FORT LAUDERDALE, Fla. _ Palm Beach County hadn't met all the federal guidelines for reopening when it ended its coronavirus lockdown, a South Florida Sun Sentinel analysis has found.
The county commission voted 5-1 on May 5 to ask Gov. Ron DeSantis to lift restrictions designed to stop the spread of the new coronavirus anyway, and he approved.
The order lifting restrictions went into effect Monday. Restaurants, salons and malls flung open their doors, albeit at 25% capacity. But over the two weeks preceding the decision, coronavirus infections in the county had remained steady, and so had the percentage of people testing positive _ and some numbers are now trending upward.
Most other large Florida counties, including Broward and Miami-Dade, have shown the general declining trends in new cases and infection rates that federal guidelines recommend. Palm Beach County has not _ yet it was among the first in South Florida to push to reopen.
Palm Beach County Commissioner Hal R. Valeche said commissioners were aware that the county did not meet the federal criteria, but it is unclear from the record at what point during the May 5 meeting the issue was raised. He said he prefers to look at hospital capacity rather than new infections as a measure of the outbreak's severity, since sometimes test results can take days to process.
"I was an advocate for getting us to Phase One reopen," said Valeche, an investment banker. "The whole idea of flattening the curve was to open up hospital space."
Hospitalizations for COVID-19 are a lagging but reliable indicator of the virus, since people can take weeks to get sick enough to require a hospital. Public data tracking hospitalizations for COVID-19 over time is unavailable, but Gov. Ron DeSantis has repeatedly cited the metric in his arguments for reopening the state.
Palm Beach County Commissioner Gregg Weiss, the only commissioner to vote on May 5 against reopening, pointed to the new infections and high infection rates at Friday's commission meeting while arguing against opening the beaches. Weiss was one of two commissioners who voted against the beach reopenings.
"To me, it looks at best that we are flat," he said. "I don't see a downward trend in the number of new cases, I don't see a downward trend in the hospitalizations."
The governor's office didn't respond to repeated requests for comment on why it gave Palm Beach County the green light to open.
Speaking only for himself, Palm Beach Mayor Dave Kerner said in a written statement that he "put more weight on declining positivity rates vs. new cases, as common sense suggests the more we test (a laudable goal), the higher the aggregate number of positive returns will rise."
In his statement, Kerner also highlighted the spare ICU, ventilator and hospital capacity in the county.
"I believe the PBC BOCC (Palm Beach County Board of County Commissioners) has made a very cautious, unified, and fully vetted decision to slowly re-open our economy and embrace a new normal," Kerner wrote.
Both the nonbinding White House guidelines for "Opening America Again" and the Florida governor's office emphasize the importance of positive test rates and the number of new infections as key figures to watch.
The White House says that it's safe to reopen when a county or city meets the following guidelines, based on a report titled "Opening Up America Again" compiled by the Centers for Disease Control and Prevention:
A decline over 14 days in the number of people with flu-like symptoms, and a 14-day decline in the number of people with COVID-19 symptoms.
A 14-day downward trend in the number of infections or a 14-day downward trend in the percentage of people who test positive.
The county can treat everyone at area hospitals, and the county can test all health, police and fire-rescue workers for the virus.
When Palm Beach County voted to enter the first phase of reopening, going into effect on May 11, it had not met either requirement for the second guideline. And in the week after it reopened, the number of people showing up at area medical centers with influenza-like symptoms _ guideline one _ actually increased.
When the Sun Sentinel asked Alina Alonso, director of the Florida Department of Health in Palm Beach County, on Friday if she was aware of the fact that Palm Beach County had opened without meeting the federal guidelines, she replied: "I have no idea about that. I mean, I don't have any comment about that because that's up to the board."
Infectious disease experts caution that early ends to lockdowns could have serious consequences for a second wave of infections if an outbreak isn't closely monitored.
Scott McNabb, research professor in global health and epidemiology at Emory University School of Public Health in Atlanta, describes the restrictions like a faucet. "Let's say they've opened the faucet too much, there's too much of a stream coming out, you can detect that, and they need to be prepared to close it, and the public needs to know why, so they don't rebel," he said.
As of Friday, Palm Beach County commissioners had yet to set specific benchmarks for closing back down in case of a second wave.
During commission meetings, Alonso has been providing comprehensive updates about infection numbers, positive test rates, deaths, hospitalizations, ICU capacity, infections in long-term care facilities, and the geographic distribution of cases by ZIP code.
But a closer look at the five graphs Alonso displayed at the May 5 meeting shows that only one _ the trend line of positive cases _ was current to that date. Two others, showing infected residents at long-term care facilities and ICU cases, were updated only to May 1. Another two graphs, showing trends in hospitalizations and deaths, were dated to April 30.
At Friday's meeting, during which commissioners voted 5-2 to reopen beaches, Commissioner Weiss said to Alonso "we've got spread going on in parts of our community, still."
"Yes, the virus is still spreading," she said, "because that's what the virus does."
