In Missouri’s pandemic response, the buck stops nowhere

Missouri Gov. Mike Parson addresses the media at his weekly press conference (photo courtesy of the Missouri Governor's Office).

Where does the buck stop in Missouri? If we are talking about the pandemic, then so far not in the governor’s office. Three recent controversies illustrate how election campaign mentality, political vanity and thin skin continue to influence the governor’s priorities.

The first controversy is the disagreement over a venue for the annual State of the State address. Gov. Mike Parson was upset that the Missouri House decided not to invite him to give a traditional address in the chamber with all the attendant pomp and circumstance.

With a significant number of staff and legislators out sick or quarantining due to COVID-19, it seems obvious that a packed room filled with officials, lawmakers, judges, staff and spectators would be less than ideal.

But Parson issued a lengthy statement attacking the House leadership for their lack of deference to his preferences. He pointed to their “hypocrisy” in holding hearings where legislators and visitors failed to wear masks. It was a terrible example of “punching down” with many having dismissed it as petty but inconsequential. But this incident is part of a larger and costly pattern.

The second controversy also involves an intemperate outburst from Gov. Parson attacking the motives of someone who raises his ire. This time Dr. Alex Garza, director of the St. Louis Pandemic Task Force, was accused of “lying” because he spoke truthfully about a dire reality: in their vaccination efforts the Parson Administration has prioritized rural areas over urban areas.

The St. Louis region should receive 37% of Missouri’s vaccine dose allocation based on population. They have received far fewer doses while less populated areas of the state have disproportionate access to vaccines. Garza’s point was not that other areas should receive less but that his region needed more to combat rising infection rates that have reached crisis proportions.

Meanwhile, the Parson Administration arranged for mass vaccination events in rural areas facilitated by the National Guard. But no such coordination was happening for more urban areas. This is a bitter irony because, while Parson was in the denial phase of his pandemic response, he dismissed COVID-19 as largely a St. Louis problem.

Parson saw Garza’s comments exclusively as a personal attack and reacted by assailing the motives and integrity of an important health care leader in the state.

Also, ironically, since the governor continues to pursue a decentralized “you’re on your own” local control approach to public health, he is especially dependent upon leaders like Garza to make that approach work. And, most importantly to the Governor, to absorb any political blame for policy failures during the pandemic.

The last controversy relates to the Parson Administration’s inept and confusing vaccination rollout strategy.

Vaccinators are confused because policy direction and action steps are unclear, and ever shifting in response to political whims. Often new policies are announced publicly with little or no advanced notice to those charged with implementing them. Details are general, vague, and come with unreasonable expectations.

Resources are limited with staff and supplies strained for almost a year. But this administration continues to do more to create stress and uncertainty than to foster efficiency, clarity, and confidence.

Local and regional leaders have been hesitant to speak out openly for fear of being punished or attacked by this administration. The fact that more and more leaders are taking the risk of going on the record to raise alarms is an indication of a critical mass of problems threatening the whole pandemic response.

The three controversies mentioned here are examples within a consistent pattern that illustrate why we need a new approach. A strategy which avoids responsibility and keeps a political base satisfied is an unacceptable substitute for a competent, caring, and comprehensive public health response.

This is not about Mike Parson, personally. It is about Governor Parson, who is failing to provide the leadership and resources needed to address this crisis plagued by decisions made on the fly, logistical incompetence, poor communication, lack of vision and “passing the buck.”

Missouri Health Care for All continues to call for a statewide, coordinated COVID-19 strategy that repairs damage, slows the spread, and protects the wellbeing of all Missourians.

We have developed a “turnaround agenda” at that addresses many of the systemic problems created or worsened by the current approach and welcome others to amplify our dire need for change.

Vaccines alone will not end this pandemic. We cannot simply demand that everyone choose to get vaccinated, while ignoring the implicit bias resulting in harder hit communities of color being “first” infected, “last” tested and vaccinated.

Without sound public policy, deep and sustained investment in public health, and ending racism in medicine, this crisis will continue. It is astonishing there are no significant increases in state level funding for public health in the Governor’s proposed budget, after a pandemic year filled with resource shortages.

Over the past year, time ran out for over 8,087 Missourians who are known to have died from COVID-19. Many more are experiencing severe “long haul” morbidity, and we are all vulnerable on some level to this disease.

We need stronger, smarter, more compassionate leadership. We need the Governor’s “bully pulpit” to set a different tone. We need a better public health strategy. We need laser focus on solving the crisis rather than settling personal vendettas. We need the Parson administration to stop courting “controversy,” stop shirking responsibility, and mount an effective pandemic response.

The election is over, the pandemic continues. The longer it rages, the more at risk we all are.

The clock is ticking, Gov. Parson. And the buck stops with you.