TISHAURA O.

JONES MATIFADZA
Mayor City of St. Louis HLATSHWAYO DAVIS, MD, MPH, FIDSA
Director of Health

Department of Health VICTORIA ANWURI, MPH

Commissioner of Health

Dear Employees,

The City of St. Louis Department of Health is updating its communications with employees
surrounding masking. The Department now recommends masking indoors for all City of St. Louis
employees effective immediately. As described in Administrative Regulation 152, employees are
not required to wear a mask but are strongly encouraged to do so. This recommendation is based
on the simultaneous marked increases in COVID-19, influenza, and RSV activity.

Additionally, upon further review of the data available for these three respiratory illnesses that
commonly peak during the winter months, the Department of Health wishes to clarify the
information provided yesterday. Previously reported percent change estimates compared the current
RSV and flu seasons to the median of previous seasons but did not adequately adjust for differences
in temporality. To simplify, data for all three illnesses are now compared to data from one month
prior.

Each winter respiratory viruses cause a significant health burden in our community; this year is no
exception. Influenza, RSV, and COVID-19 diagnoses and hospital visits have been sharply
increasing, particularly since the Thanksgiving holiday. In the month between Thanksgiving (week
ending November 25, 2023) and Christmas (week ending December 23, 2023):

• COVID-19 hospitalizations within the St. Louis Health Service Area (HSA) increased by
38%, with 270 individuals hospitalized with the disease during the week of December 23
(Centers for Disease Control and Prevention).
• Influenza cases in the City of St. Louis rose 455%, with individuals aged 25-49 years
seeing the highest number of infections, followed by children aged 5-14 years (City of St.
Louis Department of Health).
• Publicly available testing data shows Respiratory Syncytial Virus (RSV) positive tests
increased by 34%, with 400 positive tests during the most recent week with data available.

Please review the attached document for additional data and information about each virus.

It is important that residents stay up to date with vaccinations to maintain adequate protection
against these winter viruses, particularly as they evolve and new variants emerge. As of 12/1/23,
only 11% of St. Louis City residents had received the most up-to-date COVID-19 vaccine.
With the activity of winter viruses rising at such a rapid pace, we must take action to slow
transmission and prevent strain on our hospital systems. Effective immediately, City of St.
Louis employees are strongly encouraged, but not required, to wear a mask indoors. While
on duty, it is also recommended that City of St. Louis employees wear a face covering when
riding in City vehicles with one or more individuals.

1520 Market Street, P.O. Box 14702, St. Louis, Missouri 63178
Phone: (314) 612-5100 | Fax: (314) 612-5105 | Email: health@stlouis-mo.gov | Website: http://www.stlouis-mo.gov/health
Your hard work has kept St. Louis running throughout the pandemic, and together, we can
continue to protect one another by taking precautions. Prevention strategies to limit the spread of
respiratory viruses include:
· Get vaccinated
· Get tested, especially when symptomatic
· Stay home when sick
· Cover coughs and sneezes with your sleeve or a tissue, not your hand
· Avoid touching eyes, nose, or mouth
· Wash hands often, and be sure to wash for at least 20 seconds
· Wear a high-quality, well-fitting face mask
· Clean/disinfect objects and surfaces regularly

Some resources for getting tested for, or vaccinated against RSV, flu, and COVID-19 are
provided below:

VACCINATION and THERAPEUTICS: Visit https://www.stlouis-mo.gov/vaccines/ for

information about where to obtain a vaccine for COVID-19, Influenza, or RSV, or visit
vaccines.gov and enter your ZIP code to find the nearest convenient location to you. Eligibility
for the RSV vaccine is limited to those ages 60 years and older and pregnant persons between 32-
36 weeks gestation. Antibody therapy is available for younger infants entering their first RSV
season.

Vaccine scheduling is also available at Walgreens and CVS pharmacies and through the health
care systems (Mercy, SSM, People's Health Centers, Affinia, or CareSTL Health).
Antiviral therapeutic medications, like Tamiflu for influenza and Paxlovid for COVID-19, can
help reduce symptom severity and duration of illness when taken early in the course of infection.
These medications require a prescription, so talk to your healthcare provider if you test positive
for flu or COVID-19. Locations with Paxlovid availability can be found with the locator tool for
HHS's COVID-19 Test to Treat program.

If you have any questions regarding any of the above information, please contact the City of St.
Louis Department of Health at healthmonitor@stlouis-mo.gov.

Sincerely,
Matifadza Hlatshwayo Davis, MD, MPH, FIDSA (She/Her/Hers)
Director of Health