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Current as of July 20, 2020, at 8:00 a.m.
COVID-19 Testing Sites in Florida
  • Drive-Thru Testing sites available are listed by county. Each walk up site can test up to 200 individuals per day. Access the list here.

Safe. Smart. Step-by-Step.

The Florida Department of Economic Opportunity is giving daily updates on Florida’s Reemployment Assistance program: View DEO Dashboard Here .

Florida Department of Health COVID Dashboard: Access dashboard here .

Graphs, Charts, and Real-time Tracking of COVID-19

Data Sources

Data Sources on Social Media

Other Resources


Current Statistics

  • Fatality rate in Florida - 1.4%

  • Covid fatality rate in FL 15-24 years old - .02% (less than 1%) 
  • Covid fatality rate in FL 25-34 years old - .05% (less than 1%) 
  • Covid fatality rate in FL 35-44 years old - .19% (less than 1%) 
  • Covid fatality rate in FL 45-54 years old - .39% (less than 1%) 
  • Covid fatality rate in FL 55-64 years old - 1.1%
  • Covid fatality rate in FL 65-74 years old - 4.0%
  • Covid fatality rate in FL 75 and up - 13.6%
  • Seasonal influenza mortality rate in the US (2017 CDC) 18-49 yo - .02%

  • Median age of new Covid cases - 40 years old
  • Emergency department visits w/ COVID-like illness - 34% decrease
  • ICU beds available in Florida - 20%
  • Hospital beds available in Florida - 25%

Vaccine Tracking

July 17, 2020 8:25 AM PST

197
vaccines are in development.

19
are now in clinical testing.


Researchers in the U.K. recently  reviewed  two dozen studies involving more than 10,000 coronavirus patients admitted to ICUs in North America, Europe, and Asia.

From this data, they determined that COVID-19 mortality rates in ICUs at the end of March were nearly 60%. By the end of May, they had dropped to less than 42% — a decrease of about a third.

"There were no significant effects of geographical location, but reported ICU mortality fell over time," researcher Tim Cook said in a news release.

But if severe cases of COVID-19 are no longer as  likely to be fatal  as they were just a few months ago, why might that be?

COVID-19 Mortality Rates

There are several possible explanations for the declining COVID-19 mortality rates.

One is that doctors are simply getting better at treating the disease.

In March, doctors weren't sure how to treat severe COVID-19 cases. By May, however, they were starting to learn — through both published studies and word-of-mouth — that certain drugs and therapies appeared to be more effective than others.

If a COVID-19 patient's blood oxygen level was alarmingly low, for example, doctors knew that  blood thinners  had successfully raised them in studies.

They also knew that if a patient was having troubling breathing, putting them on an invasive ventilator shouldn't be the  first resort  — sometimes, simply rolling the patient onto their stomach or delivering oxygen through a nasal cannula could help.

A more selective use of  ventilators  alone could be partially responsible for declining COVID-19 mortality rates — the machines can save lives, but they can also damage organs, push the virus deeper into the lungs, and lead to life-threatening secondary infections.

"We're generally learning to recognize who needs to be intubated and who doesn't," Leora Horwitz, an associate professor of population health and medicine at NYU Langone Health,  told the Washington Post . "We're avoiding intubation where we can."

Americans Surviving the Coronavirus

In the U.S., COVID-19 mortality rates aren't only declining amongst ICU patients, they're falling in general — on May 16, the nation's case fatality rate was  6.1% , and now, it's down to 3.9%

That apparent increase in patients' chance of surviving the coronavirus may be related to doctors' improved ability to treat the disease, but there are other possible explanations.

Declining COVID-19 mortality rates could be related to patients' ages.

One theory is that the surge in new COVID-19 cases in the U.S. hasn't had time to translate into a surge in deaths — that might come later. But another key factor is the declining age of COVID-19 patients: a few months ago, the average patient was about  15 years older  than patients today, and younger people are less likely to succumb to the virus.

Another possibility is that testing is simply catching a larger share of cases now. In March, the U.S. averaged just 35,000 tests a day, with over 18% of tests coming back positive, compared to over 680,000 a day so far in July, with just 8.4% positive.

Despite a recent uptick in the positive rate, it appears that we are picking up a larger share of cases this time, making the fatality rate appear lower than in the first wave.

A few  fringe theories  include the possibility that summer heat is making the virus somewhat less potent; that masks and social distancing are decreasing the size of the viral load that is infecting people; and that the virus might be mutating in a way that makes it less deadly.

While it's still too soon to say for sure what might be causing the falling COVID-19 mortality rates among patients in or out of the ICU, the news that something appears to be helping is encouraging.


