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Florida leads nation in COVID infections, hospitalizations as patients get younger

Younger, healthier, unvaccinated adults are falling ill in Florida and filling up hospital beds as the fourth wave keeps growing.
A man is tested for COVID-19 at Mills Pond Park in Fort Lauderdale on Thursday.
A man is tested for COVID-19 at Mills Pond Park in Fort Lauderdale on Thursday. [ CARLINE JEAN | South Florida ]
Published Jul. 30
Updated Jul. 31

Florida led the nation last week in COVID-19 infections and hospitalizations as the Sunshine State becomes the epicenter of the delta-driven fourth pandemic wave.

The state saw 110,477 new coronavirus infections over the most recent seven-day period from July 23 through Thursday, according to the weekly report released by the Florida Department of Health on Friday. Florida averaged more than 15,780 infections a day.

It’s the first time since early January that the state surpassed 100,000 infections in a single week.

Florida accounts for nearly one out of every four new infections and hospitalizations in the country, according to data from the federal Centers for Disease Control and Prevention.

“We’re dealing with the delta variant, a mutation that is far more infectious, transmitting to more individuals and leading to greater complications,” said Florida Hospital Association president Mary Mayhew.

No longer is this a pandemic affecting mostly Florida seniors or those with pre-existing conditions. Now it is younger, healthier, unvaccinated adults who are falling ill. New Florida infections and hospitalizations are being driven by adults in their 20s to 40s, state data shows. They account for 53 percent of infections and about 34 percent of hospitalizations.

The state led the country with 22 percent of the nearly 470,000 new COVID-19 infections detected last week, the CDC says. That’s the same number of cases as the next three highest states combined. Florida also has double the number of infections in Texas, the state with the second-highest caseload.

Adjusted for population, Florida is only behind Louisiana with 481 cases per 100,000 residents.

The state continues to issue weekly, instead of daily, infection reports. It sent out the latest one at 5 p.m. Friday. Florida’s largest corporations were already taking action.

Disney gave all its U.S. employees 60 days to get vaccinated. Publix ordered its supermarket employees to again wear masks starting Monday. Walmart, the nation’s largest private employer, will require all corporate staff to get vaccinated and all frontline store workers to wear masks.

Related: Walt Disney World will require most of its employees to get coronavirus vaccine

Hillsborough County will require everyone using county facilities to wear masks indoors starting Monday regardless of vaccination status. The same will be true of people inside Pinellas and Pasco County court facilities.

But local governments can no longer use the tools that slowed past pandemic waves: enacting emergency orders to require masks and social distancing. In May, Gov. Ron DeSantis signed an executive order striking down all local orders. The governor also signed a bill passed by the Legislature restricting the ability of local governments to issue emergency orders.

DeSantis opposes requiring people to wear masks or show proof they’re vaccinated and reiterated that stance Friday while appearing at a Cape Coral restaurant. His supporters cheered as he vowed to try to block school districts from ordering students to wear masks when classes start in mid-August.

“There is a movement to try to impose more restrictions on the American people,” he said. “There will be no restrictions and no mandates in the state of Florida.”

Hospital admissions spike again

Florida hospitals saw 8,855 COVID-19 related admissions between July 21 and Thursday, according to CDC data. It’s the largest spike in hospital admissions since the beginning of the pandemic and a nearly 60 percent jump in admissions from the previous seven-day reporting period.

The spike in admissions means more and more COVID-19 patients require hospitalization. As of July 28, Florida hospitals were treating 8,816 infected patients — more than at any point since the first wave of infections in July 2020.

What’s different now is the current spike in hospital admissions is being driven by younger adults, according to a Tampa Bay Times analysis of CDC data.

Last winter, over 60 percent of hospital admissions were patients aged 60 and over. Now they make up less than 45 percent of new hospital admissions.

Instead, it is adults in their 20s to 40s who are making up an increasingly large share of admissions in the fourth wave. Last winter, less than 15 percent of admissions were young adults. Now over one-third of the hospitalized are adults under 50.

”When you look at the elderly population in Florida, it tends to be pretty heavily vaccinated, which is protecting them from hospitalization,” said Amesh Adalja, who studies hospital preparedness at Johns Hopkins University.

Related: DeSantis issues executive order to halt school mask mandates

What experts like Adalja didn’t expect, he said, was that so many unvaccinated adults in their 40s and 50s would get seriously ill.

“What people underestimate is the proportion of high-risk conditions in younger age cohorts,” he said, “and those younger age cohorts are what’s driving hospitalizations now.”

But it’s not just those with pre-existing conditions that face major illness, said Florida Hospital Association spokesman Marc Lotter: “We are having people in their 20s and 30s, with no pre-existing conditions that would normally have been susceptible, now coming in and requiring ICU-level care and ventilation.”

Yet vaccination rates among young adults have remained stubbornly low across Florida. Less than half of those in their 20s to 40s have been vaccinated, according to state data. That’s far short of the 85 percent vaccination rate now needed to reach herd immunity, according to public health experts.

That may be changing, however. Over 235,000 Floridians got their first shot last week, and the majority of them were under 40. That’s the highest number in two months.

