A 'trifecta' of 'lunacy': Why Florida's COVID response favors treatment, not prevention

Conservative pundits praise Florida's governor as a Pied Piper of the pandemic

Jeffrey Schweers

Starting with his first public appearance after the omicron variant began spreading through Florida, Gov. Ron DeSantis has questioned or outright inveighed against the effectiveness of vaccinations, masks and testing as the best way to stop the spread of COVID-19. 

He boasted about rejecting federal guidelines for quarantining students, saying the vaccine is not effective against spreading the omicron variant. Instead, he promoted several monoclonal antibody treatments (MABs) that the government temporarily halted shipments of after data showed they didn’t work against omicron.

More coverage from the USA TODAY Network-Florida:

“With omicron, you know, the vaccinations are not preventing infection,” DeSantis said at a news conference at Broward Health Medical Center in early January.

In promoting the continued use of Regeneron and bamlanivimab, both monoclonal antibody treatments, the governor said he was not convinced they wouldn’t work against omicron: “That hasn’t been definitely shown at all,” he said. 

But as DeSantis tilts further away from established science, conservative pundits praise him as a Pied Piper of the pandemic, a maverick bucking federal guidelines and mandates. And that stance, so far, has endeared him to many in the GOP voting base. 

The governor’s actions have raised concern among members of the medical community, however, some of whom have suggested he and state Surgeon General Joseph Ladapo are undermining proven strategies to slow the spread of COVID and decrease the severity of illness of those who get it.

“Is it ethical and practical to give those treatments to people who you think almost certainly have omicron?” asked Dr. Jeanne Marrazzo, director of Infectious Disease at the University of Alabama, in a recent Washington Post article.

Marrazzo also criticized the reopening of monoclonal antibody treatment centers disbursing Regeneron and bamlanivimab since the federal government resumed shipments of the drugs.

“It’s equivalent to giving them a placebo,” Marrazzo said.

David A. Kessler, a physician, was head of the U.S. Food and Drug Administration from 1990 to 1997. (Randi Lynn Beach / Los Angeles Times)

David Kessler, the chief science officer for the Biden Administration’s COVID response, told the Post that the use of Regeneron and banlanivimab is only effective if a large enough number of people in a community are tested to have the delta variant. 

But since omicron has been the dominant variant among the newly infected, he said, those treatments are unlikely to do much good. The only MAB proven effective against omicron is sotrovimab, which is in short supply.

The DeSantis administration said people treated with other monoclonal antibodies have improved, contrary to the initial study put out by the U.S. Department of Health and Human Services.

(Mandate-)free state of Florida

The governor has touted Florida as a state free of mandates, but he’s also enacted policies restricting the rights of school boards to require masks, even as omicron swept through Florida’s schools.

People who don’t stick to the message can feel the consequences. When former Florida Surgeon General Scott Rivkees said people should wear masks until a vaccine was approved, he was yanked out of a news briefing and rarely made a public appearance afterward. 

Florida Surgeon General Scott Rivkees speaks to the Select Committee on Pandemic Preparedness and Response in the Senate Office Building at the Capitol Thursday, Jan. 14, 2021.

More recently, Orlando’s top health official was placed on administrative leave for sending an email encouraging his staff to get vaccinated after discovering that fewer than half of his 568 employees were vaccinated.

More:DeSantis administration puts Florida health director on leave for encouraging vaccinations for his staff

“I am sorry but in the absence of reasonable and real reasons, it is irresponsible not to be vaccinated,” Dr. Raul Pino said in his Jan. 4 email. Florida Department of Health officials said Pino was on leave while the agency investigated “whether any laws were broken.”

State health officials did not respond to a request to identify which laws may have been broken. A spokesman said that getting vaccinated is a personal medical choice that "should be made free from coercion and mandates from employers."

DeSantis called a special session in November in which he got the Legislature to approve a law banning private businesses and government agencies from requiring vaccines of their employees without also offering several exemptions.

Special session coverage:

Florida Surgeon Gen. Dr. Joseph A. Ladapo before a bill signing by Gov. Ron DeSantis Thursday, Nov. 18, 2021, in Brandon, Fla. (AP Photo/Chris O'Meara)

Surgeon General Ladapo: Tests, masks, vaccines are 'trifecta' of 'lunacy'

The governor has the backing of Ladapo, a former UCLA clinical researcher who has been associated with the anti-vaccine group America’s Frontline Doctors, a group that has advocated natural immunity over vaccination.

Ladapo, who once recommended the unproven hydroxychloroquine as a treatment against COVID-19, has declined to say whether he’s been vaccinated. At a news conference in Ocala, he said when someone asked if he was vaccinated, he told them, “That’s my personal health information.”

In December when he rolled out new testing guidelines, Ladapo called for the unwinding of America’s obsession with the “trifecta'' of testing, masking and vaccines, calling it “lunacy” and a failed policy. He also downplayed the ineffectiveness of Regeneron against the omicron variant.

“The way our governor has led his state is the way every state that respects its citizens should be treating them,” Ladapo said.

While Ladapo has mentioned vaccinations and education about vaccinations as one of several ways the state is combating COVID-19, the state has also taken down a video that mentioned vaccines.

The monoclonal antibody infusion center at the Northwest Florida Fairgrounds is one many clinics around the state of Florida that were opened this summer to provide free treatment to COVID-19 patients.

Instead, the state has been encouraging MABs, as well as an oral pill by Pfizer that was recently approved for emergency use and fluvoxamine, an antidepressant that has shown some success in treating COVID-19.

More from USA TODAY:Cheap antidepressant shows promise treating early COVID-19

“This new product is effective for people who are immunocompromised,” Ladapo said. “For whatever reason, they did not respond to the vaccine or couldn't take it. This is how you should manage a pandemic.”

Tom Hladish, a research scientist at the Emerging Pathogens Institute at the University of Florida and one-time adviser to the Florida Department of Health on its COVID-19 response, told the Daily Beast that reliance on monoclonal antibodies was poor public policy.

“When people are receiving monoclonal antibodies, they’re already symptomatic,” he said. “And so they’ve already done most of their transmitting.” 

He said the resulting reduction in the spread of the virus is only linear, whereas with vaccines it is exponential.

“The vast majority of epidemiologists feel that the best intervention we have right now is vaccines,” he said. “And it’s because vaccines, even against omicron ... they still likely reduce transmission somewhat. They make it somewhat less likely that you’ll get infected.”

Jeffrey Schweers is a capital bureau reporter for USA TODAY NETWORK-Florida. Contact Schweers at and follow him on Twitter @jeffschweers.

Subscribe today using the link at the top of the page and never miss a story.