The Food and Drug Administration has given emergency approval to a new approach to coronavirus testing that combines test samples in batches instead of running them one by one, speeding up the process.

The FDA said Saturday that it reissued an emergency use authorization to Quest Diagnostics to use its COVID-19 test with pooled samples. It is the first test to be authorized to be used in this way.

With pooling, instead of running each person’s test individually, laboratories would combine parts of samples from several people and test them together. A negative result would clear everyone in the batch. A positive result would require each sample to be individually retested. Pooling works best with lab-run tests, which take hours — not the much quicker individual tests used in clinics or doctor’s offices.

The potential benefits of sample pooling include stretching laboratory supplies further, reducing costs and expanding testing to millions more Americans who may unknowingly be spreading the virus. Health officials think infected people who aren’t showing symptoms are largely responsible for the rising number of cases in more than half the country. The approach might enable mass testing at schools or businesses, though it's unclear when that could happen.

“It’s a really good tool. It can be used in any of a number of circumstances, including at the community level or even in schools,” Dr. Anthony Fauci, the nation’s top infectious-disease expert, told a Senate hearing last month.

Pooling is not always be the best option. It won’t save time or resources when used in a COVID-19 hot spot such as a nursing home outbreak. That’s because the logistical and financial benefits of pooling only add up when a small number of pools test positive.

Experts generally recommend the technique when fewer than 10% of people are expected to test positive. For example, pooling would not be cost-effective in Arizona, where a surge has pushed positive test results to well over 10%. But the approach could make sense in areas with a lower rate of positive results.


Sweden’s decision to keep schools open during the pandemic resulted in no higher rate of infection among its schoolchildren than in neighbouring Finland, where schools did temporarily close, their public health agencies said in a joint report.

Sweden decided to forego a hard lockdown and keep most schools and businesses open throughout the COVID-19 outbreak, a divisive strategy that set it apart from most of Europe.

Its Public Health Agency has maintained that the negative consequences of a shutdown on the economy and society outweigh the benefits, and says this also applies to schools.

The report, which has not been peer-reviewed, found that during the period of February 24 to June 14, there were 1,124 confirmed cases of COVID-19 among children in Sweden, around 0.05% of the total number of children aged 1-19.

Finland recorded 584 cases in the same period, also equivalent to around 0.05%.

“In conclusion, (the) closure or not of schools had no measurable direct impact on the number of laboratory confirmed cases in school-aged children in Finland or Sweden,” the agencies said in the report, published last week.

The report showed that severe cases of COVID-19 were very rare among both Swedish and Finnish children aged 1 to 19, with no deaths reported. A comparison of the incidence of COVID-19 in different professions suggested no increased risk for teachers.

Children made up around 8.2 percent of the total number of COVID-19 cases in Finland, compared to 2.1 percent in Sweden.

Sweden’s death toll of 5,572, when compared relative to population size, far outstripped those of its Nordic neighbours, although it remains lower than in some European countries that locked down, such as Britain and Spain.

State epidemiologist Anders Tegnell of the health agency, who has devised Sweden’s response to the epidemic, has said there is little evidence linking the death toll to the absence of a lockdown, pointing instead to conditions at nursing homes, a decentralised health care system and travel patterns.

Separate studies by Sweden’s Karolinska Institutet (KI), an independent medical research institute, and the European Network of Ombudspersons for Children and Unicef, showed that Swedish children fared better than children in other countries during the pandemic, both in terms of education and mental health.

WHO emergencies head Mike Ryan urged countries earlier this week not to turn schools into “another political football”, saying they could safely reopen once the virus had been suppressed.

Big U.S. companies are deciding March and April moves won’t cut it.

The fierce resurgence of  Covid-19 cases  and related business shutdowns are dashing hopes of a quick recovery, prompting businesses from airlines to restaurant chains to again shift their strategies and staffing or ramp up previous plans to do so. They are turning furloughs into permanent layoffs, de-emphasizing their core businesses and downsizing production indefinitely.

Delta Air Lines  Inc.  DAL -0.77%  curtailed plans to add more summer flights and said it  doesn’t expect business flying to recover  to pre-pandemic levels.  Chipotle Mexican Grill  Inc.  CMG 0.59%  is  adding staff and changing operations  to accommodate more to-go business. Vox Media, the publisher of New York magazine and several news websites, said it would lay off 6% of its workforce as the company confronts a prolonged drought for its lucrative events business.

   DAL -0.77%  “We cannot defy gravity and continue with the business model we had before the pandemic,” Pret A Manger Chief Executive Pano Christou said on Friday as the sandwich chain reported an 87% drop in U.S. sales and announced plans to close nearly 20 stores.

