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story.lead_photo.caption Dr. Randall Williams, director of the Missouri Department of Health and Senior Services, speaks during a COVID-19 briefing Tuesday, July 14, 2020. Photo by Beaumont Enterprise (Beaumont) / News Tribune.

Though COVID-19 hospitalizations in Missouri have been increasing, state leaders including Gov. Mike Parson said Tuesday that the situation is under control.

The number of hospitalizations in Missouri due to COVID-19 has been trending upward since mid-June — from a low of 524 on June 13 to a high of 955 on July 10, according to data from the Missouri Department of Health and Senior Services.

The increase in hospitalizations during that time was more than 82 percent, while the total number of reported cases in Missouri increased more than 73 percent in the same time frame.

Once DHSS' data dashboard was updated Tuesday afternoon to include July 11, the site showed 811 hospitalizations for the day — lower, but still part of the upward trend.

Parson said the same trends in infection are continuing: 60 percent of the new cases are coming from the areas of St. Louis, Kansas City and southwest Missouri, and a greater share of the infections are among young people.

Young people are less likely to become seriously ill and more likely to recover, but they can spread the disease to more vulnerable people.

Intensive care unit resources remain available, with patients not exceeding capacity, and while the specific picture in hospitals varies by region and whether there's a hot spot of infections in an area, "overall, we're in a good place," Parson said.

The number of hospitalizations June 13 was the state's lowest since the middle of April, and hospitalizations had been trending downward since May 5 — the state's all-time high peak so far of 984.

Missouri's first confirmed case of COVID-19 was reported March 7, and hospitalizations — first reported in mid-March — trended up between then and May 5.

The onset of symptoms of COVID-19 can be delayed up to two weeks after initial infection, with the usual time to symptom onset being four or five days, according to the Centers for Disease Control and Prevention.

Progression of the disease from symptom onset to trouble breathing usually takes five to eight days; from symptom onset to more serious respiratory distress, eight to 12 days; from symptom onset to admission to an intensive care unit, 10-12 days.

That means the vast majority of this month's rise in hospitalizations so far has been due to infections that occurred before the Fourth of July weekend, and more likely even earlier — perhaps as far back as approximately the first weekend of June for someone admitted to an ICU on July 1, but most likely for them from an infection sometime between June 14-17.

Missouri's statewide public health restrictions began to lift May 4, and all statewide restrictions completely lifted June 16.

DHSS Director Dr. Randall Williams said Tuesday that the standard for admitting someone to a hospital for COVID-19 is usually if the patient has shortness of breath and pain in breathing — not the more mild symptoms that 80 percent of people with illness have.

Someone admitted to a hospital July 1 for some trouble breathing because of COVID-19 was most likely infected between June 18-22, though potentially as far back as approximately June 9-12.

Someone admitted to a hospital for some trouble breathing because of COVID-19 on June 14 — the date that starts the current upward trend of hospitalizations — most likely was infected between June 1-5, though potentially as far back as approximately May 23-26, Memorial Day weekend.

That's all to say that people's decisions regarding social distancing, wearing face masks and hand hygiene can have consequences that will not usually manifest themselves for days or weeks after — and Missouri is only just beginning to experience whatever the effects will be of what were people's choices over the Fourth of July weekend.

Parson once again Tuesday urged Missourians to take care of their health — for their sake and others'.

"If we want to keep Missouri moving forward, we must continue taking steps to slow the spread," he said.

PPE grants available

Meanwhile, Parson and Missouri Department of Economic Development Director Rob Dixon announced the availability through grants of $50 million in federal Coronavirus Aid, Relief and Economic Security Act funding — $20 million to help companies re-tool to manufacture personal protective equipment and $30 million to help small businesses adapt to social distancing and reduced demand.

The PPE grant money can be used to reimburse expenses including equipment and facility costs, up to $500,000, Dixon said.

Small businesses may use their funding for expenses such as salaries during closures or reduced hours, on website design, and on leasing additional space for social distancing purposes.

More information is available online at showmestrong.mo.gov/business.

Parson plans to hold another news conference Wednesday afternoon — this time to be joined by law enforcement to announce a special legislative session to address the issue of violent crime.

In response to the potential of a special session, Missouri Senate Democratic leader Sen. John Rizzo, of Independence, released a letter written to DHSS Director Williams, requesting that the department "provide COVID-19 testing to anyone working within the Missouri Capitol in conjunction with any and every extraordinary session of the Missouri General Assembly called by the governor."

Rizzo noted cases had increased in Cole County and wrote that the General Assembly "must not create further hardships for the Cole County Health Department, or local hospitals, by contributing to the spread of COVID-19, especially in the Jefferson City area where more than 40,000 people live and work."

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