A Miami ER doctor explained how Florida's COVID-19 response went from success to disaster

Fewer than 5% of those tested in May were found to have COVID 19; today the number is three times that, hitting a 7-day average of just under 16%.
"When everything started to open up and ease up, then our volume picked up," Dr. Mark Supino, an emergency medicine physician at Jackson Health System in Miami, told Business Insider.
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Eight weeks back, Florida was hailed by conservative media and politicians as a model for addressing the coronavirus pandemic, showing that there was no need to shut down a state for months to ride out the first wave of the coronavirus.

Gov. Ron DeSantis, a former military prosecutor and Republican congressman, was all but saying: I told you so. And his allies were singing his praise.

"He's done a spectacular job," US President Donald Trump said at a joint news conference in April, as The Washington Post reported in a story on the apparent victory of business as usual. "He's going to be opening up large portions [of the economy], and ultimately pretty quickly because he's got great numbers in all of Florida."

By early May, Florida restaurants were once again entertaining guests, and the governor's office was boasting.

"He's not doing it the way Cuomo is doing it," a spokesperson, Helen Ferr, told the Tampa Bay Times on May 4, referring to the Democratic governor of New York. "He's doing it the conservative way."

Weeks later, the numbers have changed. While New York has overcome the first surge of COVID-19, reporting 624 new cases on June 28 down from a high of more than 10,000 a day Florida is reporting more cases than ever before: more than 5,000 a day for a week straight, as of Monday.

DeSantis has attributed that, in part, to young people. "You can't control [them]," he said Sunday . "They're going to do what they're going to do." He's also credited an increase in the number of cases to the number of tests. "As you're testing more, you're going to see more cases," he said earlier in the month .

But while youth do indeed account for an increasing share of the infected, they have been drinking at bars that the state had reopened only to close them again last Friday. And though the increase in cases does come amid an increase in tests, a higher share of those being swabbed are testing positive.

Fewer than 5% of those tested in May were found to have COVID 19; today the number is three times that , hitting a 7-day average of just under 16%.

Gov. DeSantis' office did not immediately respond to a request for comment. But front-line workers see a link between public policy and public health.

"When everything started to open up and ease up, then our volume picked up," Dr. Mark Supino, an emergency medicine physician at Jackson Health System in Miami, Florida, told Business Insider.

As The New York Times reported on Sunday , a third of the people admitted to the Jackson Memorial Hospitals' ER these last two weeks have been diagnosed with COVID-19. Statewide, the paper noted, many are young: those between 25 and 34 are testing positive at a rate of 20%. And the young can carry the virus to the old.

"We've certainly seen clusters within families, within the homeless shelters, with anywhere where anybody's confined," Supino said. "That, I think, creates a big risk factor for transmission."

If there is an upside to the latest surge it's not another "wave," we are still riding the first it's that we are better prepared, which means better outcomes for those who are hospitalized, Supino said.

"I think there is reason to be optimistic," Supino said. Patients today are receiving antibody-rich plasma from those who have already recovered; Remdesivir , an antiviral drug that a recent clinical trial found to be effective in the fight against COVID-19, is another option that wasn't around at the start of the pandemic; and even something as basic as flipping patients onto their stomachs is now more widely known as a means of improving airflow for patients struggling to breathe.

That all should decrease the lethality of the coronavirus, it is hoped, but only if hospitals aren't overwhelmed by a sheer influx of sick individuals competing for limited resources, from drugs to beds in the intensive-care unit. At Miami's Jackson Health System, the ICU is almost always approaching capacity, and that was before COVID-19.

Complacency, increasing alongside the rate of infection, could push hospitals to the tipping point. It's already hurting the mental health of patients and providers alike, the virus becoming old news and increasingly politicized.

"We were all in it together for the first months," Supino said. "It feels like those gains have been somewhat diminished, and that can leave people feeling a little gloomy."

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