Department of Health Recommends Masking in Public after Respiratory Illness Data Shows Significant Increase

The rapidly rising number of reported cases and hospitalizations suggests more precautions are necessary to avoid strain on the healthcare system.

January 4, 2024 | 3 min reading time

Update 1/5/2024

Thursday, January 4, 2024, the City of St. Louis Department of Health issued a recommendation for masking indoors for the community. This recommendation is based on the simultaneous marked increases in COVID-19, influenza, and RSV activity. 

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. 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. These clarifications do not change the masking recommendation issued by the City of St. Louis Department of Health. 

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 old 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. 

The City of St. Louis Department of Health has consistently recommended masking, and the department is not mandating masks for City residents at large. 

As previously stated, the Department of Health encourages masking along with additional steps to prevent the spread of respiratory viruses. 

  • Stay up to date with vaccines
  • Seek testing and possible treatment if you get sick
  • Improve airflow and ventilation
  • Options include bringing in as much fresh air as possible, filtering the air, using a portable air cleaner, turning on exhaust fans, or choosing outdoor options
  • Practice good hand hygiene and cover your coughs and sneezes
  • Stay home when you are sick and avoid others who are sick

Original Article 1/4/2024

As cases of winter respiratory illnesses, including influenza, RSV and COVID-19, continue to rise, the City of St. Louis Department of Health is recommending that all residents wear face masks when indoors in public spaces and crowded environments where social distancing isn’t possible.

While none of these viruses are new or more deadly than in seasons past, the rapidly rising number of reported cases and hospitalizations suggests that more precautions are necessary to avoid strain on the healthcare system.

COVID-19 continues to circulate in St. Louis communities, with hospitalizations increasing by 38 percent over the past month (December). Currently, the city’s hospitalization rate is 15.5 cases per 100,000 residents, putting St. Louis in the CDC’s Medium Community Level risk category.

Recent data from the Department of Health indicates that respiratory syncytial Virus (RSV) cases within the BJC Healthcare system are nearly 200 percent higher than the past four years during the same timeframe. Infants, toddlers and the elderly are particularly vulnerable and more likely to experience severe complications or death.

The number of flu infections this season is trending nearly vertically upward, and is already 55 percent higher than the highest median value of the past five years. The widely-available flu vaccine covers both prevalent strains and can prevent or lower the impact of infections.

“We strongly recommend that all residents wear a face mask inside and in situations when social distancing isn’t possible,” said Dr. Matifadza Hlatswayo Davis, Director of Health for the City of St. Louis. “This recommendation doesn’t come lightly - it is data-driven and focused on lowering community transmission of potentially deadly diseases. If we all do our part and voluntarily mask up, we can expect the number of cases and hospitalizations to decrease over the coming weeks.”

The most recent data available can be found at

Children, the elderly, pregnant women and those with compromised immune systems are at the greatest risk for severe illness from all three viruses. Even those who aren’t experiencing symptoms may be able to spread the viruses and are encouraged to wear masks to protect vulnerable populations.

Vaccines are currently available for all three respiratory illnesses, although doses for children aged six months to five years may have limited availability. Vaccines are covered by most insurance, but for those who don’t have insurance or are underinsured, there are low-cost and no-cost options available through the CDC’s Bridge Access Program.

For a list of vaccine locations, visit or

Related Stories

Was this page helpful?      

Comments are helpful!
500 character limit

Feedback is anonymous.