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Jun 13, 2020

Divided states of the pandemic

Co-produced with PRX Logo

The federal government’s early failures to manage the coronavirus shifted a heavy burden to local control. We look at how officials in two states, California and Florida, found their way to shutdown and eventual reopening and explore the intersection of politics and public health behind the decision-making process.

Reveal teams up with KQED in San Francisco and WLRN in Miami to investigate the early decisions these two major metro areas made in response to the virus and what we can learn from those decisions, even as the pandemic continues.

Credits

Reported by: Marisa Lagos, Melissa Lewis, Laura C. Morel, Caitie Switalski, and Lance Williams

Produced by: Emily Harris

Edited by: Jen Chien with help from Esther Kaplan and Soo Oh

Production manager: Mwende Hinojosa

Production assistance: Amy Mostafa and Najib Aminy

Sound design and music by: Jim Briggs and Fernando Arruda

Executive producer: Kevin Sullivan

Host: Al Letson

Special thanks to The COVID Tracking Project at The Atlantic for their data on tests, and The New York Times for their data on COVID-19 cases and deaths. 

Special thanks as well to Holly Kernan, Ethan Lindsay, Vinnee Tong, Scott Shafer from KQED, and Alicia Zuckerman, Terence Shepherd, and Tom Hudson from WLRN, and Crystal Liang at Sky Link TV.

Support for Reveal is provided by the Reva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, Democracy Fund, and the Ethics and Excellence in Journalism Foundation.

