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Coronavirus impact spreads across Florida as more cases hit Tampa Bay

State looks to clear up questions of “community spread” and what “travel-related” means as health leaders try to contain COVID-19.

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TALLAHASSEE — Unanswered questions hovered over Florida’s coronavirus response Wednesday even as residents learned of new cases in Tampa Bay and several groups made difficult calls to cancel events or limit public gatherings.

Eleven new cases statewide included three in Tampa Bay and the first in both Pinellas and Pasco counties. Late Wednesday, the state announced that a Broward County man who had attended an emergency medical services conference in Tampa also tested positive for the disease. Health officials said anyone who attended the conference and is experiencing symptoms should contact a healthcare provider or county health department. The additions brought the total number of people who have tested positive for coronavirus in Florida to 26.

Related: Pasco man, 46, says he’s county’s first coronavirus patient

Gov. Ron DeSantis continued to push back on the idea that “community spread” has occurred here despite a national infectious disease specialist’s assertion to the contrary Tuesday. He said he believes the label came from a few cases tied to a cruise service company at Port Everglades in Broward County, which health officials in Florida do not consider “community spread” — a label that could signal heightened risk and demand a more severe response.

“We discussed that because that three-person cluster in Broward can all be linked to the cruise ship, that technically doesn’t qualify as community spread which would be multiple people where we don’t know where they got it from,” DeSantis said.

Tuesday afternoon, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, listed Florida among four states where “community spread” has occurred, saying the risk of the disease is “a little bit more” in those places.

The disagreement between state and federal officials was another example of the confused, shifting messaging that has formed an undertow to Florida’s response to coronavirus for two weeks.

“The message should be coordinated, clear and honest. Otherwise, the public gets nervous,” said Dr. Marc Yacht, the former leader of the health department in Pasco County. “They’re nervous now.”

When asked about the conflicting messages, Helen Aguirre Ferré, spokeswoman for the governor, said DeSantis had a phone conversation with Fauci and the director of the Centers for Disease Control and Prevention on Tuesday night “to discuss Florida’s COVID-19 response," during which “Dr. Fauci emphasized COVID-19 in Florida is largely related to international travel and not community spread, at this time.”

The National Institutes of Health, which is over Fauci’s agency, did not respond to a request for comment.

Despite the uncertainty and rising case total, several groups decided Wednesday to change the way they operate in the face of coronavirus, known technically as COVID-19. The disease causes flu-like symptoms and can lead to severe respiratory infections, especially in older patients and those with chronic health conditions. It has killed more than 4,590 people worldwide, including two in Florida.

DeSantis directed Florida’s Emergency Management Director Jared Moskowitz to issue an emergency order blocking sick people or those who may be exposed to coronavirus from visiting nursing homes, assisted living facilities, adult family-care homes, long-term care facilities and adult group homes. Among those blocked are people with a cough, fever or sore throat, and anyone who has been on a cruise ship within the last 14 days.

Related: Florida’s state universities to move classes online

Florida’s Board of Governors called for all state universities to move to online teaching instead of in-person classes, and to advise students leaving campus for spring break not to come back for at least two weeks after the holiday. The NCAA said it would limit attendance at March Madness college basketball games, some of which are slated for Tampa, to essential personnel and family members. Fast food workers from McDonald’s, planning a strike Thursday for union rights and a higher wage in several Florida cities, announced they would instead “serve out their strikes from home.”

Related: NCAA limiting March Madness attendance because of coronavirus outbreak

The cancellations were not universal: In St. Petersburg, officials said this weekend’s Grand Prix will go on as planned, even after the state announced two positive tests for coronavirus among men, ages 64 and 67, in Pinellas County.

Another case was announced late Tuesday in nearby Pasco County involving a 46-year-old man. The Department of Health on its website described each of those tests as “travel-related,” meaning the patient had “a known history of exposure to COVID-19 outside of the state.”

But even that seemingly simple term is the cause of some confusion. The man who said he is the patient in Pasco, Gene DellaSala, said he has not traveled but was instead visited by a 70-year-old man who had been to China and was later diagnosed with coronavirus in Louisville, Ky.

Told of the state’s label, DellaSalla said: “That’s not true at all. I think they misunderstood.”

