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ST. LOUIS — Missouri again reported its largest single-day increase in new COVID-19 cases Wednesday, marking the fifth time in eight days the state has set a new single-day high.

Rising numbers in Missouri are prompting warnings from other governors. New York Gov. Andrew Cuomo, New Jersey Gov. Phil Murphy and Connecticut Gov. Ned Lamont announced Tuesday that Missouri will be added to a list of 31 states with travel restrictions, requiring people entering those three states from Missouri to quarantine for 14 days.

Illinois Gov. J.B. Pritzker also voiced concern about Missouri this week. Pritzker told reporters Tuesday that he thinks more cases have popped up in Illinois counties that border St. Louis because residents are traveling to Missouri, where statewide COVID-19 restrictions remain laxer.

Pritzker said Wednesday that virus statistics in the Metro East are “dangerously close� to prompting a return to tighter restrictions.

The Metro East saw 7.1% of tests come back positive as of Monday, compared with Illinois’ overall rate of 3.1%, according to a new release from the Governor's office. Pritzker attributes much of the region's increases to St. Clair and Randolph counties.

According to Illinois’ reopening plan, three consecutive days of 8% positivity, or a sustained rise in the positivity rate coupled with increased hospital admissions, would prompt additional restrictions. The first tier of restrictions can include suspending indoor bar service, reducing dine-in capacities, gathering limits, curbing elective surgeries and limits on some recreational and retail businesses. 

“I have spoken with local leaders,� Pritzker said of the Metro East on Wednesday. “And I have asked them to clamp down on where outbreaks are occurring so the state won’t have to step in.�

The seven-day rolling average for new cases reported daily in the Metro East’s St. Clair, Madison and Monroe counties increased from around 50 at the beginning of the month to 101 Tuesday.

St. Clair County Chairman Mark Kern said in a briefing earlier this week that be believed St. Clair County’s statistics were already improving from the spring.

No mask mandate

In Missouri, state officials announced 1,301 new cases Wednesday, 163 more than the previous record set one day prior. The state also announced 16 deaths related to COVID-19.

St. Louis County set a new single-day high on Wednesday with 263 cases, two more than the single-day high set last week.

The daily spikes in cases can be affected by backlogs in testing, but state health Director Dr. Randall Williams said Wednesday that increases in community spread are the primary cause of rising numbers.

Williams said figures showing about 1,000 new cases a day in Missouri are “reflecting reality,� adding that many people testing positive are in their 20s and 30s.

Missouri’s seven-day average of new cases increased to 907 Wednesday from about 644 cases a day last week.

Despite the rising numbers, Parson repeated his stance Wednesday against enacting a statewide requirement for masks in public.

“I am not anti-mask. What I am is anti-mandates,� the governor said in a news conference. “I don’t think it’s the state’s place to mandate for everybody in the state of Missouri to wear a mask.�

Indiana, Minnesota and Ohio announced mask mandates Wednesday, bringing the number of states requiring face coverings to 30.

Both St. Louis County and city have issued local orders requiring masks, but other metro areas , including Jefferson and St. Charles counties, have not.

State health director Williams agreed with the governor, citing some areas of the state with low case counts and uneven enforcement of mask rules.

“If you’re going to put something in place that’s a mandate, then you need to enforce it, and that can create more problems than it solves,� Williams said.

Parson said he was concerned about rising case numbers and believed hospital figures will go up in the coming weeks, but he also noted that hospitals are not overwhelmed at this time.

The state has reported 36,063 confirmed cases and 1,159 deaths from the virus since the start of the pandemic.

Missouri’s seven-day rolling positivity rate, the percentage of COVID-19 tests that come back positive, rose to 6.9% Wednesday, up from about 4% in mid-June, Williams said.

The positivity rate is around 8.7% in St. Louis and 5.8% in St. Louis County.

In the St. Louis area, COVID-19 hospitalizations are continuing to rise.

The weekly average for new COVID-19 hospital admissions rose to 37 Wednesday, up from 14 in mid-June, according to the St. Louis Metropolitan Pandemic Task Force.

Dr. Alex Garza, task force commander, said Wednesday the virus appears to be increasing in the region “at a critical rate.�

“This growth rate is just not sustainable,� Garza said. “And this will result in health care slowing down in our services that we offer and restriction of visitors. We just cannot handle increasing volumes of COVID patients and not have to take other actions.�

Garza said the curve in cases “will become impossible to bend backward in a positive direction� without decisive action, but added that residents wearing a mask and practicing social distancing could prevent more strict measures like the return of a stay-at-home order.

“By doing all these things we can turn that curve around, but it takes the community. And it’s really that simple,� Garza said. “If we do these things, then we increase our freedoms. We bring back youth sports, we get our kids to school — where we all want them to be — and we’re able to enjoy more things in life.�

Erin Heffernan • 314-340-8145 @erinheff on Twitter eheffernan@post-dispatch.com