Transcript

Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal's radio stories is the audio.
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Al Letson: From the Center for Investigative Reporting and PRx this is Reveal. I'm Al Letson. It's June, five months into our national experiment of managing a contagious deadly disease and the US is hurting. More than 100,000 people have died of COVID-19, the illness caused by the Coronavirus and we're now at over 2 million people infected. The disease is having a disproportionate impact on black America. Black people are dying and more than twice the rate of Asian, Latinx or white people from COVID-19. And in the midst of this, George Floyd, a black man's death at the hands of a white police officer sparked worldwide outreach.
People in every state went out into the street in record numbers to protest police brutality. The images from the days of protests are absolutely stunning, sometimes heartbreaking, but also worrisome in the middle of a pandemic. And we've moved into phase two, reopening.
Speaker 3: A first date to fully reopen Alaska. It's been the least affected by the virus [crosstalk].
Speaker 4: Another big step in the reopening of Florida hair and nail salons [crosstalk].
Speaker 5: ... Today gyms all across the lone star state can get back up and running.
Al Letson: The judgment on when and how to reopen is up to each state. That's how it went with the shutdowns too. This is not unique to Coronavirus. These types of decisions are always a balancing act between big picture and ground level factors. But this pandemic is not only more deadly but more complex than any we faced in recent history. And local leaders have been left to navigate that complexity by federal government that's largely abdicated its responsibility to lead.
Trump: States can do their own testing, states are supposed to be doing testing, hospitals are supposed to be doing testing. Do you understand that?
Speaker 7: [inaudible] come back.
Trump: We're the federal government. Listen to me. We're the federal government. We're not supposed to stand on street corners doing testing.
Al Letson: Today, we'll show you exactly who made the enormous decisions to shut down two of America's most populous and diverse states, California and Florida. They're on opposite coasts and very different politically, but they started dealing with the crisis around the same time, and they reported their first COVID-19 deaths within days of each other.
We're going to zoom in on the San Francisco Bay Area in South Florida, where local leaders found themselves having to make decisions with inadequate information and mixed messages from the top. In Florida, Reveal's Laura Morel joined forces with WLRN's Caitie Switalski. And here in California Reveal's Lance Williams teamed up with KQED's Marisa Lagos. We started in San Francisco with Marisa.
Marisa: Back in January, most Americans are preoccupied with the impeachment of President Trump, the Democratic presidential primary and the Super Bowl, but not this doctor in San Francisco.
Jen Zhang: My name is Jen Zhang, and I'm the CEO of Chinese hospital.
Marisa: The hospital is more than just a medical center in Chinatown. It was built 100 years ago when the Chinese community lacked access to white hospitals, schools and other public institutions. And perched on a hill it's still serves as a sort of nucleus of the neighborhood.
Jen Zhang: Every day you would see a lot of people coming from the community to just sit in our lobby. They're not there to see a doctor or to do a test. They just come in to social.
Marisa: Doctors Zhang grew up in China and she started medical school there. She moved here 30 years ago to finish her training. But she returns to China every year to teach and stays in touch with former med school classmates on social media. In late January, she sees a picture of a former classmate getting ready to fly to Wuhan with a big medical team. Hospitals there are overrun by a new virus. It's the eve of China's biggest holiday Lunar New Year. And Zhang is shocked.
Jen Zhang: When you deploy a team like that and you have to leave on Chinese New Year's Eve. Something must be really serious, must be really important.
Marisa: She's been tracking this novel Coronavirus from afar, but now it hits her just how close it actually is.
Jen Zhang: So you either go back to China for Chinese New Year, or they can come here because it's a holiday and the effects [inaudible] from Wuhan it's only 12 hours. And I'm like, "Oh my god, it's just 12 hours away."
Marisa: It's January 24. Washington State has recently confirmed the first US Coronavirus case. And President Trump is just starting to talk about the virus. Unlike doctors Zhang, the president isn't worried. Here he is on CNBC.
Trump: We have it totally under control. It's one person coming in from China. And we have it under control. It's going to be just fine.
Marisa: But Zhang knows she needs to start preparing now. She wants to stock up on masks and other personal protective equipment.
Jen Zhang: And so I asked my purchase team to place order of 2000 masks. Guess what? It was bad ordered. So the two things that really shocked me, we can have output here in Chinatown very really soon, and then we will be in serious problem of TPE shortage.
Marisa: Zhang believes the public should be warned. She calls the local official who represents Chinatown, San Francisco supervisor Aaron Peskin. They pull together a news conference on February 1st.
Jen Zhang: So we all know about Coronavirus. It is this outbreak in China.
Marisa: It's the first of several public warnings about the Coronavirus in Chinatown over the coming weeks.
Aaron Peskin: Let me concur that there is no need for panic. What can you do and I think this is very important. Wash your hands, continue washing your hands.
Marisa: The warnings seem to pay off, California confirms its first Coronavirus case on Chinese New Year. The first case in the San Francisco Bay Area comes six days later on January 31st. Chinese hospital doesn't admit a Coronavirus patient until the end of March. Caitie what's happening in South Florida around this time?
Caitie: Well back on January 31st, the same day that the first Bay Area case is reported. A woman shows up with flu symptoms at a hospital in the city of Hollywood. That's an eclectic beach town just outside Fort Lauderdale. She's visiting from a province in China connected to Wuhan. This sets off alarm bells.
Dr. Stanley: I don't know how the media got wind of it, but it was a media storm.
Caitie: It felt like pandemonium says Dr. Stanley Marks. He's the Chief Medical Officer of Memorial healthcare system where the woman came. Turns out that woman that arrived is not sick with the Coronavirus. It's just the flu. But the public's growing fear is real.
