Mark Bennett: As Dr. Box retires, she reflects on pandemic experiences, Hautean roots

May 18—A dynamic study of the human body in Mrs. Colleen Magnuson's sixth-grade class at Collett Elementary School in Terre Haute convinced young Kristina Box to be a doctor.

Box (then Kristina McKee) was fascinated.

"It absolutely ignited a fire in me. And from that year on, I knew I wanted to be a physician and never altered or changed my desire," Box recalled on Monday.

Her dream came true.

Box grew up in Terre Haute, living here from age 3 to 18, attending Collett Elementary; McLean, Glenn and Woodrow Wilson junior highs; and Terre Haute North High School, before studying medicine at Indiana University. She served 30 years as an obstetrician-gynecologist before Indiana Gov. Eric Holcomb asked Box to become his state health commissioner in 2017. A bit more than two years later, Box faced a medical dilemma she never imagined.

The COVID-19 pandemic.

Indeed, the deadly, debilitating coronavirus scourge vaulted Box into the public eye across Indiana for more than two years. She, Holcomb, Dr. Lindsay Weaver — chief medical officer for the Indiana Department of Health — and a team of public health experts conducted periodic COVID-19 updates that were livestreamed from Indianapolis to Hoosiers. They explained the disease's spread, precautions to prevent infection like masking and social distancing, the vaccines' availability and efficacy, and the dangers of misinformation.

"As hard as it was to do five days a week and [then] a press conference like that, and prepare for that, it really was retrospectively the best thing we could've done," Box said. "Because, we were giving the best, up-to-date information that we could possibly give."

She became the face of Indiana's COVID-19 response.

"I can't tell you how many Hoosiers that I've heard from directly and indirectly that have said, 'This was our lifeline. That really meant the world to us,'" Box said.

Now, nearly six years after becoming commissioner, Box has decided to retire at the end of this month. Holcomb has asked Weaver to replace Box as commissioner.

"I'm really looking forward to prioritizing my family on an everyday basis," Box said, "but also looking forward to doing the things I love in life like hiking and traveling and reading something other than a public health journal or public health report."

She's had plenty of reports to read since January 2020, when word arrived of a coronavirus outbreak in China and its subsequent spread around the globe. COVID-19 wound up claiming 1,123,836 lives across the United States, including 26,115 Hoosiers and 453 Vigo Countians as of March 2023, according to Johns Hopkins University. Worldwide, COVID-19 has killed 6,881,995 people.

Box first heard about the coronavirus in a TV network news report on New Year's Eve 2019. People were dying from the novel virus in China. She texted a question to then-state epidemiologist Pam Pontones, asking, "Is this something we need to be worried about?"

"And she said, 'It's something that bears very close watching,'" Box remembered.

Within two weeks, Box said, state health commissioners and their teams were regularly communicating with officials from the Centers for Disease Control and Prevention. The IDOH reported Indiana's first confirmed case of COVID-19 on March 6, 2020. The first Hoosier to die from the virus passed on March 16, 10 days later. Three days later, Holcomb directed the closing of Indiana schools.

Indiana, the nation and the world began a difficult path through uncertainty, disruption, isolation, division and heroism.

Box, Weaver and the IDOH staff dealt with the realities that created those situations, from staffing shortages at hospitals overwhelmed with COVID-19 patients to denials of the virus' seriousness, resistance to masking and vaccines, and untested remedies promoted on social media. The livestreamed updates aimed to set the record straight and guide willing Hoosiers to sources of help.

"We showed how we were being data-driven, that we were focusing on the true data that was coming back to us — the medical part of this — and tried very hard to stay away from the political stuff, and a lot of the misinformation that was out there," Box said. "I think we countered a lot of the misinformation."

Hints of their exasperation occasionally were visible at those news conferences.

"I did try to keep a poker face," Box said, "but I'm not the best at that, and I'm afraid my team might have a few videos of that."

The IDOH professionals drew from research gathered around the U.S. and world, and presented it to Indiana residents, with data-based recommendations.

"So it was difficult to see people trying other things that had no evidence that it improved outcomes and not trying things like the vaccines that had really good evidence to show that it decreased the risk of severe hospitalization and death," Box said. "And probably one of the hardest things about the pandemic really was [that] once the vaccine was out there and available, to see people coming in and getting sick and dying from this disease when we knew there was something available that could very well have changed that outcome."

While the pandemic dominated Box's tenure as commissioner, she took on other Hoosier health concerns. In announcing her impending retirement, Holcomb noted Box led the My Healthy Baby initiative to improve Indiana's long history of poor maternal and infant health, improved lead poisoning screenings for kids, and advocated for a modernization and improved funding for the state's public health system.

That modernization push included the Governor's Public Health Commission, which studied the changes needed to ensure a baseline level of public health access for every county, rather than some with a full slate of services and others with few offerings. The commission's recommendations led to the Indiana General Assembly approving $225 million for counties to take the optional step of expanding public health programs over the next two years, the Associated Press reported last month.

By comparison, Indiana had previously delivered just $6.9 million a year to county health departments for the past 21 years.

"Prior to this, the bulk of the funding came from the county itself, and a lot of that was from property taxes," Box said. "So you can imagine a county like Marion County, or even probably better Hamilton County, the access they would have to the funding and resources they need to provide public health support versus a much smaller county, like Parke County or Owen County. And so the goal is to try to help better support all counties, and having a baseline funding to help them deliver these services."

Box expressed confidence in Weaver to implement the improved system as the new commissioner, along with the IDOH staff.

Meanwhile, Box plans to read biographies and historical fiction books, garden while listening for the first time to podcasts ("I've never had the time"), and devoting time to her family and friends. Those include her husband of 41 years, David, who attended the IU School of Medicine's Terre Haute campus with her in 1979; four grown children and their spouses; and two grandchildren with another on the way.

She leaves the IDOH with a deep respect for state government and its employees. The perception that those state staffers don't work hard is incorrect, Box emphasized.

"I've never run into people who work as hard and have as much passion about the jobs that they do as I have in state government," Box said, "and that's from the governor all the way down to the people that answer our phones here at the agency level."

Mark Bennett can be reached at 812-231-4377 or mark.bennett@tribstar.com.