In many ways, living through the coronavirus pandemic in Miami has felt like the days leading up to a hurricane.
Our eyes glued to the news, we collectively wonder where exactly this thing is going and who'll get hit the hardest. We stock up on essentials for the inevitable lockdown and the arrival of lashing winds and torrents of rain.
But there's no satellite imagery to show the arrival and departure of a virus. At times, it feels like there's no end in sight. And the trepidation — and the storm — has lasted far longer than a few days.
Today, many Miami-Dade businesses will open to the public again, albeit with capacity limitations, strict sanitation requirements, and social-distancing orders still in place. To many, it might feel like the morning after a hurricane passes, when we walk outside to check on neighbors, assess the damage, and fix whatever's broken.
During a virtual town hall on Friday, Miami-Dade County Mayor Carlos Giménez said the county is "truly" ready to move forward and begin its phased reopening.
"It's definitely going to be a different way of conducting business, but it's time to get going and open up our economy," the mayor said.
But is it safe to venture back out into the world right now? To sit at a restaurant with friends, get a haircut, go shopping for clothes, or schedule a nail appointment? The answers from experts are a mixed bag, and risk management seems to be the name of the game for now.
"We're looking at safety versus risk reduction," says Kathleen Sposato, the senior director of infection prevention for Jackson Health System. "It's not going to be 100 percent safe. Until we have a safe and effective vaccine, we won't be out of the woods, and we'll have to be cognizant of the virus. I'm pretty sure it will be back, and we need to be ready for that. People need to be concerned not only for their own health and safety but also for everyone around them."
In Miami-Dade, restaurants are permitted to reopen today at up to 50 percent capacity. Retail stores, barbershops, beauty salons, offices, small businesses, and cultural spaces including nonprofit museums and public gardens may also reopen with their own restrictions and limitations.
The cities of Miami, Hialeah, Miami Gardens, and Miami Beach will allow some nonessential businesses — retail stores, barbershops, beauty salons, and museums — to open Wednesday. Restaurants in those cities won't be permitted to open until May 27. Coral Gables announced it would allow retail, offices, nonprofit museums, gardens, galleries, and personal=grooming businesses to reopen today and restaurants on Wednesday.
Other municipalities have yet to outline their reopening plans. Cities in Miami-Dade can decide to either follow the county's lead or take more stringent approaches.
Under Florida Gov. Ron DeSantis' reopening plan, phase one allows gyms across the state to reopen today. Gyms were a hot topic during Friday's virtual town hall, but Giménez said Miami-Dade residents won't be pumping iron just yet.
"The problem with gyms is multiple touchpoints and multiple people, and it's very difficult to control that," the mayor explained. "This is a highly contagious virus. Gyms are problematic."
That patchwork approach has left many Floridians wondering what they can and can't do, despite the U.S. Centers for Disease Control and Prevention's recommendations for a coordinated national response.
Dr. Terry Adirim, senior associate dean for clinical affairs at Florida Atlantic University's College of Medicine, says it's important for federal, state, and local leaders to communicate carefully and often, keeping residents informed about what the plans are, what changes are being made, how local regulations differ from the state, and what will happen if cases start to spike. She says reopening decisions should carefully consider the strain healthcare workers and hospitals could face if there is a resurgence of cases.
Federal guidelines leave reopening decisions up to state and local officials but require communities to satisfy three conditions: decreases in flu-like illnesses or "COVID-like syndromic cases" reported within 14 days; decreases in documented cases or positive tests within a 14-day period; and a "robust" testing program for at-risk healthcare workers, including antibody testing.
Giménez pointed to a steadying or reduction in hospitalizations, a decline in the use of ventilators, and adequate bed capacity at hospital intensive-care units as reasons to greenlight the county's reopening. The Miami Herald reports that the county is experiencing a decrease in positive test rates, but some data from the Florida Department of Health and local hospitals indicate some statistics have leveled off but aren't in decline.
Adirim says Florida has experienced a mild caseload compared to other states and that initial nightmare-like projections were significantly curbed because many Floridians began staying home before local governments and Gov. Ron DeSantis made it mandatory.
Adirim, who previously served as a senior public-health official in the U.S. Department of Defense and worked on the federal response to the 2009 H1N1 pandemic, says she doesn't believe South Florida has the testing and contact-tracing capabilities required for it to safely reopen.
"I think in South Florida, with our desire to reopen, which is understandable, and the political pressure that local leaders have been feeling, there's this push to open and ignore the federal criteria a little bit," Adirim says. "I haven't seen evidence of clear plans for how we're going to contain any new outbreaks in cases, which might happen once you open up."
During Friday's town hall, Giménez said he couldn't answer the question of what will happen if the county experiences a spike in cases until it happens.
"We'll try to pinpoint the reason why and then take whatever action we need to knock the virus out again," he said. "We'll discuss with medical advisers what steps we need to take. I can't say until it actually happens, and then we'll do the right thing."
Sposato, Jackson's infection-prevention director, says while the county is ready for a phased reopening, she's concerned it will signal to people that they can return to their previous behaviors. The consensus among public-health experts is that every person plays a role in helping contain the spread of COVID-19, and personal responsibility should be on everyone's mind.
"When there's a national emergency like this, you have a responsibility as a citizen of this country to contribute to the safety and welfare of this country," Adirim says. "When your behavior impacts other people's welfare and safety, you have the responsibility to do the right thing."
If you're sick, stay at home, say the experts. Wash your hands regularly. Wear a mask in places where physical distance is difficult to maintain, and wear it correctly, so that it covers your nose and mouth. Practice common sense.
"The height of selfishness is to not engage in protective behaviors," Sposato says. "Wearing a mask isn't a sign of weakness or fear. It sends a message that the person is concerned about the other people in their world. And it needs to continue."
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Vulnerable populations — immunocompromised people, the elderly, and those with underlying conditions — should be more careful about how they approach the reopening.
"Those individuals really need to behave as if they're on lockdown," Sposato admonishes.
And everyone should remember that asymptomatic people can transmit the virus to others.
"Everybody has vulnerable people in their families, so even if you don't care about yourself, you can transmit it to your loved ones," Adirim emphasizes. "There are ways you can protect yourself and still go out. Wear a mask, stay physically apart from other people, and just understand this is a long-term change in how we need to behave in order to enjoy those things we want to enjoy as we reopen."