Politicians are fighting over masks. 

Public health officials are begging people to get vaccinated. 

And meanwhile, the Delta variant continues to spread almost unchecked in the state. 

St. Louis County Executive Sam Page and St. Louis Mayor Tishaura Jones defended their mask mandates during separate appearances Wednesday. Page held a press conference stating that the county rule stands despite a vote Tuesday night to rescind it, while Jones told NPR’s Here and Now that low vaccination rates and high infection rates demand action.

Attorney General Eric Schmitt, who filed a lawsuit Monday to block the St. Louis-area mask mandates, vowed a similar tactic on Wednesday in Kansas City, where a new mandate is set to go into effect next week. 

In addition, Schmitt also filed for a temporary restraining order in his St. Louis lawsuit.

“Page and (Faisal) Khan’s refusal to withdraw their Mask Mandate is an act of stunning defiance of state law,” the motion for a restraining order states.

Across the state in Kansas City, Mayor Lucas told reporters he will submit the order to Schmitt’s office for advice on any missing legal authority.

But he hinted that he thinks Schmitt, who is running for the U.S. Senate, has a different agenda.

“You know, after a while, it’s just hard to care, right?” Lucas, a Democrat, said of the Republican attorney general. “I mean, it’s the biggest load of malarkey I think I’ve ever seen for the attorney general, who is a lawyer, to actually tweet about filing a lawsuit about something that hasn’t even been filed yet.”

In southwest Missouri’s hard-hit Dallas County, health Administrator Cheryl Eversole said a recent dip in cases there isn’t enough for her to believe the Delta variant surge has passed. She worries she still hasn’t seen the cases from exposure at a local fair and that new infections will follow the Ozark Empire Fair that begins Thursday in Springfield.

“I think this is going to be like a mountain range,” Eversole said of Delta variant cases. “It is not going to be one mountain standing alone. You are going to have peaks and valleys until you get enough people vaccinated. We need to have 70 or 80 percent of the people vaccinated before we can say we  have this under control.”

In Dallas County, 30 percent of the people have initiated vaccination and 25.1 percent are fully vaccinated. That is far below the 47.5 percent statewide who have at least one shot and 41 percent who are fully vaccinated.

In seven days, the county has added 72 cases, down from 97 in the previous seven days. But while Dallas and a handful of counties are seeing declines, the state Department of Health and Human Services reported 17,214 cases statewide in the past seven days, up almost 15 percent. Of the extra 2,203 cases, nearly 60 percent have been reported by five local health departments – St. Louis, Kansas City, St. Louis County, St. Charles County and Jackson County.

The state health department reported 2,948 additional COVID-19 cases on Wednesday. The seven-day average of reported cases stood at 2,459 per day, up 11 percent in a week and 209 percent from June 28.

In health briefings Tuesday, officials in Springfield and St. Louis described the battle they are waging as the summer surge of Delta variant cases stress hospitals and health departments.

Daily case numbers have stabilized in Greene County at about 200 per day. Daily cases are declining in Joplin and in Webster County but continue to rise in Stone and Taney counties surrounding Branson.

The county health department has recorded 32 deaths this month, Springfield-Greene County Health Director Katie Towns said in a Tuesday briefing.

“Since we are continuing to see high case numbers, it is unlikely that we have reached the peak in fatalities,” she said.

Steve Edwards, CEO of CoxHealth reported that 19 patients died over the weekend in that company’s care and Brent Hubbard, chief operating officer of Mercy Health, said his hospital group recorded 17 deaths over the weekend.

“Please make the time to get your vaccination,” Hubbard said. “Please spare your family the heartbreak we are seeing in our hallways every day.”

Hubbard asked anyone who is not fully vaccinated to wear a mask. He said he realizes they are uncomfortable, especially in summer.

“They are a lot less uncomfortable than being on a ventilator,” he said.

Besides St. Louis, St. Louis County and Kansas City, no other health department jurisdiction in the state have mask mandates or other restrictions on gatherings.

The orders direct that everyone over age five wear a mask while in indoor public places. The St. Louis and St. Louis County orders are open-ended, while the Kansas City order will expire Aug. 28 unless extended. The masks will help limit the spread of COVID-19 while people receiving vaccines now build up immunity, said Clay Dunagan, BJC HealthCare’s chief clinical officer on behalf of the St. Louis Metropolitan Pandemic Task Force.

People receiving the two-shot vaccines must wait three to four weeks between shots and full immunity is not achieved until about two weeks after the second shot, Dunagan said. That means the St. Louis region is “weeks to months away from getting where we need to be.”

Vaccinations have increased in the week since Gov. Mike Parson announced an incentive program with $10,000 prizes. As of Tuesday, the state averaged 12,527 shots a day over the previous week, about 50 percent higher than the rate at the beginning of the month.

Without a change in the trajectory of Delta variant infections, Dunagan said, St. Louis area hospitals could be facing numbers equal to or exceeding the highest of the pandemic. Over the previous seven days, he said, hospitals were admitting 55 new COVID-19 patients per day, on average.

Hospitalizations statewide have risen steadily since late May. As of Sunday, there were 1,727 inpatients and the number was increasing 33 per day, on average. Hospitalizations peaked in late December, with 2,862 inpatients, and ICU availability fell to 11 percent in early December. ICU bed availability statewide stood at 18 percent on Sunday.

“I am looking at these numbers with some alarm,” Dunagan said. “The path forward looks like it could equal, it could exceed what we saw in the holidays unless we take some preventive action.”

In the political fight over masks, opponents are making the issue personal freedom while supporters are arguing that they want to limit spread of the virus during a campaign to increase vaccinations.

“This mask mandate is about politics & control, not science,” Schmitt tweeted in his threat to file a lawsuit in Kansas City. “You are not subjects but citizens of what has been the freest country in the world & I will always fight for you.”

The surge in cases in the Kansas City region is more severe than in the St. Louis area, but Lucas as recently as Sunday on CBS’s Face the Nation said he would not impose a mask mandate. That changed when the CDC recommended masks be worn indoors by everyone in regions with low vaccination rates and high transmission rates.

“This is a huge problem,” Lucas said Wednesday. “Our doctors have been telling us it’s a problem for a while. Today, we are taking real steps to make sure that we address that concern long term. That to me is the most important issue. 

For Jones, the issue is gaining time. Vaccination rates among Black Missourians lag about 20 percent behind rates for whites.

“African-Americans are 20 percent of those vaccinated in the city and 80 percent of new cases,” Jones said. “We are hoping that people will look out for each other and make the health and safety of each other and their loved ones paramount above all else.”

Parson, on Twitter, said the CDC revision of its recommended mask policies will upset momentum in vaccinations.

“This self-inflicted setback encourages skepticism and vaccine hesitancy at a time when the goal is to prevent serious illnesses and deaths from COVID-19 through vaccination,” Parson wrote.

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