Elderly Endangered by Virus in States Imposing Loose Controls

(Bloomberg) -- Florida Governor Ron DeSantis’s refusal to issue a broad stay-at-home order has left residents worried they’re heading for a sharp spike in coronavirus cases that threatens the state’s massive 65-and-over community. And a similar approach in Arizona has sparked concern in the other U.S. retirement mecca.

Florida’s concentrated, highly social retirement communities and assisted-living facilities make it vulnerable to the disease, which is especially fatal for older patients and those with pre-existing conditions. The Miami metro area and Orlando are international tourist hubs that continued to draw swarms of travelers until very recently.

In six months, Florida’s death count may increase roughly 100-fold to exceed 6,700, the deadliest total in America after New York, according to projections from the Institute for Health Metrics and Evaluation in Seattle. On Sunday, cases in Florida surpassed Washington, site of the first major outbreak in the U.S.

“Florida is one of the places I’m most worried about,” said Bill Hanage, professor of Epidemiology at Harvard University’s T.H. Chan School of Public Health in Cambridge, Massachusetts. “Not only do we expect it to spread quickly, we expect there to be a larger fraction of severe cases.”

President Donald Trump has so far declined to issue a nationwide stay-at-home order, and DeSantis -- a staunch ally for whom Trump campaigned -- appears to be following his lead. DeSantis, like the president, has repeatedly said he’s worried about the economic fallout of such a decree in the state of 21.5 million, 4.4 million of whom are 65 or older.

The virus poses special risks to the elderly, and has torn through nursing homes in New York, Alabama, Tennessee and Washington state. In Florida, more than a quarter of the state’s cases so far -- and almost 90% of the deaths -- have occurred in patients over the age of 65. Yet, in some states replete with retirees, governors have been hesitant to act.

In Arizona, Governor Doug Ducey, a Republican, issued a statewide stay-at-home order on Monday, shuttering non-essential businesses more than two months after the first case of Covid-19 was confirmed in the state.

But Phoenix Mayor Kate Gallego, a Democrat, said his delay in action has allowed the virus to spread throughout Arizona for months. And she called the order’s provisions too loose: Its definition of essential businesses includes golf courses, hair salons and pawnbrokers.

“It is among the weakest orders in the U.S.,” Gallego said. “We are still seeing far too many people who are not taking social distancing seriously.”

Phoenix’s Maricopa County is home to the bulk of the state’s 1,157 confirmed cases, including the state’s first confirmed case on Jan. 26. That’s an underestimate of how many people have the virus, Gallego said, because of a lack of testing. The first death in Arizona, announced March 20, was a city of Phoenix employee. Since then 19 others have died, and hospitals are preparing for more.

On Saturday, Wendy Smith-Reeve, director of the Arizona Division of Emergency Management, resigned from her post. Smith-Reeve said the governor wasn’t following the state’s emergency response plan, according to the Associated Press.

Targeting Outsiders

In Florida, DeSantis, a 41-year-old first-term Republican who announced the birth of his third child Monday, has at once played down the risk to certain parts of the state while also suggesting the coronavirus has been circulating far longer than anyone realizes. He has set tough crackdowns on outsiders while allowing state residents relatively free rein.

On Monday, he used remarks in Miami Gardens to suggest that the virus could have been circulating during the Super Bowl at Hard Rock Stadium on Feb. 2.

“Listen to all your local officials,” DeSantis said. “We do this until the middle of May, and then we’ll see where we’re at.”

His office didn’t respond to a request for further comment.

The governor has mostly allowed counties to craft their own social-distancing requirements, an approach that initially allowed spring break parties to continue raging on the beaches. As recently as Saturday, at least one north Florida beach remained packed with people flouting social-distancing guidelines.

On Monday, DeSantis issued a stay-at-home order for four of the state’s 67 counties -- Miami-Dade, Broward, Palm Beach and Monroe -- all of which are in the south of Florida and account for more than half of its coronavirus cases.

DeSantis has said he’s especially concerned about importing the virus from elsewhere, and he’s told Trump as much. Under an executive order, Florida is collecting data on all arrivals at airports from the New York area and asking those travelers to self-isolate for 14 days. He has also set up checkpoints on Interstate 95 to catch incoming New Yorkers and on Interstate 10 to screen for those from another hot spot, Louisiana.

He’s also told older Floridians to stay home, and helped bring one of the state’s most expansive testing operations to The Villages, the retirement community in central Florida that’s one of the biggest in America.

The Villages

But DeSantis’s piecemeal approach hasn’t been enough for Sue Bingel, a 66-year-old retired clinical social worker who lives in The Villages. She worries that Florida could become the next New York, and she wants a general stay-at-home order.

“It should definitively happen here,” she said. “It’s a little bit late now. It’s almost like the genie is out” of the bottle.

She recalled hearing from a health-care worker recently that the state was just seeing the “tip of the iceberg.”

Indeed, the virus is already hitting older Floridians. At one assisted-living facility in Fort Lauderdale, Atria Willow Wood, six people who had Covid-19 died this month. DeSantis has blasted the facility for failing to adequately screen staff, construction workers and others. (Atria has said it began screening all visitors on March 4 and that the governor’s comments are “inaccurate and unproductive.”)

In The Villages, a University of Florida research effort has tested over 2,000 people both with and without symptoms. It found 25 positive cases, but none among completely asymptomatic residents.

“These results show evidence of initial community spread; however, it does not appear to be widespread, at least so far,” Michael Lauzardo, deputy director of the University of Florida’s Emerging Pathogens Institute, said in a prepared statement.

“While a week is a short period of time, the fact that we saw increases in the number of positive tests as the week progressed raises concerns that the infection is just beginning to take hold in the community,” he said.

At the very least, older Floridians appear to be taking steps to protect themselves, according to Laura Kammer, another Villages resident. For weeks, she said, many in her community continued to congregate in large groups, play pickle ball and golf. Lately, she’s noticed a change.

On her daily morning walks, other residents are starting to keep their distance.

“People started to realize that we’re not in the bubble anymore,” Kammer, 67, said Monday. “They were just sort of oblivious.”

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