As vaccine mandates collapse amid worsening pandemic in Kansas, what is the public health response?

The coronavirus pandemic is worsening in Kansas as courts have blocked implementation of federal COVID-19 vaccine mandates and state politicians made it easier to get exemptions.

Data show cases rising week after week. Doctors say COVID-19 hospitalizations are rising. Medical officials have been left to plead with people to get vaccinated to protect both themselves and their community.

"Get vaccinated," said Steve Stites, the chief medical officer at The University of Kansas Health System. "That will be the greatest gift you can give to anyone throughout this holiday season."

Less than half of all Kansans are fully vaccinated, according to the latest Kansas Department of Health and Environment report, while government-mandated public health mitigation measures have mostly fallen to the wayside.

Republican Attorney General Derek Schmidt signed Kansas onto a trio of lawsuits that have successfully blocked implementation of federal vaccine mandates — at least temporarily.

The federal lawsuits, led by attorneys general in other states, have won temporary injunctions against two of Democratic President Joe Biden's vaccination mandates. A third judge's order could be on the way after a Friday court hearing.

Last month, the GOP-controlled Legislature forced a special session on COVID-19 vaccine mandates. Democratic Gov. Laura Kelly signed the bill, which makes it easier for workers to get religious and moral exemptions, among other provisions.

Meanwhile, the Kansas Supreme Court has yet to rule on the constitutionality of a state law making it easier for aggrieved citizens to challenge county and school mask mandates and other mitigation measures.

More: Kansas Supreme Court indicates it could punt on whether a key COVID-19 law is constitutional

Many schools have dropped mask requirements — or never imposed them in the first place — despite evidence that mandatory masking reduces spread and helps schools stay open. Some districts with outbreaks have had to close schools.

Meanwhile, state politicians have offered few new ideas as existing strategies fail to prevent a new wave of COVID-19 cases and hospitalizations.

Public health strategy

Kelly avoided reporter questions on the special session bill while at a Christmas tree delivery to the governor's mansion last month. The governor has not held a Statehouse press conference on COVID-19 since late July, during the early days of the delta variant surge.

Last week, after a Hanukkah celebration at the Statehouse, Kelly was asked whether she is concerned the new law could undercut the state's vaccination efforts amid the emergence of the omicron variant.

"I really hope not," Kelly said. "We have tried to stay as focused as we possibly can, just on getting people vaccinated without mandates, and we will just continue that. Much like the delta variant, the fact that there's a new one will awaken some people."

"The only way we're ever going to get out of it and get to that steady state is by more people getting vaccinated," she continued.

But the state's vaccination rate has remained stagnant in recent months, even as the pandemic has worsened in recent weeks. Between Sept. 1 and Dec. 1, the percentage of all Kansans who are fully vaccinated rose from 45.8% to 49.2%, according to KDHE data.

Federal data reports slightly higher rates of fully vaccinated people for Kansas, from 48.4% to 54.7% for the same time period.

More: New COVID wave hits Kansas as post-holiday data show worsening pandemic: 'We're just asking for trouble'

With the current strategy appearing to no longer be working, what is the governor's message?

"We have been very consistent in the messaging that the vaccines are safe, vaccines are readily available and they're free," Kelly said. "So we will just continue to emphasize that, continue working with our community partners."

When asked how state and local governments should respond to the worsening pandemic, Republican leaders agreed that health officials should share information and trust Kansans to use it.

"Attorney General Schmidt believes the appropriate role of state government in COVID response is to provide to Kansans the best available information, trust Kansans to make the right decisions with that information, and be ready to respond quickly and efficiently to requests from local authorities for resources," said gubernatorial campaign manager CJ Grover.

"He encourages vaccination but opposes vaccine mandates. He believes Kansas must not repeat the damaging mistakes of its past COVID response — no more lockdowns, no more business shutdowns, no more school closings."

Senate President Ty Masterson, R-Andover, "believes that state and local government should focus on providing reliable information to the public, and then trusting individual Kansans to make their own health care decisions," spokesperson Mike Pirner said in an email.

House Speaker Ron Ryckman, R-Olathe, said in a statement that the government's role is to provide access and information.

"That means continuing the work that our state and local governments are doing to make free vaccinations readily available in every community, and providing open, honest information to Kansans," Ryckman said. "What government must avoid is the mandate mentality."

Federal COVID response expands

Despite legal setbacks on vaccine mandates, Biden has pressed onward with a federal public health response to the pandemic.

On Thursday, Biden announced a plan to combat COVID-19 this winter. The strategy includes expanded vaccine access for children and boosters for adult, free at-home rapid tests, masking on public transportation and supplying treatment pills, among other provisions.

