Florida sees one-day high of 15,300 COVID-19 cases as pandemic inundates health care infrastructure
13 July 2020
The coronavirus has infected over 13 million people globally, adding another million cases in less than five days. The world has seen over 200,000 daily cases five days running. Global deaths have also consistently stayed over 5,000 in the same period. Regardless of the factors that have been cited for decreasing case fatality rates—younger age, improved treatments, more testing capacity—by all accounts, international health agencies are bracing themselves for grim developments. Fatalities always lag behind cases by two to four weeks.
The pandemic in the United States has qualitatively shifted in a dangerous direction, growing unimpeded by the lack of any meaningful effort by federal, state and local officials to contain, let alone curtail, its trajectory. Since June 14, the number of daily cases has tripled, with sustained rates of over 60,000 per day. As had been predicted, the fatality rate, after reaching its seven-day average low of 516 daily deaths on July 5, in less than a week has grown by 40 percent to 723 deaths per day.
Florida shattered the record for a one-day high of 15,300 cases on Sunday, beating out previous one-day highs set by California last Wednesday at 11,694 and New York’s 11,571 on April 15. On July 9, Texas reported 11,394 cases. On Friday, Georgia set a one-day high of 4,484 cases. Wisconsin recorded a one-day high of 926 cases on Saturday, with COVID-19 cases almost quadrupling since mid-June. Similar spikes in new cases have been reported in Idaho, Oklahoma, Tennessee and West Virginia.
Florida’s positive test rates have climbed from 5 percent last month to 19 percent. Yet the peak of hospitalizations remains weeks away. Advent Health’s CEO Terry Shaw said on “Face the Nation” that the situation is very stressful, but continued with his businesslike demeanor to promote and tout his facilities’ capabilities. He chose not to use the opportunity to demand the state be shut down, instead emphasizing the need for more personal responsibility.
He did admit that Advent’s intensive care unit (ICU) capacity was running as high as 90 percent. Advent has over 30 facilities in the state. Questioned on the opening of Disney’s theme park, Shaw merely said he was confident of Disney’s ability to operate safely and that he was a Disney season ticket holder.
In the face of the massive number of cases in Florida, Governor Ron DeSantis dared to push for the reopening of schools in just a few short weeks, stating, “I’m confident if you can do Home Depot, if you can do Walmart, if you can do these things, we absolutely can do schools.” Clearly, schools and children are the equivalents of markets and commodities.
Hospitals throughout several Florida counties have had once again to stop all elective surgeries to divert resources for the COVID-19 surge. The 3,232 patients hospitalized across Miami-Dade, Broward and Palm Beach counties account for 42 percent of all patients hospitalized throughout the nation for the coronavirus.
Scott Gottlieb, the former commissioner of the Food and Drug Administration, placed the blame on irresponsibility and complacency among young people who are failing to take the necessary precautions. He said he expects to see the fatality rate climb, as the virus is now finding its way back into a vulnerable population. with rising cases in nursing homes.
According to a Wall Street Journal report from Saturday, nursing facilities in Tampa and Houston have seen an 800 percent cumulative increase in new cases since the last week of May, with more than 400 cases combined. Phoenix saw a 900 percent increase, with nursing homes reporting 545 new cases. There are similar trends in Miami and San Antonio. These same facilities are running short on protective gear for staff and nurses caring for elderly people and invalids. Twenty-five percent of these facilities have less than a week’s supply on hand.
Adding to the calamity, the rapidly rising number of COVID-19 cases is causing national labs like Quest Diagnostics and LabCorp to report significant delays in turnaround time. Demand for testing has exploded, while supplies are swiftly being exhausted in the hardest-hit areas of the Sun Belt. Where test results were previously reported in one to two days, they are now taking four to six days, and sometimes longer. Even the mayor of Atlanta, Keisha Lance Bottoms, had to wait eight days before receiving her results, confirming that she had been infected.
Since the end of April, when US testing capacity had reached 200,000 per day, it has risen threefold, but the surge in cases is straining the ability of vendors to keep up with requests. Some cities and states are moving to require a doctor to order the test to curb demand. Other localities, such as Austin, Texas, are beginning to ration tests exclusively to those exhibiting COVID-19 symptoms.
These delays in testing create a new set of problems that impact the ability of public health departments to conduct contact tracing. According to Doctor Amesh A. Adalja of the Johns Hopkins Center for Health Security, “If a test result takes more than five days to return, it likely defeats the purpose of the test. We need to be able to test to identify cases, isolate them and trace their contacts. And any delay impedes that process.”
Many health care workers have taken to social media to express their frustrations over these delays. One nurse in Arizona said that she could get her test back in one day if she paid a premier lab close to $300 for the test.
Given that there is a lag of several days from the time a person becomes infected to the time he or she is shedding the virus, the additional delays in test results suggest that these horrific jumps in cases represent people who were infected as far back as two weeks ago. As no real measures are being taken beyond encouraging “personal responsibility” in wearing masks, avoiding congregating in crowds and closing some nightclubs, this extremely contagious virus has hardly been slowed by any real initiative to contain it.
One of the fundamental conditions that had been stated for returning to stringent lockdowns was a surge in cases that brought the health care infrastructure to near-capacity.
Testing is just one factor in the broader need for PPE, facemasks, medical supplies, oxygen and appropriate staffing to provide comprehensive care and treatment of the population. Joseph Kanter, a regional medical director for the Greater New Orleans area, which has seen new cases rapidly rise again, told the Wall Street Journal, “This is an American failure. We’re five months into this epidemic, and we can’t figure it out.”
Dr. Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research, said on MSNBC, “The way we are going to maximize on our overall safety, health and economy is getting it shut down once and for all, coming back slowly and gradually… and living with it till we get a vaccine.” He admitted that there might be situations where the “brake” had to be applied to get outbreaks of clusters under control. He added that this month over 1,000 health care workers will have died from the coronavirus.
However, there have not been any discussions in the media about creating large mobile hospitals to provide surge capacity in the devastated Sun Belt cities facing health system collapse. There are no discussions of mobilizing the resources that had been brought to bear by FEMA in Chicago, New York City and other urban centers to handle the new cases inundating emergency rooms.
Meanwhile, Nueces County, which includes the city of Corpus Christi, Texas, is reporting that the morgue is full. The county medical examiner is urgently requesting that refrigerated trucks, also known as mobile morgue trailers, be provided. Austin and Travis County have made similar requests. Hidalgo County will share its resources with neighboring Cameron County.
Hospitals in Houston are telling emergency first responders that their facilities are on bypass, as they cannot accept new patients safely. They are scrambling to allocate any space for the care and treatment of COVID-19 patients. On Thursday, 3,812 people were hospitalized, including more than 1,000 patients that went to the ICUs. Yet the state has refused to issue a “stay at home” order to ease the burden on these facilities.
The indifference to the plight of the people, the impact on communities and the strain on the health care infrastructure on the part of the White House, the Democratic and Republican parties and state governors is criminal. This policy of malign neglect and herd immunity derives its logic from the socioeconomic conditions that have seen capitalist decay assume parasitic and sociopathic dimensions. Rapidly deteriorating conditions will lead to another resurgence of mass opposition. Very possibly, Trump’s coup attempt in June was only a dress rehearsal for his response to the next mass protest that explodes onto the world stage.