Executives who were bracing for a monthslong disruption are now thinking in terms of years. Their job has changed from riding it out to reinventing. Roles once thought core are now an extravagance. Strategies set in the spring are obsolete.

“It’s going to be a different game,” said Bill George, former CEO of medical-device company Medtronic PLC and a senior fellow at Harvard Business School. Mr. George said many companies now need to explore strategies they might have once deemed unthinkable, from hospital chains embracing a long-term shift to telemedicine to apparel makers figuring out how to market and sell their wares in an environment where many stores don’t reopen.

U.S. airlines had been signaling an easing of the broad grounding that analysts say will lead to combined losses of $23 billion this year. Some of them had begun expanding summer flights in anticipation of a pickup in demand. Much of that hope faded last week.

Both Delta and  United Airlines Holdings  Inc.  UAL -1.65%  said they would scale back their ambitions to fly more later this summer. Delta said it would halve the number of extra flights it adds in August to 500 and that capacity in the September quarter would at best be 25% of the level a year ago.

“We’re seeing stalling demand growth at this point,” Delta Chief Executive Ed Bastian said in an interview with The Wall Street Journal. The company opened the airline earnings-reporting season with a loss that Mr. Bastian called a staggering illustration of the pandemic’s impact, and he told analysts he didn’t expect the level of business flying to ever recover to its pre-pandemic level as companies rethink the need for putting employees on the road. Leisure traffic could take two years or more to recover, assuming a vaccine or treatment becomes widely available, he said.

Meanwhile,  American Airlines Group  Inc.  AAL -4.34%  told 25,000 workers that their  jobs are at risk  after federal aid expires Oct. 1 and United said it is exploring  shedding 36,000 employees , or nearly half of its U.S. workforce, as both airlines said they expect it to take years for demand to approach normal levels.

There are some signs of strength in consumer spending. The Commerce Department on Thursday said U.S. retail sales—a measure of purchases at stores, at restaurants and online— increased 7.5% in June , driven by a pickup in sales at motor-vehicle dealers, furniture, clothing and electronic stores. Spending has also been buoyed by enhanced unemployment benefits that are set to expire at the end of the month.

Still, some economists say the data obscure the reality on the ground, where consumers are increasingly fearful of the economic impact of a new surge of Covid-19 cases in much of the U.S.
“The risk of a relapse in demand is rising,” said Gregory Daco, an economist at Oxford Economics. Mr. Daco’s measure of states’ recovery finds the economic rebound has slowed week-over-week in 14 states and declined in 15, with confirmed infections rising in 39 states that together account for 90% of the U.S. economy.

The U.S. posted a single-day record of more than 77,000 new cases on Thursday and its case count on Sunday was more than 3.7 million, a little over a week after reaching 3 million. The accelerating spread has derailed what many businesses had hoped would be a smooth transition to normal levels of activity.

Executives are increasingly resigned to the idea that a vaccine is the only path back to normal.

“The real endpoint is the biology,” Gary Burnison, CEO of executive-search firm  Korn Ferry ,  KFY -1.31%  said on an earnings call this month.

California  halted indoor activities  at bars, restaurants, salons and gyms—many of which were already struggling to recover from earlier shelter-in-place orders—less than a month after allowing them to reopen. School districts in a growing number of cities, from Houston to San Francisco, said remote-only learning would continue this fall, another blow to businesses hoping to get working parents back in the office. Job site Indeed said it won’t require employees to return to its offices before July 2021.

Chipotle opened its first drive-through lane two years ago. On Wednesday, the burrito chain said it expected at least 60% of new locations would have them, adding that it had hired 8,000 people since May in part to staff reformatted stores with windows where customers who drive can pick up orders placed in advance online.

Vox Media, the publisher of New York magazine, the Verge and SB Nation, furloughed about 100 employees in the spring after it suffered sharp revenue declines as the pandemic drove down advertising spending and caused it to stop producing lucrative events.

On Wednesday it said it would lay off about 70 employees, many of them from the events business, in an acknowledgment that it doesn’t expect parts of the business to bounce back. Also last week, the Guardian announced the British newspaper would reduce its staff by 12%, or 180 people, with cuts to the newsroom and business side of its operation.

“It’s becoming increasingly clear that the second half of the year will not rebound anywhere near our pre-Covid forecasts,” Vox Media Chief Executive Jim Bankoff wrote in a memo to staff. “Furthermore, as cases rise tragically across the country and many of our elected leaders avoid decisive action, we have very limited visibility into the timing or strength of a recovery.”


The on-again, off-again opening and closing of restaurants in  Miami  has angered restaurant owners in the area. Last week, 30 of them gathered to protest the latest shutdown order by Miami-Dade County Mayor Carlos Gimenez, a Republican.

