Soon to retire, Kris Ehresmann looks back on 30 years in public health

On Feb. 2, a face who’s become extremely familiar to Minnesotans over the past two years — or rather, over the past 30 years — will pack up her office at the state health department and say goodbye to longtime colleagues.

Kris Ehresmann, 59, director of the infectious disease division at the Minnesota Department of Health, is retiring. She's been at MDH since the 1980s in various roles. Most recently, Ehresmann has been one of the architects of the state's response to the COVID-19 pandemic.

Over the years, MPR News has talked to Ehresmann about any number of health-related issues, from the yearly arrival of influenza, to measles outbreaks, to concerns over Ebola and HIV, to statewide vaccination rates and the COVID-19 pandemic.

Before her last day, Ehresmann gave an exit interview to host Cathy Wurzer.

The following extended transcript has been slightly edited for clarity. Listen to the conversation using the audio player above.

You’ve been on the front lines of the pandemic. What toll has this taken on you personally?

I think everyone is exhausted. It's been hard. Anytime you have something in public health that is so on the forefront of the public's mind, there's no way it can avoid being political because that's just how things have to be. But that certainly is something we hadn't seen in the past with other responses. And so that's been challenging.

I think there's a sense of gratification that we have done the best we could do and given it our all. But I think people are also tired. So, they’re proud and exhausted.

Have you faced backlash, vitriol or threats like others in public health?

Yes. I think when you're visible, when people have frustrations, they [say], “Who do I know in state government? I'm going to let Kris Ehresmann know.” So I certainly have gotten a few emails that weren’t very pleasant to open.

But by the same token, there have been Minnesotans from across the state who have written notes to me and to the team saying thank you. And that has been overwhelming. In retirement, I'm going to be writing a lot of notes. That made such a difference.

How much did pandemic stress play into your decision to step down?

I don't want to say that the last few years haven’t been difficult. But I lost my mom five and a half years ago to pancreatic cancer. And my husband lost his mother four days later. And so we were really struck by the brevity of life, and we started on a five-year plan to look at retiring. We downsized. That's why I was building a house and moving in the middle of the pandemic and things like that.

But I will say that the pandemic has made me very tired. And so it certainly means that this timing, while not ideal, is welcome.

What would you say to a young public health student looking at what you've gone through? What's the allure of the job?

This has been a hard couple of years, but I couldn't have asked for a more rewarding and fulfilling career. It has been the dream job. I used to joke and say, “Well, if I'm not going to be a trust fund baby, this is what I want to be doing.” It's just — it was just incredible.

What I appreciated was the diversity of things that I had the opportunity to do. There was public policy and working with the legislature. There was the media and having the chance to be able to communicate key messages. There were just management things that were rewarding — as well as the science and the work that the team did. There was never a dull moment in my career, and I'm really grateful for that.

What I'd say to someone young coming into public health is that it offers an incredible opportunity to serve, and you'll never be bored, and you will look back on a career in public health with great satisfaction. I don't want to discount the last two years. But I also think it's important to know that this will not go on forever.

Do you worry about the damage public health has taken during COVID-19?

I do, in a way. When I think about leaving the team back at the health department — [they’re] absolutely phenomenal. They’re amazing. They're brilliant. When I hand off the baton, I have every confidence in that team. [What I’m] concerned about is their exhaustion and the fact that they have to keep going. The demands have been incredible.

I also worry that, again, public health had never been in the limelight or forefront this much [before the pandemic], and it’d never really been perceived as political. And I think it's important that ultimately it can go back to being what it was, which is an apolitical part of our community that has the purpose of helping us collectively stay healthy.

Is there anything you would have done differently in the response to the pandemic?

When we started letting people know how things would progress, I'm not sure that anybody, ourselves included, could really absorb what this would mean in terms of disruption of daily life. We tried to do some messaging, but I think that was a gap.

