"It's really painful": Outgoing Health Commissioner Jan Malcolm on being villainized during pandemic, and the road ahead

MINNEAPOLIS – Minnesota Department of Health Commissioner Jan Malcolm is retiring next month after decades of public service, including the past few years helping to steer the state through a global pandemic.

When COVID-19 hit, Malcom was no stranger to being at the helm.

"My first time here as health commissioner was back in 1999 with Gov. [Jesse] Ventura," Malcolm said.

It wasn't her first time dealing with a crisis.

"We had 9/11, and that was a major trauma obviously, and that brought with it all kinds of immediate responses around things like security and bioterrorism," she said.

Still, nothing could have prepared her for the monsoon that would crash in at the start of the decade.

"It was March 6 that we had our first confirmed case here," she said. "We have had for years plans of various sorts for different kinds of emergencies. So we had to take those plans that were built for shorter-term events and try to figure out how do we keep it going? But the problem was we never knew how long it was going to have to keep going."

She also wasn't prepared for the skepticism that would follow, surrounding vaccines, masks and restrictions.  

"It's kind of hard to get your head around why people who are just trying to help other people would suddenly become kind of perceived as villains of some sort," she said. "It's really painful, but I think, you know, unfortunately this became kind of ideological and political."

At some point as a community, Minnesotans were asked to take care of each other.

"I think we did quite well early on, even though there was always, you know, a negative consequence to the closures, for instance, of businesses and kids being in remote learning," she said. "Early on, I think there was more understanding that we're kind of all in this together. I think we struggled with it at many, many levels. Certainly in our communities, in our families, as a state, as a country and, you know, all over the world, we're seeing similar fatigue."

Malcolm is heading into retirement at a time when healthcare in our state appears to be strained.

"Well, I think some of the things that we're seeing now have been pressures that have been building for quite a while in healthcare," she said. "We've lost a lot of people in healthcare and in public health. The pandemic really made it much, much worse and sort of revealed how disconnected the parts of that system are."

She says the years-long pandemic left scars and exposed fractures that still need healing.

"Whether it's kids or adolescents or people who've had ongoing health challenges or have lost people, have lost their businesses, there's just a lot of healing to do and we really need to not gloss over that," she said.

On her way out, the commissioner is still pushing Minnesotans to get the COVID vaccine. Just more than 70% of Minnesotans have received at least one dose.

"We've got 500 people every day in the hospital with COVID. Now the priority is helping people stay up to date because we've got a lot more people who got the initial shots and only about half of those have gotten the boosters," she said. "We've got great tools now to manage it, but we have to use the tools."

And it's still not too late to get a flu shot.

"It seems like it could be just that overall fatigue with all things illness-related, and fatigue with immunizations," she said.

Malcolm also addressed the new challenges for the next commissioner.

"I think some of it is just sort of the recovery phase for us as an agency, the public health and healthcare fields that have just really struggled with the burdens of the work over the last few years," she said. "We've kind of squeezed all the surge capacity out of the system over time, and we need to figure out how to build some of that back in."