The Collier County Board of Commissioners votes to approve the proposed ordinance on April 11, 2023. (Photo: CCBP)
April 21, 2023 by David Silverberg
The health ordinance passed on April 11 by the Collier County Board of Commissioners is now in force, having been filed with the state of Florida on April 17.
The Collier County Commission vote came one day after President Joe Biden signed a bipartisan congressional resolution officially declaring the COVID emergency at an end.
Given significant revisions in its final version, the “Collier County Health Freedom Ordinance,” does no harm to hospital operations or the public, as its initial version threatened to do.
However, in the event of another infectious disease outbreak along the lines of COVID-19, public health measures will be less effective and more difficult to implement.
The ordinance and its accompanying resolution, which is a statement of county opinion rather than law, were introduced by Commissioner Chris Hall (R- 2-North Naples) and unanimously approved after a session that saw 52 speakers weigh in on the measure, most opposing it. The resolution was approved by a 4 to 1 vote, with Commissioner Burt Saunders (R-3-eastern Collier) voting against it.
Opponents included two speakers from the Collier County Medical Association and the president of the local League of Women Voters. Most of the opponents were long-time residents of Collier County.
Proponents included the COVID Tyranny Task Force, a loose group of perhaps 100 people in the Naples area and anti-vaccine (anti-vaxx) activists from outside Florida.
(Links to the full text of both the final ordinance and the resolution are at the end of this article.)
The ordinance
The main change between the draft and the final versions of the ordinance was a weakening of a requirement for unanimous votes of the Board to impose mask mandates or require vaccine “passports” from the public. It also established that vaccination mandates cannot be imposed on Collier County employees.
The ordinance established no new county authority since Chapter 381 of the Florida statutes prohibits mask or vaccine mandates and supersedes any county measure, as acknowledged by the ordinance. The state law took effect in November 2021. If there are changes to state law, county law will change as well.
Otherwise, the final version of the ordinance follows the same establishing clauses (“whereases”) in the original. These initial four paragraphs state that numerous county residents expressed their concerns about federal government authority and World Health Organization (WHO) efforts to impose health mandates.
Both the original and final versions (as well as state law) prohibit businesses and the county from requiring vaccine or “post-infection recovery documentation” to receive service or entry.
Both versions prohibit private employers from imposing vaccine mandates on employees or requiring testing. If this rule is violated employees are eligible for re-employment as well as civil damages. Similarly, employees wishing to get vaccinations cannot be stopped from doing so by their employers.
Any penalties for violation will be in accordance with those imposed by state law.
The resolution
In contrast to the ordinance, the resolution underwent extensive rewriting. It will not affect medical treatment, hospital authority and is unlikely to impede public safety measures in the future.
The most significant deletion from the resolution’s initial draft was removal of a clause providing for a “right to mental health review” and prohibiting anyone in Collier County from being held for mental health reasons for longer than 72 hours without a jury trial. This addressed a fear of involuntary institutionalization for mental health reasons among anti-vaxxers.
Proponents of the original resolution also wanted to compel hospitals to follow patients’ wishes over the directives of doctors and medical professionals. It sought to force hospitals to recognize power of attorney conferred by patients and made legal, family and personal doctor visitation a right as opposed to a convenience. (During the worst of the pandemic, visits by all outsiders were limited by hospital administrators due to the extreme infectiousness of the disease.)
Furthermore, it held that if a patient wants to leave a hospital even against medical advice, “the hospital must immediately release the patient.” While not explicitly stated, this includes forcing hospitals to release patients who may be infectious and might harm the wider community.
The final version affirmed the right to patient visits by advocates, families and personal doctors but did not make allowing the visits compulsory on the hospital. However it does state that hospitals “must” release patients if they want to depart, even against medical advice.
Also extensively deleted from the original version was an attack on every outside federal agency and international scientific body.
“Human rights are given to us by God,” declared the original resolution, and “these rights cannot be restricted or infringed by United States and foreign bodies such as but not limited to the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention (the “CDC”), the National Institutes of Health (the “NIH”), United States Department of Health and Human Services (the “HHS”), National Institute of Allergy and Infectious Diseases (the “NIAID”) , the World Health Organization (the “WHO”), the World Economic Forum (“WEF”), corporations and the United Nations.”
All that verbiage was removed from the final version, which simply states that the US and Florida constitutions protect Floridians’ rights “against any mandates from the World Health Organization or any other international body.” It kept the reference to God.
While the initial draft had 14 establishing clauses, three were deleted entirely and these were the most extreme and accusatory. One argued that health protections given to hospitals, pharmaceutical companies and medical professionals along with mandates left Collier County citizens “subject to death and injury with little recourse.” Another stated that the Pfizer vaccine had caused deaths, sickness and injury and this information was censored in Collier County. The third stated flatly that the US and Florida constitutions were “no longer upheld” in Collier County.
Other establishing clauses were moderated.
The opening clause stated that federal and state health agencies displayed “a clear inability to be truthful, transparent and consistent.” This was moderated to state that they had “not demonstrated transparency and consistency” in protecting citizens.
While the draft version held that constitutional rights “were violated,” that was softened to state they were “possibly” violated. The draft version argued that doctors “are no longer” allowed to speak freely (presumably about the supposed benefits of discredited treatments like hydroxychloroquine and ivermectin). The final version stated they “were” not allowed to speak freely, putting the problem in the past.
The last establishing clause held that the resolution was being adopted because of the “failings of our federal, state, and local governments and healthcare institutions, which are directly causing harm, including death,” to citizens of Collier County. When rewritten, the final version stated the resolution was necessary because of “injustices and decisions” (rather than “failings”) of “three letter agencies” and these faulty decisions caused “potential” harm and “even” death. Lastly, the final version states that the Board of Commissioners “intends” to protect the constitutionality of its citizens rather than just flatly stating that this is what the resolution does.
