COVID-19 cases have surged in Florida (FL) to historic levels but it is a pattern that we have seen before in the USA 3 months ago and in many other countries such as China and Italy several weeks before that.  Somehow many governments failed to recognize the exponential growth pattern of an outbreak and stop it in time before it did substantial damage.  This time around for Florida to repeat the same devastating mistakes would be truly sinful.  Florida experienced an outbreak in March and luckily escaped it relatively unscathed due to the timely action of certain mayors and county officials to lockdown their local businesses before the outbreaks got serious.  They could have avoided general lockdowns if they had the testing, contact tracing, and selective isolation capacity in place.   However, since no one in the USA prepared in January and February, the only alternative was to use a blunt instrument like a general lockdown to suppress the outbreak.  Second time around, there is really no excuse not to be prepared.  Three-months further along, we should have built up the testing, contact tracing, and isolation capacity to deal with any resurgence but it doesn’t look like we are any better prepared this time around.

The figure above shows the daily confirmed COVID-19 cases reported in Florida (brown squares) over the last 11 weeks.  Florida was averaging 800 cases per day even as it expanded testing from 10,000 to 30,000 per day from mid-April to early June.  Florida was able to drive its positivity rate (percent of tests returning positive) down from 12% to near 2.7% allowing it to reopen safely in early May.  A month later FL decided to go to phase 2on 6/5 even though signs of trouble were already brewing as test capacity stalled and the positivity rate rose above 4% near the end of May.  This mistake became more evident as the month wore on and the number of daily confirmed cases surged to a series of record highs.  The 7-day moving average of cases (solid brown curve) is now near 8,000 – ten times higher than the base rate just a month ago corresponding to a doubling time of 9 days.  Where is it likely to go? 

The figure above also plots the New York (NY – blue diamonds) experience shifted by 91 days or 3 months earlier.  The middle of the curve with the exponential growth matches eerily well.  Will we follow the NY curve and top out in a week?  That would be the optimistic scenario but not the likely scenario.  By 6/21 Florida should have locked down the whole state as NY did on 3/23 (along with its neighbors New Jersey and Connecticut).  At a minimum, FL should have rolled its reopening back phase 1.  The fact that the governor has reacted minimally so far (prohibited the sale of alcohol at bars) does not bode well for Florida.  While certain counties such as Miami-Dade, Broward, and Palm Beach have resisted moving to phase 2 and required mask-wearing now, this may not be enough to stop the outbreak in the rest of the state.  In fact, Florida is in a far worse situation than NY because NY really only had one serious outbreak in metro-NYC whereas, in Florida, the infection is everywhere: metro-Miami, metro-Tampa, metro-Orlando, metro-Jacksonville and nearly every city and county in the state.  What is required now is a statewide mandate for masking and social distancing.  It requires that the state rollback reopening to Phase 1 until adequate testing, contact tracing, and selective isolation can be put into place.  Additionally, FL needs to postpone the reopening of DisneyWorld scheduled for 7/11, and the reopening of sports (MLS, MLB, NBA) that have been planned and that is sure to exacerbate the outbreak.  Otherwise, the exponential growth phase of the Florida outbreak could continue to surge well past the worst seen in NY.