Editorial Roundup: Florida

Tampa Bay Times. September 2, 2021.

Editorial: Florida should brace for a Texas-style attack on women’s reproductive rights

‘The misogyny rippling through this law is staggering.’

At midnight Sept. 1, the constitutional right to an abortion all but vanished in Texas. A state law banning the procedure after six weeks of pregnancy took effect and quickly cleared an initial hurdle at the U.S. Supreme Court. That turn of events served as a call to action for Florida’s Republican lawmakers, who have already vowed to pass similar legislation — and should be a dire warning for Floridians who care about women’s freedom of choice.

Ignoring legal precedent in place since 1973, Texas lawmakers last spring passed what’s known as a “heartbeat bill” — a prohibition on abortions once a fetal heartbeat is detected. That’s usually around six weeks — before many women know they’re pregnant. The law, which contains no exception for rape or incest, amounts to a near-complete ban since more than 85% of Texas abortions happen after the sixth week of pregnancy. The measure went into effect on Wednesday amid urgent legal challenges, and the U.S. Supreme Court, led by a new conservative majority, refused to block it while appeals play out. The Texas law now stands as the most restrictive in the nation.

With the landmark Supreme Court decision in Roe v. Wade in place guaranteeing a woman’s constitutional right to an abortion, conservative politicians in recent years have cleverly and effectively attacked the issue from the standpoint of access. Thus abortions, while “legal,” have become increasingly difficult to obtain — which is exactly the point. Florida lawmakers have happily joined the fray, requiring women to wait 24 hours to get an abortion and visit the doctor twice, a medically unnecessary hardship on poor and rural Floridians. That law is not in effect while it moves through the courts, but another measure imposes frivolous regulatory requirements on clinics and doctors. Those statutes and similar ones in other states forced many clinics to shut down — also the point.

But the Texas law stands alone, making harassment and surveillance of women seeking abortions standard operating procedure. Instead of charging state officials with enforcement responsibility, it empowers ordinary citizens to file a civil suit against anyone who performs an abortion and anyone who “aids and abets” it.

Here’s what that means in practice: To file suit you don’t have to live in Texas, know the woman seeking the procedure or show any injury from it. (Anti-abortion groups have already set up hotlines soliciting tips about women pursuing now-illegal procedures.) As for the aiding and abetting piece, that can apply not only to doctors but also to clinic staff, a person who loans a woman money for an abortion and even the person who drives her to the appointment. Plaintiffs who sue are entitled to $10,000 and legal fees if they win. Defendants, if they win, are not entitled to legal fees.

Ironically, the patients themselves can’t be sued. Because why would a woman be a party to a case governing her body? The misogyny rippling through this law is staggering.

The five conservative Supreme Court justices who refused to block the law acknowledged they were not ruling on its constitutionality. To that point, dissenting Justice Sonya Sotomayor called the Texas measure “flagrantly unconstitutional” and wrote, “it cannot be the case that a state can evade federal judicial scrutiny by outsourcing the enforcement of unconstitutional laws to its citizenry.” But don’t imagine other states won’t try. With the Supreme Court’s announcement just hours old, lawmakers in Florida vowed to take up similar legislation here. Many of the Republicans in the state Legislature can’t resist an opportunity to trample on women’s rights to make decisions about their own bodies.

The abortion ban in Texas endangers women’s lives by impeding their ability to obtain an often critically needed procedure and by exposing them, their families and their health care providers to harassment and legal jeopardy. If those threats seem far away or abstract, think again.

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Orlando Sentinel. September 3, 2021.

Editorial: Start treating opioid overdoses and deaths as a crisis, not as an afterthought

If so many Floridians weren’t dying from COVID-19, the state’s body count from drug overdoses would be a five-alarm public health crisis.

The Centers for Disease Control estimates that 7,656 people died from overdoses in Florida last year, an increase of nearly 36% from 2019.

That’s twice the number of people who died in car crashes in 2020, and seven times the number of people who were murdered with handguns.

Put another way, 21 people died every day last year from drug overdoses, many of them from heroin, prescription opioids and fentanyl, a powerful, dangerous and surging synthetic drug that’s administered through both legal and illegal means.

Imagine the left’s reaction if 21 people were being shot to death every day. Imagine the right’s reaction if 21 people were being shot to death every day by undocumented immigrants.

Instead, many on both left and right have largely gone about their political business as usual, preferring to argue over issues that divide them while paying little mind to an overdose epidemic that, in a saner world, should unite everyone in the fight.

