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Secrecy and spin: How Florida's governor misled the public on the COVID-19 pandemic

Sun Sentinel logoSun Sentinel 12/4/2020 By Mario Ariza, David Fleshler and Cindy Krischer Goodman, Sun Sentinel
a room with a wooden floor: La Hacienda's new dining room opened just before the COVID-19 shutdown, in Winter Park, Florida. Ample dining room space allows groups to be socially distanced. © Amy Drew Thompson/Orlando Sentinel/TNS La Hacienda's new dining room opened just before the COVID-19 shutdown, in Winter Park, Florida. Ample dining room space allows groups to be socially distanced.

FORT LAUDERDALE, Fla. — Throughout the COVID-19 crisis in Florida, Gov. Ron DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced, a South Florida Sun Sentinel investigation has found.

DeSantis, a Republican who owes his job to early support from President Donald Trump, imposed an approach in line with the views of the president and his powerful base of supporters. The administration suppressed unfavorable facts, dispensed dangerous misinformation, dismissed public health professionals, and promoted the views of scientific dissenters who supported the governor’s approach to the disease.

an orange truck parked in a parking lot: Health care workers administer free drive-thru COVID-19 tests at the Hard Rock Stadium in Miami Gardens, Florida on Wednesday, July 15, 2020. Case and death totals in the state contine to be high. © Mike Stocker/Sun Sentinel/TNS Health care workers administer free drive-thru COVID-19 tests at the Hard Rock Stadium in Miami Gardens, Florida on Wednesday, July 15, 2020. Case and death totals in the state contine to be high.

The DeSantis administration’s approach to managing COVID-19 information carries costs. It supports a climate in which people proudly disdain masks, engage in dangerous group activities that could spread the disease, and brush aside information that conflicts with their political views. With partygoers packing Florida bars and holiday travelers filling hotels and guest rooms, the state faces a few difficult months before the possible relief of vaccines.

a group of people walking down the street: Most visitors wore masks in October at the Las Olas Art Fair in Fort Lauderdale, Florida. Florida is one of 13 states without a mask mandate. But all attendees were asked to wear a mask upon entering the festival. © Mike Stocker/Sun Sentinel/TNS Most visitors wore masks in October at the Las Olas Art Fair in Fort Lauderdale, Florida. Florida is one of 13 states without a mask mandate. But all attendees were asked to wear a mask upon entering the festival.

These findings are based on interviews with more than 50 people, including scientists, doctors, political leaders, employees of the state health department, and other state officials, as well as more than 4,000 pages of documents.

— The Florida Department of Health’s county-level spokespeople were ordered in September to stop issuing public statements about COVID-19 until after the Nov. 3 election.

— The DeSantis administration refused to reveal details about the first suspected cases in Florida, then denied the virus was spreading from person to person — despite mounting evidence that it was.

— State officials withheld information about infections in schools, prisons, hospitals and nursing homes, relenting only under pressure or legal action from family members, advocacy groups and journalists.

Ron DeSantis wearing a suit and tie: Florida Gov. Ron DeSantis holds a press conference regarding education and COVID-19 at Boggy Creek Elementary School, on Monday, Nov. 30, 2020. © Ricardo Ramirez Buxeda/Orlando Sentinel/TNS Florida Gov. Ron DeSantis holds a press conference regarding education and COVID-19 at Boggy Creek Elementary School, on Monday, Nov. 30, 2020.

— The DeSantis administration brushed aside scientists and doctors who advocated conventional approaches to fighting the virus, preferring scientists on the fringes who backed the governor’s positions.

— The governor’s spokesman regularly takes to Twitter to spread misinformation about the disease, including the false claim that COVID was less deadly than the flu.

— The governor highlighted statistics that would paint the rosiest picture possible and attempted to cast doubt on the validity of Florida’s rising death toll.

“The governor is a smart, educated guy,” said Thomas Unnasch, co-director of the Center for Global Health and Infectious Disease Research at the University of South Florida in Tampa. “But he also is a politically savvy guy. He is encouraging people who are of the opinion that the virus is not as severe and profound as others say it is and putting politics before science.”

DeSantis has a difficult balance to strike, having to weigh the need to fight the disease against the profound harm to society of shutting down parts of the state’s economy.

DeSantis would not be interviewed for this article, but on Fox News’ “Tucker Carlson Tonight” on Wednesday, he called the media’s criticism of his approach “all political.”

