Someone other than Jan Malcolm will have to deal with the next pandemic.
The commissioner of Minnesota's Department of Health was at the center of controversial decisions — Should the state require masks? Should it close businesses to protect people? — and she is ready for a break. Her upcoming retirement was announced Wednesday by Gov. Tim Walz.
Malcolm, 67, said in an interview that she always planned to only work one term in Walz's administration, but it is clearer now that the timing is right. Malcolm lost her spouse just before the start of the pandemic and then her mother in the fall of 2020 as COVID-19 surged into a second wave. She immersed herself in the intense pace of her work, but she is ready to grieve, reflect, and take better care of herself.
"Whenever the magic turn-into-a-pumpkin day is, I hope the next day I go to the gym, frankly, and start working out," she said. "I want my job to be to start getting healthier for the near term."
Health commissioner has been something of a high-wire position in Minnesota. Dianne Mandernach resigned in 2007 over the lack of communication about mesothelioma risks among Iron Range miners. Ed Ehlinger stepped down in 2017 over a backlog of elder abuse complaints in nursing homes.
Malcolm got a taste of the pressure in her first term, when she was appointed by Gov. Jesse Ventura to serve from 1999 to 2003. She defended the state's endowments, funded by tobacco lawsuit settlements, that paid for health education and helped to reduce teen tobacco use 30% in five years.
"Nobody thought we could do that," she said.
But nothing prepared her for COVID-19.
She had abandoned medical school in her youth to pursue education and a career in health policy, but she didn't have much training in epidemiology or emergency preparedness. She did have the expertise of scientists at the Minnesota Department of Health and a calm demeanor for presenting the facts about what had been an unknown virus without scaring Minnesotans.
"While the issues surrounding her work too often regrettably became entangled in politics, she consistently rose above the fray and provided the thoughtful, steady leadership Minnesotans counted on," said state Rep. Jen Schultz, a Duluth Democrat who chairs the House Human Services Finance and Policy Committee.
Decisions didn't always go Malcolm's way. A mask mandate likely would have started sooner in 2020 and lasted longer in 2021 if her recommendations were followed, she said. But when it came time to announce the decision to discontinue the requirement, there was barely an eye roll to suggest she wasn't in favor.
That responsibility "kind of comes with the job, quite honestly," she said. "I joked many a time, 'If it was only up to me, people would have stayed in their houses longer.' But it wasn't. There were real economic consequences to consider.
"We had some really robust debates about when to loosen up," she added. "I think many people don't realize we opened up earlier than a lot of states."
The trouble with preventive public health measures is that nobody knows how well they work, though Mayo Clinic projected sharply higher COVID-19 death counts if Minnesota had done nothing. On the other hand, thousands of even temporary job losses and closed businesses were painfully evident, and Malcolm received much of the scorn.
Threats and insults, mostly anonymous, prompted her to ignore social media.
"I did not need to hear 200 times a day what a jerk I was or why I should be fired," she said.
She wasn't alone. A Johns Hopkins survey found more than half of public health officials had been harassed early in the pandemic.
Threats gained political momentum, though, when Republican lawmakers — preferring a less intense COVID-19 response — proposed at the end of 2021 to block her confirmation.
State Sen. Jim Abeler, R-Anoka, endorsed the idea at the time as a way to check Walz, arguing that "the only language the governor understands is the removal of another commissioner."
Even with her planned retirement looming, Malcolm didn't resign.
"Nuh-uh, no way," she said. "But I think this really is the right time for me personally and I really do believe there is a lot of rebuilding to do now. And that's going to take fresh energy."
On the bright side, a St. Paul microbrewery named a beer after her — the Commissioner Jan Malcolm Dazzle Me with Science IPA.
"I'm an IPA-liker," she said.
Malcolm highlighted other moments in her two stints as health commissioner, separated by several years in charge of the Courage Center, a physical rehabilitation provider. She returned in the final year of Gov. Mark Dayton's administration, and was proud to address the timeliness of complaints in nursing homes, and to create a licensure system to ensure quality care in assisted-living facilities.
Other goals were scuttled by the pandemic. Rebuilding trust in science and public health is paramount, she said. It was a struggle during COVID-19 to understand and adapt to the threat of the virus, and then to convince the public of new decisions based on that changing information.
"How did we get from being trusted scientists, doing our best to protect people, to being villains in this story?" she said. "That was emotionally difficult."