Scientist cited by White House told Florida: Shut state down

His model predicts that even if Florida does issue stay-at-home order, the state’s coronavirus outbreak is on pace to peak in early May in numbers that will overwhelm intensive care units.
Florida Governor Ron DeSantis.
Florida Governor Ron DeSantis. [ MATIAS J. OCNER | ]
Published March 31, 2020|Updated March 31, 2020

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TALLAHASSEE — One of the epidemiologists behind a coronavirus model cited by the White House over the weekend as a reason for extending national social distancing recommendations through the end of April has advised Florida’s state government to issue a statewide stay-at-home order — the kind of blanket decree that Gov. Ron DeSantis has so far insisted is unnecessary.

Ali Mokdad, a professor at the University of Washington’s Institute for Health Metrics and Evaluation, said he told Florida’s top health official Monday night that the governor should issue a blanket stay-at-home order mandating the closure of non-essential businesses and social isolation in order to control the spread of the virus. The institute’s model — which is updated daily as data changes — predicts that even if such an order is given, the state’s coronavirus outbreak is on pace to peak in early May in numbers that will overwhelm intensive care units and potentially lead to thousands of deaths by the summer.

“These estimations are based on [the expectation that] Florida will implement stay-at-home measures within a week from now. We’re assuming next Monday this will be in place,” Mokdad, a former epidemiologist for the U.S. Centers for Disease Control and Prevention, told the Miami Herald. “If they don’t, these numbers will go up.”

Mokdad, who spoke to the Miami Herald Monday afternoon before speaking to Florida Surgeon General Scott Rivkees, said he would “strongly recommend shutting down everything.”

He confirmed in an email Tuesday morning that the conversation with Rivkees took place. He said the state provided updated details about its hospital and ventilator capacity, which will be used to update the model’s projections.

The governor’s press office did not respond to questions about the call.

The model predicting the spread of the novel coronavirus that was published by the University of Washington’s Institute for Health Metrics and Evaluation has received national attention. Deborah Birx, the coordinator of the White House’s coronavirus task force, cited the analysis Sunday while detailing projections that found as many as 200,000 Americans could die from COVID-19 even if the country does an exemplary job in employing preventive measures.

Birx told reporters during a briefing in the Rose Garden that the White House had reviewed a dozen models to come up with its projections. And then, she said, they learned of the independent University of Washington model, which came to roughly the same conclusion.

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“Go on his website, “ Birx said of Institute for Health Metrics and Evaluation Director Christopher Murray. ”You can see the concern we have with the growing number of potential fatalities.”

The Institute for Health Metrics and Evaluation model currently predicts between 36,000 and 152,000 deaths in the United States by mid-August, with cases generally peaking across the nation in mid-April. The model assumes that every state in the nation will be subject to a stay-at-home order by Monday due to the increasing number of cases and hospitalizations across the country.

In Florida, the model predicts between 1,600 deaths and about 11,000 in the same window, but with cases peaking in early May — and assuming that the state shuts down by next week.

“We’re expecting everybody to do so because it’s a sound decision,” said Mokdad.

The White House is expected to release details of its projections Tuesday, according to The New York Times.

DeSantis’ administration has so far refused to identify or release any information about how it is using projections to guide forward-thinking decisions that epidemiologists say should be aimed at addressing infections that will likely lead to consequences weeks after they first occur. The IHME model, for instance, predicts a spike in Florida in about one month due to the fact that more extreme lock-downs are only now taking place in the southeastern portion of the state, where the bulk of Florida’s cases are located.

“There are several models that project COVID-19 cases and when they will peak,” Jason Mahon, a spokesman for Florida’s State Emergency Response Team, told the Miami Herald. “In order to plan for all contingencies, the state does not rely on one single model.”

DeSantis, who says he is in daily contact with President Donald Trump, has spoken about coronavirus infections with an emphasis on current data, as opposed to future projections. In choosing not to issue a statewide stay-at-home order, as more than 20 other governors have done, he has said it would be counterproductive to shut down parts of the state with only a few confirmed coronavirus cases.

On Monday, DeSantis continued to hold that line, issuing an executive order that reinforces stay-at-home decrees issued by local government authorities only in Monroe, Miami-Dade, Broward and Palm Beach counties. Despite projections that Florida may experience a peak in hospitalizations and deaths in early May, DeSantis said the order would last two weeks, because he believes the country will be rebounding before Trump’s current end-of-April social distancing recommendations expire.

As of Tuesday morning, data from the Florida Department of Health showed the state had 6,338 confirmed cases and 77 deaths. The state’s testing for coronavirus, however, has been limited, so it’s difficult to know how many cases truly exist.

“We’re going to be evaluating every day and seeing what some of the trends look like,” DeSantis told reporters. “I think the president, by doing the 30th [of April], I think he thinks we may be in a good spot before the 30th.”

As recently as nine days ago, on March 22, Rivkees suggested on a conference call with lawmakers that the state had no ability to know how many cases Florida will experience in the coming weeks. Rivkees was asked about whether the state has projections in the context of how the state was preparing to restock its hospitals — an effort that has included successful orders for 1.2 million surgical masks, 714,000 gloves, 500,000 N95 masks, 250,000 face shields, 200,000 gowns, 3,000 ventilators, 3,000 hospital beds and 150 ICU beds, according to Jared Moskowitz, the director of emergency management.

“We can’t predict that,” Rivkees said, when asked how many cases Florida might see. “We are planning for the worst.”

Mokdad, the University of Washington researcher, said the institute’s model, which was initially built at the request of the CEO of a university-affiliated hospital system in Seattle and then expanded to cover every state, was created to predict how the spread of coronavirus will strain hospital systems, intensive care units in particular.

The model takes into account local prevention measures, he said.

Miami Herald staff writer Samantha Gross contributed to this report.

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