The number of confirmed coronavirus cases in Missouri jumped up more than 70 percent in a little over 17 hours Monday and the Columbia-Boone County Department of Public Health and Human Services reported the first instances of community transmission.

In a 2 p.m. posting, the Department of Health and Senior Services reported 183 confirmed cases as reporting caught up with the numbers being reported by county health departments.

The updated figures show 69 cases in St. Louis County, where officials had reported 55 on Sunday, with "clear evidence of community transmission."

There are now cases in 24 of the state’s 114 counties and the city of St. Louis. Jackson County and Kansas City have separate health departments, reporting 10 and 17 cases, respectively.

Boone County continues to have the second highest number of cases of any jurisdiction, with 19 cases, the county health department reported. Three of the cases are attributed to commuity transmission.

The state website reported five cases in Cole County, and two in Adair County, and one each in Camden, Jasper and Moniteau counties.

The Camden County case is being treated at Lake Regional Medical Center.

"The patient is currently in isolation at the hospital to reduce the risk of exposure to others," the hospital stated in a Facebook post.

The leap in case numbers was reported a few hours after the Missouri State Medical Association urged Gov. Mike Parson to issue a statewide stay-at-home order similar to those in effect in St. Louis and taking effect Tuesday in the Kansas City area.

The association has supported Parson’s previous actions to limit gatherings, a letter signed by James DiRenna, president of the association stated.

"However, we now believe that a statewide ‘shelter in place’ order is the only way to curb the exponential spread of COVID-19 in Missouri," DiRenna wrote.

Statewide and in Boone County, the limits are looser – public and private gatherings of more than 10 people are forbidden, restaurants and bars may only provide take-out service and businesses that remain open must not allow more than 10 people, including employees, inside.

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Missourians got a glimpse into the treatments for COVID-19, the disease caused by the coronavirus that emerged last year, when state Rep. Joe Runions, D-Grandview, released a photo taken while he was on a respirator at St. Joseph Medical Center in Kansas City.

In a letter to Gov. Mike Parson, Runions urged him to take additional steps to make sure that hospitals and medical providers are ready for an onslaught of patients.

"My doctors are deeply concerned that they could run out of vital supplies, especially the equipment they need to keep themselves safe while caring for patients," Runions said in a statement that accompanies release of his letter. "They also say expanded testing is needed to more quickly identify and treat those who have contracted COVID-19."

Nationally, there were 41,708 confirmed coronavirus infections at 2 p.m. Monday, with 573 deaths attributed to COVID-19. Worldwide, the disease has caused more than 372,000 infections and 16,113 deaths.

Late Sunday, Columbia Public Schools released a letter to parents and staff at Russell Boulevard Elementary School seeking to reassure them about the possibility of being infected by an employee who later tested positive. Columbia schools suspended classes on Wednesday.

The health department is following guidance from the Centers for Disease Control that the most likely time of spread is when symptoms, including fever, difficulty breathing, coughing, and/or sneezing, are present because the virus is spread in respiratory droplets in the air and on surfaces, the note stated.

"With regard to the school district employee who tested positive, if you have not been contacted by the health department, you were not identified as a close contact of the individual and your risk of infection is considered to be no greater than the general population," the health department told Russell staff and family in the district’s message.

The Missouri Center for Public Health Excellence, an organization of public health departments from most of the state’s largest communities, had asked Parson on Friday to have a statewide rule that more closely resembles that in St. Louis and Kansas City.

They urged the governor to close all businesses except groceries, pharmacies and gas stations to in-store service, with all others closed except for curbside pickup, drive-thru or delivery orders.

They also urged "that all schools be closed until further notice, probably the end of the school year." Parson’s order allows schools to reopen on April 6 unless it is extended.

"We do not take this request lightly but feel that at this time there is no other way to protect our residents and health providers without requesting that our efforts become statewide efforts," the letter signed by Clay Goddard, president of the center and director of the Springfield-Greene County Health Department and Rex Archer, vice president and director of the Kansas City Health Department.

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