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For 105 days, COVID’s death toll in Florida counties went missing

The state and federal government could have shared the death toll in each county with the public, but didn’t.
Medical workers at Morton Plant Hospital in Clearwater work to stabilize a COVID-19 patient on Aug. 25. For 105 days this summer, the public could no longer find out how many people were dying of COVID in each Florida county.
Medical workers at Morton Plant Hospital in Clearwater work to stabilize a COVID-19 patient on Aug. 25. For 105 days this summer, the public could no longer find out how many people were dying of COVID in each Florida county. [ JOHN PENDYGRAFT | Times ]
Published Oct. 17

For 105 days this summer, while COVID-19 deaths soared across the state, Floridians had no idea how many of their neighbors were dying.

The Florida Department of Health knows how many people are dying in each county, but stopped telling the public on June 4. That’s when state officials stopped releasing daily pandemic data, switched to weekly reports and started withholding data once available to the public.

Instead of including county deaths in its weekly reports, the state directed the public to find that information via the Centers for Disease Control and Prevention.

But the CDC relied on Florida’s online portal of COVID data — which the state also took down in June. The CDC’s tally of deaths for Florida went blank.

The number of people dying in each Florida county went missing from June 4 through Sept. 17. Miscommunication has plagued the relationship between the state and federal agency since the start of the pandemic.

Related: There’s not much ‘tracing’ in Florida’s COVID-19 contact tracing program

Now that data is available, and it shows how many people died in Tampa Bay as the delta variant tore through the state:

A total of 4,437 residents in Pinellas, Hillsborough, Pasco, Manatee, Polk, Hernando and Citrus counties died over four months. That’s an average of 36 Tampa Bay residents dying each day from COVID-related complications from June 5 to Oct. 7, according to the latest data.

The data reveals how deadly the latest COVID wave has been in two of the region’s smallest, most rural counties: Citrus and Hernando rank third and fourth in deaths per 100,000 residents since June 5.

It’s another episode that illustrates how governments continue to hinder the public’s understanding of the virus and its toll.

“The issues Florida has had with data displayed by CDC has caused great confusion and allowed misinformation to perpetuate in our state,” Florida Department of Health spokesperson Weesam Khoury wrote in an email to the Tampa Bay Times.

So why doesn’t the state share that data directly with the public — just like it had been doing until June?

“The Department of Health, an agency with approximately 12,000 experts including epidemiologists, is equipped to make decisions regarding the best and most understood data,” Khoury said.

University of South Florida virologist Dr. Michael Teng countered that response: “That they are determining for us what is the ‘best and most understood data’ is paternalistic and contrary to the idea of transparency in government.”

Last year, the Times reported that Florida leaders spent years whittling down the Department of Health to nearly 13,000 employees by 2019, leaving Florida with one of the lowest numbers of epidemiologists per residents in the country. The agency did not respond to a request for its current number of employees.

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• • •

When the pandemic started last year, the Florida Department of Health produced detailed, daily reports about the toll COVID-19 was inflicting. The state also posted that data to a website that the CDC, public health experts and media organizations like the Tampa Bay Times used to extract, analyze and share information about the pandemic.

But in June, Gov. Ron DeSantis’ office declared that the pandemic had receded to the point where daily reports were no longer necessary. The state also took down its COVID data website, known as an online dashboard.

“COVID-19 cases have significantly decreased over the past year as we have a less than 5 percent positivity rate, and our state is returning to normal, with vaccines widely available throughout Florida,” said the governor’s press secretary, Christina Pushaw, in a June 3 email announcing the change.

Instead, state officials decided to issue weekly reports. They also chose to withhold information that had been public, including: county-level vaccinations by race, age and gender; infected patients and staff in long-term health care facilities; and infections among students and school staff.

The state replaced its daily release of data with a 9-page document of statistics that it posts online every Friday, after 5 p.m. The state no longer releases data to the public in a format that can be easily collected and analyzed. However, Florida still sends its data to the CDC, which relies on data from all 50 states to continually update an online COVID dashboard that the public can access.

The end result is that Florida’s COVID data is harder to come by since June 4. It is the only state that releases data once a week. It releases less information to the public than it once did. It releases data in a way that makes it harder to access and analyze. And Florida leaves it to an outside agency, the CDC, to publicize data that it won’t.

