COVID in California vs. Florida: A Compelling but Bogus Comparison
COVID infection rates and deaths are generally much higher in red states than in blue states
Author’s note: I have published an update to this article based on more recent COVID data. A lot has changed in the last year. You may read it in Politically Speaking here.
Ever since the widespread lockdowns last spring, there’s been pitched political debate over how much government should be doing to slow the spread of the novel coronavirus. Last month several media stories comparing the COVID-19 experience in California and Florida seemed to capture the flavor of that controversy.
California Governor Gavin Newsom boasted that his state suffers a lower death rate than most states, including Florida. But anti-maskers took evident glee in pointing out that the two states have had remarkably similar levels of both COVID-19 infection and mortality, despite famously restrictive policies in California and relatively laissez-faire policies in Florida. Indeed, an opinion piece in the Wall Street Journal proclaimed “vindication for Ron DeSantis” as “Florida’s Covid-19 numbers are better than California’s or New York’s.” Actually, they’re not better than California’s. But they’re in the same ballpark — or were until the recent spring-break surge.
The Pandemic’s Hit to California and Florida
Let’s review. Through the end of February — when the nationwide winter surge finally subsided — Florida had a slightly higher case rate than California relative to population size (left chart). And both exceeded the U.S. average. Florida’s per-capita COVID death rate was 9% greater than California’s, though both states have lower rates than the U.S. average (right chart). But overall, pretty similar.
The picture looked a lot different a few months ago. California was one of the first states to take decisive action to limit the spread of the coronavirus last spring, which seemed to pay rich dividends. In contrast, Florida appeared to be paying the price for its less restrictive approach. As Americans prepared to sit down to Thanksgiving dinner, California COVID-19 enjoyed an infection rate 23% lower than the national average, and 35% below Florida’s, after the Sunshine State suffered through a terrible summer surge. (So much for the theory that summer heat would halt COVID-19!)
But then the trends reversed this winter, abruptly and emphatically, with California enduring among the worst outbreaks of any large state. Notably, Florida maintained below-average infection rates through the fall and most of the winter, despite relaxing or even removing its restrictions.
Relative to national trends, California’s winter surge was not nearly as severe as Florida’s summer surge: Florida’s infection rate in July and August was more than double the U.S. average, while California’s rate in December and January was only a third greater than the U.S. average. But the absolute number of new cases during California’s winter surge was staggering, swamping the state’s laudable performance during the first nine months of the pandemic. California’s infection rate grew to be 3% greater than the national rate by the end of the winter surge.
And then came spring break in Florida. The occasion was celebrated in some quarters as emblematic of Florida’s return to normalcy (or what passes for normal during spring break) but also prompted Miami Beach’s mayor to order curfews to reduce the risk of COVID spread. It wasn’t enough, apparently. While infection rates in California continued to plunge in March and early April, COVID rates remained stubbornly high in Florida and actually began to rise again in late March — two weeks after spring break started, much as public health officials had warned.
While the rates were the same in the two states as late as early February, the new COVID-19 infection rate has been three times greater in Florida than in California over the past five weeks. Over the past two weeks, Florida has been averaging over 5,200 cases a day compared to only 1,600 in California, despite having barely half the population size.
As a result, Florida’s cumulative infection rate is now 7% greater than California’s, which has fallen below the national rate. Meanwhile, the new infection rate in Miami is now almost five times greater than in Los Angeles.
The Trade-Offs with Jobs
Overall, California has maintained slightly lower COVID-19 rates than Florida. But these have come at an economic cost. Florida’s tourist-dominated economy lost almost 20% of its jobs in the first six terrifying weeks of the pandemic shutdown, compared to the 17% job loss in California.
Since then, however, Florida has allowed — even actively encouraged — more of its economy to reopen, effectively dropping most restrictions in the fall. Thus, Florida’s economic recovery has been quicker and stronger. Employment at the end of February was down just 4.7% in Florida relative to before the pandemic, compared to 6.8% in California. And despite having an economic base arguably more vulnerable to pandemic shocks, Florida also has experienced less economic output loss than California as measured by Gross National Product (GDP).
