The Pandemic Isn't Over-- Even If Politicians-- And Lots Of People-- Are Behaving As If It Is

"Don't Let It Dominate Your Life" by Nancy Ohanian

If you can believe Florida's stats, 32,252 residents have died of COVID so far, 82 of them today. Today also saw 5,244 new cases, bringing the state's total to 1,973,109. The U.S. has 90,752 cases per million residents. Florida is slightly worse off, with 91,868.

All across the country, people are sick of this damned pandemic, so-- with the encouragement of a weak and/or venal political class, whether Gavin Newsom in California or Greg Abbott in Texas-- they are casting cautions to the wind and daring COVID to do something about it. Air travel, still considered dangerous, has increased precipitously. More than 400 Tesla workers tested positive after Elon Musk re-opened a plant in California. The NY Times reported that "Coronavirus cases are trending downward across the United States as the country’s vaccine rollout picks up speed. But despite the large drop in new infections since early this year, the U.S. death rate remains at nearly 1,500 people every day. That number still exceeds the summer peak, when patients filled Sun Belt hospitals and outbreaks in states that reopened early drove record numbers of cases, though daily deaths nationwide remained lower than the first surge last spring. The number of new reported cases per day remains nearly as high as the summer record." Thursday 62,913 more Americans were reported infected and COVID killed 1,605 more of us. Friday, there were 68,216 more reported infections and 1,529 more deaths.

Reporting from south Florida this afternoon, Patricia Mazzei noted that Miami has been struggling with more coronavirus cases than any other big city except NYC (Hasidic capital of America). "Florida," she wrote, "reopened months before much of the rest of the nation, which only in recent days has begun to emerge from the better part of a year under lockdown... For better or worse, Florida’s experiment in returning to life-as-it-used-to-be offers a glimpse of what many states are likely to face in the weeks ahead, as they move into the next phase of the pandemic-- the part where it starts to be over."

“If you look at South Florida right now, this place is booming,” Gov. Ron DeSantis, a Republican, recently gloated. “Los Angeles isn’t booming. New York City isn’t booming.”
To call what is happening in Florida an actual boom is a stretch. Though the state was fully reopened by late September, its tourism-dependent economy remains hobbled. A $2.7 billion budget deficit will need an injection of federal stimulus money. Orange County, where Orlando is, saw the lowest tourist development tax collections for any January since 2002.

One of the state's two crackpot senators, Rick Scott, formally asked the governor and the mayors to return the federal money, demanding they "'quit recklessly spending other people’s money" and, in the process, turning himself into a laughing stock.

While Republican politicians-- Gov. Ron DeSantis in the lead-- boast of how wonderful life is in delusional Florida, is, according to Mazzei "to ignore the heavy toll the coronavirus exacted in Florida, one that is not yet over... Miami-Dade County averaged more than 1,000 new coronavirus cases a day over the past two weeks, one of the nation’s most serious outbreaks. And Florida is thought to have the highest concentration of B.1.1.7, the more contagious virus variant first identified in the United Kingdom.

Yet Florida’s death rate is no worse than the national average, and better than that of some other states that imposed more restrictions, despite its large numbers of retirees, young partyers and tourists. Caseloads and hospitalizations across most of the state are down. The tens of thousands of people who died were in some ways the result of an unspoken grand bargain-- the price paid for keeping as many people as possible employed, educated and, some Floridians would argue, sane.
...Florida never imposed a statewide mask mandate, and the governor in September banned local governments from enforcing their own local orders. This week, Mr. DeSantis wiped out any outstanding fines related to virus restrictions, stating that most of the restrictions “have not been effective.”
Florida ranks in the lower third of states when it comes to vaccinations.

A couple of weeks ago Pulitzer-winning author Siddhartha Mukherjee posed an question for New Yorker readers that everyone has thought about. He wanted to know why the pandemic seems to hit some places harder than others. "The usual trend of death from infectious diseases-- malaria, typhoid, diphtheria, H.I.V.-- follows a dismal pattern," he wrote. "Lower-income countries are hardest hit, with high-income countries the least affected. But if you look at the pattern of covid-19 deaths reported per capita-- deaths, not infections-- Belgium, Italy, Spain, the United States, and the United Kingdom are among the worst off. The reported death rate in India, which has 1.3 billion people and a rickety, ad-hoc public-health infrastructure, is roughly a tenth of what it is in the United States. In Nigeria, with a population of some two hundred million, the reported death rate is less than a hundredth of the U.S. rate. Rich countries, with sophisticated health-care systems, seem to have suffered the worst ravages of the infection. Death rates in poorer countries-- particularly in South Asia and large swaths of sub-Saharan Africa-- appear curiously low."

As the pandemic engulfed the world during the past several months, I kept returning to the question of what might explain these discrepancies. It was an epidemiological whodunnit. Was the “demographic structure” of a population the real factor? Were the disparities exaggerated by undercounting, with shoddy reporting systems hiding the real toll from public-health analysts? Was government response a critical variable? Or were other, less obvious factors at play? Perhaps any analysis would prove premature. If new viral strains, such as the South African variant of the virus, known as 501Y.V2, were to sweep through Africa, every prediction of mortality might be overturned. But as I started speaking with colleagues from around the world I found that my puzzlement was widely shared. For many statisticians, virologists, and public-health experts, the regional disparities in covid-19 mortality represent the greatest conundrum of the pandemic.
...[E]everyone accepts... the most potent variable for covid-19 severity: age. The median age in India is twenty-eight. In Spain and Italy, it’s forty-four and forty-seven, respectively. After the age of thirty, your chance of dying if you get covid-19 doubles roughly every eight years... [BUT] Mexico has a median age similar to India’s; the percentage of the population that’s over sixty-five is within a point or two of India’s. Yet India’s reported rate of covid-19 deaths per capita is less than a tenth of Mexico’s.
...Around a third of the deaths in the United States have occurred among residents and staff of long-term nursing homes. How do you assess the relative risks of the “warehoused elderly” in the developed world and the “homebound elderly” in the developing world, where seventy- and eighty-year-olds often live with a handful of younger family members?

Mukherjee went through half a dozen other possibilities, from effective government intervention to the acquired differences in human immunology and plain ole under-reporting. Short answer: so far no one knows why some areas are hot harder than others.