Macrocosm: Is Comparing California and Florida's COVID Response Wise?

Colormos/Josep Gutierrez

As COVID rates begin to decline, it can be easy, sometimes even necessary, to forget parts of the grim year behind us. But ignoring policy and behavioral decisions in different states can leave us blindsided for the next pandemic - an event that, according to experts, is not an if, but a when.

From the very beginning, the two states had vastly different responses to the COVID-19 pandemic. California imposed strict standards that restricted citizens and businesses alike, leading to an impaired economy and a year-long memorandum on in-person schooling. Florida, meanwhile, adopted a laissez-faire approach to the virus that allowed restaurants to host in-person dining and made masks optional.

The effects that these two divergent approaches had are multifaceted and complex. But, experts warn, don't just look at the numbers without context. The cases in California and Florida both have teachable moments and lessons that we should heed before facing another wave, mutation, or superbug.    

Which fared better - California or Florida?

Comparing sheer numbers for either state can't give us the whole story. When comparing the number of confirmed cases or deaths in a state, it's better to have a metric by which the population is counted. In most cases, casualties will be compared per number of residents; the most common metric for COVID cases and deaths is by 100 thousand residents. For such heavily populated states as California and Florida, these statistics are measured per million residents.

California's COVID deaths per million are 1,385, while Florida's are 1,538. Florida also has a higher case number per million residents - 94,426, as compared to California's 91,364. The two states fall relatively close to each other in terms of death rates when ranked against other states. The racial demographic with the highest COVID cases and deaths in California was the Latino community, with nearly a million more cases and 10,000 more deaths than the next demographic, Caucasians. A similar report in Florida saw double the COVID rates in areas primarily populated by black and Latino people than in white people. As of the most recent estimates, Florida ranked 27th worst, while California was 28th.

But these statistics should not be taken at face value. These are the statistics as of February 2021, but last fall, Florida's cumulative death rate was as much as 84% higher than California's. When winter struck California, amidst a flurry of holiday visits and virus mutations, that margin shrunk to about 10%.

Research from the Center for Disease Control and Prevention touts that mask mandates and limits on group activities can help slow the spread of the novel coronavirus; yet, other factors must come into play. Some studies also show that humid air can help block virus particles from traveling the distance of one mouth to another. Arid air on the other hand could spread said particles further, meaning that California was already at a greater risk when winter hit, and holiday visits and a more prolonged flu season only exacerbated that risk.

Can the two states be compared?

At face-value, California and Florida are very similar states. Both are prominent tourist destinations with large populations and dense areas of urban development. But when it came to the virus, the two were not on an even playing field.

The CDC categorizes different areas in the United States regarding social vulnerability - the potential adverse effects on communities caused by external stresses on human health. These stressors can come from the natural environment (the food, water, air, land, and organisms around us) or the built environment (our human-made systems of roads, electrical grids, water distribution systems, and buildings where we live and work). This social vulnerability can be used to measure how severely a disease outbreak might affect a region. Over half of California residents live in counties with a high "social vulnerability" score, while only a quarter of Floridians do. California also has a much higher overcrowding rate in homes, another metric used to determine how fast the coronavirus spreads.

As epidemiologist Dr. Robert Kim-Farley says, "If California had behaved like Florida, where mask use and physical distancing was not practiced as thoroughly, our cumulative death rate would have been higher than Florida." Both governors still assert that their approach was the best for their population's health and economy. California's unemployment rate has dropped in recent months, though the initial devastation dealt a rough blow onto the existing industries. Over 19,000 businesses in California permanently closed as a result of the coronavirus, according to Yelp's local economic report in September 2020.

What this means for the future

It's hard to contend which state would have done the best under the circumstances present. Overcrowding is a problem that lockdowns cannot solve, and a problematic task remains for the next pandemic: pulling at the root of the problem instead of skirting around its branches. The majority of Californians are in situations that leave them more susceptible to viral spread, either through the density of the urban environment around them, the overcrowding in residential or commercial spaces, or socioeconomic factors outside of their control, like age or language fluency.

Florida had to contend with similar problems throughout its contention with the pandemic. Though its leaders handled the situation in a more lax way, it only did moderately worse than California. Experts say that there's something to be learned from this. No solution to a pandemic solves every problem, and no solution can be uniformly applied. With every restriction, there is an economic loss; with every loosening of regulations, there is a potential for an infectious spike. 

Without considering outside factors and an investment in those root causes of vulnerability, we'll see another shatter-shot response. And the next time a disease comes our way, it may be more infectious or more deadly. 

As a research study in The New England Journal of Medicine stated in 2005, "The loss of human life even in a mild pandemic will be devastating, and the cost of a world economy in shambles for several years can only be imagined." This prediction was eerily correct, and we must be prepared for what a severe pandemic can do. The answer is not, as many think, a comprehensive agreement but a carefully tailored policy that combines science with socioeconomic theory. Any alternative will leave us just as disoriented as we were last March.