Florida: The Experiment we need

By: Foss Tighe

On September 25, Gov. Ron DeSantis announced that all remaining coronavirus restrictions in the State of Florida would be lifted.

This could be the natural experiment that the people of the United States need to see. What happens when the government removes all restrictions designed to limit the spread of the virus. It is not an entirely pure experiment because local health departments can ask for exceptions, but it will put Florida in the spotlight of the debate about the appropriate government response to the Coronavirus.

Theoretically, the perfect experiment would be to randomly assign states to one of two groups: Government intervention and No Government intervention. But given the broad scientific consensus that intervention is desirable, it would raise ethical and moral questions to possibly assign a state to a behavior known to bring about inferior outcomes. Conveniently, we live in a period where moral and ethical considerations are of waning importance. So, though mainstream scientific community cannot condone such an experiment, it appears one will take place anyway.

Florida is a perfect place to conduct the test. It has both large cities and rural areas. The virus is currently widespread, so its not like we are doing an experiment in an environment where the virus was already extremely limited (think Vermont). The state is also racially diverse.

What are the possible outcomes?

I expect the infection rate to gradually rise above it current levels, though variability in testing levels (intentional and un-intentional) can impact our available metrics in that area. Two to 3 weeks after the infection rate increases I expect to see a rise in hospitalizations, and ICU admissions, and finally, a couple weeks after that I expect to see a rise in deaths. As this continues, I expect the state will have to re-impose restrictions to bring down new infections and deaths. Though I adhere to the current mainstream scientific point of view, I recognize that surprising outcomes are possible.

It is also possible that things will turn out like Sweden, where the government implemented a limited number of mandatory rules, and relied instead, on their citizens following various common sense public health recommendations. Sweden experienced an initial outbreak worse than many of its neighbors, but is currently experiencing infection rates similar or lower than other nations. For example, the United States recently passed Sweden in total per capita deaths. Part of the argument here, is that left to their own decisions, citizens will behave more carefully than if the government “tells” them how to behave.

Another possibility that might impact this experiment, is that people respond to changes in the pandemic more or less independent of government rules or guidelines. Earlier this year, when infections and deaths were rising in the south, states in the Northeast, like my home state of Massachusetts, actually saw declines in the infection rate, even while the government was still further opening the economy. My thought is that the headlines from Florida, Texas and Arizona, affected the behavior of the people of Massachusetts making them more cautious.

There is plenty of historical evidence that even without a full understanding of germ theory people intuitively understand that hanging around in crowded areas during a pandemic is a bad idea. During the black death, the wealthy left the cities and hunkered down in their country estates (like high tech workers today, working from home). The poor also did what they could to limit their exposure. Based on first hand experience during the plague in Athens in 430 BCE that killed 25% of the population, the historian Thucydides, tells us that those who provided care to the ill, were much more likely to come down with the illness. People don’t need Anthony Fauci’s years of training in infectious disease, to know that social distancing will likely reduce your risk of infection.

So will a noticeable uptick in cases and or deaths in Florida relatively quickly trigger a change in a large enough percentage of the population of Florida, to bring infections and deaths back down again, without the government ordering restrictions? A corollary might also include the possibility that a significant outbreak in other parts of the country could trigger behavior changes in Florida even before Florida experiences its own increase.

So let the experiment begin…

My plan is to use the web site covideactnow.org to monitor a county map of Florida to see what happens. This web site uses 5 metrics to color code the infection status of each county. From lowest risk to highest the scale uses green, yellow, orange and red. The first two days worth of data appear above, nothing too exciting to see yet. I will provide periodic updates of this graph for those who are interested.