Bob Snyder, who heads Flagler County’s health department–a state, not a county, agency–is almost always among the cheerier, more positive public officials in the county, whether he’s turning a school into a special-needs shelter ahead of a hurricane, anchoring the county’s public health response to the coronavirus pandemic, or making one of his many appearances on the radio or at town halls to explain the latest twists in the Covid emergency.
Not this morning. Speaking of the latest numbers in Florida and Flagler, Snyder was more subdued than he’d been before, if not audibly downcast. He had reason to be. The latest numbers, shattering the record for new infections and compounding already dismal numbers day after day for the past two weeks, are a grim reflection of the consequences of Florida’s rapid and largely haphazard and careless reopening of society and the economy since the end of April, and of dangerous complacency among residents.
Florida added a record 9,000 new cases Thursday, according to numbers reported today, on a day that also recorded a record 71,000 tests. But despite the higher level of testing, the positivity rate among those tested was over 13 percent, pointing to rampant infections. Flagler County added another 13 cases today, for a total of 50 in the last six days. The percentage of people testing positive is also skyrocketing in the state and locally.
The number of people across Florida going to emergency rooms and urgent care centers with influenza-like and Covid-like symptoms is shooting up. For Covid-like symptoms, it’s more than doubled from under 3,000 in the week ending May 31 to nearly 6,000 in the week ending June 14, according to the health department’s latest figures, and that was before the current surge in cases began.
After the numbers were announced Friday, the Department of Business and Professional Regulations, which licenses and regulates restaurants and bars, announced in a tweet and an emergency order that it was “suspending on premises consumption of alcohol at bars statewide” effective immediately. The rule applies to all businesses that derive more than 50 percent of their revenue from alcohol sales. (Read the emergency order here.)
“The data here in Flagler County reflects what’s happening in the state of Florida everyone,” Snyder said this morning. “Quite an increase, quite a surge, and the surge has been happening now for a couple of weeks,” he said. “We were not seeing the surge here in Flagler, but over the last seven days we have,” with an increase in actual cases and in positivity rate, meaning the rate at which people who are tested test positive for the disease. Two weeks ago that rate in Flagler was 1.4 percent. On Thursday, it was 10.6 percent. “So we’ve definitely had an uptick like the state and the counties surrounding us.”
If anything, the higher positivity rate suggests not enough people are being tested, leaving it to hundreds of thousands who may be infected to be spreading the disease unknowingly. “If there’s more Covid around and we’re testing the same number” as when the positivity rate was low, said Stephen Bickel, the health department’s medical director in Flagler and Volusia, “our positivity rate might jump up to 5, 10 percent, it doesn’t mean we’re under testing, and it doesn’t mean there’s anything changed with the test, it means more people now have it, so we’ve got to be ready for just an onslaught of people coming in for testing either from anxiety or more symptoms, to make sure we don’t under-test. Positivity rate is basically an indicator of under-testing. If it’s getting too high, it means you’re not testing enough.”
One of the reasons the department is intent on ramping up testing is to detect the more asymptomatic carriers to find out that they are, in fact, carriers: they are the most dangerous carriers, because they don’t know they have the disease and may be behaving more indifferently than safely–like not wearing masks or social distancing.
The health department and the county have picked up renewed interest in testing locally, at two sites–the health department and the site at the Palm Coast campus of Daytona State College, run jointly by the county and the health department. (You can set up an appointment for a test by calling 313-4200.)
When the surge began, Gov. Ron DeSantis and other politicians inaccurately attributed the rise in new cases to an increase in testing. While the increase did account for some of the rise, it was not the main reason: other states, like New York, are testing at far higher rates but not seeing anywhere near the number of cases Florida is. The new cases were and continue to be a result of community spread–the fact that people are spreading the disease unaware, through careless or minimized safety measures, or because they consider wearing masks an infringement on their personal liberties, though the wearing of masks is intended primarily to protect others from catching the disease, not to protect the mask-wearer.
Only a few weeks ago Florida’s governor was making triumphal statements about Florida’s ability to keep the disease in check while condescending to states like New York and New Jersey for their higher numbers. He maintained the triumphal approach as he rapidly reopened the economy while refusing to mandate safety measures such as masks. After Florida had initially dodged the worst of the pandemic, residents interpreted the reopening, as proof that the state was in good shape and that they could relax. They did, with even mask-wearing turning into a political issue.
Roles have now reversed: Florida’s experience is beginning to approximate the numbers New York experienced in the spring, albeit in a more widespread fashion. There’s no mystery why Florida has become the nation’s leading hot spot, with Texas and Arizona close behind.
“The community spread is increasing just like it is statewide,” Snyder said. “Up to 50 percent of the people are asymptomatic, but because the community spread has increased because we’ve opened things up, mobility has increased, and when that happens and behaviors like facial mask wearing and social distancing is not being adhered to, you’ve got like the perfect stew for community spread to increase, and that is exactly what we’re seeing throughout Florida and here in Flagler.”
The Flagler health department and local governments continue to recommend the wearing of masks in public places, but they have also stopped short of making mask-wearing a requirement. “It’s one of the main actions and measures we can take to reduce the community spread. We’ve been preaching that for quite a while now,” Snyder said.
But the focus will also be more tactical: Snyder said today he is requesting 14 additional staff members to ramp up the community testing. He said he will be adding case investigators and contact tracers, who investigate every single individual who’s tested positive for Covid, tracing down his or her contacts to map out who the individual has been in risky contact with and where. Contact tracing, when rigorous, is one of the more effective ways to limit the spread of the disease by finding people who have passed it to each other and isolating them, thus stopping their infectious behavior. But it’s enormously time-intensive and requires a lot of manpower.
In further indications that the surge is taking a toll, Snyder said he will also be adding call center volunteers or employees. “So we’re just ramping up, boy, in this continued surge, uptick, and then of course with the fall months approaching, we’re concerned about the second wave, because we’re still in the first wave, and we’re still riding that roller-coaster, and it is ascending again to a new top level.”
Snyder said about 20 local governments around the state have mandated mask-wearing. “Food for thought there,” Snyder said. Asked if they should be mandated, Snyder responded immediately: “Absolutely.” He explained: “That is my belief as a public health professional, but I do not have the authority, neither does Dr. Bickel, to mandate it. That is the authority of elected officials and government leaders. But yes, I’m going to come out and say: absolutely, I feel it should be mandated because it is the right thing to do. But again, I do not have the authority as health officer to proclaim that and to make it happen.”
“To me it’s just indefensible to be arguing against masks,” Bickel said. “I would definitely mandate masks. I understand there’s political pushback, the leaders can’t get too far, untethered from their support base, and hopefully people will come around to this, but it’s like: this is not a time for vanity. This is not a time for pride. This is a time for getting the job done, and this is one of the few tools we have that we can employ population-wide that does not have all these other negative ramifications, like not letting people go back to school, the businesses struggling. So to me it’s just a no-brainer.”
The governor is resisting more stringent measures. He is maintaining Phase 2 reopening, saying only that there are no current plans to move to Phase 3 (though Phase 3 would be necessary to reopen schools and universities in August).