The governors of Florida and California have taken somewhat different approaches to managing the COVID outbreaks in their states. California’s Governor Newsom was the first to order a statewide shutdown. Florida’s DeSantis was among the last. Also, Newsom’s order was considerably more restrictive than DeSantis’s. And, much to the chagrin of the media, DeSantis has moved more quickly to reopen his state than has Newsom to reopen his. As a result, the media has largely lionized Newsom while trashing DeSantis. (e.g., these stories in Politico and The Guardian.)1
So, I thought it would be interesting to compare the actual results in the two states.2 What I found was that the experiences have been very similar and, if anything, the situation in Florida seems to be improving slightly more rapidly than in California.
Let’s start with the cases and fatalities per 100,000 persons. California is currently at 159 cases and 6.5 fatalities, while Florida is at 174 and 7.4, respectively.
Florida has tested a slightly higher percentage of its population than has California (2.23% vs. 2.17%).
When you look at the new cases and fatalities over time, it appears that Florida has done a little better at bending its curve than California.
The similarity in the results is perhaps even more surprising given the frequent travel between Florida and New York, home to the worst outbreak in the nation, and that Florida’s median age is six years higher than California (42 v. 36). Both factors should have made Florida more susceptible to a wider outbreak and a higher mortality rate. But, at least so far, they have not.
So, what are we to make of these similar results from two supposedly different responses?
First, I do not think the approaches were as dissimilar as the media would have us believe. Newsom ordered the statewide stay-at-home order on March 19, but DeSantis was only 11 days behind on April 1 and he had closed bars and night clubs and restricted restaurants to 50% capacity earlier on March 17. Much of the perception of a difference has more to do with the politicization of COVID by the media rather than actual substantive differences in their actions.
Second, and more importantly, the results call into question to what degree we can judge the efficacy of containment strategies like the stay-at-home orders. As the curves have begun to flatten, proponents of the various containment strategies have been quick to credit them with the improvement. But coincidence does not prove causation.
We know from history and common sense that if a disease is contagious, there will be some benefit from keeping people separated. But there is little scientific or statistical evidence to demonstrate the degree of the efficacy of any particular containment strategy. The emerging picture from the data is that it appears many of the restrictions put in place may have had limited impacts and that other factors such as population density, climate and mass transit usage may be at least as, if not more, important. (See this CNN story on the difference between Florida and California compared to the Northeast.) As former FDA commissioner Dr. Scott Gottlieb recently said, “While mitigation didn’t fail, I think it’s fair to say that it didn’t work as well as we expected.” 3
In the panic that ensued from the outbreak in March, public officials, attempting to err on the side of caution, rushed pell-mell to enact very broad efforts to contain the virus with little regard for the costs or collateral damage they would cause. Since we have now gotten past the irrational fear that the outbreak is going to grow exponentially forever (or, at least, most of us have), perhaps we can now start trying to sort out a more nuanced approach to help slow its spread while doing the least possible damage to people’s lives and livelihoods.
1 To fully disclose my personal bias, I really don’t care for either one of these governors. Both represent to me the extreme partisanship to which I am opposed.
2 Unless otherwise noted, all of the data for this comparison comes from the COVID Tracking Project.
3 There has been a particularly robust debate within the Israeli medical and academic community about the wisdom of that country’s lockdown, click here for story.