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In many counties in Missouri, the percentage of fully vaccinated people is less than 24 percent. Michael Thomas/Getty Images
  • Experts say Missouri’s low vaccination rate is the prime factor in its recent surge of COVID-19 cases caused by the delta variant.
  • They note a number of counties in the state’s northern and southern regions have less than 24 percent of their population fully vaccinated.
  • They say it’s important that unvaccinated people hear from a trusted friend, family member, or community leader about the benefits of being vaccinated.

It was a chilly winter day on February 18 when CoxHealth President and CEO Steven Edwards tweeted a joyful announcement on behalf of his entire Missouri hospital team.

Above a photo of two intensive care unit (ICU) staffers with hands pumped joyfully in the air, he wrote, “This is a moment of celebration as we vacated the emergency Covid ICU… We are mindful of future worries, but for now, HERE COMES THE SUN.”

“It was a very moving time for us,” he said.

Fast-forward to the end of June.

Edwards and the staffers at his Missouri hospital find themselves back in the trenches with ICUs filling up once again.

Their hospitals, centered in Springfield, sit in the middle of what may be the United States’ epicenter of the coronavirus delta variant.

About 40 percent of Missouri residents are fully vaccinated and the variant may be, as experts predicted, searching that region to find “host locations” to spread.

Missouri now has the fourth highest number of COVID-19 cases in the country despite being only the 18th most populous state. Missouri also has the second highest per capita rate of COVID-19 cases.

This week, officials in one county requested funding to set up an “alternative care site” just for people with COVID-19.

It’s been a soul-crushing endeavor, Edwards told Healthline last month, when you consider that, in his view, it all could have been avoided.

“Nearly 100 percent of those in the ICU are unvaccinated,” he said.

To him, the staff, and the vaccinated population, it’s a bitter pill, he said.

“If we look back a year and a half ago [when the pandemic began], our employees rallied and gladly put themselves in harm’s way,” he said. “It was their heroic moment. They were inspiring, selfless, and effective.”

This time, there’s a different vibe.

“That inspiration has turned into exasperation,” Edwards said. “Because this time, every single one [of the ICU hospitalizations] was avoidable.”

Experts say the transmission of COVID-19 at this time comes down to vaccinations.

Missouri’s rural northern and southern regions fall well below the national averages for vaccinations, with a host of counties below 24 percent fully vaccinated.

Couple that with signs that the delta variant is highly transmissible, seems to impact younger people more than other variants, and packs a more powerful punch, and you’ve got all the fuel needed to spark another surge.

At the CoxHealth hospitals, Edwards said, they are — for the first time in the entire pandemic — being forced to divert patients of all types to other hospitals.

“We have all the supplies, beds, and equipment we need,” he said. “We just don’t have the staff because the ramp-up was so fast.”

Edwards sees the low vaccination numbers as beyond hesitancy and more toward refusal. He believes much of the refusal comes from a political base.

The northern agricultural section of Missouri and the southern region featuring the Ozarks lean heavily conservative and have the lowest vaccination rates.

Edwards believes that’s why this time, COVID-19 is coming at them — and the nation — in a new pattern.

“We benefited from it starting at the coast [last year],” he said. “Now, it’s starting from the middle. We’re the epicenter.”

Even with the new surge, some Missourians remain steadfast in their decisions not to vaccinate.

Katrina Huckabay is one of them.

“We feel confident we are OK [without vaccines],” she said of her husband, herself, and her children.

Huckaby got COVID-19 last July, as did her children, and escaped relatively unscathed.

Her husband got it this past Easter when they attended an adult Easter egg and alcohol hunt.

He was sick enough to be hospitalized.

While experts are saying that the delta variant breaks through past infections for reinfection, Huckabay has her doubts.

“We are a straight no,” she told Healthline. “I don’t know what would change our minds, and I find a lot of my neighbors are of the same mindset.”

Lisa Wright got her vaccination the first day she could in early February.

Wright said the one benefit of living in a place with so many opposed to the COVID-19 vaccine is that she was able to get the shots well before she expected, since so many sat on shelves.

“All the [people] who did not want the vaccine left them for the rest of us, so that was good,” she told Healthline.

But she’s exasperated by the current surge.

“I’m frustrated that people let their ideologies get in the way of common sense,” she said. “As my husband said, free bagels or doughnuts aren’t going to change anybody’s mind. People have made up their minds and decided to believe the narrative, as kooky as it is to me.”

Edwards said, from what they hear from patients, the beliefs run deep.

One nurse, he said, reported having treated a person with methamphetamine addiction who was against the COVID-19 vaccine.

“So, in other words, he will put meth into his body but not this vaccine,” Edwards said.

Missouri, the “Show-Me State,” may be showing the nation how the new variants will act in a semivaccinated population.

What people will see, Edwards said, is pockets of high infection rates that then spread outward with more young adults with serious illnesses and more reinfections of unvaccinated people who have already had the disease.

So, what’s the nation to do?

Edwards believes that even if it feels like unvaccinated people still have dug in their heels, the nation and local agencies should not stop trying.

His hope? We find a way to put aside political ideology in the debate.

“If you try to change someone’s mind via political ideology, you’re going to lose every time,” he said.

Rather, he hopes those experts people trust — such as primary care doctors and loved ones — keep pushing information to help sway people.

Edwards also believes that tragedy may end up being a motivating factor.

“You can choose the hard way or you can choose the easy way,” he said. “That’s the sad reality.”