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Passengers wearing masks at Miami International Airport in Florida. Joe Raedle/Getty Images
  • Florida currently has one of the lowest COVID-19 case and death rates in the country, but experts say the numbers can be misleading.
  • They note that the way Florida counts COVID-19 cases, as well as warmer weather and lower density housing are factors.
  • They say it’s important to focus on what each state’s goals are in combatting the COVID-19 pandemic.

Florida currently has one of the lowest per capita rates of COVID-19 cases of any state, despite having a lax — and at times outright hostile — approach to implementing public health measures to curb the pandemic.

The state’s case rate sits at about 50 per 100,000 people. Hawaii is close behind with about 51 cases per 100,000 people.

Comparing those two states sheds some light on just how complicated this pandemic can be.

Florida has eschewed issuing mask mandates and lockdowns, even as the state saw the highest surge in cases and deaths in the country in August.

Hawaii, meanwhile, has imposed tough restrictions and had ongoing mask mandates, even as the state’s vaccination rate climbed above 60 percent.

Vaccines don’t tell the whole story either.

About 80 percent of the population of Hawaii has received at least one dose of the COVID-19 vaccine, placing it among the top 5 states with the most vaccination coverage. Florida is in the middle of the pack, with a 70 percent vaccination rate, according to the COVID-19 tracking website Covid Act Now.

So what gives?

First, we shouldn’t rush to draw conclusions, as states may report their COVID-19 rates differently.

“What does that really mean when they say that Florida has the lowest rate in the country?” Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, told Healthline.

“Because Florida only reports those positive cases among people who are full-time residents of Florida. So, if your full-time residence is in Ohio, and you have a condo in Miami Beach and you go down there and you get COVID, you’re not a case in Florida. You’re not even a case in Ohio. You’re nothing, and that’s why I don’t put a lot of impact on that Florida case rate.”

But even if we do take the case rate at face value, we probably shouldn’t weigh it very strongly, says Dr. Purvi Parikh, an adult and pediatric allergist and immunologist with Allergy & Asthma Network.

“I do not think their overall caseload affects the current infection rate. That depends on the spread of disease, vaccinations, and other factors,” Parikh told Healthline. “There was a time a few months back where they had a very high infection rate, with ICUs and hospitals at capacity, while other areas of the country had low infection rates.”

One factor that might account for the current low case rate is that COVID-19 has already touched many Floridians.

The state has seen more than 60,000 deaths from the coronavirus, the third-highest in the nation behind Texas and California.

It also had the third-highest total number of COVID-19 cases — 3.6 million — again behind Texas and California.

Florida also is among the top 10 states in per capita death rates from COVID-19, at 281 deaths per 100,000 people. Its rate is higher than Texas and California.

On the other hand, more restrictive Hawaii has the second-lowest death rate in the country, at just 67 per 100,000 people, higher than only Vermont.

“Florida’s warmer weather may help in that people are outdoors more to avoid spread,” Parikh suggested. “Also, Florida is less densely populated in certain areas, which also helps.”

But much like comparing California and Florida, which took different approaches to pandemic mitigation but at one point had similar per capita case rates, there are probably too many variables to be able to clearly identify why different approaches between these states had similar results.

“If you’re only manipulating one variable, [per capita case rate] might tell you something, but where there are so many variables of whether you’re masking or vaccinating or not, schools open or not, businesses requiring documentation of vaccines, or not — I think it’s really hard to tell which of those variables is impactful,” Cutler said.

“And when you just identify them by state, it just becomes purely political. It’s about where those people lived. And I’m not sure that that has much bearing whatsoever.”

One conclusion that can be drawn is that while there may be many different public health approaches to managing a pandemic, one-size-fits-all might not be the ticket.

“Restrictions should not be applied uniformly, as every region is different based on population density, vaccination rates, etc.,” Parikh said.

Cutler agreed.

“In terms of measuring success, you have to really ask: What are we trying to achieve here?” he said. “Is it fewer numbers of cases, fewer number of hospitalizations, fewer deaths? Less impact on the economy? What is the metric that’s important? And that probably varies from country to country, state to state, even county to county.”

But that doesn’t mean “do nothing.”

“At the same time, hygiene procedures that we know work should be encouraged, such as masks, handwashing, distancing,” Parikh said. “It does not make sense for politicians to come out against or have executive orders that may discourage enforcement of these simple measures that go a long way.”