I also think that some of the messages we put out early — we said “don't wear masks” initially, “because we need to reserve them for health care workers,” because the supply of personal protective equipment was so limited … That sort of was perceived by the public as “masks don't work — don't wear them.” So when the time came to say, “We really would encourage you to wear masks,” we had to overcome that messaging.

Or when we said, “We need to shut things down so that health care can get prepared.” That was true, and that was good. But when we had to do more shutting down, people reacted [by saying, “Wait a minute — isn't health care prepared yet?” There were things with messaging like that that I think we could learn from for the future.

You also had to deal with messaging from the Centers for Disease Control and Prevention (CDC), which has been very confusing. How did that make your job more difficult?

The stakes are high for everyone at every level of government and every level of service. But what's been different about this pandemic has been that historically, the CDC partners with states, who partner with our local public health partners. And so typically if a change or something big was coming, CDC would give states a heads-up. We would be working in concert.

In this response, just about every change that has happened, MDH read about in the New York Times or saw on TV with the rest of the public — and yet we need to be able to step up with a state response. So it's been incredibly difficult.

For instance, I think about a year ago, in January, when then-Secretary [of Health and Human Services Alex] Azar announced that [the federal government was] changing who they were prioritizing for vaccination — on national television — we watched it, and then of course the public was like, “Where's my vaccine?” And we're thinking to ourselves, “Hey, we just heard this 15 seconds ago, too!”

Things like that made it really hard to be able to respond. I hope that our local partners feel that we were a bit more respectful of them in trying to get messages out. I know that at the national level, there was a lot of pressure, too, but it surely made it difficult for the state.

What has gone well in the pandemic response?

I think the people who have worked on this response have been phenomenal. It's been my honor to be a visible face for the agency. I'm representing a team of scientists that are just something else.

I know my own team, and I know the people in our division, and they step up, and they do amazing things. But this was bigger than, obviously, a division could handle. People across the agency, and even across the state enterprise, have stepped up to help. The work they did was phenomenal, and to get to know them and to strengthen and build relationships across different areas was really the silver lining, the blessing of the response. So I think the people and their amazing work — that is something I am incredibly proud of.

You've done so many interviews about so many different diseases over the past 30 years. Are there plans in place in case of an outbreak of measles or Ebola?

Oh, yes. The team is very, very nimble and very adept at that. If something [were to] happen, they would be ready to go. Obviously, if it happened right now, we would be redirecting resources away from, say, the COVID response, but they would be ready to go.

In fact, when we did our early 1999 pandemic influenza planning, we created these scenarios that we had to work through — like, we have a pandemic, and then we have a blizzard and then the power goes out. So there is planning in place to address several things at once.

We don't want anything bad to happen, but I think the team would be delighted to perhaps work on something besides COVID.

How does an epidemiologist mark a retirement during a pandemic?

We're going to have a virtual get-together here at the department. And then I have some girlfriends that I do a lot with, and we're going to go away to someone's cabin on the weekend. Those are a couple of things that I'm doing that are all COVID-appropriate.

When COVID subsides, are you and MDH Commissioner Jan Malcolm going to go out to celebrate?

Yes — we have talked about that, actually, and talked about the whole team getting together and celebrating. We want to celebrate, but obviously we know the risks of large gatherings with omicron recently, so we'll look forward to doing that in the future.

What do you plan to do in the future?

The next couple of months, I'm going to visit my dad in Florida and be warm for a little bit. And my husband and I would like to travel. We really like to bike, so we'll do some bicycling. And we have a cabin up north. It's a log cabin, not a lake home, so there's always plenty of projects to do there. We're just going to take the next couple of months to really decompress and think about things.

There's a lot of things that I really think are important. I'd like to do some volunteering. And if there was an opportunity to teach, that would be fun, too.

I don't have a big, “Well, I'm going to do X, Y and Z,” because I just need some time to be quiet.

Kris Ehresmann, we wish you well, and we thank you for your service to the state of Minnesota.

Thank you, Cathy, and thanks for getting our messages out for so many years.

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