An astonishing pattern has emerged in Florida’s COVID death tally — one that suggests the state manipulated a backlog of unrecorded fatalities, presenting more favorable death counts in the days leading up to the 2020 presidential election.

At issue is the state’s handling of the lag between the date someone dies and the date Florida reports that death in its public count. With minor exceptions, Florida stopped including long-backlogged deaths in its daily counts on Oct. 24, 10 days before the Nov. 3 election, and resumed consistently including them on Nov. 17, two weeks after the election.

The result: The daily death numbers publicized as Floridians turned out for early voting and Election Day were significantly lower than they otherwise would have been, the South Florida Sun Sentinel found.

The change came just three days after the administration of Florida Gov. Ron DeSantis announced that it would conduct an additional review of every suspected COVID death before adding it to Florida’s count.

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The impact of that change was huge. Consider: In the month that preceded the change, from Sept. 23 to Oct. 20, the state included in its daily tallies 1,128 deaths that occurred at least a month earlier -- accounting for 44% of the deaths announced during that time. But in the week before the election, the health department included just one such death in its daily tallies.

State officials have stopped releasing the list of coronavirus deaths being compiled by Florida’s medical examiners, which has at times shown a higher death toll than the state’s published count.

The list had previously been released in real time by the state Medical Examiners Commission. But earlier this month, after the Tampa Bay Times reported that the medical examiners’ death count was 10 percent higher than the figure released by the Florida Department of Health, state officials said the list needed to be reviewed and possibly redacted.

They’ve now been withholding it for nine days, without providing any of the information or specifying what they plan to remove.

Dr. Stephen Nelson, the chairman of the state Medical Examiners Commission, said the change in policy came after the state health department intervened.

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Nelson — who is also the medical examiner for Polk, Highlands and Hardee counties — said state officials told him they plan to remove causes of death and case descriptions. Without that information, the list is meaningless, he said.

Nelson said he believes the entirety of the list is public information — a stance supported by Florida public records experts.

“This is no different than any other public record we deal with,” Nelson said. “It’s paid for by taxpayer dollars and the taxpayers have a right to know.”

The Florida Department of Health’s count of coronavirus deaths reached a grim milestone Friday, surpassing 400 and climbing to 419.

But at least 40 additional people who had died from the virus in Florida were missing from the state’s count, the Tampa Bay Times has learned.

Those deaths are reflected in another tally that’s being kept by the state’s medical examiners. On Friday, it stood at 461, 10 percent more than the health department’s announced number.

The discrepancy underscores the difficulty in building a system to track the fast-moving disease in real time. But it also reflects choices by state health officials that could have the effect of understating the virus’ toll, the Times found.

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And the state health department is counting coronavirus deaths only for people who claimed residency in Florida. The medical examiners, who are legally responsible for certifying fatalities from diseases that constitute a threat to public health, are counting anyone who died in Florida, including snowbirds and visitors.

Public health experts told the Times that the state should tally all deaths that occur in Florida, which has hundreds of thousands of seasonal residents. From there, the state could break out additional statistics for its residents.

For months, Thomas Hladish, a research scientist at the University of Florida’s Emerging Pathogens Institute, asked the Florida Department of Health to let him use information from thousands of contact tracers the state had hired to interview Floridians who tested positive for COVID-19.

He and his colleagues wanted to better understand where transmission was occurring in Florida so officials could put more effective policies in place.

But Hladish, who was on the Florida Department of Health’s payroll for part of last year building statistical forecasting models about the disease, was stonewalled. He was then told not to even acknowledge the state had a set of data that showed when and where people tested negative for COVID-19 in Florida.

“They said, if it was brought to the attention of anyone that the data set exists, then the state has to release it,’' Hladish recalled last week. “It was presented to me that I should not acknowledge they have that data.”

As Gov. Ron DeSantis prepares to give his third State of the State speech on Tuesday when lawmakers convene for their annual 60-day session, many open government advocates say the state of Florida’s sunshine laws are darker this year because of the governor’s selective release of information and his attempt at times to actively shield critical details about the depths of the crisis from the public.

