JEFFERSON CITY, Mo. – Since Jan. 1, 2021, the overwhelming majority of COVID-19 cases and deaths in Missouri have occurred among the unvaccinated or partially vaccinated, as real-world numbers continue to prove the vaccine is safe and effective in combating the spread of the deadly virus.
On Thursday, the Missouri Department of Health and Senior Services (DHSS) updated its COVID Dashboard with information on breakthrough cases and reinfections. Under the breakthrough listing, the state confirmed that the unvaccinated or partially vaccinated account for 87.4% of all cases since the new year. Conversely, just 2% of all fully-vaccinated people have contracted the virus and 0.02% of all fully-vaccinated people have died.
According to the DHSS, the state has recorded 726,208 cumulative cases of SARS-CoV-2—an increase of 7,565 positive cases (PCR testing only)—and 12,406 total deaths as of Thursday, Nov. 18, a reduction of 11 over yesterday. That’s a case fatality rate of 1.71%.
And while it’s important to keep in mind that not all cases and deaths recorded occurred in the last 24 hours, the addition of 7,500 new cases—approximately 1,200 more cases than the previous single-day record—is staggering to behold. But Missouri health officials have an explanation for the dramatic shift. On Nov. 18, the state changed how it counts and reports COVID cases and deaths. A DHSS spokeswoman said the state began counting reinfections as new cases.
State health officials report 57.1% of the total population has received at least one dose of the vaccine. Approximately 68.6% of all adults 18 years of age and older have initiated the process.
The first doses were administered in Missouri on Dec. 13, 2020.
The state has administered 142,874 doses—including booster shots—of the vaccine in the last 7 days (this metric is subject to a delay, meaning the last three days are not factored in). The highest vaccination rates are among people over 65.
Joplin, St. Louis City, and Kansas City, as well as St. Louis, St. Charles, and Boone counties are the only jurisdictions in the state with at least 50% of its populations fully vaccinated. Thirty-one other jurisdictions in the state are at least 40% fully vaccinated: Atchison, Cole, Jackson, Franklin, Greene, Cape Girardeau, Jefferson, Nodaway, Cass, Ste. Genevieve, Carroll, Andrew, Callaway, Gasconade, Christian, Benton, Adair, Clinton, Dade, Livingston, Ray, Lafayette, Montgomery, Shelby, Osage, Henry, Clay, Camden, Warren, and Howard counties, as well as the city of Independence.
Vaccination is the safest way to achieve herd immunity. Herd immunity for COVID-19 requires 80% to 90% of the population to have immunity, either by vaccination or recovery from the virus.
| Month | Cumulative case-fatality rate on the final day of the month |
| March 2020 | 1.06% |
| April 2020 | 4.35% |
| May 2020 | 4.71% |
| June 2020 | 4.71% |
| July 2020 | 2.52% |
| August 2020 | 1.81% |
| September 2020 | 1.68% |
| October 2020 | 1.65% |
| November 2020 | 1.28% |
| December 2020 | 1.41% |
| January 2021 | 1.47% |
| February 2021 | 1.66% |
| March 2021 | 1.74% |
| April 2021 | 1.74% |
| May 2021 | 1.77% |
| June 2021 | 1.77% |
| July 2021 | 1.70% |
| August 2021 | 1.68% |
| September 2021 | 1.70% |
| October 2021 | 1.71% |
The Bureau of Vital Records at DHSS performs a weekly linkage between deaths to the state and death certificates to improve quality and ensure all decedents that died of COVID-19 are reflected in the systems. As a result, the state’s death toll will see a sharp increase from time to time. Again, that does not mean a large number of deaths happened in one day; instead, it is a single-day reported increase.
At the state level, DHSS is not tracking probable or pending COVID deaths. Those numbers are not added to the state’s death count until confirmed in the disease surveillance system either by the county or through analysis of death certificates.
The 7-day rolling average for cases in Missouri sits at 2,135; yesterday, it was 1,055. Exactly one month ago, the state rolling average was 797.
The 10 days with the most reported cases occurred between Oct. 10, 2020, and Jan. 8, 2021.
Approximately 49.8% of all reported cases are for individuals 39 years of age and younger. The state has further broken down the age groups into smaller units. The 18 to 24 age group has 88,261 recorded cases, while 25 to 29-year-olds have 61,472 cases.
