Dr. Fredrick Echols

Dr. Fredrick Echols, director of the St. Louis Department of Health.

St. Louis Mayor Lyda Krewson announced new social distancing restrictions on August 12 to prevent stress on the region’s hospitals from the climbing COVID-19 cases — but at least one alderman believes the moves aren’t bold enough.

Bars, restaurants and nightclubs must start limiting capacity to 50 percent of their permitted occupancy and must close by 11 p.m., according to a new order signed by the city’s Health Commissioner Dr. Fred Echols on August 12. Large venues — such as the zoo, banquet halls and museums — must also scale back to 50 percent capacity. The order goes into effect tonight at Midnight tonight (August 13). 

Last week, more than half of the new COVID-19 cases were young people in their 20s and 30s, said Krewson during her August 12 Facebook Live briefing.

“We continue to see an increase in positive cases in the City of St. Louis, particularly among young people who oftentimes show no symptoms,” Krewson said. “And while they might not always have the underlying health conditions that can land them in the hospital for an extended period of time, they still present a significant risk of infecting others.”

Dr. Echols is also asking residents to keep their social gatherings — birthdays, barbeques, graduation parties — as small as possible. 

“The number recommended is below 25, even less if you possibly can,” Krewson said. 

These actions come a week after the Joint Boards of Health and Hospitals, a 12-member board that advises Echols, recommended that the city scale back large venue capacity to 50% to help reduce the region’s surging COVID-19 hospital admissions.

“We have not moved anywhere near where we should be,” said Dr. Will Ross, the board’s chairman on August 6. “There are not a whole lot of options here. Something has to be done.” 

The board also voted to support Echols’ decision to forego fall school sports.

Since July 6, St. Louis’ major healthcare systems have reported “troubling” numbers of new hospital COVID patients. 

“We have too much virus spreading in the community,” said Dr. Alex Garza, incident commander for the St. Louis Metropolitan Pandemic Task Force. “We are far from out of the woods. There is a lot on the line here, but it’s not going to slow down until everyone steps up and does the right thing.”

On August 4, the task force reported 55 new hospital admissions in a single day. Since August 2, the seven-day average of new hospital admissions has remained around 40, which is well into the task force’s Red Zone. 

“That’s when we start to become really concerned with the number of people coming into our hospitals,” Garza said.

In his previous health orders, Dr. Echols stated that he would revise the capacity limits if the number of new hospital admissions exceeds 40 per day for three of four consecutive days or reaches a seven-day moving average of 35 new COVID-related admissions. Those thresholds have been reached.

In July, St. Louis County Executive Dr. Sam Page made strong moves to help keep the hospitals from being overrun. Page restricted gatherings to no more than 50 people, mandated that bars close at 10 p.m., and rolled back business occupancy to 25 percent — which went into effect on July 31. However until now, no other regional leaders on the Missouri side have followed Page’s lead. Krewson and Page mandated wearing face masks indoors on July 3, but surrounding Missouri counties have not done that. 

St. Louis Alderwoman Christine Ingrassia (D-Ward 6) said she appreciates Krewson's effort to get on board with taking more action. 

“But it seems a little too little, a little too late,” she said. 

Aldermen are also struggling with the mayor’s lack of communication about her plans to address COVID-19, Ingrassia said. Just on Tuesday, August 11, Krewson had a call with the city aldermen and she did not mention the new restrictions. Ingrassia found out about the plans from news reports — the same time as business owners.

“It leaves business owners with a lot of questions, and we, as aldermen, don’t have the information to give them,” she said. “That is not a great position to be in as a city.” 

Ingrassia said she and several other aldermen are getting calls from small businesses, saying that the lack of guidance makes for a lot of uncertainty. 

In Illinois, Gov. J.B. Pritzker released a mitigation plan on July 15 that includes closing indoor service at restaurants and bars in areas with testing positivity rates above 8%. On August 4, Garza reported that the region’s positivity rate is 11.1%. The City of St. Louis was at 9.3% as of July 19. 

Currently, St. Louis businesses have no marker or threshold that they can watch to know what’s coming, Ingrassia said.

“I like what Illinois is doing because there is a plan and process in place, so you know what to expect,” Ingrassia said. “Right now, there’s the uncertainty of when to expect further restrictions.”

Having clear thresholds would help small businesses know how much perishable food they should purchase, for example. A number of aldermen would like to see a more comprehensive mitigation plan, she said. 

On August 12, Krewson said it is difficult for the health department to assess the city’s current positivity rate because test results have been delayed several weeks. This makes the hospital data the most reliable marker for knowing how much virus is in the community.

The Board of Aldermen’s Coronavirus Special Committee could meet to issue a resolution to urge the health department to develop a mitigation plan. Ingrassia said she already has put in several requests to Board President Lewis Reed, who chairs the committee, to call a meeting so they could address how the CARES Act funding is being spent, as the ordinance mandates. She said she has not yet received a response.

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