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Missouri Bootheel sees COVID surge

By Annika Merrilees St. Louis Post-Dispatch

NEW MADRID – In southeast Missouri, an area hit hard by hospital closures, COVID-19 cases and hospitalizations are surging.

New Madrid County is now reporting some of the highest infection rates in the state. Health officials are worried, especially as they face the beginning of flu season.

"People aren't following the rules," said Jayne Dees, administrator of the New Madrid County Health Department. "They're not social distancing. They're not wearing masks. They're gathering."

New Madrid County, home to 17,000 Missourians, has no mask mandate nor other requirements related to COVID-19. And it is among those Missouri counties driving the rise in state numbers. As of Friday, the county's positivity rate for the past week – 41% – was the second-highest in the state, according to state data.

The city of New Madrid, the county seat, is perched on a bend in the Mississippi River, 160 miles south of St. Louis. The bootheel region, where Kentucky, Tennessee and Arkansas meet Missouri, has been hit especially hard hit by poverty, unemployment and hospital closures. Four hospitals within 100 miles of New Madrid have shut their doors in the past decade.

And like many rural areas, New Madrid saw relatively few cases of COVID-19 in the spring, when St. Louis, St. Louis County and other more densely populated areas were hit especially hard. But now cases are rising.

The county reported its first infection on April 5; through that entire month it saw just nine. In May it reported 12. But the county reported 106 cases in July, 245 in August, 149 in September and 78 so far in October. By Friday, it had reported 624 total cases and 15 deaths.

The 11-employee health department has hired four contact tracers; staff are still working overtime to keep up with the demands of the pandemic.

Hospitalizations are also soaring in southeast Missouri. The region reported a seven-day average of 42 at the beginning of August; by Friday, that figure had nearly doubled.

Dr. Nathan Sprengel, a doctor at the SEMO Health Network clinic in New Madrid, said his facility has been seeing higher numbers of positive COVID-19 tests than another clinic in Benton, just 35 miles north.

The Benton clinic is closer to Cape Girardeau, which has a mandatory mask order, Sprengel said, and canceled more public events, he said.

Meanwhile, he sees many New Madrid residents without masks.

"We have patients that come in that get very upset that we tell them that we would appreciate them wearing a mask when they're in clinic," Sprengel said. "That tells me they're probably not wearing one when they're out in public."

In southern Missouri – and particularly in the Bootheel – residents have less access to medical care than they did 10 years ago. And the hospitals that remain often serve a poorer, sicker population than others throughout the state.

"The rise in cases in the bootheel, and throughout rural Missouri, are stretching the limits of community hospitals," Dana Dahl, the Missouri Hospital Association's vice president of membership services, said in an email. "All hospitals are under strain. However, many rural hospitals entered the crisis with thin or negative operating margins, workforce challenges and more complicated populations. As COVID-19 has shifted toward rural areas, these challenges have compounded."

Of the 10 counties in the area, six have no hospitals, according to the Missouri Department of Health and Senior Services. New Madrid County residents often go to clinics scattered throughout the area, or to hospitals in Sikeston, Cape Girardeau or Poplar Bluff.