Dr. Stanley: We had to keep her in the hospital because she had no place to go. And the media storm was so, so severe that we were concerned for her just to discharge her and let her go.
Caitie: This patient is a false alarm. Still Marks like Zhang in San Francisco, quickly realizes his hospital needs to get ready.
Dr. Stanley: My chief of infectious disease and my chief epidemiologist basically said, this will come all over. We need to be prepared for a pandemic.
Caitie: He'll turn out to be right.
Al Letson: As these two doctors 3000 miles apart, are starting to plan. The White House is forming its Coronavirus task force. At the end of January, the number of confirmed cases in the US hit six.
Trump: And those people are all recuperating successfully. But we're working very closely with China and other countries and we think it's going to have a very good ending for us so that I can assure you.
Al Letson: Other people are not assured. When President Trump made that comment, scientist Rick Bright was the head of a biomedical research team at the US Department of Health and Human Services. Bright testified before Congress after he filed a whistleblower complaint and was dismissed. He said that he and other government employees warn the White House starting in January, that the country was unprepared for the coming pandemic, but no one wanted to hear it.
Rick Bright: I was met with indifference, saying they were either too busy, they didn't have a plan. They didn't know who was responsible for procuring those.
Al Letson: He also told Congress that to contain the virus we needed testing available for everyone.
Rick Bright: If we do not take seriously the call for action to put specific things in place, a coordinated national plan for testing and response, equitable distribution is in limited supplies and ramp up and prepare then this virus will overcome us in significant ways still.
Al Letson: The administration responded by attacking Bright and said he was politicizing the response to COVID-19. In a tweet, President Trump called him a disgruntled employee. But the flaws Rick Bright raises are at the heart of the federal government's failure. PPE shortages have left frontline workers exposed all over the country. And without a national testing strategy, local officials don't have the test they need to track how the virus is spreading or the guidance that could help them decide how to respond.
Also drowned out by our political chaos, consistent, accurate information to help people know what to do. Like when a top CDC official tells Americans it's not a question of if, but when the virus will spread into communities, while the president tweets that the Coronavirus is very much under control in the USA. So in the face of all that, if you're in charge of a school district, the county, a city, a state, what do you do. When we come back, we'll look at how California became the first state in the nation to declare a Shelter in Place Order. That's next on Reveal.
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Al Letson: From the Center for Investigative Reporting and PRx, this is Reveal. I'm Al Letson. By early February, California had confirmed just six cases of the Coronavirus. But at this point, only 80 people in a state of 40 million had even been tested. That's because the state has a limited supply of tests and they're being rationed. The CDC says only people who are showing symptoms have visited a virus hotspot or know they've been exposed can get tested and local officials are getting anxious. KQED's Marisa Lagos picks up the story.
Scott Morrow: It was just kind of a mess.
Marisa: Dr. Scott Morrow's in charge of public health in San Mateo County just south of San Francisco. On the last day of January, the federal government starts trying to screen passengers flying in from China. Some go into quarantine and some head home. If they come to San Mateo, Morrow's supposed to follow up
Scott Morrow: We were getting reports of hundreds a day of these people coming back and just try to find them and test them and ask them about if they were sick or not.
Marisa: But he doesn't have the one thing he really needs.
Scott Morrow: We literally, we had no testing at this time. So we were like trying to guess at all of this stuff. And so we thought we had almost no cases, and we were doing a fairly good job. But we didn't know.
Marisa: Morrow was comparing notes with other public health officers in the San Francisco Bay Area. They've worked closely together since 1985, when the AIDS epidemic was exploding, and President Reagan refused to even acknowledge the disease. Back then they formed the Association of Bay Area Health Officials or ABAHO. Based on the reality that both people and diseases don't stay inside county lines.
Scott Morrow: We know that we need to have a very regional response because that's the way the region operates.
Marisa: They meet several times a year, often running tabletop exercises to game out things like how to ration medicine or medical equipment like ventilators. The very choices that doctors in Italy and New York will soon be confronting.
Scott Morrow: We've been practicing a math, a multi agency coordination response for the last two years in response to a pandemic act.
Marisa: Federal law gives the states broad authority to manage public health emergencies. In California, much of that power is handed down all the way to County Public Health Officers like Morrow.
Scott Morrow: There are some specific laws but they're very broad and vague and basically say you can do anything you need to, to stop the spread of disease. They're kind of brilliantly written, they kind of take politics out of the mix. They make the disease the kind of the central focusing point in science, space disease control.
Marisa: Public Health Officers routinely put individuals in isolation or quarantine, usually for things like measles or tuberculosis. If there's a new unknown communicable disease, they can declare a local health emergency. That's both a signal to the public and also a technical move to open up funding to fight a disease. In early February, one of Morrow's colleagues just south of him in Silicon Valley takes that step.
Speaker 15: County of Santa Clara has declared a local emergency due to the Coronavirus, official's say the move will allow them-
Marisa: Santa Clara public health officer, Dr. Sara Cody is the first state or local official to do this in the nation.
Dr. Sara Cody: And then we had this eerie February where we had no more cases reported, no more cases detected. And that was also the month where we were desperately trying to get the ability to run the tests that the CDC was offering.