“This administration doesn’t want to put negative information out there,’' said Pamela C. Marsh, president of the First Amendment Foundation. “If there’s good news, we’ll share it, and if there’s bad news, we’ll hold onto it for a while until we are pushed and shoved to release it.”

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The Times/Herald interviewed more than two dozen researchers, journalists and legislators about their experience with open records in the last year and the common conclusion was: Florida health officials are reluctant to release new data related to COVID-19 that contradicts the governor’s upbeat narrative and they frequently withhold information until they are either threatened with a lawsuit, or convinced the trend lines have improved.

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Marsh said the motive for the secrecy “comes down to politics.”

As Florida Gov. Ron DeSantis travels the state promoting his performance fighting the coronavirus, he often points to a relatively low infection rate among children — even after his administration compelled school districts to offer in-person learning.

But this week, the NBC 6 Investigators found, he twice misled the public about how Florida stacks up to other states when it comes to infection rates among school-age children.

During comments Monday lambasting Democrats for, he claimed, putting teachers' unions "ahead of the well-being of our children," he touted how well Florida protected school children from the virus, compared to other states.

"We’ve been in-person (learning) as much as anybody in the country. And yet we’re 34th out of 50 states and DC for COVID-19 cases on a per capita basis for children," he said.

That is not true, unless -- as the governor did -- you ignore more than 50,000 children over the age of 14 who contracted the virus.

By using a statistic for children under 15, he effectively removed high school students from the data he cited twice this week to validate his decision to offer in-person classes to all public schools students.

The states DeSantis was comparing Florida to do, in fact, include those older students.

When states reporting cases among children under 18 are compared to Florida's rate for the same age group, Florida ranks ninth -- not 34th -- according to an NBC 6 analysis of state Department of Health and U.S. Census Bureau data.

DeSantis, who owes his job to early support from President Donald Trump, imposed an approach in line with the views of the president and his powerful base of supporters. The administration suppressed unfavorable facts, dispensed dangerous misinformation, dismissed public health professionals, and promoted the views of scientific dissenters who supported the governor’s approach to the disease.

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These findings are based on interviews with more than 50 people, including scientists, doctors, political leaders, employees of the state health department, and other state officials, as well as more than 4,000 pages of documents:

• The Florida Department of Health’s county-level spokespeople were ordered in September to stop issuing public statements about COVID-19 until after the Nov. 3 election.
• The DeSantis administration refused to reveal details about the first suspected cases in Florida, then denied the virus was spreading from person to person — despite mounting evidence that it was.

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• The DeSantis administration brushed aside scientists and doctors who advocated conventional approaches to fighting the virus, preferring scientists on the fringes who backed the governor’s positions.

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• The governor highlighted statistics that would paint the rosiest picture possible and attempted to cast doubt on the validity of Florida’s rising death toll.

When Gov. Ron DeSantis announced that most of the state would reopen for business on May 4, he cited his administration’s “data-driven strategy” and success at achieving “critical benchmarks in flattening the curve” to contain COVID-19.

But a review of the data the governor was using shows his public pronouncements were often in conflict with real-time facts. He either wasn’t aware the data showed that community spread, regional outbreaks and death tolls were worse than he was telling Floridians, or he selectively focused on outdated statistics to make his case.

A glaring example came on April 29, when the governor brought a slideshow to a news conference to announce that all counties but three in South Florida would lift stay-home orders for many nonessential businesses.

The state had satisfied the “gating criteria,’’ the benchmarks established by the White House Coronavirus Task Force and the Centers for Disease Control and Prevention, to begin the phased reopening of the state, DeSantis said.

“The curve was flattened,’’ he said. “The goal has been satisfied” and “we’ve done much better than everybody said we would do.’’

The curve of new cases had indeed flattened. Both new cases and the percentage of people testing positive for the disease — the “positivity rate” — had been in decline for much of April. But the data suggest that by the time DeSantis announced reopening, those trends were showing signs of reversing.

At the time the governor spoke, the state, excluding South Florida, was on the third day of a four-day rise in the positivity rate, according to confidential Department of Health data obtained exclusively and analyzed by the Miami Herald. New cases were also showing an uptick around that time.

