Conflicting messages on the pandemic

Here’s what we know about COVID in Florida

COVID-19 is overwhelming us, say the hospitals.

Hospitals are doing fine, according to the governor.

The surge has yet to reach its peak, say the doctors.

The surge is seasonal and cases are about to plummet, says the governor.

These dueling messages confused Floridians this week as the state’s coronavirus hospitalizations rose to an all-time high of almost 13,000 on Thursday. Despite the record number of COVID-19 patients at hospitals across the state and dire warnings from hospital administrators, Gov. Ron DeSantis downplayed concerns and maintained: “Our hospitals are open for business.”

He led several recent events around the state to underscore his COVID-19 policies, including the vaccine rollout that allowed seniors to get jabbed first and the banning of mask mandates in schools.

“We can either have a free society or a biomedical security state,” DeSantis said during an appearance in Panama

City.

The messages sent out by DeSantis and hospitals this week about the Delta variant-fueled surge revealed a

disconnect between opposing forces: Overwhelmed health officials and a governor seeking to control pandemic messaging to appeal to a potential electorate.

How does the situation now compare with last summer?

Even though the Delta variant has infected 90% of Jackson Health system’s COVID-19 patients in Miami-Dade, DeSantis said the number of patients is about half what they there were during the spike last summer.

“Now, we have other parts of Florida where it’s exceeding what they had last summer,” he acknowledged.

Last summer, much like this one, a spike in new cases followed Memorial Day barbecues and Fourth of July picnics even as health officials warned against large gatherings. July was the worst month of Florida’s COVID epidemic in 2020, and now the Florida Hospital Association is reporting even higher numbers for this summer, the most statewide during any point in the pandemic.

However, if the coronavirus pattern is seasonal and follows the 2020 trend, new cases would decline in September and rise again in November.

“We’ve only seen a few weeks of increase, so it’s too early to see if this is seasonal,” said Marc Napp, chief medical officer for Broward’s Memorial Healthcare System. “We have only been through one annual cycle. A year ago there was no vaccine and now there is, so it’s too early to say if it’s going to be bad every July. It could take a couple of years before we can shake out when the peaks and valleys will be.”

Who’s in the hospital

Although many Florida hospitals are seeing an increase in COVID admissions, administrators say patients are mostly young and unvaccinated, not seniors, more than 80% of whom have received their shots in the state.

“Vaccinations absolutely have made a difference,” Dr. George Ralls, chief medical officer with Orlando Health, said during the roundtable with DeSantis. “We did see a significant flip in the percentage of patients over 65. For this current wave, about 55% of our inpatients are between 40 and 64 years old.”

At the roundtable, hospital administrators said they do have vaccinated COVID patients, but those are mostly people with underlying conditions or who are admitted for other illnesses and test positive.

Carlos Migoya, CEO of Jackson Health, said 100% of COVID patients are either unvaccinated, or vaccinated and immunosuppressed.

Shane Strum, CEO of Broward Health, said while his hospitals have admitted an increasing number of COVID patients, they still make up only 20% of admissions.

Strum said his doctors believe Delta is more infectious, but not necessarily causing more severe illness. The average length of stay for vaccinated patients is two days, compared with seven for unvaccinated patients. During last summer’s surge, before vaccines became available, hospital stays averaged 10 days.

A year ago, Florida had about 180 COVID-19 deaths per day during an early August spike, but last week averaged 58 per day. DeSantis credited his strategy of prioritizing senior citizens for the first vaccines for this decrease.

“Even among a lot of positive tests, you are seeing much less mortality than you did year-over-year,” DeSantis said. “Would I rather have

5,000 cases among 20-yearolds or 500 cases among seniors? I would rather have the younger.”

Are we at the peak?

DeSantis said he expects hospitalizations to drop in the next couple of weeks, saying the spike is climaxing as Floridians spend time together indoors to escape the summer heat and humidity.

In Central Florida, Orlando Health CEO David Strong said he is also optimistic the current wave will abate. “If you look at the models in UK and Netherlands, the peak went up rapidly and fell very quickly.

We are hoping the same thing occurs here,” he said.

Some hospitals are hedging their bets. Memorial Healthcare System in Broward plans to suspend elective procedures beginning Monday, “in an effort to conserve critical resources for the care of COVID-19 patients.” Cleveland Clinic Florida’s Weston hospital has postponed some procedures, as have UF Health Jacksonville and several other Florida hospitals.

Last week, AdventHealth in Orlando shifted to “code black,” canceling non-emergency procedures after seeing a record 1,600 patients. Epidemiologist Vincent Hsu said the hospital surge hasn’t yet reached its patient peak.

Staffing

At the roundtable, hospital CEOS told DeSantis their biggest challenge is having enough staff to care for COVID patients and the flood of other sick patients coming to their emergency departments, many of whom had been steering clear of hospitals over the past year.

Some facilities are bringing in temporary nurses from staffing agencies. “Our nurses have been at this for 18 months. They are working overtime to maintain staffing ratios,” Migoya said.

A July 30 report from the federal government shows only 10 of more than

200 Florida hospitals said they had staff shortages. However, this marked a 67% increase from the previous week, according to the U.S. Department of Health and Human Services.

On Thursday, the Florida Hospital Association said

60% of hospitals in the state would face a “critical staffing shortage” in the next few days. Shortages are taking a toll on hospital staffs. Juana Mejia, nurse manager of the ICU at Memorial Hospital Miramar, has been working seven days a week.

“It has been stressful and exhausting, physically and mentally,” she said. “I have been a nurse for over

30 years and I have never experienced anything at this magnitude.”

Jackson Health announced it will require all employees and onsite vendors to be vaccinated or adhere to regular testing and other restrictions.

Jackson’s announcement comes as the hospital has seen a 385% increase in COVID patients in a month.

MEMORIAL HEALTHCARE SYSTEM VIA AP In this undated photo provided by Memorial Healthcare System, a conference area is shown that has been turned into a COVID-19 unit.