Signs Floridians should watch for this winter

Although the researchers saw it coming, Floridians failed to react to the early warning signs of the delta variant until COVID patients flooded into hospitals.

Now as winter looms, experts are monitoring for signs of potential new waves to prepare differently.

COVID is not over as some people seem to think it is, but models do show the pandemic easing in the state. New case levels have dropped to where Florida was in late June and early July, before delta took off.

With more tools to fight the virus’ spread, Florida may be at a turning point. As cooler weather and the holiday season arrive, uncertainty makes it difficult for anyone to predict where the pandemic is headed, but here’s what Floridians should consider:

Variants

One of the most significant predictors of Florida’s fate is how the pandemic plays out abroad, where variants tend to originate and make their way to the Sunshine State. The waves of infections that have hit the state since the emergence of COVID have been driven by new variants.

Delta originated in India in spring, made its way to the U.S. by summer and surged in Florida in August.

“In any location, it took delta 60 to 90 days to become dominant,” said Ali Mokdad, professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington.

Mokdad says a concern remains that a strain more infectious than delta could spread somewhere in the world at a time when Florida has few prevention strategies left in place. However, so far delta has swept the globe so thoroughly that it has crowded out almost all the

other lineages of viruses, he said.

“Right now we don’t see any variants of concern on the horizon,” said Dr. Ira Longini, a biostatistician and mathematical modeler with the University of Florida Emerging Pathogens Institute. Longini and his team at the University of Florida project without a new variant’s arrival, new infections in Florida will level off through the end of the year.

Immunity levels

When delta ripped through Florida, infecting mostly unvaccinated Floridians, it took the lives of thousands of Floridians but it also raised the level of immunity in the state.

As of Nov. 4, almost 11 million in Florida are fully vaccinated for COVID-19, or about 52% of the state’s total population. Another 3.6 million have been infected with the novel coronavirus. Higher vaccination rates and boosters will protect Floridians to a good degree, for now.

With both the COVID19 vaccines and infection, scientists know immunity slowly lessens over time. Health experts say they are closely monitoring boosters and the children’s vaccination rate to gauge the level of immunity in the state.

When immunity levels in communities start to subside, that could trigger a new resurgence of cases, or it could simply raise the daily case count in which the virus levels off, Longini said.

According to the UF models, daily COVID19 cases in Florida in November and December are projected to reach low levels similar to the state’s numbers in May and June. “Our projections are through the end of the year because information on waning immunity is just coming in.”

New cases

With future waves, it seems more likely that the percentage of infected people who die from the disease or get severely ill will remain lower than it was earlier in the pandemic.

Mokdad said that’s why monitoring new cases becomes important. “If cases increase, that’s the best indicator of what’s to come. You don’t want people to relax. You want to get more aggressive in testing to detect change.”

Only about a quarter of COVID cases in Florida are being detected, compared with about 45% nationally, he said.

“With delta, we missed the start of cases going up. People didn’t change their behavior and the state let the virus spread until it ran out of people to infect. That’s the wrong way of dealing with this virus,” Mokdad said.

With the delta variant still spreading in the state, Florida needs to encourage testing, he said.

“There are still pockets in Florida that are unvaccinated. We need to make sure we catch spread as soon as possible.”

Visitors

The U.S. has dropped the pandemic travel ban, which means international travelers can come to Florida but they will need to show proof of vaccination and a recent negative COVID-19 test. In previous waves, Florida, which attracts international travelers, saw cases of new mutations before most other states.

Zucai Suo, a professor of Biomedical Sciences at Florida State University College of Medicine, said while there are no variants as infectious as delta, visitors who get sick after arrival will need to be tracked. “There is potential for them to bring a substrain, even if it’s not a new main strain. This is something we have to watch.”

Suo said Florida health officials will need to be aggressive in sequencing positive test results to catch a new variant or more infectious sublineages of a variant in Florida. “The only way to get ahead of this is frequent sequencing.”

Because of Florida’s high volume of visitors, Suo said residents cannot rely on herd immunity, which is created when enough people have antibodies and can provide protection for those who don’t. “You have to protect yourself by getting vaccinated to get immunity rather than counting on others to be safe.”

Longini at UF said it is unlikely Florida will get its case count to zero. “We are not going to eradicate COVID-19. It’s a planetary problem. We should expect to settle into an endemic state.”