When Gov. DeSantis issued stay-at-home order, Florida had already logged 188 COVID-19 deaths

Florida governor Ron DeSantis answers reporters questions with Vice President Mike Pence at the Westminster Baldwin Park retirement community, in Orlando, Fla., Wednesday, May 20, 2020. Pence and DeSantis visited the facility to assist in delivering PPE supplies in response to the coronavirus crisis. (Joe Burbank/Orlando Sentinel/TNS)
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By Carol Marbin Miller, Daniel Chang, Ben Wieder, Kevin G. Hall and Shirsho Dasgupta Miami Herald (TNS)

MIAMI — By the time Gov. Ron DeSantis issued a stay-at-home order warning Floridians of the danger posed by the rapidly spreading coronavirus, 188 people already had died — considerably more than the 85 fatalities the state acknowledged at the time.

Most of those who died from a coronavirus infection in March were elders, though the fatalities also included a 28-year-old woman who died at Sarasota Memorial Hospital, and a 34-year-old Broward County man whose “flu-like symptoms” developed into pneumonia. A 39-year-old traveling disc jockey who had recently visited Miami died of the disease on March 26.

New information released Thursday afternoon by the Florida Department of Law Enforcement shows that, while the DeSantis administration and state health administrators were still reacting to the pandemic and moving slowly toward a state lockdown, scores of Floridians died — 135 in the final week of March alone.

The data — which contain details on 2,017 deaths in Florida that are linked to COVID-19 — had been the subject of a weekslong dispute between FDLE, which houses the state’s medical examiners, and several state news organizations, which challenged the agency’s decision to withhold certain information, including the narrative descriptions of how and why people died.

The narratives reveal how COVID-19 preyed upon those in institutions — such as nursing homes, hospitals and prisons — and how the disease spread through travel from hot spots, such as New York and New Jersey, to Florida.

They show the heavy toll on persons with underlying health conditions, especially those living with diabetes, hypertension, heart disease and obesity. And they document the disease’s impact across different races, ages and by gender.

The data contain stories of difficult choices with terrible consequences. The family of an 87-year-old woman moved her from Pennsylvania to Florida because of concerns about the spreading virus. But she was admitted to a hospital in Manatee County on April 28, complaining of shortness of breath, and died 10 days later.

The records released Thursday were compiled by the 22 Florida medical examiners, who certify many, though not all, deaths in the state. The numbers then were maintained by FDLE, Florida’s statewide law enforcement agency.

Though the FDLE spreadsheet leaves secret the names of the 2,017 who died, the doctor who heads the state Medical Examiners Commission, Dr. Stephen Nelson, released his own reports separately Thursday — including all names. Nelson, who oversees autopsies in Polk, Highlands and Hardee counties, has insisted for weeks that the state was violating the open-records law by redacting too much information.

“It IS all public information,” Nelson said in an email to the Miami Herald on Thursday.

The data show that the first coronavirus death in Florida was reported on March 5, that of a 77-year-old Fort Myers woman with a chronic respiratory ailment who had traveled with her husband in early February to the Dominican Republic. The couple visited family in Fort Lauderdale on Feb. 23, before the woman was hospitalized two days later.

The couple returned to Fort Myers, where she died.

The second death was reported the next day: a 71-year-old man who had just returned from Egypt, and died at Baptist Hospital in Santa Rosa County, in the Panhandle.

Though the disease already had been widely reported by March, some health professionals, the records show, had failed to understand its significance.

On March 21, an 87-year-old man went to West Marion Community Hospital for treatment of a cough and fever. “He was advised that he did not meet the criteria for COVID-19 testing,” a notation said. When his symptoms worsened, he went four days later to the emergency department of another hospital in Brooksville after he fell out of bed and bruised his lip. He died on March 29.

A week before DeSantis imposed his stay-home order, on March 23, the governor was resisting calls to shut down the entire state.

“You simply cannot lock down our society with no end in sight,” DeSantis said at a teleconference from the governor’s office with a handful of television reporters in attendance.

