‘We’re in a slight, slow decline.’ COVID burden lessens at Miami-Dade hospitals
What started as glimmers of hope a week ago has strengthened into a more consistent trend of a slowly declining number of COVID patients at Miami-Dade County hospitals, signaling the worst could be over, at least for now, in Florida’s coronavirus epicenter.
The hardest-hit county has made progress on multiple fronts since a mid-June surge heightened to a blistering July that brought Miami’s largest hospitals to capacity and overwhelmed Florida’s testing system.
State officials are starting to pivot to rapid tests for symptomatic people, a way around a testing backlog that has caused weeks-long wait times for results. Meanwhile, the number of COVID patients in Miami-Dade hospitals fell by more than 400 in the last two weeks.
But South Florida is hardly in the clear. Transmission of the COVID virus — measured by confirmed cases, hospital stays and other metrics — is still more than twice as high as it was before mid-June.
“We’re in a slow, slight decline, but really at a very high level — a much higher level than where we were before,” said Dr. Aileen Marty, an epidemiologist at Florida International University who advises the county mayor on the outbreak.
Miami-Dade hospitals had between 500 and 600 COVID patients throughout much of May and early June until the virus began to accelerate throughout the rest of the month and spike to a peak of about 2,300 patients countywide on July 21.
Jackson Health System, the county’s safety net hospital network, reported about 360 patients on Friday, down from a peak of nearly 500 in late July. Carlos Migoya, the hospital network CEO, said Jackson’s doctors and nurses weren’t celebrating.
“We’re in month number five,” Migoya said. “How would you be feeling running a marathon, on mile 22, not knowing that it’s going to end on mile 26? There’s a lot of stress right now.”
Jackson, which received hundreds of nurses hired by a state contractor in recent weeks, will not request additional staffing support, Migoya said. Looking back at July, Migoya said the hospitals were full at the virus’ last peak, with some wiggle room that fluctuated with patient discharges.
The county’s public hospitals were bracing for an even higher peak of potentially 3,500 COVID patients at once, a scenario that thankfully never developed, Migoya said. But he stressed that a backslide was still possible, and patient volume was still difficult to manage.
“I don’t want to create a sense of comfort out there,” Migoya said.
Fears of a third wave
This week, Miami-Dade Mayor Carlos Gimenez said the trends looked encouraging for the July COVID surge that prompted a second wave of emergency orders closing restaurant dining rooms and imposing a countywide 10 p.m. curfew.
“I’m pleased to announce that it appears we have leveled off on coronavirus infections,” Gimenez told county commissioners on Tuesday. He pointed to a declining rate of COVID tests coming back positive and a reduction in the number of people going to the hospital with the disease.
Gimenez said he expects other metrics to continue to tick down through August.
“About 10 days from now, you should see ICUs also start to trend down,” he said. “A couple of days later, you should start to see ventilators trend down. Finally, it will be the fatalities that start to trend down.”
County hospitalization reports show both trends already receding from recent peaks.
The three-day average of admitted COVID patients, which smooths out spikes and valleys, was just over 1,800 on Friday, down about 20% from a peak of about 2,250 on July 24. The number of COVID patients in intensive care is seeing a slower decline, down about 15% from a peak of about 570 on July 27.
The positive trend poses a number of challenges for Gimenez, a Republican candidate for Congress. Restaurants and their political allies are pushing him to resume indoor dining and lift the 10 p.m. curfew, which forces an early shutdown of sales. He said the county’s target for lifting restrictions is a positivity rate of around 5%.
Miami-Dade only briefly reached that rate before the June resurgence, and the rate is currently averaging about 16% over the last two weeks, a slight improvement from a peak in the mid-20s.
There’s also the possibility that any encouraging news about the pandemic waning will make residents less diligent on masks and physical distancing. The Miami-Dade Clerk’s Office reported receiving more than 200 mask citations over the last week as local police and code enforcement agents continue a crackdown on adherence to emergency orders.
A second lifting of dining restrictions would test county and state systems to keep infections under check. Miami-Dade reports more than 300 contact-tracers in place, some of them hired after a pledge of county funds.
That’s far fewer than the 1,000 Gimenez said Miami-Dade needed on the job in the spring, but more than 175 or so working in Miami-Dade when restaurants and nonessential businesses reopened in mid-May.
The county and state also have hundreds of hotel rooms available to isolate people with COVID symptoms if they can’t stay away from family members or roommates at home — options that were largely unavailable in May.
Though Miami’s hospitals are likewise in a better position now than they were in July, Migoya, Jackson’s CEO, emphasized that the “lagging indicator” of people in intensive care units is more than just a number.
“We still have a lot of sick patients who won’t make it,” he said. “We don’t feel good about that.”
This story was originally published August 7, 2020 at 6:07 PM.
