For more than two decades in many roles at the Minnesota Health Department, Kris Ehresmann has been preparing for a devastating pandemic.
As a member of the infectious disease division and now its leader, she has helped the state agency respond to outbreaks that claimed many lives worldwide — swine flu, SARS and MERS, as well as two coronaviruses.
But in February, Ehresmann immediately recognized that COVID-19, another new coronavirus, would likely require the type of public health response that hadn't been mounted in 100 years.
"We certainly have been talking about this forever," she said recently. "I realized it was going to be different, but I don't think I fully comprehended how different it would be."
Ehresmann is among a core group advising Gov. Tim Walz on the state's response to the insidious virus, which has fundamentally altered the social and economic fabric of Minnesota since it was first detected here in early March.
Although COVID-19 ebbed somewhat during June, Ehresmann is concerned about the increase in cases among younger adults.
"This disease continues to surprise us in unfortunate ways," she said. "It is a stark reminder that COVID-19 is not only a disease of old age."
The new coronavirus could also be setting the stage for other public health setbacks, she has warned. With fewer children receiving vaccines, there could be a spike in preventable diseases. And emergency room use is also down, including for heart attacks and strokes — a sign that people are not seeking care.
"What we are seeing with the data is really concerning," Ehresmann said. "It could contribute to excess mortality."
Ehresmann's experience at MDH runs deep. First hired as a student worker in 1989, she has held many of the job titles that she now oversees.
"She has led outbreak investigations for many years and one could say that she has been preparing for this outbreak her whole career," said Dr. Ruth Lynfield, the state epidemiologist and medical adviser at MDH who works closely with Ehresmann.
COVID-19 has consumed Ehresmann's life, often leading to seven-day workweeks that start at 6:30 a.m. As her husband, who also works at the agency, drives them to MDH headquarters in St. Paul, Ehresmann responds to e-mails.
"If I can't get my act together between 7 and 8:45 I am in trouble because there are usually meetings scheduled through the rest of the day," she said.
She is no stranger to crises. As director of the Infectious Disease Epidemiology, Prevention and Control Division, she oversees a department of 200 employees that deals with outbreaks of all types, whether they originate in food, water, animals or human contact.
"We have this every day all the time," she said. "We are constantly dealing with outbreaks."
In the past few years, there have been outbreaks of measles, drug-resistant tuberculosis, Legionnaires' disease, syphilis, hepatitis and the perennial flu. Her staff also investigates when people get sick from contaminated food and water or get bitten by mosquitoes and ticks that carry diseases.
Ehresmann credits the work of her team who handles the investigations and prevention efforts, one reason MDH has earned a national reputation for public health.
Her employees say she is an effective leader.
"She has a very diverse background," said Dr. Aaron DeVries, who worked as Ehresmann's medical director until 2015. "You have to have this wide breadth of expertise in order to manage" such a large division.
Life-changing trip
The daughter of a father who was a dentist, Ehresmann, 58, grew up in Bloomington. Her mother trained as a nurse but could not get hired as one after she married — a prohibition that was common many decades ago.
Following in her mother's footsteps, Ehresmann initially studied to be a nurse while at St. Olaf College in Northfield.
"I didn't even know the word epidemiology when I was an undergrad," she said.
She spent a semester working at a rural health clinic in India and saw how poverty can affect health.
"For a white girl from the suburbs who had a very comfortable life, it was eye-opening, and I didn't think I could be the same after that."
The clinic in India ran a program to give tetanus vaccines to pregnant women so they would not pass it on to their kids.
"The idea of how could you make a difference in a community, that was fascinating to me," Ehresmann said.
After graduating from college, Ehresmann initially couldn't get a job due to a nurses' strike. Eventually she landed work involving surgical, cardiac and critical care. She still holds an active nursing license.
She started graduate work at the University of Minnesota with the idea of becoming a health educator.
David Snowdon, a noted epidemiologist who led the often-cited Nun Study of aging and Alzheimer's disease, persuaded her to take a different path.
"He talked me into going into epidemiology and I have never regretted it," she said. "It was the perfect mix for me."
Michael Osterholm, the University of Minnesota infectious disease expert, hired Ehresmann as a student worker in 1989 when he was an MDH epidemiology official.
"From the very first time I met Kris it was clear that she had a passion for public health and infectious diseases," he said. "So from that standpoint she clearly stood out from the crowd."
Osterholm says Ehresmann has the organizational and leadership skills to bring people together. Those are important for managing a bureaucracy, but they are also necessary when talking to the public.
So much of public health relies on getting voluntary compliance to health recommendations, he said, whether it be vaccinations or social distancing.
"How you educate the public is really a very critical issue," he said. "The public has to see themselves as partners in that communication, not students. Kris understands that."
A new renown
Ehresmann has always been front and center for MDH's communication efforts during most significant outbreaks. With COVID-19, the department has taken the unprecedented step of holding daily 2 p.m. media briefings. She often joins Health Commissioner Jan Malcolm, as well as Walz and other agency heads in explaining the data and trends and answering questions.
Although the briefing schedule has been cut back recently, Minnesota Public Radio and other media outlets often stream the audio or video, giving the infectious disease director a new prominence.
Ehresmann has been recognized while walking her dog and while visiting her new home. (The change of residence was based on a decision last fall to downsize, but moving during a pandemic was not easy — inducing "some moments of total sheer panic and meltdown.")
"Everyone has been super gracious and kind," Ehresmann said. "Even if they have not agreed with the decisions, they have been very kind to me."
But Ehresmann avoids any media coverage of herself, joking that it might make her reluctant to make future appearances.
"I've been doing this for a long time, and I never watch or listen to myself," she said.
In the midst of the pandemic, Ehresmann has foregone the travel that she and her husband enjoyed, and the charity bicycle rides. She escapes through her devotion to her two adult children, British television mysteries and reading all types of books.
Sometimes, she will use a sleeping aid to make sure she gets her rest.
"If I wake up and start thinking about work, I can't go back to sleep," she said.
Despite her heavy workload, Ehresmann has no plans to jump ship to the corporate world or even to leave the state, preferring instead to keep the ties that she has, including going to a cabin that has been in her family nearly 100 years.
"Working in the private sector just never occurred to me," she said. "I am very much public service; that is how I have been hard-wired."
Glenn Howatt • 612-673-7192 Twitter: @GlennHowatt