More: As omicron fears grow, COVID-19 once again spoils Biden's plan to push his legislative agenda

"Experts say the COVID-19 cases will continue to rise in the weeks ahead this winter, so we need to be ready," Biden said.

Recently, Kelly has been critical of the federal government usurping the state's lead in fighting the pandemic.

For months, she took no position on federal vaccine mandates. But in November, she said such mandates "tend not to work" in Kansas, despite the existence of inoculation requirements for other diseases.

Instead, she promised to "seek a resolution that continues to recognize the uniqueness of our state."

Despite rising coronavirus rates when the special session met, most lawmakers showed no interest in addressing the pandemic. At one point, Senate GOP leadership shot down a proposed amendment that would have made it easier for railroad workers to get vaccinated.

Sen. Kellie Warren, R-Leawood, said the proposal was not germane, in-part because the bill focused on worker exemptions and "does not discuss what to do if you are an employee who wants to go get the vaccine."

'Defending that liberty' to die

There has long been consensus that one-on-one conversations with a personal physician are the best way to convince the hesitant to get vaccinated. But not enough people have changed their minds to reach herd immunity, which epidemiologists have estimated could require between 70% and 85% of people — or more — to get vaccinated.

U.S. Sen. Roger Marshall, R-Great Bend and an OB-GYN, has said he has "no words" to convince unvaccinated people to get the shot.

"That ship has sailed, the people in this room have made up their mind," he said after an October meeting in Topeka with union workers opposed to compulsory vaccination.

A large swath of the population continues to reject the vaccines, despite assurances from medical experts that the vaccines are safe and effective.

Sen. Dennis Pyle, R-Hiawatha, invoked Revolutionary War hero John Paul Jones and Founding Father Patrick Henry to emphasize a willingness to fight for freedom during the special session.

"There are people that do not want to take this vaccine, even at the expense of their own lives," Pyle said during a floor speech. "So we're here defending that liberty."

More: 'Medical freedom' isn't an American value. The Founders promoted vaccines and public health.

Vaccination isn't simply about the life of the individual, though.

"Nobody likes mandates," former KDHE secretary Lee Norman tweeted last week. "But I fail to understand why healthcare and nursing home staff don’t feel morally obliged to be immune to COVID-19 in order to protect the people in their care. Get vaccinated!"

More: Vaccinated residents die in COVID cluster at Kansas nursing home with low staff vaccination rate

Norman was forced out of the Kelly administration last month amid disagreements with the chief of staff over a desire to be more transparent with information on the pandemic.

The governor's office has since appointed a new secretary, who takes over as the agency eyes an immediate surge in the pandemic and a transition to a more endemic response.

COVID pandemic turning endemic

"The reality is we're somewhere between a pandemic, which we still have, and endemic SARS-CoV-2," said Stites, the chief medical officer at The University of Kansas Health System, during a Wednesday briefing.

The goal, he said, is to minimize the impacts so life can return to something closer to normal. He advised wearing face masks and getting vaccinated.

"I think the idea of eliminating SARS-CoV-2 right now is probably going to be difficult because it's mutated so many times already and we never got the world vaccinated," he said. "I think unless we're willing to really make a commitment to vaccinating everybody, it's going to be difficult for us to see an end to it. We just want to have a controlled endemic."

Bob Moser, dean of the Salina campus of the KU School of Medicine and a former KDHE secretary, said not enough people are vaccinated.

"It's not where we'd like to see it," Moser said of the vaccination rate. "It seems like we get a little bit of an uptake when we see a bump in, unfortunately, the number of local deaths. That seems to draw a little bit more attention that it isn't going away.

"It's here, it's a pandemic, it's going to continue to mutate, we're going to continue to see problems unless we get our handle on it. The public health measures that we've all been promoting ... the vaccinations, we've got all the measures to mitigate. But we've got to have participation."

The flu is starting to compound the problem, Stites said, unlike last year "when we had a get out of jail free card with no influenza in our hospital."

Rural hospitals are again starting to experience difficulties with transferring COVID-19 patients to larger facilities, said Jodi Schmidt, executive director of the health system's Care Collaborative.

"Folks are feeling that this winter is going to be a tough one out in the rural communities," she said.

Jason Tidd is a statehouse reporter for the Topeka Capital-Journal. He can be reached by email at jtidd@gannett.com. Follow him on Twitter @Jason_Tidd.

This article originally appeared on Topeka Capital-Journal: As COVID worsens, what are Kansas politicians doing on public health?