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How will Ron DeSantis’ surgeon general craft COVID-19 mask rules?

Legislation proposes granting Florida’s Department of Health new powers while it’s being led by Joseph Ladapo, who has voiced doubts about the efficacy of public health measures.
Dr. Joseph Ladapo, who was appointed surgeon general of Florida in September by Gov. Ron DeSantis, has drawn heavy criticism from Democrats and medical experts for downplaying the effectiveness of masks and vaccines and the role of safety protocols during the pandemic.
Dr. Joseph Ladapo, who was appointed surgeon general of Florida in September by Gov. Ron DeSantis, has drawn heavy criticism from Democrats and medical experts for downplaying the effectiveness of masks and vaccines and the role of safety protocols during the pandemic. [ GOVERNOR'S OFFICE PHOTO | Governor's Office photo ]
Published Nov. 16
Updated Nov. 16

TALLAHASSEE — Lawmakers this week are considering giving the state’s health agency massive discretionary powers when it comes to the pandemic.

Ordinarily, giving the Florida Department of Health such leeway would be a no-brainer.

But the proposed power shift comes at a time when the agency is mired in controversy. Its newly appointed leader, Dr. Joseph Ladapo, has drawn heavy criticism from Democrats and medical experts for downplaying the effectiveness of masks and vaccines and the role of safety protocols during a pandemic.

“It’s just not possible to stop people from catching viruses,” Ladapo said in an interview with NewsNation Now in July, before DeSantis appointed him to be the state’s surgeon general. “It’s a fool’s errand.”

Yet a proposed bill would grant his agency the power to decide how often employees must be tested to gain an exemption from a business’ vaccine mandate. The measure would allow the Department of Health to define how personal protective equipment may be used, and what “anticipated pregnancy” means for the purposes of similar exemptions. And it would let Ladapo’s agency determine when employees have immunity from a previous COVID-19 infection.

Related: DeSantis proposes vaccine bills for employers, but doesn't ban mandates

Lawmakers would be entrusting these powers to an agency run by a man who, because of how top agency officials are confirmed in Florida, still must be approved by state senators.

“Should he be making these decisions without being confirmed?” said Sen. Janet Cruz, D-Tampa, who sits on the Senate Health Policy Committee, in an interview.

State law allows Ladapo to serve in his post at least through the next legislative session, which begins in January, and the following session, which starts in March 2023, without being confirmed.

Republican leaders say the Department of Health is a natural choice to determine some of the medical-related rules in the bill restricting vaccine mandates.

“We have faith in our Department of Health and the experts that are in that field,” said the bill’s Senate sponsor, Danny Burgess, R-Zephyrhills. “I think it’s important that we afford the experts the ability to partake in their authorized rulemaking authority.”

Burgess’ measure would restrict employers from mandating vaccines for their workers unless they provide a number of exemptions for employees, including religious and medical carve-outs.

With some of those exemptions, Ladapo’s past stances deviate from some of the recommendations offered by medical experts interviewed by the Times/Herald.

In July, Ladapo likened calls for expanded masking to “almost a religious obsession” and said mask mandates had “at most … a modest impact” on slowing the pandemic. Days after he was appointed by DeSantis, Ladapo signed an emergency rule allowing families to choose whether to have their children wear masks in schools.

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Ladapo refused to don a mask during a meeting last month with a Democratic senator, Tina Polsky of Boca Raton, who is undergoing treatment for breast cancer. Although Senate President Wilton Simpson, R-Trilby, called Ladapo’s behavior then “unprofessional,” DeSantis defended him, noting that Polsky had been seen previously in a larger room with unmasked colleagues.

If the vaccine mandate bill passes, the Department of Health will essentially have to concede that masks are an acceptable alternative to vaccination.

Marissa Baker, an assistant professor of occupational health at the University of Washington’s School of Public Health, said although masks help protect individuals from contracting the virus, they’re not as effective as a coronavirus vaccine.

“The best policy would be to allow businesses to mandate vaccines, full stop, as opposed to coming up with all the different exemptions,” Baker said.

But if the agency were to craft a mask rule, it would have several factors to consider, Baker said. For example: Would employees be required to wear masks during meal breaks? Would a cloth face covering count as a mask for the purposes of the rule, or would the Department of Health require a certain make of medical mask for workers?

The Department of Health would have to answer similar questions about its testing rules, experts say. Baker noted that too frequent rapid testing might yield a number of disruptive false positives. Testing that is too infrequent wouldn’t catch enough infections to make the workplace safer.

Tom Unnasch, a professor at the University of South Florida’s College of Public Health, said the sweet spot would be a rule requiring testing every 72 hours.

Finally, the bill directs Ladapo’s agency to craft a standard for determining “competent medical evidence” of COVID-19 immunity for those who claim not to need a vaccine because they’ve been infected previously.

Ladapo has expressed confidence in the ability of a prior COVID-19 infection to grant future immunity. Last year, he signed the “Great Barrington Declaration,” which called for governments to allow communities to reach herd immunity by protecting the vulnerable and allowing the healthy to become infected.

Unnasch said coming up with a standard to determine immunity might be tricky. He noted that it’s relatively easy to detect COVID-19 antibodies, but it’s less certain how much protection those antibodies offer a person — particularly as more time passes since initial infection.

A pair of studies published by the Centers for Disease Control and Prevention this year found that vaccination offers more robust protection against hospitalization and infection than a prior infection.

But other papers, often cited by DeSantis, have shown that a prior infection protects a person against contracting COVID-19 in the future. For example, the Cleveland Clinic Health System Ohio found that zero of nearly 1,400 previously infected health care workers contracted COVID-19 again during the length of a study.

Christina Pushaw, a DeSantis spokesperson, wrote in an email Monday that it would be relatively simple to determine a standard for proving a prior infection.

“There are many ways to document prior COVID infection, including antibody tests and of course a record of a past positive test,” Pushaw said.

• • •

How to get vaccinated

The COVID-19 vaccine for ages 5 and up and booster shots for eligible recipients are being administered at doctors’ offices, clinics, pharmacies, grocery stores and public vaccination sites. Many allow appointments to be booked online. Here’s how to find a site near you:

Find a site: Visit vaccines.gov to find vaccination sites in your zip code.

More help: Call the National COVID-19 Vaccination Assistance Hotline.

Phone: 800-232-0233. Help is available in English, Spanish and other languages.

TTY: 888-720-7489

Disability Information and Access Line: Call 888-677-1199 or email DIAL@n4a.org.

• • •

Tampa Bay Times coronavirus coverage

KIDS AND VACCINES: Got questions about vaccinating your kid? Here are some answers.

BOOSTER SHOTS: Confused about which COVID booster to get? This guide will help.

PROTECTING SENIORS: Here’s how seniors can stay safe from the virus.

COVID AND THE FLU: Get a flu shot and the COVID vaccine to avoid a ‘twindemic.’

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