People 80 years of age and older account for approximately 42.1% of all recorded deaths in the state.
| Month / Year | Missouri COVID cases* (reported that month) |
| March 2020 | 1,327 |
| April 2020 | 6,235 |
| May 2020 | 5,585 |
| June 2020 | 8,404 |
| July 2020 | 28,772 |
| August 2020 | 34,374 |
| September 2020 | 41,416 |
| October 2020 | 57,073 |
| November 2020 | 116,576 |
| December 2020 | 92,808 |
| January 2021 | 66,249 |
| February 2021 | 19,405 |
| March 2021 | 11,150 |
| April 2021 | 12,165 |
| May 2021 | 9,913 |
| June 2021 | 12,680 |
| July 2021 | 42,780 |
| August 2021 | 60,275 |
| September 2021 | 45,707 |
| October 2021 | 33,855 |
| November 2021 | 23,288 |
Missouri has administered 7,707,728 PCR tests for COVID-19 over the entirety of the pandemic and as of Nov. 17, 16.9% of those tests have come back positive. People who have received multiple PCR tests are not counted twice, according to the state health department.
According to the state health department’s COVID-19 Dashboard, “A PCR test looks for the viral RNA in the nose, throat, or other areas in the respiratory tract to determine if there is an active infection with SARS-CoV-2, the virus that causes COVID-19. A positive PCR test means that the person has an active COVID-19 infection.”
The Missouri COVID Dashboard no longer includes the deduplicated method of testing when compiling the 7-day moving average of positive tests. The state is now only using the non-deduplicated method, which is the CDC’s preferred method. That number is calculated using the number of tests taken over the period since many people take multiple tests. Under this way of tabulating things, Missouri has an 8.9% positivity rate as of Nov. 15. Health officials exclude the most recent three days to ensure data accuracy when calculating the moving average.
The 7-day positivity rate was 4.5% on June 1, 10.2% on July 1, and 15.0% on Aug. 1.
As of Nov. 15, Missouri is reporting 1,006 COVID hospitalizations and a rolling 7-day average of 1,025. The remaining inpatient hospital bed capacity sits at 23% statewide. The state’s public health care metrics lag behind by three days due to reporting delays, especially on weekends. Keep in mind that the state counts all beds available and not just beds that are staffed by medical personnel.
On July 6, the 7-day rolling average for hospitalizations eclipsed the 1,000-person milestone for the first time in four months, with 1,013 patients. The 7-day average for hospitalizations had previously been over 1,000 from Sept. 16, 2020, to March 5, 2021.
On Aug. 5, the average eclipsed 2,000 patients for the first time in more than seven months. It was previously over 2,000 from Nov. 9, 2020, to Jan. 27, 2021.
The 2021 low point on the hospitalization average in Missouri was 655 on May 29.
Across Missouri, 251 COVID patients are in ICU beds, leaving the state’s remaining intensive care capacity at 24%.
If you have additional questions about the coronavirus, the Missouri Department of Health and Senior Services is available at 877-435-8411.
As of Nov. 18, the CDC identified 47,244,379 cases of COVID-19 and 762,994 deaths across all 50 states and 9 U.S.-affiliated districts, jurisdictions, and affiliated territories, for a national case-fatality rate of 1.61%.
How do COVID deaths compare to other illnesses, like the flu or even the H1N1 pandemics of 1918 and 2009? It’s a common question.
According to the Centers for Disease Control and Prevention (CDC), preliminary data on the 2018-2019 influenza season in the United States shows an estimated 35,520,883 cases and 34,157 deaths; that would mean a case-fatality rate of 0.09 percent. Case-fatality rates on previous seasons are as follows: 0.136 percent (2017-2018), 0.131 percent (2016-2017), 0.096 percent (2015-2016), and 0.17 percent (2014-2015).
The 1918 H1N1 epidemic, commonly referred to as the “Spanish Flu,” is estimated to have infected 29.4 million Americans and claimed 675,000 lives as a result; a case-fatality rate of 2.3 percent. The Spanish Flu claimed greater numbers of young people than typically expected from other influenzas.
Beginning in January 2009, another H1N1 virus—known as the “swine flu”—spread around the globe and was first detected in the US in April of that year. The CDC identified an estimated 60.8 million cases and 12,469 deaths; a 0.021 percent case-fatality rate.
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