On the day Missouri surpassed 1 million coronavirus cases and recorded the highest single-day tally of infections for the pandemic, Gov. Mike Parson announced he would let the state of emergency for responding to the disease expire at midnight Friday.
The decision was immediately criticized by Missouri Hospital Association spokesman Dave Dillon, who said it will restrict the ability to provide care as inpatient numbers near the peak for the year.
The order Parson will allow to expire, issued Aug. 27, provided waivers of laws and regulations to support health care staffing needs. It replaced earlier, broader emergency declarations that waived purchasing rules and other regulations, such as school attendance requirements, to give agencies power to deal with pandemic disruptions.
“Thanks to the effectiveness of the vaccine, widespread efforts to mitigate the virus, and our committed health care professionals, past needs to continue the state of emergency are no longer present,” Parson said in a news release.
The expiration of the emergency order means that licensing rules waivers that had allowed physicians, nurses and other providers to work in Missouri will end. It means that the Missouri National Guard will no longer be used for COVID-19-related duties.
The most immediate impact will be on hospitals and other providers who are trying to cope with increasing patient numbers at the same time the omicron variant is spreading rapidly. The staffing relief that will end is coming as staff shortages are aggravated by infections among staff, Dillon said.
“That gets to the nut of the issue, which is the public health emergency allows for waivers for a significant amount of the activities that have allowed us to be flexible throughout the pandemic,” Dillon said. “They are in essence, many of them, are just going to completely disappear overnight. That part is going to be very difficult to deal with at the hospital level.”
The state is going through its fourth big wave of cases. Missouri hospitals were reporting 2,265 inpatients as of Monday, the highest number since mid-August. Hospitalizations for COVID-19 peaked in late December 2020 at 2,862 inpatients.
As of Thursday afternoon, the state Department of Health and Senior Services has reported 1,006,913 infections from the coronavirus that reached the state in March 2020. That includes 815,834 lab-confirmed cases and 191,079 “probable” cases identified by rapid tests.
The disease is blamed for 16,074 deaths, 8,333 in 2020 and 7,741 this year.
There have been 99,374 cases reported this month, the most of any month in 2021 and below only November and December of 2020.
The department reported 8,143 cases Thursday, the second consecutive day that surpassed a record from November 2020.
Daily reported cases are averaging higher than at any time since mid-November 2020. The report was the last for 2021. Because of the New Year’s holiday, the state health department will not report again until Monday.
The latest state report shows that 57.1% of Missourians over 5 are fully vaccinated. About one-third of those who have been vaccinated have received a booster shot, but more than one-third of those eligible have not received any shot.
In the release that announced the state of emergency would not be extended, Parson said his response throughout the pandemic has been aimed at maintaining as much of normal daily life as possible.
He noted that he never imposed a statewide stay-at-home order or other mandates. Those strategies were used by local governments but hostile reaction to them has grown. Parson signed a law limiting local health orders and it has been used by Attorney General Eric Schmitt to sue local governments and schools over mask mandates.
“The main focus of our state of emergency was to provide regulatory flexibility to support and assist Missourians, health care facilities, and businesses and coordinate a COVID-19 response that saved lives and livelihoods,” Parson said.
The kinds of rules that helped hospitals to handle increased caseloads from COVID-19, along with other care, allowed them to exceed licensed bed capacity and bring in clinical staff without licensing delays, Dillon said.
Now each hospital at capacity would need an individual waiver of its limit and new staff will have to wait weeks, or months, for licensing, Dillon said.
“Clearly as fast as omicron is moving, that is too slow for us to use that,” he said. Other waivers allowed advanced practice nurses and physician assistants to do work otherwise reserved to physicians.
“We are right now trying to assess how many significant liabilities this creates,” Dillon said.
If changes in state rules or laws are needed to continue responding to the pandemic, Parson said in his release, that can be done in 2022. Agencies can propose rules and legislators begin their session Jan. 5, he noted.
“We encourage all Missourians to consider COVID-19 vaccination and to stay diligent, but we can work together to fight COVID-19 while living our normal lives,” Parson said. “It is time to take this final step and move forward as a state.”
The virus doesn’t know whether there is an emergency order or not, Dillon said.
“The end of a public health emergency itself is going to have absolutely no influence on how the virus spreads,” he said. “It is more incumbent that people do the right thing. We are going to have diminished capacity, initially, to care for them.”
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