Xavier Suarez: Is Miami the Next COVID-19 “Hotspot”?

Miami-Dade County Commissioner Xavier Suarez, District 7

I have crunched numbers, discussed them with advisers who are good with statistical models and observed the modeling done by national healthcare officials.

In this article, I try to parse the arguments and data to explain how there can be such discrepancy – to the point that most mainstream experts are convinced that Florida (and presumably, Miami) is “behind the curve” and likely to become a “hotspot” along the lines of New York state and/or New York City.

After looking at data for a week, I argued my case (as I do once or twice a day) to my Boston-based brother, Mel, who is an M.I.T. engineer and professionally a systems analyst. We both studied mechanical engineering at Villanova and are reasonably fluent in statistical models. We both also have some familiarity, for professional reasons, with healthcare demographics.

So here are the reasons for the discrepancy that leads, for example, the IMHE model (on which my brother greatly relies) to predict that Florida is not yet anywhere close to reaching a peak in infected subjects, hospital admissions and deaths.

I will take them in no particular order.

First Assumption: States Outside New York/New Jersey Are Lagging in the Cycle of Contagion.

It took me a whole week to figure this out. Now I think I know but I am still not sure I can explain.

I remember hearing Governor Cuomo say that his state would likely experience 40% to 60% spread of the virus to the overall population. I wondered, at the time, where he got that figure.

As I have found subsequently, many models make that assumption – including the aforementioned IMHE model that is widely quoted by the president’s task force.

I have not been able to pin down where those assumed rates of contagion come from. I know this: the only randomized testing so far reported publicly was done in San Miguel County, Colorado. It involved about 650 subjects, of which only 1% tested positive; another 1-2% were inconclusive; 97% tested negative.

In Miami Dade, we have tested some of our first responders using the same technique that we plan to use for a random test of 7,000 residents, using FPL data banks and methodology designed by a University of Miami public-health expert. About 5% tested positive, and it is entirely possible that those are people who have been exposed to strong viral doses.

Again, I have no idea where the models being touted base their assumptions as to the overall spread of the virus. We do know that about 10% of those with symptoms test positive.  And we have very recent figures from the City of Miami that show only 7% of those tested with the contagion, but that reflect some self-selection, as some of those tests were done in the convenience of the subject’s home. (And it may also reflect some late-reporting results.)

Are our low rates of contagion, or of mortality, due to an assumption that those infected, presumably overseas, entered the United States through New York, rather than through Miami? If so, I have seen no data whatsoever to back that model of geographic dispersion.

Second Assumption: Governmental Actions Are Not a Big Factor in the Initial Spread of the Virus

In the United States and Europe, the decision to stop all human interaction – or to implement mandatory “social distancing” came perhaps a bit late, in the opinion of the experts, to stop the virus cold.

On this issue, we can certainly agree that New York should have stopped all subway transit, New Orleans should have canceled Mardi Gras, and Washington State and Broward should have stopped visitors at nursing homes.

Perhaps New York City should have required all persons using elevators to wear masks. (If not, maybe it’s not too late to implement that measure.)

Miami, as stated in my prior article, took prompt, and probably effective, steps in canceling Ultra and Calle Ocho. As a very horizontal metropolis (2,400 square miles) compared to Manhattan (22 square miles), which implemented social distancing, shut down hotels and restaurants, and prohibited large gatherings, it is entirely possible that we will never follow the New York model of either infection or mortality.

Lately, we are maintaining a constant rate of deaths to confirmed cases (about 0.8% in the county), which is in stark contrast with New York and New Jersey, which are closer to the worldwide norm of 5%.

Third Assumption: The Virus Spreads at the Same Rate in the North as in the South

This assumption is one I just don’t understand. Almost universally, the southern states, from California to Florida, are experiencing much lower fatality rates, in proportion to confirmed cases, than the northern, urban states. Typical is Florida, which has consistently stayed at about 1.7%; California is at 2.3% and Pennsylvania, which is much colder, is even lower at 1.3%.

In conclusion the models being thrown around all seem to suggest that Florida and California are somehow “behind the curve” in relation to New York and New Jersey.

But that may not be the case at all – particularly if those spreading the virus are limited in their travel, or at least required to prove that they are contagion-free.

In that regard, I must, once again, give kudos to the mayor of Miami, who recently asked the president to restrict passenger travel from northern “hotspots” to our fine city, which has no observable reason to become a “hotspot,” except in the meteorological sense…

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  1. Only people who are tested are included in the statistics. Many are excluded from testing that might well be positive.

  2. Let’s also give credit to The Youth Fair and their board who were critized when they decided to shut down the Fair.

  3. I think there are a lot of valid points in this article, and in the end, I think I understand that the Commissioner is skeptical that Miami is a hot-spot, based on the data and modeling assumptions, but nowhere in this article is the actual position stated…

  4. It is fascinating to watch a politician, touting his “expertise”, while mixing up state and nation wide data with our county data. The Discipline of engineering and science is not about pick and choose data which can fit a narrative.

    First of all I am missing the actual references to actual models where these assumptions has been phrased out as Mr. Suarez did.

    I have no idea what is Mr. Suarez objective to create “assumptions” and challenge them when those assumptions never been presented or accepted as an input for the model. It is quite troubling that Mr. Suarez trying to play the “scientist” and present causations while not even able to show correlation!

