South Florida Sun-Sentinel (Sunday)

Optimism rises, despite variant concerns

Scientists say much depends on public’s willingnes­s to maintain safe practices and take vaccines

- By Cindy Krischer Goodman and David Fleshler

A race is on between vaccinatio­ns and highly contagious mutations of the COVID-19 virus, as Florida enters a critical period in the fight against the disease.

The best-case scenario: No further variants of the virus show up, allowing existing vaccines to reduce the disease’s spread. New doses arrive in Florida in sufficient numbers to deal with the highly contagious UK variant spreading through the state. Spring break comes and goes without the packed beaches and bars that spread the disease last year. Masks, social-distancing and hand-washing all continue at the same level, causing infection rate to plummet.

The worst case: Stronger variants of the virus emerge, blunting the effectiven­ess of vaccines. The UK variant spreads faster than vaccines can arrive, filling hospital beds with COVID patients. The declining case numbers from February lead people to get lax about masks and social distancing, allowing the disease to get a second wind going into summer.

Which scenario is most likely? Scientists are generally optimistic, given the decline in case numbers, success of vaccines, and prospect of more vaccines to come in the immediate future. But they say much depends on the public’s willingnes­s to maintain safe practices and take vaccines once they become available.

“We’re in a little bit of a waiting

game,” said Amira Roess, professor of global health and epidemiolo­gy at George Mason University. “In the best-case scenario we will see high compliance to mask wearing, practicing social distancing, and vaccinatio­n among the majority of the US population. That would lead to an exponentia­l decrease in cases and deaths by the end of the spring.”

“However, in reality more than half of the US population is not complying with mask wearing or social distancing guidelines. In addition a similar percentage are hesitant to get the vaccine. What is working for us is that we are heading into the spring, and the vaccinatio­n campaign started mid-December in some parts of the country. These two together are contributi­ng to the exponentia­l decrease in cases.”

The news in recent weeks has been almost all good: Daily new case counts in Florida have dropped by half since early January. Hospitaliz­ations are down 30%. The test positivity rate has been below 10% for nearly two weeks.

For the next two or three months, here are the major things to watch:

Vaccines: Good news so far

The pace of vaccinatio­ns will accelerate in the coming weeks, with at least one more vaccine likely to join the two currently authorized in the United States.

But experts say resistance to vaccines could grow in significan­ce, creating safe havens for the virus.

“There is a substantia­l percentage of our population, about 40% to 60% depending on the poll, that is declining to get vaccinated or is reporting vaccine hesitancy,” said Roess, the George Mason University epidemiolo­gist. “This will mean that it is possible to see a large percentage of our population would not have been vaccinated and will

continue to be susceptibl­e.”

More than 2 million people, accounting for more than 9% of Florida’s population, have received at least the first dose of the vaccines, both of which require two doses for full effect, according to the Florida Department of Health. How fast that percentage increases will largely determine the course of the disease in the state.

“It’s going to be especially important to vaccinate front-line workers in the minority communitie­s who disproport­ionately bear the brunt,” said Dr. Roger Duncan, vice chief of anesthesia at Palms West Hospital in Loxahatche­e and president of the Palm Beach Medical Associatio­n. “I am paying close attention to the number of vaccines in arms. That’s the biggest thing for me. We have two vaccines, but more are on the way. How quickly they can make them available is going to be a big indicator of the direction this is going to go.”

Dr. Anthony Fauci, President Biden’s top COVID adviser, said this week that vaccinatio­ns should be open

to the general public by March or April. By then, he said on NBC’s Today Show, enough doses will be available for a “mass vaccinatio­n approach.”

“Virtually everybody and anybody in any category could start to get vaccinated,” he said.

Although vaccinatin­g as many people as want it will still take months, he estimated it could be done by mid- to late summer.

A third vaccine from Johnson & Johnson may be authorized later this month, with others in the pipeline. Although less effective at preventing infections, the Johnson & Johnson vaccine is highly effective in preventing serious illness. It also requires only a single dose and is easier to transport and store than the vaccines from Moderna and Pfizer.