Asked about the lack of clarity in this case, DeSantis said he would need to see the specifics to offer direct comment.

But Ferré, the spokeswoman, later specified how Florida is broadly defining “travel-related.”

“'Travel-related’ refers to those who traveled out of the state, including internationally, and/or have been in contact with someone who has traveled out of the state,” she said.

An airplane taxis on the tarmac at Tampa International Airport (TIA) on Tuesday, March 3, 2020. A woman later diagnosed with coronavirus flew through the airport returning form a trip to Italy. [ DOUGLAS R. CLIFFORD | Times ]

Florida lists all but a handful of its cases as “travel-related. One is “under investigation.” The outliers (listed as specifically not travel-related) are four in Broward County (three tied to the Port) and a Manatee County man in his 60s who last week the governor said had not traveled to countries with outbreaks of coronavirus.

“In the Manatee case, the person had contact with individuals who had traveled abroad,” Ferré said. It was not clear late Wednesday why that case was still listed as not travel-related on the Department of Health website.

Of the nearly two dozen instances of coronavirus in Florida, 10 are connected to cruise travel on the Nile River in Egypt, according to the governor, including five of the eight cases announced Tuesday night and a man in his 70s from Santa Rosa County who died. The state has issued a warning to anyone who went on such a trip in February or March to self-isolate for 14 days.

The haziness over what “travel-related” means comes as Florida health workers attempt to trace the contacts of people who have coronavirus. When a case is not related to travel, it means the patient might have contracted the disease elsewhere in the community. The U.S. Centers for Disease Control and Prevention defines community spread as: “People have been infected with the virus in an area, including some who are not sure how or where they became infected.”

“I think if you have been exposed to somebody who had been traveling from those areas it would not be considered community spread because we’d be able to identify the source and trace it back to those areas,” DeSantis said. “With a community spread situation you have three or four people who never traveled, wasn’t in contact with anyone that traveled, then that’s when you start thinking, ‘Well, maybe they touched a public railing and started doing all this.’ ”

Health and state officials have said they expect to see more cases but the risk to the general public remains low in Florida, with the chief guidance being for people to wash their hands and cover their coughs or sneezes.

Dr. Ilene Robeck, M.D., right, 69, speaks to a small group about the recent coronavirus outbreak Tuesday, March 10, 2020 at the St. Petersburg Free Clinic - Health Center. [ CHRIS URSO | Times ]

Regardless of whether leaders believe they have identified community spread here, they should proceed as if coronavirus is being passed from person to person, said Dr. Derek Cummings, a biology professor in the University of Florida Emerging Pathogens Institute.

“Given the limited number of cases and the amount of testing, I think we need to assume there is community spread in the state of Florida and we need to respond accordingly,” Cummings said.

A week ago, health officials reported just three people in Florida had tested positive for coronavirus, 16 tests were pending and 24 had come back negative. As of Wednesday, 23 people had tested positive, 147 tests were pending and 301 had come back negative.

“I think we should be considering closing schools, we should be minimizing large gatherings and individually we should be trying to minimize non-essential social interactions if we can,” Cummings said.

Other parts of the country are taking such steps. Health officials in Washington, D.C., urged organizers of events with more than 1,000 people to cancel. Leaders in San Francisco planned to start similar guidance in California.

Making such decisions earlier, Cummings said, can help stymie the spread of coronavirus before the health care system becomes overwhelmed.

“It’s a difficult decision, but I think it’s something we need to be courageous about,” he said. “Given the uncertainty, it’s better to over-respond.”

Times staff writers Matt Baker, Jack Evans, Megan Reeves and Romy Ellenbogen contributed to this report.

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Tampa Bay Times coronavirus guide

Q&A: The latest and all your questions answered.

PROTECT YOURSELF: Household cleaners can kill the virus on most surfaces, including your phone screen.

BE PREPARED: Guidelines for essentials to keep in your home should you have to stay inside.

STOCK UP YOUR PANTRY: Foods that should always be in your kitchen, for emergencies and everyday life.

FACE MASKS: They offer some protection, but studies debate their effectiveness.

WORKPLACE RISK: A list of five things employers could be doing to help curb the spread of the disease.

READER BEWARE: Look out for bad information as false claims are spreading online.

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