Residents of Missouri's biggest cities have been ordered to stay home to help slow the spread of the coronavirus, which sickened nearly 130 people statewide, including at least five people linked to a suburban St. Louis preschool and four to a Springfield assisted living facility.

ST. LOUIS — Residents of Missouri's biggest cities have been ordered to stay home to help slow the spread of the coronavirus, which sickened nearly 130 people statewide, including at least five people linked to a suburban St. Louis preschool and four to a Springfield assisted living facility.

The shelter-in-place order in St. Louis took effect Monday, a day before such orders were set to be enforced in the Kansas City and St. Joseph areas. The orders call for residents to remain in their homes unless they have a vital reason to go out, such as to go to the grocery store or pharmacy.

Missouri has had more than 130 cases of COVID-19, the disease caused by the virus, and three deaths.

Four teachers and the parent of a student at a preschool in the St. Louis suburb of Creve Couer were among the latest to catch the disease. There also was evidence in St. Louis County of "community-spread," in which it's not clear how an infected person contracted the virus and its origin can't be traced.

In southwestern Missouri, the Springfield-Greene County Health Department announced Monday that its positive cases had grown to 17 from 10, including four new coronavirus cases tied to the Morningside of Springfield-East nursing home. Springfield-Greene County Health Department Director Clay Goodard said the nursing home cases were the county's first so-called community spread cases, in which officials couldn't figure out how those patients caught the disease.

Meanwhile, CoxHealth's president and CEO, Steve Edwards, urged Greene County and the City of Springfield to order stricter isolation requirements, the Springfield News-Leader reported.

"In an epidemic we are generally making decisions two (weeks) behind (given the incubation period)," he tweeted Saturday. "By this time in about 7-10 days COVID will be endemic and our hospitals will start to fill. Act right now!"

For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

On Monday, Kansas City's school district announced that one of its staff members had contracted the disease and it said it was extending its school closures through April 24.

"We will provide any help needed to ensure our employee's ongoing recovery," Superintendent Mark Bedell said in a written statement. "This is an unprecedented situation."

Efforts to keep the public safe proved challenging. The Kansas City International Airport said in a Facebook post  that several hand sanitizer dispensers had been ripped off the wall in restrooms and that it won't be able to purchase replacements for months. 

"Acts like this impact many people," the post said. We are doing all we can to protect the health of our customers. This act makes that difficult since this is the only way we can offer hand sanitizer since it is in dispenser bags, and bottled sanitizer is not available."