Sara Branscome, 61, marveled at how life goes on amid crisis as she sat masked in her home’s screened patio several miles away. After returning to the gym for just two weeks, she stopped going as case numbers soared during Florida’s devastating summer coronavirus wave and as friends and acquaintances became infected, including a member of her synagogue who died. She has been on shutdown mode ever since.
“We did everything,” Branscome lamented. “And why is it that we have to be the ones who do everything again?”
As Florida appears to be turning the corner from a coronavirus rampage that fueled record new infections, hospitalizations and deaths, its residents and leaders are surveying the damage left from more than 7,000 deaths reported since July Fourth and the scars inflicted by feuds over masks and vaccines. New infections were averaging more than 22,000 a day in the last days of August but have fallen to about 19,000. Yet recovery could prove fleeting: Holiday weekends such as Labor Day have acted as a tinderbox for earlier outbreaks, and late summer marks the return of students to college campuses.
In the wake of the summer surge, older Floridians cling to a sense of safety afforded by vaccines.
Health-care workers process the trauma of witnessing mass suffering and death that could have been averted if only more people had been immunized.
And hospital leaders exhale as covid-19 admissions appear to have subsided from a peak of more than 17,000 in late August, dipping to about 15,000. The decline follows weeks of frenzy as a slew of hospitals treated more patients than at any point in the pandemic, reassigning employees, postponing surgeries and treating patients in hallways and reconfigured rooms.
“Hospitals have pushed to the limits their ability to surge,” said Mary Mayhew, president and chief executive of the Florida Hospital Association. “It’s going to take us quite some time to really assess the short-term and long-term consequences.”
Epidemiologists say Florida taught the nation important lessons as the highly transmissible delta variant of the virus accounts for nearly all new cases.
Even with vaccination rates slightly above the national average, Florida provided ideal conditions for the virus to flourish. Businesses have largely reopened. Gov. Ron DeSantis (R) has waged high-profile fights to stop mask mandates at schools and to shield businesses from fines for allowing unvaccinated and unmasked patrons.
Cindy A. Prins, an infectious-disease epidemiologist at the University of Florida, said her state’s experience shows policymakers must act quickly to stave off an explosion of delta variant cases.
“Every time in Florida, we are a warning for everyone else,” Prins said. “If you do remove those precautions, I would have a very low threshold before deciding to put them back in. If you wait two or three weeks, it’s too late.”
As the delta variant began to spread, it appeared that Florida might be spared the worst, with vaccines seeming to prevent a wave of death in a state in which vulnerable older residents were immunized in disproportionately high numbers. In late June and early July, the state averaged fewer than 30 deaths a day.
But as of Thursday, Florida averaged 325 newly reported deaths daily in the preceding seven days, the highest since the pandemic started.
Experts attribute Florida’s high death count to its substantial population of older residents, which means even an unvaccinated minority includes hundreds of thousands of susceptible victims.
But this wave spared no age group. By early June, 82 percent of all covid-19 deaths since the start of the pandemic had been among people 65 and older. In July and August, older Floridians accounted for less than two-thirds of covid deaths, according to state figures.
With so much virus in circulation, disease trackers fear the emergence of more fearsome threats.
“Unfortunately, there are leaders in very important places that seem to have a mind-set that it’s best to let the virus spread out and let the chips fall where they may. But I think that’s an incredibly dangerous and callous approach,” said Aileen Marty, a physician and infectious-diseases expert at Florida International University. “Remember that every time you allow it to continue to have high transmission, you are facilitating the creation of a worse variant.”
Florida health officials did not respond to interview requests.
Christina Pushaw, a spokeswoman for DeSantis, defended the governor’s leadership during the summer surge. She contended that Florida was faring better than expected because it does not have one of the highest death rates in the country despite having one of the largest populations of senior citizens, the most likely age group to die of covid-19.
Florida’s per capita covid death rate since the pandemic started ranks 18th among states, according to Washington Post tracking. But during the Southern surge over the past eight weeks, Florida’s rate has been higher than all but those of Arkansas, Louisiana and Mississippi.
Pushaw also credited DeSantis for a string of appearances encouraging use of monoclonal antibodies, an effective, widely available covid treatment that experts say has been insufficiently promoted by the federal government.
All states “should be working to provide patients with free and easy access to monoclonal antibody treatment — and governors have an important platform to educate their constituents about this clinically proven, lifesaving early treatment,” Pushaw wrote in an email.
While the antibodies help once people are sick, health authorities stress that vaccines remain the best way to prevent death. Hospitals have reported that unvaccinated people account for most deaths.
