Exponential growth of coronavirus infections had appeared in national numbers between late January and mid-March. That sort of growth now appears to be affecting Florida, where the Department of Health overnight announced 39 new cases, for a total of 100. On Friday, the department had announced 15 new cases. On Saturday it announced one death in Lee County and 25 new cases, none in Flagler County.
The absence of cases recorded in Flagler does not mean that the virus is not in the community. It merely means that no one who has been tested for it has tested positive locally, assuming anyone has been tested. The local health department, under orders from the state Health Department, is not disclosing how many people have been tested. Nor is it disclosing how many people are under monitoring for potential exposure in the community. Physicians who refer patients for testing and get a positive result are required by law to disclose the results to the department of health.
Governor DeSantis on Saturday ordered the expansion of the prohibition of “all visitation to nursing homes, assisted living facilities, adult family-care homes, long-term care facilities and adult group homes to all visitors for the next 30 days,” according to the health department. In a break for drivers whose licenses are expiring, they will have an extra 30 days to do so. The recommendation to cancel all large gatherings targets gatherings of 250 people or more.
Local churches with large congregations, such as Santa Maria del Mar Catholic Church, was continuing services as scheduled, but with communion “received in the hand only,” according to a church notice. Holy water has been removed from parish grounds. Similar measures apply through the Diocese of St. Augustine. Churches like Palm Coast’s First United Methodist have taken to quoting Isaiah (“Be careful and stay calm. Don’t fear, and don’t lose heart”). The church is offering services but cancelling all small-group and community meetings for two weeks. Like many churches around town, First Baptist Church was holding its Sunday services and making them available live on Facebook. (“I have missed this so much! Thank you so much for doing this. Not being able to drive and get out a lot I truly appreciate this,” one resident responded.) First Baptist Church’s sermon topic today: “A Pandemic Response.”
The World Health Organization declared the coronavirus outbreak a pandemic earlier this week.
“Cases of COVID-19 and instances of community spread are being reported in a growing number of states,” the Centers for Disease Control states in its situation summary today. Community spread means that infections are not being traced to travelers but to residents who are spreading the virus, usually unknowingly. The three states currently experiencing significant community spread are California, Washington and New York.
The virus has an incubation period of up to 14 days, with a median incubation period of four days, according to the latest study based on cases in China. Because of the lack of testing capacity in Florida, and the slow pace of testing when it is available, infections have been more rampant. The state is promising more readily available testing beginning Monday.
Exponential growth in infections is seen across the country. The first case of Covid-19 was diagnosed on Jan. 21. It took a week for the number to rise to five, with the numbers essentially doubling each week: 14 on Feb. 11, 25 on Feb. 18, then 59, 125 and 1,004 in the three weeks to March 10. In the five days between March 10 and today, the number has risen past 3,000, with 60 deaths so far across the country, and four in Florida. The virus has claimed 6,000 lives worldwide, with 162,000 cases so far, with 76,000 recoveries.
The New England Journal of Medicine study based on cases in China notes that the median age of infections is 47, with men affected more readily than women (the rate of infection for women was 41.9 percent), and 0.9 percent of patients being younger than 15. The most common symptoms were fever (*in 44 percent of patients) and cough (in 68 percent). But fever eventually developed in 89 percent of patients. Of all patients under study, 24 percent had a co-existing illness such as hypertension or obstructive pulmonary disease.
The numbers the Florida Department of Health is releasing continue to be sketchy: it continues to claim, as it has for days, that there are 221 pending test results, that 1,413 people have been “monitored” to date, that 365 people are currently being monitored–but the department won’t say where–and that 478 tests that have been administered have returned as negative. Extrapolating from the numbers the department is releasing, that means fewer than 700 Floridians have been tested–a disturbing indication of what likely lies ahead when testing does ramp up.
Adam Kucharski, a mathematician at the London School of Hygiene & Tropical Medicine who uses math to understand outbreaks of diseases and has just published “The Rules of Contagion” in Britain, told The New York Times: “One signal to watch out for is if the first case in an area is a death or a severe case, because that suggests you had a lot of community transmission already. As a back of the envelope calculation, suppose the fatality rate for cases is about 1 percent, which is plausible. If you’ve got a death, then that person probably became ill about three weeks ago. That means you probably had about 100 cases three weeks ago, in reality. In that subsequent three weeks, that number could well have doubled, then doubled, then doubled again. So you’re currently looking at 500 cases, maybe a thousand cases.”
He also notes that fatality rates are deceptive when looked at whole–and when the coronavirus may have a much higher fatality rate among the elderly than it does on average.