Moving Average: New COVID Hospital Admissions

The St. Louis region is still on the path to hit a second peak in COVID-19 hospitalizations in September if the region takes no action to prevent it, said Dr. Alex Garza, incident commander of the St. Louis Metropolitan Pandemic Task Force, in his August 3 briefing.

“We are still in that danger zone, and that’s mostly because we still have a large number of cases circulating out in the community,” Garza said. “If we continue with the pace and don’t bring cases down, we will see a peak in September.” 

St. Louis County Executive Sam Page took decisive action on July 27 in limiting gatherings to fewer than 50 people and scaling back capacity of businesses to 25 percent. St. Louis Mayor Lyda Krewson has not taken any blanket action since the face mask requirement on July 3. Businesses are still at full capacity and large venues are at 75 percent capacity. Instead, the city is trying to temporarily shut down certain businesses — particularly downtown bars — that are not abiding by social distancing and masking requirements. Krewson and the city’s Public Health Director Dr. Fred Echols are well aware of the looming COVID peak, Garza said.

“We do discuss our projections and what we’re seeing as far as hospital admissions and hospital occupancy and all the other data that we share with all the elected officials,” Garza said. “They believe they can get transmission down with this targeted approach, and we hope they’re right about that.”

The region also doesn’t have a universal masking requirement, which would also help lower the spread of the virus, he said. The number of cases in Jefferson County has nearly tripled since July 1, but the county has no mask mandate.

Garza holds briefings three days a week to share the hospital data for the task force, which makes up the region’s four largest healthcare systems: SSM Health, BJC HealthCare, Mercy and St. Luke’s Hospital. These systems represent 2.8 million people for an area that includes surrounding counties in Missouri and Illinois.

On August 3, the task force reported 55 new hospital admissions (data lagged two days). Garza has repeatedly said that the milestone of 40 new hospital admissions puts the region in the “red zone.” On August 3, the region’s seven-day average for new admissions is 44.

On Mondays, Garza shows more projections and detailed information on how the pandemic is impacting the region. Florissant, St. Peters, Chesterfield and the City of Black Jack all saw a rapid rise in new COVID-19 cases from last week, according to a map Garza showed of area zip codes.

The task force looks at the percentage of positive cases to understand how prevalent the virus is in the community and if enough testing is being done. The World Health Organization has said that countries that have conducted extensive testing for COVID-19 should remain at 5 percent or lower for at least 14 days. The St. Louis region is currently at 11.1 percent.

“If a community’s positivity is high, it suggests that that community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases,” according to Johns Hopkins University and Medicine’s website. “A lower positivity may indicate that a community is including in its testing patients with milder or no symptoms.”

In the City of St. Louis, that rate was 9.3 percent, as of July 19.

Early on in the pandemic, COVID patients were largely coming from nursing homes, Garza said in his July 31 briefing. Now only 4 percent of new hospital patients are coming from congregate settings, whereas before they made up over 50 percent. 

“Previously most of the hospitalizations were dominated by an older population,” Garza said. “And now the younger populations are trending up. A misconception out there is that younger people will do okay. But we are seeing such a large increase in cases that we are going to see an increase in hospitalizations from that younger age bracket.”

On August 3, the seven-day moving average of hospitalizations increased from 252 yesterday to 258 today. Inpatient confirmed COVID positive hospitalizations decreased from 290 yesterday to 286 today. Inpatient suspected COVID positive hospitalizations decreased from 179 yesterday to 178 today.

The number of confirmed COVID positive patients in the ICUs decreased – from 72 yesterday to 70 today. The number of confirmed COVID positive patients on ventilators increased – from 30 yesterday to 34 today.

Across the system hospitals, 41 COVID-19 patients were discharged yesterday, bringing the cumulative number of COVID-19 patients discharged to 4,023.  

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