A Sample of Just Two Is Not Meaningful
To summarize, California has performed a little better than Florida on health outcomes, somewhat worse on economics. Certainly, Florida’s better economic performance tracks with expectations about the impacts of imposing fewer versus more pandemic restrictions. But California’s only modestly lower infection rates? That seems counterintuitive — frustratingly so for public health professionals, businesses, and citizens alike.
How to explain this? We don’t know exactly and likely won’t until there’s serious academic study in the years to come. As summarized by a public health expert interviewed for a Healthline article, “I can’t explain why Florida is not worse off than it is. . .We’re still learning a lot about this virus.” The complexity of accounting for variations in COVID’s spread and mortality in different countries with similar health policies was explored in great detail in a recent New York Magazine article.
Which leaves us with the unsatisfying conclusion that there’s much we still don’t understand about this virus. After all, this novel coronavirus is but a year old, so it’s reasonable that we have not yet fully discovered every nuance about its transmission.
Still, this issue is pretty basic. Does masking matter? Should we be limiting indoor dining? Naturally, we’d like greater assurance of beneficial outcomes if we’re going to incur the incredible expense and burden of restricting social mobility and everyday commerce.
What can we learn from a California-Florida coronavirus comparison? By itself, not much. We cannot pick two states at random — albeit two prominent states that seem to exemplify the spectrum of public health responses — and expect them to broadly represent what’s necessary to control the pandemic’s spread. Perhaps features unique to one or both of these two states make them particularly prone or resistant to virus spread? It’s too early to know.
“Red” versus “Blue” America
Which is why we need to zoom out our focus a bit to look at the bigger picture. “Blue” states led by Democratic governors generally have taken more decisive action to fight the pandemic relative to “red” states led by Republicans. And residents of blue communities typically have been more accepting of these public health restrictions. Not always, everywhere, but generally.
In a recent series of articles, I have explored the growing divide between “red” and “blue” America in terms of voting patterns and demographics and now the pandemic’s impact on local communities. The trends are clear. States with Republican governors tend to have significantly higher rates of COVID-19 infection than states with Democratic governors. And states that voted Republican in the 2020 Presidential election, on average, have much higher rates of COVID-19 infection than states that voted Democratic.
Finally — and most telling of all — states with Republican governors and that voted for Trump in 2020 tend to have higher infection rates than states that voted for Trump with Democratic governors. And states with Republican governors and that voted for Biden in 2020 typically have higher infection rates than states that voted for Biden with Democratic governors.
To be sure, the red-blue disparity is not nearly as clear-cut with regard to COVID-related deaths, mainly because the very blue New York metropolitan area accounted for such a disproportionate share of these deaths before public health officials understood much about the pandemic or how to treat it. Since then, COVID deaths have taken a decidedly red-state turn.
Moreover, significant geographic and demographic differences between red and blue states influence their susceptibility to medical conditions such as COVID-19. Blue states tend to be more affluent and often have better medical facilities than those in red states, which together might lower their infection rates and deaths, all else being equal. On the other hand, blue states, on average, are more densely populated, which tends to promote the incidence of diseases that spread through social interaction.
Nonetheless, much of the difference between “red” and “blue” America in COVID’s spread can be attributed to “nonpharmaceutical interventions” (NPIs), which the CDC defines as “actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses.” Measures like social distancing, masking, and government restrictions on social interactions. Rigorous study is needed to tease out the impacts of the various NPIs. But it is clear that we cannot draw meaningful public health conclusions based on the experiences of just two random states.
As it happens, the caseload in California ranks on the high side of “blue/blue” states (states that voted Democratic in 2020 and have a Democratic governor) while Florida’s caseload is below average for “red/red” (states that voted Republican in 2020 and have a Republican governor). We can speculate as to why, but neither state is typical of the red-state vs. blue-state paradigm for public health interventions.
For all the glitter of a California versus Florida comparison, it really doesn’t tell us much at all.
