Fine & Landekic: Dan McKee’s public health failure cost many lives
“Sometimes, leadership means making unpopular choices in the service of the common good. Some people may argue that keeping the economy [open] served that common good. But we disagree…”
There are many claims and counterclaims being made in the race for the Governor of Rhode Island. Politics makes for strange bedfellows, and strange twists on the truth. Pundits maneuver and manipulate for advantage, inventing some facts and distorting others, as they prey on the fears and biases of the voters to create advantage for themselves and to portray themselves in a good light.
We don’t have special knowledge about much of public policy. But we do have expertise in medicine, bioscience and public health, and have followed, and commented on, the COVID-19 pandemic day by day, so feel qualified to offer judgement on Governor Daniel McKee’s claim that he ‘managed’ the COVID-19 epidemic well because Rhode Island’s vaccination rate is the highest in the nation, and our recent mortality rate is one of the lowest in the nation.
True enough, those ‘facts’. But what those ‘facts’ obscure is that Rhode Island still has the second highest rate of total infections in the country, and a very high total mortality rate (3,432 per million, 21st in the United States but three times the mortality rate in Hawaii and Vermont, states with similar immunizations rates and good health care systems like ours – about seven times the morality rate in South Korea and ten times the morality rate in Taiwan and Japan, industrialized democracies where the pandemic was well managed.)
Even worse, we watched in horror as Governor McKee failed to lead in the fall of 2021. We saw community transmission beginning to rise in August of 2021, and saw it become very high, by late October of 2021, even before Omicron arrived here. This data was publicly available. It was displayed daily in the New York Times, and many other places. If the Governor had acted then and required masking in public places, dialed back some segments of the economy (like bars and restaurants) and used federal funds to compensate their owners and workers for income lost, evidence suggests Rhode Island would have saved between 250 and 500 lives. Instead, the Governor ‘kept the economy open’. By the time he instituted a half-hearted (and meaningless from a public health perspective) four-week mandate for masks in public venues with over 250 people, it was too late. Omicron was out of control. It would kill 558 Rhode Islanders.
If the Governor had acted then in the interest of the public’s health, we would have likely cut the number of people who were infected in that period at least in half. Nearly 60% of all COVID infections in Rhode Island happened over just the four months of last winter’s Omicron surge: 237,415 tested positive but likely two or three times that number or even more were likely infected. We would have had half or fewer hospitalizations, and half the number of people developing Long COVID, (now thought to represent about 20% of cases), and saved much misery, heartbreak and expense, had Governor McKee acted to protect the public’s health.
Masking was unpopular. Although the Center for Disease Control continued to recommend masking for places with high levels of community transmission, no other New England governor mandated masking (although California and New York did.)
We’ll never know how much the Governor’s desire for election trumped his responsibility to protect the health and safety of the people of Rhode Island. But we know this: in December of 2021, and in January and February of 2022, 558 Rhode Islanders died of COVID-19, and many, if not most or even all those deaths were preventable.
Two Directors of the Rhode Island Department of Health chose not to work under Governor McKee’s leadership. The Governor failed to do what was necessary to create an appropriate salary for the Director in the last legislative session, leaving the Director of the Rhode Island Department of Health among the lowest paid physicians in state government, a situation that will make the hiring of a new permanent director difficult if not impossible – and illustrates the importance that the legislature and the Governor give to public health – slim to none.
Sometimes, leadership means making unpopular choices in the service of the common good. Some people may argue that keeping the economy open served that common good. But we disagree. Keeping the economy open at the expense of the lives of so many Rhode Islanders represented a failure of leadership. If human life isn’t valued by our leaders, why are they in office?
Michael Fine, MD, is an author, family physician, the Director of the Rhode Island Department of Health from 2011-2015, and lives in Scituate, RI. Nick Landekic, MA MBA is a biotech CEO and entrepreneur who lives in Bristol, RI.