COVID-19 Setting Death Records in Florida

For six weeks COVID-19 cases have been surging in Florida but the governor has insisted that it was not a problem because Florida was testing more and revealing more mild and asymptomatic cases.  Then when the percentage of positive results started to rise 5 weeks ago from 4% toward 20% recently, he conceded that community spread is occurring but it was mostly among younger adults who will not require hospitalization or stress Florida’s health care system.  When hospital usage started to surge 3 weeks ago, he claimed that Florida has plenty of hospital beds and very few people will die.  Now, this week, death counts have been rising and setting new 7-day rolling average highs every day (see figure below).  He is still resisting healthcare experts’ calls for instituting more mitigation measures ranging from mandating mask usage to rolling back reopening steps, to statewide lockdown.  Even Texas Governor Abbott has conceded that a lockdown is possible if the virus continues to grow unchecked.   

What are the prospects for the next couple of months for Florida?  The rise in deaths this week results from widespread flouting of CDC guidance for masking and social distancing beginning 6 weeks ago on Memorial Day weekend.  That led to the surge in confirmed cases 5 weeks ago.  Deaths now appear to lag diagnosis by about 4 weeks due to the availability of widespread testing (however testing delays now will probably shorten this lag time back to 3 weeks).  So we already know that death counts will continue to rise for the rest of July (see dashed line in the figure above) due to all of the diagnosed patients in the pipeline: hospitals, ICUs, and ventilator users.  The case fatality rate (CFR = deaths/cases) in July will be lower than it was in the spring due to the lower average age of infectees, dropping from above 4% to below 2%.  However, this positive trend may have reversed:  the age distribution of new cases that had dropped the median age of new cases from 45yrs old to 33yrs old 3 weeks ago is now 40yrs old (the detailed age distribution published by Florida for new cases looks exactly like that for existing cases).  This reflects the fact that young adults who got infected in bars and beaches go home and interact with parents and grandparents and transmit the disease to them.  So based on what has already occurred, FL death count will at least double that recorded this past Spring.   

What will happen to Florida’s confirm case count for the rest of this month and August?  To gain an insight into this question we had looked at the similarity between the current outbreak in FL compared to the earlier outbreak in New York (NY) 3 months ago.  The figure below shows that Florida’s outbreak has tracked NY’s remarkably well except that FL started at a higher base infection level. 

 

The other major difference is that early along NY’s exponential outbreak, the NY governor (along with the governors of NJ and CT) imposed a statewide lockdown on March 23^rd.  Three weeks later NY’s outbreak topped out and started to improve and get under control.  Florida is now near that NY top but will FL break its fever naturally as some lockdown skeptics have suggested?  We find no reason to be optimistic.  While certain cities and countries in Florida have imposed mandatory mask-wearing and rolled back the reopening of bars, indoor dining, beaches, etc.  the state as a whole has not.  Moreover, some counties are continuing to reopen further against the advice of health experts.  Disney World reopened today, and MSL and NBA and AAU Volleyball are restarting this month in Orlando.  The Republican Convention is still scheduled for Jacksonville next month.  All of these actions will exacerbate rather than mitigate the spread of the pandemic.   If the governor really feels that reopening K-12 schools in August is important for the welfare of the children and their parents, it is imperative that the state government takes strong action now to mitigate the rise in cases so that schools can reopen safely.