COVID-19 Trends in St.

Louis County
09/03/2020

Contents
Overall Trends ................................................................................................................................. 1
Demographic Trends ....................................................................................................................... 5
Youth Supplement ........................................................................................................................ 14
Impact on Schools ......................................................................................................................... 18
Indicators and Thresholds ............................................................................................................. 19

Overall Trends
8/4–8/17 8/18–8/31
1. Rate of new cases ● ●
2. Trend in new cases ● ●
3. Contacts per case* ● ●
4. Test positivity rate ● ●
5. Hospital admissions ● ●
6. Deaths ● ●
7. Daily tests ● ●
8. Hospital capacity ● ●
NOTE: To account for reporting and data entry delays, this report focuses on data about COVID-
19 cases diagnosed and laboratory specimens collected for COVID-19 testing through 08/31.
Unless otherwise specified, all averages are seven-day rolling averages. Data are current as of
09/03. *Indicator still in development

1
New Cases
The average number of new COVID-19 cases diagnosed among St. Louis County residents
decreased by 12.8 percent between 08/18 (210.4 new cases per day) and 08/31 (183.4 new
cases per day). Despite this decline, the average rate of new diagnoses (18.4 cases per 100,000
per day) remains very high.

Test Positivity Rate

The COVID-19 positivity rate as of 08/31 is 8.3 percent. The positivity rate among St. Louis
County residents has been relatively stable since early July, fluctuating between 7.5 and 9.5
percent of specimens tested.

2
Hospital Admissions
Based on data released by the Pandemic Task Force and analyzed by Dr. Christopher Prener at
St. Louis University, average new hospitalizations for COVID-19 at SSM, BJC, Mercy, and
St. Luke’s hospitals in the St. Louis metro area increased by just 0.4 percent between 08/18
(39.57 admissions per day) and 08/31 (39.71 admissions per day).
St. Louis County DPH is still developing its ability to more specifically track COVID-19-associated
hospitalizations among St. Louis County residents.

Deaths
COVID-19-associated deaths decreased by 53 percent between 08/18 (3.0 deaths per day) and
08/31 (1.4 deaths per day).

3
Tests per Day
As of 08/31, the average number of specimens being collected for COVID-19 PCR testing from
St. Louis County residents is 2,189 per day, which is 146 percent of St. Louis County’s target of
1,500 tests per day (approximately 150 tests per 100,000 residents per day). However, average
testing volume has gradually declined from a peak of 3,094 tests per day on 07/29.

4
Hospital Capacity
According to data released by the Pandemic Task force, 66.5 percent of the inpatient beds at
SSM, BJC, Mercy, and St. Luke’s hospitals in the St. Louis metro area are filled as of 08/31.

Demographic Trends
Age Groups
Between 08/18 and 08/31, new COVID-19 diagnoses decreased across all age groups except for
20–29 year olds, who experienced a 19 percent increase. The largest decrease (-36.8 percent)
has been reported among people aged 80 and older. Currently, the rate of new diagnoses is
highest among people aged 20–29 years (38.9 cases per 100,000 per day) and lowest among
people aged 9 years and younger (4.3 cases per 100,000 per day).

5
As of 08/31, the prevalence of SARS-CoV-2 infection among those tested in St. Louis County is
highest among people aged 10–19 years (17.3 percent) and 20–29 years (12.9 percent).
Positivity is currently above 10 percent for the above-mentioned groups, below 5 percent
among people aged 80 years and older, and between 5 and 10 percent among all other age
groups.

Testing coverage is currently below St. Louis County’s target of 150 tests per 100,000
population per day for children aged 9 years and younger (59.0 tests per 100,000 per day) and
10–19 years (122.5 per 100,000 per day). Testing coverage is comfortably above the target
threshold for all other age groups. Coverage remains very high (479 tests per 100,000 per day)
among people aged 80 years and older, due in part to the aggressive COVID-19 surveillance and
prevention strategies being implemented in long-term care facilities.

