SPRINGFIELD – As Missouri’s coronavirus caseload spikes, researchers are seeing another potentially troubling trend: more young people are getting sick than ever before.
A Missouri Hospital Association analysis released Friday found that last week, people ages 20 to 44 made up more than half of all reported cases for the first time after several weeks of steady growth.
At the peak of the state’s surge in mid-April, the average age of infected Missourians with new cases was 56. But on June 20, the average age was 38.
The shift in Missouri follows a trend public health officials are seeing across the country as states push to re-open their economies and see people again crowding beaches, bars and restaurants.
And the hospital association paper pointed out that it made sense: Missourians under age 45 make up a majority of the population and are the group most likely to be exposed going back to work or social events.
It also pointed out that the younger cohort is generally more likely to survive infection, explaining the good news of how hospitalizations and deaths have declined since Memorial Day even as cases have risen.
Missouri reported six additional deaths on Saturday, including two in Joplin, where there had been no deaths previously. Joplin is in the center of an outbreak with hundreds of cases, many tied to food processing plants.
There was, on average, about 6 deaths per day last week in Missouri. Deaths peaked in the state in the second week of May at 17.3 per day.
Missouri’s case counts, however, are the highest they have been since the pandemic began. The state reported an additional 347 infections on Saturday, slightly below the average for the week of 381.6 per day. That is the second consecutive week with a new high in cases per day and 54 percent higher than the highest week early in the pandemic.
Missouri now has recorded 20,261 cases of coronavirus infection since early March.
But the paper also had bad news: younger people are also more likely to be sick without symptoms, making them more likely to unwittingly spread the virus with friends and family members at greater risk of getting very sick and dying.
"This gets to the essence of this disease and why it’s so hard to control," said Dave Dillon, a spokesman for the Missouri Hospital Association. "You can be walking around with this disease, not know it, and still do a lot of damage. You might do fine, but then you go to dinner and grandma has diabetes and dad has heart disease."
Clay Goddard, who leads the Springfield-Greene County Health Department, had similar concerns.
"We run the risk of young people going out and then boomeranging that exposure to older co-workers and family members at greater risk," he said.
The MHA analysis acknowledged that the data had yet to register a clear uptick in deaths related to such incidents.
But it said that data already suggest the virus is spreading more now than it was two weeks ago and noted that reports of hospitalizations and deaths would lag an influx of new cases.
To prevent that worst-case scenario, the paper said all Missourians need to ensure they’re social distancing and wearing masks, especially those the paper called "young invincibles."
On Friday evening, Columbia Mayor Brian Treece tweeted that he wanted to pass an ordinance requiring "masks in all public settings."
Today I asked the City Manager to have an ordinance drafted to require masks in all public settings. With rising cases of coronavirus, this is a responsible & simple public health initiative to curb the spread of COVID-19, protect public health and keep our economy open.— Brian Treece (@BNTreece) June 26, 2020
"It’s going to be incumbent on everyone to not only look to themselves, but the whole community as well," Dillon, the MHA spokesman, said.
Dr. James Blaine, a longtime local physician who has paid close attention to the outbreak, said Dillon is dead on, especially on masks.
The only problem, Blaine said, that most masks are better at keeping a sick person from spreading the virus than protecting an uninfected person from it, and not enough people are wearing them to truly control the disease.
Kansas City’s mayor issued an order requiring the masks Friday, though, and city leaders in Springfield are exploring a similar move to bump up participation, which Blaine supports.
"If we can get to 60 percent, then we can really reduce the risk of the virus spreading," Blaine said.
It’s not clear how many political pushes will be successful, though.
A similar effort failed Wednesday night in Joplin despite the city’s location in the middle of one of the fastest-growing outbreaks in the country.
And many people and even some experts have also questioned how helpful masks really are despite the Centers for Disease Control and Prevention and the World Health Organization recommending people wear them in public, especially when social distancing isn’t possible.
Goddard, the Springfield-Greene County health director, told City Council members here that the evidence for masking is clear, though.
When a reporter asked for citations, Goddard pointed to a study by University of Iowa researchers published June 16 showing that states that imposed mask requirements saw significant declines in caseload growth afterward.
He also pointed to the results of a natural experiment at a Springfield Great Clips last month, where two masked infected hairstylists saw 140 masked customers without any of the latter group catching the disease.
"Masking and social distancing are fairly simple mitigation policies that would help bridge us to vaccination or therapeutics," he said.
And Dillon, the MHA spokesman, said that even they don’t solve everything, anything that slows the caseload growth down is preferable to shutting down again or letting people die.
"The smartest thing to do is realize this (younger) population has the potential to spread this very rapidly," he said, "and not let this time go by without doing the easy thing, which is the public health protections, because nobody wants to do the hard thing again."
Steve Edwards, the CEO of Springfield-based CoxHealth, posted similar thoughts on social media in recent days.
"I encourage our leaders to not worry about how people judge them today, but instead, how history will judge them," he wrote on Twitter. "Masking can save lives and protect our economy. Let’s protect our community."
Rudi Keller of the Tribune contributed to this report.