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Did California or Florida handle COVID-19 better? The answer is complicated

California Gov. Gavin Newsom and Florida Gov. Ron DeSantis.
(Associated Press)
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Good morning. It’s Tuesday, Nov. 28. Here’s what you need to know to start your day.

Which state handled COVID better: California or Florida?

The Golden State and the Sunshine State have come to represent polar opposites: east vs. west, blue vs. red. Their rivalry will reach a new stage this week as California Gov. Gavin Newsom and Florida Gov. Ron DeSantis prepare to debate on Fox News for a national audience.

Ahead of that political cage match, my colleagues Rong-Gong Lin II, Luke Money and Sean Greene decided to examine the contrast between the two states in terms of COVID-19.

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In a subscriber exclusive story published this week, they unpacked years of data to see which state handled the historic health crisis better. California’s government, following the lead of public health officials, enacted a stay-at-home order, implemented mask mandates and later embraced vaccines. Florida leaders’ approach to the science was more nonchalant and, in some cases, defiant of national policy. Now that the pandemic’s emergency phase has ended, how do Florida and California stack up?

The death toll is stark — but not a complete picture

In terms of the proportion of lives lost to the virus, the data show many more people in Florida died from COVID-19 compared to Californians.

According to a Times analysis of Johns Hopkins University data through early March, California had the lowest cumulative COVID death rate among the four most populous states:

  • California: 2,560 COVID deaths for every 1 million residents
  • Florida: 4,044 COVID deaths for every 1 million residents

“In other words, Florida’s raw death tally — 86,850 in early March — came close to California’s total, 101,159, despite California having roughly 18 million more residents,” Rong-Gong, Luke and Sean noted.

But raw figures don’t tell the whole story. When adjusted for age, the mortality rate gap between the two states narrowed, according to one estimate. Another estimate factored in Florida’s larger share of “unhealthy” residents and found that Florida then ranked better than California. One analysis published in The Lancet earlier this year found California had a 34% worse death rate when adjusting for age and health factors — like obesity and diabetes — among both states’ populations.

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A more granular understanding of the spread of COVID — not just the death toll — in both states paints a much more nuanced picture, which is important, since the two states have some key differences, namely in population age and housing density.

California’s overcrowded housing enabled more COVID transmission. That was particularly true in Los Angeles County, home to roughly a quarter of the state’s total population. And as my colleagues explained, Florida’s larger share of older residents actually might have helped keep transmissions low in the early phase before vaccines were available.

“Many of Florida’s seniors may have strictly avoided gatherings during that first winter while younger, restriction-weary Californians could have been more apt to travel, socialize and potentially pass the virus to more vulnerable family members,” they wrote.

What about vaccination rates?

Though DeSantis initially applauded his state’s high vaccination rates for seniors, he later adopted much more skeptical messaging about inoculation. Younger Floridians didn’t get their primary vaccination series at the same rates younger Californians did — just 43% compared with 54% by mid-June 2021, respectively. At the peak of the Delta wave in summer 2021, the share of Florida residents under 65 who died from COVID-19 doubled.

And the share of older Florida residents who kept up-to-date on boosters has fallen off.

“As of early May, 48% of California’s seniors had received an updated booster formulated specifically to combat Omicron, compared with 31% of Florida’s seniors,” Rong-Gong, Luke and Sean reported.

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So how do health experts feel about comparing the responses and data between the two states?

Rong-Gong, Luke and Sean asked Dr. Robert Wachter, chair of the Department of Medicine at UC San Francisco, who felt California followed the scientific evidence “better than many other states, including Florida” from the start, which kept Californians safer.

“When you looked at the early curves of death rates, it was substantially lower in California than in many other states,” Wachter told them. “I think a lot of lives were saved at that stage.”

You can read more of Rong-Gong, Luke and Sean’s reporting in their Times subscriber exclusive.

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Commentary and opinion

Today’s great reads

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What one man’s castle in Scotland says about L.A.’s homelessness crisis. Scotland has what some California politicians and advocates have long sought: a legal right to housing. Because of that policy, the local government there must act quickly to ensure that people at risk of becoming homeless find a temporary place to stay — even if that place happens to look like a Harry Potter stage set.

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How can we make this newsletter more useful? Send comments to essentialcalifornia@latimes.com.


For your downtime

Carmel River State Beach.
(Christopher Reynolds / Los Angeles Times)
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Going out

Staying in

And finally ... a great photo

Show us your favorite place in California! Send us photos you have taken of spots in California that are special — natural or human-made — and tell us why they’re important to you.

Palm trees with a mountain in the distance
Sunrise colors west of La Quinta, Calif., looking toward the aptly named Santa Rosa Mountains.
(Michael Cartabiano)

Today’s great photo is from Michael Cartabiano of Carlsbad: Santa Rosa Mountains. Michael writes:

Spectacular Thanksgiving Day sunrise colors at La Quinta looking toward the aptly named Santa Rosa Mountains. Always a beautiful dawn and a great vista to start the day with a good cup of coffee.

Have a great day, from the Essential California team

Ryan Fonseca, reporter
Elvia Limón, multiplatform editor
Kevinisha Walker, multiplatform editor
Laura Blasey, assistant editor

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