TALLAHASSEE, Fla. — As Covid infections begin creeping up again across the country, current and former health officials in Florida are warning that the state remains woefully underprepared to handle the next wave of the pandemic.
Florida’s 250-plus hospitals are still facing staffing shortages that continue to worsen as the Covid-19 pandemic drags on. The state Legislature budgeted more than $100 million for community colleges and universities to expand medical training programs to boost the number of qualified nurses in the state and injected $10 million to build medical training centers.
But all that money will not provide immediate relief, not for the next Covid surge or the next worldwide health crisis, Florida Hospital Association president and CEO Mary Mayhew said in an interview.
“The biggest challenge we face will be having enough staff to respond if we experience a significant surge,” Mayhew said.
A report by the association estimates 70 percent of Florida hospitals are facing a critical staffing shortage, and the state will be short 60,000 nurses by 2035.
The fresh warnings come as the worries over Covid-19 and its variants have generally receded, even as cases rise across the country. The seven-day average of positive cases through April 25 increased more than 20 percent nationwide, to 44,416, with hospitalizations up 6 percent from the previous week.
In Florida, the weekly rate of new Covid infections was 9.2 percent as of April 24, according to the Centers for Disease Control and Prevention — it was around 3 percent as of March 11. The state’s Covid-related hospitalizations increased slightly to 1,039 inpatients as of Thursday from the 970 the previous week.
But America is also facing a new stage in the pandemic, one focused on risk acceptance over shutdowns and mandates. The CDC last week reported nearly 60 percent of people in the U.S. have antibodies for the virus, with the numbers even higher for children, a significant increase from previous estimates. Most major cities are no longer instituting mask mandates. Vaccines are readily available for most Americans. Even a positive Covid diagnosis is treated with less anxiety for healthy people, including Vice President Kamala Harris, who announced recently that she tested positive but was showing no symptoms.
Yet with this new dynamic comes concerns that cities and states are letting their guard down.
“We have not committed, at the federal and state level, the resources necessary to prepare us for the next pandemic,” said Jared Moskowitz, the former director of the Florida Division of Emergency Management who helped lead the state through the first year of the pandemic.
Moskowitz said Florida’s pre-Covid-19 pandemic guidance was scrapped after the first infections were reported in Tampa more than two years ago because the virus was new and health officials across the globe were rushing to understand how to treat it.
“Before Covid, every emergency manager in the country had a playbook on how to deal with a pandemic, and after Covid, everyone had to throw that playbook away,” said Moskowitz, a Democrat who is running for retiring Democratic Rep. Ted Deutch’s congressional seat. “Now there’s a very good playbook for Covid, but do I think the country is prepared for the next pandemic? The answer is no.”
In Broward County, where Moskowitz serves as a commissioner, health officials offer testing and vaccination services to residents, and those resources can be expanded quickly in the event of another Covid spike. But Broward, the state and the country, are not prepared for the next illness.
Part of that lack of preparedness stems from ongoing supply chain issues. Medical supply shortages that left the entire world scrambling for essential items such as facemasks, ventilators, swabs and hospital gowns could return with a new virus surge, especially with a continued heavy reliance on foreign manufacturers.
“The supply chain issues we had in the beginning, have we done anything about them? The answer is nothing,” Moskowitz said.
Mayhew agreed, highlighting that the medical industry still relies on overseas markets such as China, which all but shut down during the pandemic.
“We’re vulnerable because of where so much of our product is coming from,” Mayhew said.
Another factor in Florida’s Covid preparedness is Republican Gov. Ron DeSantis, who has fought against Covid-related restrictions, shutdowns and mandates. During the deadly Delta variant surge over the summer and fall, DeSantis prohibited schools from implementing mask mandates for students. He also banned large businesses from implementing vaccine requirements for workers and pushed monoclonal antibody treatments over vaccines.
“We have the vendors in place and we have the supplies,” Florida’s Department of Emergency Management spokesperson Samantha Bequer said. “Just like a hurricane, Florida is prepared.”
The medical resource shortages early in the pandemic, however, quickly wiped out what little resources the state had on hand, making restocking all the more difficult. Moskowitz, for example, ended up converting a media briefing room in the state’s emergency center to a bullpen for staffers so they could call suppliers around the world. The swabs needed for Covid tests, for example, were only made by a supplier in Italy.
The Florida Department of Health now oversees the state’s distribution of personal protective equipment. Health department spokesman Jeremy Redfern said much of the testing and diagnosis has been left up to the private sector. If someone has Covid-19 symptoms, for example, they can visit a doctor who will refer them for testing. The health department will, however, furnish supplies to counties upon request.
“In the realm of expanding operations, that’s in the realm of the counties,” Redfern said.
The health department has not received a request from a county in three months. When asked about preparedness, Leon County Administrator Vince Long said the county is prepared to request aid from state and local authorities if a spike comes up. Leon is one of Florida’s smaller counties and is home to the Capitol and the governor’s mansion, meaning that it is often near the top of the list for state health resources.
“Since the COVID-19 pandemic began more than two years ago, the County has been the lead agency in coordinating and convening local agencies and support — all in lockstep with CDC guidance,” Long wrote in a statement. “Should we face another surge, we would again ensure federal and state aid reaches those who need it most, along with testing, treatment, and vaccinations.”
The Division of Emergency Management is also capable of recruiting contract nurses to work in Florida medical facilities, but they have proved to be expensive for medical providers.
Hospital officials told state lawmakers during a November committee meeting that contract nurses had driven up labor costs by almost eight times the normal rate. The nationwide push to hire nurses under lucrative contracts also led to an exodus of staffers at Florida hospitals earlier in the pandemic. Now, facing burnout from increasing workloads and less help, many medical staffers are retiring early or leaving the field entirely.
“Other businesses are having to look at changing their shifts, changing their hours of the week, changing the days of the week they’re opened,” Mayhew said. “We can’t do that, so it’s just a multifaceted problem.”