Florida enters critical period in fight
The next two weeks will be crucial in Florida’s struggle with coronavirus, as we learn if the staggering numbers of new cases produce a sharp increase in deaths and whether new government restrictions succeed in slowing the disease’s spread.
Here are two scenarios, based on interviews with experts:
The worst case: The disease jumps from younger people, who account for most new cases, to older people, who are most likely to die. Deaths start to take off again. Mandatory local mask laws and other control measures prove insufficient, and the number of new cases continues soaring.
The best case: New cases remain largely confined to younger people, as older people continue to isolate themselves. Deaths remain flat. The latest control measures choke off the spread of the virus, causing the new-case curve to flatten and decline.
“You could get a shift in cases back towards older individuals, and then we would expect there to be a pretty dramatic increase in hospitalizations and deaths,” said Thomas Hladish, research scientist at the University of Florida’s Emerging Patho
gens Institute. “The worst-case scenario is this is a wave moving through the younger part of the population, and these younger people interact with older people. The bestcase scenario is that this wave that we’re experiencing really just stays among younger people. I don’t know how realistic this is.”
Although Gov. Ron DeSantis has resisted calls for a statewide mask requirement, city and county government across Florida have adopted them, along with several other restrictions on public gatherings.
Broward and Miami-Dade counties tightened mask requirements and banned late-night restaurant dining. Palm Beach County imposed a requirement for masks in public. Miami Beach adopted a curfew. All three South Florida counties closed beaches for the July 4th weekend. The state banned drinking in bars.
“Those are very good decisions, but the problem is we won’t see the effects of those decisions for about two weeks,” said Dr. Mary Jo Trepka, chairwoman of the Epidemiology Department of Florida International University. “I hope that beginning in the next two weeks we start seeing a decrease. If we don’t see a decrease and it starts increasing exponentially, then we’ll have to do stricter stay-at-home precautions, maybe go back to where we were back in April.”
DeSantis invoked the younger age of the typical coronvavirus patient Friday to express optimism that Florida would keep the death toll down in the coming weeks.
“The hospitals are seeing a different class of patient than they were seeing in March or April,” he said, speaking at a news conference in Tampa with Vice President Mike Pence. “They’re seeing people that are skewing a little younger, and I think the clinical outcomes are going to be better.”
But a major question is the extent to which the new cases, now predominantly occurring among people aged 25-54, will spill over to the elderly, who are more likely to get seriously ill or die. As experts gauge whether this is happening, they are focusing on two numbers, both currently headed in the wrong direction.
The daily death total, which had declined from its late-April peak, has started to creep upward. The state reported 68 deaths Thursday, only the sixth time the daily death toll has been that high. Meanwhile, the median age for infected people has also increased, rising from 33 last week to 37 on Wednesday.
“I expect a shift in the age distribution, and I think we have to assume it’s already happening,” said Derek Cummings, an infectious disease epidemiologist at the University of Florida. “My expectation is that the big increase in 20- to 45-year-olds will trickle into other categories. And those people are more likely to be hospitalized and much more likely to die.”
The Florida Department of Health on Thursday confirmed 10,109 additional cases of COVID-19, a record-breaking tally that brought the confirmed case total to 169,106, breaking a record set Saturday. The skyrocketing numbers mirrored trends in several other states such as Arizona and Texas that had joined Florida in reopenings that many now consider to have been premature, allowing the disease to roar back.
Predictions for the Florida death toll, which currently stands at 3,718, vary widely, partly due to the models used and partly due to unknowns about the status of future government restrictions to control the disease.
An ensemble forecast of 21 models for Florida produced a cumulative death toll of 5,873 by the end of the month, with predictions ranging from 4,050 to 18,404, although the high number is an outlier.
The University of Washington’s model predicts a range of possibilities, depending on whether Florida imposes a mask requirement or continues easing restrictions. With a mask requirement, the model forecasts the death toll rising to 5,280 by the end of the month and 7,046 by Oct. 1. Without one, the model predicts the toll rising to 5,569 by the end of the month and 13,349 by Oct. 1.
Although local governments have imposed mask requirements and other control measures, many scientists say they’re insufficient to get the disease under control.
Dr. Aileen Marty, an infectious disease expert at Florida International University’s Herbert Wertheim College of Medicine, said further restrictions are necessary, including a more widespread testing program that tracks down every infected person’s contacts and a statewide mask requirement, with fines for non-compliance.
“If we move on this immediately, we can completely change what South Florida will look like in a month,” said Marty, who advised Miami-Dade County on the issue. “If we don’t, we’re headed toward increasing problems. It really, really depends on whether or not people change within the next seven days. If they do not change their behavior within the next seven days, then unfortunately we’ll have to end up doing something like another lockdown.”