Missouri’s new health director says ‘masks work’ as COVID cases rise, school in session

‘With the increase in positivity rates among adolescents, it only makes sense to wear a mask,’ said Donald Kauerauf, the director of the state health department

By: - September 16, 2021 1:29 pm
Donald Kauerauf

Donald Kauerauf, the director of the Department of Health and Senior Services, speaks during a press conference at the Missouri Capitol in Jefferson City on July 21, 2021 (Photo courtesy of Missouri Governor’s Office)

As the fight over mask mandates in schools continues, and the state’s attorney general wages lawsuits to block them, Missouri’s new health director had a clear message on Thursday: masks work.

“I rely (on) the experts at the CDC on that. Everything I’ve read, everything I’ve seen: masks work,” Donald Kauerauf, the director of the Department of Health and Senior Services, told reporters during a briefing Thursday.

Kauerauf’s comments come amid an uptick in new COVID-19 cases statewide as students have returned in-person to school in recent weeks.

On Thursday, the seven-day average of new cases rose to 2,376 a day — a 17.5 percent increase from the previous week. Over the past seven days, a little over 29 percent of lab-confirmed COVID cases have been among children.

During the summer of 2020, roughly 8,200 Missouri children contracted the virus, according to the Missouri Hospital Association. During the same period this year, nearly 34,000 Missouri children have contracted the virus — a more than four-fold increase, the association said.

The increase in cases among children has led to an increase in students in quarantine. During the first week of school in St. Louis County, at least 429 COVID cases among students and staff led to 1,318 quarantines. The St. Louis County Department of Public Health noted the actual number is most likely higher.

“With the increase in positivity rates among adolescents, it only makes sense to wear a mask,” Kauerauf said. “Again, that’s a decision you need to make, understanding that some people cannot wear a mask.”

With the increase in positivity rates among adolescents, it only makes sense to wear a mask.

– Donald Kauerauf, director of the Department of Health and Senior Services

Kauerauf said the state health department will take a “fresher look” at the state’s input to schools, and is reviewing its guidance to provide clear information “so that we can get away from some of this confusion.”

Mitigation measures have largely been left to school districts and local health agencies to determine on their own. The local control approach has led to a gamut of responses, with some districts mandating masks and bolstering testing, while others make such mitigation measures optional — and even defy a federal order to wear masks on school buses.

It’s unclear what specific guidance may be, however Kauerauf said the department hopes to share “clear ideas” that keep kids in school while allowing locals to customize to fit the needs of their community.

“One size does not fit all,” he said, “but we have to provide some of the baseline.”

He stressed the importance of in-person learning, noting scores on state standardized tests declined amid the pandemic.

“It’s too bad that this outbreak has got to a point where it has landed on the children. They have nothing to do with this,” Kauerauf said. “Their objective is, they need to be in a classroom.”

While Kauerauf stressed the importance of local decision making, he declined to speak to the impact new laws enacted this past legislative session have had on contributing to the virus’ spread.


After leaving mitigation measures in the hands of local officials for most of the pandemic, Missouri lawmakers passed new legislation that limits the authority and scope of public health orders aimed at curbing the spread of a contagious disease. It’s the same law Attorney General Eric Schmitt has used as the basis of lawsuits challenging local mask mandates, including in schools.

In its lawsuit against Columbia Public Schools, the attorney general’s office argued masks are unnecessary, because of the “low risk to children of death” a “low risk to children of hospitalization” and a “low risk of children spreading” COVID-19.

When asked if he was concerned the new limits on public health officials’ authority were exacerbating the Delta variant’s spread, Kauerauf said “this is one that haunts me.”

However, he went on to share his concerns of the broader politicization of public health amid the pandemic, and did not directly address the new law’s impact on Missouri.

“It should be a concern of all of ours — that loss of respect,” he said. “We cannot set a public health system back decades for all the stuff that’s bantering around in the world. We’ve got to renew our trust and our spirit and go back to that trust that we had prior to the COVID.”


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Tessa Weinberg
Tessa Weinberg

Tessa Weinberg covered education, health care and the legislature with the Missouri Independent. She previously covered the Missouri statehouse for The Kansas City Star and The Columbia Missourian, where her reporting into social media use by the governor prompted an investigation by the Attorney General’s office. She also covered state government in Texas for The Fort Worth Star-Telegram.