They need the protection: Younger adults make up the largest share of cases of any age cohort, accounting for 53 percent of new infections last week, despite making up just 37 percent of the population.

Tampa Bay hospitals holding up

State hospitalizations jumped 140 percent in the last two weeks, according to the Florida Hospital Association.

Tampa Bay hospitals are faring better than other parts of the state, Mayhew said, due to the large number of older residents who have been vaccinated. Hospitals in northeast Florida are operating at 192 percent of the capacity level seen in July 2020, while in Southwest Florida it’s 75 percent (which includes Tampa Bay).

Hospitals face additional pressure due to an unusually high volume of non-coronavirus admissions, Mayhew said, as patients who put off medical concerns during the pandemic now suffer complications.

Tampa General Hospital reports 100 COVID-19 patients as of Friday, 46 of whom are in the intensive care unit and 10 are on ventilators. The number of cases has more than doubled from two weeks ago, said hospital spokesperson Philip Buck.

He said 80 percent of the hospital’s COVID-19 patients are unvaccinated. The vaccinated patients who fell ill tend to have other conditions, such as those who have had transplants or are oncology patients.

The median age of COVID-19 patients in Tampa General’s intensive care unit is 42, Buck said. Last year most were in their mid-70s.

COVID-19 patients in BayCare’s 15 West Florida hospitals more than tripled in the last three weeks.

Bayfront Health St. Petersburg hospital reports 26 COVID-19 hospitalizations, 12 of which are in the ICU, said hospital spokesperson Ryan Jeter.

Jeter said 90 percent of infected patients are unvaccinated.

AdventHealth West Florida Division hospitals currently has more COVID-19 cases than any other point in the pandemic. More than 90 percent of infected patients are unvaccinated.

What’s the plan?

The Times asked the governor’s office if there is a plan to slow infections. DeSantis’ office said it stands by the governor’s strategy of vaccinating seniors first:

“The high immunization rate among Florida’s seniors means that we are not seeing the same proportionate increase in COVID deaths as we saw last summer before the vaccines were available.”

Florida reported 409 deaths in the recent seven-day period, though because of delays in reporting, some may have died two to three weeks ago. It’s a sharp increase from previous weeks, but still less than one-third the fatality rate seen last summer and earlier this year.

Outbreaks are starting up again across the state. A total of 177 of Florida’s nursing homes had employees or residents who tested positive for COVID-19 in the week ending July 18, according to federal data. That’s a quarter of the state’s nursing homes, and 25 are in Tampa Bay.

The Pasco County Sheriff’s Office reported 39 inmates were infected as of Wednesday at the Land O’ Lakes Detention Center compared to six in all of June.

The Clearwater Threshers postponed Friday night’s game because the organization suffered an outbreak and is conducting contact tracing and testing.

Related: 177 Florida nursing homes report COVID-19 cases among residents or staff

Some local officials took measures this week to try to slow the rate of infections. Miami-Dade Mayor Daniella Levine Cava ordered masks be worn in all county buildings and urged businesses to follow suit. She also urged residents to wear masks in large crowds. Leon County ordered all its employees to get vaccinated or face termination.

The Broward and Gadsden county school districts will require students to wear masks when classes start in mid-August, and school board attorneys expressed doubt that the governor has the legal authority to stop them. Tampa Bay districts do not plan to require masks.

President Joe Biden this week imposed tough rules to encourage federal employees and contractors to get vaccinated.

State government is going in a different direction. The Florida Department of Health, which oversees COVID-19 data, took steps earlier Friday to enforce a new law that bans so-called “vaccine passports.” The law allows the state to issue $5,000 fines against businesses, government agencies and educational institutions that require proof of vaccination.

The governor’s office noted state law does not prevent private companies like Disney and Walmart from requiring vaccinations. But the governor will continue to oppose any government mandates, orders and restrictions, his office said:

“There is no silver bullet that any government in the world can use to ‘reduce infections,’ especially because the vaccines do not seem to prevent infections in everyone who gets vaccinated. But the Governor encourages Floridians to protect themselves by getting the vaccine, because that protects most people from serious illness requiring hospitalization.”

Related: Florida health department moves forward on vaccine ‘passport’ ban

Wear a mask, get the shot

While masks and social distancing cannot be mandated, they’re still effective at protecting the vaccinated and unvaccinated alike, said Dr. Nishant Anand, BayCare’s chief medical officer. Studies show masks are nearly 70 percent effective at preventing infections.

The more transmissible delta variant is infecting some vaccinated people, though they’re well-protected from the worst symptoms.

The most effective way to end the pandemic is through vaccinations. But only 53 percent of Floridians 12 and up are fully vaccinated. While 62 percent have had at least one dose, partial vaccinations are less effective against the delta variant.

However, the age group of 12 to 19 went from 35 percent vaccinated to 39 percent in just one week.

The problem is that 39 percent of Florida’s population remains unvaccinated, and children 11 and under still cannot receive it.

Those who do get vaccinated will not only be protected from the delta variant, Mayhew said, but also the next variants, which could be even more dangerous.

“We’ve got to get people vaccinated,” she said.

Times staff writer C.T. Bowen contributed to this report.

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