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Doctors Say Statewide Surge In Coronavirus Cases Could Swamp St. Louis Hospitals

Erin Jones | Barnes-Jewish Hospital

Hospitals in the St. Louis region are treating more coronavirus patients from outlying counties, health officials said Friday.

That means local health systems are bearing the burden of the virus’s spread in rural areas, doctors said. The increase in patients from outstate regions is putting a strain on metro health care systems, which are regularly seeing more than 50 new admissions a day, a rate officials call “unsustainable.”

“What’s going on in those rural areas is going to affect the urban areas,” said Dr. Alex Garza, head of the St. Louis Metropolitan Pandemic Task Force. “That’s where the bulk of the health care is consumed.”

That has hospital officials concerned as case numbers begin to climb again in St. Louis and St. Louis County. The St. Louis bistate region saw a 16% increase in case numbers in the past week, and the rate of hospital admissions among people from St. Louis and St. Louis County is beginning to go up again.

“Now the urban areas are starting to catch up with the rural. That means there's going to be that many more patients coming into our health care systems,” Garza said.

The region’s four largest hospital systems still largely treat local patients. But over the past month, they’ve admitted people from Jefferson, Franklin, Monroe and other counties at higher rates than local patients, Garza said.

Mercy, St. Luke’s and other hospitals have fielded patient transfer requests from hospitals outside St. Louis, Garza said.

The increase reflects the coronavirus’ surge in rural and exurban areas, said Chris Prener, a sociology professor at St. Louis University who uses public health data to track how the virus is spreading. The highest numbers of new cases have recently been in southern and central Missouri.

“The perception we had early in the pandemic was that this was an urban phenomenon, it was something affecting urban parts of the state,” Prener said. “That was never fully true … but more than ever, we are seeing this accumulation of cases in rural parts of Missouri.”

St. Louis and St. Louis County governments have required people to wear masks in public places and have placed capacity limits on businesses. Jefferson, St. Charles and other counties have resisted similar mandates.

“We’re seeing the number of patients in St. Louis go up that are hospitalized, but they’re not necessarily from St. Louis City and St. Louis County,” Prener said. “They’re from more rural areas, and these overwhelmingly don’t have those mask policies and other policies that would help mitigate the spread of COVID.”

Rural and far-suburban regions have fewer inpatient beds and limited medical staff, so they may need to transfer patients to larger hospitals, said Mary Becker, vice president of Missouri Hospital Association.

“If the one respiratory therapist has to quarantine or gets sick, that care is not available at that hospital,” she said. "That’s why it really is important for the community to rally around these precautions and rally around their local hospitals.”

Rural hospitals are experiencing higher rates of hospitalizations. They aren’t yet at capacity, but “it’s something we’re obviously keeping an eye on,” she said.

In emergencies, hospitals can transfer patients to other locations, even if they’re managed by different companies, Becker added.

Even if hospitals work together, there’s still a ceiling on the number of patients they can easily manage, Garza said.

“Anytime you have this rise in that population that’s being admitted it’s going to put stress on the systems,” he said. “I think one of the things we wanted to show is this is a widespread disease, it’s growing at a faster clip in these nonurban areas, it is affecting people in the community … to drive home the point that we all need to be diligent.”

Becca Clark-Callender contributed to this report.

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Sarah Fentem reports on sickness and health as part of St. Louis Public Radio’s news team. She previously spent five years reporting for different NPR stations in Indiana, immersing herself deep, deep into an insurance policy beat from which she may never fully recover. A longitme NPR listener, she grew up hearing WQUB in Quincy, Illinois, which is now owned by STLPR. She lives in the Kingshighway Hills neighborhood, and in her spare time likes to watch old sitcoms, meticulously clean and organize her home and go on outdoor adventures with her fiancé Elliot. She has a cat, Lil Rock, and a dog, Ginger.