6
Race
Between 08/18 and 08/31, the rate of new COVID-19 diagnoses increased by 20 percent among
multiracial residents of St. Louis County and decreased among all other racial groups. The
steepest decrease has been reported among Black or African American residents (-33 percent).
As of 08/31, rates of newly diagnosed cases are highest among white residents (10.8 cases per
100,000 per day), followed by multiracial (10.2 cases per 100,000 per day), Black or African
American (9.0 cases per 100,000 per day), and Asian residents (3.4 per 100,000 per day).
Racial groups with fewer than one case diagnosed per day (American Indian/Alaska Native,
Native Hawaiian/Other Pacific Islander, and other race) have been excluded from this analysis.

7
Ethnicity
Between 08/18 and 08/31, rates of new COVID-19 diagnoses decreased by 32 percent among
Hispanic or Latino residents of St. Louis County and by 19 percent among non-Hispanic
residents. The rate of new diagnoses among Hispanic residents (15.2 cases per 100,000 per day)
is currently 1.9x the rate among non-Hispanic residents (7.9 cases per 100,000 per day).

8
Region
St. Louis County DPH often divides the county by ZIP Code into five regions, based on economic
and demographic factors, for the purpose of measuring broad geographic trends below the
county level.

Rates of new COVID-19 diagnoses increased by 1.4 percent in west St. Louis County and
decreased in all other regions between 08/18 and 08/31. The steepest decrease was reported
in the South region (-24 percent). Currently, the rate of new diagnoses is highest in the West
region (21.4 cases per 100,000 population per day) and lowest in the Inner North region (13.3
per 100,000 per day).

9
As of 08/31, the positivity rate is highest in the South region (12.3 percent), followed by the
West (11.5 percent), Outer North (10.0 percent), Inner North (8.7 percent), and Central regions
(7.2 percent).

As of 08/31, testing coverage is highest among residents of the Central region (202 tests per
100,000 per day). Coverage is similar across the other four regions, ranging from 152 to 182

10
tests per 100,000 per day. Testing coverage has decreased in all five regions, but all regions are
still exceeding St. Louis County’s target of 150 tests per 100,000 population per day.

ZIP Code
Between 08/18 and 08/31, the rate of new diagnoses among St. Louis County residents ranged
from 109.3 cases per 100,000 (63133) to 654.9 cases per 100,000 (63044). See below for a map
and data table of COVID-19 case counts and rates by ZIP Code tabulation area (ZCTA). ZCTAs
have been excluded from the analysis if they had between one and four cases diagnosed
between 08/18 and 08/31 or if their residential population is less than 100 people.

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ZIP Cases, Cases, last Population Cases per 100,000 Cases per 100,000
Code total 14 days population, total population, last 14 days
63044 311 69 10536 2951.8 654.9
63137 491 74 13820 3552.8 535.5
63128 562 149 29823 1884.5 499.6
63025 253 41 8369 3023.1 489.9
63005 374 80 17887 2090.9 447.3
63026 498 93 22180 2245.3 419.3
63127 73 20 4986 1464.1 401.1
63040 137 32 8258 1659 387.5
63122 688 135 38686 1778.4 349
63131 322 60 17627 1826.7 340.4
63129 877 168 53671 1634 313
63144 168 27 8725 1925.5 309.5
63017 823 128 41556 1980.5 308
63069 162 15 4888 3314.2 306.9
63132 266 39 13427 1981.1 290.5
63011 525 108 38436 1365.9 281
63031 1230 131 47419 2593.9 276.3
63124 215 29 10827 1985.8 267.8

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63123 805 129 48406 1663 266.5
63034 459 47 17879 2567.3 262.9
63141 385 54 20550 1873.5 262.8
63117 180 22 8456 2128.7 260.2
63033 1167 111 42991 2714.5 258.2
63021 865 142 56233 1538.2 252.5
63146 499 75 30178 1653.5 248.5
63125 516 80 32689 1578.5 244.7
63038 110 17 7077 1554.3 240.2
63042 392 46 19443 2016.1 236.6
63043 486 51 22524 2157.7 226.4
63074 292 34 15234 1916.8 223.2
63126 193 31 14781 1305.7 209.7
63130 491 59 28421 1727.6 207.6
63136 1123 88 43470 2583.4 202.4
63143 107 14 7111 1504.7 196.9
63105 193 34 17369 1111.2 195.8
63134 360 26 13525 2661.7 192.2
63114 683 68 35487 1924.6 191.6
63088 160 16 8376 1910.2 191
63119 617 63 33796 1825.7 186.4
63138 503 34 18573 2708.2 183.1
63121 513 40 24634 2082.5 162.4
63135 399 26 21869 1824.5 118.9
63133 150 8 7316 2050.3 109.3

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Youth Supplement
Given the attention being paid to youth sports and the start of the 2020–2021 school year, the
following section takes a closer look at COVID-19 trends among St. Louis County residents aged
19 years and younger.

