Missouri’s new health director wants to bring a scientific, evidence-based approach to improving the state’s public health and guiding residents out of the coronavirus pandemic.
Gov. Mike Parson named Donald Kauerauf as the director of the Department of Health and Senior Services in July after the previous director, Dr. Randall Williams, resigned. Kauerauf previously worked as the assistant director of the Illinois Department of Public Health.
Kauerauf’s appointment comes as disputes between state and local health officials have reached a fever pitch. Earlier this year, the Republican-controlled legislature passed a law limiting local government’s ability to issue public health orders, a decision Kaueroff said haunts him.
At a press conference Thursday, Kauerauf said his immediate priority is to increase COVID-19 vaccination rates in the state. Although he supports masking and other public health measures to decrease coronavirus infections, he said the state should focus on informing Missourians about the vaccine, not vaccine mandates.
He responded to the following questions from Missouri reporters.
Q: Are you concerned with the delta variant’s presence that limitations [state lawmakers have passed] on issuing health orders are exacerbating the variant’s spread?
Donald Kauerauf: [People are] taking a process that is about people caring about people, and they’re still politicizing it. And that's a shock to me. Because that's not what our field’s about. And that's not what I bring to the table here.
Public health is not politics. It is helping people. [There’s] damage that is being done across not only Missouri, but across the country, where there's the … quarrelling, the lack of respect and knowledge, downright meanness towards each other in the public health field. Public health's going to happen after COVID. And if we've lost that local respect of the system, how are we going to recover from that?
Q: Do you commit to increasing Missouri's funding for public health?
Kauerauf: You look at some of the health indicators across the country, you pull up into the [Centers for Disease Control and Prevention] websites and see Missouri is near the bottom … in a lot of indicators. That’s not good.
This legislative season, there are some initiatives in there to try and look at increased funding. I will have a greater opportunity as I learn more about some of the funding structures here within Missouri to help increase that.
I've looked at some of those same stats…looked at what type of funding is committed in the states for public health. Missouri is near the bottom for that.
That’s something that's really going to be a challenge for me, is to see how we can increase funding to support public health.
Q: What are your thoughts on a vaccine mandate?
Kauerauf: When you start saying the word “mandate,” you're basically acknowledging that everything else has failed. Public health should have never got to a point where we even need to worry about a word "mandate."
It's clear the importance of vaccinations … every day we're seeing new studies coming out because that the outbreak is disproportionately affecting those that have not been vaccinated.
There’s probably about 30% of the public Missourians who are truly what I would call hesitant. I’m not going to define hesitant as, as everyone not being vaccinated. [When I look at those who are vaccine-hesitant], it’s those that are people still needing accurate information to make the right decision. So it's not about the mandate. It’s — for us — to make sure that we are getting the right information at work.
Q: Do you think more stringent measures like required masking in schools will be necessary?
Kauerauf: We are now reassessing our position on what information we provided locals. I think in some situations where we have an opportunity to provide more clear guidance to the locals to help them this process.
One of the things we can't factor in is that every community is different. … One size does not fit all, but we have to provide some of the baseline. We’re going to have some documentation to work on now for schools that can provide some clear ideas of ways to achieve [keeping] kids in school, allowing the locals to be able to customize to the point where it really addresses the needs of that community.
The delta variant is vastly different from the alpha variant, in its transmissibility, the incubation period, how quickly and how sudden it brings onset of symptoms and individuals. And for people to go back and say, well, you know, historically, kids aren't being impacted … that's not true.
If you look at [the alpha variant], we saw that the kids weren't as impacted as adults. But if you look at the delta variant, it's the opposite. And I think that's where we gain some of our problems is that people are thinking what they read or heard a year ago, and they're trying to say that is the standard for today. So we need to treat the delta as its own disease.
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