As the delta variant spread across the state earlier this month, Gov. Ron DeSantis told reporters that Florida was well-positioned to handle the next wave of COVID-19 infections.
The state had already vaccinated its oldest — and thus most vulnerable — residents, he said.
“I’d rather have 5,000 cases amongst 20-year-olds than 500 cases among seniors,” DeSantis said during an Aug. 3 news conference in the Everglades.
But public health experts say COVID-19 is still a threat to older Floridians.
Since the latest wave of cases started rising on June 18, Floridians ages 60 and up have accounted for 16 percent of infections. But they represent about half of all hospitalizations and 74 percent of deaths.
Nearly 3,500 older adults have died of COVID-19 in Florida since the start of the fourth wave. That’s about three times the number of deaths suffered by every other age group combined.
Florida has seen record infections and hospitalizations in recent weeks, due to the more transmissible variant and lagging vaccination rates in younger populations.
University of Florida epidemiologist Cindy Prins said there’s no way to protect one segment of the population from this level of mass infection. Hundreds of thousands of older adults haven’t received the vaccine in a state where 38 percent of the total population is unvaccinated.
“The 5,000 cases among the younger are going to turn into 500 cases among the older,” she said. “The populations are not mutually exclusive. They are family members, and they’re neighbors, they’re co-workers, they’re caretakers.”
The governor’s office did not answer questions from the Tampa Bay Times for this story.
Dr. Santosh Kamata, a geriatrician who practices in Manatee County, said the toll older adults will suffer is inevitable.
“I think that in the next few weeks, we could see a much higher mortality in the 65-plus age groups.”
Older adults remain at risk
Florida’s 60-plus population has the highest vaccination rate in the state. But as of Friday, more than 200,000 older adults were only partially vaccinated and more than 900,000 Floridians over 60 have yet to receive their first shot.
Vaccination rates among the elderly have plateaued, increasing just 3 percent in the past two months. ”This suggests to me that we’re seeing a largely resistant population or they face persistent barriers like isolation or internet illiteracy,” said University of South Florida epidemiologist Jason Salemi. “It may take a lot of effort to make that percentage budge.”
Once an unvaccinated older adult is exposed to the virus, the likelihood that it develops into a serious infection is much higher compared to younger patients.
The Centers for Disease Control and Prevention estimate that people ages 65 to 74 are six times as likely to be hospitalized from a COVID-19 infection compared to the 18-to-29 age group. They are 95 times as likely to die.
The statistics look bleaker among older adults. Those 85 and over were 15 times as likely to end up in the hospital and 600 times as likely to die.
“Older people are just not capable of mounting the immune response that is necessary to fight the virus,” said Johns Hopkins University epidemiologist Morgan Katz. “And older people just develop over time comorbidities that put you at risk for a more severe reaction.”
Kamata has been treating several older patients for COVID-19 who then ended up hospitalized. One story struck him: A husband and wife in their 60s both contracted the virus at the same time – but she was vaccinated, and he was not.
“The outcome is just so starkly different,” he said. “Looking at his X-rays and lab work is like looking at patients that I saw in early February 2020, when COVID first came in and we didn’t have any vaccines.”
The husband remains hospitalized and was placed on a ventilator.
Proof vaccines work, and COVID is deadly
The numbers for older Floridians remain grim nearly 18 months after the pandemic started and eight months since vaccines became available. In January, adults over 60 accounted for nearly 70 percent of Florida’s hospital admissions, according to federal data. Now, they make up half of all Floridians admitted to hospitals for COVID-19.
While fewer older adults are dying during this wave, they still account for the majority of Florida deaths. Floridians over 60 made up 89 percent of deaths prior to June 18. Now they account for 74 percent of deaths. They also account for the majority of Florida’s record hospitalizations: More than 7,400 adults over 60 were admitted to Florida hospitals last week. That’s nearly 50 percent of COVID hospitalizations that week.
Older Floridians still have the highest death rate. The state has lost nearly 3,500 older adults to the current wave, five times the rate of younger Floridians, adjusted for population size. Breakthrough cases remain rare among those who were vaccinated, but do happen. Florida does not report breakthrough infections or whether those who were hospitalized or died from COVID were vaccinated or unvaccinated.
But a recent Kaiser Family Foundation study found that, in 25 states, less than 1 percent of vaccinated individuals tested positive for COVID-19 and basically zero percent were hospitalized or died due to COVID-19.
Health experts worry that older adults and the immunocompromised are most at risk for breakthrough infections. But Dr. Jacqueline Crowley, vice president for population health at BayCare Health System, says they are rare even among elderly cases.
“It’s the minority of cases,” she said. “The majority of cases really are the younger patients and those that are unvaccinated.”
Federal health officials announced plans last week to roll out booster shots for Americans who received either the Pfizer or Moderna vaccines. Pending federal approval, the shots would be available Sept. 20 to Americans eight months after receiving the second dose of either two-part vaccine.
The announcement came on the heels of three studies released last week by the CDC, which showed a declining effectiveness of the two mRNA vaccines.
The announcement indicated that booster shots may also be needed for Americans who received the Johnson & Johnson vaccine.
Rising cases puts everyone at risk
All of Florida is considered an area of high community transmission by the CDC. The state’s positivity level is 19.8 percent.
“We have a perfect storm here,” said Katz, “where there’s a significant number of people who are unvaccinated who are also not wearing masks in public, and then the delta variant is much more contagious than the previous variant.”
That level of uncontrolled spread threatens to overwhelm Florida’s hospital systems, she said, putting vulnerable COVID-19 patients, many of them 60-plus, at even greater risk.
Prins, the University of Florida epidemiologist, said the best way to protect older adults is to use the same methods that proved effective earlier during the pandemic, including wearing masks and social distancing. But the best advice remains the same:
“The number one thing, and we’ve been saying this for months, is for everyone in your family to get vaccinated.”
Times staff writer Hannah Critchfield contributed to this report.
• • •
DELTA VARIANT: The contagious variant has changed what we know about staying safe from COVID-19. Here’s what you need to know.
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BOOSTER: Officials say you’ll need another shot for protection.
VACCINES: The best way to stay safe from COVID-19 is to get vaccinated. Here’s a primer on the coronavirus vaccines.
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