We can’t take our eyes off COVID, which is killing people at a breathtaking rate in Florida. But we also can’t afford to let opioid addiction and death become a back-burner issue.

Everyone — from politicians to nonprofits to business to the media — needs to pay more attention to the problem and to solutions.

Because the opioid crisis is getting worse, in part because of the other public health crisis facing Florida — COVID.

The past 18 months have been a whirlwind of lockdowns, economic trouble, sickness and death. And just when we thought things were getting back to normal, the even more contagious delta variant started making more people sick. Younger people are dying, and more kids are being hospitalized.

The resulting stress and anxiety have created a mental health crisis like we’ve not seen before, Dr. Phillip Toal, the senior vice president of Aspire Health Partners, said at a recent panel discussion sponsored by Project Opioid and the Orlando Sentinel. He described people seeking treatment for addictions collapsing in the nonprofit mental health provider’s parking lots, having to be revived with an emergency overdose medication called Narcan.

Toal said people were unprepared to cope with the COVID pandemic, having never lived through anything like it before, and how isolation cut people who are addicted off from the coping resources they had, like friends and family.

The consequences have been grim.

Project Opioid found people already using opioids used them more often during the pandemic, and that people found it harder to get help for their addictions. The group’s study found the crisis was particularly hard on communities of color, with overdoses among Black people increasing by more than 100% in the early months of the pandemic. The increase was 67% among Hispanics.

And in some communities of color, there’s still a powerful stigma attached to getting treatment, said another panelist, Bishop Derrick McRae, president of the African American Council of Christian Clergy.

Opioid abuse is not going to be easy to solve. It took Florida way too long to crack down on pill mills that were handing out opioids to Appalachian buyers, who then sold the drugs back home. Today, far fewer overdoses are the result of prescription painkillers. And yet, the numbers continue rising, in large part due to fentanyl.

Florida could make another dent through a settlement with pharmaceutical distributors that will bring in some $1.6 billion in the coming years. The money is an ideal opportunity for Florida to ramp up programs to prevent and treat addiction.

One of the most promising solutions is medication-assisted treatment, which allows people with opioid addictions to take other types of drugs that allow them to function in society. Yes, people remain dependent, but not on a drug that could kill them and prevent them from leading their lives.

Lawmakers also need to seed local organizations that can recruit trusted ambassadors from faith, business and nonprofit institutions to convince substance abusers to seek help.

While the settlement money holds promise, we can’t help but be leery. Lawmakers have shown in the past they can’t be trusted with big chunks of settlement money.

Florida voters had to approve a constitutional amendment in 2006 forcing the Legislature to spend more tobacco settlement money on successful anti-smoking ads after lawmakers cut the marketing budget to the bone. (Then Rep. Jeanette Nuñez, now Florida’s lieutenant governor, led a failed move in 2018 to overturn that amendment.)

And earlier this year, lawmakers eliminated the Lawton Chiles Endowment Fund, which was seeded by tobacco money and paid for health-care programs. Lawmakers moved nearly $1 billion from the endowment to a reserve fund.

Fortunately, some of the opioid settlement comes with financial strings attached, which may reduce the amount of financial mischief by the Legislature.

With so many lives at stake — 21, every day — Florida needs to use that money to save lives.

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South Florida Sun Sentinel. September 3, 2021.

Editorial: Farewell, Dr. Rivkees. Florida needs a true public health expert ' Editorial

Dr. Scott Rivkees resigned.

Scott who? you ask. That’s the whole point. He was in charge of health, but his true skill was stealth.

As Florida’s chief public health officer, Rivkees held the dual titles of surgeon general and secretary of the Department of Health at a salary of $140,000 a year. But Floridians rarely saw him or heard from him. He spent two years on paid leave from his tenured position as professor of pediatrics at the University of Florida College of Medicine.

His last day is Sept. 20. Then his office will be empty. Will anyone notice? No.

Rivkees’ calling card was silence — a frustrating, maddening, irresponsible silence. The night janitor at the state Capitol had a higher profile.

From the outset, Rivkees, 65, was a controversial choice because he’s a pediatrician, not an epidemiologist or infectious disease expert. But Gov. Ron DeSantis selected him anyway — the last of his major state agency hires — then isolated him as the COVID-19 virus engulfed the state. When Floridians desperately needed reliable, science-based information to stay alive and healthy, Rivkees was largely invisible.

A mega-state battling a massive public health crisis has had no public advocate for the better part of two years.

