Flagler Covid Cases Set New Record for the Week, Including 6 Children 14 Or Younger; 22 in Treatment at AdventHealth

The latest Flagler County residents to test positive, according to the state Department of Health, include girls age 2, 5 and 8 and boys age 8, 9 and 14. Those cases are significant in light of school’s potential reopening in August, as they indicate the susceptibility of children to the diseases, and of children as carriers. In all, 38 Flagler County children 14 or younger have been infected. None have been hospitalized in that age group. But the Department of Health does not disclose if the children are the likely origins of infection in older people, or the possible number of those infections. On Thursday, the Putnam Health Department reported the death of the youngest person from Covid causes in Florida yet: a 9-year-old girl. Three children 14 or younger have died of the disease in the state so far.

Florida today exceeded 400,000 cases since the coronavirus pandemic began in late February and is on pace to surpass New York next week in total number of cases while approaching California’s, where daily case loads have been slightly lower than Florida’s. The Sunshine state added 12,444 cases today, the highest total since July 19, though the seven-day average has fallen to 10,500.

“We seem to be plateauing with Covid in Florida right now, which is a good thing. Flagler County, not as much,” said Stephen Bickel, a physician and the medical director at the Flagler and Volusia health departments, speaking on WNZF’s Free For All Friday this morning. “We’re kind of still creeping up a little, although we’re probably getting to the plateau. So hopefully these measures like mask-wearing and more aggressive vigilance on the part of the community are helping. We still got a way to go here.”

The state reported 135 Covid-19 related deaths today. Since July 1, the disease has claimed 2,118 lives in Florida, or 37 percent of the 5,768 people who have died since March 1. Some 1,350 more people have died of the disease in Florida in less than five months than the entire death toll sustained by the American military in Iraq in a decade of war. Eight Flagler County residents and two non-residents have died in Flagler from the disease, a number expected to change because of the high number of local hospitalizations right now.

As of 3:30 p.m. Friday, there were 22 patients hospitalized with a primary diagnosis of Covid-19 at AdventHealth Palm Coast, according to the state Agency for Health Care Administration, and an overall bed capacity of 12 percent at the local hospital–and 0 percent in the intensive care unit.

Wally de Aquino said the licensed ICU bed capacity of 18 reported to the state agency isn’t the actual number of ICU beds the hospital has been allowed to add during the Covid emergency. “It’s a lot more than that,” de Aquino said. The 18 licensed beds is “the official we have with ACAH. We’re going north of 30,” he said of emergency ICU bed capacity. Some of the patients at the hoispital were transferred from other areas, and vice versa.

“We are treating patients with ventilators, we are treating patients in our ICU,” de Aquino said. “But there is a little bit of good news that we are noticing and we hope that this becomes a trend. We don’t know that it is a trend as of today. But I am happy to report that during this week, at least for the past seven days, we feel that we hit a plateau in terms of the number of hospitalized Covid patients, which is good news, because we had been seeing increases day after day. It would slow down for a few days and then pick up again. But the numbers that we experienced for the past seven days stayed pretty much the same, with not much of an increase, in terms of capacity, to the point where we were able to help out some of our neighboring hospitals in treating some of the patients that got transferred to us.

De Aquino cautioned: “But I am reluctant in saying that this is good news, that we hit a plateau and hopefully we could see the hospitalization numbers decreasing because we don’t want to let the public think that, ok, we beat this, right? We don’t want the wrong impression of this information getting out there. I was looking at the data back on the week of July 5, July 4, we hit a new peak at that point. And then it really decreased from there, only to increase again last week. I would say that the newest peak for us was last week, and this week we are not seeing that increase again. So again there are different peaks out there. I hope that this is a result of a better trend coming in the near future.”

He said the patients are “a little bit younger” than in March and April, but not by much.

The positivity rate, according to the state Department of Health’s numbers, rose to 12.6 percent the first six days of this week, still higher than the 14-day average, though Flagler health department officials have continued to report a significantly lower positivity rate based on a different accounting that includes antigen tests. (The state reported a cumulative total of 456 positive cases and a cumulative total of 9,676 tests as of 14 days ago. It reported a total of 756 cases and 12,406 tests today, a difference of 2,730 tests, 300 of them confirmed positive cases in that time span. Dividing 300 by 2,730 nets the 11 percent positivity rate.)

