St. Louis brings back mask mandate amid surge in Indian 'Delta' COVID cases in Missouri as officials blame superspreader tourist hotspot Branson where 20% of all residents are currently infected

St Louis on Friday announced the return of a mask mandate after Missouri saw a statewide surge in COVID-19 cases thanks to a tiny superspreader town run by an anti-masker mayor where the current rate of infection is ten times the national average. 

St Louis's decision follows that of Los Angeles County, which on Sunday ushered in the first major return of compulsory face masks.

In St Louis, masks will be mandatory in indoor public places and on public transportation for everyone age five or older, even for those who are vaccinated.  Masking outdoors 'will be strongly encouraged,' especially in group settings.

Dr Marc Johnson of the University of Missouri School of Medicine has blamed the small tourist town of Branson for the state-wide surge, calling it 'ground zero' for the high infection rates.

'Branson has a lot of country-western shows,' he told Daily Beast. 'No Vaccines. No masks. A bunch of people indoors and air conditioning, tightly packed, listening to music, possibly singing along, i.e. a superspreading event.'

Mayor Larry Milton of Branson, Missouri, is seen with Missouri Gov. Mike Parson in a Facebook photo posted June 7. Milton is passionately opposed to mask mandates and vaccination passports

Branson, a town of 11,000 people, makes its living through tourism, and has passionately rejected calls for mask mandates

Branson attracts tourists with its shows, theme parks and family-friendly museums

Visitors ride on go-karts at an amusement park in Branson on June 29

Johnson, who oversees a statewide program to monitor COVID-19 via wastewater samples, said they first spotted the Delta variant in Branson on May 10 - which quickly spread to surrounding towns.  

'By week three, it was already pretty much everywhere,' he said.

The last sample from anywhere in Missouri that did not contain the Delta variant was on June 7.  

Delta was followed by a spike in cases within three weeks, wherever it appeared.

'It's pretty scary,' Johnson said. 'I don't know that the Branson is what seeded the entire outbreak in Missouri.  

'But I always suspected.'

As the rest of the state shuts down, the town that caused the trouble is continuing like the pandemic never happened.

The a vacation town of 11,000 people situated 40 miles south of Springfield, has business booming as the mayor - elected on an anti-mask platform - vowed to resist any public health orders. 

'First, let me state clearly and for the record: I will not support another government mask mandate, nor will I support a vaccine mandate,' he declared on Facebook on July 13. 

Monica Mileur packs grocery items into a box at Union Loafers restaurant in St Louis in April 2020, when the original mask mandate was in place. It is now back

Nurses and doctors are pictured in Springfield, Missouri, on July 16. The state is dealing with a surge in COVID cases, and bracing for the deaths to follow

'I didn't talk about freedom and liberty during my campaign for Mayor simply as a way to get elected. I championed those values then, as I do now, because I believe that each individual should have the right to decide for themselves how to best handle their own medical decisions.'

He added: 'I DO NOT believe it's my place, or the place of any politician, to endorse, promote or compel any person to get any vaccine. That's a decision that should be made by each individual in consultation with their doctor and their family.'

He closed by saying, 'Be good to one another. Be good to those who visit our town. Don't let temporary disagreements drive us apart forever. Whether you are masked or not, vaccinated or not, make smart decisions… Be aware of those around you who may think differently than you do about the issue. Be courteous, be thoughtful, be Branson.' 

The infection rate for Branson and surrounding Taney County is 19.3 per cent, and there are 54 new cases a day in a county population of 57,000, which is 10 times the national per capita average. 

More than two-thirds of the population are unvaccinated, The Daily Beast reported, including the tourist information person.

'It's not happening,' she said when asked by the site if she had got her shot. 

'Have a blessed day.'

Branson is known for the 'world's largest toy museum', the Titanic museum, Silver Dollar City theme park and Dolly Parton's Stampede Dinner.

Only 40 per cent of Missouri's population are fully vaccinated - making the state 12th worst in the nation for vaccine takeup. Alabama is the worst with 33 per cent fully vaccinated; Vermont is the best, with 67 per cent. 

The decision comes as both of Missouri's urban areas are seeing a big uptick in cases in hospitalizations that began in rural areas of the state, especially in southwestern Missouri around Springfield. 

The Kansas City Star reported Friday that medical leaders in that region appear to be on the verge of calling for a new mask mandate there as well.

Dr Fredrick Echols, acting director of health for the city of St Louis, said more than 500 residents of the city have already died from COVID-19, 'and if our region doesn't work together to protect one another, we could see spikes that overwhelm our hospital and public health systems.'

Missouri has averaged 542 new cases a day over the last week, and five deaths a day.

The state's positivity rate is 14.4 per cent, on a rolling seven day average, according to the Missouri health authority. By contrast, in New York City it is currently 2.2 per cent.

There were 1,632 people hospitalized as of July 20. 

In Springfield, 200 miles to the south west of St Louis, hospitals are readying for a surge in admissions.

Mike Parson, the Republican governor of Missouri, announced on Thursday that 10 advanced life support ambulances, 20 medical professionals, two 'strike team' leaders and a logistics specialist were being sent to Springfield. 

Their role will be to help with transporting patients in a city where hospitals are near capacity. 

It's also home of Branson’s Famous Baldknobbers Show, a country music spectacular.

A long-serving Baldknobbers guitarist, Randy McConnell, died from COVID-19 on July 18, aged 59. 

Branson's Famous Baldknobbers are seen on stage. The country music sing-a-long is a popular draw for tourists

Randy McConnell, a popular long-standing member of the band, died from COVID-19 on July 18, aged 59