Marisa: With testing hamstrung, no county health official in California can get a clear picture of how the virus is spreading.
Dr. Sara Cody: So terrifying when you look back on it. And now we know that there of course, there was community transmission going on throughout February and certainly most likely, through quite a bit of January, but we couldn't see it.
Marisa: Meanwhile, from the White House podium and on the campaign trail, the President is downplaying the reality of the virus.
Trump: It's going to disappear one day, it's like a miracle it will disappear.
Marisa: But the day before Trump said that, California confirmed the first case of community transmission in the nation. The message from Washington is muddled. The President is saying that more testing isn't necessary but on March 4th, the CDC eases restrictions on who can get a test. And a few days later, Trump says.
Trump: Anybody that wants a test can get a test.
Marisa: Scott Morrow, the San Mateo public health officer knows that's just not true. There still aren't enough tests. He realizes California could be facing a catastrophe.
Scott Morrow: We all suspected that it was spreading like wildfire. And it was spreading like wildfire under our noses, but we could not prove it because we just did not have the testing capacity.
Marisa: Morrow starts posting long messages to the public on the County Health Department website, you can sense his concern and frustration in this one from March 10th.
Scott Morrow: If I am filled with uncertainty, I can only imagine how the general public must be feeling. People want very specific answers to their questions, and they deserve them. But in many cases, there are not satisfactory answers to give them.
Marisa: In early March, the crisis in California shifts into high gear. On Monday, March 9, after days of uncertainty, the Grand Princess cruise ship docks in Oakland carrying 3500 crew members and passengers. At least 21 of them are infected with the Coronavirus. The same day health officer Sara Cody bands gatherings of 1000 people in Santa Clara County, effectively shutting down barrier professional hockey and soccer. Education officials from across the state arrange a meeting with democratic governor Gavin Newsom, San Francisco school superintendent Vincent Matthews is there.
Vincent Matthew...: The one thing that I build up there to hear or to find out was whether he got closed schools or not.
Marisa: Matthews has already had to shut down one high school in his district sending 3000 students home after one parent test positive for the Coronavirus, but the city still doesn't have enough kits to test the rest of the family. Knowing that schools are a major hub for spreading contagious disease, and the closing will be controversial, Matthews hopes that the governor will take the lead but Newsom doesn't bite.
Vincent Matthew...: He was emphatic about that. He said he just felt it was a local decision and he was going to let local districts make the call.
Marisa: Matthews is worried about the virus. San Francisco schools don't even have the soap and hand sanitizer they need.
Vincent Matthew...: We call in an emergency board meeting on Thursday.
Marisa: Thursday, March 12. The meeting last hours.
Speaker 18: This is a message for SFUSD students, staff and families. We are closing schools to students for three weeks beginning this Monday-
Marisa: Ultimately the board decides to shut down San Francisco schools. Other barrier districts announced they're doing the same. So do Governor's in Ohio, Oregon and Michigan. The next day Florida shutters schools statewide.
At this point, local governments here are inching toward more restrictive crowd bands. But it's a patchwork across counties as officials grapple with how to proceed. Even though Santa Clara County bans large sporting events starting Monday, March 9th, the Golden State Warriors host an NBA game in San Francisco the next day.
Speaker 19: Week ends with a man's jam.
Marisa: The day after that game, Wednesday, March 11. Governor Newsom bans gatherings of 250 or more people statewide. Things are heating up nationally as well. Thursday, President Trump announces he's limiting travel from Europe, causing overcrowding and chaos at airports. And Friday, New York's Mayor declares a state of emergency. For people living here, the week feels like whiplash. San Francisco health director Grant Colfax has been watching other countries close down everything.
Grant Colfax: It became clear to me that no jurisdiction was saying, "We were too... We overreacted to this virus."
Marisa: But down in Santa Clara, Sara Cody feels like she's just made the toughest call she can.
Dr. Sara Cody: On Friday, March 13 I issued the order to ban gatherings greater than 100. And it's the moment that I issued that order that seems so monumental and so difficult and having such profound impact. Never did I imagine that 48 hours later, I would have come as far as thinking that we actually needed to completely shut things down and Shelter-in-Place.
Marisa: Yet by Sunday, that's exactly what health officials all over the Bay Area are mulling. Colfax in San Francisco spends that Sunday morning with one question on his mind.
Grant Colfax: My morning thinking as I was drinking my two cups of coffee and then three cups of tea was really about are we doing enough?
Marisa: He's thinking about closing down all San Francisco restaurants.
Grant Colfax: Closing all restaurants. I mean, that's just a seismic shift when you leave with the science and data that doesn't necessarily mean that sort of our culture and our collective thinking shifts. And even for me, I was like, "Am I really going to recommend that we close all restaurants in San Francisco?" It's not just about the restaurants but really shutting the city down.
Marisa: A text wakes up San Mateo County's health officer Scott Morrow that morning, San Francisco and Santa Clara want to get on a call together. Eventually other public health officers and county lawyers join in.
Scott Morrow: We talked about what we thought and needed to be done, the lawyers listened and that day to another worldly, literally other worldly. I have no idea how they did this. It did not seem in the realms of this world, based on what we had said we thought we needed to do. But together, the bones of the Shelter in Place Order.
Marisa: The health officers fear California hospitals would become overwhelmed as the world had seen in Italy. The state has reported about 1000 tests by now. Most of them are in the Bay Area, but that's still too few to show exactly what's going on. So they felt they had no other choice but to shut down their region.
Scott Morrow: And that day, they wrote a full order. We knew every minute counted, every second, every minute that went by we were getting further and further behind and we were going to become Italy.
