Ron DeSantis sidelined his health department. Florida paid the price.
Things were looking pretty good in Florida on April 13, when Gov. Ron DeSantis and state officials held a press briefing in Tallahassee. A reluctant DeSantis had issued a lockdown two weeks before, but coronavirus infections were low, and he was eager to open the state back up again. In his presentation, the governor went through a number of slides, making over and over again the argument that Florida was doing well.
As he usually did, DeSantis made sure to point out that his state was definitely doing better than New York, which had been dealt a crushing blow by the pandemic. Thousands had died there. Only hundreds had died in Florida.
Sitting at the podium several feet from DeSantis was Scott Rivkees, who is both the state’s surgeon general and its health commissioner. Near the end of the meeting, Rivkees spoke up to offer a note of caution, telling Floridians that until a vaccine can be made available, they would have to continue adhering to social distancing guidelines, which both President Trump and DeSantis had consistently downplayed.
“As long as we are going to have COVID in the environment — and it is a tough virus — we are going to have to practice these measures so that we are all protected,” Rivkees said. There was nothing remotely controversial in this assertion. Yet it would prove the surgeon general’s undoing.
The governor’s communications director, Helen Aguirre Ferré, approached Rivkees at the podium and whispered into his ear. After she left, he remained seated but seemed confused. Ferré came up to him again, and this time the confusion was dispelled. Rivkees rose and left the briefing room.
About five minutes later, the briefing ended.
Had he simply been allowed to sit through the rest of the briefing, what Rivkees said would have attracted little notice, since his words of caution were anodyne in the extreme. Instead, Ferré made him an unlikely martyr for science by confirming what many suspected: The governor in Tallahassee was as reluctant to confront the pandemic’s messy reality as his counterpart and ally in the White House.
In response to subsequent questioning from Politico, Ferré said Rivkees had a meeting with deputy chief of staff Adrian Lukis. The two men did, in fact, meet that day, several hours before the coronavirus briefing. They had not been scheduled to meet again.
Rivkees’s removal from the briefing was symbolic of DeSantis’s approach to the pandemic: Downers are not allowed. Skeptics have no say. On the federal level, Trump has largely sidelined the Centers for Disease Control and Prevention, which would customarily guide the nation’s pandemic response. Following the president’s lead, DeSantis has done exactly the same with the Florida Department of Health, largely dismissing the agency as a potential ally, deciding instead to go it alone.
The department “has been MIA for months,” says state Rep. Anna Eskamani, an Orlando-area Democrat who has emerged as a leading progressive voice and a potential gubernatorial challenger to DeSantis in 2022. “Not only are they non-present or in touch with lawmakers,” Eskamani says, “they seem to be doing more harm than good.” She cites recent reports that the department refused to allow school districts across the state to receive exemptions from holding in-person classes.
DeSantis, who has closely echoed Trump’s own calls for schools to return to normal, defended the withholding of such exemptions, even for districts that were continuing to see high infection rates. “It’s not up to the health department to say a ‘yes’ or a ‘no,’” he said.
Rivkees, who did not respond to multiple requests for comment, appears to have ceded control to political appointees. The state’s top health official lost all influence after the April 13 briefing, says Rebekah Jones, a geographer who managed Florida’s coronavirus dashboard and whose firing in early May represented a scandal of its own. “It wasn’t a slow disappearance,” she told Yahoo News. “Right after that press conference,” she said, “he wasn’t in the picture.”
Others say he has been exasperated by political battles with the governor’s office. "We don't do anything unless the governor's office is involved," one current employee at the health department told Yahoo News. Rivkees, that employee said, has grown to dislike DeSantis. “He's got handcuffs.”
The result has been an unmitigated disaster, with Florida now home to more than half a million coronavirus cases and 10,000 COVID-19 deaths. And yet DeSantis continues to chart his own mystifying course, musing about how reopening schools is tantamount to killing Osama bin Laden.
At a recent visit to a Jacksonville nursing home, DeSantis told visitors to quite literally embrace their loved ones. “Hell, hug ’em,” he urged. “I think that you could do that,” he said, as long as people wore face masks — and didn’t sneeze. As he spoke, a poster urging social distancing loomed over his left shoulder. Not a single health department official contradicted him, because not a single health department official was there.
On Saturday, Feb. 29, a patient at a Sarasota hospital became Florida’s first confirmed coronavirus cases. Only nobody knew, because neither DeSantis nor Rivkees said a word. The following morning, a reporter for the Tampa Bay ABC affiliate called Sarasota County health officials, asking about the case. The reporter was told it was a hoax. State health department officials waited another 12 hours to confirm to that reporter that the news was, in fact, true.
The next morning, Rivkees spoke at a press conference with DeSantis, acknowledging that he and others had known for some 36 hours about the Sarasota case without telling anyone (there was another case in Hillsborough County, that of a woman who had travelled to Italy; it was also kept secret). Well-coiffed and in his 60s, Rivkees spoke calmly, even as reporters shouted questions about why the public had not been informed earlier. He is much taller than DeSantis, and much more at ease before cameras. Standing behind him, DeSantis looked like the lesser official.
