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story.lead_photo.caption Gov. Mike Parson and Dr. Randall Williams, right, held a news conference after a meeting Tuesday, March 3, 2020, with State of Emergency Management Agency officials, external stakeholders and Missouri Cabinet members at SEMA Headquarters. Williams is director of the Division of Health and Senior Services. Photo by Julie Smith / News Tribune.

Missouri Gov. Mike Parson declared a state of emergency in response to the novel coronavirus (COVID-19) outbreak Friday.

Two more Missourians tested presumptive positive for COVID-19 earlier in the day, Parson said. He did not have details about where the cases were or how they came in contact with the virus. The new cases bring the total in Missouri to four.

Parson said his greatest responsibility as governor is to keep citizens healthy and safe.

The declaration came hours after President Donald Trump declared a national emergency over the COVID-19 pandemic. He called on states to begin emergency operations. He also laid out some of the actions the declaration set in motion.

For more news about the COVID-19 coronavirus, access the News Tribune's Health section

The declaration allows for doctors to treat patients across state lines. It also allows "Critical Access Hospitals" to expand the number of emergency beds on hand. Critical Access Hospitals are designated by the Centers for Medicare and Medicaid Services to provide emergency care and additional emergency acute care beds for patients in rural communities.

The federal declaration is expected to free up $50 billion in federal funding nationwide, which is to be used to help fight the spread of the disease. And, the state declaration makes up to $7 million available. It's too soon to tell where money will be used, Parson said.

"We are taking steps to expand our COVID-19 testing capabilities by coordinating with the University of Missouri and Washington University labs," Parson said. "We have shared positive COVID-19 samples with Washington University that will allow them to create a control (sample) and conduct testing themselves in the near future."

The state is also working with the University of Missouri. Between the two universities, the state's capability to test samples is expected to grow rapidly, he said.

Coronaviruses make up a large family of viruses. Some cause illnesses in people, while others infect only animals. Rarely, animal coronaviruses have emerged to infect people and can spread between people. This is suspected to have happened for the virus that causes COVID-19. The current virus was first detected in Wuhan City, Hubei Province, China, according to the Centers for Disease Control and Prevention. Early infections were widely linked to live animal markets, but the virus is now spreading from person to person.

Parson said schools should seek the guidance of public health officials when determining whether to close schools. He reiterated that those decisions should be made on a local level.

Working with federal officials, the administration is attempting to augment health insurance coverage and unemployment benefits.

The emergency declarations give Missouri the capability to deploy temporary structures in coordination with the State Emergency Management Agency and the National Guard, should the need arise, Parson said. Those structures could be used as hospitals or COVID-19 test sites, he said.

Some state agencies have take steps to limit the spread of COVID-19 within their facilities, Parson said.

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"As a precautionary measure, the Missouri Veterans Commission has restricted access to our veterans homes across the state," he said. "Yesterday, the Missouri Department of Corrections announced it is suspending visitors at the state corrections facilities for the next 30 days. Today, the Missouri Department of Mental Health also restricted visitor access at state mental health facilities."

However, state employees will stay on the job.

"We'll consider all options, but right now it's important that the state be open for business," Parson said. "The Governor's Office, for example, we're going to be open every day so we can do business with the people of the state. All the operations of state government have effects on everyone out there in the state. It's very important to me to make sure all those facilities are open and prepared to be able to handle the public in their time of need."

Lindsay Huhman, director of marketing at Capital Region Medical Center, said the hospital has been monitoring the spread of COVID-19.

"We are following closely the CDC guidelines and adhering to screening protocols across the system," she said. "In an effort to help our patients heal and keep our community healthy we are asking the public to partner with us as we work together to combat the spread of infectious disease. We are encouraging the limiting of patient visitors to one visitor at a time per patient and all visitors must be over the age of 12. We are asking anyone with signs or symptoms of illness to please refrain from visiting patients in the hospital."

Also, for the safety of its volunteers, the hospital suspended its volunteer program temporarily.

In addition to funding, the declaration makes available resources that may be used to respond to the disease, according to Dave Dillon, Missouri Hospital Association vice president of public and media relations.

One example of why it matters is that the federal law that governs treatment in Emergency Departments requires that any individual enters an emergency department is given care, treated and stabilized at the minimum, in that department.

"For the purpose of caring for an individual who believes they may have the COVID-19 virus, it isn't necessarily best to do that in the Emergency Room," Dillon said. "If a symptomatic individual comes into an emergency department, you wouldn't want to keep them in a waiting room with other patients."

In other states, local governments are creating alternative testing sites to create environments where possible COVID-19 patients aren't potentially exposing other patients to the disease while they're being tested.

Those sites could be in separate buildings, tents or even mocked-up drive-thrus, Dillon said.

Early this week, the MHA sent identical letters to all 10 of the state's national delegation, requesting the federal emergency declaration.

"Missouri has been fortunate, having only one confirmed case in the state," the letters stated. "However, as evidenced by the experience in other states, the containment efforts, despite the best efforts of public health officials, have been challenging. Once we transition from containment to mitigation, a strategy already acknowledged by Vice President (Mike) Pence, it will be necessary to use all available tools and resources at our disposal."

Some changes to care required federal waivers to rules set by Medicare, Medicaid, the Children's Health Insurance Program and other provisions.

The CDC recommends several common-sense ways to lower the chance of coming down with COVID-19.

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing.
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you're sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

The News Tribune is offering free online access to coronavirus coverage.

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