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How Ron DeSantis transformed into an anti-public health crusader

DeSantis’s surgeon general is accused of manipulating data to justify an anti-vaccine agenda. How did we get here?

Ron DeSantis, in a blue suit, removing a surgical mask next to a Florida flag in front of a backdrop that says “Jackson Health System.”
Florida Gov. Ron DeSantis removes his face mask during a press conference to address the rise of coronavirus cases in the state at Jackson Memorial Hospital in Miami on July 13, 2020.
Chandan Khanna/AFP via Getty Images
Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

In March 2020, in the uncertain first weeks of the pandemic, Florida Gov. Ron DeSantis acted and talked like most other politicians. He shut down public schools and prohibited visitors at nursing homes. He expanded testing capacity and closed parks out of what he called a need to meet the Centers for Disease Control and Prevention’s guidelines on social distancing. By early April, he had issued his own version of a stay-at-home order and was urging his state’s residents to stay “spiritually together, but to remain socially distant.”

Three years later, DeSantis has transformed himself into the face of an anti-“woke,” anti-public health movement that blossomed during the pandemic — the leader of an administration that was willing to not only defy the public health consensus but to control and manipulate information in order to advance its narrative of a crisis that has killed more than 1.1 million Americans, including more than 87,000 Floridians.

A report this month from the Tampa Bay Time revealed that DeSantis’s state surgeon general had altered scientific data in order to justify his official position that young men should not receive the Covid-19 vaccine. DeSantis, who has criticized former President Donald Trump for deferring to public health officials like Anthony Fauci, has embraced conspiratorial talking points. He has suggested profits and not public health drove the Covid vaccine campaign and convened a state grand jury to investigate any “misconduct” on the part of drug manufacturers and the scientific community related to the vaccines.

What the hell happened?

There is no single, fully satisfactory answer. Even within his own state, DeSantis is viewed as an enigma and his motivations are not well understood, even by those who were hired or consulted by his administration.

What’s clear is something changed, and quickly. Within a month of pleading with Floridians to remain socially distant, DeSantis had begun to reopen the state’s economy. As months went by, he became more brazen in his willingness to bend the truth around Covid and staffed his administration accordingly. Within a year, he had hired a Covid vaccine skeptic as his surgeon general, who would later be accused of altering study data to advance that agenda, and was fighting cruise ships over their plans to impose vaccine mandates for their passengers.

“When DeSantis started on this, I think he probably had the best interest of Floridians’ health at heart,” Aileen Marty, an infectious disease expert at Florida International University, told me. “By the end, he focused more on forcing measures he hoped would provide an economic recovery.”

But with the benefit of hindsight, clues about DeSantis’s transformation may reveal themselves. In March and April, the governor’s approval ratings sagged. For those who wanted him to be aggressive in fighting Covid-19, he was not doing enough. For the conservative voters beginning to believe an alternative narrative of the pandemic, his response was an overreaction. As he fumbled through the first few weeks of Covid-19, DeSantis seemed to satisfy no one.

So the governor picked a lane. DeSantis sided with the Republican base upon which he would depend for his political future.

One public health expert who spoke directly with DeSantis around that time, who, like others I interviewed, did not want to be quoted by name for fear of retribution, said the governor referred specifically to senior residents in conservative areas like the Villages as “my people” and appeared preoccupied most with them when considering the response to the coronavirus. Later on, his vaccine-skeptical agenda reflected the mood of many conservative voters, who had glommed onto mischaracterizations about the risks of Covid-19 and conspiracy theories about the vaccines meant to stop it.

DeSantis’s pandemic response helped make him into a national figure, valorized among conservatives and villainized by Democrats and many public health experts.

It is difficult to say with certainty how much any particular government policies affected how a state fared during Covid-19, given that factors beyond anyone’s control (such as demographics and infrastructure) played a large role in dictating the course of the pandemic at the local level.

But the public health experts I spoke to believe DeSantis’s approach probably made things worse. His state did see a faster economic recovery than many others, but it came with a cost: Florida ranks 13th among states in deaths per capita. Adjusting deaths for age, the most important driver of fatalities in the pandemic, Florida was at best middle-of-the-road among states in its pandemic performance.

His evolution is also another window into the kind of political leader Ron DeSantis is. As Vox’s Andrew Prokop explained previously, the governor’s modus operandi has been to take whatever the dominant conservative issue and position is at a given time and embrace it.

His pandemic record is the most striking example of DeSantis’s chameleon-like political persona. And once he picked a path, he followed it ruthlessly.