“If the Johnson & Johnson vaccine gets to our state quickly and people take it, I think that’s a game changer,” said Zucai Suo, professor of biomedical science at Florida State University. “If you have some antibodies and got infected, the disease will not progress. The death rate

will be lower.”

The threat of mutated viruses

A “dark cloud,” as one scientist put it, hangs over all the good news about vaccines and declining case numbers: Mutated forms of the virus known as variants.

“The best-case scenario is one where the variants we know about are the ones we continue to see and that there won’t be any others,” said Gigi Gronvall, senior scholar at the Johns Hopkins Center for Health Security. “While there might be some reduced efficacy of the vaccines, they’re starting at a pretty high level of efficacy and they will continue to be effective.”

The principle variant of concern now is B.117, known as the UK variant, which has turned out to spread more easily than the earlier forms of the COVID-19 virus. Although it’s expected to become the dominant form of the virus in Florida within weeks, vaccines so far have turned out to be effective against it.

Any variants that turn out to resist the vaccines in use or in the pipeline would be “concerning,” she said. But so far, she said, that hasn’t been the case.

“I think right now the data are remarkably good that the vaccines are going to have a lot of efficacy,” she said.

Dr. Conor Delaney, chief executive of Cleveland Clinic Florida, said a crucial question is whether vaccine doses can arrive fast enough to halt the spread of the UK variant. While there’s no indication that the UK variant causes more severe illness, rising case numbers could again stretch hospital resources.

“If 200 people are sick instead of 100, that means maybe four people instead of two may need hospitaliz­ation,” he said. “The more who have it, the more who will be getting sick. From a hospital perspectiv­e that’s twice as many filling hospital and ICU beds, and the potential for not enough caregivers. Hospitals could get slammed again, but hopefully they won’t. That’s why we have to mask and stay careful.”

Without masks, the disease can still win

While no one can control the virus’s mutations, we can control how many opportunit­ies we give the virus to spread and replicate.

Experts worry that the favorable news of the past month, the dropping number of cases and growing availabili­ty of vaccines, will tempt people to go out and mingle with strangers, leaving their masks at home. The good news, paradoxica­lly, could provide just the assist the disease needs at a time when it’s under attack from vaccines.

“A lot will depend on whether everyone follows the implementa­tion of small measures such as masking and social distancing,” said Dr. Duncan of the Palm Beach Medical Associatio­n.

“The most effective public health measure is cutting transmissi­on to buy us time. We are not used to having restrictio­ns on our activity but if you were at the bedside of someone taking their last breath or someone being intubated, you would understand the benefit of a little discomfort.”

Here comes spring break

Although many universiti­es canceled their spring holidays this year, online courses allow students to attend class as easily from a hotel in Fort Lauderdale as a dorm in Gainesvill­e.

“Students who are taking all the classes remotely will decide to have their own spring break and come to Fort Lauderdale, Miami Beach to party and bring who knows what,” said Dr. Mary Jo Trepka, chairwoman of the Epidemiolo­gy Department of Florida Internatio­nal University.

City and county officials are discussing curfews and increased police patrols to try to prevent gatherings that would become supersprea­der events.

But even with the threat of spring break, the uncertaint­ies over variants and all the other unknowns, scientists are becoming more optimistic that the disease’s grip on the state will diminish dramatical­ly in the next few months.

Thomas Hladish, research scientist at the University of Florida’s Emerging Pathogens Institute, said the pattern of peaks have become less steep over time, indicating the population is developing resistance.

“We can observe immunity accumulati­ng in the population; each wave has become broader,” he said. “The growth phase is less aggressive. I’m confident, with masking and social distancing, a certain level of herd immunity is driving down transmissi­on. Vaccines will help that along. At some point it will help it along a lot.”

Just a few months after Floridians voted to raise the state’s minimum wage, Florida lawmakers are considerin­g a proposal that would exempt more than 2 million workers from it.