Those increases could have made parts of the state ineligible for reopening for at least 10 more days, depending how the state applied the criteria set by the CDC.

As Florida’s eldest residents struggled to sign up to receive their first dose of the COVID-19 vaccine, nearly all those ages 65 years and older in a wealthy gated enclave in the Florida Keys had been vaccinated by mid-January, according to an emailed newsletter obtained by the Miami Herald.

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Ocean Reef Club is an ultra-exclusive neighborhood that is arguably one of the highest-security private communities in the nation. According to Sotheby’s International Realty, it has more than 2,100 members who live there either full- or part-time. It is also where the very wealthy and where dignitaries, including President Joseph Biden, come to stay when they visit the Florida Keys.

Many wealthy donors to the Florida Republican Party and GOP candidates, including Gov. Ron DeSantis, live there.

In fact, the only people from Key Largo who gave to DeSantis’ political committee live in Ocean Reef. All 17 of them had given the governor contributions of $5,000 each through December 2020, according to the Florida Division of Elections.

But on Feb. 25, one resident of Ocean Reef, Bruce Rauner, the former Republican governor of Illinois and former chairman of the Chicago-based private equity firm, GTCR, increased his contribution and wrote a $250,000 check.

Since DeSantis started using the state’s vaccine initiative to steer special pop-up vaccinations to select communities, his political committee has raised $2.7 million in the month of February alone, more than any other month since he first ran for governor in 2018, records show.

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By hand-selecting the communities, DeSantis allows residents to bypass state and local vaccine registration systems and go directly through their community organizations, like the Medical Center at Ocean Reef.

Last month, a high-end community developed by Republican fundraiser Pat Neal was chosen by DeSantis to host a pop-up vaccination clinics near Bradenton. Only people from two ZIP codes were eligible to receive the vaccine at the Lakewood Ranch site, and names were chosen by Manatee County Commissioner Vanessa Baugh, who included herself on her vaccine selection list.

DeSantis chose two other Neal developments for pop-up sites in Charlotte and Sarasota counties. Campaign finance data shows that Neal, a former state senator, donated $125,000 to DeSantis’ political committee in 2018 and 2019 but is not reported to have made a contribution since.

Organizers of the three-day vaccine distribution event last month in Lakewood Ranch in Manatee County were focused on more than shots, text messages between them and the governor’s office show.

They were also keenly aware of the political optics of bringing Gov. Ron DeSantis into town to promote vaccines in their Republican-rich neighborhood. Rather than rely on a random selection of vaccine-eligible residents, the governor’s staff wanted them to create a list of who would get a vaccine.

“Gov said he might show up,’' wrote Lakewood Ranch developer Rex Jensen in a text message Feb. 9 to Manatee County Commissioner Vanessa Baugh. “Should try to see if that would help him get exposure here.”

“Excellent point. After all, 22 is right around the corner,’' Baugh responded, referring to the 2022 race for governor.

Jensen had just finished a call with DeSantis and another Lakewood Ranch Developer and Republican donor, Pat Neal, about hosting the event and what followed was carefully-choreographed, records obtained by the Bradenton Herald show.

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The vaccine event has since spawned community anger and a criminal and ethics investigation.

Gov. Ron DeSantis sent a message to locals looking to get extra COVID-19 vaccine doses: Kiss the ring, or else.

DeSantis stopped in Manatee County Wednesday to announce a pop-up vaccination spot for 3,000 seniors at a planned community called Lakewood Ranch. The catch: only residents of two ZIP codes qualified. Those areas are predominantly white and well-off — and the least impacted by COVID-19 in the county.

But local officials and residents had better be grateful the great governor bestowed such honor on the county. And they’d better stop complaining that Manatee’s wealthiest residents are getting VIP access to shots when poorer, non-white residents have been disproportionately impacted by the coronavirus.

“If Manatee County doesn’t like us doing this, then we are totally fine putting this in counties that want it. We’re totally happy to do that,” DeSantis said during a news conference. “Anyone that’s saying that, let us know if you want us to send it to Sarasota or Charlotte or Pasco or wherever. Let us know — we’re happy to do it.

