COVID-19: What we can learn from Florida’s losses

Throughout this pandemic, I have written about aspects of it that I either find fascinating, or that I feel may need more (or even just a slightly different) explanation than the all-too-often inflammatory stories that typically play out in the media.

At the beginning, I addressed many of my experiences as a New Yorker living in the epicenter of the American COVID-19 crisis. But those early “hot spots” have shifted a lot since then. And they’ll continue to do so as we work to reopen our economy safely.

That’s why, today, I want to talk about an article that recently appeared in my inbox, which details what’s currently going on behind-the-scenes in Florida. And let me warn you… it isn’t pretty.

The health budgets are bare

This article interviewed both a doctor and a public health department nurse who had witnessed firsthand the gutting of Florida’s county health department budgets and staffing over the last 20 years.

Health experts blame the recession of the late 2000s, as well as greater legislative support for profit-based healthcare services. But whatever the reason, those chickens have come home to roost in a very sinister way.

Florida has never been less prepared to respond to an outbreak of any kind—and yet, here we are, in the middle of the worst health crisis we’ve faced as a nation in over a century. The only hope now is that, maybe, we can all learn some valuable lessons from this lack of preparedness.

Because the truth is, public health funding has suffered drastic cuts nationwide. It just so happens that Florida’s cuts were particularly fast and furious—leaving entire communities vulnerable as a result.

In fact, between 2010 and 2019, while Florida’s population boomed by an additional 2.4 million residents, they lost nearly 4,000 health department employees—and suffered a 41 percent cut in per capita health spending. (That’s compared to an 18 percent drop nationwide.)

Here’s what that means, practically speaking: There are fewer contact tracers to contain STDs and diseases like hepatitis. There are also fewer nurses to teach people how to protect themselves against illnesses like HIV and the flu.

And that’s before COVID-19 gripped the country. The “contact tracing” that you’ve been hearing about lately has always been an integral part of the public health engine. It’s how we contain disease to keep the general population well. (In fact, I was a contact tracer myself when I was in public health school—it wasn’t fun, but it definitely made for some good stories and life lessons!)

But effective contact tracing hasn’t been the only casualty of dismantled public health services in the pandemic age…

Mixed messages cost lives

Most notably, experts inside Florida’s health departments got the muzzle over issues like wearing masks—leaving residents confused as to what they should be doing to prevent the transmission of COVID-19.

To quote Chad Neilsen, the director of infection prevention at the University of Florida-Jacksonville: “We know that masking works.” But with different rules across different counties, it’s no wonder that Floridians can’t seem to agree on the facts.

There’s no nice way to put this: People have died because of these budget cuts and leadership vacuums. A situation that, in the words of one former health department deputy, should count as “governmental malpractice.”

And let’s be clear: It’s not just Florida’s population that suffers from this failure. Viruses don’t respect borders, so even one weak link compromises the entire country’s ability to effectively respond to a pandemic.

Now, I’m not blaming Florida for what has clearly been a larger mishandling of this health crisis from the very beginning. I’m just pointing out what happens when you don’t have science-based leadership.

Whether you like New York’s Governor Cuomo or not, he provided exactly that: a singular, clear, and informed voice to follow. And having this one consistent voice of leadership is absolutely critical during a pandemic—as is leadership that models the behavior that we want citizens to emulate, like mask-wearing.

Meanwhile, Florida did (and continues to do) quite the opposite: State officials are repeatedly silencing public health workers and feeding them talking points from the top. (In one particularly bold example, state leaders allegedly required local school boards to get health department approval in order to keep schools closed… and then told health directors to withhold it.)

The end result—which I have lamented here before—is the censorship of experts armed with scientific facts in favor of politics over the public health. And, as both a medical doctor with a master’s degree in public health and a proud citizen of the United States, this angers me greatly. (In my view, anyone who’s not mad isn’t paying close enough attention.)

We simply can’t afford to keep people who don’t value public health in power. So as always, I urge you to vote accordingly this November… and in every election thereafter.

P.S. As a Reality Health Check reader, I encourage you to continue staying “in the know” by subscribing to my monthly Logical Health Alternatives newsletter as well. All it takes is one click!


“How Starving Public Health Fueled a COVID Fire in Florida.”  The Washington Post, 08/23/2020. (