Related: Florida adds 19,519 COVID cases, 1,192 deaths in past week

The same month that Florida officials changed the data policy, the highly-transmissible delta variant emerged and infections took off again. Florida went from averaging about 1,000 infections a day at the start of June to more than 21,000 a day by August. Florida averaged a peak of 372 deaths a day on Sept. 1.

State officials have repeatedly defended the weekly reports, saying daily spikes in cases and deaths can be misinterpreted.

“To be fair, trends are more important than daily numbers, which can be skewed for any number of reasons,” said Teng in response to the state. “But reporting data in weekly blocks isn’t the best way of illustrating trends.”

As cases and deaths climbed this past summer, state officials said they will not switch back to daily reports, or share previously-available data. Instead, they told journalists and researchers that data requests should go through the CDC.

But for more than three months, the CDC dashboard showed zero new fatalities in Florida’s counties. That’s because the CDC was still trying to pull data from the state’s defunct online dashboard.

The CDC, however, was also receiving that data from the state via another avenue. When the pandemic started in March 2020, the CDC requested that the state transmit its daily COVID data to the federal government. When Florida officials took down the dashboard 15 months later in June 2021, the CDC did not adjust and utilize the other source of data from the state.

The Florida Department of Health notified the CDC about the issue on Sept. 3, according to emails obtained by the Times, but it still took days for the federal agency to start posting how many people were dying in each county.

Related: 2022 Medicare Guide: How Florida seniors can stay safe from COVID

The episode highlights a common problem during the pandemic: that different governments report data in different ways, said Beth Blauer, executive director of the Centers for Civic Impact at Johns Hopkins University.

“This is an indication of why there needs to be standards that compel reporting,” she said.

Without those standards, local and state governments have to improvise. That creates problems when federal agencies try to aggregate data from different local governments.

“There was absolutely room for the CDC … or other (federal) leadership to articulate exactly how counties and states should be reporting COVID cases, deaths, and hospitalizations,” Blauer said. “And that didn’t happen.”

When the Times asked the CDC why county deaths were missing from its dashboard, federal officials blamed the state health department for not providing that data. However, the state provided emails to the Times that show it has been transmitting data to the CDC since last year.

CDC officials did not respond to the Times’ requests to respond to the state’s assertions.

• • •

It’s not just the state and federal governments that have failed to tell Floridians how many people were dying in their counties. Tampa Bay’s local governments aren’t reporting it to the public, either.

The Pinellas County Commission holds weekly calls with state health officials to get briefed on COVID-19. Each week, the commissioners learn how many people are dying in Pinellas, said Assistant County Administrator Lourdes Benedict in a statement to the Times.

However, county officials are not posting that data to Pinellas’ own public COVID dashboard. “Deaths are a lagging indicator” of a pandemic’s severity, Benedict said, “unlike positivity rates and case counts which are more real time indicators.”

The Hillsborough County Commission receives regular COVID-19 updates from Emergency Management Director Timothy Dudley Jr., but his reports do not include local deaths. County officials said they need more time to answer a query from the Times about whether it receives those numbers from the state.

Related: Get a flu shot and the COVID vaccine to help Florida avoid a ‘twindemic’

Pasco County officials say they do not receive county deaths from the state.

The Hernando County Commission receives daily emails from the county’s local office of the state health department that kept them up-to-date on the county’s death toll. But Commissioner Jeff Holcomb said that because deaths lag infections by weeks, it’s not as important as other metrics, such as how many students get infected and how backed-up hospitals are.

“Once they’re in the hospital, whether they live or die, there’s not much a county commissioner can do,” he said.

Blauer, of Johns Hopkins University, said knowing who is dying locally can help policymakers identify areas where COVID-19 is rapidly spreading and act to reduce infections in vulnerable communities.

“We know that the vaccinations are highly effective at preventing hospitalizations and deaths,” she said. “A concentration of deaths in a particular area is the number one signal that you’re not doing enough to get that population vaccinated.”

University of South Florida epidemiologist Jason Salemi said knowing how many people are dying in each county helps residents answer an important question: “They want to know: ‘how does this affect me in my community?’”

• • •

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