Without mandates or lockdowns, Florida better managed COVID than New York
When the final history of the COVID-19 pandemic is written it will likely conclude that most of the non-pharmaceutical public health measures taken to combat the disease — that is, mask mandates and lockdowns — were largely ineffective.
The unimportance of public mitigation measures can be illustrated by comparing outcomes in states that imposed strict mitigation measures versus states, such as Florida, that adopted a minimalist approach.
Florida, New York, California and Illinois are all large states with multiple urban areas. But while Florida has been the poster child for a hands-off approach by government, the latter three states imposed multiple intrusive measures over long periods of time.
Florida, for example, recommended but did not require face coverings. While several large counties imposed their own mandates, Governor Ron DeSantis issued an executive order barring governments and school districts from imposing them last May.
New York’s Gov. Kathy Hochul lifted the state’s general mask order on Feb. 10, but masks are still required in schools, health care facilities and on public transit. California lifted its universal indoor mask mandate on Feb. 16, but the requirement remains in effect for the unvaccinated. Illinois announced it will lift its long-standing mask mandate, with the exception of schools, at the end of this month.
Any comparison of the four states must account for the different age distributions of their populations and especially the percent of the population that is 65 and older.
Far and away the most important factor in determining the severity of COVID-19 illness is age. There is an exponential relationship between age and COVID-19’s infection fatality rate. The estimated IFR is very low for children and younger adults (0.002% at age 10; 0.01% at age 25), increases to 0.4% by age 55, and then soars with advanced age (1.4% at age 65; 4.6% at age 75; and 15% at age 85).
Florida has the second-highest percentage of population 65 and older (21.3%) in the nation. In contrast, New York ranks 25th among the states in the percentage of population 65 and older (17.4%), Illinois is 35th (16.6%), and California is 45th (15.2%).
Remarkably, despite its elderly population and laissez-faire approach, Florida has only the 33rd highest age-adjusted COVID-19 death rate per 100,000 population (251) among the states. That puts it in the same ballpark as mandate heavy Illinois (ranked 32 with 255 deaths/100,000) and California (ranked 38; 234) and well below New York (ranked 7th highest; 334).
This result is not terribly surprising. Multiple studies have confirmed that lockdowns had little to no impact on COVID-19 mortality. In part this is because people react to the risk of infectious disease — by staying home and avoiding crowded indoor areas for example — before and independent of government mandates.
And the effectiveness of masks in curtailing the spread of COVID-19 has always been suspect. Bandanas and most cloth masks are probably worthless. Higher quality surgical and N95 masks do have some impact although likely more as source control than as protection for wearers. But even these masks are subject to limitations of compliance and proper usage. Masks work best in medical settings where genuine N95 masks are available, providers are properly fitted for them, and observance of masking requirements is high.
In elementary schools where a variety of inferior masks are used and children rarely wear them properly (tightly covering the mouth and nose) for very long, effectiveness declines. And the mask that Nancy Pelosi brought to her hairdresser, but kept in her purse, had no value at all.
From early in the pandemic the media vilified Florida Governor DeSantis as irresponsible and dangerous. Some labeled him “DeathSantis.” But DeSantis’s approach proved to be right. The mitigation measures imposed in other, largely blue, states did little to improve health outcomes. And Florida was better able to preserve its economic health than most other states.
As COVID cases, hospitalizations and deaths continue to plummet around the country, hold-out public health officials and politicians should strongly consider mimicking the COVID policies of that “Florida Man.”
Dr. Joel Zinberg, MD, is a senior fellow at the Competitive Enterprise Institute and director of public health and wellness at the Paragon Health Institute.