Analysis: Venting rage vs. protecting health
As was pointed out during the debate over the ordinance, the real authority for establishing health mandates—or prohibiting them—lies with the state of Florida, which already forbids mandates. The Collier County ordinance simply restates this on the county level.
Essentially, the whole ordinance/resolution package was introduced to give vent to the accumulated anger and frustration of anti-vaxxers and opponents of public health protections over the course of the COVID-19 pandemic. They opposed vaccines, masking, or any restrictions on their behavior because an infectious disease was ravaging the world. Protecting their fellow citizens was not a priority and they rejected all established experts, credible scientific evidence and government efforts, especially those by federal agencies. Encouraged by a president who promoted denialism, they put faith in unproven and ineffective nostrums and remedies that the medical world rejected based on scientific evaluation. Now the political forces in Collier County are aligned in a way that they are able to express themselves in legislation.
With modifications, the Board went along with them, politically threading the needle between fully placating Hall and the anti-vaxxers and doing no harm to hospitals and the considerable healthcare establishment of the county.
The most important result of passage of the package was that the ability of doctors and hospital administrators to protect the public was not infringed. While the resolution establishes that patients should be allowed to leave hospitals on their own initiative, even if sick and infectious, hospitals and doctors are not legally required to do so, since that “right” is mentioned only in the resolution. Hospitals can also still restrict patient visitation if necessary, although this is also discouraged in the resolution, but it does not have the force of law.
Nonetheless, the most important substantive change in the ordinance was the raising of the bar for approval of vaccine mandates, documentation and treatment of Collier County employees.
In 2020, the Board by a simple 3 to 2 majority established a mask mandate to protect Collier County residents. Hall and his allies sought to require a unanimous vote to do the same thing in the future. However, the Board took a middle path, requiring a supermajority or 4 to 1vote to establish any future mandates (which would depend on changes to state law anyway).
From a practical, immediate, political standpoint, the move to a supermajority deprives Hall of a veto on future mandates. If a situation arises that requires a mandate of some kind, Hall, a MAGA anti-mandate Republican, is likely to reject any mandatory health measures on principle. However, he—or any other commissioner—can now be overcome by a supermajority of the Board. It’s a tougher standard than previously but still allows for a degree of flexibility.
Rejecting the world
Both the ordinance and the resolution reflect a profound and willful ignorance of the role of the World Health Organization, an agency of the United Nations.
WHO is an advisory and advocacy organization. It collects health and infectious disease data from all over the world, analyzes it and issues recommendations based on its conclusions. It has no direct authority anywhere in the world. It cannot make anyone do anything.
It was WHO that declared COVID a global pandemic on March 11, 2020, citing the disease’s alarming spread outside of China and recommending that governments take aggressive action to stop it.
(A note on terminology: To this day there remains confusion about the differences between the words “endemic,” “epidemic” and “pandemic.” All are based on the Greek word “demos,” meaning “people.” “Endemic” means that a disease or condition is “in” the people, like seasonal colds or the annual flu. “Epi” is Greek for “on” and an “epidemic” means a disease is “on the people,” like a localized outbreak. “Pan” is Greek for “all” and indicates that a disease is present in every country in the world. The words describe the extent of a disease, not its severity.)
WHO was extremely careful before officially declaring COVID a pandemic and did it only when the data confirmed its wild and uncontrollable spread in every country—until vaccines halted that spread.
Even though WHO had no authority anywhere in the United States to compel anyone to do anything, anti-vaxxers and COVID-deniers felt that it did because of the respect with which its recommendations were regarded in the media and among medical professionals. In this they largely reflected the biases of President Donald Trump during his term in office when he largely rejected advice and sound practice based on scientific evidence and credible data.
The resolution rejects any international intrusion into Collier County, which international bodies had no power to do anyway. It reflects isolationism in its purest form.
Facing the future
The world has endured two extremely deadly pandemics since 1900: the global influenza of 1918 and the COVID outbreak of 2019. If this pattern holds, the next pandemic could come in 2118 or 2119—or not. It might never happen or it could arrive tomorrow.
Collier County suffered during the COVID pandemic. Estimates of COVID deaths in Collier County range from 551 to 1,175 people. According to the Johns Hopkins University Coronavirus Resource Center, an estimated 86,850 people died in Florida. Some 1,125,366 people are estimated to have died in the United States, according to the US Centers for Disease Control and Prevention. The World Health Organization estimates that COVID took 6,887,000 people worldwide.
When—not if, when—there’s a new outbreak, Florida will be extremely vulnerable and may face many more deaths than elsewhere, not only in the country but in the world. Its governor chose to ride resentment of unpopular COVID health precautions to re-election in 2022 and he is doing everything he can to minimize public health precautions for the future. He is betting on the notion that the dead don’t vote and the living forget the dead.
Florida will have fewer protections, procedures and mechanisms in place the next time it confronts an infectious disease and its hospitals and medical professionals will face greater legal obstacles and hindrances in saving lives and protecting its citizens.
It is rare that societies, having experienced trauma and loss, choose to step backward in time and make themselves weaker and more vulnerable. With its fulminations against public health protections, science, outside authority and global coordination, the Collier County ordinance and resolution represent a step backward.
Fortunately, in this instance, cooler heads minimized the damage these measures sought to do.
With thanks to Lisa Freund for her reporting .
Follow this link to read the full text of the Collier County ordinance.
Follow this link to read the full text of the Collier County resolution.
A video of the entire April 11 Board of Commissioners meeting can be viewed here.
The full text of the initial versions of the ordinance and resolution are included here.
Liberty lives in light
© 2023 by David Silverberg