    1. Outside of NY everybody lagging

    This is a fact on the ground. Why challenge it? Does this mean all state will reach NY level? Absolutely not. And the Florida model doesn’t even show that!. Yes, Cuomo, an other politician, made some comment, however he put out so many hedging and parameters around it that you cannot really use it as an argument.

    However, the biggest mistake what Mr. Suarez makes is the testing rate. He make argument about how MIAMI Dade testing, where they have tested was 5% and 10% and trying to make reassuring statements.

    It is simply NOT TRUE. Miami Dade test rate of the positive case is oscillate between 18-20%. It means that every fifth person who has been tested came back positive. I give you one more data what you can find in the official FDH arcgis datasoirce. In the last 5 days every test came back 40%+ positive! Almost every second person who we test now in Miami Dade comes back positive! Check the data. Make snapshot of the data every day and check the testing numbers and the new case numbers and you can see it. I am posting about it every single day.

    You really downplaying Mr. Suarez the 40% positive to test ratio? Really???

    Second assumption: governmental action has no effect on the initial spread.

    Who said that? EVERY, I mean every models, discussion proves otherwise! Every experts, scientist, data scientist and network modeler talks about the importance and effect of early government actions.

    Third assumption: the virus spread South and North the same.

    Mr. Suarez not even try to present any data around the virus spread just jumps directly to mortality rate comparison. (In this case why did he selected this “assumption”???)

    Please, show me some correlation before you make argument on causation. Where is Washington State? North. What is the fatality rate, despite being the first? Relatively low. Where is Louisiana? North? South? What is the fatality rate. High. Where is Germany? North-ish? What is the fatality rate? Low. Where is Italy? South? So, what is the mortality rate? High.

    Currently there is no correlation between mortality rate and being in North or South.

    His conclusion that Miami will not going to be a hot spot based on his arguments is totally bogus. He is trying to be a politician and provide an answer. In science we have the most powerful answer sometimes: “ We just don’t know.” And cannot be known as we work with imperfect data.

    However, in the last 20 days Miami Dade consistently did the 10 fold in 10-11 days. (Check on any dataset). In the last 5 days 40% of our tests come back positive. If these gives him a hope he has to know some other data what is not available to us, regular mortals.

    However, I HOPE wholeheartedly that our physical distancing action kicks in and breaks the current trends soon. I HOPE he is right. Not because of his data analysis or his assumptions “assailing” because it would be good for all of us. It would be less human suffering.

    Mr. Suarez. You are a politician. Please, just don’t pretend expertise in engineering and science. It’s just not a good look. Use your tools. If you want to console us, lift up our spirits and give us hope, please do that and it would be appropriate and we would appreciate it.

  5. Southern states have much warmer winter temperatures compared to northern states, and have longer durations of daily UV time. Perhaps these may be factors on why southern states currently have lower numbers than northern states.

  6. Y la gente que sigue congregandose en nombre de Dios en las iglesias y sinagogas no ven como sus hermanos trabajadores de la salud estan dando la vida por ti y la de tu familia? Deja la ignorancia. Deja de seguir pastores curas o rabi’s. Sigue a TU Dios Sigue a TU Jesucristo. VE A TU CASA Y AMA A TU PROJIMO COMO A TI MISMO. Yo estoy indignada de que en Florida no prohiban la cancelacion de misas y servicios. PARA QUE TANTO ESFUERZO DE LA MAYORIA. Si van a dejar a los fanaticos religiosos hacer lo que se les da la gana. La iglesia no es un edificio. La verdadera iglesia eres tu. QUEDATE EN TU CASA. SI NO AYUDAS NO ESTORBES.

  7. This would be my second comment to Mr. Suarez:

    Maybe in a city like New York with over 4 million subway users per day, many of those that have tested positive, in general could have been exposed to the virus to a greater degree, and have built up more virus particles than those tested positive in other areas. Therefore one reason that could account for a higher death rate.

  8. Thank you for this article. One thing I am noticing is that since the tourist industry has closed or restricted access to dwellings for those fleeing hot spots from other areas there has been a serious increase in air bnb activity in residential areas. While the City of Miami prohibits rentals of less than 30 days this is very difficult to enforce. The state prohibition against allowing municipalities to pass new legislation restricting minimum lengths of stay may exacerbate this problem for cities which did not already have such code on the books. Allowing people to ignore shelter in place restrictions will result in the inevitable spread of the virus; as a student of history I am sure you are aware of how malaria, cholera, smallpox and bubonic plague epidemics were spread throughout history.

  9. Perhaps southern states or cities, like Florida and Miami show fewer cases of the virus because we don’t live in such a crowded place like New York City- our houses are already ‘socially distant’, we enjoy good weather, so we can walk outside (with masks), and can keep our distance from other pedestrians at the same time. Thanks to God for good weather!

  10. The quote below, was in the NYTimes on March 3, 2020 pertaining to COVID-19 in NYC.
    “The Metropolitan Transportation Authority, which oversees the subway, buses and two commuter railroads, said late Monday that it had started a major cleaning of all equipment that called for an industrial-grade disinfectant to be applied to everything from train cars to MetroCard machines every 72 hours.”
    In a 72 hour period, the MTA is used by over 12,000,000 passengers.

  11. No data is accurate. Testing and results are too long. We need to find a cure for the virus. What has China used to decrease the spread. If that country is telling the truth then ask for help to stop the spread.


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