The next day, on March 24, DeSantis gave a small nod toward restricting the movement of Floridians when he issued an executive order telling anyone 65 or older, or those with medical conditions that made them vulnerable to the virus, to stay home. For March as a whole, more than 80% of the COVID-19-related fatalities were of people 65 and older, though the data do not show which of the deaths occurred in a long-term care facility.

Though the fatality records by no means constitute an epidemiological study, they do offer tantalizing clues to the virus’s lethality: The word “hypertension,” which is the same thing as high blood pressure, appears in the description of almost 400 deaths. Hypertension is common among elders.

The words “asymptomatic of COVID-19,” appear in 15 incidents, suggesting that a good number of Floridians died without ever knowing they had contracted the virus.

Not surprisingly, the word “pneumonia” appeared in 653 cases in the data, as many COVID-related deaths have been attributed to respiratory infections.

The data also contain 17 cases in which patients died after having been treated with hydroxychloroquine, a controversial treatment involving an anti-malaria drug promoted by President Donald Trump, who said recently that he is taking it himself.

Among Florida’s 67 counties, Miami-Dade reported the largest number of deaths, and accounts for more than a quarter of the state’s COVID-19-related fatalities. It is followed closely by Broward and Palm Beach counties, with each accounting for roughly 15% of the deaths.

Of the 2,017 people who died of COVID-19, nearly 45% were women. A little more than 60% of the fatalities were categorized as white. A fifth were black — though, according to U.S. Census data, 77% of the state’s population is white, and 17% is black.

A tenth of the deaths involved people under age 60, with the youngest victim being 26. Among those fatalities, 40% were identified as black and 33% white. Another 11% were identified as Hispanic.

Among the victims aged 60 and older, roughly 70% were white and nearly a fifth black.

Fourteen of the coronavirus fatalities were 100 or older.

Several Floridians died alone and unnoticed — and were discovered days later when worried neighbors reported them missing. That’s what happened with a 58-year-old man in Broward County who was last seen alive on April 5 and had complained to a neighbor that he wasn’t feeling well, according to the records.

Police found the man dead inside his home two days later on April 7, the data show. He tested positive for COVID-19 a few days after that.

The data contain numerous examples of people who initially refused medical care, only to succumb soon after.

An 81-year-old-pastor at a youth camp in Sebastian with a history of heart disease, hypertension and prostate cancer appeared at the Cleveland Clinic Indian River Hospital on April 9 complaining of severe shortness of breath. He refused a COVID-19 test and signed himself out against medical advice to return home and finish a sermon. He returned to the hospital the next day in severe respiratory distress, was intubated and never left.

His family withdrew care 30 days later.

A 67-year-old man visited his primary care doctor on April 29 complaining of shortness of breath and was tested for COVID-19. His doctor wanted to admit him to the hospital, but the man refused. The doctor was unable to reach the man to tell him he had tested positive for COVID-19, and he died at home on May 4.

Many of the deaths reported in Florida included references to recent travel — indicating that the people who died may have spread the disease to others aboard airplanes, ships and trains.

One of the fatalities was a pilot who had recently flown back to Florida from Mexico. A description of the man’s case noted that most of the passengers on the flight had been sick. The pilot went to a hospital emergency room in Miami-Dade on April 1 with flu-like symptoms — including shortness of breath, fever, dry cough and chills — that had persisted for more than three days.

The 70-year-old man died April 12, and the medical examiner reported the probable cause of death was COVID-19, pneumonia and hypertension.

Another pilot, identified by FedEx as 58-year-old Paul Fox of Bradenton, died April 7 after seeking medical care from a hospital in Manatee County. Fox, a captain for 32 years, had recently returned from China, the medical examiner narrative said, and reported feeling short of breath.

One 66-year-old man who died in Okeechobee County on April 5 had recently returned from a trip to the United Kingdom and entered the United States through Newark Airport in New Jersey, where he was screened and registered a temperature of 102 degrees, records show.

