How South Florida screwed up its best chance to avoid a surge of COVID-19 cases

• In May, Miami-Dade County Mayor Carlos Giménez promised to hire up to 1,000 people to conduct COVID-19 contact tracing.
• "We may have to do some of this on our own," Giménez said at the time.
• But now the mayor's office tells Business Insider that the county can't act alone after all. It's not sure how many contact tracers are working in Miami-Dade. "It's been difficult getting answers on this," a spokesperson said.
• But Daniella Levine Cava, a Miami-Dade County commissioner running to be the next mayor, told Business Insider there's blame to go around.
• "We have a president who's been in denial, we have a governor who's minimized the disease, and we have a mayor who is running on the Republican ticket for Congress," Levine Cava said.
• Dr. Marissa Levine, a public health expert at the University of South Florida, told Business Insider that contact tracing should have been ramped up months ago.
• "Pretty much everything we do with a pandemic, if we do it earlier, we have better outcomes," Levine said. "But it requires good leadership, strong messaging, and good public participation."

Days after reopening barbershops and restaurants, Miami-Dade County Mayor Carlos Giménez pledged to follow up by hiring the contact tracers necessary — up to 1,000 people who would track every confirmed COVID-19 patient's interactions with others — to ensure that a flattened curve did not immediately become a jagged spike.

"We're trying to work with the state on this," the mayor said, "but we may have to do some of this on our own."

That didn't happen. His office now insists that doing it "on our own" was never an option. Spokesperson Patty Abril told Business Insider that the hiring spree promised in May has been stalled by the Florida Department of Health, "the only entity authorized to conduct contact tracing." She couldn't say how many people are working to track the spread of the coronavirus in South Florida, nor when talks with the health department might conclude.

"It's been difficult getting answers on this," Abril said. "Conversations have been going on for a while."

In the meantime, the pandemic has exploded — and not, as some elected officials insist, just because more people are now being tested. These numbers are easier to obtain: A month ago, on June 7, Miami-Dade County reported 229 new COVID-19 cases; a month later, July 7, it reported over 2,900 cases, the rate of positives jumping from less than 8% to a hair under 22%.

Before all this — the economic reopening, the mayor's promise, and the state's failure to deliver — Daniella Levine Cava, a county commissioner running to replace the term-limited Giménez this fall, sounded an alarm. On March 23, the Miami Herald reported, weeks before the mayor announced his initiative, she cautioned that "there is not sufficient contact tracing" to safely reopen the economy.

Asked for her assessment of the effort since, Levine Cava was blunt.

"We do not have a contact tracing system," she told Business Insider. That, she acknowledged, is in part the fault of the state, which is led by Gov. Ron DeSantis a close ally of President Donald Trump who was eager to open up Florida's economy early on in the pandemic.

But, more broadly, she argued there was blame to go around.

"We have a president who's been in denial, we have a governor who's minimized the disease, and we have a mayor who is running on the Republican ticket for Congress," she said (Giménez is hoping to unseat a Democrat this fall in Florida's 26th district). "He wanted to open, because that was the Republican playbook: 'Open.'"

The mayor has, since the most recent spike, decided to close back up again. On July 6, he signed an emergency order shuttering dance halls, party venues, and gyms, along with reimposing a ban on indoor dining. He attributed the rapid spread of the virus to "packed parties" and "street protests where people could not maintain social distancing and where not everyone was wearing facial coverings," a reference to the recent social unrest over police killings.

A day later, he reversed course and allowed indoor exercise at gyms to resume.

The claim about protests, in light of the mayor's stance on indoor recreation, strikes Levine Cava as politics. "I was part of many of these marches and demonstrations and people were masked, in the open air," she said.

In addition to protests, people were (until recently) tanning on Miami's reopened beaches — both of which experts believe are far less dangerous than dining indoors.

"It's all speculation without contact tracing," she said.

Dr. Marissa Levine, a professor at the University of South Florida's College of Public Health, agrees.

Across the state, "the big areas, like Miami-Dade, Tampa, Orlando, I think are all playing catch up right now," she told Business Insider. "They are not adequately staffed to do the contact tracing needed now for the new case numbers that are coming in."

When CNN contacted patients in the state, less than a quarter said they had heard from anyone in the health department.

But more hiring, now, is also not a silver bullet. Contact tracing is most valuable early on in an outbreak, before an explosion — when a handful of infected persons, and the people they know, can be tracked down and quarantined before they infect thousands of others. In the case of COVID-19, it would have also been more useful before the disease and the danger it poses became a partisan matter.

In late June, the Pew Research Center found that most Republicans were not concerned by the prospect that they might unknowingly spread the coronavirus, compared to two-thirds of Democrats. And that's reflected, if not a product of, the mixed messages from the respective parties and their leaders.

As The New York Times reported July 6, the problem is not just that there aren't enough contact tracers in Miami-Dade County, but the entire state: Florida has only 1,600 people performing the task, with a contractor reportedly set to hire 600 more, far below the level recommended by public health experts.

Staffing isn't the only problem, The Times noted: Some of those infected individuals whom the state does manage to contact don't want to talk.

"We are starting to encounter a fair amount of pushback from younger folks when you call them up and say, 'We want to know everyone who was at your party,'" one doctor told the paper. "There's very much a sense of, 'That's none of your business.'"

Levine, the public health expert, told Business Insider that attitude reflects errors from the top: political leaders encouraging social distancing while at the same time urging a return to business as usual — and only belatedly adopting policies, from mandated face coverings to contact tracing, long demanded by those most familiar with the science.

"I think we've had a lot of mixed messaging," she said. "Pretty much everything we do with a pandemic, if we do it earlier, we have better outcomes. But it requires good leadership, strong messaging, and good public participation."

Have a news tip? Email this reporter: cdavis@insider.com