Cases by Age Group

As of 08/31, the rate of new COVID-19 diagnoses is highest among St. Louis County youth aged
15 to 19 years – 4.8x higher than among their 10 to 14 year old peers (37.2 vs. 7.8 cases per
100,000 per day, respectively). Between 08/18 and 08/31, average daily diagnoses increased by
6.8 percent among 10–14 year olds and decreased among the other three youth age groups.

Positivity by Age Group

As of 08/31, the prevalence of SARS-CoV-2 infection among those tested is considerably higher
among 15–19 year olds (20.2 percent) than among other St. Louis County youth. Positivity rates
are currently between 6 and 9 percent for the other youth age groups. Between 08/18 and
08/31, positivity increased considerably among 15–19 year olds, decreased among 5–9 and 10–
14 year olds, and remained stable among children aged 4 years and younger.

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Testing Coverage by Age Group
As of 08/31, testing coverage is well below St. Louis County’s target of 150 tests per day per
100,000 population among youth aged 4 years and younger (64.8 tests per 100,000 per day), 5–
9 years (51.7 per 100,000 per day), and 10–14 years (60.2 per 100,000 per day). Coverage
among 15–19 year olds (183.8 per 100,000 per day) is above the target, but declined
considerably between 08/18 and 08/31.

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Cases by ZIP Code
Between 08/18 and 08/31, the rate of new diagnoses among St. Louis County youth ranged
from 0 (63049) to 548.4 cases per 100,000 population (63040). While there is considerable
variation, most of the ZIP Codes with the highest rates among youth over the past two weeks
are in the West and South regions of the county. See below for a map and data table of COVID-
19 case counts and rates among St. Louis County youth by ZIP Code tabulation area (ZCTA).
ZCTAs have been excluded from the analysis if they had between one and four youth cases
diagnosed between 08/18 and 08/31 or if their youth population is less than 100 people.

ZIP Youth cases, Youth Youth cases per 100,000

Code last 14 days population population, last 14 days
63040 15 2735 548.4
63005 28 5705 490.8
63128 29 6205 467.4
63044 12 2832 423.7
63088 7 1731 404.4
63127 5 1252 399.4
63122 40 11155 358.6
63131 18 5039 357.2
63025 9 2589 347.6

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63124 8 2576 310.6
63146 18 5943 302.9
63017 27 9768 276.4
63026 17 6459 263.2
63038 5 1906 262.3
63141 11 4703 233.9
63132 9 4050 222.2
63011 24 10867 220.9
63129 26 12159 213.8
63123 19 10009 189.8
63021 27 15202 177.6
63105 6 4116 145.8
63034 6 4150 144.6
63042 7 4885 143.3
63130 8 6106 131
63074 6 4765 125.9
63043 6 4783 125.4
63134 5 4479 111.6
63033 14 12636 110.8
63031 16 14652 109.2
63119 9 9434 95.4
63121 6 6335 94.7
63125 7 7557 92.6
63114 7 9698 72.2
63136 9 13840 65
63120 0 193 0
63049 0 1007 0

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Impact on Schools
In addition to individual case data among youth in St. Louis County, DPH also works with
schools and school districts to understand the impact of COVID-19 at the school level. The
information below is derived from reports from and discussions with individual schools and
school districts. It includes K-12 schools, both public and private, that reported to DPH a
positive case and/or a contact among staff or students from 8/1/2020 through 8/31/2020.

