Perry County is on red alert.
Health department director Sylvia Forester on Friday announced that the county's COVID-19 risk assessment level was being advanced to "red," the highest threat level, in response to the continuing trend of positive cases of infection from the novel coronavirus in the county, which hit new highs Friday, including nearly 300 active cases.
Forester told the Republic-Monitor on Friday that it wasn't an easy decision, but it was necessary.
"We've been at the highest level based off all the available data at the federal level through the White House pandemic task force," Forester said, "but we understand the implications of what moving to the highest level means, especially for the mental health of our local community."
Earlier this week, data from the Missouri Department of Health and Senior Services showed Perry County as No. 1 in the state for cases per capita and No. 2 in overall cases per capita. Those numbers fell to No. 4 on Thursday and to No. 17 and No. 4 respectively on Friday morning.
That seven-day period included two of highest single-day totals for new cases since the pandemic began — 45 on Nov. 4 and 56 on Nov. 5. The record for active cases of the novel coronavirus in the county also keeps rising, with a high of 242 reported Wednesday.
Friday evening, the health department reported an additional 114 new lab-confirmed cases and 11 new probable cases in Perry County since Wednesday along with 76 additional recoveries. Those numbers, which bring the county's totals to 1,444 cases and 1,144 recoveries, include 61 cases Thursday and 64 Friday, both new record highs.
There are now 291 active cases of COVID-19 infection in the county, also a new high.
Forester said hospital admissions lent considerable weight to her decision. Hospitalization data, which is normally reported on Friday, was unavailable this week because of the "overwhelming number of new and actives cases."
"In our decision to move to that red level, we always take into consideration the hospital and their capacity," Forester said. "Today, there were many regional press conferences held by our partners and friends in the medical field, and the message was the same. We're not on a sustainable course."
The increase of infections in Perry County — the DHSS reported that, as of Friday morning, Perry County had a positivity rate of 81.4 percent — is also adding to the burden faced by hospitals around the region.
"Cape Girardeau County and their hospitals down there held a press conference today, pleading and begging leaders and decision makers to make a change and for citizens to do their part," Forester said. "We're right there in Perry County. We're not on a sustainable course of action, and our lack of control of the virus is not just burdening Perry County, but it's now burdening others throughout the state of Missouri as well."
Thursday afternoon, the Perry County Commission, together with Perryville city government, issued a statement that stopped well short of any discussion of a mask mandate or other measures, but urged residents to take "personal responsibility" and follow the health department's recommendations to help control the spread of the virus.
"All of us are experiencing 'COVID fatigue' and are tired of hearing about it, but we cannot yet declare the virus defeated or let our guard down," the statement read. "A vaccine is coming but until that happens, we must continue to take personal responsibility to protect ourselves, our families, and our fellow citizens as best we are able."
On Friday, Forester said that plan hasn't exactly been working.
"We understand there is no political will locally to create or enforce any restrictions that would help protect the health and lives of Perry County citizens," Forester said. "However, the personal responsibility stance is not working, and it's causing more harm to many of our citizens who have tried to take precautions themselves."
She again stressed the same recommendations her department has been making since the pandemic began — frequent hand washing, staying home when sick, avoiding large gatherings, social distancing and wearing a facemask when social distancing isn't possible — but went a bit further, in light of the new risk assessment.
"We're strongly suggesting that people go to work, go to school and go home, like the things that we were doing in March and April," Forester said. "We need everyone to do that again."
Perry County Presiding Commissioner Mike Sauer said Friday that the county won't be issuing any sort of mandate or order in response to the health department's, but that it's past time for county residents to take the virus seriously.
"The health department had no choice but to make this decision with the way the numbers are going right now," Sauer said, "and the commission is very concerned. We are asking people to please wear a mask when you can, social distance, and follow the health department's guidelines. We do stand with the health department. However, we don't feel that it is our responsibility to mandate and force people to follow these rules; they should be willing to do it on their own."
"That's about the simplest way I can put it."
Sauer said the commission is briefed regularly by the health department and is working diligently to determine what other measures are working around the county and in other parts of the state.
"We're trying to figure out what is working elsewhere and what's not working," Sauer said. "It's obvious a mask mandate is not the answer. It's obvious a shutdown is not the answer. Another shutdown would be devastating. We've already hurt people bad enough by shutting down."
But, he said, if county residents don't start taking the health department's recommendations seriously, that could be out of their control.
"What we're trying to get across to people that we have such an outbreak, that if people don't start taking control of themselves, we won't have to do anything about shutting places down," Sauer said. "Places will be shut down because they won't have employees."
Sauer said part of the problem, at least among county residents he's spoken with, is COVID fatigue, something he and the commissioners referred to in Thursday's joint statement.
"The people have been preached to and preached to and preached to about this COVID and the whole year, their lives were taken away from them," Sauer said. "They are so tired of this virus and so tired of being preached to. They're just turning a deaf ear they throw a wall up as soon as you mention [the virus]."
And that's where the danger lies, Forester said, pointing to Perry County School District as a prime example of how the virus can be contained. Local data, as well as data collected by the state, shows that, for the most part, schools that have mitigation factors in place are successfully containing — or at least curtailing — the spread of the virus.
"They're showing what works and what doesn't work," Forester said. "Inside a controlled environment where you have mitigation factors in place, we're not seeing spread. It's outside of this controlled environment, where these mitigation factors are not being taken is where we're seeing the spread."
She said the real difference is what happens when the students and staff are outside the classroom.
"A [student] is going to be safer in a classroom where masks and social distancing and hand hygiene and all those things are being followed then being at home and going to parties or whatever when it's free time. That's where spread is going to happen, not inside the classroom."