Flagler County Covid-19 cases are now up to 11, with two of the cases affecting two women–ages 65 and 30–who had recently traveled to New York, the pandemic’s epicenter in the nation. Florida coronavirus cases have surged to 2,900, with 34 deaths, a sharp increase in fatalities in the last few days.
The testing rate in Florida, including Flagler, remains among the lowest in the nation despite this week’s ramped up testing in a few parts of the state. In Flagler, 101 tests had been completed as of 5 p.m. Thursday, with eight positive, according to Department of Health figures. Five of the cases affect Palm Coast residents. One of those cases has resulted in hospitalization. Earlier this week the health department said one of the cases affects a Flagler resident who is being treated in a different county.
Florida as of Thursday had conducted 27,500 tests, but that was still among the lowest rates in the nation, at 128 tests per 100,000 people. It’s the 16th-lowest level of testing in the nation. Arizona is last, at 13 tests per 100,000. New York is leading the nation, at 627 tests per 100,000 people, and 37,258 total cases. As the number of people tested nationally for coronavirus has surged–it doubled from Wednesday to Thursday, to 146,000 tests in a single day–so has the number of people testing positive. That number is expected to cross the 100,000 mark today.
And with infection numbers rising locally and across the state, and indications of less rigorous adherence with social distancing rules, Jonathan Lord, the county’s emergency management chief, hinted that more stringent restrictions could be ahead.
“If people continue to not follow” social distancing rules, he said, “then we will see much stronger restrictions coming down from the state or even potentially here locally.” He said the only way the spread of the coronavirus is through social distancing, however uncomfortable. “We really don’t want to have to put in measures, the state doesn’t want to have to put in measures,” he said. “We’re well aware of the impact it has on our local businesses, and are being very cautious, and I fully understand that. But at this point in time the public health needs are more important to keep our numbers as low as possible, especially in Flagler County.”
Counties on their own would have limited efficacy if they were to impose further restrictions on their own, “but I’m pretty sure there’s great efficacy if it’s done at a statewide, or larger level,” Lord said. “But for us to do with the amount of travel in between other counties, there would be limited efficacy with such a fluid, moving populace. But if the state did something like that, we would obviously have to enforce that and we would participate in that, and I think there could be a difference. Because we do see other states showing a difference in slowing their case numbers by doing so.”
If it comes to that, a lockdown would mean that only “essential workers” such as first responders, health care workers, public health staff and critical government staff would be allowed to circulate freely, along with a limited number of service workers and businesses such as restaurants, delivery people, grocery stores, pharmacies. Residents would of course still be allowed to make trips to those businesses for essential services.
With serious shortages in personal protective equipment, urgent preparations under way locally at many levels–government, health care, schools–reflect the sense that the emergency is still in its earlier stages and will be playing out over at least several more weeks. And they reflect what health and government officials have been learning rapidly from other communities where the rate of infection and hospitalization zooms upward, as it is still expected to do in Florida, if not in this region. The hospital, for example, is preparing for a surge of Covid-19 patients in several ways.
Summarizing the situation at AdventHealth Palm Coast on WNZF’s daily program on Covid-19 this morning, Chief Operating Officer Wally De Aquino said the hospital had set aside a ward for Covid-19 patients but that both the hospital in general and the intensive care unit were in solid shape. He said the big tent outside the hospital is not for Covid-19 testing, but for overflow patients who would not need more intense hospitalization, and that Palm Coast government is offering the use of the city’s Community Center on Palm Coast Parkway as an additional overflow location for Covid-19 patients.
“At the moment, the hospital is actually doing well,” De Aquino said. “We have a good number of beds available. We’ve been tracking it closely to make sure that nobody that really [doesn’t] need to be admitted is admitted, or, if they are in our hospital currently, we’re checking currently to make sure that they can go home as fast as possible, obviously keeping in mind the safety of our patients. But everything is going fine. We have enough beds in our ICU. We have a cohort unit where it’s separated from the rest of the patients, so we have that especially for any patients that are under investigation until we get results from the testing. That’s going well.”De Aquino also addressed a lot of speculation and confusion about the big tent outside of the hospital. “The purpose of that tent is really if we have a large influx,” he said. “We’ve got to make sure that we have a place where we can separate patients that are coming in with upper respiratory issues, and separate them from the others that are showing up in our ER for other reasons, to minimize contamination. So we set that up about two weeks ago as a precaution. We have it equipped, we have it ready to go, we’ve been doing some drills. We’ve done multiple drills, we brought the fire department here to check it out and learn about our drills as well. The tent–it’s not a drive-thru test location. It is set up only if we have a surge.”
