Sedgwick County health officer explains timing of his stay-home order

A quiet, careful man who most Wichitans don’t know made what may be the biggest impact on their lives this week.

That’s Garold Minns, the county health officer who on Tuesday signed a stay-at-home order to help prevent the spread of the new coronavirus.

In late December, before most Wichitans were fully aware of COVID-19, or coronavirus disease 2019, and what it meant, the infectious disease physician began watching it develop. He knew what it meant.

With “so many people traveling by our wonderful planes that we make in Wichita, I knew it would get here eventually,” Minns said.

Since then, a lot of people — from physicians to average Wichitans — have formed opinions on how best the community should proceed in either fighting the virus or calming down about it.

Minns, the one whose opinion perhaps matters most, said he’s been looking for facts.

“It’s been very difficult to have the data we need to make informed decisions for a lot of reasons.”

Lack of testing is one.

So Minns focused on the data he did have, starting with statistics from China, where he said four out of five coronavirus cases weren’t lethal. Some, he said, were asymptomatic or were similar to a mild or moderate head cold.

“I wasn’t considering this a disease that was going to ravage our population.”

Minns said the goal was not to stop the coronavirus from reaching Wichita.

“That would have probably required very draconian restrictions on people. We were seeking ways to slow its transmission.”

In addition to weighing health risks, the Wichita economy — and the impact from imposing restrictions on movement earlier than necessary — also weighed on Minns.

“Having no money is also a health issue,” he said.

Minns, who is dean of the KU School of Medicine-Wichita, said he is deliberate in making decisions even in nonpandemic times.

“I don’t like making rash decisions unless it is so urgent that we need to do something. If we’re not forced to make a quick decision, let’s weigh all sides.”

As Minns has been weighing, others have been criticizing or publicly disagreeing, including some colleagues in the medical community.

The Sedgwick County Medical Society, which represents 1,250 physicians, sent a letter to the County Commission that called for a “shelter-in-place order that would be reassessed in two weeks.”

“I understand where they’re coming from,” Minns said. “They’re most concerned about the overwhelming of our hospital facilities. . . . I get that. I don’t want them swamped either.”

In a 45-minute interview with The Wichita Eagle on Tuesday shortly after signing the stay-home order, Minns explained his thinking behind the timing of it, but he wanted to be clear that by sharing his reasoning he’s not trying to defend it or offer a rebuttal of any sort.

Minns said he’s been surprised at how some of his public comments have been perceived.

He said he feels like the totality of the considerations behind his decisions has not been fully expressed in media reports and that some people, including others in the medical profession, may have misinterpreted his thoughts and words.

“I admit, that’s partly the way I express myself, and I can’t blame the media for that.”

Detective Minns

Minns never planned to be a physician. The 69-year-old McPherson native simply liked to learn, and that’s how he viewed his time at McPherson College.

“I suppose you could say I was kind of naive and not very forward thinking at that time.”

Some professors steered him toward medicine, and some faculty and physicians helped guide him toward becoming an infectious disease specialist.

“It was certainly an eye-opening experience. . . . More intense, time consuming, but fascinating.”

Like most infectious disease doctors, Minns enjoys the process of figuring things out.

“We have to be pretty versatile in terms of having a fairly good understanding of all the organ systems — not just one — and we do a lot of detective work.”

That’s in part because of the variety of agents that can cause infections.

“Sometimes it’s a challenge to figure out which one it is.”

It’s one of the reasons doctors have to keep studying long after med school.

“COVID-19 didn’t exist back when I was in school,” Minns said.

Continual learning is what he called a stimulating challenge that sometimes makes it hard to do his day-to-day job.

“Most of the microbes in the world have a very high turnover rate, so their cells are dividing frequently, and many of them have what I would call genetic instability,” Minns said. “When the cell divides, sometimes the nucleic acid isn’t replicated exactly like the parent DNA.”

Minns said because cells divide often, thus creating a chance for those changes, “That’s one reason bacteria and viruses change their behavior over time and often change their sensitivity to our medications.”

It’s what’s known as antibiotic resistance.

Even without a pandemic, Minns frequently employs hand sanitizer, since it’s often more readily available than a sink and soap.

At one time, Sedgwick County had its own board of health, but today county commissioners play that role while Minns takes the lead. It’s a part-time position he was appointed to in 2008.

That means he helps protect the public, particularly from preventable diseases. That could be helping the county ramp up for flu season. On isolated occasions, Minns has to deal with a rare disease a Wichitan brings home after travels, particularly to foreign places with different diseases than what are in the United States.

“Most of the time, things are quiet,” Minns said. “It’s not often, but occasionally the health officer has to get involved with the political side of the county.”

And politics is squarely where Minns finds himself mired now.

‘The right answer’

Throughout Wichita’s coronavirus preparations, Minns said he’s attempted to remain open-minded and advise a worried city that the outbreak will have to be reviewed daily.

“Through open and calm dialogue, we can get through this, and I’m always open to other people’s opinions. I don’t think anyone has the right answer.”

Over the weekend, when there was a crescendo of calls by some for tighter controls on public activity, Minns hesitated to make that call.

“I fully realized that at some point there would be some orders to reduce person-to-person action.”

Minns said he didn’t feel like he needed to make that order yet because of the lack of cases in Wichita and how well people seemed to be doing at social distancing.

“I was so impressed.”

Minns said he was wowed by the voluntary measures taken by churches, restaurants and others.

“I thought the city was doing a great job in understanding how this disease is spread and how to change their daily behavior and what they need to do to decrease it.”

As a physician, Minns said, “I always feel people are more accepting of changes in their life if they see why they need to do it.”

He said he even thought that’s why Wichita’s cases are lagging behind counties around Kansas City.

“In my opinion, Sunday afternoon, I didn’t feel a surge (of cases) was imminent,” Minns said. “Basically I was saying, ‘Can we just give this a few more days to see how this goes and what changes on the state level?’

“I was cautious that I didn’t want to move ahead of the state.”

That’s in part because if Sedgwick County businesses were forced to close and neighboring counties didn’t have the same restrictions, people from here would have gone elsewhere to conduct their business.

“You can’t really incarcerate your population,” Minns said.

As he’s walked the tightrope of balancing health and economic needs, Minns said, “It’s often daunting to know how to come up with a decision that balances those things.”

Even without a Monday county commission vote to recommend that he sign the stay-home order, Minns said he may have arrived at that decision on his own.

So while some assumed he was putting off a decision for a lengthy period, Minns said, “No, I thought I said we need to re-evaluate this tomorrow because things are moving so dynamically.”

At the end of the 30-day order, Minns said he could decide to increase restrictions or decrease them. He said he won’t know until then.

Even if he weren’t in the middle of a public health crisis, Minns probably wouldn’t be doing much else besides focusing on health care anyway.

Outside of maybe listening to a little classical music or some vintage western tunes, Minns likely would be reading medical journals, which he does instead of having hobbies.

“Oh, my spouse would say I don’t have enough of them.”

Instead, he’s spending his time making what could be life-and-death health and economic decisions and facing public and professional scrutiny for it.

“I guess I was a little surprised by the intensity of the reaction by the medical community,” Minns said.

And though — again — he’s not trying to justify his decisions, Minns has tried to explain them since he was asked.

Anything else he’d like to say to his colleagues?

“I’m not angry at anybody. I’m not upset. . . . I can see where they felt like I wasn’t considering their worries.”

And to the public?

“I’d like people to know I’m trying to do the best for all of our citizens.”

This story was originally published March 24, 2020 at 5:00 PM.