What Numbers Should You Look To For Reassurance During Florida's Reopening?
Most of Florida has already moved into phase two of Florida’s reopening plan for the novel coronavirus. In most of the state, people can now visit bars, movie theaters and casinos, along with beaches, gyms and restaurants. Of course, this comes with some caveats for social distancing and wearing masks.
Most of South Florida is still in phase one of reopening, with Miami-Dade, Broward and Palm Beach counties following closely behind the rest of the state. Monroe County is in phase two — the checkpoints at the county line are down and bars have reopened. As more of us venture out into this new normal, a series of questions is on many Floridians’ minds: Is it safe to leave home? What specific numbers should we look toward for reassurance?
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The answer is unsurprisingly complex, and even a little bit frustrating.
The state has created a dashboard with data and numbers tracking all sorts of things like total case numbers, death count, and testing statistics. But some of that data is erroneous and filled with little inaccuracies, as WLRN has previously reported.
“It’s okay to have some imprecision with the data,” said Mary Jo Trepka, a professor of epidemiology at Florida International University and former top epidemiologist for Miami-Dade County.
Trepka said that as long as the data is revised and perfected over time to make the overall trajectory of key metrics clear, a degree of imperfection is expected in a pandemic situation.
“A best practice would be — you completely clean the data and you wait till it’s complete, you clean the data and you release it,” said Trepka. “But that wouldn’t happen for three months, and that would actually end up being a poor practice. Because we need to make a decision today, not three months from now.”
Focusing on a single datapoint on the state dashboard does not tell the whole story, she said.
The problem with death counts is that they can be delayed several weeks before they show up in the data. The total case count only counts people being tested, so that doesn’t include people with no symptoms who never bother to get tested. And data on people visiting emergency rooms with COVID-19-like symptoms is not fully accurate either.
A lot of people don’t go to the hospital. Some have even died of COVID-19 at home, and don’t get counted in those symptomatic data numbers.
“Each one of these types of information has its weaknesses in terms of being incomplete, or being delayed,” said Trepka. “The whole picture includes all those pieces of information.”
Isolated numbers can play mind tricks when they are devoid of context. Case in point is the number of confirmed new coronavirus cases that Florida reported last Thursday. It marked 1,419 new cases, the largest single day increase since the state started releasing daily case metrics in March. Yet this happened as the state is rapidly increasing its testing capacity.
“As any county or any state or any region expands the number of test sites, of course you’re going to have more people testing positive,” said Carlos Migoya, the president and CEO of Jackson Health System, the largest public healthcare system in the state.
“But the important piece is not the number of people testing positive, but what percentage of the population are testing positive?” said Migoya.
That number has been going down across the state, according to the state dashboard, despite an uptick in overall new cases reported. That upswing is not necessarily a sign of a second wave of infections.
The most fool-proof number that experts are following is one that is not publicly available: The number of people that are in hospitals in real time. Migoya, of Jackson Health System, called this the “most important” datapoint.
This number is crucial because it tracks how many serious cases of COVID-19 are in Florida, and the ability of hospitals to respond to them. Asymptomatic cases are important to track for contact tracing and surveillance, but more pressing is the number of people who are so sick that they are currently in a hospital bed.
“We saw the number around April 7th, April 10th, peak. And then it flattened out for a long period of time, and then the numbers started coming down,” said Migoya. “Now the only time that the number goes up is when we have issues in a specific nursing home or multiple nursing homes.”
For the state as a whole, this number is not publicly available or viewable. Gov. Ron DeSantis has touted the hospitalization rate in Florida, but that number is impossible to factcheck. The state dashboard lists the total number of people who have been hospitalized in the past, but not at the moment. It’s a vital distinction, said Migoya.
“What’s more important is the number of people who are in hospital beds today, not two months ago,” he said.
Miami-Dade County Mayor Carlos Gimenez ordered that the county’s hospitalization data be made public. He said it’s a critical piece of information that is used to evaluate when different sectors of the economy reopen.
“That’s monitored everyday,” he said in a press conference. “And if we find that somehow there’s some kind of an uptick in the number of infections — none of this [reopening] is written in stone, it’s written on paper. It can be rescinded.”
The rest of the state is more in the dark.
“The emergency managers have that information, the general public doesn’t,” said epidemiologist Trepka. “That is being used by the policy makers to decide what to do.”