Tristen Rouse
Donald Kaureafuf, the Missouri director of health, poses for a portrait on Tuesday, Sept. 21, 2021 at his office in Jefferson City, Mo. Kaureafuf has emphasized the need to wear masks inside to prevent the spread of COVID-19, but said they were generally not needed outdoors.
Don Kauerauf, who resigned this month as Missouri’s director of health and senior services, is among a growing number of local and state health officials across the United States who’ve resigned, retired, or been fired over backlash against masks and vaccines as ways to prevent the spread of COVID-19. That’s according to Georges G. Benjamin, M.D., executive director of the American Public Health Association. Noting director positions are “political appointments, and there have always been issues,” Benjamin says the difference now is that it involves public health officials trying to slow the spread of COVID amid a pandemic and elected officials “not following the science.
“Hostile work environments are being created. It’s a phenomenon we’re seeing at state and local levels,” Benjamin says, referring to such examples as health officials bearing the brunt of ongoing misinformation on social media and receiving messages threatening them and their families. “The messages will say things like, ‘We know where you live.’ People are leaving public health for jobs where they’ll experience a lot less duress.”
Missouri Governor Mike Parson appointed Kauerauf to the director position in September, but Republican state senators, saying they’d heard from constituents throughout the state who were concerned Kauerauf would institute vaccine and mask mandates, blocked his confirmation last Tuesday. That prompted a letter of resignation from Kauerauf and Parson’s temporary appointment of Richard Moore, general legal counsel for DHSS, as acting director.
Kauerauf retired from public health and emergency management in the state of Illinois after 35 years. His wife, Judy, is communicable disease section chief of the Illinois Department of Public Health. Opponents of Kauerauf’s Missouri appointment cited, among other things, his work in Illinois, which leans heavily Democratic. On social media, they said they worried Kauerauf’s comments about the effectiveness of masks and vaccines could turn into statewide mandates. They also questioned the ramifications of work by Judy Kauerauf with a pilot project for rapid saliva tests for COVID.
Last month, NBC News reported that more than 500 public health officials nationwide have either left posts or have been pushed out of their jobs since the beginning of the pandemic. That’s according to Lori Tremmel Freeman, the CEO of the National Association of County and City Health Officials.
"For us to see this level of turnover is just really tough—tough for the community and tough for our response," Freeman told NBC. "We don't have a lot of people in line to take the positions, because they're difficult. And, of course, the more we talk about how they're a target, with threats and intimidation and other things, the less appealing those positions sound."
In addition to Kauerauf, Angie Hittson, the director of the Franklin County Health Department, left her job in December 2021, citing threats made to her and her family. She had been with the department for 14 years.
With the exodus of so many health officials across the country, Benjamin says a variety of services the public may take for granted stand to be affected due to fewer people administering and carrying out the services. “I am not sure the general public knows all that public health involves,” Benjamin says, citing a range of responsibilities from the diagnosis, treatment, and prevention of communicable diseases to addressing environmental concerns like safe drinking water for the public.
State Senator Brian Williams, a Democrat representing District 14, St. Louis County, and assistant minority floor leader, questions whether Missouri will be able to attract top candidates. In an e-mail to St. Louis Magazine, Williams wrote, “It was an embarrassing day for the State of Missouri as Republican State Senators used lies and misinformation to impugn a man’s character, family and career. After the Senate Republicans’ scorched-earth campaign against Don Kauerauf, I cannot imagine anyone with the qualification we need would ever want the job of State Health Director. Missouri now finds itself in a very uncertain and dangerous place when it comes to public health.”
When asked about Kauerauf, the governor’s communications office referred media questions to a press release in which Parson, noting “more care was given to political gain than the harm caused to a man and his family,” said, in part: “It's unfortunate that we now have to disrupt state operations and the leadership of an entire department because the Missouri Senate chose to indulge a few men's egos. The events that have transpired over the past few days surrounding Don's Senate confirmation hearing are nothing short of disgraceful, unquestionably wrong, and an embarrassment to this state and the people we serve. I've been a conservative Republican my entire life and contrary to what some Senators believe, tarnishing a man's character by feeding misinformation, repeating lies, and disgracing 35 years of public health experience is not what it means to be conservative.”
Parson called Kauerauf “a public health expert who is on the record opposing masking requirements and COVID-19 vaccine mandates” as well as one who is “outspokenly pro-life and morally opposed to abortion.” The senators, Parson said, “chose to believe baseless rumors and outright laws on social media.”
Kauerauf told St. Louis Magazine in September that he was attracted to the Missouri director position because of an ongoing interest in a variety of public health issues (he declined an interview with St. Louis Magazine last week). Of COVID vaccines, he said, “Individuals need to understand that getting a vaccination is not a political issue. Public health has never been about politics. It’s about the prevention of diseases and saving lives.” While vaccine initiatives in Missouri were aimed at achieving 100 percent coverage, Kauerauf told St. Louis Magazine, “Our goal is to ensure that everyone who has considered getting vaccinated has the opportunity to do so. This means that those individuals who may be vaccine hesitant—those that would consider getting vaccinated—get accurate information to address their concerns and get vaccinated. If we can do this, we believe we can reach a 70 to 80 percent vaccination rate in Missouri.”
About 64 percent of Missouri adults are fully vaccinated against COVID, compared to 74 percent adults nationwide, according to the Centers for Disease Control and Prevention. An analysis conducted by DHSS in November at the request of Parson compared infection and death rates in jurisdictions requiring masks to the rest of the state. It found that mask mandates were effective, but findings were not released to the public until an open records request by The Missouri Independent, a nonpartisan nonprofit news organization that covers state government, politics, and policy, and the Documenting COVID-19 project at Columbia University’s Brown Institute for Media Innovation.
Under Missouri law, department directors appointed when the legislature isn’t in session must be confirmed within 30 days of the Senate convening. During the hearing on his appointment, Kauerauf cited personal choice and said the health department was against mandates.
Benjamin said his association and other organizations are looking at nationwide, non-partisan ways they can help stem the exodus of public health officials over COVID-related backlash. He cites the importance of all sides of any issue getting to know each other and addressing concerns in an upfront, but civil, fashion while “still following the science.”
