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‘Where we are.’ Florida’s window to act on virus growth is closing, experts say

“We are where we are,” Gov. Ron DeSantis said at a press conference in Tampa, adding that he has not yet given the green light for the state to move into the third and final stage of reopening.
Florida Governor Ron DeSantis puts his mask back on after speaking during a news conference at Cristo Rey Tampa Salesian High School in Tampa on Thursday, June 25, 2020.
Florida Governor Ron DeSantis puts his mask back on after speaking during a news conference at Cristo Rey Tampa Salesian High School in Tampa on Thursday, June 25, 2020. [ IVY CEBALLO | Times ]
Published Jun. 26, 2020
Updated Jun. 26, 2020

The explosive spread of COVID-19 in Florida and other states is much wider than the rising number of cases indicate, the nation’s top public health officials said Thursday — the same day that the United States saw the highest single day of new cases, more than 37,000.Public health experts warned that now is the time for state and local governments to slow reopening efforts before the only option left is another shutdown of the economy.

But while South Florida’s local governments have stepped up enforcement of social-distancing measures and issued face mask orders, Florida’s governor gave no indication that the Sunshine State will do anything differently as it moves forward with the phased reopening that began in May.

“We are where we are,” Gov. Ron DeSantis said at a press conference in Tampa, adding that he has not yet given the green light for the state to move into the third and final stage of reopening. Florida entered the second phase of reopening on May 19, allowing bars, gyms and movie theaters in all but three South Florida counties to reopen at partial capacity.

Texas, among the first states to reopen and one of several now seeing a dramatic spike in COVID-19 cases, paused any further phases of reopening and stopped some surgeries in four counties in order to preserve hospital beds.

But unlike Texas, where hospitals are nearing capacity, about one in five adult ICU hospital beds in Florida remained available on Thursday afternoon, according to the state Agency for Health Care Administration’s hospital capacity dashboard.

Many Florida hospitals have reserve capacity they can open up in the event of a surge. Though AHCA’s dashboard does not reflect this additional capacity, Miami-Dade hospitals, which report data daily to county officials, said 484 ICU beds were available on Thursday. But local hospitals also reported the highest number of inpatients with COVID-19 to date, 885 people.

As new COVID-19 cases soar and hospital admissions rise in response, public health experts say they are concerned state officials are making policy decisions based on test data that reflects infections that occurred weeks ago.

If states want to avoid the surge of demand on hospitals that is likely to follow exponential growth, officials need to take measures right away, said Barry Bloom, an immunology and infectious disease researcher for Harvard T.H. Chan School of Public Health.

“What you see today is not really what’s out there and happening in the community,” Bloom said. “What you see today is going to get much worse tomorrow.”

In Florida, new cases have swelled over the last week. The health department reported a second day of more than 5,000 new COVID-19 cases on Thursday, raising the state’s total count to more than 114,000 people infected — with 21% of all cases reported in the last seven days.

But the number of actual COVID-19 cases in Florida may be more than 1 million, said Dr. Robert Redfield, director of the Centers for Disease Control and Prevention.

“Our best estimate right now is that for every case reported there actually were 10 other infections,” Redfield said during a media conference call.

The CDC estimates that 20 million or 6% of Americans likely have been infected by SARS-CoV-2, the virus that causes COVID-19, based on a national serological survey of people with antibodies to the disease.

That means more than 90% of Americans have not been infected, Redfield said. Slowing the spread of COVID-19 is key to protecting those who have not been infected and those who are at high risk for severe outcomes, especially the elderly and persons with chronic medical conditions.

Each day scientists and doctors are learning more about a virus no one knew existed seven months ago, and on Thursday the CDC issued a warning for people of any age with certain underlying medical conditions considered at high risk for hospitalization and potentially death from COVID-19. The highest risk conditions include chronic kidney disease, type 2 diabetes, serious heart conditions and obesity.

Dr. Dana Meaney-Delman, the CDC’s deputy manager for COVID-19 response, said pregnant women with COVID-19 are more likely to develop serious medical complications than those who do not have the disease.

“From the data we have pregnant women are not at increased risk of death,” Meaney-Delman said. “But we do see higher rates of admission to ICU and mechanical ventilation.”

Though cases in Florida and other states are growing among a younger population than those identified in March and April, public health experts say it’s only a matter of time before those younger individuals begin to spread COVID-19 to older relatives.

DeSantis and state officials have emphasized that the majority of Florida’s new cases are occurring among persons younger than 60, but CDC officials said there is no cut-off age at which people should not be concerned.

Dr. Jay Butler, the CDC’s deputy director of infectious diseases and the agency’s COVID-19 response incident manager, warned that young people should not assume they are safe just because of their age. Butler noted that medical professionals are finding that obesity also is a high risk factor.

“It appears even a body mass index above 30 may increase risk as well,” Butler said. “Obesity is appropriate to include as one of those conditions where there might be an increased risk.”

Redfield said he is “highly concerned” about the U.S. healthcare system’s ability to cope with COVID-19 and influenza in the fall and winter, and noted that the nation’s high rate of obesity compared to other countries is worrisome.

“Our nation isn’t as healthy as some other nations, particularly as you look at the issue of obesity and some of the other chronic conditions,” he said.

As the number of cases in Florida continued to climb, there was evidence that more people are seeking testing at state-run sites.

At Hard Rock Stadium in Miami Gardens, state officials reported performing 904 nasal swab tests for active virus and 195 blood antibody tests on Thursday, while in Miami Beach drivers waited up to four hours in line for COVID-19 tests at the Miami Beach Convention Center.

The Miami Beach test site performed a record 989 tests on Thursday, a spokeswoman said. The Florida Division of Emergency Management boosted the facility’s testing capacity to 1,000 from 750 a day on Thursday after city officials asked for more resources. Miami Beach officials also extended the city’s local state of emergency for COVID-19 through July 1.

The recent rise in cases also affected some of the region’s largest institutions. Florida International University reversed course on a phased reopening that would have returned its 55,000 students to campus classrooms and announced that students instead would have four learning options — in a physical classroom, through an online curriculum, a hybrid of classroom and online, or by remote video.

Miami-Dade reported 885 new cases and nine deaths on Thursday, raising the county’s totals to 28,664 confirmed infections and 935 deaths. In Broward, the health department said there were 367 new cases and one death, for a total of 12,584 known cases and 379 deaths. Palm Beach saw 304 additional cases and four deaths. The county now has a total of 11,840 known cases and 486 deaths.

In Miami, city officials issued an emergency order mandating that people wear face coverings in public or risk a $50 fine. That came a day after County Mayor Carlos Gimenez announced plans to provide shelter for people who get sick and have nowhere to stay other than a crowded home.

On a press call, Bloom, the Harvard epidemiologist, praised that idea, saying it was a key part of what brought the epidemic under control in places like China, South Korea, Japan and Hong Kong.

“They provided temporary housing for people who tested positive to isolate them, and that’s a key intervention to keep people from transmitting in their households,” Bloom said.

On the same call, William Hanage, also a Harvard epidemiologist, said that shutdowns like those seen in March and April are a last resort, but the window to prevent one is closing fast.

“I think shutdowns are a bad thing,” he said, “but if they’re the only tool you have to prevent hospitals from being overwhelmed, you might have to use one again.”

Miami Herald staff writers Joey Flechas, Michelle Marchante, Martin Vassolo and Colleen Wright contributed to this report.

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