Nick Sharp, who owns three restaurants, said of the mayor’s latest closure order: “It’s moronic. It’s idiotic. It doesn’t make any sense.”

The owners say they have complied with previous dictates limiting them to 50% indoor capacity, hand washing, and  masks  on servers, but were still ordered to close. If such measures are supposed to protect people from getting the virus, why does Mayor Gimenez now deem them insufficient? It makes one wonder if the “experts” and politicians can be fully trusted.

Mitchell Sanchez, co-owner of Latin House, told station WSVN, “It was a decision that was made in haste, definitely with no science backing it.” The owners are also angry that Gimenez’s decision was made without consulting other area mayors, some of whom oppose his edict.

After the protest, Gimenez partially reversed himself, saying outside dining, as well as takeout, would be “allowed,” which underscores for many the arbitrariness of it all. Outside dining is also problematic due to Miami’s sometimes heavy summer thunderstorms.

In an email to Gimenez he shared with me, Nick Sharp said: “We demand that our elected officials show specific data on how indoor dining rooms are responsible for the spikes (in COVID-19 cases). Without this data, we insist that restaurant dining rooms re-open, countywide, immediately.”

Some restaurants in South Florida are permanently closed and employees lost their jobs after the last shutdown. Owners still in business believe many of them will not survive the current closure, causing additional job losses, along with severe impacts on supply chain food distributors, the local economy, and state taxes.

In a phone interview, I asked Sharp how long his restaurants could survive this latest closure. “Maybe one month,” he replied. He said 25 other mayors in the region oppose Gimenez’s directive and that Gimenez “never consulted with anyone.”

Sharp was just getting started: “[Mayor Gimenez] gives no solution to reducing the positivity rate, other than ‘public responsibility.’ That’s the only solution he offers. That’s what we have now, and it isn’t working.”

It is unfair to single out a single and prosperous industry for special treatment, especially when there is no scientific consensus or reason for doing so.

Sen. Rand Paul, R-Ky., an eye doctor who contracted COVID-19 in March and recovered after self-quarantining, recently said at a Senate hearing:

It is a fatal conceit to believe any one person or small group of people has the knowledge necessary to direct an economy or dictate public health behavior. I think government health experts during this pandemic need to show caution in their prognostications. It’s important to realize that if society meekly submits to an expert, and that expert is wrong, a great deal of harm may occur … when we allow one man’s policy or one group of small men or women to be foisted on an entire nation.

That is a good model, not only for Miami-Dade County, but also for the rest of Florida and the nation. One size doesn’t fit all, and neither should the opinions of a few “experts” dictate to everyone, especially when other scientists and political leaders have differing opinions.

The economy and health of the country are at stake and decisions made now could harm or help America for decades.


More than 120,000 American schools have closed since March, a change  affecting  more than 55 million students. As we approach August, an intense debate about  reopening schools  has been brewing. One side argues that schools should reopen so that families can return to work and children can receive the education taxpayers have paid for. The other side says that schools cannot reopen safely without  $116 billion  more in federal funding, on top of the $13 billion  already allocated  to states to reopen schools.

This debate wouldn't be so contentious if we  funded students  instead of school systems. The funding could follow children to wherever their families feel they would receive an effective education, be it a district-run school, a charter school, a private school, or a home setting. In that situation, if an individual school decided not to reopen—or if it reopened unsafely or inadequately—families could take their children's education dollars elsewhere.

That is how food stamp funding currently works. If a neighborhood grocery store refuses to reopen, it may be inconvenient, but families wouldn't be devastated; they could take their money elsewhere.

Imagine if you were forced to pay your neighborhood Walmart the same amount of money each week regardless of whether they provided your family with any groceries. The store would have little incentive to reopen in an effective or timely manner.

It sounds absurd. But you have essentially just imagined today's compulsory K–12 school system.

And it's even worse than that. Even if the institution were required to provide goods and services through online or other platforms, it would still have weak incentives to get things right, because families would still be powerless.

New data show that's precisely what happened with the K–12 school system during the lockdown. 
A nationally representative  survey  conducted by Ipsos Public Affairs found that private and charter schools were substantially more likely to continue providing students with meaningful education services during the lockdown than traditional public schools.

The survey found that private and charter school teachers were more than  twice  as likely to meet with students daily than teachers at district-run schools. Private and charter schools were about 20 percent  more  likely to introduce new content to their students during the lockdown. About 1 in every 4 traditional public schools simply provided  review  material for what students had already learned before the closures. Arlington Public Schools, for example,  decided  in April  not  to teach students any new material for the rest of the school year.

