week, and now hovers just below 15 percent, suggesting MANY more people should be getting tested during their quarantine or when they have COVID like symptoms (even mild symptoms). My hope is that the new guidelines regarding testing during shortened quarantines will encourage more people to be tested. 

The “7-Day Case Rate per 100K” graph continues a steady decline of new cases from a peak rate of 750 new cases per 100K per weekday two weeks ago. However, our current rate (476 new cases per week per 100K) is still significantly above the threshold for extreme risk (350).

Another way to look at this is during the week of Thanksgiving, our rate peaked at 110 new cases per week in Gasconade County and is now down to 70 new cases per week. However, to drop out of the governor’s Extreme Risk category, our county would need less than 51 new cases in a week, and to drop below Critical Risk, we would need 14 or fewer new cases per week.

Quarantine shortened

The Centers for Disease Control issued new guidance allowing a shorter quarantine period after COVID exposure. The state agreed with CDC guidelines, but wanted to reserve the shorter quarantine for counties with low amounts of COVID.

After multiple meetings with the health department, we decided to approve the shorter quarantines, despite our high number of cases, in the hope that this will increase the percentage of people who complete their quarantine (some residents of our county had begun ignoring the 14 day quarantine).

The new guidelines allow for a person to be released from quarantine after 10 days if they never develop symptoms during their quarantine, or after only seven days if they never developed symptoms AND got a negative COVID test (PCR test on or after day five, or an antiGEN test on or after day seven).

There are a few additional important details about who the shorter quarantine is appropriate for, so please read the guidelines in full and call the health department if you have any questions.   

Vaccine news

The Pfizer COVID vaccine was approved for emergency use last week. This is great news but will not likely have much effect on residents of Gasconade county.

The Pfizer vaccine requires very specialized storage freezers (minus-144 degrees Fahrenheit), as well as requiring an organization to order a minimum of 700-plus doses at a time, which need to be given in just a few days. A very similar vaccine from Moderna, which will likely be approved this week, does not require specialized equipment to store and can be ordered at 100 vaccines at a time.

The following information is changing rapidly, and may be outdated by the time of this printing, but in the interest of full transparency, I wanted to share what we know so far and hope for:

Hermann Area District Hospital and Clinics are working closely with the Gasconade County Health Department to have everything in place and hopefully be able to begin vaccinating healthcare personnel in our county as soon as it is sent to us (best guess is either next week or just after Christmas).

The current plan is for our most vulnerable population (nursing home and assisted living residents and their staff) to be vaccinated through CVS Pharmacy, likely with the Pfizer vaccine, and hopefully starting around the same time or sooner. The state has given us guidance regarding the order of who should be offered the vaccine, which we will follow.

One thing the state has made us aware of, is that there is extra paperwork related to giving the COVID vaccine (reminder cards for patient about second dose, a bit more detailed consent to go over, and the need to enter each patient’s information into the state vaccine database).

This will limit how many doses a nurse can give in a day (current best guess is 30 to 50 shots if a nurse is not doing anything else). 

To begin with, vaccines will be coordinated through a dedicated COVID vaccine clinic and will require an appointment. Our hope is that as we become more efficient with the process in the coming weeks we will be able to vaccinate more people each day, but as our county has 14,000 residents, and each will need two doses of the vaccine to be protected, this is going to take a while, even if we had enough vaccine for everyone who wanted it today.

Many people will have an opportunity to get one of the vaccines at another location or through another organization. My advice is if you get the chance to be vaccinated, take it. I know there are many people with questions about the vaccine (safety, efficacy, etc.) and I plan to try to answer those questions over the coming weeks.

Right now, I’m hoping to be able to get the vaccine myself this week or next week.