Fred Piccolo Jr., the governor’s spokesman, said DeSantis has not been trying to spin anything, just stick with a consistent, facts-based message that would accomplish the most in saving lives.

“The governor has been consistent since the beginning of the pandemic,” he said. “Wash hands, maintain social distance, wear a mask, etcetera. But he’s also adapted to the data as it becomes available.

“He acted quickly to save thousands of nursing home residents. He knew of drugs in the pipeline and was ready to act for Florida when he knew they were coming online. He’s been consistent even as the pandemic has become political.”

Piccolo did not respond to questions on why the administration shut out mainstream scientists, or denied that person-to-person spread was taking place or resisted the release of COVID-19 information on nursing homes, schools and prisons.

WITH TRUMP’S REELECTION AT STAKE, FLORIDA BANS COVID-19 NEWS

In the last week of September, as the presidential election neared, word went out to the state employees who served as county-level spokespeople for the Florida Department of Health: Talk about anything but COVID-19.

Don’t issue news releases or write social media posts about COVID-19, they were told, according to three health department county spokespeople who asked not to be identified. Instead, talk about flu shots, hearing-loss screenings — anything but the virus.

“It is all part of the top-down control of messaging from the governor’s office,” said a senior official in the health department.

The order came from Alberto Moscoso, communications director for the state health department. It’s unclear who told Moscoso to issue the order. He left the department on Nov. 6 and declined comment for this report.

During the presidential election campaign, Trump quipped that he would “fire” DeSantis if he lost Florida. DeSantis worked hard to help him win the state’s 29 electoral votes, praising Trump at news conferences and attending the president’s rallies where the maskless governor was photographed high-fiving the crowd.

The attempt to deflect attention from negative news is called “blue sky” messaging, and that’s how it was described to local health representatives, according to three health department spokespeople.

“Nothing gets approved without it passing through the governor’s office,” said one county health department spokesperson. “If it’s not blue sky, then it’s held up or we’re told to hold off and it never gets approved.”

On Sept. 24, after months of Facebook and Twitter posts about COVID-19 safety, the health department stopped posting anything on social media about the disease, a blackout that lasted through November. The department did, however, continue to run prepaid COVID-19 public health ads on Facebook urging handwashing, masks and social distancing.

In the week before Election Day, as case counts climbed, the health department posted on Twitter and Facebook about flu vaccinations, the prevention of carbon monoxide poisoning and lead poisoning detection. Nothing about COVID-19.

Piccolo, the governor’s spokesman, defended the changes in Florida’s pandemic health messaging in the run-up to the election and beyond.

“As Pew Research showed, the messaging on prevention and COVID-19 has reached saturation,” Piccolo said. “People are doing all they can to mitigate risk.”

That nationwide poll, however, made no mention of COVID-19 prevention messaging, instead asking respondents only if they’d worn a mask in the past month.

Dr. Dominique Brossard, chairwoman of the Department of Life Sciences Communication at the University of Wisconsin, Madison, says that inconsistent messaging can have real-world impacts on human health.

“Clear, consistent and transparent messaging. If you don’t do that then people won’t trust you about behavior change,” she said.

A PATTERN OF SECRECY FROM THE FIRST DAYS OF THE PANDEMIC

The administration’s tight control of messaging goes back to the earliest days of the pandemic and continued as the disease penetrated every part of the state.

In February, as Floridians wondered whether this mysterious illness had arrived, state officials said no one had tested positive but wouldn’t say how many people they were monitoring or testing for the virus. They defended their refusal by citing a state law on patient privacy, although legal experts said the epidemic met the threshold for the information to be made public. At the time, other states were giving out the information.

In early March, the reluctance to acknowledge the extent of the threat included the crucial issue of whether Florida was experiencing “community spread.” That’s the person-to-person transmission of the disease, rather than its isolated appearance in a few people who contracted the virus elsewhere, such as a cruise ship or a trip abroad. Community spread would elevate COVID-19 from a concern to a crisis, raising the prospect of shutting down parts of the economy.

A March 8 briefing package for the governor from the U.S. Centers for Disease Control and Prevention delivered the bad news: Florida had “limited community transmission.” In other words: community spread.

