I have a piece up on the homepage today about Florida’s approach to the COVID-19 crisis. If you talk to Governor DeSantis and his team, it’s impossible to conclude anything other than that they have taken this seriously from the beginning, been immersed in the data and research, and crafted a well-considered response. Which makes it all the more astonishing and unfair that the media has been portraying DeSantis as a yokel who was going to get Floridians killed with his lax approach. In fact, on an absolutely central policy question — how to deal with the nursing homes — DeSantis and his team were much more stringent than other states.
To simplify, in places in the Northeast like New York, the idea was to supposedly save the hospitals by getting COVID-positive patients out of hospitals and into nursing homes; in Florida, the idea was to save the nursing homes by keeping COVID patients in the hospitals or getting them into hospitals. Now, it’s obvious who was right, but Florida officials had to fight the hospitals on this. Here is a passage where Mary Mayhew, secretary of Florida’s Agency for Healthcare Administration, explains:
Mary Mayhew had daily calls with the hospitals, with people involved in discharge planning on the line. “Every day on these calls,” she says, “I would hear the same comments and questions around, we need to get these individuals returned back to the nursing home. We drew a hard line early on. I said repeatedly to the hospital, to the CEOs, to the discharge planners, to the chief medical officers, ‘I understand that for 20 years it’s been ingrained, especially through Medicare reimbursement policy, to get individuals in and out. That is not our focus today. I’m not going to send anyone back to a nursing home who has the slightest risk of being positive.’”
“What we said constantly is let’s not have two cases become 20 or five become 50,” she continues. “If you don’t manage this individual as you return them back, you will have far more being transferred back to the hospital.” Early on, when tests had a slow turnaround, there was a lot of pressure to give way, but Mayhew was unmovable on the question.
At the other end of the equation at the nursing homes, the state made it clear, according to Mayhew, “if you are unable to adhere to these infection-control standards, if you are unable to safely isolate and dedicate staff to an isolation wing or unit, you need to transfer that individual to a hospital.”
As the health officials put it, succinctly, “We wanted people out, not in.”
I urge you to read the whole thing — the insights of DeSantis and his team are an important contribution to the debate over how to respond to COVID.