Emails show health department officials argued over basic things like office space during a major tuberculosis outbreak in the Kansas City area. Some staff think the tension set back the tuberculosis response -- or at least made it more difficult.
Emails obtained by the Kansas News Service show there was a lot of tension between Wyandotte County Public Health Department's then director, Elisha Caldwell, and state health officials during the response to one of the largest tuberculosis outbreaks in recent U.S. history.
When the outbreak reached a fever pitch last summer, the Kansas Department of Health and Environment and the Centers for Disease Control and Prevention stepped in to assist the local health department. Ultimately, in late November, the state took control of response efforts, pushing the local health department out.
Wyandotte County's public health officer, Dr. Allen Greiner, said he thinks they shouldn't have changed who was leading the response efforts.
"Instead of that, we just had a lot of people disagreeing at different times. Even down to the sort of simple thing of when do you release information to the public," he said.
The Kansas News Service reached out to both health departments with questions about how the conflict impacted the response. One of the main questions was, "Did the conflict shown in the emails hinder the TB response?". Here's what we heard back from spokespeople from the organizations.
Wyandotte County Public Health Department:
"I have confirmed that these questions fall under personnel matters. Therefore, we are not able to comment. Thanks for reaching out!"
Kansas Department of Health and Environment:
"Thank you for reaching out to our office with your questions. The Kansas Department of Health and Environment's (KDHE) mission is to protect and improve the health and safety of everyone who lives, works and visits the state. That mission drives the agency's decision-making process, ensuring essential care is provided to minimize the impact of disease or other health risks. The relationships KDHE maintains with local, state and federal partners greatly influence the lives of Kansans. It is only through the collaboration of these partners that we can effectively respond to and mitigate the tuberculosis outbreak in Wyandotte and Johnson Counties. We will continue to collaborate and expand our partnerships as we work to ensure a robust and responsive public health system that can address any challenge and meet the needs of every Kansan in every corner of our state."
Caldwell, who no longer works for Wyandotte County's health department, said he is not ready to talk about his departure.
"I just think it's not the right time to talk," Caldwell told the Kansas News Service in a brief phone conversation last week. "I'm very passionate about public health and this community."
While it's unclear whether or not bickering at the local and state level slowed TB response, it certainly made things harder. Some sources spoke to the Kansas News Service on the condition of anonymity because they are fearful of losing their jobs or damaging their careers.
They said about 10 employees left the Wyandotte County health department over frustration with how Caldwell was handling the response and treating employees. And they said when the state abruptly took over in November, patients were confused over where to receive care.
Greiner can back this up. He said thankfully, he doesn't believe patients slipped through the cracks and missed treatments during the transition, but it was frustrating.
He said it was hard on families to change doctors and the location of where they were receiving care.
"I wonder whether the deployment of resources and the feel of care for these patients and families wouldn't have been better if we would have just kept things simple as we had them in the beginning," Greiner said.
Greiner said the November switch-up was not the first controversial change in who was caring for TB patients. He said over the summer, Caldwell did not renew the contract of a family physician who had been doing the brunt of the tuberculosis work and had extensive knowledge of how best to reach the community experiencing the outbreak.
"I'm a big believer in continuity of medical care, and that if people sort of get used to certain physicians or certain nurses or certain public health staff, they're probably going to do best without having to learn who new people are," he said.
Greiner said the outbreak is winding down and the general public is not in danger.
Bek Shackelford-Nwanganga reports on health care disparities and access for the Kansas News Service. You can email her at [email protected].
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.