But at a news conference the next day, despite the CDC’s alert, DeSantis denied the existence of community spread, saying that a single cluster of cases at Port Everglades wasn’t sufficient to meet the criteria.

The conflict between the governor’s assessment and that of the federal government became public at a March 10 briefing by the White House Coronavirus Task Force, when Dr. Anthony Fauci, the top federal expert on infectious diseases, confirmed that Florida was among four states undergoing community spread.

DeSantis finally acknowledged this fact at a news conference on March 14, as the number of Florida cases reached 77.

As the disease spread through Florida, state agencies refused to release information about how many people were sick at individual nursing homes, prisons, hospitals or schools.

Eventually, under pressure from families, local officials, advocacy groups and news organizations, the DeSantis administration relented. Florida now produces regular reports on the extent of the disease in nursing homes, prisons, hospitals and schools.

“The media and public should not have to rely on engaging attorneys to get this information,” said Mark Caramanica, an attorney for Florida media organizations. “The Department of Health should be as proactive as they can about giving out the data and allowing people to make informed choices.”

EXCLUDING THE EXPERTS

Florida’s wealth of university-affiliated experts on infectious diseases have largely watched from the sidelines as the governor consulted coronavirus advisers who would back his policies.

“We have over 200 affiliated faculty within this institute,” said Dr. Glenn Morris, director of the University of Florida’s Emerging Pathogens Institute. “This is what we do for a living. Yet the state has not taken full advantage of that expertise.”

The DeSantis administration’s failure to rely on the institute — established by the state Legislature in 2006 to address disease threats to Florida — is emblematic of its decision to shut out mainstream scientists in favor of a select group who would confirm the less-restrictive COVID-19 policies favored by many Republicans.

“Unfortunately, they’re not drawing on the best science, they’re drawing on political needs,” Morris said. “In many ways, it’s a tragedy.”

Florida Surgeon General Dr. Scott Rivkees, who runs the Florida Department of Health, initially took steps toward assembling what scientists hoped would be a robust statewide COVID-19 task force. But after convening a single meeting in early March, he let the initiative fizzle.

“At first, he reached out to me to form a group that can advise us through the pandemic,” said Dr. Aileen Marty, an infectious disease expert at Florida International University who advised Miami-Dade Mayor Carlos Gimenez. “And I went and found fantastic people in Florida. And the next week we had a teleconference, and we started going through the steps and the things we needed to do to move this forward.”

But then Rivkees announced there would be no more meetings.

“At the end of the conference, he said, ‘This is the only one we’re going to have. We don’t want anything getting out in public.’ At that point I thought to myself: We are on our own,” Marty said.

The surgeon general himself largely disappeared from public view after a news conference in April, where he said social distancing practices could be necessary for another year — a statement at odds with DeSantis’ optimistic message on the disease.

Rivkees did not respond to a request for an interview.

“Immediately after he finished saying that, he was pulled off of the dais by the governor’s team. And we didn’t hear from or see Dr. Rivkees for weeks and weeks after that,” said state Rep. Carlos Guillermo Smith, an Orlando Democrat who has been critical of the governor’s COVID-19 policies. “That leaves the public with the perception that our state surgeon general is being muzzled by the governor.”

LET’S FIND SOMEONE WHO AGREES WITH US

In place of Florida scientists, the governor called on a group of experts and quasi-experts who would tell him what he wanted to hear.

Among them was Dr. Scott Atlas, a radiologist and senior fellow at Stanford University’s conservative Hoover Institution, who served as Trump’s coronavirus adviser despite having a medical specialty that did not involve infectious disease. Atlas won Trump’s favor with optimistic statements on the pandemic, skepticism of masks, advice to limit testing and promotion of an approach that involved reopening the economy.

At the end of August, DeSantis invited Atlas on a tour of Florida. The two appeared at a series of news conferences, where DeSantis rattled off favorable statistics on the fight against the disease and Atlas backed the governor’s less-restrictive approach.

But Atlas’ statements have been widely panned by other scientists and drew a rebuke last month from the Stanford Faculty Senate, which adopted a resolution to “strongly condemn” him for promoting a view on COVID-19 that “contradicts medical science.” Atlas responded that he was “disappointed” in the faculty resolution, saying, “My views in favor of the careful protection of our nation’s most vulnerable while safely re-opening society are far from contrary to science.”

