BREVARD COUNTY, Fla. – On Friday, just before the Brevard County Policy Group voted for a second time on whether to partially close Space Coast beaches, Maria Stahl, the Florida Department of Health representative on the panel, offered a sober but stark assessment of the local COVID-19 situation to the group's eight members present.
The number of COVID-19 cases exceed what official numbers showed, she said, and were sure to rise in the coming days, News 6 partner Florida Today reported. She said Brevard’s cases not only included patients with out-of-state connections but also instances of “community spread,” meaning that residents are passing on the infection without any link to known cases. The numbers of ill were going to increase, Stahl warned. It was time to close the beaches.
In the end, Stahl and Brevard Emergency Manager Kimberly Prosser were the only votes to close the beaches. The other seven members present, which included two elected officials — County Commission Chair and head of the Policy Group Bryan Lober, and Sheriff Wayne Ivey — voted to keep county beaches open.
In the days since the vote, however, and even before, a number of local elected officials, political leaders and experts, as well as former officials, echoed Stahl's assessment and raised the alarm that policy decisions based only on confirmed cases would likely be ineffective as the numbers do not reflect reality.
They warned officials from the county commission to the office of Governor Ron DeSantis that unless that reality is recognized, the new coronavirus would only spread further and faster.
Among the first to raise the issue in emails to local officials, was John Dittmore, the deputy mayor of West Melbourne, acting upon information from an emergency room worker, and internal memos from a healthcare provider, which FLORIDA TODAY has since identified as Health First.
In a note to city officials Friday, Dittmore shared the concern that "not enough was being done to get people in the community to STAY at home," and that "the numbers of affected COVID-19 patients are severely being under reported."
“I was told that many patients are currently being diagnosed with COVID-19, WITHOUT any testing, and are being sent home to self quarantine,” he wrote.
"We have been focused on tested individuals as the barometer and there are persons being seen at the emergency room and diagnosed with coronavirus and sent home to self quarantine solely based on a diagnosis," he told FLORIDA TODAY in a phone call.
Testing, he added "is only being done at the facility for someone who has been admitted to the hospital."
"This healthcare professional advised that they have seen as many as one person per hour that’s been diagnosed with COVID-19," Dittmore said.
One internal memo from Health First obtained by FLORIDA TODAY stated that “contrary to media reports, there are not enough tests” for ambulatory or drive-thru testing.
Health First would not comment on the lack of tests.
“Health First continues to work closely with the Florida Department of Health and the Centers for Disease Control and Prevention (CDC), regarding COVID-19 and is following all protocols for testing, reporting and treating individuals who display symptoms,” Health First wrote in a statement.
Documents from another hospital group, Parrish, painted a similar picture.
According to an internal bulletin reporting data from Parrish's online COVID-19 screening tool, as of Thursday 1,568 people had completed a coronavirus questionnaire. Of those, 379 weredeemed “at risk” and 138 qualified for a “care navigation call.”
Parrish spokeswoman Natalie Sellers stressed these calls are not diagnoses, but outreaches meant to identify individuals who may need further assessment or directions in "strict accordance with CDC guidelines."
Sellers said Parrish communicated daily with county and state officials, but deferred questions about COVID-19 testing and surveillance to the Brevard County Policy Group and the FLORIDA Department of Health.
On Saturday, Dittmore shared his concerns with State Representative Randy Fine.
"Can you assist on this? Decisions are being made on the County and Local level based on test results that are 10-14 days old. Concerns are that there are many other COVID-19 patients not being counted," he wrote in an email.
In the past days and weeks, FLORIDA TODAY has received emails, calls and comments of residents concerned about access to testing. People who say they fit testing criteria or present symptoms including pneumonia yet are declined a test by their healthcare providers or the Department of Health are common.
David Peterson, a paramedic who is working at a fire department in the county, told FLORIDA TODAY that he tried to get tested through the health department after coming down with symptoms. He even had a known contact with a colleague who had been deployed to a hot spot in California. After two weeks his symptoms passed.
"I realized they don’t have the ability to test — either they can’t or they don’t want to," Peterson said, adding that the official positive case numbers are "not a reflection of what's really going on."
The demand for clear messaging, like Stahl's, and for more tests have not gone unnoticed.
On Friday morning, State Rep. Tyler Sirois wrote to Surgeon General Scott Rivkes asking for more testing or a mobile test site in the County.
"While reviewing the Florida Department of Health Data and Surveillance tool, it appears that fewer Brevard County residents are 'tested or awaiting testing' compared to other counties of similar size," he wrote.
Sirois told FLORIDA TODAY he was acting upon an outpouring of concern raised by his constituents that testing was lacking and so the true extent of the disease burden was being missed. He said Rivkes recognized the need for more testing, said the state is working to secure resources from the federal government, and "assured me the health department is working with our local hospitals."
Rivkes also reminded him of the "importance of following social distancing and guidelines of the Centers for Disease Control."
"That messaging is necessary at every level of government," Sirois said. "Now is not the time to take risks, it’s not the time to gamble, it’s the time to exercise that individual responsibility."
Former County Commissioner Jim Barfield, who also has a masters in public health and runs a company that provides medical staff to the military, likened Brevard's relative lack of testing to running along a cliff at night without a flashlight.
“There’s a lack of real knowledge, we’re shooting in the dark and it’s scary,” he said. “We don’t know what the magnitude is.”
Barfield pointed to statewide testing numbers. Brevard, which is the 10th most populous county out of 67 counties in the state, as of Sunday morning ranked 59th in tests administered per capita.
“Our governor needs to be all over this,” Barfield said. “Why are we not getting our fair share?”
Like Stahl and Dittmore, Barfield said we have to assume there are more cases than being counted. “We should not even be really that focused on how many there are, it’s how many we don’t know about,” he said.
Barfield said county commissioners have some tough decisions to make.
“They need to understand that, hey, this is not about doing what the constituents want in this case. You’re doing your job protecting public health, and you may make decisions the public does not like, but that’s just part of the job,” he said.