Public health leaders concerned as McKee searches for new RIDOH chief

SOME PUBLIC HEALTH LEADERS say they're concerned with the loss of Dr. Nicole Alexander-Scott as the longtime director of the R.I. Department of Health amid a politically charged pandemic, and they're keeping a close eye on the search for a replacement. / COURTESY WPRI
SOME PUBLIC HEALTH LEADERS say they're concerned with the loss of Dr. Nicole Alexander-Scott as the longtime director of the R.I. Department of Health amid a politically charged pandemic, and they're keeping a close eye on the search for a replacement. Pictured above with Alexander-Scott are Gov. Daniel J. McKee, center, and DOH Deputy Director Thomas McCarthy, who is also resigning, effective Feb. 1./ COURTESY WPRI AND PBN FILE PHOTO/MICHAEL SALERNO

PROVIDENCE – In the wake of the resignation of the R.I. Department of Health’s widely respected director, Dr. Nicole Alexander-Scott, the office of Gov. Daniel J. McKee said the state plans to name an interim director by Thursday, Jan. 27.

At the same time, McKee said recently he is embarking on a search for a long-term leader for the Department of Health, with the input of a seven-person team of advisers from the local health care community, including Dr. Megan Ranney, an emergency physician and associate dean of the School of Public Health at Brown University.

It’s not clear how long the process will take. McKee’s office didn’t offer a timeline when asked recently.

What is clear, however, is that the next director will be stepping into a position that’s been made increasingly difficult by competing interests influencing the government’s approach to the COVID-19 pandemic, at a time when the virus has been spreading rapidly in the state, according to public health leaders who spoke to Providence Business News.

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Former R.I. Department of Health director Dr. Michael Fine said public health officials are being second-guessed and their recommendations have been disregarded in the past year, leading to a surge in COVID-19 cases this winter and a wave of preventable deaths. Fine said Rhode Island was late to re-enact masking and proof of vaccination requirements last month, and more restrictions should have been put back in place on large gatherings and indoor dining.

While he said he had no personal insight into the relationship between McKee and Alexander-Scott, nor any direct knowledge about her reasons for resigning, Fine pointed to reports showing that 500 local and state public health officers across the country who have either resigned or been fired amid a politically charged pandemic, as elected officials balance the needs of businesses and public opinion, while sometimes disregarding the advice of public health experts about policies that could have helped prevent the spread of COVID-19 and hundreds of needless deaths in Rhode Island.

“This is a time of extraordinary friction between political folks and public health folks,” said Fine, who served as the director of the R.I. Department of Public Health from 2011 to 2015, now working as a chief health strategist for Pawtucket and Central Falls. “The jobs of public health officers are to protect the health and safety of the public. We know how to do that, and how to do it well. But if you look at the nation as a whole, our performance from a public health perspective has been abysmal. That is, in my view, because people were stopped from doing their jobs.”

Dr. Christine Gadbois, president of the Rhode Island Public Health Association and CEO of the nonprofit CareLink, agreed that public health officials have been put in a tough situation due to the conflict between their jobs and politics.

“It’s exacerbated by polarization of all of us as citizens in terms of our political belief and whether or not we believe public health measures are political statements,” Gadbois said. “I think Rhode Island is in the same challenging position that our national government is in … because of politics and not listening to the science. I don’t know enough about the specifics of Dr. Alexander-Scott’s reason for resignation. But certainly, it’s troubling.”

However, Gadbois said she has confidence that McKee is trying to make the right decisions for the health of all Rhode Islanders.

“I believe that our governor wouldn’t deliberately discount the science and will choose someone who is properly qualified and not just providing the answers he’d prefer to hear,” Gadbois said. “I’m not close enough to it to really know. I’m sure that there exists that sort of disconnect sometimes between the science and what makes people happy, and what they’d like to believe. We’d also like to believe that chocolate cake is good for us, right?”

On the heels of Alexander-Scott’s departure, her deputy director Thomas McCarthy also tendered his resignation, effective Feb. 1, after he was appointed by former Gov. Gina M. Raimondo to serve as the executive director of the state’s COVID-19 response team about a year ago. Alexander-Scott was first selected as the director of the R.I. Department of Public Health in March 2015 under Raimondo, and then at the outset of the pandemic she was given a new five-year term that was set to last through June 2025.

McKee’s office didn’t respond to questions about the reasons his two top public health officials resigned, or how long it would take to replace them, but the administration said it is confident in the Department of Health and would be announcing an interim director before Alexander-Scott steps down on Friday. McKee noted in his announcement about the search process for a new permanent director that Marc R. Pappas was recently reassigned from his position leading the R.I. Emergency Management Agency to his office serving as senior advisor and chief COVID administrator to lead a “whole of government” response to the pandemic.

“We have a strong team in place to ensure a smooth transition,” McKee said recently.

However, the turnover at the helm of the R.I. Department of Health has some public health leaders worried. 

“To be completely honest, I am feeling a bit nervous about the situation,” said Dr. Deep Mukherjee, a professor of community and public health at Rhode Island College and a member of the Rhode Island Public Health Association. “I must admit that this latest news on the resignation of Thomas McCarthy makes me even more uncomfortable. It raises even more questions. … McCarthy’s resignation has, in my opinion, exacerbated the leadership vacuum at R.I. Department of Health.”

Mukherjee and others said Rhode Island’s public health response suffered a big loss with Alexander-Scott’s departure, and the state needs to be careful to get it right when finding a successor.

“Dr. Alexander-Scott had become the epitome of Rhode Island’s fight against the COVID-19 pandemic. Indeed, her daily briefings through the peak months of the pandemic were reassuring yet honest, informative yet understandable, and firm yet respectful,” Mukherjee said. “I hope that there will be due diligence in finding Dr. Alexander-Scott’s successor. I agree that there will be a lot of expectations from her successor and they will certainly feel the pressure. Leading a department of health is never an easy task, even when there is no pandemic.”

Fine said that aside from the pandemic, the next R.I. Department of Health director comes at a pivotal time for public health in the state, as the state’s two leading hospital companies, Lifespan Corp. and Care New England Health Systems, undergo a proposed merger.

“The new director is going to have to figure out how to thread the needle of Lifespan/Care New England merger, which is both a challenge and opportunity and is very important,” Fine said. “And [the new director] needs to figure out what the direction for public health is going to be like in Rhode Island for years to come, thinking about issues around what’s sometimes called health equity, or optimal health for everyone, things that Dr. Alexander-Scott pioneered.”

Gadbois called Alexander-Scott’s resignation “a great loss” but said she’s confident that the state can find a qualified replacement.

Gadbois said that Dr. James McDonald, medical director for the R.I. Department of Health, who became widely known for his video illustrating the spread of COVID-19 using a jar of jelly beans, would be “very well qualified” to at least to serve as interim director.

“There are certainly very many qualified public health experts who are educated to a terminal degree,” Gadbois said. “We do have some folks that are prepared at that level who are active in our state that might be well prepared. … We’re fortunate that Dr. Jim McDonald is very well qualified and has really been doing a very good job at being accessible and very hands on throughout this pandemic.”

Marc Larocque is a PBN staff writer. Contact him at Larocque@PBN.com. You may also follow him on Twitter @LaRockPBN.

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