DeSantis’ decision to bring Atlas to Florida dismayed outside experts and at least one top state official. “Dr. Atlas is a wonderful radiologist,” said a senior DeSantis administration official who wanted to remain anonymous. “If I need some film read, I’ll go to him.”

In late September, DeSantis assembled a televised public health roundtable of scientists from Harvard and Stanford who backed his policies. In the two-hour discussion, the governor played the role of an attorney asking friendly witnesses for the expected answers.

DeSantis: “Dr. Kulldorff, do you think, from a public health perspective, having an open, functioning society, with protections for the folks that are specifically vulnerable to this disease, do you think that’s the best approach?”

Martin Kulldorff, a professor of medicine at Harvard: “That’s the right approach, certainly.”

Public health experts called the event more of a public relations exercise than a public health discussion.

“Calling people in from out of state to be experts who are of your same mindset, you are controlling the narrative, and it’s politics not science,” said Dr. Jay Wolfson, senior associate dean of the University of South Florida’s Morsani College of Medicine. “Florida is one of the top states in the nation for expertise to draw on. Unfortunately, at the state level, I’m afraid we are not being heard, and evidence-based data is not being used as far decisions being made.”

A TWITTER FEED OF COVID-19 MISINFORMATION

A reliable source of misleading statements on COVID-19 is the Twitter account of a prominent state official — the chief spokesman for the governor.

Fred Piccolo Jr., a Republican who fills his Twitter feed with attacks on Democrats and the media, has sent out multiple false or misleading tweets about the disease. Among them: COVID-19 is less deadly than the flu and masks are only marginally effective.

Here are some examples:

Tweet: Claimed the COVID-19 plans of the Florida Democratic Party and Joe Biden meant “locking people in their houses even though it’s less deadly than the flu, talk down a vaccine, force you to put something on your body, yank kids from school, & cower in fear. Oh & tank the economy.”

Facts: Although researchers have yet to establish the exact COVID-19 death rate, there’s broad agreement it’s at least several times more lethal than the common seasonal flu. On average, the flu has killed between 10,000 and 60,000 Americans every year since 2010. So far this year, COVID has killed more than 272,000, according to dashboard run by Johns Hopkins University.

“We’re talking over 200K,” said Jill Roberts, associate professor at the University of South Florida’s College of Public Health, after reviewing Piccolo’s tweets. “How could you possibly try to sell that message? That’s ridiculous. The data speaks for itself.”

Tweet: Urging the need to acknowledge progress in the fight, on Oct. 13, Piccolo tweeted “we had one Covid death in Florida yesterday. yes you read that right. One.”

Facts: On the day he referred to, the state reported 47 deaths. But either way, Piccolo would have had no way of knowing how many people actually died from the disease that day, since the fatality reports can take weeks or months to be recorded.

Tweet: Piccolo retweeted an observation by Dr. James Todaro, an ophthalmologist who gained attention for promoting Trump’s favored COVID-19 policies, that read “Wearing a mask outdoors is more ludicrous than wearing a seat belt in a car showroom.”

Facts: Experts say masks should be worn outside if it’s not possible to maintain a safe distance from people you aren’t normally near. “I would say that tweet is dangerous,” said Michael Mina, assistant professor of epidemiology at Harvard University’s T.H. Chan School of Public Health. “Masks cut risk. I would call that a false tweet.”

Asked about the claim the disease was less deadly than the flu, Piccolo said, “I should have said kids rather than people.”

Regarding the incorrect report of a single death one day, he said, “At the time of publication, there was one death that day. Those numbers do change, but it is more accurate than the often used ‘deaths on date reported’ that headlines love to use.”

On masks, he said, “The governor has always advocated wearing a mask, he just does not believe in mandates.”

Although the governor advocated masks early in the pandemic, his more recent statements have focused on his belief that masks should be voluntary and mandates aren’t effective. Florida is one of 13 states without a mask mandate.

CONTINUING TO SPIN A CATASTROPHE

At a hospital in The Villages, the vast retirement community northwest of Orlando, DeSantis began an Aug. 31 news conference with a parade of upbeat statistics about the course of the disease since its July peak.

“Since that time, we’ve had really positive trends,” he said. “So, for example, today we can report in Florida that the number of COVID-positive patients that are currently hospitalized is down nearly 60% statewide from our July peak.”

“There’s been a lot of positive movement over the last four to six weeks,” he said. “And we want to obviously see that continue.”