The CDC did not allow the man onto his connecting flight, and he was taken to a hospital in Newark. The man denied experiencing any symptoms, and a chest X-ray was negative, records show. Doctors swabbed the man for a COVID-19 test and he was discharged before the results returned.

The man then arranged to travel to Florida on an Amtrak train, records show. By the time the train had reached Okeechobee County, the man was found to be having a heart attack. He was taken to Raulerson Hospital, where he died, and was swabbed for COVID-19.

Both tests in New Jersey and Florida came back positive, records show.

One New York transplant, a 65-year-old woman living with lung cancer that had metastasized to her brain, had recently moved to Martin County due to her high risk of contracting the disease. The woman had been feverish before and during her move, records show. She was taken to Lawnwood Regional Medical Center shortly after arriving in Florida and tested positive for COVID-19. She died at Treasure Coast Hospice on April 13.

Cruise ships quickly became traveling incubators of the disease. All told, more than 40 people in the data set were either passengers or crew members on a cruise.

On March 20, a 75-year-old man went to the medical center of his Holland America cruise ship, the Zaandam, and complained that he had been coughing for five days. A doctor treated him, then released him to walk freely around the ship.

Four days later, the man was admitted to the Zaandam’s medical center and diagnosed with pneumonia and respiratory failure. On March 26, he was one of two Zaandam passengers who died from exposure to the coronavirus. Another died the next day.

The Zaandam was one of two Holland America cruise ships that became marooned in the Atlantic after ports throughout the Caribbean and up the Atlantic Coast refused to allow passengers to disembark. On April 2, the Zaandam was allowed to dock at Port Everglades in Fort Lauderdale after Broward commissioners negotiated an agreement with the company.

Two others from the ship, including a crew member, reportedly died a week later on April 8. Then a 69-year-old man died on April 11.

Other cases underscore the challenges faced by doctors and other health care workers when COVID-19 tests produce false results — confounding medical professionals and delaying an accurate diagnosis until it’s too late, the data show.

One 66-year-old man died in a Palm Beach County hospital on April 9 after he had tested negative for COVID-19 six days earlier. The man, who had a history of high blood pressure and diabetes, went to the hospital on April 3 complaining of shortness of breath.

After his test result returned negative for COVID-19, doctors tested him for other illnesses, including influenza and a bacterial infection, which were also negative. They also performed repeated chest X-rays showing the man had fluid in his lungs, records show.

Doctors tested the man for COVID-19 a second time on April 6. But by the time they received a positive test result on April 10, the man had died.

Another man who died on April 7 in Palm Beach County also had tested negative for COVID-19 prior to his death, records show. The 84-year-old went to a hospital emergency room on March 21 and complained that he had been feeling weak and had fallen repeatedly. The man had not traveled recently, but his wife told doctors the couple had been dining out frequently.

The man later developed acute respiratory failure and had to be intubated on March 24, records show. Doctors tested him for COVID-19, and the following day his results came back positive. The man was diagnosed with pneumonia, bronchitis and COVID-19. He was transferred to hospice, where he died on April 7.

Trump halted travel from China, where the virus originated, in early February, and followed with a later ban on travel from Europe. But the FDLE records show that travel from Latin America fueled some fatalities, with at least six deaths following travel from Ecuador, one of the hardest hit countries in the hemisphere.

A 71-year-old man in Miami-Dade tested positive on March 23, nine days after returning from Ecuador. Similarly, a 62-year-old woman with no known medical problems died in Lee County on March 30, five days after going to the emergency room and being sent home only to return later in the day in respiratory distress.

“She was a resident of Ecuador and arrived about two weeks ago to visit with her daughter in Lehigh Acres,” said the medical examiner’s report.

And an 84-year-old appears to have contracted the virus after her daughter returned from a visit to Ecuador.

(Tallahassee bureau chief Mary Ellen Klas contributed to this report.)
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