Marisa: Sunday afternoon, Governor Newsom steps in with a statewide order but not a full shutdown.
Governor Newsom: We are calling for the home isolation of all seniors directing that all bars, nightclubs, wineries, brew pubs, and the like, be closed in the state of California.
Marisa: The next day Monday, March 16. The Bay Area health officers schedule a midday announcement.
Speaker 22: Well, personally, I can tell you I was scared shitless and also a feeling of this has to be done. But there are no other options. It just has to be done.
Marisa: A few minutes later, he stands with his colleagues from around the Bay Area as Santa Clara's health officer Sarah Cody announces the first shut down order in the US, telling almost 7 million people to basically stay home.
Dr. Sara Cody: These new orders direct all individuals to shelter at their place of residence and maintain social distancing of at least six feet from any other person when outside the resident.
Speaker 22: And so we all did there. We did our joint press conference. There were no politicians. It was just health officers got up, made our statement. The Shelter in Place Order was starting midnight that night.
Marisa: In Sarah Cody's County, the mayor of the biggest city, San Jose didn't know this was coming. Mayor Sam Liccardo.
Mayor Sam Licca...: As I understood it there was a pact among the public health officers that there would be meeting in secret and it'd be kind of like selecting a Pope. They go into a tower and eventually you wait for the smoke to come out and we have the pronouncement.
Marisa: San Francisco Mayor London breed got word, but she was frustrated that other local politicians didn't.
London breed: They said they didn't want to put politics in it, but that's wrong. The fact is, they put forward directives and then we have to motivate people to comply with those orders.
Marisa: But public health officer Scott Morrow says this was a time for emergency action, not a drawn out political debate.
Scott Morrow: We didn't have time to go through a great process. At this moment this had to take precedence because we knew from history that, like New York, New York is going to be damaged for generations, so much death, so much devastation, that it's going to be etched in the psyche of the children and the adults for generations. We understood the economic problems with it. We understood all sorts of problems with it, but this had to take precedence.
Marisa: Still mayors, including Liccardo want some continuity. He and others start lobbying Governor Newsom to close down the whole state.
Mayor Sam Licca...: No city or region is an island here. And if we didn't have a uniform set of rules, then we would all just have our communities getting reinfected by everyone who's traveling across the county lines.
Marisa: Two days after the Bay Area Counties Act, Newsom sends a letter to the White House asking for help. He writes of the state's epidemiological models, show more than 25 million Californians could be infected by mid May, if nothing is done. The next day, Governor Newsom orders all of California's nearly 40 million residents to stay at home, except for workers and essential business. He's the first governor in the country to take this drastic step.
Governor Newsom: We direct a statewide order for people to stay at home.
Al Letson: At this point, California's confirmed cases have quadrupled over the last week, and the state is about to shut down. This is a massive experiment to fight a new disease. Will anybody follow? When we come back, we're crossing the country to Florida, where the annual rite of spring break has just begun.
Speaker 25: If I get Corona, I get Corona. At the end of the day, I'm not going to let it stop me from partying.
Al Letson: This is Reveal. From the Center for Investigative Reporting and PRx, this is Reveal. I'm Al Letson. On March 11. A week before California closed, the World Health Organization declared the Coronavirus outbreak, a global pandemic. In the US the virus had reached 35 states. California had just over 200 reported cases and Florida had 26. People were stocking up on toilet paper watching the news, and some were already starting to make their own tough calls.
Ruth Ann Bradle...: I kind of knew what was going on in different parts of the country.
Al Letson: Ruth Ann Bradley runs a yoga studio in South Florida in Broward County. As the Coronavirus spread, she was chatting on Facebook with other yoga instructors across the US.
Ruth Ann Bradle...: I just kind of saw the writing on the wall.
Al Letson: Ruth Ann is worried about her health and her business. She and her students start a new, more intense cleaning routine.
Ruth Ann Bradle...: Everybody had hand sanitizers around the studio and we were washing hands like crazy and I was washing props and things that we had.
Al Letson: She does this for a week and finds it exhausting.
Ruth Ann Bradle...: I was almost like I can't go through another week of all this cleaning if I'm basically going to be closing anyway.
Al Letson: On March 15th, she closes her studio indefinitely. Like many other businesses, she takes action even before the government tells her she has to.
Ruth Ann Bradle...: It just seemed like the right thing to do.
Al Letson: But as she's shutting down her business, Florida beaches are filling up with visitors, young people hell bent on spring break.
Speaker 27: We met these other people in our little Airbnb spot, so we're just hanging out with them and trying to get drunk before everything closes.
Al Letson: If a pandemic can't scare away spring break crowds, what will it take to protect people's health. Let's go to Miami with WLRN's Caitie Switalski.
Caitie: It's the second week of March and the mayor of Miami Beach Dan Gelber is taking a weekend stroll.
Dan Gelber: I walked out Ocean Drive just to get a sense of what was happening.
Caitie: Its peak spring break, the unceasing party that takes over much of South Florida's coast every March, bringing a lot of business. Ocean Drive is the main drag of Miami Beach. A city on a long thin Island, just east of Miami. Gelber walks under palm trees, past our deco buildings, people watching.
Dan Gelber: There wasn't a single person, I think, exercising social distance, not one out of the 10s of thousands.
Caitie: At the time, most people aren't even talking about social distancing yet.
Dan Gelber: We invite large gatherings, we have all sorts of venues and an incredible amount of bars and restaurants and cultural establishment and seven and a half miles of features. I mean, so nobody comes here to be distant from one another.
