State may be emerging from its worst COVID surge

Miami-Dade residents line up as they are tested for COVID-19 at Cagni Park, a Miami-Dade County testing site in North Miami on Aug. 1.

FORT LAUDERDALE – Slowly, Florida seems to be emerging from its worst COVID wave to date.

In the past week, Florida hospitals have seen roughly a 10% drop in patients with COVID-19 and a 13% reduction in daily admissions. The state’s positivity rate also has dropped from the prior week, from 19.8% to 16.8%. The record daily increases in new cases have tapered off as well.

But experts say it is too soon to breathe a sigh of relief.

“It’s too early to know if we will go down or up again,” said Mary Jo Trepka, an infectious disease epidemiologist with Florida International University.

“What I think is happening is we are hitting a plateau. If we didn’t have schools and universities reopening and a holiday weekend coming up, I would say we would come out of the plateau.”

Trepka said because young people in Florida are driving the new cases, and spreading it into other age groups, “It’s possible we will get a second peak.”

Florida will need to wait a few more weeks to know if a true decline has taken hold, she said.

‘Glimmer of light’

In crowded hospitals, health care workers are still treating thousands more COVID patients than they did in previous coronavirus waves. 

On Tuesday, 15,177 COVID patients were in Florida hospitals, compared with more than 17,000 only a week ago, but still above the 11,909 of the previous peak in July 2020.

“Hospital workers don’t want to let their guard down, nor has their work changed all that dramatically given the high number of patients across the board they are still caring for,” said Mary Mayhew, president and CEO of the Florida Hospital Association. “But it feels like a glimmer of light at the end of this tunnel in this most recent surge.”

Around the world, COVID is following an odd but predictable pattern in each wave: New cases surge for about two months before starting to fall, according to The New York Times.

Researchers who have studied the delta surge in India, Britain and other countries discovered that, despite its contagiousness, the variant followed this pattern too.

Scientists are still trying to understand whether the pattern is caused by human behavior or if the virus recedes when it reaches a certain percentage of the susceptible population.

‘Deaths will continue’

While the COVID wave appears to be receding in Florida, caseloads are not guaranteed to continue to fall in the coming weeks, said Howard Forman, a professor of public health at Yale University who tracks cases globally.

Forman believes Florida peaked in transmissions two or three weeks ago, case counts a week to 10 days ago, hospitalizations a week ago and deaths this week. Parts of Florida, he said, are peaking at different times, and cases in the under-21 age group have yet to reach their highest count.

What concerns Forman, however, is that Florida’s peak in transmissions has not yet been followed by a drop.

“I’m amazed at how flat the curve looks this time versus the last peak,” Forman said. “That flatness is devastating. Deaths will continue instead of going down.”

Forman said about 2,000 people a week are now dying of COVID. He’s hopeful those numbers will decline.

“It looks like the situation is improving but I can’t say it’s over. The growing number of cases in young people can trickle back into older groups. The signs are favorable right now if people can continue to keep their guard up,” he said.

Uncertainty is frustrating

The uncertainty of whether this decline is temporary has hospital leaders frustrated. While fewer patients are being admitted, intensive care units remain nearly full with younger, unvaccinated patients fighting for their lives.

As of Aug. 27, roughly 68% of eligible Floridians were vaccinated with at least one dose of a COVID vaccine, according to the Florida Department of Health. The CDC says that 70% of people in the United States have received at least one dose of the vac- cine.

“If we follow the pattern of prior waves, we should be seeing improvement, but we are still at elevated levels,” said Justin Senior. “What would help the most would be getting more Floridians vaccinated.”

Dr. Samer Fahmy, chief medical officer of Boca Raton Regional Hospital, agrees. He said this summer’s wave has been the most difficult for health care workers. “The decline in admissions has given us a bit of hope.”

Fahmy said Baptist Health South Florida’s hospitals, including Boca, still have most beds filled in their intensive care units. “Yes, overall numbers are down, but patients — young and unvaccinated — are still ending up in the ICUs at a level we’re not comfortable with.”

Florida Gov. Ron DeSantis repeatedly has said COVID’s prevalence rises and falls in different regions at different times of the year, and in Florida that is summer. At news briefings, he said the recent summer COVID wave was expected.

A winter wave?

Public health experts in Florida point out that the delta variant has spread worldwide, causing recent outbreaks regardless of the season in each country.

“I don’t think this wave had any- thing to do with seasonality,” Trepka said. “We don’t have a disease that has a July peak. That isn’t the way respiratory diseases act. It is the in- creased transmissibility of the strain that has caused the cases.”

Most experts believe a future winter wave, if it happens, will not be as severe unless a new more infectious variant emerges.

A model created by Edwin Michael of the University of South Florida’s College of Public Health found if immunity gained from infection proves to be long-lasting and if vaccines continue to hold, this could be the last significant wave in Florida.

Meanwhile, Jay Wolfson, a colleague of Michael at USF, said researchers will be watching closely for a consistent two-week decline that would signal the end of Florida’s delta-fueled wave.

“It’s dangerous to make any conclusions until we have that, particularly with Labor Day coming up,” he said. “The models suggest we will see a mid-September decline, but we will see.”

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