Why are so many Floridians still dying from COVID? | Editorial
How Florida’s COVID death rate compares to other states, including California, Texas and New York.
File illustration of coronavirus.
File illustration of coronavirus. [ TNS ]
This article represents the opinion of the Tampa Bay Times Editorial Board.
Published Sept. 9, 2022|Updated Sept. 12, 2022

Florida recently passed 80,000 COVID deaths. The number reminds us that for more than 2½ years, through lock downs and mask disputes, vaccine rollouts and omicron outbreaks, the virus has taken a wearying toll. The pace ebbs and flows, but the deaths keep coming, about 70 a day in recent weeks. We want COVID to be over, but the virus has other ideas.

Given the morbid milestone, just how is Florida doing in preventing COVID deaths? The answer likely depends on your political and moral perspective. But try a thought experiment. On March 1, 2020, when Gov. Ron DeSantis announced the first two cases of “novel coronavirus” in Florida, what — if anything — would you have been willing to do differently if you knew that COVID was going to kill 80,000 Floridians? There are studies that suggest the state could have prevented thousands of those deaths. That said, Florida isn’t alone in its less-than-stellar track record of keeping residents alive during the pandemic.

Florida, for instance, focused early in the pandemic on keeping its large senior population safe, an age group particularly susceptible to dying from COVID. Florida has the second-highest percentage of residents 65 years and older. Only Maine has more. The seniors-focused strategy made sense, especially before vaccines became widely available in the spring of 2021. But Florida appears to have let its guard down. Since April 1, 2021, Florida has by far the highest COVID death rate among the country’s six most populated states — California, Texas, New York, Illinois and Pennsylvania rounding out the half dozen.

Florida has also had a comparatively tough summer, again leading the other large states in COVID death rate by a wide margin. The state’s summer jump in COVID deaths has not approached the state’s peak from last September or even the spike in January — and it’s not expected to in the near future. But over the summer, Florida’s daily COVID death rate was three times higher than the rate in New York, the next highest among the large states.

Why the recent uptick in Florida’s COVID deaths? One often cited hypothesis is that Florida is hot in the summer, so residents take relief in air conditioned indoor spaces where the virus spreads more easily. More people contract the virus, so more people die. The idea of a “seasonal effect” may yet be proven true, though Florida isn’t the only hot state. The Sunshine State has the third-highest average temperature in the summer. What about the other sweltering states? Did they see similar increases in COVID deaths this summer? Not really.

The Times Editorial Board looked at the 10 states with the hottest summer temperatures other than Florida — Louisiana, Texas, Oklahoma, Mississippi, Arkansas, Georgia, Alabama, South Carolina, Arizona and Kansas. None of them had an overall death rate per 100,000 residents that was nearly as high as Florida’s this summer. Arkansas was closest, recording about two deaths for every three in Florida, after accounting for the differences in total population. Combined, the 10 states had a death rate about one-third of Florida’s. So the explanation for the increase in Florida’s COVID deaths this summer doesn’t seem as simple as “It’s hotter here.”

What about Florida’s older population? Older groups are far more likely to die from COVID, but Florida isn’t the only state with an older population. An analysis of the 10 other states with the most residents 65 years and older show that Florida didn’t fare well this summer. The 10 — Maine, West Virginia, Vermont, Delaware, Montana, Pennsylvania, Hawaii, New Hampshire, South Carolina and Oregon — total about 30.1 million residents, including nearly 6 million at least 65 years old. Like the 10 hot states, the 10 old states had a far lower rate of COVID deaths than Florida this summer. The rates were fairly close in May and June, but last week Florida’s rate was running about three times as high as the average of the other 10 states. In colloquial terms, Florida was three times as bad.

Another way to better account for population differences including age disparities is to look at excess deaths. Excess deaths measure the difference between the reported deaths in a given time period and an estimate of the expected deaths for that period had the COVID-19 pandemic not occurred. By that measure, Florida’s summer numbers look better. Among the large states, Florida had a lower percentage of excess deaths than California and Texas, though still more than the national average.

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What about excess deaths when comparing Florida to the hot states and old states? Florida still doesn’t look great. From May 1 to Aug. 20, Florida’s excess deaths totaled 9.1 percent. The other old states averaged 8.6 percent and the hot states, 7.3 percent. It’s easy to dismiss the numbers as being fairly close, but they represent deaths, real people who really died from COVID, perhaps unnecessarily.

Of course, it isn’t a secret that Florida has lots of older residents. We all knew that fact going into the pandemic. But it wasn’t inevitable that Florida had to have a higher death rate because of its older population. Maine has an even higher percentage of older residents, and its death rate since the start of the pandemic is nearly half of Florida’s. It also has a much lower percentage of excess deaths. Yes, Maine is a much different state — less densely populated and its residents were more likely to get vaccinated and wear masks, for instance. The point is that demographics alone don’t have to be destiny. States and their residents have agency; their behavior can bend the death curve for better and for worse. When COVID finally passes, we would be smart to look hard at what worked and what didn’t.

One thing we know works: vaccines. They aren’t perfect and they won’t prevent everyone from getting the virus, but they keep large swaths of people out of the hospital and the morgue. Unfortunately, Florida lags in nearly every age group when it comes to getting a first booster, let alone a second. The state is ranked 46th in the percentage of 12- to 17-year-olds with a first booster, 44th in 18- to 64-year-olds and 46th for the 65 and older group, according to data from the Centers for Disease Control and Prevention. (Maine is ranked 2nd, 7th and 7th, respectively.) Florida’s failing grades don’t bode well going forward. Vaccines remain one of the the best tools to avoid dying from COVID, but too few Floridians are availing themselves of the boosters. Could Florida’s comparatively weak vaccination rate be playing a role in the state’s summer spike in the COVID death rate? Time — and more research — will tell.

None of this is to say that the state needs to lock down businesses or close schools. The state is way past that, and for the better. But as COVID spikes, residents have effective tools: get informed about the prevalence of COVID in your community, wear an N95 mask in crowded indoor spaces, and social distance, if it’s appropriate for you. For those who say omicron is no worse than the flu, who wants the flu? And if you knew you’d get the flu if you didn’t wear a mask in certain situations, wouldn’t you wear one? And none of this takes into account long COVID, which is an ongoing concern.

It seems that the state’s leaders have adopted a “don’t say COVID” mindset. The state needs much better and more consistent messaging from the governor and other state leaders on the importance of vaccines. Gov. DeSantis and Florida Surgeon General Joseph Ladapo rarely mention vaccines or the pandemic anymore even as it kills scores of Floridians every day. They want to put COVID in the rearview mirror, but it keeps showing up in the backseat. Residents should get vaccinated and then get the boosters, too. They save lives. Do it for yourself. Do it for Florida. Why shouldn’t the great state of Florida be able to outperform Maine?

Editorials are the institutional voice of the Tampa Bay Times. The members of the Editorial Board are Editor of Editorials Graham Brink, Sherri Day, Sebastian Dortch, John Hill, Jim Verhulst and Chairman and CEO Conan Gallaty. Follow @TBTimes_Opinion on Twitter for more opinion news.