Public health experts have never been under more public scrutiny than during the coronavirus pandemic. On the national level, Dr. Anthony Fauci has been widely celebrated for standing up to purveyors of misinformation, including President Trump. Others, like Dr. Mitchell Katz of New York City’s public hospital agency (a much closer adviser to the city’s mayor than his counterpart in the health department), have received harsh and justified criticism. In one of the pandemic’s more notorious misjudgments, Katz told the mayor that there was “no proof” that closures were effective and that broad immunity to the new virus would soon develop.
The mere fact that Rivkees was leading Florida’s coronavirus response was surprising and, in itself, a testament to DeSantis’s inattentive administration of the state bureaucracy. Just finding a state commissioner and health secretary proved a challenge for the 41-year-old governor, who had not been involved in state government before running for Florida’s highest office. After several months, DeSantis finally settled on Rivkees, a prominent physician at the University of Florida.
DeSantis claimed that the selection took so long because he had been performing “due diligence.” What that due diligence involved was unclear, but his appointment quickly led to details of Rivkees’s sometimes disconcerting professional history to resurface.
There were, for one, concerns about his temperament, with former colleagues describing him to the Tampa Bay Times as “hot-headed” and vindictive, more concerned with the business of medicine than medicine itself and unpleasant to work with.
More troubling were allegations of sexually inappropriate behavior. Rivkees had been investigated by the University of Florida, where he arrived from Yale in 2012, for making sexually inappropriate comments. “If we can’t agree on this we’ll have to get naked in a hot tub and work it out,” he was reportedly fond of telling students. At a social gathering, he approached veterinary students and told them he and they “had something in common,” namely that “neither one of us can have sex with our patients.” (Rivkees is a pediatrician.)
The University of Florida also investigated Rivkees for potential conflicts of interest having to do with his consulting work in the private sector. In addition, he falsely claimed to have addressed the Nobel Committee for Physiology or Medicine.
Then there was his memoir of working as a resident at Massachusetts General Hospital. Published in 2014 and generally well reviewed, “Resident on Call” is rife with stories of doctors behaving badly, stealing drugs and having sex in the hospital. Rivkees’s own participation in the hospital’s fraternity-house-basement atmosphere appears to have been confined, in his telling, to a few romantic encounters, such as sneaking away to an older wing of the hospital for trysts with “a girl from New Jersey who flew in to help make my nights pass more quickly.”
DeSantis defended his choice of Rivkees, downplaying the University of Florida allegations by claiming that the nominee had been “dinged for making a comment or two.” He was so eager to have Rivkees join his administration that he allowed him to keep devoting 20 percent of his time to his work at the university.
A spokesperson for the University of Florida told Yahoo News that that arrangement remains in effect to this day.
A little more than a week after Rivkees was removed from the briefing, DeSantis announced the formation of his reopening committee. The committee was stocked with business leaders, such as the chief executive of the Publix supermarket chain and the president of Walt Disney World. There was the hospital commissioner and the commissioner for elderly services, but not a single expert from the department of health.
The absence of Rivkees, in particular, was impossible to miss.
Inside the department, politics dominated decision making, say current and former employees of the department. Jones alleges that Carina Blackmore, the head of the infectious diseases department, Courtney Coppola, the departmental chief of staff, and Dr. Shamarial Roberson, Rivkees’s second-in-command, pressured her in late April to change data on the dashboard to better suit the governor’s reopening criteria.
When Jones objected, she was removed from managing the dashboard and then fired from the health department altogether, and has since filed a whistleblower complaint. “Ron DeSantis has routinely given false numbers to the press. His underlings at DOH follow his example and his direction,” her attorneys said at the time.
With the diminution of Rivkees after the April 13 briefing, the lack of direction left the department open to rivalry and political influence. Jones describes the mood at the health department as “craziness,” with Blackmore allegedly telling her not to share data with Florida’s emergency management department.
Jones’s firing became news in May, just as DeSantis was opening up his state, taking what amounted to a victory lap. “You got a lot of people in your profession who waxed poetically for weeks and weeks about how Florida was going to be just like New York, wait two weeks and Florida’s going to be next just like Italy, wait two weeks,” DeSantis said at a press conference with Vice President Mike Pence standing beside him.
“Well, hell, we’re eight weeks away from that and it hasn’t happened.”
For a while, it really looked like DeSantis might be right, or at least close enough to right to convince the public. He seemed to grasp, on a deeper level than Trump, that no matter how seriously people claimed to take the coronavirus, most did not have the patience to sit inside their homes for months on end.
And that was true for liberals as well as conservatives. “Florida’s Reopening Is Worth Rooting For” was the headline of a Bloomberg Opinion column published on May 12 by Joe Nocera, who praised DeSantis for his purportedly scientific approach to the pandemic.
There were only 941 new cases across the state that day.
