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Many people in California hit the beach during the pandemic. Alexi Rosenfeld/Getty Images
  • As the pandemic seems to be on the decline in the United States, we looked at two states that had very different approaches to reopening.
  • California has slowly been dropping restrictions on indoor eating and gatherings.
  • Florida Gov. Ron De Santis lifted restrictions last fall, while California Gov. Gavin Newsom has favored a slower tiered approach.

More than 3,760,303 people in California have developed COVID-19 since the pandemic began.

While that is the highest number of cases reported in any state in the country, California is also the most populous state with about 40 million residents.

But because of growing rates of immunity, continued efforts to vaccinate, and other measures to stop the spread of the virus, California now has one of the lowest rates of new cases in the country.

California reported an average of 1,783 new cases a day over the past week. That’s 4.69 daily cases per 100,000 people in the state. Oklahoma is now the only state with a lower rate of new cases.

COVID-19 infection rates have also declined in other states since peaking this past winter.

Florida reported an average of 3,635 new cases a day this past week. That’s down 80 percent since early January. Still, Florida’s per-capita rate of new cases is nearly 3.75 times higher than that of California.

The states approached reopening very differently. Florida Gov. Ron De Santis began to fully reopen the state in the spring with zero limits on indoor dining. Earlier this month, he also lifted any locally imposed restrictions as well. In California, Gov. Gavin Newsom favored a slower-tiered approach based on a county’s rate of infection and current COVID-19 case count. The method has sometimes been criticized as going too slowly.

Many factors may account for the disparity in cases according to experts. And there isn’t one simple answer, Emily Pond, MPH, a research data analyst at the Johns Hopkins Coronavirus Resource Center in Baltimore, told Healthline.

“It’s very difficult to compare between states, just because the demographic composition is different,” Pond said. “Even within a state, it can be significantly different between regions.”

California and Florida have been hit hard by the COVID-19 pandemic.

Los Angeles County alone has reported 1,235,828 confirmed cases of the disease. That’s more cases than any other county in the United States. Miami-Dade County has the fourth-highest cumulative caseload in the country, with 491,028 confirmed cases.

More than 62,330 people in California and 35,783 people in Florida have died from COVID-19. Other people who have contracted the virus have survived and now have some naturally acquired immunity, which may help account for the decline in new cases.

“California had a very difficult third surge in the winter, which led to a lot of exposure among Californians to the virus,” Dr. Monica Gandhi, MPH, an infectious diseases doctor and professor of medicine at the University of California, San Francisco (UCSF), told Healthline.

The California Department of Public Health reported in March that over 38 percent of Californians had detectable antibodies against the virus that causes COVID-19. That means they’ve been exposed to the virus and have some natural immunity against reinfection. Experts don’t yet know how long that immunity will last or how much protection it provides.

Florida also experienced a peak in cases this past winter, which was lower than the peak in California. After an initial decline from January into March, Florida saw a spring break surge when cases increased before dropping again.

Efforts to vaccinate people in California, Florida, and other states have been crucial to curbing the spread of the coronavirus.

Roughly 65 percent of California adults have received at least one dose of COVID-19 vaccine. Among adults ages 65 and older, nearly 89 percent have received at least one dose and nearly 69 percent are fully vaccinated.

In Florida, nearly 55 percent of adult residents have received at least one dose of vaccine. In people ages 65 and older, almost 86 percent have had at least one dose and 71 percent are fully vaccinated.

Both states prioritized in their vaccine rollouts healthcare workers, long-term care residents and staff, some essential workers, and people with high-risk health conditions.

Both states also prioritized older adults. Older people are more likely to develop a severe and potentially life-threatening case of COVID-19.

The spring break surge was concentrated in young adults before widespread access to the vaccine was available.

Differences in viral variants are also shaping COVID-19 transmission in California, Florida, and other states.

Several new strains of the coronavirus have emerged since the pandemic began. Some of those variants are more easily transmitted than others.

The B.1.1.7 variant is particularly transmissible. Commonly known as the “UK variant,” it is now the most common variant in the United States.

The UK variant accounts for roughly two-thirds of COVID-19 diagnoses in the region where Florida is located. In comparison, the UK variant accounts for less than half of new cases in California and surrounding states.

“The so-called West Coast variants, B.1.427 and B.1.429, are competing with the UK variant in California,” said Dr. George Rutherford III, a professor of epidemiology at UCSF.

“The U.K. variant has sort of nudged in front of them in terms of percentage of isolates, but the fact that we were able to hold off the U.K. variant for much longer than other states gave us a chance to get more people vaccinated and stay in front of it,” he said.

Although the West Coast variants spread more easily than the original strain of the virus, they are less contagious than the U.K. variant.

Along with other factors, differences in COVID-19 restrictions might contribute to disparities in current case rates.

In general, California has taken a more restrictive approach than Florida in mandating face masks, closing businesses, and passing other measures to reduce the spread of the coronavirus.

“In California, the local health departments and the state health department have been very conservative in their approach, slow to reopen, and slow to avoid the kinds of mistakes a few other states have made. So I think that that’s also been a huge help,” said Rutherford.

Florida passed a stay-at-home order early in the pandemic, but DeSantis lifted most state-level restrictions in September and didn’t implement another lock-down when cases spiked this past winter.

Local governments in Florida could still pass COVID-19 ordinances. However, DeSantis signed multiple executive orders to prevent local officials from fining individuals or businesses who broke those laws.

On May 3, DeSantis signed another executive order that suspended all remaining COVID-19 restrictions imposed by counties and local municipalities across the state.

Although case rates are dropping in most parts of the country, some states and communities continue to have lower rates of vaccination and higher rates of infection than others.

“Just because cases are dropping around you doesn’t mean you don’t need to get vaccinated,” said Rutherford.

The more people who are vaccinated in a community, the less chance the virus has to spread — including to young children who aren’t currently eligible to be vaccinated against COVID-19.

“It is important to understand that the risk to a vaccinated individual of contracting or becoming ill from COVID-19 is very minimal, given all we know of the effectiveness of these vaccines,” Gandhi said. “However, the risk to unvaccinated individuals depends on case rates in the community.”

Increased vaccination rates will not only help reduce the number of people who develop COVID-19, it will also allow for the “eventual return to normal life,” Gandhi added.