Ever since U.S. COVID-19 cases started their precipitous post-holiday decline, Americans have been anxious about the threat of yet another hurdle on the long road to recovery: a possible “fourth wave” of infections driven by the newer, more contagious U.K. variant known as B.1.1.7. Experts, meanwhile, have been watching Florida as a bellwether — the place where a fourth wave would probably crash first.
After all, Florida has more documented B.1.1.7 cases than any other state. It’s also rolled back precautions more quickly than most. If a spike is coming, the thinking went, Florida is where it would start.
Except … it hasn’t started yet.
Quite the opposite, in fact. After peaking on Jan. 8 at just under 18,000, Florida’s average daily case count has fallen by nearly 75 percent; today it’s down to 4,800. Hospitalizations have declined by half over the same period, as has Florida’s positivity rate (which now stands at 5.9 percent). And while other states such as New Jersey, New York, Rhode Island, South Dakota, Tennessee and Idaho are starting to see cases plateau — or even inch upward — as residents relax and restrictions are loosened, Florida’s case and hospitalization numbers have continued to fall by about 10 percent each week.
“We have a bellwether to know if the B.1.1.7 strain will hit the US — Florida,” Dr. Eric Topol of Scripps Research wrote earlier this week. “And there’s no sign of any increase in cases. All good so far.”
The key phrase, as always during this unpredictable pandemic, is “so far.” Just because a variant-driven fourth wave hasn’t yet struck Florida (or the U.S. as a whole) doesn’t necessarily mean it won’t, and nothing heightens the risk of another surge more than reckless, maskless indoor gatherings — at full-capacity restaurants; at crowded bars; at private parties — with lots of unvaccinated people. Events such as this week's 300,000-person motorcycle rally in Daytona Beach are still risky. Like all Americans, Floridians should proceed with caution.
Yet the good news from Florida is an encouraging sign for the rest of us. It doesn’t mean America is out of the woods. But it does suggest we could emerge sooner than we thought.
B.1.1.7 continues to spread in Florida. A month ago, it accounted for about 4 percent of all positive COVID-19 samples in the state; last week, it accounted for more than 40 percent. This rapid spread is consistent with everything we know about the variant — namely, that it’s anywhere from 40 to 50 percent more transmissible than earlier versions of the virus. At some point this week, B.1.1.7 became the dominant variant in Florida and is now responsible for more than half the state’s infections.
That sounds scary, especially because B.1.1.7 is also estimated to be 64 percent more lethal in unvaccinated people than its SARS-CoV-2 predecessors. But here’s the thing: There’s a difference between 51 percent of a big number and 51 percent of a smaller number. Even as B.1.1.7 makes up a larger and larger proportion of COVID-19 cases in Florida, the overall number of cases there continues to come down. The numerator may keep growing, but the denominator keeps shrinking. In and of itself, B.1.1.7 doesn’t seem to be causing more COVID.
This hasn’t always been the case. When B.1.1.7 took hold in England, Ireland, Israel and Portugal, their overall case counts exploded; strict lockdowns turned the tide, but now similar B.1.1.7-driven surges are terrorizing Estonia, Hungary, Poland, Jordan, Italy and the Czech Republic. Regardless of what’s happening in Florida, B.1.1.7 is still very dangerous.
So what is happening in Florida? Some force, or forces, seem to be exerting more downward pressure on transmission than whatever upward pressure B.1.1.7 is able to muster.
Immunity is probably the most powerful of these forces. An estimated 30 percent or more of Floridians have already contracted COVID-19, which helps them resist future infection. Roughly 18 percent of the population has received at least one vaccine dose. There’s overlap between these two groups, which means that about 40 percent of Floridians now have some protection against COVID.
In comparison, just 7 percent of Italians have gotten jabbed, and fewer than 10 percent have been infected. Given that B.1.1.7 doesn’t seem to evade either vaccine- or infection-induced immunity, the share of susceptible individuals in a state like Florida is relatively small, and getting smaller with each vaccination.
Then there’s timing to consider. In places like England and Ireland, B.1.1.7 took hold late last year — just in time to intensify surges triggered by cold-weather holiday gatherings. In Florida, however, the variant didn’t gain steam until after the holidays ended and cases had started to fall. Transmission begets transmission, and even an opportunistic variant like B.1.1.7 will have a tougher time reversing a downward trajectory than steepening an upward one.
Florida’s weather has likely worked against B.1.1.7 as well. Researchers are still learning how climate affects the virus, but some studies suggest that when the air is humid, droplets fall to the ground faster, so people are less likely to become infected; other studies have hinted at possible correlations between transmission and sunlight (or pollen, or wind). Regardless of where the science ultimately lands, Florida does have the mildest winters in the continental U.S., with daytime highs that range from 64°F in Tallahassee to 77°F in Miami and overnight lows that tend to linger in the 50s or 60s. Translation: In January, February and March, it’s easier to be outdoors in Florida than most other places.
Of course, Floridians have for months enjoyed more “freedom” to crowd indoors (without masks) than many of their fellow Americans, a fact that Republican Gov. Ron DeSantis takes pride in. But that only strengthens the case for fourth-wave optimism. If a state with a lot of B.1.1.7 and not a lot of restrictions is still doing OK, shouldn’t the rest of the country take that as a sign of hope?
The tentative answer is yes. America’s overall immunity numbers are almost identical to Florida’s: 30 percent infected, 19 percent vaccinated, about 40 percent protected to some degree. Spring is 10 days away; the weather will only get warmer. And cases and hospitalizations continue to fall nationwide by 10 to 15 percent a week.
B.1.1.7 will keep spreading, in Florida and elsewhere. It will eventually become “dominant.” But whether that dominance actually causes a fourth wave of infections is looking a little less likely every day.
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