A virus spike connected to the Delta variant has led to a record number of Covid-19 hospitalizations in Florida. Gov. Ron DeSantis has not altered his approach, for better or worse.,

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MIAMI — Gov. Ron DeSantis of Florida snapped this week at a reporter who asked if masks might help keep children safe in a state that now has more Covid-19 hospitalizations, including for pediatric patients, than anywhere else in the nation.

He blamed President Biden’s purported failure to control the spread of the virus across the border after the president suggested that governors like Mr. DeSantis should either “help” fight the coronavirus or “get out of the way.”

And he touted a new state rule, adopted on Friday, that will counter local school mask mandates by allowing parents to request private school vouchers if they feel that the requirements amount to “harassment.”

Mr. DeSantis has been unyielding in his approach to the pandemic, refusing to change course or impose restrictions despite uncontrolled spread and spiking hospitalizations — an approach that forced him to undertake the biggest risk of his rising political career.

The governor reopened his state’s economy last spring and kept it that way, defying coronavirus surges that filled hospitals, and then celebrated as a statewide vaccination campaign took hold and life in Florida began to look normal.

Now Mr. DeSantis is gambling again. A new virus spike has led to a record number of Covid-19 hospitalizations that have undone some of Florida’s economic and public health gains and again raised the stakes for Mr. DeSantis.

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Patrons exited a bakery in the Wynwood neighborhood of Miami last month after the C.D.C. recommended that masks be worn indoors.Credit…Scott McIntyre for The New York Times

If the latest surge overwhelms hospitals, leaving doctors and nurses unable to properly care for the younger, almost entirely unvaccinated people packing emergency rooms and intensive care units, Mr. DeSantis’s perch as a Republican Party front-runner with higher aspirations could be in serious trouble.

If, however, Florida comes through another virus peak with both its hospital system and economy intact, Mr. DeSantis’s game of chicken with the deadly pandemic could become a model for how to coexist with a virus that is unlikely to ever fully vanish.

Mr. DeSantis successfully sued the Centers for Disease Control and Prevention over its requirement that cruise ship passengers be vaccinated, though some of the cruise lines were keeping the mandate anyway. He opposes mandating vaccines for hospital workers, saying that would result in worsening staff shortages.

“We can either have a free society, or we can have a biomedical security state,” Mr. DeSantis said this week in Panama City, Fla. “And I can tell you: Florida, we’re a free state. People are going to be free to choose to make their own decisions.”

Florida has the country’s highest hospitalization rate and second-highest rate of recent cases, next to Louisiana. Infection levels have been rising in every state, with especially alarming rates in the South. Many of those governors have also been reluctant to impose new restrictions or require masks.

Nationally, hospitalizations and deaths remain well below past peaks, in part because 80 percent of Americans age 65 and older are fully vaccinated. Deaths in Florida have so far remained much lower than past peaks, but mortality data can lag cases and hospitalizations by weeks.

“Nobody knows where this is going to end,” said Dr. Marissa J. Levine, the director of the Center for Leadership in Public Health Practice at the University of South Florida. “The approach has almost been one of denial that this is a big deal.”

Mr. DeSantis has argued that prioritizing vaccinations for older people, as his administration did, has reduced the death toll. So has the availability of treatments for some patients, like monoclonal antibodies, which Mr. DeSantis spent part of this week promoting. The governor has consistently urged Floridians to get vaccinated, though he no longer holds public events at vaccination sites as he did earlier this year.

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Dr. Michael DesRosiers checked on an intubated patient in a Covid-19 unit at Jackson Memorial Hospital in Miami last month.Credit…Scott McIntyre for The New York Times

About 49 percent of Florida residents are fully vaccinated and about 59 percent have received at least one dose, rates that are roughly in line with the national average and far better than most other Southern states.

Florida never instituted a statewide mask mandate. Mayors imposed local ones a year ago; a new state law prohibits them now, but some municipalities have reinstated mask rules in government buildings and mandated vaccines for their employees. The state of emergency that Mr. DeSantis initially declared to deal with the pandemic expired in late June, and he has declined calls to bring it back, though doing so could make it easier for hospitals to hire more doctors and nurses.

