On the day Missouri recorded its biggest single increase in COVID-19 cases and two deaths, Gov. Mike Parson tried to deflect criticism of his orders restricting gatherings and businesses by saying he wasn’t yet ready to order residents to stay at home.

During a daily Capitol briefing held for the first time without reporters present, Parson said he is trying to preserve as much of the state’s economy as he can through the crisis.

“When you start talking about shutting the state down for 30 days, 60 days, 90 days, the effect that has on everyday people is tremendous,” Parson said. “It means businesses will close. People will lose their jobs. The economy will be in worse shape than ever.”

Parson spoke about an hour after the daily report from the Department of Health and Senior Services showed the number of confirmed coronavirus infections increased more than 70 percent from Sunday.

It was also soon after the Columbia-Boone County Department of Public Health and Human Services reported the first instances of community transmission in the county.

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 cited by county health departments. Boone County has 20 cases, and three are blamed on community transmission.

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

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

Cooper and Platte counties all recorded their first cases of coronavirus infection, reports that are not reflected in the official state number.

Nationally, there were 43,667 confirmed coronavirus infections at 6 p.m. Monday, with 552 deaths attributed to COVID-19. Worldwide, the disease has caused more than 378,000 infections and almost 16,500 deaths.

Missouri’s fourth death from COVID-19 on Monday was a St. Louis woman in her 30s. Officials said they are still trying to figure out how she got the disease.

Her relative youth “is a cause for concern for us,” Dr. Fredrick Echols, the city's health director, said at a news conference. He said the woman was hospitalized on Sunday, though he declined to provide further personal details about her.

The fifth was reported a short time later in Greene County, a woman in her 80s who lived at a local assisted living facility.

The University of Missouri Health Care drive-through testing site has taken samples from 738 people since opening last Wednesday, according to figures provided by MU Health Care. The free telehealth screening for coronavirus has had 658 visits since the $10 charge was eliminated last week.

The state’s largest metropolitan areas are under stay-at-home orders and several groups, including the Missouri State Medical Association and the Missouri Center for Public Health Excellence, have called on Parson to take the order statewide.

In Columbia and Boone County, the rules currently in effect reflect the state rules — no gatherings of more than 10, with pick-up or delivery service only at bars and restaurants and other businesses where in-store customers are prohibited.

The rules do not apply to grocery stores, pharmacies, gas stations or child care centers.

The medical 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.

Asked about that during the briefing, Parson said he wants to see whether his current emergency order works to slow the spread of the virus.

"We placed an order in effect just a couple of days ago, and we believe that order needs to be in effect right now and that everybody abide by that order,“ Parson said.

Parson took several steps to control the virus by other means, including closing all state buildings to the public and making it easier for medical providers from other states and students studying nursing and other professions to work during the outbreak.

He also issued an order allowing restaurants to sell their stocks of unprepared food, usually forbidden in normal times.

He is acting, Parson said, to relieve shortages that have left store shelves empty.

“I want to assure you this is a demand issue, not a supply issue,” Parson said.

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.”

The number of hospitalizations is unknown except by anecdotal accounts. The Missouri Department of Corrections announced it has an inmate who is hospitalized in Kansas City for COVID-19. The inmate had been in isolation at the Western Reception, Diagnostic & Correctional Center in St. Joseph on March 4.

Another patient was hospitalized at Lake Regional Medical Center in Camden County.

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

One of the first COVID-19-related criminal charges in Missouri was filed Monday against an Ashland man, Anthony Nunes, 26, who allegedly told clerks at two stores in Cole County that he had the coronavirus.

The clerks said he was coughing and told them he had a high fever and sore throat.

Cole County Sheriff John Wheeler said the county takes temperatures of all prisoners as part of its protocol. He said Nunes did not have a fever as of Monday afternoon, when he was being held in the Cole County Jail on a $5,000 bond.

All of the Tribune's coronavirus coverage is being provided free to our readers. Please consider supporting local journalism by subscribing to the Tribune at columbiatribune.com/subscribenow.