“There’s folks that are going to complain about getting vaccines. I’ll tell you what, I’d be thankful because you know what? We didn’t need to do this at all. We saw a need and wanted to get the numbers up for seniors.”

DeSantis was responding to criticism from some Manatee County commissioners who were concerned about the optics of picking and choosing who gets the vaccine.

For DeSantis, there’s nothing to see here — that the organizers of the vaccine pop-up are politically connected, nor that the Manatee commissioner who helped organize the pop-up, Vanessa Baugh, made sure she and the developer of Lakewood Ranch were on the list of people with priority for the vaccine, as the Bradenton Herald reported.

The governor spent little time talking about prevention or the value of social distancing, and when it came to mask wearing to prevent the aerosol transmission of the virus, he was never an advocate.

DeSantis, like Trump, rarely wears a mask — except in Miami, where it has been required. Photographers caught him incorrectly strapping on an N95 mask one time and another time wearing only one glove.

“If you put the mask on, you’re more likely to be fiddling around your face, and actually you may even be more likely to transmit the virus if you’re in contact with it,” DeSantis told reporters in February. “So those really need to be used for healthcare professionals, who are treating patients who may or may not have this illness but who may be susceptible to it.”

Fred Piccolo, spokesman for Gov. Ron DeSantis, deactivated his Twitter account Wednesday after he tweeted in the middle of night that photos of each dead COVID-19 victim should be balanced with 99 photos of people who survive the disease.

In response to a Reuters photo gallery on COVID-19, Piccolo wrote, “I’m wondering since 99% [of] Covid patients survive shouldn’t you have 99 photos of survivors for every one fatality? Otherwise you’re just trying to create a narrative that is not reality.”

According to screenshots captured by Miami Herald reporter Ben Conarck and WLRN reporter Danny Rivero, Piccolo was responding at about 4 a.m. to a tweet by Corinne Perkins, the North America editor for Reuters Pictures.

“This thread is dedicated to those saying we aren’t seeing images of the reality of COVID-19 in hospitals across the U.S.,” Perkins wrote. “This is not an exhaustive list but I wanted to highlight the stories @reuterspictures photographers bring to light.”

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Piccolo’s tweet drew an almost immediate angry response.

“Survive? I have friends who ‘survived’ who have hair falling out and can’t walk across a room without getting winded,” read one reply.

“Do some math for me, Fred. How many people is 1% of 330 million?” read another.

“‘Creating a narrative that is not reality’ is a good way to talk about Florida’s COVID numbers,” replied another, with a link to the South Florida Sun Sentinel article about the difficulty of determining how many Floridians died of COVID following Thanksgiving gatherings.

Since taking the top communications post for Florida’s governor in July, Fred Piccolo Jr. has used his personal Twitter account to spread misinformation about the coronavirus pandemic.

During the gravest health crisis the state has ever faced, the governor’s spokesman has questioned the efficacy of mask wearing and mask mandates at least 16 times, and has claimed that COVID-19 is less deadly than the flu at least three times.

Only about 3,100 people follow Piccolo on Twitter, and while he identifies himself on the account as the governor’s spokesman, he doesn’t appear to use it as an official messaging channel.

Piccolo, a public employee who government records say makes over $154,000 a year, offered “context” for his tweets. The South Florida Sun Sentinel asked independent experts to fact-check his tweets and the context he offered.

“It makes everyone’s jobs more difficult,’ Leslie M. Beitsch, chairman of behavioral sciences and social medicine at Florida State University College of Medicine, said after reviewing a half-dozen of Piccolo’s tweets. “But worse than that, it politicizes something that we are going to struggle to un-politicize. We need to get on the same page, all of us.”

“I guess from the perspective of someone working within public health, we would have really preferred to have a unified message from the top down, but instead we have a fight in messaging between political sources and the expert in the field,” said Dr. Jill Roberts, a professor at the University of South Florida’s College of Public Health, after reviewing Piccolo’s tweets.