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COVID-19 Morning Report

Florida Department of Health

State health officials reported 4,115 new COVID-19 cases, Wednesday, for a total of 790,426 cases. The Florida Department of Health also reported 66 new coronavirus related deaths, Oct. 28, increasing the statewide death toll to 16,775 fatalities.

Over the past seven days, the single-day average number of new infections reported stands at 3,983 cases. The average number of daily deaths reported over the past week comes to nearly 52 fatalities a day.

The latest single-day positivity rate recorded, Tuesday, by the Florida Division of Emergency Management using the formula recommended by the World Health Organization stands at 6.49%.

Over the past two weeks, Florida's single-day positivity rate has ranged between 4.64% and 8.02%.

Here in the Southwest Florida region including Charlotte, Collier, Glades, Hendry, Lee, Manatee and Sarasota Counties, health officials have reported a total of 66,684 COVID-19 infections and 1,639 coronavirus-related fatalities since the beginning of the pandemic.

About 180 million Americans get health benefits from employer-sponsored plans, and the open enrollment period is ahead for many in the coming weeks. Despite a projected rise in healthcare costs in 2021, most insurance companies are not expected to raise employee deductibles or co-payments next year.

The Naples Daily News reports the health and benefits firm Mercer projects health care costs will increase 4.4% in 2021. PwC, previously PricewaterhouseCoopers, predicts healthcare costs will increase somewhere between 4 and 10 percent and the non-profit Washington D.C.-based Business Group on Health is calling for a cost increase of 5.3% next year.

According to Florida Blue employers in Southwest Florida are not expecting significant increases in the cost of health plan premiums.

However, what remains unclear in these projections is how the ongoing COVID-19 pandemic will impact healthcare costs going forward and whether the coronavirus may permanently change how Americans get access to medical care, including the current decrease in patients seeking treatment in emergency rooms and the increased use of virtual telemedicine services.

The Mercer survey finds that 57% of employers don't plan to pass on cost increases to workers, 18% do plan to pass on some cost increases to policy holders and that for 25% of employers, that answer remains unclear.

These projections don't reflect the impact of the millions of job losses caused by the pandemic-induced economic shutdown earlier this year. The Employee Benefits Research Institute finds that an estimated 811,000 Floridians lost health benefits this year. Nationally, an estimated 14.6 million people lost employer-sponsored health insurance.

Venice City Council members voted, Tuesday, not to renew an ordinance mandating that people wear face coverings in public in an effort to help curb spread of the coronavirus.

City councilors first imposed the mask mandate in August and the current continuation of that ordinance expires at the end of the month.

Council member Mitzie Fieldler was the swing vote in opposition to maintaining the ordinance. She told the Sarasota Herald Tribune her vote against continuing the mandate was prompted by Governor Ron DeSantis' decision to nullify penalties in local mask ordinances. She said the governor's action make the local mandates hollow and unenforceable.

To date, Venice police have not cited anyone for violating the ordinance.

Fieldler said she still personally supports wearing masks, citing a University of Washington study that projects the coronavirus-related death toll in the U.S. could exceed 500,000 fatalities by February, but that universal mask wearing could cut that number by 25% and that physical distancing could reduce that death toll increase by another 25%.

Collier County Commissioners voted, Tuesday, in favor of another round of federal CARES Act allocations to entities and businesses hurt by the ongoing COVID-19 pandemic.

The Naples Daily News reports commissioners approved about $5 million for fire departments, law enforcement and emergency medical services, $800,000 for child care costs to first responders, $1 million for expanded personal protective equipment reimbursement costs to government agencies, and $1.85 million to be distributed in $5,000 grants to hard hit businesses like restaurants and retail stores.

Collier County initially received about $16.8 million in federal CARES Act funding and then a second allocation of about $13.4 million.

The Lee County School District has closed its third classroom so far this school year due to the coronavirus. The closure, reported to families Tuesday, involves a classroom at Bonita Springs Elementary School.

The district is not disclosing the grade level or number of students and staff impacted by the classroom closure and 14-day quarantine, but the News-Press reports, effected students are temporarily shifting from in-person instruction to the Lee Home Connect model, where students receive live, virtual instruction with a teacher from their school.

Since the Lee County school district reopened Aug. 31, officials have sent home 152 positive case alerts to families.

District officials closed a classroom at Gateway Elementary school Sept. 10 and another classroom closed at Villas Elementary school Sept. 29.

Antigen tests are also known as rapid point-of-care tests because they don’t require a lab to produce the results and someone can get an antigen test done conveniently, where they live or work, because the machine needed to process the specimen is on site.

This week, President Donald Trump’s administration announced that Florida’s getting 6,460,000 COVID-19 antigen tests, produced by Abbott, called BinaxNOW. These antigen tests don't require the entire nasal passage to collect the specimen.

"Just the tip of your nose," said Admiral Brett Giroir, a physician who works at the U.S. Department of Health and Human Services on the country’s COVID-19 testing efforts, on a press call. "You swipe five turns on one, five turns on the other. This looks like a card-based test. So you put this swab into the card that you've already put six drops of fluid on. You close it."

Then the machine looks for a protein in the specimen specific to this coronavirus.

"It's very similar to what you'd have, a flu test, a pregnancy test," he continued. "If there's one line, the test is valid and you're negative. If there's two lines, the test is valid and it's positive."

The process takes about 15 minutes. Antigen tests produce results quickly, but they're not sensitive tests, so health professionals worry about false negatives.

The Trump administration is sending 6,460,000 Abbott antigen tests to Florida to use at sites like nursing homes, grade schools and universities.

"You're going to have false negatives, but you're going to have really fast false negatives," said Dr. Aileen Marty, an infectious diseases expert at Florida International University. "That's the problem."

Antigen tests would need to be used regularly, like daily, to catch people who are positive, Marty recommended. Take a school, where a student might test positive — a typical reaction might be to test all of the other students in the same classroom.

"Well, that’s useless, because all those other kids at that time, on the day that first kid became positive, are very unlikely to test positive with the antigen test," Marty explained. "It's going to take a few days to build up enough virus in each child's body."

Molecular tests are far more sensitive and likely to catch that someone has the virus in their body, even a low viral load, but these take longer. The specimen usually goes to a lab where technicians use reagents, or chemicals, to amplify the genetic material and look to see if it corresponds with that of COVID-19. Lab turnaround times are improving, but that continues to present a challenge.

Giroir said another challenge is that molecular tests are so sensitive that someone might test positive for weeks, but no longer be infectious.

"Bottom line, there is no such thing as a perfect test. One is not better than the other," he added. "They each have their place in the ecosystem."

Doctors also disagree on whether Florida should depend so much on antigen tests right now as the positive case numbers and the state’s positivity rate have been going up in recent days. The antigen tests are being distributed to places like nursing homes, grade schools and historically Black colleges and universities.

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Verónica Zaragovia