Another national  survey , this one conducted by Common Sense Media, found similar results. Private school students were more than  twice  as likely to connect with their teachers each day, and about 1.5  times  as likely to attend online classes during the closures.

A recent  report  by the Center for Reinventing Public Education found that only 1 in 3 school districts examined required teachers to deliver instruction during the lockdown, and less than half of all districts expected teachers to take attendance or check in with students regularly.

And just yesterday,  The   New York Times   reported  that in many towns, private schools are reopening while public schools are staying closed.

Traditional school systems' failure to adapt to COVID-19 helps explain why many families are turning toward homeschooling. A new nationally representative  survey  by EdChoice and Morning Consult just  found  that the pandemic has made families about 2.4 times as likely to have a more favorable view of homeschooling as they are to have a less favorable view. Another  national poll , this one by RealClear Opinion Research, found that 40 percent of American families say they are now "more likely" to homeschool after the lockdowns end. So many families in North Carolina  committed  to homeschooling this month that they  crashed  the state government's website.

This might also explain why the new national  Education Next   survey  found that parents were substantially more satisfied with private and charter schools' responses to the pandemic than they were with those of district-run schools. Parents of children in private and charter schools were at least 50 percent  more likely  to report being "very satisfied" with the instruction provided during the lockdown than parents of children in traditional public schools.

These results aren't surprising. Private schools can adapt to change more effectively because they are less hampered down by onerous  regulations  than their government-run counterparts. Choice schools also have real incentives to provide meaningful educations to their students while reopening safely. Private and charter schools know that their customers—families—can walk away and take their money with them if they fail to meet their needs.

K–12 students have been getting the short end of the stick for far too long. But it doesn't have to be this way: We could fund students directly and truly empower families. Legislators

in  Pennsylvania  and  Maryland  have already made proposals to partially fund families directly in the fall. Hopefully they'll succeed—and hopefully more states will follow.

The COVID-19 vaccine being developed by researchers at Oxford University and the pharmaceutical giant AstraZeneca reportedly stimulates the body's immune system in early trials to produce  both antibodies and killer T-cells . Antibodies protect against infections by binding to pathogens in order to prevent them from entering or damaging cells, and by coating pathogens to attract white blood cells to engulf and digest them. Longer-lasting killer T-cells work by finding and destroying infected cells in the body that have been turned into virus-making factories.

If this pans out, it's great news. Recent studies have shown that protective antibodies  decline steeply  in a large proportion of people who have recovered from COVID-19 infections. Swiftly waning levels of antibodies might mean that people could be reinfected and that the vaccines that are being rushed through testing and production would only offer transitory protection against the novel coronavirus. But if the vaccines provoke the immune system to produce T-cells, they could still offer some  longer-term protection  against coronavirus infections.

While more research needs to be done, some  preliminary data  suggest that the COVID-19 vaccine being developed by Moderna may also elicit the production of T-cells that react to the coronavirus.

The idea that T-cells could offer protection against the COVID-19 coronavirus is bolstered by  new study  in Nature. It reports finding T-cell immunity in people who recovered from both COVID-19 and SARS coronavirus infections. The researchers also identified T-cells that react to both coronaviruses in about 50 percent of healthy study subjects who had never been infected by either virus.

"This could be due to cross-reactive immunity obtained from exposure to other coronaviruses, such as those causing the common cold, or presently unknown animal coronaviruses. It is important to understand if this could explain why some individuals are able to better control the infection,"  said  study co-author Antonio Bertoletti in a press release from the Duke-National University of Singapore (Duke-NUS) Emerging Infectious Diseases program.

Earlier studies  by Swedish and German researchers have also found that a substantial number of subjects who had never had COVID-19 produced a T-cell immune reaction to the virus. It's still speculative, but it looks increasingly likely that a good portion of humanity may already have developed some T-cell immune protection against the novel coronavirus. Nevertheless, the Swedish researchers  caution , "It remains to be determined if a robust memory T cell response in the absence of detectable circulating antibodies can protect against" the virus.

"While there have been many studies about the [COVID-19 coronavirus], there is still a lot we don't understand about the virus yet," said Duke-NUS researcher Jenny Low in the aforementioned press release. "What we do know is that T cells play an important role in the immune response against viral infections and should be assessed for their role in combating the [COVID-19 coronavirus], which has affected many people worldwide. Hopefully, our discovery will bring us a step closer to creating an effective vaccine."

Even as COVID-19 vaccines are being tested in clinical trials to determine their safety and efficacy, production for several is being revved up in order to deliver them (if they work) as early as this fall.

AstraZeneca announced in June that it planned to manufacture  2 billion doses  of its vaccine, with 300 million slated for delivery to the United States and the United Kingdom by the end of this year. Moderna plans to deliver about  500 million doses  per year, and potentially up to 1 billion annual doses starting in 2021. An effective vaccine against this scourge cannot come too soon.


