What went wrong in the face of the Florida pandemic – 8/29/2021 – world

The unexpected and unwanted coronavirus epidemic currently on the rise in the United States has hit the states that have been slow to adopt vaccination hardest. Florida is one example.

While that state’s rulers have also refused lockdown and mask-wearing orders, they have made vaccinating vulnerable elderly people a priority. Gov. Ron DeSantis (Republican) opened mass vaccination posts and sent teams to retirement communities and retirement homes. Young people also lined up to get vaccinated.

DeSantis and public health experts had expected an increase in cases this summer as people huddle inside and are air conditioned. But what happened was far worse: The cases spun out of control, peaking higher than Florida had ever seen. There have been many hospital admissions and deaths in significantly higher numbers than those currently affected anywhere else in the country.

“This is a very sad time for all of us,” said Natalie Dean, a biostatistician at Emory University who until recently worked at the University of Florida and closely followed the state’s pandemic. “It was really hard to imagine we were going to get back to this point.”

The situation in Florida is a warning on how to deal with the current embodiment of the coronavirus. The United States has used vaccines as a basic weapon against the pandemic. But Florida shows that even a state that has made a major vaccination effort – it ranks 21st among states and the Washington Federal District, which have vaccinated people of all ages with at least one dose – can be crushed. by the delta variant, reaching frightening proportions. hospitalization and death rates.

“Obviously, vaccines keep most people out of hospitals, but we’re not creating the herd immunity that people expected,” DeSantis said at a press conference last week. . “There is a huge percentage of people – adults – who have been vaccinated, but we still had a wave.”

The morgues and crematoriums are full, or close. The Orlando and Tampa utilities have asked residents to reduce their water consumption so that liquid oxygen, which is used in water treatment, can be saved for hospitals. As of Friday (27), Florida recorded an average of 242 deaths from the virus per day, almost as many as California and Texas combined, although some states still have a higher percentage per capita, according to public health data analyzed by The New York. Times.

Florida pandemic data, more sparse since the state ended the declared Covid-19 emergency in June, reveals only limited information on who dies. Hospitals said more than 90% of their patients were unvaccinated. The exact reason the state has been hit so hard remains a problem. Other states with comparable vaccine coverage have a small fraction of Florida’s admission rate.

The best explanation for what happened is that Florida’s vaccination rates were good, but not good enough for its demographics. There are so many elderly people that, although the vast majority have vaccinated, more than 800,000 have remained unprotected. Immunization rates among young people were uneven, so groups of people continued to be at risk. Previous waves of the virus, which were milder than in some other states, only partially provided natural immunity.

And Florida is Florida: People spend many months socializing at bars, parties, and travel, activities that promote the rapid spread of the virus.

Unlike places like Oregon, which are re-enacting restrictions including wearing masks outdoors, DeSantis continues to stay the course, hoping to gain traction despite the devastating human toll. A Quinnipiac University poll released last week found DeSantis’ approval rating to be 47%.

He and other state officials tried to avoid measures that could have reduced infections, such as strict orders to wear masks in public schools. Larger school districts enforced them anyway, and a state judge on Friday ruled Florida couldn’t stop the orders; the education ministry plans to appeal the decision.

Florida has seen more deaths than usual – from all causes, not just Covid-19 – during the pandemic. In the first weeks of 2021, with the increase in cases and the start of vaccination, the state recorded an average of 5,600 deaths per week, about a third more than the typical number for this period of the year. year, according to figures from the Center for Control and Prevention of Diseases (CDC). The deaths fell and then rose again.

These excess deaths are important because a number of deaths from Covid occur outside of hospitals and also because the virus can contribute to deaths from other causes due to overloading the healthcare system.

In the first week of August, the state recorded an additional 5,600 deaths. But as death rates typically decline during the summer months, the number was more than 50% above average.

The situation in nursing homes for the elderly, where infections can spread quickly, was also problematic. While immunization rates among seniors in Florida were generally good, the rate of residents in these fully immunized homes – an average of 73.1% in each household – is lower than in all states except the United States. Nevada, according to the CDC. About 47.5% of nursing home workers were fully immunized by August 15, the lowest percentage of any state except Louisiana.

The elderly are also more likely to have immune deficiencies and comorbidities, which makes them more susceptible to general infections and hospitalizations, said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco. And some data, but not all, suggests that immunity to infection has decreased in the vaccinated elderly; the Biden government has indicated that these people will be on the front lines for booster vaccinations.

Then there are the younger ones, who now account for a higher percentage of Florida virus deaths. Before June 25, those under 65 accounted for 22% of deaths. This proportion has since increased to 28%.

Fifty-six percent of people ages 12 to 64 in Florida’s top ten counties are fully immunized, according to national figures. But in the rest of the state, that number is only 43%, and in 27 counties, less than 1 in 3 people in this age group are fully vaccinated.

Child deaths remain rare and those of young adults and middle-aged people have become routine.

“My mother had no previous illnesses – she was as strong as an ox,” said Tre Burrows, whose 50-year-old mother died of Covid-19 on August 7. “There was literally nothing wrong with it. It came out of nowhere.”

Cindy Dawkins, a mother of four who worked at a restaurant in Boynton Beach, started to feel bad right before her birthday as the family were on their way to celebrate in Orlando. Dawkins developed a cough and shortness of breath. Four days later, he went to the hospital. Doctors put her on a mechanical ventilator, but she died within 32 hours.

Her son said she was not vaccinated because she feared possible side effects.

Those who have not been vaccinated are only part of the explanation behind the new outbreak. Many states attacked by the virus have already developed deep reservoirs of natural immunity against previous infections, allowing them higher levels of protection than would be evident from vaccination rates alone.

This did not happen in Florida. Compared to other states, Florida has been spared the devastating wave of winter cases that hit other parts of the United States – in part because the milder climate has allowed people to congregate in the outside. It was good for the state’s economy and its political leaders, but a problem in the summer, when the state didn’t lean on the same wall of natural immunity that now helps protect places infested with virus this winter.

Additionally, the hot weather pushed people inside and attracted hordes of tourists, creating the conditions for the delta to expand. Despite the focus on vaccines, the scientists said, the trajectory of the virus remains heavily dependent on the number of people, where they congregate and the precautions they take.

For other states whose residents will be sheltered indoors when the temperature drops in the fall and winter (starting in September), Florida offers an important lesson, Dean said: Just like the start of the pandemic, admissions in the hospital must be contained.

“The least we should be able to do is keep that number low so as not to overwhelm the healthcare system because it doesn’t just affect Covid patients, it affects everyone,” she said.

And policymakers, Dean said, need to understand that vaccination rates need to be higher than previously thought to control a more contagious strain of the virus.

“Things can get out of hand,” she said. “I think it could happen in other states as well.”

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