Palm Beach County reopened without meeting federal guidelines, investigation shows

Palm Beach County hadn’t met all the federal guidelines for reopening when it ended its coronavirus lockdown, a South Florida Sun Sentinel analysis has found.

In the two weeks preceding the decision, coronavirus infections and the percentage of people testing positive in the county had not declined, and now some numbers are trending upward.

Most other large Florida counties, including Broward and Miami-Dade, have shown the general declining trends in new cases and infection rates that federal guidelines recommend. Palm Beach County has not — yet it was the first in South Florida to push to reopen.

The county commission voted 5-1 on May 5 to ask Gov. Ron DeSantis to lift restrictions designed to stop the spread of the new coronavirus anyway, and he approved. On Monday, restaurants, salons, and malls flung open their doors, albeit at 25% percent capacity.

Palm Beach County Commissioner Hal R. Valeche said commissioners were aware that the county did not meet the federal criteria. He said he prefers to look at hospital capacity rather than new infections as a measure of the outbreak’s severity, since sometimes test results can take days to process.

“I was an advocate for getting us to Phase One reopen,” said Valeche, an investment banker. “The whole idea of flattening the curve was to open up hospital space.”

Gov. Ron DeSantis has repeatedly cited the hospitalization metric in his argument for reopening the state, but data on hospitalizations over time is not publicly available and is not a federal guideline for reopening. The governor’s office didn’t respond to repeated requests for comment on why it gave Palm Beach County the green light to open.

When the Sun Sentinel asked Alina Alonso, director of the Florida Department of Health in Palm Beach County, if she was aware of the fact that Palm Beach County had opened without meeting the federal guidelines, she replied: “I have no idea about that. I mean, I don’t have any comment about that because that’s up to the board.”

Palm Beach County Mayor Dave Kerner declined to answer questions from the Sun Sentinel, and instead issued a written statement saying he “put more weight on declining positivity rates vs. new cases.”

However, state Department of Health data shows that the county’s positivity rate – the percentage of people tested who are positive for coronavirus – was at best steady and is now increasing.

In his statement, Kerner also highlighted the spare ICU, ventilator and hospital capacity in the county.

“There is no exact road map in striking the careful balance between medical and economic health,” Kerner wrote. “We as a Board recognize and appreciate that the suppression of the spread of COVID-19 in our community is a result of the diligent efforts of our community at large. While we believe our community is ready to embrace a slow entry into the normal, our focus and commitment to protecting our most vulnerable remains unbreakable.”

Both the White House guidelines for “Opening America Again” and the Florida governor’s office emphasize the importance of positive test rates and the number of new infections as key figures to watch.

The White House says that it’s safe to reopen when a county or city meets the following guidelines, based on a report titled “Opening Up America Again” compiled by the Centers for Disease Control and Prevention:

A decline over 14 days in the number of people with flu-like symptoms, and a 14-day decline in the number of people with Covid-19 symptoms.

A 14-day downward trend in the number of infections or a 14-day downward trend in the percentage of people who test positive.

The county can treat everyone at area hospitals, and the county can test all health, police and fire-rescue workers for the virus.

When Palm Beach County voted to enter the first phase of re-opening, going into effect on May 11, it had not met either requirement for the second guideline. And in the week after it reopened, the number of people showing up at area medical centers with influenza-like symptoms — guideline one — actually increased.

Infectious disease experts caution that early ends to lockdowns could have serious consequences for a second wave of infections if an outbreak isn’t closely monitored, and there are growing concerns in a number of states and countries that are seeing increasing virus activity after lockdowns were lifted.

Scott McNabb, research professor in global health and epidemiology at Emory University School of Public Health in Atlanta, describes the restrictions like a faucet. “Let’s say they’ve opened the faucet too much, there’s too much of a stream coming out, you can detect that, and they need to be prepared to close it, and the public needs to know why, so they don’t rebel,” he said.

Palm Beach County state health director Alonso has provided county commissioners with comprehensive updates about infection numbers, positive test rates, deaths, hospitalizations, ICU capacity, infections in long-term care facilities, and the geographic distribution of cases by ZIP code. That information was often dated, the Sun Sentinel found.

A closer look at the five graphs Alonso displayed at the May 5 commission meeting shows that only one — the trend line of positive cases — was current to that date. Two others, showing infected residents at long-term care facilities and ICU cases, were updated only to May 1. Another two graphs, showing trends in hospitalizations and deaths, were dated to April 30.

Despite the troubling trends in the data, Palm Beach County is pressing forward with a wider reopening, and on Friday the commission voted 5-2 to reopen beaches. Commissioner Gregg Weiss, the only commissioner to vote against the business reopenings on May 5, continued to raise questions on Friday. He pointed to the new infections and high infection rates, but could not persuade a majority of his colleagues on the commission to keep the beaches closed. Commissioner Mack Bernard joined Weiss in voting no; Mayor Kerner, Vice Mayor Robert S Weinroth, and commissioners Melissa McKinlay and Valeche voted to reopen beaches.

“To me, it looks at best that we are flat,” Weiss said. “I don’t see a downward trend in the number of new cases, I don’t see a downward trend in the hospitalizations.”

As of Friday, Palm Beach County commissioners had yet to set specific benchmarks for closing back down in case of a second wave.

Staff writer Aric Chokey contributed to this report.

Mario Ariza can be reached at mariza@sunsentinel.com or 954-356-4233.