While thousands of Floridians continue to be infected by coronavirus, state health officials already are treating COVID-19 as an endemic disease — with health experts clinging to hope that it has become more predictable, manageable and less deadly.
Memorial Healthcare System had only one patient die from COVID for the week ending Dec. 27, a drastic decline from January when nearly 43 people in the hospital system surrendered their lives to the disease in a single week.
“Everybody’s keeping their fingers crossed that this is really just in the background now,” said Dr. Marc Napp, chief medical officer of Memorial Healthcare System. “We just have to wait and see, but certainly COVID is not anywhere near where it was a year ago or even during Delta, which was about a year-and-a-half ago.”
Floridians desperately want to believe the pandemic is over, and the shift to an endemic is underway. They look toward 2023 as the year COVID becomes known as a seasonal virus that circulates in the fall and winter like the flu or cold.
If ever there was an inflection point in a state where vulnerable seniors bore the brunt of the infectious disease, this is it.
Masks are off, airports are jammed, holiday celebrations are underway — and urgent cares are busier than ever. Once again, several counties in the state, including Miami-Dade and Broward, shed their low risk of COVID transmission and moved to medium as reported cases rise.
While confirmed cases are rising weekly, the state has closed all but a few of its testing sites in each county. Public health officials recognize there is no way to know how fast and furious COVID is spreading in Florida with most of the testing now done at home, if at all.
“We are seeing a lot of it and are definitely in a surge,” said Dr. T’anjuihsien Marx, Regional Medical Director with MD Now urgent cares. “My hunch is COVID is here to stay but that doesn’t mean doom and gloom anymore. Treatments are better, early diagnosis is easier, vaccination is available, and we can keep most people out of the hospital. It’s a different picture than two years ago.”
Just 12 months ago, Memorial Healthcare struggled to care for a flood of patients at its six hospitals in Southern Broward County, an area with one of the highest concentrations of COVID in the state. On Jan. 13, 2022, COVID admissions reached a peak with 727 patients. This week, Memorial had only 124 patients admitted with COVID, and only nine of them are in an intensive care unit.
“The numbers are up over the last couple of weeks,” Napp said. “I think we are going to see an up-and-down pattern until COVID becomes a seasonal event.”
The third year of the pandemic, 2022, proved tumultuous in Florida with nearly 21,300 people dying from COVID and more than 174,000 people landing in a hospital with or for COVID. The majority of deaths were people aged 65 and over. The year brought the state’s biggest wave with the omicron variant. But since that wave waned in April, case levels remain below any previous surge.
Now, as the nation enters the fourth year of dealing with the pathogen, the virus continues to evolve into more transmissible variants and the focus has shifted to hospitalizations and deaths and not just counting cases.
“Hospital admissions are increasing about 15 to 20 percent per week,” said data scientist Scott David Herr. “We saw a bump related to Thanksgiving gathering, and I am assuming we will see a similar bump from Christmas and end of year holiday gatherings that will show up in the next week or two.”
“From data you can see that people are not taking as many precautions,” he said. “There are not many getting boosted, not nearly enough compared to what’s needed.”
Since omicron arrived in the U.S., the virus has continued to evolve with more than 500 sublineages now circulating. So far, not one has been designated as a new variant of concern. But the evolution has led to fewer options for Floridians who get sick from COVID as immunity wanes and Floridians avoid the new bivalent COVID booster.
“Every monoclonal antibody treatment we had no longer works,” said Dr. Aileen Marty, an expert in infectious disease with Florida International University. “The good news is antivirals like Paxlovid, Remdesivir and Molnupiravir do work.”
Marty said Florida has reached an endemic stage with a current outbreak that is manageable and is not likely to reach public health emergency levels. Now, the state can maintain its stability or reverse its progress. With waning immunity and potential variants, the state’s path is hard to predict, she said.
Experts believe new COVID variants pose the biggest threat to progress Florida and the U.S. have made in 2022. China, which is undergoing a huge surge since lifting its COVID restrictions, could give rise to a new variant of concern. Or, virologists believe, there also is a possibility that the surge in China will accelerate the rate at which the world starts to normalize.
“What’s going on in China will absolutely impact the entire world,” Marty said. “We could be headed for trouble.”
Marty said increasing uptake of the bivalent booster, which hasn’t been well accepted in Florida, could curb the worst of any future wave.
“If we can keep the bulk of our population in Florida with best level vaccination level possible at the appropriate times, we won’t fall into the trap of an out-of-control healthcare system,” she said. “A future spike would be annoying but we would not see terrible infection.”
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