Jeffrey Schweers

USA TODAY NETWORK-Florida Capital Bureau

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Within hours of the World Health Organization declaring a global pandemic related to the deadly COVID-19 disease, Gov. Ron DeSantis Wednesday announced restrictions on who can visit nursing homes, assisted living facilities and other places for vulnerable, elderly Floridians.

The restrictions apply to anyone who has traveled internationally, on a cruise ship or in a community with confirmed community spread or lives in a community with confirmed community spread for 14 days.

Also barred from visiting are anyone infected with the novel coronavirus who hasn't had two negative tests separated by 24 hours, anyone showing signs or symptoms of respiratory infection, or been in close contact with an infected person who hasn't tested negative.

"These are important efforts to mitigate the risk to our most vulnerable population to COVID-19, which is our elderly population, especially those with serious underlying conditions," DeSantis said at an afternoon press conference.

The announcement came after the state saw a 64% increase in people testing positive for COVID-19, from 14 to 23 in two days.

In a statement sent at 10:41 p.m. Tuesday, the Florida Department of Health announced eight new "positive" cases. All but one of the cases are people over 60, and all but one are travel-related. Most are related to cruise ship travel.

Three are in Collier County, which is next to Lee County, where two previous cases were reported.

Three are in the Tampa Bay area: Two in Pinellas County and one in Pasco County, bringing the total in that region to five, with two previous cases reported in Hillsborough County.

Two new cases put Northeast Florida on the map. One in Nassau County and one in Alachua County, although the person in Alachua County is from Georgia and that case is being investigated by the Georgia Department of Public Health.

All people were being isolated until they can be cleared by public health officials.

Many of the cases are related to a Nile River cruise in late February, DeSantis said: "We've had several passengers, not just in Florida but in the U.S. that developed symptoms and been confirmed to be infected."

The investigation started with the death of a Santa Rosa man that had been on the cruise that appeared to be an isolated case. When someone else tested positive who had been on the cruise, he said, state officials informed the Centers for Disease Control and Prevention.

Ten Florida cases were connected to the cruise, he said, including five of the new cases announced Tuesday.

"We've also had four cases in Broward County, (and) linked three of those to Port Everglades," DeSantis said. The fourth case was still being investigated.

After a day of no new cases being reported, it raises the bar on whether the state is showing what's called "community spread" of the potentially deadly disease.

DeSantis said that there are no documented cases of community spread in Florida, despite what Dr. Anthony Fauci said during a White House press briefing Tuesday.

“There are parts of the country right now that are having community spread in which the risk there is clearly a bit more, and you know the places: Washington State, California, New York and Florida,” said Fauci, head of the National Institute of Allergy and Infectious Diseases and a member of the President's Coronavirus Task Force.

DeSantis said he spoke with Fauci and Dr. Robert Redfield, director of the CDC, Tuesday night.

"Florida was identified as one of the four states and it was said that there was 'community spread.' We discussed (that) because that three-person cluster (in Broward County) can be linked to the cruise ship, (and) that technically doesn't qualify as community spread," DeSantis said.

"Community spread should be multiple people who we don't know where they got it from. We haven't necessarily got to that point yet."

Community spread can have many meanings, said Dr. John Lednicky, a University of Florida virologist who has spent years studying the coronavirus, of which the SARS-CoV-2 is the newest strain.

"When you talk about community spread, you need to know what the definition is," Lednicky said. "Also, what does it mean when someone is infected?"

The CDC defines community spread as occurring when a person infected with the coronavirus "reportedly did not have relevant travel history or exposure to another known patient with COVID-19."

One point of confusion is people refer to the virus, SARS-CoV-2 with the disease, COVID-19, interchangeably.

"So when people talk about transmitting the coronavirus it gets very confusing," Lednicky said. "Are you transmitting the disease or the virus? Those are very different, espeically when you talk about community spread. You need to know what the definition is."

Also, he asked, what does it mean when someone is infected?

"When the doctor says you have the influenza infection, it means you show signs of influenza," Lednicky said. "But in virology terms, it means you have the virus in you, whether you show signs or not."

The difference with the novel coronavirus, he added, is that "the whole population is susceptible. No one has the antibodies."

Data shows the target population are people in their 60s, 70s and older, especially with underlying serious medical conditions like diabetes, cancer and heart disease. That is the population state health officials are focusing on, as well as people in nursing homes and on cruise ships.

Lednicky said smokers of all ages are also especially at risk: "The information getting out isn't complete."

Also, there isn't enough testing being done, especially on younger, non-symptomatic individuals, not just in Florida but across the nation, he said.

The state Department of Health website said 222 negative test results came back, with 155 tests pending. State health officials refuse to say how many test kits they have on hand, or how many tests they are capable of processing per day.

"The thing that hurts us the most worldwide is the lack of testing being done," Lednicky said. "No one knows how to go about paying for it. The capability for testing is an issue."

DeSantis expects the state will be able to expand its ability to test more patients than it does now, especially as more labs are clinically certified by the FDA and as LabCorp and Quest Diagnostics come online.

He has asked the Legislature for $25 million to help with coronavirus containment and prevention efforts, and expects the state to receive $27.9 million from the CDC as part of its newly announced $604 million appropriation.

Also, the CDC expects to send out 4 million test kits by the end of this week.

"Florida’s share of that will hopefully be significant," DeSantis said. "We have the capacity to meet everyone who is coming in now and can increase capacity in each lab if circumstances warrant it."

Contact Jeff Schweers at jschweers@gannett.com and follow him on Twitter @jeffschweers.

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