In his lawsuit challenging mask mandates in St. Louis and St. Louis County, Missouri Attorney General Eric Schmitt questioned the effectiveness of past COVID-19 restrictions there.
“Despite having the most restrictive and unconstitutional orders in Missouri, St. Louis County and St. Louis City suffered some of the highest COVID-19 case rates and death rates in Missouri,” the lawsuit filed Monday states.
The problem is that it is wrong.
Missouri Department of Health and Senior Services data shows both St. Louis and St. Louis County cumulative case rates are lower than the statewide rate. And both are in the bottom half of the 117 local health departments reported by the state.
Both have death rates above the statewide average, but neither is in the highest 25% of local health departments.
The mistakes in the rankings aren’t the only problems in the petition. An analysis by the Missouri Independent found several other places in Schmitt’s 37-page filing where data comparisons are questionable, either because they mix state and local data or omit entire classes of cases.
Asked for more information on how the data was chosen, Schmitt spokesman Chris Nuelle did not provide any explanation on Tuesday.
“We filed a thorough, detailed lawsuit to seek relief for the people of St. Louis, and will do so expeditiously,” he wrote in an email. “We are confident and proud of our suit.”
The St. Louis County Health Department cannot comment on the lawsuit’s characterization of the COVID-19 data, said spokesman Christopher Ave, because it will not comment on any aspect of the case. A spokesman for the St. Louis Health Department did not respond to a telephone message.
The results from comparing data reported locally by any single county with every other county’s state data are unreliable because local data often does not match state data. Local health officials get test results sooner, and may report cases based on different criteria, than the state.
The state reports cases identified by the long-swab PCR test and cases identified by the quicker antigen test. The data is reported separately as “confirmed” and “probable” cases, but that is a distinction without a difference.
Some local health departments, like St. Louis, only report PCR cases on their dashboards. Others, like Boone County, report PCR and antigen cases without separating them. And still others, like St. Louis County, report PCR, antigen and “probable” cases of people with COVID-19 symptoms living in the same household as a case identified by testing.
The state dashboard generally does not agree with local data and hasn’t since early in the pandemic. St. Louis reported 23,706 total PCR cases on Tuesday; the state reported 23,239. Boone County reported 20,673 cases Tuesday; the state reported 20,114. And St. Louis County reported 106,864; the state reported 100,444.
The same is true for deaths. St. Louis reports 538 deaths locally while the state has recorded 481. Boone County lists 118 deaths locally and 100 on the state dashboard. St. Louis County is reporting 2,299 deaths compared to 1,937 in the state report.
When The Independent compiled local reports in March for comparison to the state dashboard, it found local health departments were reporting about 80,000 more cases and 1,100 more deaths than the state health department data showed.
The biggest reason for the differences found in case totals in March was that the state health department was not reporting results from antigen tests. When those cases were added, it increased the state count by 81,206.
As of Tuesday, local health departments were reporting just under 10,000 more cases than the state health department website shows. The lag in death reporting at the state levels remains, with local health departments reporting 10,693 deaths, 1,071 more than the state data showed.
The problems with Schmitt’s data are illustrated by one comparison that mixes state and local data and omits the state data for antigen cases entirely.
Schmitt asserts that St. Charles County, which “never imposed a government mask mandate,” has a lower overall infection and death rate than neighboring St. Louis County. That is true only if the local data for St. Louis County is compared to state data for St. Charles County and no notice is taken of the antigen case rate.
A comparison that only uses state data, with antigen data included, shows the infection rate in St. Charles County is about 12% higher than St. Louis County. Comparing data from the local dashboards show an even larger gap of 16.5%.
Schmitt’s lawsuit seeks an order declaring that the mask mandates are “arbitrary and capricious,” violating state law and constitutional rights. The St. Louis County Council voted 5-2 Tuesday night to overturn the order, but County Executive Sam Page on Wednesday said the vote exceeded the council’s authority.
“I want to make it clear that a mask mandate remains in place in St. Louis County,” Page said.
The CDC on Tuesday revised its guidelines to recommend masks in indoor spaces in areas where the transmission rates are high and vaccination rates are low.
Kansas City will announce a mask rule Wednesday, Mayor Quinton Lucas wrote on Twitter.
“I will return Kansas City to a mask mandate indoors based upon national and regional health guidance and discussion with other Kansas City leaders,” Lucas wrote.
Schmitt, who is seeking the U.S. Senate seat being vacated by U.S. Sen. Roy Blunt, made it clear he does not believe mask mandates are effective or legal.
“This continued government overreach is unacceptable and unconstitutional, especially in the face of a widely available vaccine,” Schmitt said in a news release announcing the lawsuit. “There is absolutely no scientific reason to continue to force children to wear a mask in school.”
A scientific analysis of mask mandates, however, reached a different conclusion. On July 3, 2020, St. Louis and St. Louis County imposed mask mandates, while the surrounding region of St. Charles, Franklin and Jefferson counties did not.
The counties were on a similar trajectory of increasing cases prior to the mandate, said Enbal Shacham of the College of Public Health at St. Louis University. The study found that masks lowered transmission within three weeks.
“Ultimately we found that St. Louis and St. Louis County consistently had a 40% reduction in cases (compared to the neighboring counties) and it did not increase,” she said.
To make the comparisons, Shacham and her colleagues, Stephen Scroggins and Matthew Ellis, with the College of Public Health, and Alexander Garza, former chief of the St. Louis Pandemic Task Force, used the state health department data. The data was reliably comparable, she said.
“You can’t compare these infection rates if they don’t have the same infection reporting,” Shacham said.
Missouri Independent is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.
