Four weeks after the governor lifted all restrictions on restaurants and other businesses, Covid-19 cases are again rising in Flagler County and Florida, mirroring on a smaller scale a surge cascading across the country and sparing few states as officials speak of a third wave of the pandemic on the cusp of the holiday season.
Cases have increased for the third week in a row in Flagler, with some 200 cases in the last two weeks and 53 cases in the last two days, according to the state Department of Health.
County officials have regularly boasted about Flagler’s numbers remaining low, relative to other counties in Florida. But Flagler’s seven-day average has not been that healthy in recent weeks. If, in cumulative numbers, the county had the lowest case-to-population ratio, its recent averages have been a different story. Last week Flagler’s seven-day average placed it 22 counties from the bottom, with the 45th-worst ratio out of 67 counties. As of Thursday, it had risen sharply to 26th-worst, and still rising: the calculation doesn’t include the cases added today.
Unlike the summer surge, when cases struck mostly younger people, keeping the median age of those affected in the 30s and 40s, new cases have been striking somewhat older people, with the median age in the 40s and 50s, raising concerns about a heavier mortality rate in weeks ahead.
“This is something that was talked about just a few months ago, that we’re concerned about the fall months because it’s getting cooler,” Flagler Health Department Chief Bob Snyder said today. “Holiday time, people heading indoors, it’s not the time to let our guard down despite the fact that people may be experiencing covid fatigue. This is not the time to be complacent, it’s just not. We are expecting a third wave, so let’s try to keep it minor.”
Flagler County last week crossed the 2,000-case cumulative total since the beginning of the pandemic, with 2,052 cases, including 15 non-state residents diagnosed locally. The median age of all cases since March has been 49, with a total of 167 hospitalizations and 37 deaths–well above the total of deaths by car crashes or by suicides in any single year in Flagler’s history. Based on last year’s figures, covid-19 is now the seventh leading cause of death in Flagler.
In Florida 16,544 deaths have been attributed so far to the disease. The Institute for Health Metrics and Evaluation projects that based on current standards–Gov. Ron DeSantis weeks ago lifted all restrictions on businesses in the state–the state’s death toll will reach 29,000 by Feb. 1–higher if mandates ease, lower by 3,000 if masks are worn universally.
Today, the nation set a new single-day record for confirmed coronavirus infections, topping 79,000 as hospitalizations have risen 40 percent in the last month. On Thursday, Florida saw its highest single-day total of new cases, 5,558, since Oct. 11, but the seven-day average has been more telling as it’s moved up steadily since late September, when it went as low as 2,200. It is now 3,300 and rising.
“How long has it been since we opened bars and restaurants?” Dr. Stephen Bickel, the medical director at the Volusia and Flagler health departments, said today, referring to the governor’s lifting all restrictions a month ago. Case numbers always lag a change in restrictions, as they did in June, a month after the governor lifted the lockdown in the state. “There’s a lot more socializing going on. You can’t wear a mask at a restaurant.” There are more birthday parties again, activities between children afterschool, social gatherings among adults: people converge with their masks on, but the masks don;t always stay on and the distancing narrows.
“Across the country what’s clear is that the cold weather is driving people indoors and that’s definitely having an impact,” Bickle said. That’s not yet the case in Florida, but it may be ahead. “The fall might be bad but that might be the last time we have a bad phase of it.”
Nevertheless, on Thursday DeSantis ordered visitation rules at nursing homes and assisted living facilities relaxed, allowing outdoor visitation regardless of whether the facilities have Covid infections. Currently in Flagler, nursing homes and assisted living facilities are largely covid-free after several facilities weathered a wave of infections among patients and staffers over late summer, Snyder said.
Indoor visitation at nursing homes and other facilities will still be tied to Covid infection rates of facility residents and staff members. The state changes will also allow children to visit long-term care residents, with the governor noting during an appearance in Fort Myers that children “aren’t particularly vectors.” If by “vectors” he means that a smaller proportion of children relative to adults has been infected by the coronavirus , the governor is accurate: The American Academy of Pediatrics reports children represent 10.3 percent of all cases reported in 49 in the 49
The changes came less than two weeks before the Nov. 3 general election, when voters will consider candidates — ranging from candidates for president to congressional and legislative seats — through a COVID-19 lens that includes how to balance a return to normalcy with public health and safety. Florida barred visitors to nursing homes and assisted living facilities in the spring to try to prevent spread of the deadly virus. But the DeSantis administration on Sept. 1 issued an executive order authorizing visitation to resume and providing broad guidelines that nursing facilities were required to follow.
While acknowledging the higher infection numbers locally, Snyder said there were more positive signs as well, such as the number of people hospitalized currently with a primary diagnosis of covid-19 at AdventHealth Palm Coast. That total fell to just two patients on Thursday, the lowest number since before the summer surge. “Wally even sent me emojis, clapping, because that is great news,” Snyder said of Wally de Aquino, the chief operating officer at AdventHealth. (The number was up to three this afternoon.) The number of people reporting to the hospital with covid-like symptoms is also trending down for now.
There have been no recent major outbreaks or superspreading activity. “Also on the positive side, the number of cases in our schools, students and staff members including teachers, are low,” Snyder said.
According to the school district’s report for the week ending Thursday, three students tested positive and two staffers did, the cases spread between Buddy Taylor Middle School, Flagler Palm Coast High School, and the district office in Bunnell. There are 12,200 students in the district, not including Imagine School at Town Center, the charter school.
But Snyder cautions about the weeks ahead. “With holiday time, I think it’s good guidance to avoid large crowds, keep holiday gatherings small and be careful,” he said. While the nature of the new cases don;t have a common thread, “it is community spread, it is out there, and our job is to catch it.” He described it as a “roller-coaster surge.”