Caitie: But Gilbert is familiar with the concept at this point. He's heard about it as he's been watching the Coronavirus spread across the globe over the last few weeks. Florida got its first confirmed case on March 1st, and by now they've reported 70. But there are no state, federal or local orders for people to keep six feet apart yet. And like California, Florida is limiting who can get a test for the Coronavirus.
Dan Gelber: You could have full community spread without even knowing it. It is like telling us if you see unicorns on Biscayne Boulevard, you should do something, how would we know there was community spread if there wasn't a single test available to determine it.
Caitie: Without clear evidence of who's infected and where the guidance that's available doesn't make sense to Gelber.
Dan Gelber: It was just sort of advice from the CDC to not be too close together. And if you get a lot of it, then you shouldn't be in large gatherings. It felt like it was telling you to avoid bad breath as opposed to a deadly virus.
Caitie: Florida has about half the population of California. And compared to California, Florida has a more centralized public health infrastructure. There are no independent County Health Officers, those working locally act more as branches for the state office and take orders from the governor. That means if the state's leadership is slow, it can slow everything down. We asked the Florida Department of Health about their strategy for responding to COVID-19. They declined all interview requests. So we emailed a list of questions. They replied to some of our inquiries regarding testing. All other questions were answered with an official statement they gave little detail, saying their approach has been quote, strategic and methodical. We do know at this point, they're largely referring local officials to the CDC guidance, and Republican Governor Ron DeSantis, has left closing beaches up to local officials like Dan Gelber.
Dan Gelber: And so at that point, I realized that I was not going to rely on the federal government to tell us what to do if I couldn't rely on the state obviously. So I called the mayor of Fort Lauderdale.
Caitie: That weekend the mayors of the two cities talked and so did the city managers.
Dan Gelber: I remember taking a phone call one Friday night from the city manager at Miami Beach.
Caitie: Chris Lagerbloom is the city manager in Fort Lauderdale. Another spring break destination just north of Miami Beach. Chris Lagerbloom helps run the city and what he hears on that call feels big.
Dan Gelber: Chris, I think we're going to shut our beaches down.
Caitie: Florida closes its beaches for one thing, hurricanes. And even then, a few foolish souls always end up on cable news next to crashing waves just before the storm rolls in. Lagerbloom knows if one beach closes the party will just move to the next one. On a call with West Coast City leaders who are a couple of weeks ahead of Florida and their response to the Coronavirus, he asks for advice.
Dan Gelber: And the answer was a resounding, don't wait for it to get worse before you decide to take action. And it was one of those times where that sank in.
Caitie: So on Sunday, March 15th, as health officials in the Bay Area are drawing up their other worldly order to shut down their entire region. Dan Gelber and Chris Lagerbloom stand with other officials from their two cities on the steps of Miami Beach City Hall. The joint announcement comes, the two big spring break beaches will close down effective immediately in Fort Lauderdale and at midnight in Miami Beach. Here's Gelber.
Dan Gelber: The message has to be clear to people who are coming anywhere but namely to our cities right now. You can't do that anymore. The party's over.
Caitie: Lagerbloom says that closing the beach felt like a big move at the time.
Chris Lagerbloo...: I think it was sort of perceived at the time as why are you doing this and why so soon? And maybe now hindsight being 2020 we said why didn't we do it a week sooner.
Caitie: Governor DeSantis publicly supports these first beach closures but he doesn't want to shut down the sand all over the sunshine state because he thinks some people can be there safely.
Governor DeSant...: If you have a mother just walking down the beach with their daughter, I think that can be done safely. That is much different than doing a jello shot off somebody's stomach.
Caitie: The day Miami Beach in Fort Lauderdale close their beaches, Florida has about 100 confirmed cases of the Coronavirus. Schools are closed statewide by now with the governor's approval, and he also locks down long term care facilities to visitors. On March 17th, the governor limits restaurants to half capacity and closes bars and nightclubs. In those two days since the beach closures, it looks like the number of Florida's confirmed cases has doubled from about 100 to just over 200. But it's hard to say exactly what that means.
You're going to see an uptick in the number of cases not just when more people are getting sick, but also when more tests are being done. And on that day Florida reported more new test results than they had on any day before. March 17th is also election day in Florida, the presidential primary. Some states have postponed but not Florida.
Governor DeSant...: We're definitely voting. I mean they voted during the Civil War. We're going to vote.
Caitie: Some poll workers have different plans. They start calling in to quit a week before the election because they're afraid of getting sick. Two poll workers who do show up in two different cities later test positive for the Coronavirus but DeSantis defends the decision to hold the election.
Governor DeSant...: I think having to cancel it. I think in an environment where people were on edge I think it would have really sent a signal about a panic and I don't think that's the signal that you want to send.
Caitie: Election Day in Florida is the first day those Bay Area counties in California are closed. The mayor of the city of Miami Francis Suarez sees what the California officials did and wants to follow their lead. So he talks to a friend.
Francis Suarez: I'm very close to, I'm friends with the mayor of San Francisco, London Breed.
Caitie: Breed can confirm.
London breed: Oh my gosh, he's amazing. And you know he had COVID and everything but he was still working his butt off. And we shared information for sure.
Caitie: Breed says, yeah, she advised Suarez to shut his city down.
London breed: I did. I told a few mayor's. At the time, people probably thought I was overreacting just a little bit. But when my department of public health director told me that if we do nothing, that this could get out of control, and people can be turned away from the hospital. How is that possible in 2020? How is that even possible?