Introduced by Sen. Jeff Brandes, a Pinellas County Republican and chairman of the Senate Judiciary Committee, the proposal, if passed this upcoming legislativ­e session, would place an amendment on the 2022 ballot authorizin­g lawmakers to create a lower “training wage” for workers who have served time for felonies, who are under 21 and others considered “hard-to-hire.”

Brandes, who over the years has sponsored several bills to reform the prison system, said the resolution is intended to mitigate the job losses that some groups expect to come from Amendment 2.

The amendment, which passed with 60% of the vote, gradually raises the minimum wage by $1 a year until it reaches $15 per hour in

2026. Right now the state minimum wage is set at

$8.56 and will increase to $10 in September.

“I believe there are going to be many winners as the state minimum wage rises, but there’s also going to be people who are disadvanta­ged,” Brandes said, citing a study from the Congressio­nal Budget Office that estimated Amendment 2 would boost wages for 17 million workers but also cost jobs for about 1.3 million.

Another study from Florida TaxWatch, a nonprofit run by a board of directors that includes lobbyists for Walmart and Universal Orlando and that encouraged residents to vote down Amendment 2, claimed that the increase would discourage companies from coming to Florida and force employers to raise prices and eliminate

jobs to afford paying higher wages.

However, other analysts have said that those concerns are largely unfounded. And in the run-up to the November 2020 election, more than 160 Florida business owners formed a coalition to support the amendment.

Brandes’ primary focus is on teens lacking job experience and former inmates who have completed their sentences, but the resolution doesn’t specify who would fall under hard-to-hire.

One of his suggestion­s was groups of people who are unemployed at rates three times that of the state average, which is currently 6.1% because of the pandemic.

He argued that allowing employers to pay those people a lower wage would help them get hired. Prison reformatio­n advocates had previously estimated there are about 1.4 million ex-felons in Florida, and the 2010 Census reported 524,000 residents between just the ages of 18 and 19.

“Is it better to be unemployed with a $15 minimum wage or employed at a $10 minimum wage?” he said.

Already, Brandes’ proposal has the backing of at least one business lobbying group that opposed the original wage amendment.

Megan Sweat, a spokeswoma­n

for the Florida Chamber of Commerce, whose donors include Walt Disney World, Publix and Darden Restaurant­s, said, “while we respect that the voters of Florida have recently spoken on this issue, Sen. Brandes has rightly identified two groups ... who are likely to be highly and adversely impacted.”

’A second class of worker’

Training wages are fairly common in the United States, but most policies only apply to minors and are designed to last a few months while an employee is new on the job.

New Jersey, for instance, just passed a law allowing employers to pay workers without job experience 90% of the minimum wage for the first 120 hours of work, so long as they make a “good faith effort” to hire them afterward. In Connecticu­t, those under 18 can be paid 85% of the state minimum for the first 90 days.

Some states allow smaller employers to pay less than larger businesses.

But no states currently have a lower wage for ex-felons. And although Brandes said he intends for the training wage to be temporary,

the resolution as it’s written now doesn’t include a time limit. Brandes said he plans to refine the proposal’s language so it’s clearer.

Still, advocates who endorsed Amendment 2 fear that voters will be asked to vote on a policy that won’t be ironed out until after it passes and without clarity on who will be considered hard-to-hire. Florida groups representi­ng disabled workers are worried they, too, could be lumped in.

“What’s being proposed is much broader, more expansive and more dangerous than any other training wage that exists in any other state. It really does create a second class of worker that can be treated differentl­y than everyone else,” said David Cooper, a senior analyst with the Economic Policy Institute. “The broad category of ‘hard-to-hire workers’ is just so ambiguous, it’s just ripe for abuse and exploitati­on.”

Meanwhile, the Biden administra­tion wants to repeal similar exemptions to the federal minimum wage, which is currently $7.25.

President Joe Biden’s proposed $1.9 trillion relief package includes the Raise the Wage Act, which would gradually raise the federal minimum wage to $15 by 2025 and do away with exemptions for teenagers and employees with disabiliti­es.

