ORLANDO, Fla. — The suspension of Orange County’s Dr. Raul Pino — after urging his health department staff to get vaccinated against COVID-19 — is the most blatant example yet of the state’s increasingly tight muzzle on health authorities fighting the pandemic, critics say, making Florida one of the most repressive in the nation when it comes to public health matters.
According to six sources, including former Florida Department of Health employees, the state in recent years has required even the most mundane public statements to be approved by administrators in Tallahassee. And previous governors have been known to forbid county-level health workers from speaking in public forums on such topics as climate change.
But the heavily politicized COVID-19 pandemic appears to have brought a new level of scrutiny.
“This (suspension) is just shocking and dismaying,” said Dr. Leslie Beitsch, who worked for the Florida Department of Health for 12 years before joining the faculty at the Florida State University College of Medicine. “It starts with a callous disregard for science, and quite frankly it can have a dangerous chilling effect” as important health information is stifled.
Brian Castrucci, president and CEO of the Maryland-based de Beaumont Foundation, which advocates for improving community health programs, called the move “immoral and unethical — but legal.”
“This is a pretty blatant move to silence a state employee,” he said. “They are preventing him from doing his job. They are preventing him from protecting the public. And they’re doing it to advance a political agenda. This is chilling for any public health leader in the state of Florida.”
Pino, 58, became a respected voice of the pandemic response in the nation’s tourism capital, often appearing alongside Orange County Mayor Jerry Demings, a Democrat, at news conferences. He was placed on paid administrative leave from his post as the state’s chief health officer in Orange County after a health department employee complained about an email Pino sent to staff.
Pino’s Jan. 4 message, titled “Concerned for us and our families,” came a day after a prenatal clinic run by the health department had to cancel all appointments because too many workers were absent, presumably because they had tested positive for COVID-19 or were out sick.
“In order to have a better picture on how this current wave could affect us and the people we served, I ask(ed) our analyst to run vaccination data for our (employees),” Pino wrote. “Shocker! ... We are not even at 50%.”
Less than 39% had been fully immunized, and less than 14% had received a booster, he wrote. “I have a hard time understanding how (we can work) in public health and not practice it!”
Earlier this week, Florida Department of Health spokesperson Weesam Khoury said the department is investigating whether any laws were broken, adding, “The decision to get vaccinated is a personal medical choice that should be made free from coercion and mandates from employers.”
Pino said he could not comment for this story. The state Department of Health did not respond to questions on the situation and a request for comment.
Last fall, Gov. Ron DeSantis signed a law prohibiting state government agencies from implementing vaccine mandates, and Florida’s Agency for Health Care Administration has warned health care providers in the state that they may face fines if they comply a federal vaccination mandate for health workers that is expected to overcome legal challenges.
That would almost certainly mean a showdown between the federal and state government over COVID-19 vaccinations, including those for Florida Department of Health employees that staff medical clinics and COVID-19 testing and vaccination sites.
Although the pandemic has spawned national political divides over a range of public health issues — masks, lock-downs, vaccinations and even the seriousness of the virus — the tensions in Florida tend to run higher. For one, Gov. DeSantis has disagreed sharply with federal health officials, including those at the U.S. Centers for Disease Control and Prevention, on how to respond to the spread of the virus.
But Florida’s public health system is also set up differently than those in most of the nation. While some health-related duties are left to the counties — care for jail inmates, restaurant inspections and some primary-care clinics, for instance — the response to infectious disease is led by the state.
“Across the country, the majority of states have a decentralized model, where the local health departments and the state health departments are independent entities,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials. “Any time that politics intersects with public health like this, it impacts how the local experts can do their jobs.”
The chief health officer in each county reports to the state’s surgeon general — currently Dr. Joseph Ladapo, a controversial figure who has sparked outrage with statements against masks and mass COVID testing.
“If Gov. DeSantis wants a particular policy for public health, he’s going to get it and nobody in the state is going to push back,” said a former high-ranking Department of Health employee, who spoke on condition of anonymity because of fear of reprisal by his current employer. “That just wouldn’t happen in a lot of states.”
But Florida is certainly not alone in butting heads with health officials.
Last summer, Tennessee’s top vaccination officials, Dr. Michelle Fiscus, a pediatrician, was fired after Republican lawmakers protested a letter Fiscus sent to medical providers explaining the legality of allowing them to vaccinate children 14 and up without parental consent. The state’s health department did not comment on the reasons behind the move.
Elsewhere, public health workers have faced a barrage of verbal attacks from lawmakers and threats of violence from the public. Nationally, more than 500 local health officials have left their jobs since the beginning of the pandemic, either because they were forced out explicitly or felt railroaded or burned out.
“Seeing that much turnover in local health departments is particularly rare and alarming,” Casalotti said. “What we are losing is experience that’s critical not just to get us through this pandemic, but also to help us rebuild and recover and prepare for whatever the next crisis is.”
Part of the solution should be a separation between elected officials and public health leaders, Castrucci said.
“The question for anyone working in public health these days is: Is your priority the politics or the people?” he said. “More and more, if you want to keep your job or you want to get promoted, it’s the politics that take priority. And that’s a bad day for the people.”
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(Orlando Sentinel reporter Stephen Hudak contributed to this story.)
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