Caitie: Suarez first had to make sure closing the city was even legal.
Francis Suarez: We had to put a lot of internal pressure on our city attorney with our commissioners to get her to agree to it, to finally agree to it.
Caitie: It might have helped that Mayor Suarez tested positive for the Coronavirus. He posts openly about it in a video diary. Here's his first entry.
Francis Suarez: How do I feel, I feel good. I feel like I have some symptoms of what is like the onset of a cold, maybe the onset of a flu. What I want to do is kind of have a diary where I share with everybody what I'm going through, what I'm feeling because inevitably more people are going to get infected unfortunately.
Caitie: The city of Miami shuts down March 24th. And by now nearly half of Florida's cases come from just three South Florida counties. This is the densest region in the state. Dozens of cities spread inland from the beaches in north from Miami. in Fort Lauderdale, city manager Chris Lagerbloom describes his area like this.
Chris Lagerbloo...: Knowing the geography of our city, you can blink and you're in Oakland Park and then you can blink again and your at Wilt Manors and before you know it you're in Pompano or Dania beach.
Caitie: With Governor DeSantis largely supportive of local control. Many of these places are writing their own Coronavirus rules. And it's getting confusing for residents who routinely drive across city lines to run errands or to get to and from work. So Lagerbloom gets involved in another coordinated effort with leaders from other cities in Broward County. County officials on March 26 strongly urge people to stay home. But city officials don't think that goes far enough.
They work overnight to hammer out a stronger template together. And by the day after the county acts, all the cities have issued their own safer at home orders. Some details still vary, like curfews and enforcement. But Lagerbloom feels like the coordination went well.
Chris Lagerbloo...: It was really neat to watch, very honestly because I didn't think it was possible.
Caitie: Still, rather than follow the local lead as California's governor Gavin Newsom did, Florida's Governor DeSantis is hesitant to drop a statewide order that would keep people cooped up.
Governor DeSant...: You simply cannot lock down our society indefinitely with no end in sight. That is not something that the society would accept.
Caitie: We reached out to the governor's office for details on their communications with the White House, local leaders, the State Department of Health. They declined our interview requests but did reply with an email. They offered little detail and directed us to the governor's public schedule. On March 26th, the US passes China for the highest number of Coronavirus cases reported in the world. And now, like California, Florida has a cruise ship crisis heading its way.
Speaker 32: The biggest problem now, where will both ships dock?
Caitie: Passengers on two ships are sick with flu like symptoms. Some test positive for the Coronavirus. The ships want to dock near Fort Lauderdale. But the governor and local officials fear they'll get stuck with a bill and with sick people from out of town. Broward County Commissioner Michael Udine is frustrated.
Michael Udine: Why would this be a last minute thing when it becomes a humanitarian issue and a humanitarian crisis that this gets hurled upon a local government in a local port.
Caitie: This time unlike in California, President Trump pushes for letting the ships dock in Florida and ultimately they do. CDC guidelines allow the vast majority of passengers to take charter flights home. All over the world more than 200 fly to San Francisco, which at this point has been under lockdown for two weeks. On April 1st, during the final cruise ship negotiations, Florida passes 7700 confirmed cases of the Coronavirus more than triple what it was the week before. DeSantis follows what dozens of other governors across the US have already done and issues a safer at home order to take effect two days later statewide.
Governor DeSant...: You know, at this point, I think even though there's a lot of places in Florida have very low infection rates. It makes sense to make this move now. And I did consult with with folks in the White House. I did speak with the President about it and so that order will be coming out momentarily. It will go into effect tomorrow night at midnight.
Caitie: Florida's shutdown order came almost two weeks later than California's. By the time it went into effect, Florida had around 10,000 reported cases of Coronavirus and 169 reported deaths. When California shut down there were just over 1000 reported cases and 19 reported deaths. Marisa, Florida had 10 times the reported cases when Governor DeSantis shut down the state. Does that mean Florida should have shut down sooner? Did California make a better call?
Marisa: Honestly, we don't know because testing. By the time Florida shut down, they'd reported about 17 times more tests per capita than California at they're shut down. And as soon as California started doing more testing, its numbers jumped. They're now in line with Florida's but we still don't have a clear picture of how many people have been infected in either state.
Caitie: Wow. So California might have had way more cases they just didn't know it. Still, all the public health experts we spoke to agree, shutdowns do make a difference. A study just published in nature estimates that nationally the shutdowns and other policies prevented as many as 60 million infections in the US alone. And the numbers show it wasn't just government orders, individual actions also make a difference.
In Florida cell phone location data first reported by the Tampa Bay Times shows the people actually started staying home several weeks earlier than the statewide shut down order. And there were people like Ruth Ann Bradley, the yoga teacher near Fort Lauderdale, who closed her business here before she was required to.
Marisa: But there are still so many unknowns and that makes it tough for local leaders and even individuals to make informed decisions. We spoke to Marisa Levine, professor of Public Health at the University of South Florida, and she points back to the federal government's failure to lead.
Marisa Levine: I think the challenge we have here is that every state has kind of been left with to its own to figure out the path forward, there wasn't really a national strategy.
Marisa: Levine says in general, it's a good thing for local officials to make their own decisions. But it has to be with guidance, resources and data from up top.
Caitie: She says there are federal plans and systems that have been developed to handle a pandemic. And if they'd been used, it would have helped guide these decisions at every level.