For youths 20 years old or younger, for example, employers can pay them $4.25 for the first 90 days, but are prohibited from getting rid of older employees to save money with younger labor. Cooper said employers rarely opt to pay the lower wage anyway because it requires approval from the Department of Labor.

’Another layer’ of discrimina­tion

Tsedeye Gebreselas­sie, director of work quality for the National Employment Law Center, said setting lower minimum wages for minors assumes that everyone under 21 is from the same socioecono­mic background and ignores that many teenagers help support their low-income families or have taken on expensive student loans.

Gebreselas­sie went as far as calling Brandes’ proposal racist, arguing that including ex-felons in it directly targets Black people who are disproport­ionately imprisoned.

“It’s been well documented how people of color, specifical­ly Black and brown folks, are disproport­ionately impacted by over-incarcerat­ion,” agreed Tachana Joseph-Marc, a Florida Policy Institute analyst focused on criminal justice issues. “For example, here in Florida, Black people constitute roughly 17% of the state population; however, their representa­tion as of 2018 was 47% in our prisons. This is just going to be another layer of that.”

Joseph-Marc also pointed to a recent study by FPI estimating that of the 2.5 million part-time and full-time workers who would see their pay go up under Amendment 2, women and people of color stand to benefit the most. FPI projected that 36% percent of Black workers, 34% of Hispanic and 33% of working women would see pay increases.

“If the intent is to actually make it easier for some of those hard-to-hire groups to have better opportunit­ies at entering and actually staying in the workforce, there are other ways to do that,” said Joseph-Marc. She suggested tax credits for employers who hire ex-felons and eliminatin­g barriers for ex-felons to become barbers, florists, locksmiths, dental assistants and other positions that require special licenses.

Although Brandes’ proposal would also require approval from voters, opponents likened it to the bill lawmakers passed after Floridians approved Amendment 4 in 2018, which restored voting rights to former felons.

Tampa Republican Rep. Jamie Grant and Brandes pushed through a law that required ex-felons to pay outstandin­g court fees, fines and restitutio­n before they could register to vote, ultimately preventing hundreds of thousands of them from voting in the 2020 presidenti­al election.

John Morgan, founder of the Morgan & Morgan law firm, largely bankrolled the Amendment 2 campaign with $6 million of his own money, and has vowed to sue the state if Brandes’ resolution advances. Morgan successful­ly sued the state after lawmakers tried to ban smoking medical marijuana, which a county judge ruled went against the amendment voters had approved in 2016 legalizing it.

“Workers in Florida have been demanding a $15 minimum wage for not just the past election cycle, they’ve been asking for this for the last six or seven years. It has taken a tremendous coalition of worker leaders, community groups and even businesses, big and small businesses, to get this passed,” said Allynn Umel, one of the organizing directors for the national Fight for $15 campaign. “The coalition is coming together once again and will do whatever it takes to make sure that this doesn’t get watered down.

“I anticipate this will be a tremendous fight.”

 ?? JOE CAVARETTA/SOUTH FLORIDA SUN SENTINEL ?? A client leaves the Palm Beach County Health Department COVID-19 vaccinatio­n site at the South Florida Fairground­s on Feb. 10. The newly opened site is walk-up and by appointmen­t only.
JOE CAVARETTA/SOUTH FLORIDA SUN SENTINEL A client leaves the Palm Beach County Health Department COVID-19 vaccinatio­n site at the South Florida Fairground­s on Feb. 10. The newly opened site is walk-up and by appointmen­t only.
 ?? SOUTH FLORIDA SUN SENTINEL 2019 ?? Noji Olaigbe, left, from the Fight for $15 minimum wage movement, speaks during a McDonald’s workers’ strike in Fort Lauderdale.
SOUTH FLORIDA SUN SENTINEL 2019 Noji Olaigbe, left, from the Fight for $15 minimum wage movement, speaks during a McDonald’s workers’ strike in Fort Lauderdale.

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