• Thirty-nine students tested positive for COVID-19. Among these:

o At least 23 resulted in school-related exposures to staff, students, or both. These
exposures resulted in over 325 students and staff members being placed on
quarantine.
o The remaining students tested positive for COVID-19, but without any school-
related exposure or transmission to staff or students.
o The majority (90%) of cases were among middle and high school students.
• Thirty-four staff members tested positive for COVID-19. Among these:
o At least 14 resulted in school-related exposures to staff, students, or both. These
exposures resulted in more than 120 students and staff members being placed in
quarantine.
o The remaining staff members tested positive for COVID-19, but without any
school-related exposure or transmission to staff or students.
• More than 200 students and staff were required to quarantine after exposure to
positive cases that were not school-related. The majority of these missed in-school
instruction, activities, or work due to their quarantine.
• At this time, we are still looking into how many secondary cases resulted from school-
related transmission.

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Indicators and Thresholds
Indicator 1: Rate of new cases
Data are collected daily and include all new cases among St. Louis County residents. This is the
rolling seven-day average of new confirmed or probable cases diagnosed among St. Louis
County residents per 100,000 population.
• Red: Greater than 8 cases per 100,000 per day
• Yellow: Between 4 and 8 cases per 100,000 per day
• Green: Less than 4 cases per 100,000 per day
Indicator 2: Trend in new cases
Data are collected daily and include all new cases among St. Louis County residents. This is the
change in the seven-day rolling average of new confirmed or probable COVID-19 cases over a
fourteen-day period.
• Red: If cases are increasing (more than a 10% increase) during the fourteen-day period.
• Yellow: If cases are flat (less than a 10% change in either direction) during the fourteen-
day period.
• Green: If cases are decreasing (more than a 10% decrease) during the fourteen-day period.
Indicator 3: Number of non-household contacts per case
This is an average of the total number of contacts divided by the total number of cases (using a
7-day moving average), where the number of cases and contacts is taken from our case
investigation and contact tracing databases.
• Red: If the average number of non-household contacts is increasing (more than a 10%
increase) during the fourteen-day period.
• Yellow: If the average number of non-household contacts is flat (less than a 10% change in
either direction) during the fourteen-day period.
• Green: If the average number of non-household contacts is decreasing (more than a 10%
decrease) during the fourteen-day period.
Indicator 4: Percent positivity
Data on the number of positive and negative PCR tests for COVID-19 are provided daily by the
Missouri Department of Health and Senior Services. This metric is the proportion of SARS-CoV-2
PCR tests that were positive over a rolling seven-day period.
• Red: Greater than 10 percent positive
• Yellow: 5 percent to 10 percent positive
• Green: Less than 5 percent positive
Indicator 5: New hospital admissions

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Data on the number of new hospital admissions provided daily by the regional pandemic task
force across the four major hospital systems. This metric uses the 7-day moving average of new
COVID-19 related hospital admissions.
• Red: If new hospital admissions are increasing (more than a 10% increase) during the
fourteen-day period.
• Yellow: If new hospital admissions are flat (less than a 10% change in either direction)
during the fourteen-day period.
• Green: If new hospital admissions are decreasing (more than a 10% decrease) during the
fourteen-day period.
Indicator 6: Number of COVID-associated deaths
Data are collected daily and include all COVID-19 associated deaths among Saint Louis County
residents. This is the change in the seven-day rolling average of COVID-19-associated deaths
over a fourteen-day period.
• Red: If deaths are increasing (more than a 10% increase) during the fourteen-day period.
• Yellow: If deaths are flat (less than a 10% change in either direction) during the fourteen-
day period.
• Green: If deaths are decreasing (more than a 10% decrease) during the fourteen-day
period.
Indicator 7: Percent of test target
This is the rolling seven-day average of COVID-19 PCR tests conducted among St. Louis County
residents, relative to St. Louis County’s target of 150 tests per 100,000 population per day.
• Red: Less than 50 percent of the target
• Yellow: Between 50 and 99 percent of the target
• Green: 100 percent of the target or greater
Indicator 8: Hospital bed capacity
Data about hospitalizations are provided daily by the Pandemic Task Force. Calculating this
metric is dependent on those data continuing to be collected and available.
• Red: Occupancy is more than 80 percent (extremely low availability of beds).
• Yellow: Occupancy is between 60 and 80 percent (low availability of beds).
• Green: Occupancy is below 60 percent (sufficient availability of beds).

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