A frightening wilderness

Rivkees should have been Florida’s version of Dr. Anthony Fauci. Instead, we were led into a frightening wilderness by an ambitious politician who rejects science, plays political games with human life and punishes officials who insist on masks as the death toll mounts and spreads to younger people.

As Rivkees heads for the exit, the doctor is now defendant Scott Rivkees. He’s accused of violating Florida’s public records laws by refusing to release daily COVID-related case numbers, deaths, hospitalizations and positivity rates.

State Rep. Carlos Guillermo Smith, D-Orlando, and the Florida Center for Government Accountability have performed a vital public service. They filed suit in circuit court in Tallahassee, asking that the information be released and that the Department of Health restore its daily dashboard reporting. DeSantis pulled the plug on daily reports, saying the information is eventually released by the Centers for Disease Control.

A critical component of any public health campaign is communicating in a clear, concise, consistent manner. People trust doctors. Floridians can handle the truth, and they need it now more than ever. Rivkees should have been out front, every day, nudging the governor in a more medically sound direction.

Rivkees’ departure means DeSantis has to find a replacement for one of the most important positions in state government. The next health secretary must be a public health expert with authority to speak directly to 22 million Floridians and millions more who visit the state every year. It’s a demanding and important job. But DeSantis has politicized public health to the point where it’s hard to imagine why a serious expert would want it.

A senator’s challenge

A few weeks ago, Democratic Sen. Gary Farmer of Lighthouse Point challenged Rivkees to counter the misinformation DeSantis was spreading to justify his statewide ban on mask mandates in a July 30 executive order.

Farmer said Rivkees had a moral and ethical obligation to set the record straight, especially because mask mandates are recommended by the American Association of Pediatrics, a group that includes Rivkees as a member. The doctor’s response was typical: Silence.

Rivkees’ brief but memorable moment in the spotlight was revealing in a way neither he nor DeSantis intended. At a public meeting in April 2020, Rivkees said people would have to wear masks and maintain social distancing until a vaccine was available, which could take a year or more.

The sudden burst of candor was a surprise. He was right, of course, but the message put him at odds with DeSantis. A spokeswoman for the governor immediately whispered in Rivkees’ ear and ushered him away from microphones and out of the Cabinet room in the Capitol.

Nearly a year-and-a-half later, Floridians are still wearing masks, DeSantis is still railing against mask mandates, and nobody knows who’s in charge of public health in the third-largest state. Crucial data is kept secret and masks are weaponized for political advantage.

This is no place for someone to hide in plain sight. Next time, DeSantis needs to get this job right.

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Palm Beach Post. September 5, 2021.

Editorial: COVID vaccine mandates essential for all healthcare and nursing home employees

Give Gov. Ron DeSantis credit. He started fighting COVID-19 by prioritizing vaccinations at nursing homes and for seniors over 65. Too bad, that that one good decision and subsequent efforts to encourage vaccines are being undermined by people who should know better -- nursing home operators, their staffs and other healthcare workers.

You read that right. Many men and women working the frontlines in positions most responsible for caring for Florida’s elderly, sick and vulnerable are shunning a proven procedure that would protect their patients. For months, nursing home and healthcare operators have waited on recalcitrant workers to become aware, get educated, see the light and take the shot. Many of them still haven’t. Nonsensical doesn’t quite explain the reluctance that amounts to healthcare professionals blowing off a key part of healthcare.

Millions of people in the United States have received COVID-19 shots under some of the world’s most intense medical safety monitoring. The U.S. Food and Drug Administration just gave full approval for the Pfizer vaccine, a new safety standard that will open the door for more employers to require employees to get vaccinated. The Biden administration also weighed in, using the leverage of the federal government to force nursing homes to make sure their staffs are vaccinated.

With the spike in delta variant cases, hospitalizations and deaths, you’d think the push to require COVID vaccinations for employees who have direct contact with the public, especially in healthcare and geriatrics, would be seen as prudent. Well, think again.

Florida’s nursing homes are balking at federal plan to make COVID vaccines a requirement for work. They believe the new mandate will make it more difficult to retain workers, and their trade group, the Florida Health Care Association, has a survey to back their stance. About 9 of 10 nursing homes in Florida face serious workforce shortages, according to the association’s July survey. “As our members maintain their commitment to protecting our state’s most vulnerable residents, it’s important they have the support they need to attract and retain long-term staff,” Emmett Reed, the association’s CEO, said in a statement on the vaccine requirement. “A strong and stable long-term care workforce is a crucial part of meeting the needs of those we care for today, as well as an aging population that is continually growing.”

