Every county in Missouri had moderate or high levels of community transmission of COVID-19 going into the Thanksgiving holiday weekend, with 97 percent of counties in the red zone, according to the federal government.
Meanwhile, private entities and state officials report nursing home and prison deaths continue to increase, including more deaths in Jefferson City nursing homes.
Central Missouri Newspapers requested the White House Coronavirus Task Force's Nov. 22 report from Gov. Mike Parson's office last week and received it this week.
Red zone status is based on high levels of new cases per 100,000 residents and high lab test positivity rates.
In addition to the kind of pre-Thanksgiving warnings such as the guidance given by Parson and his administration before the holiday, the task force report touted "aggressive mitigation" as successful in reducing community spread in other parts of the country and the world, while also being able to keep schools open.
"In states with aggressive mitigation, we are beginning to see the impact of that mitigation despite the cooling weather. We are also seeing stabilization in many European countries that implemented strong public and private mitigation, but preserved schooling," according to the report's top recommendation.
Further in the report, the task force notes: "Europe is experiencing a fall surge similar to the USA and is showing early signs of improvement through country-specific mitigation efforts."
More than 90 percent of 60 European countries have "significant restrictions on gathering size," and 80 percent not only "require wearing masks in all public settings," but "most countries have imposed fines for non-compliance."
Sixty percent or more of European countries also have "some form of nonessential business closures, initially focused on bars and reducing restaurant capacity;" "some form of entertainment or public space restriction;" and "have deployed a contact tracing app."
The report adds: "However, in many areas of (the United States), mitigation efforts are inadequate or too recently implemented to see a significant impact. All states and all counties must flatten the curve to sustain the health system for both COVID and non-COVID emergencies."
Missouri's rate of new cases was more than 53 percent above the national average and was the 18th-highest rate in the country, according to the task force report.
The state's test positivity rate ranked fifth highest in the country.
Jefferson City was listed as Missouri's metro area with the fourth-highest level of COVID-19 case activity, followed by Columbia, and Cole County had the eighth-highest level of case activity among counties.
"The silent community spread that precedes and continues to drive these surges can only be identified and interrupted through proactive, focused testing for both the identification of asymptomatic and pre-symptomatic individuals. This must be combined with significant behavior change of all Americans," according to the White House task force's report.
"Ensure masks at all times in public, increase physical distancing through significant reduction in capacity in public and private indoor spaces, and ensure every American understands the clear risks of any family or friend interactions outside of their immediate household indoors without masks," the report advises.
The task force has continued to recommend specific mitigation measures. Meanwhile, Parson introduced the week before Thanksgiving a statewide, uniform framework for helping counties decide what type and level of mitigation measures to enact and for how long, though none of it is mandated. Local governments may also go beyond the state's recommendations.
Outbreaks a concern for nursing homes, prisons
Widespread case growth would not only continue to strain hospitals and their staff but also increase the likelihood of outbreaks within congregate places such as nursing homes and prisons.
The White House task force notes in its report: "During the week of Nov. 9-15, 31 percent of nursing homes had at least one new resident COVID-19 case, 54 percent had at least one new staff COVID-19 case, and 10 percent had at least one new resident COVID-19 death," and those numbers are indicative of "unmitigated community spread."
At least 45 Jefferson City nursing home residents who tested positive for COVID-19 have died since March: 28 residents at the three skilled care facilities of StoneBridge Senior Living (Adams Street, Oak Tree and Villa Marie); 10 residents at Heisginer Bluffs, and another four at Lutheran Senior Services' neighboring St. Joseph's Neighborhood Care Center; and three who've died at JMS Senior Living's Jefferson City Manor.
Meanwhile, six more inmates in the state's prison system have died since the total given last week by the Missouri Department of Corrections - 33 offenders who had died as of Tuesday, since March, compared to 27 last week.
DOC does not report the locations where deaths happened. The number of staff who have died - four - had not changed.
All but one of the offenders who have died have died since September.
Most offenders and staff who have tested positive at facilities in Jefferson City, Fulton and Tipton have recovered, though those outbreaks continue - especially at Fulton Reception and Diagnostic Center, where there were 190 active cases among offenders and 10 active cases among staff cases, with 315 offenders and 66 staff who had recovered there.
Full DOC data is available at doc.mo.gov/media-center/newsroom/covid-19/data.