Power, politics and public health: the back and forth in Florida

ON Florida recovery, with Tom Hudson of WLRN and Melissa Ross of WJCT, how the pendulum of public health power has passed from local governments to the state. Also, why have childhood vaccination rates gone down? And a big deal for painkillers?

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The pandemic has brought the spotlight on Florida’s push and pull on power, politics, and public health, but it didn’t start with COVID-19.

In Florida, decisions on infectious diseases and all kinds of public health matters come from the state capital. Tallahassee calls the shots on things like vaccine masking and quarantine. For decades, however, individual counties have had a lot of say in public health.

Public health in Florida began in the 19th century with yellow fever. For a long time, the big decisions that impacted the health of Floridians came from the county health departments. Aiming for greater equity, Democrats have channeled that power to the state and, somewhere along the way, Republicans have embraced the transformation of public health into a big government.

Most states don’t have a general surgeon, but Florida is one of them. The position is the state’s top public health official. He was a lightning rod for litigation during the pandemic and helped shift public health decision making in Florida from county health departments to state government.

First, Surgeon General Scott Rivkees was out of the public eye during most of the public health emergency and was not allowed to answer questions from the public or lawmakers. Eventually he resigned.

The new surgeon general – Dr. Joseph Ladapo – did not shy away from controversy and voiced Gov. Ron DeSantis’ opposition to vaccine and mask mandates, among other policies.

WLRN’s Danny Rivero and Verónica Zaragovia explored the balance of power with public health in the “Tallahassee Takeover” podcast.

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‘I just stopped counting’

The COVID-19 pandemic is in its third year and continues to affect the lives of healthcare workers.

Darleen Gruver lives in Brooksville, a town north of Tampa. She has been working as a nurse in a hospice providing end of life care for nearly 20 years. She says she has seen many people die, but COVID-19 has made things worse. During the first year of the virus, she Gruver kept a sad count of the people she helped comfort during their final hours or days as they died from the virus.

“I think when I hit 40, I stopped counting on my own. I didn’t want to know anymore. And that was the first year. It was 2020,” she told WUSF.

Adding to his concerns after more than two years is a shortage of colleagues. Its teams of staff members are less than a third the size they were before COVID-19. Instead of teams of 20 to 22 people, they dropped to six.

A decline in routine vaccinations

The Centers for Disease Control and Prevention report that fewer children receive the routine vaccinations needed to enter school.

Jill Roberts, a professor of public health at the University of South Florida, pointed to several reasons for the national decline starting in the first year of the pandemic. Initially, parents may have been concerned about taking a child to a doctor’s office, and the school was largely online during the first three months of the pandemic. The health record requirements were not applied at the time.

“So, unfortunately, the other factor is probably vaccine hesitation,” he told WUSF. “The COVID difference is that people put it in a different category. They see children after they contract COVID and recover and seemingly fine,” he said.

“So in their mind, COVID is not the same as polio and all these other diseases we vaccinated for. So this hesitation has really grown to say, ‘Well, maybe we don’t need it, maybe this is a mild disease, maybe I’m putting my son at risk. ‘ If you put that small amount of doubt in there, people promoting anti-vaccination campaigns will jump on it in a heartbeat, ”Roberts said.

According to data from the CDC, Florida nurseries are in better condition than others. During the 2020-2021 school year, only one in 500 nurseries in Florida did not have the full recommended vaccine schedule. Nationally, 17 out of 500 people did not get full vaccination coverage for diseases such as measles, mumps and diphtheria.

Opiate battles across Florida

More people die in Florida from drug overdoses than in almost any other state. Only California has more, according to national statistics.

Nearly 8,000 Floridians died from drug overdoses in 2021. It increased 4% from the previous year. The most common culprit is opioids like prescription pain relievers and synthetic opioids like fentanyl, which can be up to 50 times stronger than heroin.

Fentanyl deaths extend from large urban counties to smaller, more rural areas of the state. Escambia County in the Panhandle saw fentanyl deaths increase by more than 350% last year.

“We are not doing well in the Panhandle,” Dr. David Josephs, clinical director of the Lakeview Center in Pensacola, told WUWF. “For many years, there has been a push to take painkillers, mostly opiates, to manage pain. And of course, these drugs are extremely addictive,” he said.

He’s bad everywhere, “Dr. Kenneth Palestrant told WQCS. He is a senior member of the Treasure Coast Opioid Task Force. Nearly three out of four deaths he has seen recently involve fentanyl.

“As laws in different states have cracked down on opioid prescribing, what ends up happening is that many of these people who are addicted to prescription opioids and no longer get it from their doctors, go the way, and unfortunately the stuff on the street is contaminated with fentanyl, “he said.

A new wave of opioid deaths, often mixed with psychostimulants, is raising old fears in Palm Beach County, so now families are urging the sheriff’s office to transport Narcan. Drug overdose deaths increased nearly 30 percent in the first two months of the year compared to the same period last year, according to the Palm Beach County Coroner’s Office. That surge brought a new scrutiny to the Palm Beach County Sheriff’s Office policy against MPs carrying emergency medicine to reverse opioid overdoses.

Southeast Florida recovery supporters held a rally in January outside a sheriff’s executive office. Organizer Maureen Kielian and others sent a letter asking PBSO MPs to treat overdose. Palm Beach County Sheriff Ric Bradshaw did not accept an invitation for an interview with WLRN. A spokesperson said the policy was based on concerns about accountability.

The sheriff’s office also said paramedics arrive earlier on suspected drug overdoses. This claim was based on a 10-year study that is no longer available.

According to the Florida Department of Law Enforcement, most Florida sheriff’s offices train lawmakers on how to administer naloxone and get it transported.

Break the glass ceiling of the baseball

Florida is where baseball’s glass ceiling gets broken. A year ago, the Miami Marlins became the first major league baseball team led by a woman. Kim Ng is the general manager of the Marlins.

And this spring, Rachel Balkovec became the first woman to coach a minor league team affiliated with the major league when the Tampa Tarpons took to the field.

Balkovec is used to the former. In 2019, she was the first woman to become a top manager in the minor leagues when she held the role for a minor league affiliate of the New York Yankees.

She is a former softball catcher who learned Spanish to improve communications with players.

“If I can walk in front of a room, talk confidently, I know what I’m talking about, oh, and then I can say in Spanish too, it’s like, alright, this woman is on business and this is a job, she’s a professional” he told WUSF. “I really think it doesn’t take too long before they realize, you know, that I’m just a coach. And in the end, they forget and they’re themselves around me.”

He led his Tarpons to a 9-6 victory over the Lakeland Flying Tigers in the season opener in April.

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