“We’re testing a lot more people but we’re finding that we’re getting a lot more positives,” including a 14.5 percent positivity rate on Thursday, the local health department’s Gretchen Smith said. But the 14-day positivity rate she reported was 6.9 percent.

Either way, it’s far above the 3 percent threshold health department officials say is relatively safe for some reopening, and well above the 1 percent rate the county had experienced during the May and early June lull.

“The positivity rate doesn’t mean what a lot of people think it means,” Bickel said. “It’s a sign of: are we doing enough testing. The real thing we need to know about in terms of the disease is how many cases are happening or developing.”

For example, if the county had 100 cases in a week while testing 1,000 people, then had another 100 cases the following week while testing 2,000 people, the positivity rate would be cut in half, from 10 to 5 percent. “Are we making progress? Well, we’re making progress in doing enough testing, we’re not necessarily making progress in terms of controlling the infection. So basically the thing that really tells us how we’re doing with the disease is, for the most part, the number of cases, and then of course how serious the cases are, how many are in the hospital, things like that. But there is a slight issue with the testing where, if we’re testing more people we’re going to be picking up more cases because there are people out there we’re picking up who haven’t been tested. It’s useful, but it’s not like a major trend indicator that will tell people, oh, we’re making progress or not. That is really the case number that tells us that. These 30, 40 numbers–they’re not good. They’re the highest we’ve been.”

Flagler recorded a one-day high of 40 cases earlier this week, with its weekly high the sort of numbers that provoke lockdowns in many other countries, yet Flagler and Florida as a whole, following the lead of a largely insouciant governor, continues to avoid any strict measures other than encouraging mask-wearing and socially distancing. Palm Coast, Flagler Beach and Bunnell passed mask mandates earlier this month, only to be told by the sheriff that the mandates are not enforceable.

“We’re stuck with this for a while, once these numbers get up this high, it’s hard to get them down quickly,” Bickel said. He spoke of the R value–the number of cases that a single case will lead to. So if one person in the community is infected and the R value is one, the person will give it to one other person, and that second person will give it to one other person, and the rate of transmission will stay the same. If the R value is higher–if it’s 2–then the transmission becomes exponential: the person will pass it to two other people, those two will transmit it to four, the four to eight, and so on. Conversely, if the case load is 100 but the R value has been cut to 0.5, then the next cycle will see 50 cases, and then 25, and so on, though it takes draconian measures to get there.

In the July surge in Florida, the R value got as high as 1.47, sending case numbers to explosive levels. But since then, the R value has fallen down to just under 1, which is why the numbers in the state have plateaued. But that doesn’t mean the case numbers will fall significantly, only that the numbers of infections will continue to develop at the rate of 9,000, 10,000, or 11,000 cases a day, as they have.

“That’s why we keep pushing the mask thing because it’s relatively unintrusive and wouldn’t necessarily require all these business impacts,” Bickel said. “But the problem people may not grasp is that it is very hard to get that R way below 1 without really being aggressive.” The common flu behaves differently, its R value rising seasonally but falling of itself when the weather warms. “I think people were thinking that’s what was going to happen with Covid. But the problem with Covid is that it isn’t that drastically affected by temperature. It’s somewhat affected. And it’s just way more contagious, so that is not happening like it does with the flu, and I think it’s kind of confused people because they think if we just ride this wave out it will go away. But that’s really not true. If we don’t stay really vigilant, we could be at this same case number in Florida, 10,000 a day, for the entire year. The R value stays at 1, the case load does not go up, but stays at this quite high level, and we’re stuck with it. That’s kind of the worst nightmare.”

The Flagler Health Department received $481,000 through a federal Covid-related aid package (the CARES Act), which the department is spending on ramping up the full-time equivalent of 16 individuals (likely to be 40 actual workers by the time part-timers are included) to conduct case investigations and contact tracing. “$481,000 we have to spend by the end of December, Dec. 31, that’s the money we’ve already received,” Bob Snyder the health department chief, said.

The department is currently tracing 500 cases that are either positive or in close contact to positive cases. The department is about to create a call center for its tracers, occupying the second floor of the county’s building at 120 Airport Road, at the county airport (the same building where the county’s tourism bureau is located), with some of that CARES Act money used to pay rent to the county.

The picture is not brightening in the rest of the nation. On Thursday, the nation saw 70,000 new cases, a 24 percent increase over 14 days, with 1,116 deaths Thursday alone, for a total death toll nearing 150,000.