South Florida hospitalizations are surging again as Florida COVID total hits 1 million

Nearly nine months out from when Florida confirmed its first COVID-19 case, some of the state’s largest public hospital networks are managing a late fall resurgence of the virus that has health leaders extending contracts for out-of-state nurses.

South Florida hospitals say they are cautiously optimistic they can continue to care for increasing numbers of COVID patients without scaling back non-emergency medical procedures, even as a surge that has built since early November intensifies and the state eclipses 1 million COVID-19 cases, the third-highest tally in the nation behind Texas and California.

Meanwhile, local leaders such as Miami Mayor Francis Suarez and Miami-Dade County Mayor Daniella Levine Cava have no recourse to issue the types of emergency measures — from business closures to public health curfews — that were stripped away by Gov. Ron DeSantis at the conclusion of September. Suarez was an early COVID patient, contracting the virus in the spring and isolating at home at that time.

At a Tuesday meeting with Miami-Dade commissioners, Levine Cava addressed what she called an alarming escalation in the coronavirus situation — while isolating at her home with a COVID diagnosis she received Monday.

“Cases are going up astronomically. Two thousand cases yesterday. That includes me and my husband,” she said on a video feed into the commission chambers. “It’s really quite astonishing.”

The fall surge’s gradual build has in recent days accelerated to triple-digit admissions of COVID-19 patients across Miami-Dade hospitals, which are treating more people with the disease than they have since August. Peter Paige, Miami-Dade’s newly minted chief medical officer and chief clinical officer at the county public hospital network, Jackson Health System, said clinical staff are bracing for the current surge to last for several weeks, or months, as the region awaits the imminent approval and arrival of the first doses of COVID-19 vaccines.

Paige, like top hospital officials at South Broward County’s Memorial Healthcare System, said he is optimistic that this surge won’t carry the same force of the one seen over the summer.

“We’re hopeful that we don’t get back to that point, but it’s still really early to tell,” said Paige. “We’re starting to see this trend going up.”

The thinking, which has been articulated by some infectious disease experts and floated to Jackson leaders by top state officials including Surgeon General Scott Rivkees, is that a certain level of partial population immunity — or the sheer number of people already infected and who no longer transmit the virus — from hard-hit areas like Miami will dampen future surges.

The summer surge likely also affected behaviors such as physical distancing in populations that lived through the first surge, which peaked in late July, when Jackson Health System was treating as many as 485 COVID patients daily. The Jackson hospital network is currently treating about 170 COVID-positive patients.

Preparing for a long winter

Memorial Healthcare System reached a height of 680 COVID-19 inpatients in late July before dipping to about 100 over much of the fall. Now, the hospital network is treating about 200, according to Maggie Hansen, senior vice president and chief nurse executive for the system.

Memorial was so inundated with COVID-19 in the summer that it had to convert auditoriums into treatment areas and repurpose other parts of its hospitals to accommodate the surge. On top of that physical restructuring, the hospital network hired 300 nurses from out of state through its internal staffing agency.

About a month ago, Hansen said, Memorial refreshed some of those contracts, re-signing about 100 surplus nurses heading into what they expect to be a long winter.

“We have to have the staff to take care of our patients,” Hansen said. “... Our nursing and medical staff, they’re tired. We’ve got to take care of them, too.”

Hansen said Memorial has completely retooled many of its facilities to accommodate patient flow in the COVID era while still performing other essential medical procedures. Hospital leaders expect that to be the status quo for some time.

As far as how much worse things will get, Hansen similarly expressed optimism that Memorial’s doctors and nurses won’t face another situation like the one in July.

“We just don’t know, and I think that’s part of what’s so stressful for our frontline staff, is that they don’t see an end,” Hansen said. “They experienced that July surge and they’re afraid of it happening again.”

Miami Herald Staff Writer Douglas Hanks contributed to this report.