AdventHealth in Orange County, one of the first Florida health systems to sound alarms about rapidly increasing admissions, recently activated plans to use refrigerated trucks to store bodies because hospital morgues could not keep up with rising covid deaths.
“The floodwaters were rising so quickly you had to make decisions on the fly,” said Vincent Hsu, AdventHealth’s executive director of infection control. “We’ve had a plan for preparing ever since the pandemic started, but the number of the cases in this surge of the delta variant was just really unprecedented, and it was quite catastrophic.”
In southwestern Florida, Lee Health in Fort Myers — which operates a safety-net hospital — has been recording as many as a dozen patient deaths a day from covid and expects that number to grow because fatalities tend to peak several weeks after the peak of hospitalizations.
“If people would only have the opportunity to walk around the ICU hallways and see what’s going on and seeing the sickness and how young people are being struck down with this disease,” said Larry Antonucci, the hospital’s president and chief executive.
But the misery inside hospital walls often remains invisible from outside, frustrating some who have been caught in the summer wave.
In the Villages, David Rubin is recovering from a breakthrough case that left him hospitalized. He received convalescent plasma treatment for three days and oxygen at home for several weeks. Rubin, who is 78 and has a pacemaker and high blood pressure, credits vaccination for saving his life. He and his partner, who had a breakthrough infection with milder symptoms, are regularly wearing masks again and are disturbed to see that many of their neighbors do not share their sense of urgency.
“No masks, partying, carrying on like crazy, people doing all the stuff they did before, not even any consideration,” Rubin said.
Other vaccinated people said their brushes with covid left them more confident about their ability to navigate daily life.
Lee Ann Rozanske, 64, a retired Illinois schoolteacher living in the Villages, experienced no serious symptoms after testing positive in mid-August. She said she wishes she had worn a mask during a two-day substitute-teaching stint at a charter school where face coverings were not mandated. A sneezing and coughing student approached her desk.
But she also feels “bullet proof” as she anticipates an upcoming cruise she and her husband plan to take — armed with their masks. She figures she has plenty of antibodies from her infection and from getting the shot. Her takeaway: People should get vaccinated and live life with simple measures such as masks to protect themselves.
“It reduced my anxiety,” Rozanske said about her breakthrough case. “I got it. It was the thing that I feared, and it wasn’t a big deal.”
Florida’s relative normalcy was on display at Clearwater Beach near Tampa last weekend. Couples held hands, parents pushed strollers, and mostly maskless groups of people strolled the palm-tree-lined sidewalks along the beach. A string of red and gray balloons heralded the entrance to a private grand-opening party for a bar owned by wrestler Hulk Hogan.
T.J. Haskins, a visitor from North Carolina, said he wasn’t concerned about the spike in cases as he jostled for a photo with a wrestling manager he spotted in the bar.
“Florida is open,” Haskins, 44, said.
At a mostly deserted grass lawn nearby, Millie Lincoln, 28, and her partner, Carmen Cristobol, watched Cristobol’s young niece run around as they sought an escape from the surge in coronavirus cases consuming their lives as health-care workers in Orlando.
Lincoln, a patient care technician, was skeptical about vaccines until the surge of covid patients at work underscored the stakes of inaction. She and her partner, a nurse at a hospital where covid patients take up an entire floor, were the only customers wearing masks at a chocolate shop earlier that afternoon.
“I don’t think this will stop if we don’t do something,” Lincoln said, a mask clinging to her face.
A boat horn wailed in the distance. Lincoln turned and pointed to a rooftop bar packed with people.
“You look up there, and there’s a rooftop party going on in the middle of a pandemic,” she said.
Meanwhile, Florida funeral homes are enduring the strain of hundreds of deaths a day. Rick Prindiville said the Orange County funeral home he manages fielded more than 40 calls last month — triple the usual — and is booked for the next two weeks.
“With all of these deaths, somebody has to take care of these people passing away and, unfortunately, that is our job,” said Prindiville, board president of the Florida Cemetery Cremation and Funeral Association.
At a cemetery in St. Petersburg, heavy equipment buzzed in the background as a nearly 10-worker crew got their orders for the day.
After weeks of overseeing grave digging for covid victims, cemetery supervisor Ross Nelson plans to get vaccinated despite earlier concerns about long-term side effects.
“I’ll probably end up getting it,” Nelson said. “Hopefully, the best version of it.”
Amrhein reported from the Villages. Leone reported from Clearwater. Nirappil and Dupree reported from Washington.