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KANSAS CITY, Mo. — On Monday, Missouri stumbled into first place for having the highest rate of new COVID-19 cases in the nation, according to the state health department’s COVID-19 dashboard.

But state and local officials in Missouri said getting a handle on the enormity of the state’s problem is difficult because of poor data.

“I don’t think anybody in the world has true numbers on who’s been vaccinated,” said Wanda Laramore, nursing director at Pulaski County Health Center & Home Health Agency. “I don’t think the president himself could figure out who has been vaccinated.”

FOX4 Problem Solvers contacted roughly 40 county health departments in Missouri with vaccination rates lower than 22% to find out how many county residents are hospitalized. Roughly 38% of the counties contacted, and its hospitals, either did not respond or said they were not even sure how to find that information out. 

“We learned early on that we can’t track hospitalizations,” Laramore said. “We don’t even know where the hospitals are. Pulaski County is so small that it doesn’t even have a hospital, so most of our residents spread out and visit neighboring hospitals in surrounding areas.”

Some health officials are concerned inaccurate data compilation at the county and state levels has negatively impacted hospitalization, vaccination and positive case numbers reported by the Centers for Disease Control and Prevention [CDC]. 

“They [the CDC] have a county-by-county breakdown, but those numbers are only what’s given by the state, and they don’t include federally funded vaccinations,” Laramore said. “It’s practically impossible to keep up with.”

Laramore said federally funded vaccines include those sent straight to a federal institution, rather than being purchased through the state and distributed. For example, the Army does not record its vaccination data in the state system for monitoring.

Justin Krohn, CARES research project analyst at the University of Missouri, said in an email that Missouri does not require its hospitals to report in-patient hospitalization data to county health departments. In fact, hospitals are only required to report positive case numbers to the counties.

“County health departments [then] have to report the number of confirmed cases to the state,” Krohn said.

Laramore said state health departments are responsible for passing along county data to the CDC, and those having a hard time tracking COVID are being left behind.

Missouri counties with smaller populations, like Pulaski County near the Arkansas border, may have to contact more than six hospitals to get an accurate idea as to how many county residents are hospitalized.

Furthermore, those hospitals are not required to report their numbers directly to the state.

Problem Solvers analyzed the CDC’s county-by-county data to figure out if Missourians living in counties with low vaccination rates are more likely to be hospitalized than those that live in areas with higher vaccination rates. 

Because county health departments, like St. Joseph Health Department in Buchanan County, don’t track hospitalizations, Problem Solvers visited Mosaic Life Care Hospital, which has seen an alarming rise in cases. 

Eleven COVID hospitalizations were reported at the Mosaic Life Care last week. On Monday, it jumped to 14 hospitalizations.

Also concerning, 40% of Mosaic’s staff has refused the vaccine.

“Right now, we do not mandate [vaccinations for employees], and we are going to continue to wait and see,” said Dr. Davin Turner, physician and chief operating officer at Mosaic Life Care.

“When 40% of your caregivers have opposition to that, that’s a high percentage. We continue to encourage them to get their vaccine, [but] we will wait to mandate the vaccine at this time.”

Turner said one of the hospitalized patients had been vaccinated prior to contracting the illness. However, this is not information the hospitals or counties disclose on their websites — though some believe they should.

“They [hospitals] don’t communicate that [to the counties],” said Iris Queen, epidemiology investigator and human resource officer at the St. Clair County Health Center. “We were doing some tracings, but they’ve done away with a lot of that.”

Clay County, which reports roughly 40% of the county population fully vaccinated on its website, includes weekly updates on the number of cases, deaths and hospitalizations in the county.

But other counties, like Buchanan and Newton counties, don’t report these numbers because the state doesn’t require them to do so.

“I do believe some cases fall through the cracks because their [a patient’s] positive results got hung up at the doctor’s office or at the state,” Queen said. “I’d say we catch 90-95% of those cases, though.”

Laramore said she believes counties should be able to enter their data into the CDC’s data system themselves. She said this would improve data accuracy and transparency across the board.

She also said the CDC should create a centralized database for the United States in which counties manually enter data for the federal government’s use. 

“In my lifetime, I’ve never known it [the data] to be done this way before,” Laramore said. “I can’t even tell you whether or not someone was [fully] vaccinated.”