During the depths of the COVID-19 shutdown in early spring, many physicians with private practices struggled both financially and emotionally. And they may not be out of the woods yet.

In March, many physicians responded to the calls from their professional associations to close their offices or limit the number of patients they saw. A survey of 500 physicians, nurse practitioners, and physician assistants found that by late March, almost 9 in 10 were limiting patient visits to their offices.

Dr. Alieta Eck, who runs an internal medicine practice in Piscataway, New Jersey, was one physician who did not close down her practice.

"We noticed a lot of our colleagues were closing their practices," she said. "We didn’t. We figured when people are sick, that’s when they need us."

Still, Eck did see a decline in office visits.

"About one-quarter to one-third of visits became telemedicine visits, as people were afraid to come to our office,” she said.

The fear that patients had of visiting the doctor for fear of contracting the virus in a waiting room took a toll. Total doctor visits declined 37% from early March to late June, according to the Commonwealth Fund. At the worst point in late March, visits declined by 58%. While traffic to doctor’s offices began to recover in early April, it still hadn’t fully recovered by late June, when visits were still down 11%.

The decline in visits also had a financial impact. An analysis in  Health Affairs  found that primary care physicians would lose an average of $67,774 in income due to the pandemic.

Dr. Kelly Green, an ophthalmologist in Marble Falls, Texas, shut her practice down on March 20 and reopened on May 4. She wouldn’t specify an exact amount that her practice lost but said that "it was in the hundreds of thousands."

She received loans from the  Paycheck Protection Act  and Small Business Administration to help keep her practice open.

"I know that some people think that doctors are highly paid, but patients should care because if private practice doctors don’t make it, then you could lose your doctor," she added.

The  Health Affairs  article noted that physicians could reduce their losses to about $25,000 if they furloughed staff and reduced benefits. But that leads to another set of problems.

"There are 18 people who work at my practice," said Green. "Some of them are single moms, some of them take care of aging parents. And some of them don’t have a safety net or a family nearby." She worked closely with her staff to get them unemployment benefits and provided financial assistance to those staff who did not receive them.

A recent Primary Care Collaborative survey found that 70% reported high levels of strain on their practices, and almost 4 in 10 agreed with the statement that "burnout in my practice is at an all-time high."

At times, the stress was overwhelming for Green.

"Every day, you wake up, and you want to go to work and have it be normal, and you can’t," she said.

"And you just want to see your staff and see your patients … You don’t know how it is going to go. You wonder, are my patients going to get sick and die?"

Green recounted one patient who lost part of her vision who she couldn’t see because of the pandemic. However, she said that didn’t seem to occur much during the shutdown.

Eck saw lots of difficult cases at the Zarephath Health Center, a free clinic she runs in New Jersey.
"We just saw the saddest cases, people who were just destitute," she said. "They lost their jobs, they lost their insurance, a lot of people lost everything, and that was hard to see. Depression [among these patients] was rampant."

As the virus surges again in parts of the United States, the possibility that physician practices would have to close again looms. In July, Texas has had over 8,100 new cases of COVID-19 daily. In response, Gov. Greg Abbott, a Republican, ordered hospitals in 100 counties to stop nonessential procedures unless they can meet certain COVID preparedness standards.

"The governor is closing up a lot of things, but the governor never told me to close up. It was my professional society [of ophthalmologists]," said Green. "We now have an approach to maintain a safe atmosphere for the patients if we stay open, which I hope we do."

In all, primary care offices could lose up to $15 billion due to the spring shutdown, according to the  Health Affairs  study. While the study did not estimate the effect of a summer virus surge, it did account for the possibility of one in the fall. In that case, total losses could exceed $19 billion.

When a Michigan retiree accidentally underpaid his county property tax bill by $8.41, he lost his house and all of the equity in it. Oakland County seized the property and sold it, ultimately pocketing about $25,000 beyond the tax debt owed.

Uri Rafaeli, the homeowner, is just one of many people to be victimized by Michigan's overly aggressive tax asset forfeiture laws in recent years. But the absurdity of his case earned national media attention, and on Friday the Michigan Supreme Court issued a near-unanimous rebuke to Oakland County and the legal regime that allows governments in Michigan to profit off unpaid tax bills in this way.

While Oakland County was allowed to seize Rafaeli's property to satisfy the tax debt and "any interest, penalties, and fees" associate with it, Justice Brian Zahra wrote in the opinion that accompanied the 6–1 decision, the county is not entitled to the full value of the home.

