Missouri continues to report thousands of new COVID-19 cases as distribution of vaccines to health care workers and nursing home residents accelerates.
And a look back at the course of the pandemic in Missouri during 2020 shows that no region was spared death and disease. While absolute numbers of cases and deaths were highest in urban areas, the worst per-capita outbreaks and fatalities occurred in rural parts of the state.
For the second straight week, the days after a major holiday showed a drop in newly reported cases but the seven-day average of reported cases remains at a high level. On Monday, the Department of Health and Senior Services reported 1,196 new cases, the lowest daily total since Oct. 7, while the seven-day average of reported cases was 2,763.
There have been 402,957 COVID-19 cases and 5,562 deaths tied to the pandemic in Missouri.
A dip in new cases also occurred in the days after Christmas but was followed by tallies at the end of the week that were the highest in almost a month.
Last week, Gov. Mike Parson stated in a news release that 66,000 front-line health care workers, together with staff and residents of long-term care facilities had received their initial doses of the Pfizer or Moderna vaccines. The first to receive their inoculation will be receiving their second dose this week, Parson stated.
The state expects 157,000 more doses by the end of this week, the news release stated.
Missouri reported its first confirmed case of COVID-19 on March 7, and when 2020 ended on Thursday the total stood at 392,570 cases confirmed by testing. The first death, reported March 17 in Boone County, was followed by 5,518 deaths reported through Thursday.
When the year ended, Missouri's per-capita infection rate of 6,396 cases per 100,000 residents was 24th nationally and slightly above the national rate. The death rate, 89.9 per 100,000 residents, was 31st nationally and slightly below the national rate.
COVID-19 resulted in death in 1.4 percent of confirmed cases in Missouri, compared to 1.7 percent nationwide.
The worst week for new cases was the third week of November, averaging 4,512 per day, and the worst month was November with 3,885 cases per day. The rates fell in December but it was still the second-worst month, with 2,994 cases per day.
The 10 counties with the most cases, all but Christian County with more than 100,000 residents, account for 217,803 of the COVID-19 infections reported by Dec. 31.
The 10 counties with the highest per-capita infection rates - Sullivan, Madison, Cole, St. Francois, Perry, Pettis, New Madrid, Moniteau, Gentry, and Saline - are spread throughout the state. Of that group, seven have a population of fewer than 25,000 people.
The 10 counties with the lowest infection rates - Dallas, Mercer, Ozark, Iron, Knox, Mercer, Cedar, Reynolds, Linn, Clay and Platte - are also spread throughout the state and include seven counties with populations below 15,000 people.
Like cases, the highest death totals are in the state's largest population centers but the highest per capita death rates are in rural areas. Then five counties with the highest death rates - Clinton, Gentry, Grundy, Carroll and Holt - all have populations of 25,000 or less. The highest death rate is in Clinton County, where 56 deaths is equal to 2.75 deaths per 1,000 residents.
Four of the five counties with the lowest death rates - Platte, Schuyler, Putnam, Adair and Iron - include four with a population of 25,000 or less.
The demographics of COVID-19 in Missouri mirror the national experience. While infections are spread fairly evenly across age groups, with children under 18 representing 10 percent of the cases and those over 70 years of age totalling 17.4 percent, older patients have the highest death rates.
There have been only two deaths among patients under 18, and 4,253 deaths, or 76.5 percent of the total, among people aged 70 and older. Just under half of all deaths have been among people 80 or older.
The ethnic breakdown of Missouri COVID-19 cases and deaths includes a great deal of uncertainty. While the state health department reports 8.8 percent of cases have been among the state's Black residents and 48.6 percent are among whites, no racial data is reported for 27.3 percent of cases.
The same is true for death data. The department reports that 12.7 percent of Missouri COVID-19 deaths have been among the states Black residents and 56.8 percent have been among whites, 7.4 percent have an unknown race.
According to the latest data from the Census Bureau, whites are 83 percent of Missouri's population and Blacks make up 11.8 percent.
The Missouri Independent is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.