Will Florida and USA See Another Surge in COVID-19 cases this Fall?

Daily COVID-19 new cases, hospitalizations, and deaths have been falling for several weeks in Florida along with that for the USA as a whole.  The pandemic in the USA has not burned out and many states in the Midwest are experiencing flare ups.  In Florida, the daily new case count after falling for 6 weeks has just flattened out this week at a level 5 times higher than in May when Florida first tried to reopen (see figure below).  


This has not deterred the governor from doing his second COVID-19 victory tour and encouraging counties to resume reopening, nursing homes to accept visitors, residents to celebrate Labor Day, and schools to reopen for physical classes and team sports. Will an early victory dance and complacency encourage the virus to surge again this fall in Florida and the USA?  

The governor is betting that kids can go to school safely because they are less likely to get infected than adults.  We have shown that this is not true especially given the rebellious nature of teenagers.  A further assumption is that when they do get infected few will die from it.  This is true although the corollary that they will not suffer severe long term health damage is probably not true.  While only 0.02% of kids 17 and under die from COVID-19, 1.2% of these young people do require hospitalization.  Finally, the assumption that child-to-adult transmission is less likely than adult-to-child transmission is controversial. 

The data show that children can and are getting more infected throughout the country as schools reopen.  In Florida, the earlier resurgence saw thousands of young adults get infected as they celebrated in bars and attended other large gatherings.  The median age of new cases dropped to 33 in June from 45 in April (see figure below).  


As the younger adults transmitted the disease to older adults at home and in the community, the median age increased back to near 44 in August. Now we are seeing the pattern repeat as kids go back to school.  In the first 5 days of September more than a thousand school-age kids in Florida have been infected along with hundreds of college students.  What is not clear yet is whether these younger kids going home to generally younger parents and grandparents will transmit as seriously as the young adults did in earlier.  We are betting that while it will not be as bad it will nevertheless contribute to a second resurgence in hospitalizations and deaths.  Thus we may never experience a real respite from the pandemic as a potential true second wave comes along with seasonal flu this winter.  

A second resurgence or a third peak is still avoidable.  As long as people continue to wear masks, and practice social distancing and good hygiene, the virus spread can be mitigated.  Governments and institutions such as colleges and businesses need to provide easily accessible and timely testing as well as effective contact tracing and selective isolation facilities.  However, if the government claims victory too early again, and continues to send mixed messages about masking, social distancing, and testing, the odds are on the virus’s side. 

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