In short, Mr. DeSantis said, life will go on even as the pandemic does, too.

“We knew this is something that you’re going to have to live with,” Mr. DeSantis said on Friday, articulating a sentiment that many public officials are beginning to express, publicly and privately, as the pandemic powers through its second summer.

Understand the State of Vaccine Mandates in the U.S.

College and universities. More than 400 colleges and universities are requiring students to be vaccinated for Covid-19. Almost all are in states that voted for President Biden.Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get the Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force. In N.Y.C., workers in city-run hospitals and health clinics will be required to get vaccinated or else get tested on a weekly basis.Federal employees. President Biden announced that all civilian federal employees must be vaccinated against the coronavirus or be forced to submit to regular testing, social distancing, mask requirements and restrictions on most travel. State workers in New York will face similar restrictions.Can your employer require a vaccine? Companies can require workers entering the workplace to be vaccinated against the coronavirus, according to recent U.S. government guidance.

Mr. DeSantis’s resistance to new mandates, even for children returning to school who are too young to get vaccinated, prompted a testy back and forth this week with Mr. Biden. The governor accused the president of “helping facilitate” the virus spread by not securing the U.S. border with Mexico. “Until you do that, I don’t want to hear a blip about Covid from you,” Mr. DeSantis said.

Asked about Mr. DeSantis again, Mr. Biden quipped: “Governor who?”

Democrats have assailed the governor, calling him irresponsible and accusing him of trying to shift blame over the handling of the pandemic. Last summer’s surge hurt Mr. DeSantis in public opinion polls, though his approval rating mostly rebounded afterward.

Mr. DeSantis, who faces re-election next year, has used the tit for tat with the president in campaign fund-raising pitches. (He fund-raised in Michigan on Monday, The Detroit News reported.) Later, he decried “media hysteria” over the rising Covid case numbers and downplayed the dire situation in hospitals — even as the Florida Hospital Association warned about overcrowding as a result of the virus.

“Hospitals are eliminating right now any procedure services that can be scheduled and postponed that are not emergent,” said Mary Mayhew, the association’s president and chief executive. She previously worked as a member of Mr. DeSantis’s administration overseeing nursing homes. “They’re doing that in order to redeploy staff” to Covid-19 cases, she said.

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A drive-through coronavirus testing site in Miami this week.Credit…Chandan Khanna/Agence France-Presse — Getty Images

Of particular concern has been the Memorial Healthcare System in Broward County, north of Miami. This week, it had more than 1,600 patients, a record, nearly 600 of them with Covid-19. The hospital system usually does not care for more than 1,400 patients at a time.

The crush of sick people forced Memorial hospitals to make room for beds in a cafeteria, a conference center and an auditorium, Dr. Marc L. Napp, the chief medical officer, said in a news conference. “So far, I’m happy to say that we’ve been able to provide that care, but it’s not without a stress on the system,” he said.

Four conventions have already canceled their plans to meet in Orlando, Mayor Jerry Demings of Orange County said, an economic impact of nearly $44 million.

The reports about overwhelmed hospitals and the more contagious Delta variant have at least moved more people to get vaccinated, according to state and local officials. In Jacksonville, the region hit hardest by the latest surge, Berlinda Gatlin, 55, got her first dose on Thursday, worried that one of her three children could bring the virus home once they start school next week.

“I’m not happy with the governor,” she said about Mr. DeSantis’s opposition to masks in schools.

Gabriel Molina, 30, said he waited for others in his family to get vaccinated first. Once he saw they experienced no side effects, he got the shot himself, so that he would lower the risk of getting his young son sick.

“I have a 3-year-old boy I’m concerned about,” he said.

He was also concerned by other people’s growing antipathy toward masks and fears now that the virus is not going away.

“I think this is going to be a new normal,” he said.

Andrew Pantazi and Mitch Smith contributed reporting.