National coronavirus models and some state officials agree that the peak infection rate in Florida has come and gone. That has prompted some to question models that predicted more doom and gloom and call for the state to re-open.
But it's not that simple, said Thomas Unnasch, co-director for the Center for Global Health Infectious Disease Research at the University of South Florida.
The Peak
For most of Unnasch's career, he has studied vector-borne diseases like Eastern Equine Encephalitis and Zika. When the pandemic started, his work turned to COVID-19 where he’s helped USF develop its own models for coronavirus predictions.
And he says – yes – Florida has reached its peak. But it’s not a singular event. It’s more like climbing a mountain.
“How flat is the top of the mountain?” Unnasch asks. “You reach the top of the mountain, but the mountain top, if you're in the Appalachians, is a mile across, and you have to cross the top of that mountain before you're heading down.”
He says knowing when the peak is actually over is a matter of hindsight.
“We will really not know if we're past it until we actually see a week or two of steadily declining case numbers across the Tampa Bay area, and the entire state, before we can really say we're on the downslope.”
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Can We Trust Models?
The models predicting when the peak would occur and its impact on hospitals have changed – and changed again – because of policies put into place by local, state and federal governments.
And because they fluctuate, people are skeptical. They ask: Can we trust them?
George E.P. Box, a British statistician widely regarded as the founder of the field of mathematical modeling for diseases - is attributed as saying “all models are wrong, but some are useful.”
"The models are probably not going to give you actually the correct answer. But they're going to give you estimates about what is going to be close to what the correct answer is,” Unnasch said.
“We have hurricane models that we pay attention to every summer. And those models all vary in their predictions. And most of the time, when the hurricanes strike, they never strike precisely where the model said they were going to strike three days ago, or at the strength that they said that they were going to strike three days ago, but we still rely on those models to give us a general idea of what may be going on.”
Ali Mokdad, Chief Strategy Officer for Population Health at the University of Washington, said all models are only as good as the data fed into them. And while the university’s Institute for Health Metrics and Evaluation is widely regarded as one of the best for predicting peaks and outcomes across the United States, he says all models are saying the same thing.
“All models are telling us exactly the same message. We have a deadly virus on our hands. We don't have a vaccine for it. We don't have a drug for it,” Mokdad said. “The only thing that could help us right now in order to be prepared is have more tests and to stay at home if we can.”
From an infectious disease standpoint, Unnasch said there’s no way to entirely prevent infections and death – especially for a new virus that has no treatment and no vaccine.
Despite criticism of Gov. Ron DeSantis’s handling of state closures, he said Florida has flattened the curve.
“So we've been very successful in this first wave of overcoming the threat to overwhelming our healthcare system, which was the primary point of the whole social distancing,” Unnasch said.
Re-opening the state
While medical professionals statewide have reported personal protective equipment shortages, the infection rate is much lower than expected- and emergency rooms and COVID-19 wards statewide have not been overloaded as feared.
Florida could have implemented social distancing sooner, and made a more cohesive, organized effort statewide to communicate information, Mokdad said. But local municipalities picked up the pace and implemented measures before the state did, leading to less strain on local hospitals, he said.
But that means most people are still susceptible to the virus.
"So if we open up again and we go back, we're going to be putting ourselves, without making some changes, we're going to be putting ourselves in exactly the same situation that we were facing at the end of February, beginning of March," Unnasch said. "So the question is, how do you let the air out of the balloon slowly?"
The state shouldn't open up businesses and social events too quickly, he said.
RELATED: State Leaders Push For ‘Parameters’ They Can Give Businesses, School Districts Before Re-Opening
"So if we can release the pressure slowly, so that the number of cases doesn't overwhelm the healthcare system, we will build herd immunity in the population,” Unnasch said. “More and more people will become immune to this infection even in the absence of a vaccine over the next several months.”
The next two weeks are going to mean tough decisions for DeSantis and his Re-Open Florida Task Force, Unnasch said.
“They're going to really make a real, big difference in in the overall course at this epidemic moving forward, whether or not we managed to get out to the tail end and have nothing much going on after this, or whether we're going to be facing a large second wave like they did in the 1918 influenza epidemic is going to depend to a large extent on the decisions that are made,” he said.
Mokdad said in order for the economy to begin re-opening safely, employees are going to need to be tested before going into work, so that we don’t have another situation like the Smithfield shutdown where hundreds of employees tested positive.
He said businesses for the next few months at least are going to need to continue with spacing customers out in lines, restricting the number of people inside businesses, encourage wearing masks, and more.
But people shouldn’t expect to attend events with large crowds of people anytime soon.
Unnasch said we are going to be able to hug our loved ones again, go to concerts, and cheer on our favorite sports teams eventually. But we’re not at the beginning of the end, he said, we're at the end of the beginning.