DeSantis’s pivot from a “conventional” Covid-19 response to anti-public health establishment crusader

Revisiting press reports from March and April 2020, what is most striking is how typical DeSantis’s response initially was. Like most political leaders in the United States and around the world, even then-President Trump at times, the governor seemed to recognize the enormity of the challenge ahead.

On March 12, he discouraged Floridians from hosting and attending large gatherings, and the next day, a 700-person gala to be hosted by Lara Trump at Mar-a-Lago was canceled. A couple of days after that, DeSantis put the state’s emergency operations center on its highest level of alert. Schools were closed until at least the end of the month, and the governor issued an order prohibiting most visitors to the state’s nursing homes. His administration sought to funnel protective equipment to those facilities with the most vulnerable patients — a move that even his critics still credit DeSantis for, though some facilities were still reporting shortages in the summer of 2020. Indicators suggest Florida’s nursing home residents were less likely to die compared to those in most other states, though they still accounted for about one in every three of the state’s overall 87,000 pandemic deaths.

He demonstrated an understanding of how the chain of transmission works and the risks it posed to the most vulnerable people. “You could acquire this, have no negative impact on you personally, but then can be involved transmitting to someone where it could be serious,” the governor said during one early press conference.

The state hired scientists to beef up its emergency response capabilities and initially spent millions on contact tracing and data collection efforts. On March 23, DeSantis closed the state’s parks. The Florida environmental agency said the closures were necessary to “successfully uphold [CDC] guidance to maximize social distancing and avoid gatherings larger than 10 people.”

DeSantis dragged his feet on issuing a broad stay-at-home order. The Miami Herald upbraided him in a March 22 editorial to “act like you give a damn.” The governor had been urging Floridians to voluntarily adhere to social distancing rules. But, after national media reports on spring breakers in the state defying public health guidance, he finally issued a 30-day stay-at-home order on April 1.

“We want people during this time to be spiritually together, but to remain socially distant,” DeSantis said on April 6, shortly before the Easter and Passover holidays. “Please keep God close, but please keep Covid-19 away.”

The public health expert who met with DeSantis at this time described his approach to the pandemic as “conventional.” DeSantis seemed to want to control the narrative — not unusual for a politician, this person said — but he took the virus seriously, to the point that he did not get physically close to some of the experts present at a private meeting.

Then something changed. When the public health expert met with DeSantis a month later, the governor delivered a 45-minute “lecture” to a small group of public health experts about what he thought was going on with the coronavirus: It was only a risk to the elderly, and so restrictions for younger people didn’t make sense.

Over the course of the meeting, the governor never asked the experts in the room a single question, this person said.

Around this time, the mood among conservative voters and leaders toward pandemic restrictions was souring and sometimes turning violent. President Trump was urging states to reopen the economy, as he launched a reelection campaign. Southern governors were reportedly making plans in concert to ease those restrictions, an effort that DeSantis was part of.

On May 1, the state began reopening. Restaurants could resume operations at limited capacity. Hospitals began conducting elective surgeries again. Over the rest of the month, restaurants were allowed to expand their capacity, and other businesses, such as gyms, were permitted to reopen. In early June, theme parks — a major source of tourism in the state — and bars started to reopen, too.

As his reopening progressed, DeSantis began taking a more combative tone with the media. He portrayed his approach as conservative and data-driven. The state had yet to experience its first major wave of the pandemic, and so, in the governor’s view, reopening was warranted.

“People need to realize that a lot of what was said there has not been proven to be true,” he said in mid-April.

The DeSantis administration’s campaign of Covid-19 misinformation

But in the months to come, when cases and deaths accelerated, DeSantis largely stayed the course. In fact, he dug in. He was selling a story about Florida as an oasis from public health orthodoxy.

One data scientist who was contracted by the state told me about a meeting with senior health department officials in June 2020. As this person looked at the data, they thought it was clear that Florida’s first major coronavirus wave was building and told the officials as much. But their response was that the uptick in cases was the result of more testing, not a meaningful increase in the real number of infections.

This scientist said they explained to the senior health officials that the math didn’t support that conclusion, that the increase in case numbers was exponentially greater than the recent increases in the state’s testing capacity. There was no response to that counterargument from the health department’s leaders.

“I think the scientists I was talking to knew I was right,” this person said. “But to say that was to break with the administration.”

Sure enough, coronavirus infections in Florida exploded in June and July, as the daily average of new cases rose from less than 1,000 on June 1 to a peak of nearly 11,900 by the middle of July. About 180 Floridians were dying every day as the calendar turned from July to August.

