Missouri's COVID-19 death toll increased by more than 20 percent Thursday afternoon to more than 15,000 fatalities.
The 2,771 deaths added to the report aren't news to local health departments. They have been frustrated for months by the Department of Health and Senior Services' unwillingness to recognize deaths where the patient's diagnosis was confirmed by antigen, or rapid, tests, rather than through a lab-tested sample.
The deaths data, which the department calls "probable" COVID-19 fatalities, is being added eight months after the department began reporting antigen-identified infections in its daily report. The reason, the department stated in a news release, is that the Centers for Disease Control and Prevention recently updated its definitions of "probable" cases and deaths.
Those updates were issued in August.
"We've been working as quickly as possible on this and other data reporting requirements for CDC while also making sure we're reporting as accurately as possible," Lisa Cox, spokeswoman for the department, wrote in an email.
The updates also increased the total number of cases statewide to 888,720, or 10,706 more than were reported Thursday morning before the updated information was released.
The 15,198 deaths represents 1.71 percent of the total of positive cases. Nationally, the death rate among identified cases is 1.61 percent. Worldwide, the rate is 2 percent.
Other changes made Thursday include information on breakthrough infections among vaccinated Missourians and cases where a person who had COVID-19 previously tested positive more than 90 days later.
"The dashboard enhancements released this week were a natural evolution of the data we now have available on the virus and further define the importance of getting vaccinated," Donald Kauerauf, director of the department, said in the release.
The data shows breakthrough infections, defined as cases where a person tests positive more than two weeks after receiving a final vaccine dose, have risen from about 10 percent of new cases in early June to more than 25 percent of cases in recent weeks.
In all, there have been 54,285 breakthrough cases, 13 percent of the cases reported since Jan. 1 and about 2 percent of the vaccinated population. The deaths among people with breakthrough infections, 654, is about 10 percent of deaths in 2021 and 0.2 percent of fully vaccinated Missourians.
There are 6,581 people who have previously tested positive for the coronavirus that causes COVID-19 who tested positive again more than 90 days later.
"This data reaffirms what we have been saying for nearly a year. COVID vaccines work very well to prevent hospitalizations and death," Kauerauf said in the news release. "The vaccines continue to be an effective tool to protect Missourians from serious illness. This new data being released by DHSS also highlights the importance of receiving boosters when eligible, especially for those of higher risk due to age or health concerns who may not have as strong of an immune response following vaccinations."
The update mirrors the Independent's findings tracking the difference between data reported by local health departments and the information presented online by the state health department.
In March, a few days before the department added antigen-identified cases, local health department reports showed 78,112 cases weren't being reported at the state level and about 1,100 deaths were not included.
When the department added antigen- identified cases March 8, the total cases in the state increased by 81,206.
The difference between the state's official death count and the local reports grew through the year and when the Independent checked local data in late October, local health departments had logged 1,373 more deaths than the state report showed.
An analysis of the newly reported cases shows rural counties were the most underreported. The largest 10 percentage increases were all in counties with a population of 21,000 or less. Grundy County in northwest Missouri had the biggest addition, representing 5.4 percent of previously reported cases.
An analysis of the deaths added Thursday shows rural counties were also most underreported on COVID-19 fatalities. Chariton County, in central Missouri, added 22 additional deaths on top of the eight already recognized by the state health department.
Two other counties, Scotland and Mercer, also more than tripled the number of deaths previously reported.
With the updates, the counties with the highest per capita death rates, where more than one out of every 200 people have died of COVID-19, are Grundy, Gasconade, Holt, Livingston and Dade.
The lowest death rates are in Worth County, where deaths have been fewer than one out of 1,000, and Boone County, where the death rate is just more than one out of 1,000.
The Missouri Independent is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.