Kansas City and St. Louis business and health care leaders have issued an urgent, blunt warning to Missouri Gov. Mike Parson: Immediately order uniform social distancing across the state to help mitigate the spread of the coronavirus pandemic.

In a formal letter obtained by KCUR, the leaders of 10 business and health care groups said they have consulted with medical experts across the state who advise that mandatory social distancing is essential to slow the COVID-19 spread. The letter, sent Thursday, asked Parson to make orders based on public health officials' advice and that Parson has to ensure that hospitals have the capacity to treat patients with life-threatening symptoms.

“The number of patients with such symptoms will increase exponentially in the coming days,” the letter says. “Missouri must act now.”

The letter was signed by Tom Chulick, president and CEO of the St. Louis Regional Chamber; Steven Edwards, president and CEO of CoxHealth in Springfield; Jason Hall, CEO and co-founder of Arch to Park in St. Louis; Steve Johnson, president and CEO of AllianceSTL; Melinda Estes, president and CEO of St. Luke's Health System in Kansas City; Jeff Johnston, senior vice president and regional president Mercy in St. Louis; Richard Liekweg, pesident and CEO, BJCHealthCare in St. Louis; Laura Kaiser, president and CEO of SSM Health in St. Louis; Kathy Osborn, president and CEO of the Regional Business Council in St. Louis; and Tom Santel, president of Civic Progress in St. Louis.

“The coronavirus does not respect state lines, city limits or other jurisdictional boundaries,” the letter says. “This public health emergency will affect all Missourians – no matter what county, municipality or ZIP code they call home.”

In a response, Parson’s chief of staff, Aaron Willard, reminded the letter writers that Parson “emphasized the importance of social distancing” in a daily briefing on Thursday, as well as encouraging groups of 10 or less to gather.

In an email obtained by KCUR, Williard told Santel, who sent the governor the original letter, that all school districts in the state were closed on Thursday.

Parson has “fully supported” the decisions by local leaders in the state’s larger cities, like St. Louis, Kansas City, Springfield and Columbia, Williard wrote. But Missouri has “many very diverse communities” within its 114 counties and not every community has the “resources and assets” that St. Louis has, he wrote.

“Our concern has been that forcing them to meet a deadline that they cannot meet only creates more panic, and subsequently more fear and fear is one of the biggest things we are also trying to combat,” he wrote.

“At the same time we have been trying to communicate with all of these entities at all levels and channels to help them prepare, help them plan, offer advice, and offer the best information we can so that they can make the correct decisions for their communities and maintain safety and control.”

As of Friday, Missouri had 28 confirmed cases of COVID-19 and one death; Kansas had 34 cases and one death.

Compared to Kansas Gov. Laura Kelly, who was the first governor in the country to close all schools this week, Parson has been described as taking “a frighteningly leisurely approach” to combatting the spread of the coronavirus. On Wednesday, he said that combatting the illness has to “go back to personal responsibility.”

The letter asks four actions by Parson, each with a proviso that he should keep them in place “until public health officials advise” that it’s safe to relax any restrictions. Leaders asked Parson to: order all gatherings and events to be limited to 10; close all schools across the state; order all restaurants and bars to transition to take-our or delivery, or close; and “strongly urge that all Missourians stay home as much as possible” and observe social distancing.

Correction: A previous version of this story incorrectly stated some of the signers of the letter; this version updates the number and names of leaders who signed the letter.

Peggy Lowe is a reporter at KCUR and is on Twitter at @peggyllowe.