Dr. Steven Douglas had heard that there was a positive case of COVID-19 related to the Southeast Correctional Center three days ago.

By Friday, that number had increased to 22 among inmates and three staff.

“Unfortunately, the word outbreak might well be the case,” Douglas said.

Douglas is a family health practitioner in Mississippi County, which prior to this week had reported no cases of COVID-19.

Department of Corrections spokeswoman Karen Pojmann said the facility administered a COVID-19 test April 15 for an inmate experiencing symptoms. The test came back positive on Tuesday.

The Mississippi County Health Department announced the additional positive cases on its Facebook page Thursday evening, saying they would be counted as Mississippi County residents.

“I would not call this a worst-case scenario,” Pojmann said. “We isolated it immediately.”

The new cases are yet to be reflected in the state Health and Human Services Department count, which shows Mississippi County with three COVID-19 infections.

Pojmann said that because the facility has seen a decrease in offenders, they were able to isolate all positive cases in a single wing.

The Southeast Correctional Center houses minimum, medium and maximum security inmates. It has a capacity of 1,658.

All individuals that came into contact with known COVID-19 cases were placed in another wing in the same building. The state prison system tested prisoners and staff members from a housing unit wing quarantined after the discovery of the three positive prisoner infections.

Of the 68 inmates in the unit, 19 have tested positive.

“We were very active about containment. We were able to contain it very quickly,” Pojmann said.

The state prison system has barred visitors since early March and is screening staff as they enter and leave each facility. Prisoners and staff have been given cleanable and reusable face covers manufactured within the prison system.

Douglas said his primary concern is if employees of the facility were to unknowingly transmit the disease to the wider community. Three employees of Southeast Correctional Center have tested positive for the illness, but none are residents of Mississippi County.

Like many rural Missouri counties, there is no hospital in Mississippi County, no ICU beds and no drive-thru testing center. All of this makes combating an outbreak of COVID-19 extremely taxing on local health care professionals.

Meanwhile, the average daily new cases of the disease have been on the decline statewide. This comes as Gov. Mike Parson looks to reopen parts of the state’s economy when the statewide stay-at-home order expires May 3. He said the state will increase its testing efforts and target them to areas experiencing a local outbreak, using a “boxing in” strategy.

Douglas still isn’t sure if Mississippi County will see any cases of COVID-19 linked to community spread. He and his partnering practitioners have run about 20 tests for the disease out of their East Prairie clinic so far.

His practice is associated with the Saint Francis Healthcare System, which is able to run tests within their primary facility in Cape Girardeau. As for Mississippi County though, there is only Douglas’s clinic and three others in nearby Charleston.

If the county were to experience an outbreak similar to Moniteau or Saline county, he worries their combined testing capacity would not be enough.

“There is no way they could handle the population of the county,” Douglas said about himself and the nearby clinics in Charleston. “It would have to be some sort of drive thru.”

The degree of community concern regarding a possible outbreak, he said, would likely become clearer in the coming days as information becomes clearer. For now, he said, he’s just watching the numbers.

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