‘Leading indicators of a resurgence,’ COVID-19 numbers trending up since reopening
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A Numbers Game
The Miami Herald analyzed both public and non-public data in order to illustrate the spread of the novel coronavirus in Florida, examine reopening benchmarks and look at what comes next.
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‘Leading indicators of a resurgence,’ COVID-19 numbers trending up since reopening
As bars, gyms, vacation rentals and movie theaters reopened at partial capacity last week in all but three South Florida counties, the number and rate of new COVID-19 cases were rising statewide — a troubling indicator that the disease could be spreading more quickly.
The 64 counties that moved into the second phase of reopening on June 5 saw a near 42 percent increase in new cases the week before that could not be explained by increased testing alone, according to a Miami Herald analysis of the Florida health department’s case data. Testing had increased by only 8 percent over the same period.
Florida’s coronavirus numbers have continued their surge, including Thursday’s statewide tally of new positives — 1,698, which was the highest single-day total of confirmed cases yet. That number, in turn, was exceeded on Friday, when the state announced another 1,902 confirmed cases.
“We are seeing the very leading indicators of a resurgence in the number of cases, and now is the time to take action,” said Eric Toner, a pandemic preparedness expert with the Johns Hopkins Center for Health Security, who reviewed the Herald analysis.
The Herald used three-day rolling averages of new cases and the percentage of positive tests out of total tests to calculate trends over seven- and 14-day periods. Guidelines from the Centers for Disease Control and Prevention suggest that communities should not move into phase two without seeing a “downward trajectory” in either new cases or rate of positive tests for at least two weeks after entering phase one.
Signs of increased transmission of the virus are also apparent in statewide trends of new cases recorded during the last weeks of May and early June. Over the two-week period prior to June 5, the percentage of people testing positive for COVID-19 increased by about 1.6 percentage points statewide. (Positivity trends later flattened as testing increased in June.)
Helen Aguirre Ferré, a spokeswoman for Gov. Ron DeSantis, acknowledged the recent rise in new cases in an email statement to the Herald. Ferré said the state has focused on increasing accessibility to testing, with 30 drive-thru and walk-up test sites in urban and rural areas.
“We fully anticipate that the success of this effort to seek out COVID positive individuals will be seen in higher numbers which, if treated early, can be beneficial not only in treating the patient but helping control the spread of the virus,” she said.
However, over the past month, testing has been inconsistent, and trended slightly downward during the two weeks before the June 5 reopening, according to the Herald analysis. Despite that, new cases increased by almost 50 percent over the same period.
Robert A. Bednarczyk, an assistant professor at Emory University’s Rollins School of Public Health who also reviewed the Herald analysis, agreed that the stubborn positive test rate, along with increasing new cases, could indicate a viral resurgence.
Trends of new cases, testing totals and positivity rates identified by the Herald in early June “seem to be an indicator that a really good level of control of the spread of the virus has not been achieved across the counties that you’re looking at and in Florida as a whole,” Bednarczyk said.
Although upward trends in new cases began later in South Florida than they did in the rest of the state as a whole, by the start of the second week of June the region was seeing an increase of about 23 new cases per day.
“The testing has not been [consistent] and hasn’t increased that much, and doesn’t explain the increase in cases to my view, bottom line,” said Toner of Johns Hopkins.
In the first nine days of June, testing in the three South Florida counties increased by 54 percent — while new cases increased by 64 percent.
“The action right now is not to shut down businesses,” Toner said. “The action is for people to take individual responsibility and for governments to do really vigorous messaging to the public.”
Ferré told the Herald that rising numbers of positive test results were not reflected in data about hospitalizations and deaths. She said the availability of Florida hospital ICU beds and ventilators indicates that “individuals who are testing positive for COVID do not have underlying issues, and/or we are getting better at treating this disease.”
But epidemiologists interviewed by the Herald said when increases in case counts outstrip increases in testing, that can be an early warning sign of a possible future uptick in hospitalizations and deaths, which tend to happen weeks after a new outbreak occurs.
“A cautionary tale for that is Arizona,” said Bednarczyk, pointing to a rise in new cases that began in the state several weeks ago. “Now they’re starting to see their hospital beds, ICU beds reach some levels of critical capacity.”
U.S. Rep. Donna Shalala, speaking at a teleconference on Thursday, accused Gov. Ron DeSantis of ignoring the White House’s and the CDC’s gating criteria for reopening. The teleconference was hosted by Protect Our Care, a left-leaning organization that advocates for the Affordable Care Act.
“Gov. DeSantis in Florida has been pushing the state of Florida to reopen,” Shalala said in her opening remarks.
Shalala, a former secretary of Health and Human Services, noted that Florida has averaged more than 1,000 new cases a day over the past week — including Thursday’s record total, which lasted until Friday, when a new record was established.
Still, a resurgence of the disease in Florida is likely to unfold at a slower rate than when the novel coronavirus first appeared in the United States, Toner said — largely because many Floridians are still following recommendations on social distancing and wearing masks.
“If we do these things, we can keep this increase somewhat under control,” Toner said. “If we don’t, we’ll see a much larger increase in cases. A month from now, six weeks from now, whenever, governments will have no choice but to shut down again. And no one wants that.”
This report has been updated to include Friday June 12’s tally of confirmed COVID-19 cases, a record total.
This story was originally published June 12, 2020 at 8:00 AM.
