Opinion: There doesn’t seem to be a plan. Is that intentional?

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OPINION

BY LEN CABRERA

It’s been 31 days since the first recorded case of COVID-19 in Alachua County, and there are still no objective criteria for loosening restrictions, much less a plan to return to our normal lives. Should we blame President Trump for trusting governors to use their judgment? Should we blame Governor DeSantis for issuing a state-wide stay-at-home order without explicit guidance? Should we blame County Commissioner Hutchinson for arbitrarily imposing additional restrictions as if we were experiencing an outbreak similar to New York City? There is plenty of blame to go around.

Everyone was quick to lock everything down to “flatten the curve” and avoid millions of deaths, but it was an emotional response to an unverified model. Even with social distancing measures, the initial Imperial College projection said the U.S. would have a million deaths. Now the latest model prediction from the University of Washington’s Institute for Health Metrics and Evaluation predicts 60,000 deaths in the U.S. (4,357 in Florida), about the same as a bad flu season. Watch out for politicians claiming the drop is because of their great leadership. The models always assumed social distancing measures, and even after multiple revisions, they continue to over-estimate COVID-19 cases, hospitalizations, and deaths. When a model is consistently wrong in the same direction, that’s called bias.

Even with numbers biased on the high side, the model shows that Florida will not have a shortage of hospital beds, ICU beds, or ventilators. 

Now what? We need to find a way to balance the threat of lost lives with the economic damage (which also costs lives). Just imagine the damage caused by 16 million new unemployment claims in just three weeks. That’s over 10 percent of the work force, and there are probably many more unemployed people who were not able to file because many states’ systems have been overwhelmed. Unfortunately, crime and economic data at the county level are not reported as quickly as the COVID-19 data. So we have a dashboard that screams out every new COVID-19 case, but we may not know about crime, suicide, abuse, and unemployment trends until 2022. 

It seems no politician wants to say it’s safe to return to normal because they don’t want to be blamed if COVID-19 deaths occur after the “all clear.” But it is practically guaranteed that COVID-19 deaths will continue, especially if we continue Dr. Birx’s policy of labeling all deaths with COVID-19 to be caused by COVID-19. Even a vaccine will not eradicate the virus. People still get measles and mumps, despite having vaccines since 1968. 

Politicians and pundits have been tossing out false dichotomies: We stay locked down for 18 months or more until there’s a vaccine (ignoring that vaccines are never 100% successful), or we immediately go back to normal and everyone dies (despite very low death rates for healthy people under age 65… and if you point that out, you’re accused of wanting to kill old people). “Flattening the curve” was intended to spread the severe cases over time, not ensure that nobody ever got sick. 

Scott Gottlieb at the American Enterprise Institute suggested several triggers to gradually return to normal: (1) a sustained reduction in cases for at least 14 days, (2) local hospitals are able to treat all patients requiring hospitalization, and (3) capacity exists to test all people with COVID-19 symptoms.

The criteria should be applied at the county level instead of the state level, especially since Miami-Dade and Broward Counties account for over 50% of all COVID-19 cases in Florida (according to the Dashboard’s 6:30 p.m. update on April 9th). Alachua County has about 1/5 the population density of Miami-Dade (307 vs. 1430 people/square mile of dry land area) and about 1/4 the per-capita COVID-19 caseload.

Having a sustained reduction in cases for 14 days in Alachua County  will be difficult to achieve because we have had such low numbers. Since the first case on March 10th, we have only had 3 days with double-digit new cases (13 on March 21st, 11 on March 30th, and 12 on April 2nd). Since test data started being reported by county (March 19th), the growth rate for new cases per day in Alachua County is statistically zero.

The hospital criterion is clearly met in Alachua County. We’ve only had 21 people hospitalized for COVID-19; that’s the cumulative total, not the number currently hospitalized. According to the American Health Care Association, Alachua County has 1,657 staffed hospital beds (681 available on April 9th). In fact, there is the potential that we’ll lose hospital capacity if we do not loosen restrictions and resume elective surgeries. 

As for test capacity, less than 6 percent of our tests each day come back positive for COVID-19. (Percentages in the past few days have been even lower.) That suggests we have plenty of tests relative to the actual number of cases. We are not even close to hotspots like New York City (40% positive), New Orleans (28% positive), or Detroit (26% positive). In fact, Dr. Birx said a positive test rate as low as Los Angeles (9%) would be a big success. 

Governor DeSantis needs to allow counties to react to local conditions instead of treating the whole state like Miami-Dade County. Alachua County should not be adding restrictions to the state-wide order (especially occupancy restrictions). As soon as possible, the county should show some leadership in the state and begin to roll back the stay-at-home order. We can start with people who are low risk (under 65 with no health issues). Let people decide for themselves. Those who are at risk or in fear of COVID-19 can continue the stay-at-home order, but the rest should be allowed to resume their normal lives.

The data clearly show that many counties in Florida, including Alachua, are not at any major risk from COVID-19. Maybe our politicians do not understand the data or can’t tell the difference between data and models. Worse, maybe they don’t care about the data and continue to push panic so they can maintain emergency powers.