Chris Kaposy draws lessons from diverging claims of success versus failure in the management of the pandemic in Florida and Canada.

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Florida governor and candidate for US President Ron DeSantis has been claiming that Florida was a success story during the COVID-19 pandemic, due to his leadership. According to DeSantis, “Florida got it right”. In DeSantis’s telling, he resisted the prevailing public health orthodoxy regarding vaccine mandates, lockdowns, and school closures, while also avoiding significant illness and mortality. These claims have been contested, however. DeSantis’s decision to discourage widespread vaccination when the vicious Delta strain of the virus was circulating in 2021 likely resulted in an excess of 16,000 deaths and 61,000 hospitalizations.

Overall, the death rate from COVID-19 in Florida as of March 2023 was 404 per 100,000 people. Florida has an older population, which is correspondingly more vulnerable to COVID-19 than younger populations. If you adjust for age, the death rate is lower, but still in the range of 300 deaths per 100,000 people.

Photo Credit: Egonetix_xyz/pixabay. Image Description: A digital illustration of Covid-19 Virus.

Meanwhile, in Canada, the death rate from COVID-19 is about 137 per 100,000 people. As of mid-2023 53,000 people have died from COVID. With a smaller population than Canada, over 87,000 Floridians died from COVID-19. Yet in Canada, no one seems to be patting themselves on the back as Governor DeSantis has been. On the contrary, just two weeks ago medical experts issued a call for a “full national inquiry” into Canada’s “failures” during the COVID-19 pandemic.

What’s going on here? On the one hand, many more people died in Florida, yet DeSantis is running for President on his record of managing the pandemic. Fewer people died in Canada, and we are wringing our hands about having failed.

For one thing, the Canadian experts calling for an inquiry aren’t comparing Canada to Florida. Despite the lower death rate than Florida, Canada’s death rate was higher than the global average of 86 deaths per 100,000. Australia’s rate was about 77 deaths per 100,000, for example.

Furthermore, in each case, consider who is making the claims about COVID success and failure. Governor DeSantis is a politician with an interest in making himself look competent. The calls for a national inquiry in Canada are coming from public health experts. A politician seeking election may be rewarded for mastery of the dark arts of misinformation and propaganda. Public health experts, in contrast, have their claims judged against facts and evidence, scrutinized by other experts. It matters that 16,000 or more Floridians could be alive today if only their state had better leadership. It matters that 37% fewer Canadians would have died if only we had managed the pandemic as well as the average country around the world. Public health experts are more likely than politicians to be honest about these losses and to learn from them.

If pandemic response should be guided by good-faith expertise, we should not take public health tools out of the hands of decision-makers. This is a further lesson we should draw from the difference between Florida and Canada. Governor DeSantis passed a state law in Florida banning COVID-19 vaccine mandates, among other measures – in spite of his state’s devastating death toll.

In the hands of such politicians, vaccine mandates are made to seem like extreme violations of rights and freedoms. But rights always have reasonable limits. Even in the freedom-loving USA, there is a Supreme Court precedent allowing mandatory vaccination in the interest of public health.

From the perspective of ethics, vaccine mandates can be seen as bringing about a conflict between respect for personal autonomy versus protection of the public. Ethicists are always concerned about achieving the right balance between these important values. Protecting the health of the public is the mandate of public health, but not all interventions in pursuit of this goal are justified.

Governor DeSantis’s management of the pandemic and his law banning vaccine mandates proposed to balance personal autonomy versus the protection of the public by giving priority to autonomy. But it is hard to believe that such a position is the correct balance when preventable mass death is the result. Sometimes our freedoms ought to be violated. To take vaccine mandates off the table is a dangerous and foolish policy. In order to dodge the shocking truth of the mismanaged pandemic in Florida, DeSantis’s only option is to gaslight the public and claim that his state was a success story.

In this context, it is laudable that Canadian public health experts are now saying that Canada failed in its efforts to deal with COVID-19. We can only learn from the pandemic if we are honest about what happened, and about how we could have done better. 

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Chris Kaposy is an Associate Professor at the Memorial University Centre for Bioethics, and an editor of the Impact Ethics blog. On Mastodon @ChrisKaposy@mindly.social