As they struggle to find personal protective equipment, Missouri hospitals find they are in a bidding war that is driving up costs and returning items of questionable quality.


At the same time, black leaders in Missouri are raising concerns that the coronavirus is killing black Missourians at a disproportionate rate, especially in the state’s urban areas.


Data reported Monday showed that 27 hospitals of 114 reporting hospitals face a shortage of surgical masks and 26 are short on N95 masks, which are fitted to a user’s face and filter out particles.


At the CoxHealth Hospital in Springfield, CEO Steve Edwards told the Springfield News-Leader that he recently submitted a winning bid for 100,000 N95 masks for about seven times the normal price.


"It's like the wild, wild West," Edwards said.


A fit test when the first batch arrived showed the masks – one of the most sought after because of their design – revealed the masks had errors and were not as secure to the face as they should have been.


CoxHealth contacted the seller about the issue, Edwards said.


"They said, 'You can return it, but we've got people who will pay even more for it right now,'" Edwards said. "So because we need masks so desperately ... and they are better than maybe a (surgical) mask, we went ahead and paid money for it."


While CoxHealth took the supplies, the state on Monday announced it was recalling 48,000 N95 masks shipped to law enforcement and firefighters on April 2 and Wednesday. Sandy Karsten, director of the Department of Public Safety, said the masks were defective.


"Testing over the weekend showed that some of these mask did not meet standards," Karsten said.


The struggles to find gear comes as the expected surge in patients is 12 days away.


Hospitals are prepared but struggling financially, Herb Kuhn, executive director of the Missouri Hospital Association said. With most providers postponing elective surgeries and most other procedures that can be put off, he said, revenues are down by more than 50 percent.


A package of federal aid to support health providers will provide some relief, he said, but with lost revenue at $32 million a day, the money will last only 10 days, he said.


The state’s first alternate care facility — the term being used to describe care facilities set up in arenas and hotels — is now ready at the Quality Hotel in Florissant, Gov. Mike Parson said at his daily briefing.


It is not currently needed but is now ready, he said.


The number of people hospitalized for COVID-19 outside of the state’s two largest cities remains fairly low. CoxHealth has about 25 patients known to have COVID-19 or who are awaiting results, with about the same number of cases at University of Missouri Health Care in Columbia.


Confirmed cases of the novel coronavirus in the state rose by 228 Monday to 4,288, with deaths in the state attributed to the disease at 114. Inconsistencies with county data remain due to reporting issues, but many numbers are now more in line with what counties are reporting due to reporting requirement changes made by the state last week.



Boone County’s local confirmed case count remained at 79 on Monday, but increased by two in the report from the Department of Health and Senior Services, to 82.


MU Health Care’s testing service had completed almost 3,650 tests, with 99 positive results. Boone Hospital Center’s drive-through testing sites resumed work Monday after being closed for Easter.


State data continued to indicate the most serious outbreak remains in St. Louis County, with 1,724 total cases, up 91 from the day before. The city of St. Louis added 25 cases to bring its total to 639, and outlying St. Charles County had 346.


On the other side of the state, Kansas City added 21 cases to bring its total confirmed cases to 329, and Jackson County outside the city had 223.


Cole County’s confirmed count increased one to 37, with one death. Montineau County’s count remained at three, and Howard County added a case and now has two identified infections.


Springfield’s Greene County’s case count remained at 71.


Even now, the numbers could very well be incomplete, as state numbers can only track confirmed cases that were tested.


Data on the racial breakdown of deaths in Missouri is incomplete because many local health departments are not providing that data to the state.


But of the 19 people in St. Louis who died from COVID-19, the illness caused by the coronavirus, 16 were black, one white and one Hispanic. The race of one person was unknown. St. Louis is nearly evenly split between black and white residents.


Blacks have accounted for 20 of the 42 deaths in St. Louis County, while 14 victims were white and no race was listed for eight others, according to data on the county health department’s website. About one-quarter of St. Louis County residents are black.


Kansas City — Missouri's largest city — has reported eight deaths from the coronavirus, including five black residents, two whites and one whose race was cited as "other" by the local health agency. About 29% of Kansas City residents are black.


Missouri NAACP President Nimrod Chapel on Monday said he has written to Gov. Mike Parson but has been unable to get answers about what the state is doing to help black residents get tested and treated for the coronavirus.


"Their only job is to look after the public welfare, and they’re literally watching people die," Chapel said in a phone interview.


Email messages left with spokeswomen for Parson and the Missouri Department of Health and Senior Services were not immediately returned.


The state health department does not provide a racial breakdown for coronavirus cases or deaths, noting that about 40% of medical providers were not reporting that information. Chapel questioned how local departments could not be required to provide information that could help direct outreach.


"Who’s in charge?" he asked. "If we’re going to leave this to cities and counties and they’re not doing the job right, somebody’s got to step in to save lives."


To treat COVID-19 patients, the state is asking anyone who has been infected to donate plasma for use by others who are sick. The plasma from recovered patients will be given to those at highest risk, the state health department said in a news release.


"The plasma obtained from the blood of people who recovered from COVID-19 (convalescent plasma) is being evaluated as treatment for hospitalized patients with serious or immediately life-threatening COVID-19 infections, or those judged by a healthcare provider to be at high risk of progression to severe or life-threatening disease," the release stated.


Evidence continued to mount that the growth in new cases in the United States is slowing. The number of new cases in the U.S. grew by less than 5 percent in 24 hours.


At 4:30 p.m. Monday, the U.S. had 577,307 confirmed cases, up 27,291 from late Sunday afternoon, with 23,078 deaths attributed to COVID-19. Worldwide, the virus is known to have infected almost 1.9 million people and is blamed for 118,854 deaths.


The Springfield News-Leader and Associated Press contributed to this report.


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