"Defendants were required to return the surplus proceeds to plaintiffs, and defendants' failure to do so constituted a government taking under the Michigan Constitution entitling plaintiffs to just compensation," Zahra wrote.

Exactly how much compensation Rafaeli is due will be hashed out in a lower court. Still, Friday's decision is a "momentous" victory for homeowners in Michigan, according to the Pacific Legal Foundation, the nonprofit law firm that represented Rafaeli.

"This decision will protect people across Michigan by prohibiting county governments from stealing from struggling property owners," said Christina Martin, the attorney with PLF who argued the case. "Today's decision sends a message across the country that this kind of abuse should not be tolerated in the United States any longer."

As Reason  reported last year , Rafaeli was just one victim of a 1999 state law that gave county treasurers the power to seize properties with unpaid taxes, settle the debt, and keep the remainder for their own budgets. Some of them have used this law quite effectively. Wayne County, for example, has funneled more than $382 million in delinquent tax surpluses into its general fund since 2012. Oakland County, where Rafaeli's house was located, has hundreds of millions of dollars in its Delinquent Tax Revolving Fund.

Tax asset forfeiture has been particularly pernicious in Detroit. Rather than helping to more quickly get vacant homes back on the market, it has contributed to an increase in the number of abandoned and blighted properties, according to a report by the Quicken Loans Community Fund.

"Most Detroit homes that have been tax foreclosed do not return to productive use," the group concluded.

The process has  created a perverse incentive  for local governments to seize homes rather than allow homeowners to pay off tax debts. When Cass County was going through the process of seizing a multi-million-dollar home over a small, unpaid tax bill, the county treasurer and other officials exchanged emails joking about using the lakefront property for cookouts.

When Oakland County had to defend its forfeiture of Rafaeli's property to the state Supreme Court last year, county attorneys  argued  that keeping the proceeds from tax forfeitures was a punitive measure necessary to compel property tax payments from residents. During oral arguments, one county attorney compared the process to telling his kids, "If you don't pick up your stuff, it's mine."

Lower courts accepted this grotesquely paternalist argument, but the state Supreme Court soundly rejected it. Because the homes seized for unpaid property tax bills have not been connected to criminal activity, there is no grounds for the county to claim that the action is a forfeiture, Zahra wrote. Simply failing to pay your taxes, Zahra notes, is not a criminal act allowing forfeiture.

"The remedy for a government taking is just compensation for the value of the property taken," wrote Zahra. "Therefore, plaintiffs are entitled to the value of those surplus proceeds as just compensation."


In 2004, with New Jersey facing a revenue shortfall, then-governor Jim McGreevey’s administration borrowed—in defiance of the state’s constitution—some $2 billion in order to boost spending by a hefty 17 percent. Though the state supreme court ruled the move unconstitutional, it allowed the debt to remain because the state had already budgeted the money. It was one of a series of court decisions that prompted voters in 2008 to approve, overwhelmingly, a referendum that tightened borrowing restrictions.

Trenton is now planning to defy the will of the voters. The Democratic-controlled state legislature has approved an unprecedented plan backed by Governor Phil Murphy to borrow $10 billion to close a projected deficit. Despite the squeeze on state budgets caused by the Covid-19 lockdowns, only three other states—California, Illinois, and New York—have  announced  similar borrowing plans (most other states are announcing significant budget cuts). Relative to the size of its budget, New Jersey’s deficit is by far the largest. Jersey plans to cover most of the cost of its deficit with debt by tapping a last-resort Federal Reserve lending program.

New Jersey is already the nation’s most fiscally unsound state,  according  to the Institute for Truth in Accounting. It bears some $234 billion in debt, including about $100 billion in unfunded pension liabilities. A recent Pew study estimated that, between 2003 and 2017, the state spent $1 for every 91 cents in revenue it collected.

Fiscal 2021, which began on July 1, is a difficult budget year for all states, which are projected to lose hundreds of billions of dollars in tax revenue as a result of the lockdowns. Among the  hardest-hit states , according to the National Conference of State Legislatures, are California, Colorado, New Mexico, Wyoming, and New Jersey, all projecting revenue declines of about 20 percent this fiscal year. Yet California’s budget allows Governor Gavin Newsom to transfer $11 billion from dedicated funds to the general budget—a kind of borrowing by the state from itself—while Illinois and New York plan to borrow more conservatively, relative to the size of their budgets, than New Jersey.

Before the pandemic, Murphy had proposed a $40.7 billion budget for fiscal 2021, a spending increase of 5.4 percent. Though the new fiscal year has already technically begun, the state has yet to produce a final budget, as Murphy and the legislature argue over details of the borrowing. The administration has taken only marginal steps to reduce spending by, for instance, delaying water infrastructure projects.

