The number of COVID-19 cases among black children compared to white children in the City of St. Louis is concerning and begs a deeper look, said Dr. Will Ross, chair of the City of St. Louis’ Joint Board of Health and Hospitals during a May 22 meeting.
As of May 27, 27 African-American children between the ages 10-19 had tested positive for COVID-19 in the city, compared to eight white children in that age group. For those 9 and under, 8 black children and fewer than 5 white children have tested positive, according to the city’s website.
“This is the area that we will have to focus on as a board going forward,” said Ross, who leads the 13-member board that advises the city’s public health director. “These are school-age kids, and we talk about returning to schools. We’ve all been getting lots of questions about ‘when is it safe? Is this population safe?’”
St. Louis Public Schools Superintendent Kelvin Adams told TheSt. Louis American that the information Ross presented was “brand new” to him.
“Safety is a big concern for us,” Adams said. “We want to be mindful of any data that would help us make any decision.”
Regarding what schooling will look like in the fall, Adams said it’s still premature to make any decisions, but he is working together with superintendents locally and nationally to plan for all kinds of scenarios.
Ross said another new concern is the disease now impacting children under 5. It appears to be similar to Kawasaki disease, which causes inflammation, fever, rashes and swelling. There is a strong correlation between COVID-19 and these symptoms, Ross said, yet it’s not yet known if the virus is causing it. So far there have been four cases identified in the St. Louis region.
“We don’t know enough about this yet,” Ross said.
Dr. Fredrick Echols, director of the City of St. Louis Department of Public Health, said we will likely see more cases in the upcoming months now that doctors are aware of the new condition and “it’s on our radars.”
Since the onset of the pandemic, Ross has been advocating for targeting resources to areas that are being hit hardest by the virus. In the City of St. Louis, the rate of COVID-19 cases in African-American neighborhoods is astoundingly higher than for majority-white areas.
In the neighborhoods north of Delmar Boulevard, the rate is between 740 and 1,600 cases per 100,000 people. If you go south of Interstate 64, it’s largely between 81 and 447 cases per 100,000 people. The 63116 zip code in South City — a neighborhood with large pockets of immigrants and African Americans — has a higher rate of 447 and 747 cases per 100,000.
The city health department needs to distribute more personal protective equipment and increase contact tracing, disease investigation, and surveillance testing in these affected areas, Ross said.
“We are assuring the community we know what’s right, and we’re procuring the resources to do all of this,” Ross said during the meeting.
Echols explained that contact tracing plays a key role in containing the virus. If a person contracts the virus, disease investigators at the health department try to figure out where that person contracted it and who they have come in contact with since. Then investigators contact those people and tell them to get tested or quarantine for 14 days.
There are about 15 people working on disease investigation and contact tracing currently at the city health department. Four were provided by the state health department. Echols said they plan to add 15 more staff in the fall in time for flu season, and these employees will stay on through 2021. In the meantime, the health department is bringing on more volunteer students from the Washington University School of Medicine to help with contact tracing.
Tim McBride, a public health professor at Washington University, expressed concern about the disparity between the county’s and city’s respective resources and ability to do contact tracing. St. Louis County announced it will hire 100 contact tracers, who will be phased in over time.
“The city has a lot more resource constraints relative to the county for a lot of well-known reasons,” McBride said.
St. Louis County received $174 million in federal CARES Act funding, compared to the city’s $35 million. Overall, the city has a higher rate of COVID-19 cases — with the city at about 560 cases per 100,000 compared to the county’s 480 cases per 100,000. The county has 2.5 times the cases — 4,832 cases compared to 1,867 — as of May 27. Yet, the county received five times the funding as the city.
“We have an artificial barrier of a separate city and county when we have movement of a virus that couldn’t care less,” Ross said.
Ross said he spoke with St. Louis County Executive Dr. Sam Page, who agreed to have county contact tracers support the city.
Ross pointed out that the number of patients in regional intensive care units has come down, as reported by the St. Louis Metropolitan Pandemic Task Force. As of May 26, there were 86 people in ICUs at the region’s four major healthcare systems — BJC HealthCare, Mercy, SSM Health, and St. Luke’s Hospital.
The seven-day moving averages of hospital admissions was 22 as of May 26 and the seven-day average for hospitalizations overall was 421.
“That’s good news for us,” Ross said. “We have not overwhelmed the capacity of hospitals.”
However, looking at the city’s cases, there is an average of about 22 new cases each day, which Echols said shows some stabilization. Ross showed a graph of the city’s case numbers reflecting an upward trend.
“If you stand back from a distance,” he said, “we really are continuing to see these cases increase in the city.”