The intersection of politics and public health has led to volatile and divisive outcomes. The seeds of doubt sewn two years ago by then-President Donald Trump have blossomed into full-fledged scenarios where medical scientists are seen as villainous arbitrators of draconian public safety measures that harm the economy.
Many health officials are ridiculed by right wing media and lambasted at community and at public school meetings. In a bizarre world where people rely on politicians for leadership during the pandemic, it’s understandable if public health officials are hesitant to contradict the political missives of local, state, and federal politicians.
Not so for Dr. Faisal Khan, acting director of the St. Louis County Public Health Department. Khan spoke with the St. Louis American after Gov. Mike Parson ended the state’s emergency responses to the pandemic.
Khan feels he has no choice but to take an oppositional stance, especially after the governor downgraded the state from pandemic status to an “endemic” recovery stage.
“I don’t have any other mode,” Khan said, explaining his conflicting attitude. “This is not the time to declare premature victory over COVID and say the crisis is over. It most certainly is not. The pandemic is still with us.”
To emphasize his concern, Khan pointed to the more contagious Omicron sub-variant, BA.2, which has already become dominant in China, Europe and spreading to the U.S and many other parts of the world.
“Current data nationwide tells us that almost 72% of new cases being diagnosed are related to BA.2, which means there’s a high level of community transmission taking place,” Khan warned.
“We simply have no idea what might happen in a few weeks or in a couple of months. This is definitely not the time to send people the wrong message about being complacent and letting our guards down.”
On Tuesday, the Centers for Disease Control and Prevention reported a subvariant, called BA.2.12.1, an offshoot of the BA.2 version of omicron, now accounts for roughly 1 in 5 new cases nationwide.
The majority of cases in the U.S. are still caused by BA.2., which has been the country’s dominant variant since late March.
Parson’s announcement came at a peculiar time. According to John Hopkins Coronavirus Research Center, Missouri, to date, has had more than 1 million confirmed coronavirus cases with more than 20,000 deaths.
As part of his pronounced “transition stage,” Parson, a Republican, said the state will “discontinue detailed, county-level and individual case reporting.”
Last year, the Americaninterviewed several St. Louis County health department officials who commented on the importance of their data-driven work. Khan re-emphasized his department’s role.
“Data-collection happens locally and on the state level. From a public health perspective, the data we collect allows us to characterize the disease and what it’s doing and how it’s spreading in our communities and across the state,” Khan said.
Parsons’ declaration will be carried out through the state Department of Health and Senior Services (DHS). Local health departments, like St. Louis County’s, can still carry out daily COVID assessments. But not being able to coordinate local and state outcomes, Khan said, can be problematic.
“One of the things DHS will no longer do is collect and report on the metrics that we’ve all been accustomed to following that characterize the pandemic. This means that two years of hard work in strengthening the disease surveillance system will suddenly be mired in confusion and weakness,” Khan explained.
“That (announcement) is disappointing because there will be activities the state will no longer invest in or continue which means local health departments will have to pick up the burden and continue to do whatever we can. It’s not ideal and it does not help.”
At the local level, Khan stressed, his team is determined to remain vigilant.
“Unlike others, we don’t have the luxury of hiding in our offices. We serve the public directly, locally. It’s where we live and breathe. So, we have to provide answers and explain disease statistics and the big picture of the disease in our community,” he said.
In backing Parson’s COVID crisis announcement, Paula Nickelson, acting director of DHS, said the decision to reduce reporting on COVID-19 statistics is justified because “the science doesn’t support” such data-driven analysis.
Khan breathed deeply when asked to respond to the comment.
“I don’t understand that statement. All I can do is just laugh at it,” Khan responded.
“If you ask any scientist or epidemiologist, they will say ‘what are you talking about?’”
Data collection not only identifies COVID’s impact and mutations, Khan added, it has also exposed massive disparities in the healthcare system.
“Just look at what the African American population in St. Louis County has experienced. It’s there for all to see, Khan said before citing several examples.
“A recent report stated that older Black Americans (between 65 and 74 years of age) were five times more likely to die (from COVID) than white Americans. Additionally, between April 2020 and June 2021, 1 in 310 Black children lost a parent or caregiver compared to 1 in 738 white children and that’s just one huge disparity.”
Khan also took issue with the governor’s decision to downgrade the virus from a “pandemic stage” to an “endemic” phase.
“The word ‘endemic’ is a scientific term. It means a disease has regressed back to a baseline of what we would consider a normal/usual existence, like West Nile or Lime diseases,” Khan said.
“Are they major threats to public health? Not really. But the problem with COVID is that we don’t know what the baseline normal is yet. So, using that word and saying we’re ‘transitioning to an endemic stage means nothing and it’s frustrating to even hear.”
Khan has walked the intersection of politics and public health often in his career in St. Louis health. He worked as the director of communicable disease control and was acting director for the county department of public health from 2010 to 2015. After he was appointed public health director, he resigned in frustration in 2018 after the county council forced him to trim his budget by more than $8 million which, Khan said, held up several contracts with his department.
Last year, Khan was in the news again after he was met with hostility and disdain from audience members and council members at a St. Louis County council meeting where he was invited to talk about reintroducing mask mandates in response to rising COVID cases in the county.
In most cases, Khan said, politics and public health are complimentary.
“The two work well together and depend on each other. It is sad and disappointing, however, when the worst public health crisis in over a century has become politicized. This virus does not discriminate. It doesn’t care what your political opinions are. It affects everyone regardless. When people use political rhetoric to attack us, they’re not doing anything useful, they’re actually creating more problems than there ought to be.”
According to Johns Hopkins, less than 60% of Missouri residents are fully vaccinated, a number Khan and other health officials wish was much higher. Only about 30% of Missourians eligible for boosters have had their shots, Khan said. Khan said Parson’s premature announcement of COVID’s ending, will not help boost vaccination results.
“We still don’t know yet what the full picture of immunity related to the full vaccination series looks like because boosters are a necessary part of that series. You can’t just stop at your first or second shot,” Khan said.
“Uptake has been slow and such preannouncements could increase a sense of complacency where people may feel ‘well, I don’t need to get vaccinated or complete my shot series because the chief executive (of the state) said the crisis is over.’
“That is frustrating because we’re in the middle of the pandemic, not at the end of it.”
Sylvester Brown Jr. is The St. Louis American’s inaugural Deaconess Fellow.