These 2 States Have Handled COVID the Worst, Virus Expert Says

As the COVID-19 pandemic has progressed, so has our understanding of the virus and how we combat the spread of the disease. Unfortunately, waves of outbreaks brought on by new variants have also forced health officials to act quickly to bring down new cases, hospitalizations, and deaths in their respective areas. But while all states suffered missteps and tragedies throughout the pandemic, one expert points out that officials in two states in particular appear to have handled COVID the worst: Florida and South Dakota.

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During an appearance on CBS' Face the Nation on Sept. 19, Scott Gottlieb, MD, former Food and Drug Administration commissioner, was asked by host Margaret Brennan if there were any states which appeared to handle the COVID-19 pandemic particularly poorly. Gottlieb quickly explained that specific metrics, such as deaths per capita, may not tell the whole story when gauging how badly officials responded in some places. He said this was especially true in the earliest days of the pandemic in areas like New York and New Jersey when effective treatments for the rapidly spreading virus weren't available and hospitals became overwhelmed.

"There are going to absolutely be disparities in the state-by-state experience. And you know, it's not easy to decouple in every case, the policy from the experience, because this wasn't an epidemic that was experienced the same way nationally—this was highly regionalized," Gottlieb said. "But what you were starting to see after that first wave was a much more regionalized experience based on differences in policy approaches."

But when asked which areas had seen the worst outcomes due to bad policy decisions, Gottlieb began listing specific examples. One such state was South Dakota, where Gottlieb said COVID "was just allowed to travel largely unfettered with public health interventions, where you saw one of the highest death rates per capita. You have to look back and say that was a bad experience."

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Gottlieb then pointed out how certain officials such as Florida Gov. Ron DeSantis made controversial decisions early on that eventually proved themselves correct. Notably, this includes controversially reducing social distancing requirements in public from six feet to three feet months before the Centers for Disease Control and Prevention (CDC) made a similar policy change. But he also lamented the top official's decision to drop most of the public health precautions that could have slowed the spread of the virus in the Sunshine State.

"They let the virus spread largely unchecked in terms of personal mitigation," Gottlieb said. "People weren't wearing masks. They weren't encouraged to wear masks. Vaccination was encouraged for the elderly population, but not widely…So they made policy choices, and the consequence was an infection that largely engulfed most parts of the state," adding that "Florida probably has one of the highest positivity rates of any state in the nation right now."

Gottlieb briefly switched tracks to credit DeSantis' efforts to keep kids in school as "the right decision." But he quickly warned that current policies could be putting young people in Florida in danger as classrooms reopen, saying he disagreed with "the decision to let the virus spread the way it has and not even employ mitigation in the school as they're doing now." Similarly to South Dakota, Gottlieb argued that Florida could've avoided their dangerously high numbers, saying: "I think that there are things we could have done that were relatively easy interventions like requiring people to wear masks [and] trying to get people high-quality masks that could have slowed the spread [and] could have kept certain settings like schools safer."

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Florida is the third-highest ranked state in the number of reported COVID-19 cases per capita, with 16,314 per 100,000 people since the beginning of the pandemic, according to data from The New York Times as of Sept. 21. South Dakota ranks as the eighth-highest state with 15,871 all-time cases per 100,000. Both states are also comparable in reported deaths per capita, with Florida and South Dakota ranked tenth and eleventh with 242 and 238 per 100,000 people, respectively.

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Other top health officials have also previously called out COVID responses in the two states. In January, Deborah Birx, MD, White House coronavirus response coordinator for former President Donald Trump, called the decision by South Dakota Gov. Kristi Noem to host the large annual Sturgis motorcycle rally "not O.K." And on Sept. 6, Anthony Fauci, MD, current chief White House COVID adviser, told CNN that DeSantis was "completely incorrect" to suggest that vaccines were "not important for people."

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