Florida Infections Spike to Near Peak Again, Flagler Cases at 52; St. Johns Reopens Beaches Partially

“Because of the increase in testing we are starting to see more cases,” Lord said. “It doesn’t mean people are more sick per se. We are just starting to se more cases. We did find out today that there has been a little lag in data entry on the testing numbers, so sometime in one or two of the next couple of testing cycles, we’ll see a little jump. It’s not because we had a jump of cases in one day. It’s just the data collection system is just a little lagging right now. I’m sure it’s going to be fixed in the near future.”

Palm Coast has 42 cases, Flagler Beach has four, Bunnell three. The rest are in unincorporated Flagler.

Remarkably, Flagler County government, which since Thursday has pivoted away from its previous messaging reinforcing stay-at-home restrictions, issued a false and oddly cheery press release this afternoon, claiming “testing has increased by 75% over the past week,” but “numbers of positive cases do not.” The press release made it seem as if Flagler’s numbers were in a marketing competition with other counties.

The numbers are false: “The positive number of cases increased from 45 on Monday to 52 on Friday,” the release states. But going back to Sunday evening, and based on Department of Health figures, 664 tests had been conducted in Flagler by that night, compared to 902 in the figures reported this morning, the span of time in which the cases have increased from 45 to 52. That’s a 36 percent increase in testing administered. And it doesn’t account for the lag in additional positive cases expected as a result of the week’s testing. (Julie Murphy, the county’s public information officer who issued the release, said after this story published that the numbers were calculated from last Friday, when 597 tests had been administered, to this Friday. Even then, testing would have increased 51 percent, not 75.)

On Thursday, the Department of Health recorded six new confirmations in Flagler–two women, ages 51 and 59, and four men, ages 64, 43, 43 and 41. One woman had a recent history of travel to New York, another had a recent history of travel to Georgia. Otherwise, the infections could not be traced to any known hot spots, making them the result of community transmission.

Hospitalizations in Flagler remain relatively low: the number has been at between seven and eight for several days. It is a cumulative number, meaning that people who have been in and out of the hospital (or two people who have died) are still counted in that figure. The health department is not breaking down the figure to reflect the history of each case. But it has started breaking down the number of confirmed cases in Flagler by race or ethnicity, with whites accounting for 67 percent of infections, blacks 10 percent, and Hispanics 20 percent.

In Florida, 686 people have died due to Covid-19. Just over 35,000 Americans have died of the disease in the nation, with close to 900 deaths in the past 24 hours.

But hospitalizations in Florida are not at a critical stage. Staewide, according to the Agency for Health Care Administration’s figures this morning, hospitals had a capacity of 36 percent in their ICUs. At AdventHealth Palm Coast, capacity was at 28 percent (with five of 13 adult ICU beds available.) There are no pediatric beds listed in ACAH’s census for AdventHealth Palm Coast. Outside the ICU, Palm Coast’s hospital had 26 of its 86 beds available, or 30 percent capacity.

The testing rate per 1 million residents is now at 10,400 nationwide, placing it on par with that of South Korea, an early leader in testing, but still well below rates in Italy, Spain and Germany. South Korea’s testing protocols were more aggressive very early in the pandemic there, which helped to limit the pandemic’s community spread through intense contact tracing.

For comparative purposes, the testing rate on the same scale in Flagler County is 7,834 per 1 million resident. In actual numbers, 902 residents have been tested out of a population of 115,000, resulting in a 6 percent rate of infection. The testing rate is also cumulative: more and more residents will get tested as time goes by. But the testing numbers are not in and of themselves finally indicative of infection rates, since the very same people who test negative one day could well test positive on a subsequent test, and there have been a considerable number of false negatives with current tests. Lord said the testing batch the county is using has been FDA-approved, and has officials’ full confidence.

“We have been testing since Tuesday. We continue to test today. We will pause Saturday and Sunday to regroup and start up again on Monday,” Lord said this morning on WNZF’s Covid-19 wrap-up, referring to the county’s drive-up testing location on the Palm Coast campus of Daytona State College. “In addition to the urgent care centers that are able to offer it at times as well as the health department who offer it directly at their clinic, as well as AdventHealth’s drive-through one they have down in Daytona, that’s so close to all of us as well. So I’m happy to see that there’s more and more testing options readily available. Each site may have slightly different testing criteria, especially the private ones. That’s their right to do that. Most typically their criteria are more lax than the public ones.”

AdventHealth Palm Coast has conducted 73 tests, but AdventHealth labs have processed 15,742 tests as of this morning. AdventHealth Daytona Beach has conducted 833 tests. Those figures appear to include the testing location at the International Speedway.

Dr. Stephen Bickel, the medical director at the Flagler Health Department and the Volusia Health Department, said the proportion of asymptomatic people now appears to be much higher than originally thought–even well beyond the 25 percent proportion that’s been frequently quoted in news reports between March and April. Bickel at one point cited a 50 percent figure or higher, but qualified it as nothing close to a certainty, just as has been the case with so much of the emerging science regarding Covid-19. On the other hand, he said, there’s also an unprecedented surge in scientific research on one single virus, constantly yielding a trove of new information. Bickel only tangentially alluded to one recent study, in Iceland, that has been grabbing attention.

The study was published this week in the New England Journal of Medicine. Its findings are catching the attention of school officials, as it is showing that in Iceland, where community testing was more advanced than in most nations (percent of the population was screened), children 10 and younger were shown not only to be almost immune from complications from the disease, but also showed remarkably less susceptibility to infection. That means younger children are also less likely to be carriers, which then argues for more safety in re-opening schools.

