Florida has now tested 1% of its population for COVID-19. Experts say testing is crucial to curtailing the epidemic and must be expanded.
Florida is behind 20 other states, including neighboring Louisiana and Mississippi, when it comes to testing its residents for coronavirus.
Testing is crucial to limiting the spread of the pandemic. Yet Floridians around the state, including the most vulnerable, report significant difficulties getting tested.
It’s not exactly clear why Florida is behind others in testing. But it is more restrictive than some states, such as Tennessee, which announced this week that it would allow anyone — if they have symptoms or not — to get tested for COVID-19.
Florida's Department of Health directs people who suspect they have the virus to their local health professional. Only those who meet certain guidelines get the test: symptoms such as fever, cough and shortness of breath, contact with an infected person or travel to an impacted country.
Even people with coronavirus symptoms have found it hard to get tested.
Nicole Buchanan fought for days to get her husband tested for COVID-19 after he tested negative for the flu yet kept getting worse.
Conrad Buchanan, a Fort Myers disc jockey, died March 26.
"None of the testing sites wanted to take him," she said. "He was only 39."
Testing results reported by the Department of Health seem to be falling off from the peak of 15,469 on April 9 to 14,788 on Wednesday evening.
Experts contend the opposite needs to happen. In order to mitigate the spread of the deadly contagion, they say Florida needs to dramatically increase its testing.
Florida has tested only 1% of its residents, slightly above the national average of 0.95%. New York, which has been hard hit by COVID-19, had the highest rate of testing: about 2.6% of its population.
Florida hit the 1% milestone Wednesday, when the virus had infected 22,519 state residents, hospitalized 3,249 of them and killed 614, according to Department of Health data posted Wednesday evening. Publicly available state data do not include the number of people who have recovered.
New York had 10,834 deaths from COVID-19, according to the most recent data. The death counts in Louisiana and Mississippi were 1,013 and 111, respectively. The testing rate and is 2.7% in Louisiana and 1.3% in Mississippi, according to the Johns Hopkins University Coronavirus Resource Center.
The News-Press and Naples Daily News analysis of testing rates is based on Census Bureau population estimates and regularly updated data collected by The COVID Tracking Project.
Gov. Ron DeSantis has touted efforts to increase testing, with additional mobile testing sites being set up around the state, National Guard "strike forces" going into nursing homes and the availability of quick tests.
The National Guard strike teams were so successful they have been expanded, DeSantis said this week. The state has 10 teams of four soldiers each testing people in nursing homes, where there is concern over direct-care workers who are asymptomatic but may have been exposed.
Those strike teams took samples from 500 people on Tuesday, DeSantis said: "We want to expand that as widely as we can. It is very, very important we focus resources on those people who are most vulnerable to COVID-19."
Department of Health officials did not have an immediate explanation for the recent dropoff in testing numbers, but DeSantis acknowledged on Monday that some results were coming in late, and there may be a lag in testing. The private labs that do the bulk of the testing for Florida are a week or more behind on processing the tests the state is sending in, state officials said.
More testing in nursing homes
Floridians around the state, including the most vulnerable, report significant difficulties getting tested. Nursing homes, where residents' ages and underlying health conditions make them susceptible to the disease and more likely to die from it, have been on the forefront of a cry for increased testing.
On April 14, Martin Goetz, CEO of River Garden Senior Services, a senior living community and nursing home in Jacksonville, wrote DeSantis, Mary Mayhew, secretary of the Agency for Health Care Administration, and Scott Rivkees, Florida’s surgeon general, to demand the immediate testing of nursing home staff and residents in Florida.
While grateful for the Florida National Guard “strike teams,” Goetz wrote: “Telling facilities that testing will begin in another week is unacceptable. The need is immediate and response must be in proportion to the identified threat.
“To date, all we have accomplished is chasing where the virus has been, not where it is headed,” Goetz wrote.
According to covidtracking.com data, U.S. states and territories have tested 3.14 million people, of which 605,243, or 19%, were positive. In Florida, the Department of Health’s Wednesday evening report shows 214,210 tested and 22,519, or 10.5%, positive.
Experts worry that the testing protocols are not broad enough to contain the spread of COVID-19. Testing only people with symptoms excludes those who might be spreading the virus even though they don't appear sick, they say.
“Florida should be changing its testing strategy,” said Dr. Camara Jones, a fellow at the Radcliffe Institute for Advanced Study at Harvard University and past president of the American Public Health Association. “You shouldn't wait for people to be symptomatic. You have to sample those people who are not symptomatic.”
Jones said that by testing only sick people, “we are documenting the course but not changing it.”
That change in course would have resulted in fewer deaths had it been implemented from the start, she said.
“The people leading this are not public health people,” Jones said. Instead, the fight against the pandemic is being led by “clinical medicine,” which she said has a “narrow view of how to use a test.”
She cited Germany’s low death rate from COVID-19 as an example. Germany, Jones said, did contact tracing, which identifies people who had contact with an infected person. That allowed them to be tested, often before they become symptomatic, thus limiting further spread of the virus.
According to the Johns Hopkins University Coronavirus Resource Center, the case fatality rate – the number of infected people who die from COVID-19 – is 2.96 in Germany and 4.81 in the U.S.
The Germans “controlled the epidemic as opposed to taking a movie of it. They got up on the stage and changed things. They put themselves in the middle of it and changed what was happening rather than just recording what was happening,” Jones said.
Testing rates have improved in Southwest Florida, where waits for results had stretched as long as 10 days. The region's largest hospital system, Lee Health, has begun in-house testing. As of Tuesday, Lee Health reported that it had no pending test results.
"(T)hanks to our in-house testing capability and the clearing of backlogs at labs, we expect to continue to return nearly all results within 24 hours," said Larry Antonucci, Lee Health's president and CEO.
Flattening the curve
Although testing is limited, it continues to expand.
Jerne Shapiro, a field epidemiologist at the University of Florida, said she's seeing some hopeful signs that testing and social distancing practices are starting to flatten the infection curve in Florida.
But much broader testing is needed to fully contain COVID-19, she said.
"I think we're getting on a more solid footing now. We have more tests available, and the cases are plateauing." Shapiro said. "We need to be able to have that surveillance — that anyone who wants to be tested can be tested. I think we're moving toward that."
In the wealthy enclave of Fisher Island, that's already happening. The private island community south of Miami Beach purchased enough COVID-19 blood test kits from the University of Miami Health System for all of its residents and the people who worked for them to be tested.
According to the Miami Herald, Lisa Worley, a spokeswoman for the university, explained it this way: “This is what the Fisher Island residents wanted."
Frank Gluck is a watchdog reporter with The News-Press and the Naples Daily News. Connect with him at firstname.lastname@example.org or on Twitter: @FrankGluck.
Melanie Payne is an investigative reporter with The News-Press and the Naples Daily News. Connect with her at email@example.com or on Twitter: @TellMel.
Jeffrey Schweers, a reporter with the USA TODAY NETWORK-Florida Capital Bureau, contributed to this report. Contact him at firstname.lastname@example.org and follow him on Twitter @jeffschweers.
This story originally published to news-press.com, and was shared to other Florida newspapers in the USA TODAY Network - Florida.