Is Florida doing better on COVID-19 than 'locked down' states?

Florida Gov. Ron DeSantis has resisted pleas from some of his state’s mayors to enact statewide measures to fight COVID-19, such as a mask mandate and the power to adopt local restrictions.

The day before Florida recorded its 1 millionth case, DeSantis told reporters that states in lockdown mode are faring worse than Florida.

"So I hear people say, ‘Oh, well, Florida is open, and they’re having increased cases,’" DeSantis said Nov. 30. "Well, OK, the states that are locked down are increasing at twice the rate we are. If you look at the per capita cases, in a lot of these states that have closed schools, businesses shuttered, some of them even post stay-at-home orders there, you see a huge increase in these cases."

We checked DeSantis’ claim that "the states that are locked down are increasing at twice the rate we are." We found that while Florida is doing comparatively well at the moment, DeSantis overstated the correlation between cases and lockdown rules. It’s likely that other factors beyond just a state’s rules are affecting COVID-19 rates.

In an effort to reduce the spread of the virus, states have enacted — and then sometimes relaxed or lifted — various restrictions, including mask mandates, limits on restaurant capacity, and bans on large gatherings.

DeSantis, a Republican, issued an order Sept. 25 that generally lifted restrictions on businesses and suspended fines for people who didn’t comply. While many stores and restaurants have adopted their own mask and social distancing rules, Floridians have still packed into some bars and other gathering spots. 

In November, cases in Florida were on the rise, but unlike some other governors, DeSantis said he wouldn’t issue new mandates.

We asked Fred Piccolo, a spokesperson for DeSantis, for evidence to explain the governor’s claim that cases in states that are locked down are increasing twice as fast as in Florida.

Piccolo cited a New York Times state-by-state analysis, updated Nov. 30, showing which states have businesses that are mostly closed, which ones have no restrictions, and which ones are "mixed." The Times also published a map showing states with stay-at-home orders or advisories.

Piccolo then used the Covid Act Now website to calculate the number of cases and hospitalizations per 100,000 residents in some of the states with more stringent restrictions.

We checked the numbers ourselves. We focused on the states that the Times had cited as enacting the most stringent restrictions for either businesses or residents as of Nov. 30, as well as the states that had a medium level of restrictions on both businesses and residents. All told, 10 states qualified for this group of states with high coronavirus-related restrictions. (Our list of 10 states was slightly different from the one Piccolo provided, but not substantively so.)

Broadly speaking, we found that Florida’s record, at least as of the beginning of December, compared favorably with most states across the country, including those with tighter restrictions. Specifically, in comparisons of coronavirus cases deaths and hospitalizations per capita, Florida ranked among the best, and better than some of the more highly regulated states. (Click on the chart to see separate comparisons for cases, deaths, and hospitalizations.)

So there’s something to what DeSantis said. However, there are also some important caveats.

First, some of the more highly regulated states performed better than Florida did. For instance, Oregon, Washington state and California had fewer coronavirus deaths per capita than Florida did, while Massachusetts, Oregon and Washington state had lower hospitalization rates.

Second, DeSantis’ reference to "twice the rate" undercuts the strength of his argument. Out of the 10 states with the most stringent rules, only about half had per capita cases, deaths and hospitalizations that were twice as high as Florida’s rate.

Third, Florida may be faring better than many other states in fighting the coronavirus, but that doesn’t necessarily mean that a lack of restrictions is to credit for better coronavirus statistics.

The following chart shows 27 states, including Florida, that the New York Times’ analysis found to have the least restrictive COVID-19 rules on businesses and residents. 

Once again, Florida ranks well compared with the other states on cases, deaths and hospitalizations. But many of the states that followed similarly  low levels of restrictions as Florida did ended up with far worse outcomes. 

We found that 12 of the low-restriction states had double Florida’s case rate, eight had double the rate of deaths, and nine had double the rate of hospitalizations. Five states had double Florida’s rate in each of the three statistics — South Dakota, North Dakota, Montana, Nebraska, and Indiana — and another five states had twice Florida’s rate for two statistics. 

RELATED: In Nebraska, skyrocketing cases of COVID-19 put localities, governor on separate tracks

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It’s also important to note that some states added or tightened restrictions in November, making the impact so far difficult to evaluate.

The comparison with other lightly regulated states suggests that Florida may be doing relatively well for reasons other than its low-regulation policy.

For example, Florida’s weather makes it easier for residents to eat and gather outdoors, even at this time of year. Scientists have generally said that the virus passes from person to person less easily outdoors than in cramped indoor spaces.

"I think it’s reasonable to say that the warmer weather certainly plays a part in Florida’s relative success," said Brooke Nichols, an infectious-disease mathematical modeler at the Boston University School of Public Health. "It’s no longer incredibly hot, necessitating indoor gathering for air conditioning, but not too cold that people need to congregate indoors for heat."

In addition, it’s hard to establish causation: Is it the loose regulation that helps reduce infection rates, or is it the low infection rates that allow for looser regulations? 

Miami-Dade, the state’s most populous county, had an increase in cases following the removal of the mitigation strategies, said Mary Jo Trepka, chair of the Department of Epidemiology at Florida International University.

"We don’t know how bad it will get," Trepka said.

It’s also important to remember that states aren’t walled-off jurisdictions. During much of the pandemic, Florida has been open to tourists, which means we don’t know whether coronavirus transmission within Florida is increasing infections in other states after those tourists return home, said Marissa Levine, a public health professor at the University of South Florida.

Jason L. Salemi, associate professor of epidemiology at the University of South Florida, cautions that the success DeSantis claimed is only in comparison with other states, and that cases and hospitalizations have been rising over the last few weeks. "That, to me, is indicative of how serious the situation is across the country," he said.

DeSantis said, "The states that are locked down are increasing at twice the rate we are" in Florida.

Currently, Florida does have relatively low rates of coronavirus cases, deaths and hospitalizations. But the connection between those statistics and Florida’s light restrictions on businesses and residents is less clear-cut than DeSantis suggests.

Only about half of the 10 most stringently regulated states saw rates of cases, deaths and hospitalizations that were twice as high as Florida’s — DeSantis’ benchmark.

Meanwhile, numerous other states that followed the same less restrictive policies as Florida have fared far worse than Florida. This suggests that factors other than behavioral regulations, such as warm weather, may play a role in keeping coronavirus infections relatively low in Florida.

We rate the statement Half True.