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Dr. Mark Levine retires as Vermont’s health commissioner this week after an eight year tenure marked by historic events. Dr. Levine is best known as the steady hand guiding Vermont’s response to the Covid-19 pandemic, which by many measures was one of the most successful in the nation. Vermont had the second lowest Covid fatality rate, after Hawaii. According to the Vermont Department of Health, 1,283 people died from the Covid pandemic in Vermont.

During the dark days of lockdown in 2020 and 2021, Dr. Levine stood alongside Gov. Phil Scott and reassured anxious Vermonters about how to stay safe, the need for masking and social distancing, and the critical importance of vaccinations. His grandfatherly baritone voice conveyed wisdom and compassion.

In announcing Dr. Levine’s retirement, Gov. Scott said, “I will be forever grateful for his advice and counsel over the years, but especially during the pandemic, as he appeared with me daily at press conferences during those difficult days, giving much comfort to Vermonters as our very own ‘Country Doc’.”

Sen. Peter Welch said that Dr. Levine “helped Vermont through those incredibly challenging times, and saved many lives.” 

Prior to Dr. Levine’s appointment as health commissioner in 2017, he worked as a primary care physician and as a professor and associate dean at the University of Vermont’s Larner College of Medicine, where he still teaches.

Dr. Levine, 71, steps away from health care leadership at a fraught and uncertain moment. Public health and science itself have come under unprecedented attack by the Trump administration. Robert F. Kennedy, Jr., the country’s newly appointed secretary of Health and Human Services, has been derided for being a conspiracy theorist and one of the top purveyors of medical misinformation. This week, Kennedy announced the layoffs of 10,000 health workers and $11 billion in cuts to public health grants dolled out to states. This includes a $7 million cut in aid to Vermont that state health officials said would “negatively impact public health in our state.”

All of this comes as measles is infecting unvaccinated children in the U.S. in what is already being described as the worst outbreak of this century.

Dr. Levine reflected on how Vermont compared to other states in managing the Covid pandemic. “Our economy looks like many of the states that had far worse outcomes from Covid and prioritized their economy more in terms of keeping a lot of sectors open. When you look at the bottom line in the end, our economic status and theirs don’t look very different, yet our public health status looks much, much better. And I’m going to hang my hat on that as very, very important for the way we approached the pandemic here in Vermont.”

“You know, there isn’t a hell of a lot I would have done differently, to be honest,” said Levine.

Levine insisted that there are not many critics who say “you shouldn’t have had vaccines. You shouldn’t have masked us up. You shouldn’t have closed down things. When you close them down, they kind of understand that the major outcome was that Vermont fared much better as a state than many other states. So it’s hard for me to have too many regrets.”

Why did Vermont fare better than other states?

“We come from a culture here in Vermont where people look out for their family, they look out for their community, and they work collaboratively,” said Levine. “The second thing is that in public health, we always say, be first, be right, be credible. And the communication that the governor and I and the rest of the team had was frequent, it was with integrity about what we knew and what we didn’t yet know, and it was with great transparency … revealing the data every time and showing what we were responding to.”

Levine leaves his post with deep concern about what lies ahead for public health. “When disinformation comes from the top, whether it be the secretary of (Health and Human Services) or the president, it has an impact and it makes our job much harder.”

Levine noted that even when Trump administration officials are trying to control the measles epidemic, “they always manage to sort of agree, but then say the wrong thing and let you know that they really aren’t completely aligned, which is a problem I am very concerned about.”

Levine says that federal budget cuts could have a serious impact on Vermont, where “40 percent of my budget is related to federal grant money.”

If the latest cuts “are a signal of what’s to come, then they are of tremendous concern. And the problem is, of course, we’re not seeing broad visions and huge strategic plans with discrete timelines associated. We’re seeing abrupt moves by the federal government that basically say, today your grants were stopped, and by the way, we’re interested in chronic disease prevention. But they haven’t actually shown us the vision and the timeline and what the resources will be and (where they) will come from.”

Dr. Levine said of his legacy, “People will always remember Covid, and I’m fine with that, but I hate for that to be the defining moment because public health is so much more than that. One thing I’m very proud of is work we’ve done to protect our children’s health.”

“I’d like to be remembered that we’ve now turned the curve on the opioid overdose death rate, and it’s clearly on the way down. It’s not a mission accomplished. There’s still a lot of work to be done. But at least it’s going in the right direction.”

As he retires, Levine lamented the rise in the “great anti-science bias” and the movement of those who are “vaccine resistant, or at least hesitant.”

“We do in public health as much as we can to provide what we consider not the alternative viewpoint but the actual evidence-based viewpoint. But the recipients of that have to be willing to receive that information, and we’re in a time where many people get their information from one set of resources and they won’t veer from those resources to others. So it’s a challenging time for public health, indeed.”