One Kansas doctor’s call: COVID-19 carnage demands national vaccination strategy

Former health officer says unfair to ask 3,000 local agencies to cope

Gianfranco Pezzino, the former Shawnee County health officer, says United States needs to implement a national strategy for vaccinating people for COVID-19 because a decentralized process will lead to missed opportunities to help people. (Noah Taborda/Kansas Reflector)
Gianfranco Pezzino, the former Shawnee County health officer, says United States needs to implement a national strategy for vaccinating people for COVID-19 because a decentralized process will lead to missed opportunities to help people. (Noah Taborda/Kansas Reflector)

TOPEKA — Former Shawnee County health officer Gianfranco Pezzino said COVID-19 exhibits hallmarks of national calamity — death on a profound scale, sky-high unemployment, collapse of businesses, political unrest and demand for massive federal aid.

But, Pezzino said, the fractured response of the United States government to the disaster hasn’t matched the scope of the challenge. Evidence is the wild approach to acquisition of protective gear, imprecise adoption of a testing system and stumbles with vaccinations aimed at 328 million people in this country. Congress and President Donald Trump appropriated trillions of dollars in relief since March, but left big decisions to states. The Kansas Legislature, in turn, decided key responsibilities managed by Gov. Laura Kelly should be handled by the state’s 105 county commissions.

“A simple way to put it is that this is a national catastrophe and it requires a national strategy,” said Pezzino, who served 14 years as Shawnee County’s health officer before stepping down in December.

“It cannot be done one county at the time,” he said. “We have about 3,000 local health departments in this country. We can’t leave each of those 3,000 departments to decide what needs to be done in their own community.”

Pezzino took the long route to the Kansas. He grew up in Italy and graduated from medical school there before working in Africa, earning a master’s degree in public health at Johns Hopkins University, serving at the U.S. Center for Disease Control and Prevention, and accepting a job as Kansas Department of Health and Environment’s first state epidemiologist in 1994. The doctor started as Shawnee County’s health officer in 2007.

On the Kansas Reflector podcast, he said the nation should appreciate the remarkable speed with which coronavirus vaccines were developed. The vaccination phase has been a struggle, he said, but people must be patient.

“This is a humongous undertaking. We have never, never in recent history vaccinated our entire population twice. Never done it. So, it’s understandable. Things are not going exactly how people hope. We need to be patient,” Pezzino said.

The Kansas Republican Party and others have denounced the Democratic governor for the pace of inoculation. Kelly said the state’s focus was on getting vaccine in people’s arms rather than reporting progress. In recent weeks, Kansas’ reported vaccination rate has improved.

 

Tough job

Pezzino declined to go into detail, but early in the pandemic he was threatened by a person who appeared to have mental health issues. He said county health officers around the state were emotionally and physically threatened by people unhappy with mandates on businesses operations and large gatherings as well as orders requiring social distancing and face coverings.

The job of county health officer isn’t considered glamorous, he said. Sometimes, he said, county officials beg local doctors to pitch in. As COVID-19 spread deeply into Kansas, Pezzino said, public responses became more vicious. Some health officers resigned rather than absorb the harassment.

“I learned that rural communities can become really hard places to live in a situation like this,” Pezzino said. “It was hard enough for me being part of the city of Topeka, but for some of my colleagues in a rural community, they had to go against the same buddies that they went to high school with or that they go to church with or whose children play together in high school.

“It’s a very close community, and all of the sudden those are your friends or relatives or neighbors that you have to turn to and say, ‘You got to do this. And, if you didn’t do it, then you’re violating the law.’ Then, you become the enemy,” he said. “It’s really, really hard to do.”

 

Early departure

Pezzino was scheduled to retire in December from his position as health officer in Shawnee County, but resigned two weeks early to protest the Shawnee County Commission’s decision to reject his public health recommendations. He said the adjustments weren’t dramatic but, the time had come to shock the county’s political system.

“I decided that I just couldn’t work for the commission that was putting local business interests ahead of the health of the citizens,” he said.

In mid-2020, the Kansas Legislature passed a bill updating the state’s disaster response law. It was originally intended to help with isolated natural disasters rather than pandemics.

The new law specifically addressed COVID-19, but the GOP-led Legislature also limited the governor’s authority to issue statewide mandates. County commissioners were given power to reject executive orders on business openings, mass gathering and on mask orders.

“That was really a game changer. Because now all of a sudden, my main concern couldn’t be just what’s best for the Shawnee County community from the public health protection point of view,” Pezzino said. “Elected individuals were given a responsibility that they weren’t ready to have.”

 

Conclusions

Pezzino said the public needs to accept COVID-19 won’t give up easily.

“The virus that causes COVID-19 disease is probably going to stay with us for the foreseeable future. All we can hope is that we’ll be able to contain the effects through the use of vaccine and containment measures,” he said.

He said the pandemic taught him something about himself and about Kansans, despite having lived in the state a quarter century.

“I learned that Kansas can have a very big heart. I know that the vast majority of people wanted to do the right thing. They were afraid. They still are. They want clear directions from a reputable source, and they want to stick to those directions,” he said. “I also learned that when politics start interfering with those directions, that’s when everything falls apart.”

“I never thought that I could tire out of a job in public health,” he said of personal toll of the pandemic. “I became tired not just physically, I became tired emotionally. I realized I didn’t have the energy for this job anymore. And, so, I hope the county can find someone who can bring some fresh energy because it takes a lot.”