Spike in new coronavirus cases 'inevitable,' experts say. Is Florida prepared?
On Saturday, the day after Phase 2 of Florida’s reopening began, the number of positive tests for the novel coronavirus spiked above 1,000 for the fourth day in a row.
In fact, state data shows a small but steady rise since April 28, just days before Gov. Ron DeSantis signed an executive order declaring a partial Phase 1 reopening, allowing restaurants to reopen at 25% capacity.
Among other operations, now bars, bowling alleys and theaters — not exactly set up for social distancing of 6 feet or more — are free to resume business in 64 of the state's 67 counties. South Florida, where the pandemic hit hardest, is excluded.
So did Florida jump the gun on reopening?
“Yes,” says Julie Swann, head of the Edward P. Fitts Department for Industrial and Systems Engineering at North Carolina State University in Raleigh.
“We are seeing in many cases an increase in transmissions,” said Swann, a science consultant for the Centers for Disease Control and Prevention during the 2009 H1N1 flu pandemic. “This was expected because the pandemic is ongoing. It was inevitable.”
For the last three days in a row, the number of confirmed cases in Florida has been over 1,000 — correlating each time with an increase in the number of test results processed. The percent of positive results over the last two weeks has ranged from 4% to 8%, according to Florida Department of Health data.
The big question is whether the state is prepared for what is likely to be a new surge, or several localized "microsurges," as Florida reopens, according to Swann. She's advising public officials in North Carolina on the coronavirus outbreak and has collaborated on plans for infectious disease outbreaks.
Rural areas with nursing homes, prisons and meat-packing plants may be particularly prone to microsurges as the people who work in those places are exposed to the coronavirus and transmit it to their families and friends, she said.
“People on holiday run the risk of contracting COVID-19, and spreading it around their community when they get home,” Swann said. “There is no better recipe for disease transmission. In the next week or two, I would expect cases to increase."
Tourists are more of a concern than the widescale protests over the killing of George Floyd, she said, while noting that COVID-19 has affected a disproportionately larger share of blacks and Latinos than whites. Racism is a public health risk, she said.
“Being pepper-sprayed and coughing can spread the virus,” she said.
Florida Emergency Management Director Jared Moskowitz said the state is ready to respond to any increase in cases as well as any potential hurricanes or tropical storms, stockpiling protective gear, extra ventilators and temporary hospitals on standby.
The Atlantic hurricane season began June 1.
Testing has been a priority of the DeSantis administration since a public health emergency was declared March 1.
More:Coronavirus Florida: Gov. DeSantis moving most of state into 'Phase 2' reopening
Indeed, testing has ramped up, with more than 1.1 million people tested in Florida. More than 300,000 of those people were tested at mobile sites run by the Florida National Guard. Teams have also gone into nursing homes to test residents and staff.
The Division of Emergency Management has partnered with Publix and Quest Diagnostics to run mobile testing sites across the state. And the Department of Health has more than 1,000 people engaged in contact tracing, as well as working with the CDC to establish mechanisms for monitoring and coordination of epidemiological investigations.
The department also has begun antibody testing and will begin providing weekly updates on those results.
Currently, Florida’s coronavirus risk is moderate, said Dr. Leo Nissola, a medical doctor and immunology scholar who is the health advisor to Covid Act Now, which provides projections on infections, death rates, and hospital capacity at the national and state level.
“The positive test rate at 3.5% (for Florida) indicates that testing is still limited,” Nissola said.
On the plus side, he noted the state has about 6,059 intensive care beds, and based on the latest occupancy numbers, “there’s the capacity to absorb a potential new wave of COVID-19 infections, in case such patients require intensive care.”
That was the goal of the one-month lockdown, DeSantis has said several times, asserting that Florida successfully flattened the curve. The state defied early projections that hundreds of thousands would have to be hospitalized if no action was taken, he's also said.
More:Gov. DeSantis: Florida bars, movie theaters can reopen at 50% capacity on Friday
That’s why public health officials recommended sheltering in place, Nissola said, “to slow the spread and make sure we are prepared to take care of patients who needed hospitalization and that our healthcare system did not overload.”
As the economy reopens and more people begin to interact at gyms, restaurants, and elsewhere, it’s natural to see an uptick in the number of infections, he added.
“And there’s evidence to support that the more COVID-19 infections a country has, the worse its economy performs,” he said.
Several things can push the infection rate up, said Cindy Prins, a clinical epidemiology professor and director of the Master of Public Health Program at the University of Florida:
- More people who are asymptomatic are suddenly being identified through increased testing.
- Isolated areas of very high risk, like nursing homes and prisons, are undergoing more testing.
- Increased community spread of COVID-19 as people venture out of their lockdowns.
“I’m not exactly sure of the cause of the bump over the last three days but I am very concerned that it’s due to people engaging in more high risk behavior,” Prins said. “The state is opening in phases and small steps and promoting safe behaviors, but I see more people interacting as they did before the pandemic; in close proximity to others and without wearing masks.”
More testing is needed to ensure that anyone with symptoms gets tested, people they come into contact with get tested, and then anyone who has high potential to expose others, such as nursing home personnel, are getting tested regularly, Prins said.
After that, she said it would be ideal to have voluntary testing of people who don’t have symptoms as the state continues to open up, “to help control the spread from those who are asymptomatically infected.”
People cannot stay confined to their homes forever, Swann said.
“Individually, people have to evaluate the risks they are willing to take,” she said. “We take risks every day, whether we drive our car or walk to work.
"We have to balance our own vulnerabilities and comfort with what we need to do. Everyone has to look for a new normal.”
Contact Jeff Schweers at jschweers@gannett.com and follow him on Twitter @jeffschweers.
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