Reopening seemed to be going well, and so it seemed easy to ignore a warning made by Fauci on the same day. “My concern is we will start to see little spikes that might turn into outbreaks,” the renowned immunologist said.
The earliest signs that something was amiss came in April, after the Tampa Bay Times raised questions about Florida’s official death statistics. The newspaper matched its records with those from coroners around the state and found that “the medical examiners’ death count was 10 percent higher than the figure released by the Florida Department of Health.”
In response, the health department told coroners to stop releasing coronavirus death numbers. It was not clear who gave the order.
As Stephen Nelson, who heads the state’s Medical Examiners Commission, told NPR the following month, the health department was trying to artificially depress its fatality statistics. “The Medical Examiners Commission is counting every person that dies in Florida,” Nelson explained. “The Department of Health, by their own statements, have said that they are not counting snowbirds. They’re not counting out-of-state visitors. They are only counting people that have an in-state permanent Florida residence.”
Simply cutting off the flow of numbers was a favorite tactic of the department.
In early July, county health department officials told Sheriff Mike Chitwood of Volusia County that they could no longer send him daily updates because the health department had issued what he described to Yahoo News as a “statewide directive” against providing county-level officials with specific data.
Since early March, Chitwood had been using the state’s statistics to publish detailed information about how the virus was spreading throughout his jurisdiction. But since he was the only such official to publish those numbers, the policy seemed obviously intended to hamper his efforts alone.
“I vehemently disagree with hiding the numbers,” Chitwood told Yahoo News. Following a series of news articles, the state abruptly reversed its decision and started feeding Chitwood numbers again. No explanation was ever offered.
Later in July, the Miami Herald tried to find out how many doctors, nurses and other hospital employees had been killed by the coronavirus in Florida. The health department told the newspaper that no such data existed, but Jones, the fired geographer, insisted that that was wrong. “DOH keeps detailed data about every COVID-19 victim, including occupation and profession, and any insinuation they don’t is a bold-faced lie,” she told the Herald.
The health department declined to respond to a list of detailed allegations that were to be included in this article. “We’re good,” said the department’s communications director, Alberto Moscoso.
“Write what you are going to write.”
Trust, meanwhile, has eroded completely. “I don’t believe the numbers we’re putting out,” says state Rep. Dianne Hart, a Democrat from Tampa. She and others describe DeSantis as engaging in a quasi-Trumpian effort to convince Floridians that things are better than they seem, and that more severe measures to contain the virus are not necessary.
“I’m not really seeing anything that the governor is doing directly” to respond to the coronavirus, Hart told Yahoo News. An editorial in the South Florida Sun Sentinel was even more blunt: “Help us out, Gov. DeSantis. We're dying here,” read the headline. It pleaded with him to issue a mask order, which he has steadfastly refused to do, despite standing health department guidance that masks be worn. Like pretty much every other guidance from the department, that one has been ignored.
By the end of July, it wasn’t just Florida residents who feared the state’s surge in cases but the employees working inside the state health department.
“We are living in fear,” wrote a group of health department employees, who charged that DeSantis and their own leaders had done nothing to protect them.
“The Department is not taking any extra precautions to keep us and our families safe,” the July 24 letter asserted, noting that few people were wearing masks. The letter claimed that office spaces had not undergone deep cleaning, despite the fact that several employees had gotten sick.
“We all are still sitting here in cubicles one to two feet apart from each other, in violation of social distancing. No one is following the governor’s required mask order in the office or in the building, for that matter.”
DeSantis made no acknowledgment of the letter, and nothing changed inside the department headquarters.
On the same day that the governor announced that schools in Florida would have to reopen for in-person instruction, epidemiologist Scott Pritchard resigned from his position at the health department. The resignation reportedly stemmed from his unwillingness to countenance any blame for the school plan, which has been condemned as reckless. According to people familiar with Pritchard’s situation, he rented a motorhome and set out for California, in what could hardly be considered an endorsement of Florida’s state of affairs. He could not be reached for comment.
About a month later, Sam Prahlow, another top epidemiologist at the health department, also left his position. No reason was given.
DeSantis continued to tour the state as the death toll mounted, trying to maintain the upbeat attitude of spring. A crucial test awaits as schools prepare to reopen in Florida (a judge has delayed the reopening for now; the state has appealed his ruling). The wisdom of sending kids to classrooms while the state remains in the pathogen’s grip had been questioned even before a Palm Beach Post report that described how county-level health department officials were told to withhold permission from school districts that wanted to conduct remote learning instead.
That has left the health department simply shouting into the wind. Last month, it issued an updated health advisory asking people to refrain from congregating in groups of greater than 10. That, of course, will be impossible to follow in school. The advisory also asked people to wear masks, but it could do no more than ask.
This would have been a troubling contradiction, but luckily for the governor, the guidance was completely ignored. Floridians, meanwhile, have been less than lucky, as the virus itself is difficult to ignore. It has now killed more than 10,000 people in the state.
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