There’s been some movement among South Florida hospitals that have relied on urging their employees to learn more about the vaccine than requiring them to take it. Baptist Health of South Florida has announced that its medical staff, volunteers and other employees must get the vaccine by Oct. 31. The decision means Boca Raton Hospital, Bethesda Hospital East and Bethesda Hospital West will soon join the West Palm Beach Veterans Affairs Medical Center as the only hospitals in Palm Beach County to require their workers be vaccinated.

Staffing shortages are indeed a problem for nursing homes, and to the industry’s credit, steps have been taken to provide better pay and benefits to retain good employees. Unfortunately, fixing structural workplace problems will take time and changes in the way society ultimately cares for the infirm and elderly, a luxury we currently don’t have due to the immediate devastation of the virus.

COVID-19 is still a problem in Florida for the elderly. People between ages 65 and 74 are six times as likely to be hospitalized from coronavirus when compared to the 18-to-29 age group, and are 95 times more like to die from the virus, according to data from the federal Centers for Disease Control and Prevention. The older you are, the worse the statistics. The CDC estimates that for persons 85 and older, compared to the younger group, are 15 times as likely to be hospitalized and 600 times as likely to die. Even in a state that averages more than 21,000 new infections each day, those health stats involving the elderly are downright frightening.

Vaccinated healthcare workers send a clear sign that their facility is doing all that it can to protect its operations, staff and, more importantly, vulnerable patients. It strengthens the overriding message that the industry is practicing what it preaches when it comes to providing healthcare and curbing the spread of the virus.

The mandate to require nursing home staffs and volunteers to be vaccinated is an important step that should be expanded to include all healthcare facilities.

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Miami Herald. September 2, 2021.

Editorial: Change in COVID death count makes Florida look better. Lack of transparency makes it look worse

On Aug. 10, as COVID ravaged the state, Florida changed the way it compiles data on COVID deaths. It did so without telling the public — even though the change abruptly made it look as though the pandemic was, as one expert put it, in “artificial decline.”

A Miami Herald analysis published this week exposed the behind-the-scenes shift. Here’s what changed: Instead of counting each COVID death on the date it was recorded, as many states do for their daily COVID stats, the Florida Department of Health switched to a different methodology, counting each death on the date it actually occurred.

There is often a significant lag — days or weeks — between the day a person succumbs to COVID and the day the death is officially recorded as a COVID death. Charting the deaths under the new methodology can make it look as though deaths are declining even when that’s not true.

TRANSPARENCY MATTERS

It shouldn’t be left to the public or scientists to guess what the real numbers are when more than a year’s worth of data as important as this changed overnight, as Shivani Patel, a social epidemiologist and assistant professor at Emory University told the Herald. Yet that’s exactly what happened. The state may have had valid reasons for making the switch. But the public has a right — in this case, a critical right — to be informed every step of the way.

And there are big ramifications here — both in the actual numbers we use to gauge how bad the pandemic is and, more broadly, in the continuing erosion of trust in government.

In numbers, here’s an example of what the change means, according to the Herald story. Under the old system of record-keeping, Florida death data on Monday would have shown an average of 262 daily deaths reported to the U.S. Centers for Disease Control and Prevention over the previous week. Under the new methodology, the state shows 46 “new deaths” per day in the previous seven days.

Where did all the other deaths go? They were added to totals in previous weeks because they actually occurred back then. That has the effect of pushing the bigger numbers into the rear-view mirror, over and over.

POLL NUMBERS DIP

But it isn’t even the re-calibrating of the numbers that’s the biggest problem here. It’s the lack of transparency. This is a state that is already infamous as a COVID hotspot, and the Florida health department has done this kind of thing before — for example, including, and then excluding, non-resident deaths in its total counts. That has made it hard for regular citizens to get a clear picture of how bad things are.

The lack of a full-on acknowledgment of this latest change smacks, once again, of a state government with a reflexive inability to own up to anything that might be construed as negative for the DeSantis administration.

Gov. Ron DeSantis already is seeing dropping poll numbers. A Quinnipiac University poll said that a majority of Floridians think COVID-19 in out of control and think the governor is wrong to oppose masks in schools. Those surveyed also indicated, 46% to 41%, that the governor is hurting efforts to slow COVID’s spread in the state. You’d think he might catch on that obfuscation in a time of COVID could turn out to be a deadly miscalculation for him politically.

We’d like to suggest to Florida state government something radical: Trust the people, and tell them what’s going on.

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