Editor's note: This is a daily briefing updating the latest information on the COVID-19 pandemic at 4 p.m. each day.
The criteria to test for COVID-19 is expanding in Missouri, said Dr. Randall Williams, director of the state Department of Health and Senior Services.
"As we move out of the acute phase to box in new outbreaks as they arise, and to give doctors and other providers … a broader decision making ability as to who gets tested."
Patients will still need to be seen by a health care provider.
A test can be given if the patient has a fever or symptoms of lower respiratory illness and are in an at-risk group.
• health care worker or first responder;
• resident of a congregate living facility;
• currently hospitalized or "at high risk for negative health outcomes based on the provider's clinical judgement."
• anyone that has close contact with a COVID-19 case or a patient under investigation with a pending test within 14 days of symptoms starting, also qualifies.
"The new criteria allows us to do comprehensive testing, in other words, testing everyone — staff and patients in congregate facilities for both symptomatic and asymptomatic," Williams said. "It also expands the criteria so that we can test more first responders to not only increase the amount of testing that can be done, but also to increase access to those tests."
Anyone not meeting DHSS criteria for testing, health care providers can still use private laboratory testing, which does not require DHSS approval.
Also, postmortem testing can be approved through the state lab if an individual would have met a criterion prior to their death.
The state lab is currently testing to detect the presence of COVID-19 RNA that indicates a likely current infection.
"Providers should be aware that some patients may shed virus for several weeks, the maximum of which is still being studied," the DHSS health update states.
The state will soon also be offering "serological testing" that detects the presence of antibodies in a person who has been exposed to the virus.
That test, DHSS says, is "not useful for determining if the patient is currently infectious, or if (a) person has developed immunity."
This test is important, Williams noted, for people who did not have symptoms but were around multiple patients who may have had the virus and become infected without knowing it.
The state announced Wednesday that an additional 19 people have died from COVID-19, matching the largest one-day total set on April 9-10 and 14. Missouri reached 208 deaths over the last 36 days.
There are now 6,137 confirmed positive tests for the virus in Missouri, an increase of 196 from the previous day.
Locally, there was one new case in Ripley County, the first since April 10. Butler County has not reported a new case in three straight days, remaining at 23.
DHSS says approximately 59,266 patients have been tested for COVID-19 in a state of 6.137 million people.
"The reason the numbers are low right now is because of the criteria itself and it's why we're expanding that criteria where we can do more and more testing," Gov. Mike Parson said. "We're going to give the providers the ability as a staff, somebody walks in there and say if you want to test them you can test them."
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The Poplar Bluff R-1 School District meals program has provided 153,000 meals to students as of Tuesday, Chris Rushin of the Boys and Girls Club of Butler County said.
The nine locations and six bus routes that serve students in the district average 5,500 to 6,800 meals a day, Rushin said. The program is a joint venture through the school district, Chartwells and the Boys and Girls Club.
The Missouri Department of Elementary and Secondary Education reports that nearly 1.3 million meals have been served around the state by schools.
The Missouri National Guard will help some school districts in the state distribute food, the Associated Press reported, including Richland in Stoddard County, Portageville and Cape Girardeau. Nearly 200 members of the Guard will distribute meals for the next several weeks.
Lesley Rone, field representative for Senator Roy Blunt, updated Butler County officials on the recently passed legislation in the Senate.
A $483 billion aid package features $75 billion to be given to hospitals, including $10 billion for the nation's rural hospitals, $25 billion spent on testing for the virus with at least $11 billion to state governments. Another $60 billion will be available for a small-business loans and grants.
It now goes to the House, which is scheduled to vote Thursday, and President Donald Trump has pledged to sign it into law.
Missouri Gov. Mike Parson announced the start of a marketplace to help health care providers connect with state manufacturers and suppliers of personal protective equipment.
The Department of Economic Development has gotten interest from more than 200 manufacturers and suppliers of the equipment to signup for the system while the state, with help from the Missouri Hospital Association, has reached out to health care providers for access.
Missouri businesses interested in selling or manufacturing personal protective equipment can contact DED at ded.mo.gov/howtohelp .
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A look at stories you might have missed from the DAR:
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} • Jackson respiratory therapist who worked in NYC tests positive for COVID-19 • Reimagined school year includes Zoom with teachers, tech support • Federal court expects to hold video sentencing this week
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A look at three stories from the Associated Press:
• CDC confirms weeks-earlier California deaths • Southern states largely go it alone in reopening decisions • Administration offers plan to cover virus care for uninsured Latest coverage from AP.
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As of 2 p.m. Wednesday, April 22:
US DEATHS: 45,894 Mo. Deaths: 208 (+19) Mo. Cases: 6,137 (+196)
Cases by area county: Butler County: 23 Carter: 3 (1 death) Dunklin: 19 (2 deaths) Stoddard: 19 Ripley: 4 Reynolds: 2 Wayne: 0 Scott: 59 (1 death) Perry: 38 Cape: 40 (1 death) St. Francois: 24 (1 death) Pemiscot: 17 New Madrid: 9 Bollinger: 3 Madison: 1 Mississippi: 1 Clay, Ark.: 1
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Cloth face coverings are recommended for everyone by the Centers for Disease Control and Prevention.
Do not use surgical masks or N95 masks. Those are critical supplies needed for health care workers and first responders.
Be sure that the face covering "fits snugly but comfortably against the side of the face; secured with ties or ear loops; include multiple layers of fabric; allow for breathing without restriction; be able to be laundered and machine dried without damage or change to shape." (CDC)
Instructions for sewn cloth face coverings can be found here.
Don't know how to sew? Click here to watch a short video on how to make a face covering.
To donate masks in Butler County, text or call 573-714-4197. Someone will come pick up the masks and distribute them where needed.
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From the AP: For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death. The vast majority of people recover.
Here are the symptoms of the virus compared with the common flu.
One of the best ways to prevent spread of the virus is washing your hands with soap and water. The U.S. Centers for Disease Control and Prevention recommends first washing with warm or cold water and then lathering soap for 20 seconds to get it on the backs of hands, between fingers and under fingernails before rinsing off.
You should wash your phone, too. Here’s how.
The Missouri coronavirus information hotline is 877-435-8411.
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