Many other cuts Murphy has announced involve simply shelving plans to spend more money, including $850 million in new spending for schools, expanded pre-K programs, and free college tuition. Throughout his three years in office, Murphy has  left  on the table billions of dollars in savings from employee benefits recommended by a state commission. Bypassing such cuts, Murphy wants to borrow the equivalent of nearly one-quarter of likely spending.

Republicans in the state legislature have promised to sue to stop the borrowing. Their problem: the New Jersey Supreme Court, one of the most  activist  top courts in the country, has a history of disregarding state constitutional debt limitations. A 1991  Wisconsin Law Review  article on state borrowing limits  concluded  that no other court had gone as far as New Jersey’s in ignoring voters’ wishes. “The New Jersey Supreme Court has effectively read the limitations out of the constitution,” the article observed.

The court’s disregard for its own state constitution is what prompted the 2008 referendum that added new lending restrictions. After the court allowed McGreevey to keep the money he’d illegally borrowed, it demanded that the legislature find money to fix deteriorating inner-city schools that local municipalities couldn’t afford to repair themselves. The result: an $8.6 billion bond offering made through a state entity without any revenues of its own. That deal allowed Trenton to claim that it wasn’t borrowing the money itself and therefore didn’t have to seek voter approval. The court brushed aside lawsuits challenging the debt, and when the state squandered much of the proceeds on patronage and overspending, the court demanded that it finish the job with another $3.9 billion in borrowing.

Though the New Jersey constitution now limits borrowing without voter approval, Murphy believes that the constitution’s debt limitations don’t apply to his proposed borrowing. The pandemic, he claims, has created an emergency that allows the state to take on debt without asking voters’ permission. He’s betting that the court will agree.

With one of the worst credit ratings among the states, New Jersey might not be able to issue bonds. Instead, it could  take  a low-cost loan from the Federal Reserve’s Municipal Liquidity Facility, designed to be a lender of last resort for states. The deal, however, raises questions about whether the Fed hasn’t simply introduced a new way for fiscally unsound states to keep piling on debt that worsens their stability. That’s a bad line of business for a central bank to be in.

Consider New Jersey, among other things, a valuable lesson about the perils of judicial activism: a state with a judiciary that often ignores voters’ intentions has helped create one of America’s most financially unstable governments.

The tributes are rolling in far and wide for John Lewis, the civil-rights leader and Democratic Congressman who died Friday at age 80. His life is worth celebrating for its own sake, but it’s all the more valuable for what it says about the progress of his country.

Lewis was one of 10 children of a sharecropper in Alabama when state power enforced white supremacy in the American South. He dreamed of being a preacher, but he had a political awakening over civil rights while attending American Baptist Theological Seminary in Nashville. He led the Student Nonviolent Coordinating Committee, and in the early 1960s became the most prominent young leader of the civil-rights movement that broke Jim Crow.

White political supremacy at the time was enforced by state and local governments. Nonviolent protests built moral authority and widespread political support for the movement that triumphed in the mid-1960s with the help of federal law and enforcement authority. The fight took too long and required much sacrifice, including the cracked skull endured by Lewis as he marched across the Pettus Bridge in Selma in 1965. But legal segregation and black political exclusion were defeated with the Civil Rights Act of 1964 and Voting Rights Act of 1965.

The arc of Lewis’s life and career shows how much the South and America have changed. Born into a world of segregated schools and lunch counters, Lewis became a political activist and in 1986 won election to Congress from Georgia. He served there until his death, rising to the heights of power as so many black Americans have. Forty-five years after the 1963 March on Washington for Jobs and Freedom, where Lewis spoke, America elected a black President.

We had differences with Lewis on policy, not least his opposition to the 1996 welfare reform when he predicted a catastrophe for the poor. The reform, passed by a GOP Congress and signed by President Bill Clinton, is the most successful bipartisan reform of the last 30 years.

But these differences are trivial compared to the significance of Lewis’s life and contribution to America. He famously forgave George Wallace, Alabama’s segregationist Governor in the 1960s, in an example of reconciliation all of us should emulate. He never gave up his belief in nonviolence, despite the violence used against him. He never lost faith in the capacity of American democracy, despite its flaws, to strive for a more perfect union.

These days much of the left dismisses the racial progress America has made. They would rewrite history to say America was founded to maintain slavery and continues to enforce white supremacy. This ignores the central principle of the Declaration of Independence—“all men are created equal”—that inspired the slavery abolitionists and the post-Civil War amendments to the Constitution.

The civil-rights movement that John Lewis helped to lead vindicated those principles, and his rightly celebrated life is a refutation of those who would now consign America to a future of continuing racial rancor and division.