State Of Missouri public health warning

The country is currently experiencing an extreme outbreak of COVID-19. As we move from fall into the winter months, respiratory illnesses spread more rapidly as people move indoors and environmental conditions change. COVID-19 is following that pattern. The risks will become more serious with the onset of flu season. Every state is affected. Every community is at risk.

If we do not slow the spread of the virus, we risk having our health care systems overwhelmed by COVID-19 patients. This poses a significant risk not only to those suffering from COVID-19, our first responders, and those working in our healthcare systems, but to anyone requiring health care support. This includes people requiring emergency services and ICU access from car accidents to treatment of serious health conditions such as cancer.

We will continue to take a balanced approach to Missouri’s COVID-19 response. Our approach is data- driven and based upon the most recent research. We have learned much since the start of the pandemic about how to live and work responsibly in the COVID-19 environment. Until a vaccine is made available to the general population in 2021, the most effective weapon against COVID-19 remains prevention.

We do not need to lockdown our communities if people do the right things to fight the spread of the virus.

Due to extreme COVID-19 risks, the State of Missouri issues the following public health warning to set expectations for all individuals living and/or working in Missouri and for our local jurisdictions:

Personal behavior advisory

The foundation for our success in fighting COVID-19 remains individuals doing the right thing. To protect our families, our neighbors, our communities, and our ability to continue our daily lives, we need everyone who is able to follow these basic principles:

• Wear a mask at all times in public and other settings outside your home where social distancing is not possible.

• Maintain social distance of at least 6 feet wherever possible, and limit close contacts with other individuals to less than 15 minutes.

• Wash hands multiple times a day. • Stay home when sick or if you have symptoms. Self-isolate from other family members. • As much as possible, limit your regular interactions to a small group (<10) of family members,

friends, and/or co-workers if living in a Category 1 or 2 community.

Business Advisory

In addition to the basic guidance for individuals, all businesses are advised to implement basic infection prevention measures informed by industry best practices:

• Modify physical workspaces to maximize and maintain social distancing. • Develop an infectious disease preparedness and response plan, including policies and procedures

for workforce contact tracing when an employee tests positive for COVID-19. • Monitor workforce for indicative symptoms. Symptomatic people should not physically return to

work until cleared by a medical provider.

• Develop, implement, and communicate about workplace flexibilities and protections, including: o Encouraging telework whenever possible and feasible with business operations;

o Working in phases and/or split shifts, if possible; o Limiting access to common areas where personnel are likely to congregate and interact; and o Ensuring that sick leave policies are flexible and consistent with public health guidance.

Travel advisory

We want to minimize the risks of COVID-19 spread within Missouri and across states, especially as we approach the holiday season.

• Minimize travel outside of Missouri. If traveling outside the state, please follow all guidance and requirements for your destination. Upon return, take as many precautions as possible, wear a mask, and monitor symptoms.

• If planning travel for gatherings during the holidays, especially those including individuals at high risk, encourage all people to self-isolate or isolate as family units as much as practicable in advance of any such gathering.

• Do not attend any gatherings, family or otherwise, if you have any symptoms.

Local government advisory

Missouri is a diverse state with diverse communities. A core principle of Missouri government is that we embrace local-level decision making tailored to each community’s unique needs. At the same time, Missourians live and work together. Most importantly, our healthcare systems are interconnected. What happens in one county affects its neighbors. Consequently, the State of Missouri government provides a baseline of public health standards and expectations. Local communities can establish higher, more stringent standards above the State’s public health advisory baseline.

In light of the COVID-19 challenge, the State of Missouri’s COVID-19 advisory provides expectations for communities based upon their localized public health data. This advisory acknowledges different jurisdictions will face different situations as the COVID-19 challenge evolves.

NOTE: Communities can move down in risk category after two consecutive weeks of meeting the lower category’s criteria.

The latest county-level positivity rates and case rates can found at: https://showmestrong.mo.gov/public- health-county/. Data on this link is updated daily.

Category 1 County Action Plan: Extreme Risk

Criteria for county:

• PCR 7-day positivity rate: 15% or above (using CDC method), and

• 7 day case rate per 100k: 350 or above Business occupancy: Occupancy limits reflective of social distancing.

Social group size: 10 or less.

[NOTE: For the purposes of this advisory, “social group” is defined as any planned or spontaneous event or convening that would bring together a group of people in a single space at the same time, excluding normal business activities, religious services, schools and school activities, and extended family gatherings.]

Masks: Strongly advised in all offices and businesses where social distancing is not possible.

Category 2 County Action Plan: Critical Risk

Criteria for county:

• PCR 7-day positivity rate: 10-14% (using CDC method), and

• 7 day case rate per 100k: 100-349 Business occupancy: Occupancy limits reflective of social distancing.

Social group size: 25 or less. Masks: Advised in all offices and businesses with 10+ people where social distancing is not possible.

Category 3 County Action Plan: Serious Risk

Criteria for county:

• PCR 7-day positivity rate: 5-9% (using CDC method), and

• 7 day case rate per 100k: 10-99 Business occupancy: No limits.

Social group size: Limited to maintaining 6 feet distance. Masks: Advised in all offices and businesses with 10+ people where social distancing is not possible.