Such recitations of upbeat news are familiar to anyone who has watched the governor’s news conferences. Seeking to put the best face on the pandemic, he highlights the most favorable data points available in the daily blizzard of statistics on new cases, hospitalizations and deaths.

He has pointed to declines in the positivity rate. Or declines in the daily count of new cases. Or a reduced number of hospitalizations. Or the drop in the age of the average person infected, since COVID-19 tends to cause less harm to younger people. Or at his most recent news conference Monday, the coming vaccines.

“He has these press conferences where he says how great everything is,” Miami Beach Mayor Dan Gelber said. “It’s more like an Amway meeting than an emergency management meeting. This constant refrain of how well everyone is doing. It’s so the wrong approach.”

The governor also questioned the validity of his administration’s own fatality numbers, claiming they might have been exaggerated. After a motorcycle crash death was initially classified as a COVID-19 fatality, DeSantis seized on it as evidence that the death count may be inflated.

The Florida Department of Health on Oct. 21 ordered a review of all deaths, citing concerns about accuracy and the time-lag that led some COVID-19 deaths to go unreported to the state for more than two months.

“We had the opportunity to review death certificates for some of Florida’s recent COVID-19 deaths,” tweeted Piccolo, the governor’s press secretary. “And we can tell you definitively that Florida is counting deaths that were not directly caused by COVID-19.”

Many experts who have studied epidemics say the opposite is more likely true, and Florida’s current official death toll of more than 19,000 is likely an undercount. Studies from the CDC suggest that Florida’s total death toll from the pandemic could have been as high as 23,000 in early October.

The governor’s spokesman denied that the state was trying to raise doubts about the official death toll. “No one in the administration is trying to cast doubt on the number of COVID deaths,” Piccolo said. “We are trying to get to the facts.”

The DeSantis administration also has chosen a positivity rate calculation that yields more favorable results and is not widely used.

DeSantis frequently cites the state’s positivity rate to justify reopening schools and businesses. But there are different ways of calculating it, and the one favored by DeSantis gives more weight to negative tests, skewing the results in a more favorable direction.

Piccolo defended the state’s preferred method. “New cases are a better snapshot of the day and provide better numbers to detect trends,” he said.

Jason Salemi, an associate professor at the University of South Florida’s College of Public Health, said Florida’s preferred positivity rate is “more controversial. You tend to not see it in a lot of other places.”

FACING A ROUGH WINTER

The number of new cases has been rising, following an upward slope that began in mid-October. So has the positivity rate. So has the number of people hospitalized. That means more dry coughs, fevers and agonizing, lonely deaths.

On Nov. 19, when the state posted more than 9,000 new cases, the governor went on YouTube to announce a vaccine would be available at five hospitals and nursing homes within six weeks.

“I do believe these breakthroughs represent the greatest rays of hope we have seen since the pandemic began,” he said in the video. “They offer the possibility of saving thousands and thousands of lives and the potential to bring this pandemic to an end.”

At a news conference Monday, the governor said the hard evidence on tactics such as lockdowns and mask mandates shows they simply don’t work.

“At some point you have to look at the observed experience about what’s happening,” he said. “And I think there’s narratives like ‘lockdowns work.’ And they don’t, if you look at the evidence, business closures, all this stuff, look at what just happened in Europe, France locked down Switzerland didn’t — same viral curve, literally, no difference. So you focus on protecting vulnerable people. You provide the resources to our medical and hospitals as they need it.”

Regardless of when a vaccine arrives, experts say, Floridians should be isolating, wearing masks, and fighting the virus by stopping its spread.

“I think it’s a really bad idea to bank on just these vaccines,” said Michael Mina, the Harvard epidemiologist. “All signs point to this not being widely available until the spring.”

Instead of taking precautions, however, many in the Sunshine State are partying on. At the open-air Wharf bar and restaurant complex on Fort Lauderdale’s New River, hundreds of maskless partiers packed the place to drink, dance and talk on a recent Saturday night.

“It’s hard to drink with a mask on,” one 20-something said. Another said, “There’s no such thing as COVID in South Florida.”

———

©2020 Sun Sentinel (Fort Lauderdale, Fla.)

Visit the Sun Sentinel (Fort Lauderdale, Fla.) at www.sun-sentinel.com

Distributed by Tribune Content Agency, LLC.

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