DeSantis’s response to his state’s rise in cases and deaths was limited. He resisted calls to require masks in public spaces. He cited younger people as the major drivers of spread, and while he did warn again that younger people could spread the virus to others, he was more fatalistic about the government’s ability to influence their behavior.

“They’re going to do what they’re going to do,” he said on June 28.

Over the summer, DeSantis was meeting with some of the academics who authored the controversial Great Barrington Declaration, in which they criticized lockdowns and other interventions while arguing that allowing most people to be exposed to the virus would be the fastest way to build up immunity in the population. DeSantis would embrace this concept of herd immunity in the months to come. He seems to have, in concert with the conservative base’s rebellion against public health interventions, lost his faith in their ability to make a difference. The economy would reopen and the virus would do what it would.

The one thing DeSantis could try to control was the narrative of the pandemic. Some of the allegations made against his administration, such as those by whistleblower Rebekah Jones, have not held up to scrutiny. But DeSantis’s personnel decisions and the actions of his subordinates tell the clear story of an administration that would become comfortable with increasingly brazen manipulation of the facts.

In the fall of 2020, DeSantis’s administration hired an Ohio resident and amateur blogger who had gained some notoriety for skeptical takes on Covid-19 to serve as a pandemic data analyst.

The governor later appointed Harvard-educated Joseph Ladapo to be the state surgeon general that September. Ladapo, the top health official in the state, would become the face of Covid-19 vaccine skepticism in Florida, a cause that DeSantis has embraced with increasing fervor, at the same time his party’s base also grew more and more skeptical about the new vaccines that did ultimately prove effective in preventing deaths and hospitalizations.

DeSantis privately received an initial dose but has been coy publicly about whether he received any booster shots. In public, his comments have evolved from an emphasis on individual freedom to casting doubt on the safety and effectiveness of the vaccines themselves. The governor eventually asked the state courts to convene a special state grand jury charged with investigating the Covid-19 vaccines, the companies that produced them, and the public health experts who endorsed them.

Ladapo has been the megaphone for these anti-vaccine views, including saying healthy children should not receive the vaccines and suggesting that for some, the risk of the vaccines could be greater than the risk of Covid-19. That guidance has been justified in part by manipulated data, according to the recent Tampa Bay Times investigation.

According to the Times, an analysis produced by the state showed that the risk of cardiac-related deaths increased for young men after vaccination. Ladapo cited that analysis in his recommendation that young men not get vaccinated. But that final analysis omitted key information that had been present in earlier drafts of the report: The risk of death for young men from a cardiac event was higher after a Covid-19 infection than after vaccination.

Ladapo demurred when asked by the Times about the apparent deletion, pointing to DeSantis’s request for a grand jury investigation into the pharmaceutical companies that produced the vaccines.

“As surgeon general, my decisions continue to be led by the raw science — not fear,” he said in a statement to the newspaper. “Far less attention has been paid to safety of the Covid-19 vaccines and many concerns have been dismissed — these are important findings that should be communicated to Floridians.”

When contacted by Vox for this story, DeSantis’s press office said, “This topic has been debated in the media for over three years, and the false narratives have been debunked ad nauseam.”

A Florida health department spokesperson, asked about the Tampa Bay Times report, linked to a study published in the American Heart Association’s journal Circulation that did find a higher incidence of myocarditis in young men after vaccination than after infection. They also cited a Nature study out of the United Kingdom that in the conclusion stated it found “no evidence of substantially increased mortality risk, either due to cardiac events or overall, from mRNA vaccines” and that said the methodology used in Florida’s own analysis of the vaccines that was the subject of the Tampa Bay Times report had “introduced bias” in the results. The Florida health department also pointed to Ladapo’s claim this month that the World Health Organization now recommends against giving children the Covid-19 vaccine, a claim debunked by the Associated Press.

The arc of the DeSantis administration’s transformation from relatively anodyne crisis management into the purveyor of misinformation is clearer with hindsight, based on the public record and interviews with experts who were on the ground in Florida. DeSantis came to prioritize the economy over the public health consensus.

All potential interventions did have limits, and experts are still arguing over the precise impact of different policies. But experts in Florida who saw him and his administration up close believe that DeSantis’s approach came at a cost to protecting people’s health. The empirical evidence would suggest that his state did have a mediocre performance at best on the most important metric of the pandemic: saving lives.

To the experts frustrated by the governor’s actions over the past three years, the specter of politics looms large.

“When the base is moving in that direction, then it’s logical — but not driven by science or public health — to do what was important and best for his people,” the expert who met with DeSantis told me.

As time went on, this person thought DeSantis’s approach became: “Dazzle them with bullshit.”