There’s a critical shortage of ventilators across the country. WNZF’s David Ayres asked De Aquino what the hospital’s preparedness was in that regard. De Aquino did not address the question directly. “The question is what if we get an overflow of people that are extremely sick, the 20 percent that we see in other areas, and over here, it could be more than 20 percent,” he said, a reference to the county’s heavily elderly population. In that case, the community center and possibly other areas in the county would kick in. “We have a tight, tight, very tight control process here at the hospital right now, and just this morning I received a text from our friend John Subers,” De Aquino said of one of the hospital’s top leaders, currently assigned to the Emergency Operations Center, “I just received a text this morning that we should be getting a shipment of supplies,” namely, personal protective equipment. He said regional companies are trying to come up with solutions to the mask shortage.
Jonathan Lord, the county’s emergency management chief, said the county is short on personal protective equipment, and what supplies it has received have been scant. “We’re hoping for more supplies, but at this point in time, until we actually see them sitting in front of us, we can’t say when we’re getting them,” Lord said.
The hospital has committed to pay the salaries of all its employees whether they are working or not. The employees have to agree to help outside their normal stations if a surge occurs, De Aquino said. Meanwhile, they can be home and not worry about losing their paycheck. The hospital has been cross-training many of its employees, especially in departments that are not as busy as others, to lend a hand in case of a surge.
Testing is still being limited by the lack of re-agents–the chemicals needed to complete a test at the lab. But local officials concede that the limitation is hurting: they would rather have a much higher level of testing, including drive-in testing. For now, they simply don’t have the means.
“Ideally, if we had all the testing capabilities we’d like,” said Dr. Stephen Bickel, the medical director at the Flagler and Volusia health departments, “I think we’d all agree we’d be aggressively testing. The countries that have done the best controlling this tested early and often to get a really good handle on the extent of the illness in the community–not so much for patient care, because there’s no treatment at this point. But for [understanding] how much is out there and do we need these population-wide suppression measures, or can we do just aggressive quarantining of people who have it, and also their contacts. So there’s no dispute there.” But given a limited number of tests, reagents and protective equipment, he said, “what has been developed is this strategy that is taking the higher risks and higher likelihood of having the disease, groups, testing them, conserving resources, so we can maximize our impact on the illness, on people affected now.”
Bickel acknowledged that individuals who have tested positive and who have had various physical contacts with objects that cannot possibly be traced, like door knobs in the community, are “one of these threads that’s not ideally dealt with at this time. But we are working hard, [Health Department Chief Bob Snyder] and I talk about this every day, how to get more tests, what the strategy would be to increase testing capabilities once we have the test, like setting up drive-in sites and things like that. We want to do this. It’s really a critical part of moving from this population suppression strategy to a more smart-suppression strategy, where you’re aggressively identifying cases and then managing their contacts. That’s how you transition to a less suppressive approach to this.” In other words, an approach that would not depend on strict stay-at-home orders.Meanwhile, if local jails have seen fewer incarcerations elsewhere in the state, the numbers remain stable in Flagler, Sheriff Rick Staly said today, with the jail population hovering around 200 and daily calls for service at 400.
This afternoon, Superintendent Jim Tager announced the launch of the resumption school–virtually, starting Monday, and involving all district employees.
“The health of all our employees is my main concern,” Tager said. “We’ve got great teachers ready to start our Virtual Education plan Monday, and I believe it’s the best health-related move to simply have the vast majority of our 1,700 employees remain home.” The superintendent told staff earlier Friday that everyone is to work remotely, remain available during their normal work hours, and if needed, be able to come to their worksites. This move will not impact employee pay. Schools across the state are under order to keep their campuses closed to students through April 15, a date that could be pushed back, depending on the state of the emergency. A decision is likely early next week. With Florida’s rapidly rising number of infections, resumption of school on campuses is unlikely.
“I’ve told our staff that this county has survived hurricanes, flooding, and devastating fires over the years,” Tager said. “I’m confident we will overcome this pandemic and this is the right move to do our part in that battle.”
At the end of today’s radio update on the virus, Snyder, the health department chief, went on record that “a cold beer while fishing,” as Ayres put it, would–in Snyder’s word–“be recommended.” He predicted a “great celebration” when the emergency is over.