In all, testing showed that only 0.6 percent of those chosen at random in the population tested positive for the virus, while 13.3 percent of those tested in the “targeted” group (meaning those who showed symptoms) tested positive. The numbers would appear to validate the approach taken in Flagler, where those with symptoms were tested first (although the definition of “symptoms” has itself been controversial, and started off as being far more defined, and restrictive, than it has been in more recent days). Because of Flagler’s small population, the actual proportion of those tested in the county now exceeds the proportion in Iceland.

“The evidence is pretty clear in Flagler County that we’ve had a relatively small number of symptomatic cases, mainly by testing the most at-risk people,” Bickel, who has been instrumental in framing local protocols, said. (Had it been up to him, he’s said before, he would have tested at a far higher rate in the early goings. But the means were simply not at hand to do so, as testing shortages plagued the nation’s and the state’s public health response.)

“We’ve had a number of people in the hospital that’s consistent with that small number of cases,” Bickel said. “What we don’t know is, are there more people out there, either less at risk of complications, or less symptomatic, and also asymptomatic, that could become spreaders in the future. So, in terms of managing what we’ve been dealing with, I think the strategy has been totally appropriate. What we now need to know though, is, is it more prevalent out there in the community than we thought, and if so, then we can’t relax things as quickly as we’d like to, because this whole scenario might start multiplying again. That’s the piece we don’t know, and that’s where the expanded testing becomes valuable. And the answer to that is, I don’t really know. I think it’s a lower number than a lot of people think, but we’ll see. But we definitely have to know that before we can confidently open things up in my opinion. That’s the next stage of this.”

Bickel added: “Some countries have done this from the get-go, like Taiwan, South Korea, that had a lot of experience with SARS, so they already had totally geared up for this happening again. When they did this massive testing from the beginning and were able to contain it without all these population measures. That would have been great. We didn’t do it, for a variety of reasons, but we can get back there, and that’s where we want to go.”

The county today again defended its decision to reopen some of its trails and public parks, even though it was clear the county was doing so against medical and public health advice. The decision reflects some pressures on elected officials to start “reopening” the country, pressures aided by a president pushing for the reopening, and some state and local officials echoing his approach, even though the approach is not based on scientific evidence so much as economic pressures.

“We did this after a lot of thought,” Lord said. “It was in line with what the governor’s guidance was. We also want to take some of the pressure off of the sidewalks and other areas where we’ve seen some increased foot traffic on. So we kind of went that route. We went and shared it with our bigger partner group before we publicly released it and got feedback from those partners, and we summarily modified what we were going to do based on their feedback and concerns.”

Palm Coast, Flagler Beach and Bunnell on Thursday issued a joint statement that did not explicitly condemn the county’s decision but reasserted the cities’ decisions to stick with their existing closures of all parks and trails. Palm Coast Mayor Milissa Holland on the radio this morning sought to paper over the rift with the county’s approach, speaking with more conciliation than criticism. But there’s no question, based on the discussion that took place Thursday morning between city, law enforcement and county officials about the county’s decision–which was presented as a done deal rather than a proposal–that the county’s approach took others aback, both for its method and its intent.

“I don’t want to make this out to be us against them because that’s actually not what’s occurring,” Holland said. “We have a different set of thought processes in this moment, and that’s OK. Frankly, we, like the county does, have a ton of meetings throughout the day, speaking with different stakeholders, trying to understand the dynamic of how this has changed over and over again. We’ve just come to a different opinion at this time. That doesn’t mean that the cities do not understand that we will at one point need to have a plan in place, and we do–I speak to my city manager every morning about it–what is the plan, what does that soft opening going to look like, that does that mean. So we will be doing that at one point.

Today, St. Johns County decided to reopen its beaches–partially. The beaches are open from 6 a.m. to noon seven days a week for uses that include physical activity and motion. Activities now permitted there include walking, running, exercise, surfing, biking, fishing, swimming, surfing, and other uses that require physical activity. No lifeguards will be on duty.

“Walk to exercise not to socialize,” said Dawn C. Allicock, who heads the St. Johns health department. “As long as individuals adhere to the CDC guidelines of social distancing, getting exercise and fresh air can be beneficial for our citizens’ physical and mental health.”

The grouping of persons, commercial activities, group sports, and activities that do not require motion, such as sunbathing, and sitting are not permitted. Items not allowed on the beach include blankets, chairs, coolers, umbrellas, tents, and any item that promotes a stationary presence. Beach visitors must continue to adhere to CDC social distancing guidelines, including limiting gatherings to no more than ten persons and distancing themselves from other parties by a minimum of six feet. All public parking lots are now open, but beach driving remains prohibited.

In other related developments, a third Florida prisoner has died as a result of the disease, state corrections officials said Thursday. The Florida Department of Corrections did not release the name of the facility where the inmate was housed. Two inmates at Blackwater River Correctional Facility in Santa Rosa County also have died from complications associated with the disease, the News Service of Florida reported Wednesday. Blackwater, a private prison operated by The Geo Group Inc., is the state’s hardest-hit correctional facility, with 34 inmates and nine workers testing positive for the virus as of Thursday afternoon. Tomoka Correctional Institution is the latest prison to report a sudden outbreak of COVID-19, the respiratory disease caused by the novel coronavirus. As of Thursday, seven inmates and three workers at the Daytona Beach facility tested positive for the highly contagious coronavirus, a jump from zero cases on Monday.

Earlier today, the Florida labor department released unemployment figures for March, when the pandemic was just beginning to undo the state’s and the nation’s economy. The unemployment rate shot up to 4.3 percent, from 2.8 percent in February–and that’s expected to be a blip compared to the April unemployment report, with initial claims pushing the state’s unemployment figure closer to 10 percent. In Flagler, the March unemployment rate shot up to 5.1 percent, from 3.6 percent the month before, with 2,400 people unemployed, up from 1,738 the month before. Again, those figures are being overwhelmed by subsequent unemployment filings.