Why Florida’s case and death toll is so bad during the delta surge

It’s no mystery what’s going on in Florida right now – or why.

The state is experiencing its worst wave of a pandemic. Last week, it averaged nearly 25,000 new cases every day. The previous record, in January, was around 18,000. More than 17,000 Floridians are hospitalized with Covid-19, another record; around 230 people die every day. Florida leads all states in the number of hospitalizations and deaths per capita.

The city of Orlando has urged residents to limit their water use, as the same liquid oxygen used to treat the water supply is used to provide air to Covid-19 patients. The Florida Department of Health has asked the federal government to send in more ventilators as the number of hospital patients soars – a request Gov. Ron DeSantis, who has staked his political reputation on his laissez-faire response to the pandemic , claimed to know nothing.

In recent days, cases may have started to level off, increasing “only” by 11% in the past two weeks. But it is difficult to be sure because the tests are insufficient: nearly 20% of the tests come back positive in the state. Experts say that number should be 5% or less to be sure most cases are detected.

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For most of the past year, Florida has looked like a success story for people who have argued for a less restrictive response to Covid-19. Its case and death rates were not significantly worse than other states that were more aggressive in imposing masks or shutting down businesses.

So why is Florida having its worst outbreak now, 18 months after the start of the pandemic, when vaccines are widely available?

In some ways, what’s happening in Florida now is a microcosm of the current wave across America: an average vaccination rate has collided with a more contagious version of the virus. And it does so in a state where political leaders continue to insist that people act as if the pandemic is over – even though more people are dying every day than at any time in the past year.

Florida is inundated with new Covid-19 cases and hospitalizations

About half of Florida residents, 52 percent, are fully vaccinated, according to data from The Times. It’s not great – Mississippi and Alabama are currently in last place, with less than 38% – but it’s not great either. The Sunshine State is 25th among states for vaccination rate.

Florida is not a monolith; some communities have much higher levels of protection than others. Case levels are changing accordingly, with less vaccinated areas more widespread. In counties with more than 1,000 new cases per 100,000 population, vaccination rates stalled in the 1930s and 1940s.

Counties with vaccination rates of 60 percent or higher are still experiencing good spread. But it is significantly less, sometimes more than half, than the most disadvantaged areas, according to state data. The less vaccinated counties were the source of the current wave.

“Poor immunization coverage is a big part of this,” Cindy Prins, an epidemiologist at the University of Florida, told me.

Chandan Khanna / AFP via Getty Images

The now dominant Delta variant has also made matters worse as it spreads more efficiently than previous iterations. It also appears to cause more virulent illness, which is likely contributing to the record number of hospitalizations.

Different age groups also have different degrees of protection against the delta variant. Nearly nine in ten Floridians over 65 are vaccinated, offering a high level of protection to those most vulnerable to Covid-19 disease.

But less than 60% of people aged 30 to 39 are vaccinated, as are less than 50% of people aged 12 to 29, according to state data. A lot of young people in Florida are totally vulnerable to the delta variant, and some of them get very sick. A hospital system serving central Florida reported last week that half of its patients currently hospitalized with Covid-19 are under the age of 40.

Hospitals are feeling the pressure of the current wave. According to the Florida Hospital Association, only 7% of the state’s intensive care beds are currently available, and more than half of people currently hospitalized in the state’s intensive care have Covid-19.

“Several hospitals had to procure and ask for more [ventilators], and oxygen deliveries continue to be a challenge, ”FHA spokesperson Savannah Kelly said in an email.

Governor Ron DeSantis’ pandemic strategy is put to the test

DeSantis, who has clear presidential aspirations in 2024, has positioned himself and his state’s response to Covid-19 against the public health establishment throughout the pandemic and, more recently, the Biden administration .

Although he, like most governors, closed many businesses last spring, they were allowed to reopen in May 2020; DeSantis categorically refused to consider further closures in subsequent waves in summer and winter. He ended the state’s mask warrants on May 4, 2021, before the CDC changed its own masking guidelines, and he has resisted calls to reimpose them even as cases rose again.

The governor tried to prevent local school districts from setting their own mask mandates for the new school year and threatened to withhold salaries from any official who implemented a masking policy. Some school districts are moving forward anyway. He also opposed companies requiring vaccines for their employees or customers.

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Experts said state policies, which have signaled to vaccinated and unvaccinated people that it is normal to lead their normal lives, are making it easier for the virus to spread.

“There are still a large absolute number of unvaccinated people, relatively few people practicing social distancing or masking, by choice and also due to the lack of policies obliging them,” Joshua Michaud, associate director of policy Global Health at the Kaiser Family Foundation, told me. “Schools and universities are resuming their sessions and many delta introductions in the state are all happening at the same time.”

The situation has led to a kind of theater of the absurd, with DeSantis fighting local mitigation measures while promoting new treatments for people who fall so ill they need to be hospitalized because of Covid-19.

Florida’s pandemic failures are a microcosm of America’s struggles

Florida, like much of America, was betting the pandemic was behind it – and was wrong. Previous experience may have lulled the state into a false sense of security, unprepared for the aggressiveness of the delta variant.

As I reported last year, Florida has enjoyed structural benefits to slow the spread of Covid-19. It is less densely populated than a state like New York, with more single-family homes, reducing the chances for people to have contact with others and potentially spread the virus. The weather is warmer, making it easier for people to stay outdoors, where the virus is less easily transmitted.

At the end of last year, there wasn’t much of a discernible difference between the number of cases and deaths in a state like Florida, with its relaxed approach to Covid-19, and a state like California which was much more proactive. This gave credit to the DeSantis and other conservatives case, that public health experts were too aggressive in trying to regulate people’s behavior, with little obvious benefit.

But then Florida’s vaccination rates lagged and the virus evolved to be more infectious. The stage was set for another devastating wave.

It’s the same story across the country. Florida is surrounded by states – Mississippi, Louisiana, Alabama, Georgia and South Carolina – with below-average vaccinations and few official restrictions that are currently experiencing some of their worst weeks of Covid-19.

Emily Kask / AFP via Getty Images

People are also returning to their lives. Walking and driving activity surpassed pre-pandemic baseline in Florida, according to mobility data from Apple, and public transportation is back to near normal levels after a sharp drop last spring .

It’s not hard to see why. The federal government appeared to signal the end of the pandemic a few months ago, with more relaxed masking guidelines and Biden’s White House adopting July 4 as a kind of national reopening, before the delta variant returned.

The new wave of cases across the country has forced many state and national leaders to revise their public messages. Vaccines still offer strong protection against the more severe symptoms of Covid-19, but more caution may be warranted given the high level of spread in the United States. Experts are urging people to wear masks in public again and to consider avoiding large gatherings, especially indoors.

DeSantis has stood firm against new interventions, despite record cases and hospitalizations, following the same playbook it has stuck to throughout the pandemic. Yet Florida is paying a high price for its struggles to vaccinate people and maintain vigilance against the virus. Almost 43,000 Floridians have died in total during the pandemic.

Even if the latest wave hits a plateau, there are still tough weeks ahead – in Florida and across America.