I finally got Covid this week after flying to Florida to attend a family wedding. Getting Covid was no surprise – all of us will get it eventually – and I was lucky to have a relatively mild version – headache, congestion, fever, fatigue, and cough, bad for one night, worse the next but then fading because I tested myself the first morning, went into isolation for five days right away, called my primary care clinicians, got Paxlovid and started it in less than 12 hours of the first symptom.
Nothing that crazy so far.
Many people assumed that Covid just went away when the pandemic ended, but that’s far from the truth. What ended was pandemic spread of the virus, the kind of spread that happens when a new virus humans haven’t seen before and aren’t yet immune to comes on the scene and spreads wildly, hospitalizing and killing more people than it should because none of us are immune to it yet.
But Covid is still here, only now most of us have some immunity to it. It will still crop up from time to time. It is still killing 700 people a week in the U.S. and spreads locally, when conditions are right. But over the next three to five years it will gradually fade into the infectious disease background among many other viruses and bacteria – influenza, RSV, other corona viruses (there are four others that are known to infect humans) pneumococcal pneumonia – that cause mild illness in most of us. but can kill the elderly and infirm. They are all causes of what we perceive to be the common cold, all as we develop more immunity to Covid-19 from repeated infections and vaccinations as individuals, and we as a community develop community resistance aka herd immunity.
But getting Covid in Florida made we think about one of the things that is crazy about Covid, which is the way the Governor of Florida claims he did such a great job during the pandemic that we should elect him President. (Spoiler alert – I’m not a Democrat. This is not a partisan political message.) I kept the state open! DeSantis says. I opened the schools! I got rid of mandatory masking! Which might sound great if you are selling cars. But those claims were absurd if you understand anything at all about public health.
During the pandemic, it wasn’t possible to know how states and nations compared regarding their management of the pandemic, because the disease spread in surges. A state or nation that was doing well this week might be doing poorly the next. The question always was, which place would have the lowest case fatality rare at the end of the pandemic — the lowest number of deaths per capita — after most people had become immune and pandemic spread stopped. It was possible that our short-term strategies, like masking or social distancing, might have produced short term benefits but no long-term mortality advantages. Technically possible. I wanted to wait until the end of the pandemic to see, because it is scientifically important to keep an open mind.
I was particularly interested in the strategy of countries like Sweden that let people get infected and relied on the herd immunity they acquired to protect their populations. I didn’t think that would work, but I thought we needed to wait until the end of the pandemic spread before we drew any conclusions. The same was true for Florida. My gut feeling was that what DeSantis was doing in Florida — opening the state and getting rid of masking –was a little nuts, but I couldn’t be sure it didn’t work.
But now that the pandemic is over, and the jury is back, we know the answer. Just to keep this objective, I asked my colleague, Nick Landekic, to run the numbers, so there was a different person crunching the data from the person interpreting it.
Here’s what Nick found:
Florida has recorded 88,505 total COVID deaths to date. If they had managed the pandemic as well as the most successful continental state (Vermont) they instead might have had only 30,737 deaths – 57,768 fewer than they had.
If one assumes Florida had managed the pandemic as well as California (most populous state) or the District of Columbia (most densely populated) they instead might have experienced between 42,509 and 56,678 deaths, 31,827-45,996 fewer deaths than they had. If Florida had done as well as South Korea (another peninsula) they would have had only about 10,000 deaths, 78,000 fewer deaths than they had.
Florida didn’t do a little badly in the pandemic. It did miserably badly, and the decisions that DeSantis made, which threw the public health principle of an abundance of caution (you made public policy carefully and to protect life at all cost until you have all the facts) out the window, and killed about 50,000 Floridians.
The notion that a man who has the blood of thousands of people on his hands can even run for President at all strains the imagination. The notion that he can stand before us and with a straight face claim that he did a good thing – that’s entirely wild bullflop crazy.
We made a mess of the pandemic. CDC sent conflicting messages and tried to finesse its failures. That we let our politics get in the way of simple public health measures – masking, social distancing, closures when the disease was spreading, the intelligent use of testing, quarantine, and isolation – should drive us all crazy with guilt.
We could have and should have gotten schools open quickly by keeping teachers and other school personnel over 50 home; by mandatory PCR testing twice a week for public school students (the way colleges and universities did it); by cocooning the elderly; by building isolation hospitals for people who needed isolation etcetera and so on. You do what you need to do to keep the viruses from spreading until you get a vaccine, and then you vaccinated anything and everything that moves. This is not rocket science. (Our vaccination rate never got beyond 70 percent, by the way. In South Korea, they are more than 95 percent vaccinated.)
Other nations did these things and they saved lives and kept their economies open. But for Governor DeSantis to claim he steered Florida through the pandemic successfully when his management likely cost the lives of 50,000 Floridians – that’s really crazy, and that he got reelected anyway, that’s crazier yet.
But craziest of all is the notion that the economy is more important than human lives. Or that it is okay to profit from the misfortune of others.
But I ain’t buying what DeSantis and others like him are selling, which is that stamping your feet, and yelling “I don’t wanna” counts as leadership.
It ain’t not, as they say in the South.
(Dr. Michael Fine is a former director of the Rhode Island Department of Health, a community healthcare advocate, and an author of novels, medical books, and short stories)