SPRINGFIELD — With the more-contagious delta variant now the dominant strain of COVID-19 in the United States, case numbers and hospitalizations are surging, with the virus especially preying upon regions with low vaccination rates.
Such is the case in Missouri, where the Ozarks region in the southwestern part of the state has emerged as a hotspot. In Springfield, Missouri, virus-related hospitalizations hit an all-time high last week, with one hospital being forced to open a third COVID-19 intensive care unit to deal with the deluge of patients. The hospital also announced it had increased its morgue capacity in anticipation of more deaths.
Concern over the virus has spread to other parts of the state, with cities like Kansas City and St. Louis reinstating indoor mask mandates, even for vaccinated people. The CDC followed suit on Tuesday, recommending masks be worn inside in areas of the country with substantial or high transmission of the disease.
According to The New York Times, Missouri has reported 40 cases of COVID-19 per 100,000 people over the past two weeks, the fourth-highest of any state in the country.
Illinois, on the other hand, is in the middle of the pack, with 12 cases of COVID-19 per 100,000 people.
But, a closer look at the data indicates a spillover effect as Illinois regions that share a border with the Show-Me State, and where vaccination rates are lower than state average, experience higher rates of infection than other parts of the state.
According to data from the Illinois Department of Public Health, the seven-day rolling positivity rate in the Metro East region near St. Louis is 9.1%. In Region 5, which includes 20 counties in Southern Illinois, the rate is 8.4%. In Region 3, which includes Quincy, Springfield and several rural counties in west-central Illinois, the rate is 6.2%.
No other regions in Illinois are above 4.3% positivity. Some, such as Chicago and suburban Cook County, remain below 3%.
“If you think about it, it isn't that surprising,” said Bill Powderly, director of the Institute for Public Health at Washington University in St. Louis. “The virus doesn't know anything about geography, it doesn't know anything about human boundaries. It will just follow patterns of people's movement.”
With the significant connections between Metro East and St. Louis, whether for work or recreation, the higher rates of infection make sense, Powderly said.
Brenda Fedak, public information officer for the St. Clair County Health Department, agreed that these cultural links were likely a contributor to the spread taking place in her region.
But at the end of the day, she said, the stagnant pace of vaccinations in the region is the main culprit. St. Clair County's vaccination rate is about 42%. Madison County, the next-largest county in the region, is at 43.6%.
About 50.6% of Illinois residents are fully vaccinated, according to IDPH.
“In the beginning, we didn't have enough vaccine to give to all the people that wanted it,” Fedak said. “Now we have excess vaccine that we're trying to give away to people that don't want it. So we're trying to educate people and encourage them to get vaccinated.”
For state and local public health officials, it hasn't been easy convincing the vaccine-skeptic residents in culturally-conservative, rural downstate Illinois.
Rates of vaccination are even lower outside Metro East, sitting between 25% and 35% in many rural counties in Southern Illinois. This even as the state has rolled out incentives, such as entry into a vaccine lottery and free targets of trap, skeet or sporting clays at the Worldwide Shooting and Recreation Complex in Sparta for those who vax up.
Though some high-profile Republicans, such as Rep. Mike Bost, R-Murphysboro, have encouraged people to get vaccinated, leadership has been lacking on the issue from others.
Rep. Mary Miller, R-Oakland, who has openly flouted the mask mandate on the U.S. House floor and just recently tweeted "Do vaccines work?" in response to the revised CDC mask recommendations (they do).
Only about 34% of Miller's constituents are fully vaccinated, the lowest of any congressional district in the state, according to data from Harvard University. A public message encouraging vaccination could go a long way.
Same with state Sen. Darren Bailey, R-Xenia, a downstate candidate for governor. He pointedly refused to endorse the vaccine in an interview earlier this week with WCIA, despite the vaccine's effectiveness at preventing hospitalization and death.
"The political leadership needs to look at what's going on in their jurisdiction and figure out with the public health people what is the best approach," Powderly said. "The ideal approach for the country across the board is to get as many people vaccinated as possible because that's going to save lives."
State leaders are listening to the CDC's recommendation for indoor masking in areas of substantial and high spread, which now encompasses much of the central and southern portions of Illinois.
“Cases and hospitalizations due to COVID-19 both continue to increase, overwhelmingly among the unvaccinated, but the risk is greater for everyone if we do not stop the ongoing spread of the virus and the Delta variant," said Ngozi Ezike, director of IDPH. "We know masking can help prevent transmission of COVID-19 and its variants."
Though Metro East and Southern Illinois' positivity rates would have triggered mitigations if the state were still in Phase 4, we are now in Phase 5. As such, Pritzker officials said there are no plans right now for restrictions on businesses, recreation and other activities.
“The Governor continues to listen to the advice of scientists and doctors as he considers all possible avenues to keep the people of Illinois safe,” said Pritzker spokeswoman Jordan Abudayyeh. “During the previous pandemic surges, he was laser focused on ensuring that our health care system and hospitals weren't overwhelmed and that will continue to be his guiding light as he evaluates the need for mitigations.”
Abudayyeh added that "the administration is also reviewing its options for mandating vaccines, particularly for state employees who work in congregate or health care settings."
Regarding the potential return of a mask mandate, Powderly said it will help curb the spread, but is ultimately a band-aid.
"Masking is an added benefit to vaccination, but it's not a replacement," he said.