Florida Is Living With Covid—and Freedom

The state’s surgeon general, Joseph Ladapo, on his advice against tests for the asymptomatic, his opposition to vaccination mandates, and life in Los Angeles under lockdown. 

By James Taranto of The WSJ. Excerpts:

"The Omicron surge has triggered a mutation in the conventional wisdom about Covid-19. The virus “is here to stay,” oncologist Ezekiel Emanuel and two other experts who advised the Biden transition proclaimed in a Jan. 6 article for the Journal of the American Medical Association, “A National Strategy for the ‘New Normal’ of Life With Covid.” That means no more “perpetual state of emergency”: “The goal for the ‘new normal’ . . . does not include eradication or elimination.”

Joseph Ladapo reached the same conclusion almost two years earlier. “Please don’t believe politicians who say we can control this with a few weeks of shutdown,” Dr. Ladapo, then a professor at UCLA’s medical school and a clinician on Covid’s frontline, wrote in USA Today on March 24, 2020. “To contain a virus with shutdowns, you must either go big, which is what China did, or you don’t go at all. . . . Here is my prescription for local and state leaders: Keep shutdowns short, keep the economy going, keep schools in session, keep jobs intact, and focus single-mindedly on building the capacity we need to survive this into our health care system.”"

"As policy makers’ views began to converge with Dr. Ladapo’s, he became a policy maker. His writings caught the attention of Florida Gov. Ron DeSantis, who in September 2021 appointed him surgeon general, the state’s top health official."

"The governor declared a state of emergency in early March 2020, followed in April by the first in a series of executive orders reopening the state. Restaurants, bars, gyms and movie theaters were back in business by June 2020, and public schools were in session that fall. In May 2021 Mr. DeSantis suspended all local Covid-19 restrictions, including mask mandates, and signed legislation ending them permanently. Last summer’s Delta wave hit Florida hard, but the Sunshine State imposed no new restrictions."

"One way to bring the case count down is by testing fewer people. “Historically in public health, for respiratory viruses in the general population, we consider ‘cases’ to be people who have symptoms, not a PCR test,” Dr. Ladapo says. “But during the pandemic, you can have a positive PCR and be completely healthy but be considered a case and be required to behave like a case, which is to isolate and those types of things.”

On Jan. 6 Dr. Ladapo issued guidance that only people who have Covid symptoms and a risk factor (old age, certain diseases, or current or recent pregnancy) “should” get tested. Those with symptoms but no risk factors are advised to “consider” a test. For the asymptomatic, the guidance discourages testing, saying it “is unlikely to have any clinical benefits.”

"“A test is most valuable when it’s most likely to lead to a change in a decision, a change in management,” he says. “I mean, that’s so basic.” To keep hospitalizations down, he adds, the state has made clear “that we expect clinicians to treat patients with risk factors”"

"He describes the asymptomatic as “a very special group, because this group—you can’t feel any better than not having symptoms. So this group can only be harmed from treatment”—not to mention the “personal downside to them” of being expected to isolate."

 "He says he’s spoken favorably of vaccination throughout his career, and he acknowledges that Covid shots provide “reasonable protection . . . against hospitalization and serious illness” and that “infection case rates are higher in people who have not received the vaccines.”"

"This week an official of the European Medicines Agency confirmed Dr. Ladapo’s intuition by warning that repeated boosters could eventually weaken the immune system.

The justification for mandatory vaccination is that the unvaccinated put others at risk of infection. Dr. Ladapo maintains that rationale doesn’t apply to Covid, especially given Omicron’s infectiousness. So many people have been vaccinated that “if the vaccines stopped spread, this pandemic would be over,” he says. “The argument for the negative externalities does not hold water.”"

"“The closing of the schools when the data was indicating that kids were at extremely low risk—that just completely looked like a bad decision"

"Miami-Dade County has had a higher per capita Covid case count than New York City for several weeks, but its hospitalization rate is somewhat lower. That sounds like a wash until you flip the question: Is the possible reduction in risk worth the price in freedom?

After the interview, an aide to Dr. Ladapo sends me a graph ranking all 50 states and the District of Columbia by age-adjusted Covid mortality rates throughout the pandemic. Florida comes in at No. 30. California does slightly better at 33rd, while New York ranks seventh.

Florida’s permissive policies didn’t stop Covid, but neither did other states’ restrictive ones. It’s an open question whether lockdowns, masking, forced vaccination and the rest have conferred any benefit at all. As the federal government and states like California and New York search for a “new normal,” they should consider following Florida’s example of simply being normal."