Marisa Levine: It really should be an integrated aligned response process, when you don't follow that it gets really messy really fast. And not that it's perfect, but it provides some structure in a chaotic time. And that structure is really important.
Caitie: We're still in that chaotic time right now yet reopening is moving forward. And it's a patchwork depending on where you live. Florida started reopening just a month after shutting down while California waited longer. Nearly eight weeks. What's that look like where you are Marisa?
Marisa: Well, it's mostly happening county by county, the state set some broad benchmarks based on testing case numbers and the ability to trace infected people's contacts. But it's really up to each county to decide how fast to go. Here in the Bay Area most people who can are still working at home, but curbside retail has been allowed since May 18th. Summer camps are set to resume this week. And on June 5th, San Francisco said people can start socializing outside their households as long as they stay outside and wear masks. But after an initial flattening of the curve in mid April, cases have actually climbed here along with testing. Is that different in Florida?
Caitie: Well, that cell phone location data shows that people are moving around again, cases are going up too. During the first weeks of June, the state has been reporting some of the highest figures since the pandemic began. Where I am in South Florida. The reopening has gone more slowly than the rest of the state. But the beaches are back and restaurants and bars are open at limited capacity. Still, as local leaders loosen restrictions, they're also saying we're not out of the woods yet. And even as businesses reopen with limitations, it's not clear if people trust that these rules will keep them safe. Ruth Ann, the yoga teacher is still teaching on Zoom, even though she's technically allowed to reopen.
Marisa: Yeah, we're all having to make our own decisions here too. Like I have two young kids at home, and I would love to put them back in preschool and camps this summer. But how do I know it's safe? How am I supposed to know what information to pay attention to? It's like our data colleague Melissa Lewis told us, we're all the Dr. Fauci's of our own households, and it feels so true. We all have this responsibility, but not the knowledge.
Caitie: Professor Levine says it's the government's role to give us accurate information so we can make informed decisions.
Marisa Levine: I think everybody needs to assess their own risk. Well, it would be really nice if there was a risk assessment tool that was easy to use. So you and your book club or friends, neighbors who want to have a backyard barbecue. This is a great opportunity to have those conversations, what have you been doing to protect yourself? Here's what I've been doing, and how can we work together to make sure when we get together, we're protecting each other.
Caitie: We are still living in the middle of this pandemic. A lot of schools still don't know what they're going to do in the fall, wearing a mask has become politicized. We've seen armed protests against closures.
Marisa: And let's not forget, as we're recording this, the US has confirmed 112,174 deaths. And many experts believe that number's an under count. And we know that even with a limited data picture we have, black Latinx and lower income people are being disproportionately affected by the virus. And now there's this historic uprising against racism and police brutality, bringing 10s of thousands of people together to protest across the nation, gatherings that may lead to more spikes.
Caitie: Still, Levine says she remains optimistic that America can harness this moment, the protests and the pandemic, to make real change.
Marisa Levine: I think we have a great opportunity in this upheaval to rise and come together in a way that we've never done before. And I think it's going to require a kind of leadership that we may not have seen yet but a leadership at all levels. People really standing up and we've seen a lot of people really stand up, young people, older people, people in all different walks of life. And now we need in my opinion for that to coalesce and then be supported by the authority figures if you will, but we could really do something great here.
Al Letson: Thanks for Marisa Lagos of KQED and Caitie Switalski of WLRN. This story was coreported by Reveal's Lance Williams, Laura Morel, Melissa Lewis and lead producer Emily Harris. Today we've been talking about the Coronavirus, but before the pandemic hit, the US was in the middle of another public health emergency, opioid addiction. For the past few years our reporters at Reveal have been investigating how America treats people with addiction. What they uncovered is a dark corner of the rehab industry have profits by sending people seeking cheap into work for no pay.
Starting July 4th, we're going to tell you that story over six weeks in Reveals first serial called American rehab. Be sure to check it out. Jen [Gene] edited this week's show, with help from Esther Kaplan and Sue [inaudible]. Thanks to Najib Amini for production help. Special thanks to the COVID tracking project at the Atlantic for their data on tests and the New York Times for their data on COVID-19 cases and deaths.
Special thanks as well to Holly Kernan, Ethan Lindsey, Vinnee Tong and Scott Shafer from KQED and Alicia Zuckerman, Terence Shepherd and Tom Hudson from WLRN. Victoria Beranetsky is our general counsel, Taki Telonidis is our supervising editor. Our production manager for the last time this week is Mwende Hinojosa. Mwende is moving on to other horizons and we are going to miss her so much.
If you've listened to Reveal for any length of time, I should let you know that Mwende's hands have been on every episode that you've heard. She has been fundamental and instrumental in everything we do here. And she makes me better at my job. And I cannot even put into words how much I'm going to miss her. Mwende Hinojosa, I love you and your family and I wish you the best.
Our sound design team is the dynamic duo Jbreeze. Mr. Jim Briggs and Fernando my man Jo Aruda that helped this week from Amy Mustafa and Claire [inaudible] Mullen. Our CEO is Christa Charlottenburg. Matt Thompson is our editor in chief and our executive producer is Kevin Sullivan. Our theme music is by Comarado, lightning. Support for Reveal's provided by the Reva & David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, the Democracy Fund, and the Ethics and Excellence in Journalism Foundation. Reveal is a coproduction at the Center for Investigative Reporting and PRx. I'm Al Letson and remember, there is always more to the story.
Speaker 35: From PRx.