NEW YORK — As a global pandemic raged through New York City, one public official kept a notably low profile: Health Commissioner Oxiris Barbot.
At a time when Barbot should have been a public face of the city’s Covid-19 response, she was relegated to a near-invisible status, after a long-simmering feud with Mayor Bill de Blasio erupted over how to handle the fast-spreading virus.
By Tuesday she’d had enough. Realizing de Blasio had picked her eventual replacement, Barbot, a pediatrician by trade who has led one of the nation’s largest and oldest health departments since 2018, sent de Blasio a letter announcing her resignation. In it she also chastised his oversight of the biggest health crisis in a century.
Barbot made her move following one final dispute with City Hall over de Blasio’s plan to reopen schools, which was announced last week, according to four people familiar with the situation.
For weeks Barbot, who had been repeatedly sidelined by de Blasio and stopped stopped regularly appearing at his daily news briefings, was absent from high-level talks about how to reopen the nation’s largest public school system, according to three people involved in those negotiations.
But as a decision neared and she was informed about the city’s plan she joined other health department officials in opposing two contingencies: The protocol that teachers be tested before returning to school, and the shuttering of schools if two students in two separate classrooms test positive for Covid-19, according to the sources. They said she and her aides did not believe that is the best way to contain the virus, but the city moved forward without her sign-off.
“City Hall wanted to have an automatic trigger,” said one person, who requested anonymity to speak freely about a sensitive personnel matter. “The health department felt like you needed experts to assess every case. An automatic trigger means there could be 100 schools closed on a given day.”
The episode was the final fight in Barbot’s tumultuous stint as the city’s top doctor.
De Blasio benched her after they fought over the city’s shutdown plans in March, as the virus began to spread through the five boroughs. Though Barbot initially did not raise alarms when the city recorded its first Covid-19 patient, she eventually urged de Blasio to shut schools during what was described as a tense exchange at City Hall on March 10. He did not make that decision for another four days.
Concerned about the economy and listening to the head of the city’s public hospital system, Mitch Katz, de Blasio at first ignored Barbot’s suggestions and brought in former city official and infectious disease specialist Jay Varma — setting off rival factions within city government.
The monthslong feud led to de Blasio pulling the Covid-19 contact tracing program from the health department and giving it to NYC Health + Hospitals in May, as New York City remained the national epicenter of the pandemic.
The episode underscored a long-standing distrust de Blasio has had with the health department, which predated Barbot’s tenure as commissioner. The mayor, who is keenly aware of public perception, has felt the agency demonstrates little understanding of the political pressures of his job. Some of his top officials, in turn, have argued for years that he prioritizes politics over sound policy.
The feud with Barbot illuminated deeper problems: To the mayor and his team, she provided confusing guidance at a time of profound crisis, did not embrace the need for contact tracing early enough and did not demonstrate strong leadership, according to four city officials who would only speak on background about the commissioner. Yet to the health department, de Blasio was a continued obstructionist at a time that called for cohesion.
“If you have really good public health epidemiologists, you should listen to them. That’s why you hired them,” said a former de Blasio official. “What is the point of having really good people who know who they are talking about if you’re just going to listen to yourself?”
Shortly after, Barbot was caught in a messy dispute with the NYPD after police tried to commandeer masks that were being held for medical workers. Since then, her resignation has been widely anticipated.
With the city now reporting drastically fewer cases of Covid-19, Barbot informed her staff that she would be moving on in an email Tuesday morning.
“I have every confidence that you, the committed individuals of this agency, will continue to dedicate yourselves to protecting the health of all New Yorkers during this unprecedented public health emergency,” she wrote to staff.
Barbot became acting commissioner in August 2018 when Mary Bassett stepped down for a position at Harvard. De Blasio officially appointed her to the role in December 2018. A person familiar with the situation said Barbot sent her resignation letter to the mayor, with stronger wording than her staff memo, after she heard the administration found her replacement.
“I leave my post today with deep disappointment that during the most critical public health crisis in our lifetime, that the Health Department’s incomparable disease control expertise was not used to the degree it could have been,” she said in her resignation email sent to de Blasio.
Within 30 minutes of Barbot’s resignation, de Blasio named Dave Chokshi, chief population health officer for the city’s public hospital system, as the new health commissioner.
As health commissioner, Chokshi will earn a salary of $243,171 — the same as Barbot, according to City Hall.
Chokshi’s appointment drew concerns from politicians, health department staffers and advocates who believe Katz, head of the city’s public hospital system, is “running the show” and could lead to a major shift in how public health is administered in New York City.
Katz created a “health super-agency” during his time in Los Angeles and some fear he is attempting to do the same in New York, according to five people who spoke with POLITICO.
When Katz arrived in New York to head the city’s public hospital system in January 2018, Los Angeles health officials warned their East Coast colleagues that their department may see major restructuring.
“There was this suspicion for a long time,” a person familiar with the situation told POLITICO.
Katz allegedly dismissed suggestions to streamline or merge the city health department with Health + Hospitals, saying it wasn’t feasible and that it certainly could never be done during a pandemic. However, people within city government said Katz has benefited from de Blasio’s long-standing disdain for the health department, which peaked during a much smaller outbreak of Legionnaires’ disease in 2015. De Blasio also pulled correctional health services from the city health department in August 2015.
De Blasio has continually defended shifting the contact tracing program to the public hospital system, despite being one of the hardest-hit systems during the first wave of the pandemic that killed more than 23,000 people, and understating the health department’s expertise in responding to infectious diseases like measles, HIV, Ebola and tuberculosis.
“This was something that had to be created on a vast scale. It’s not about something that ever existed before, and there was a model,” de Blasio said at his press briefing Tuesday.
Meanwhile health department employees described being surprised Tuesday to learn the news. Though Barbot was not in good standing with City Hall, several people said they believed she had weathered the storm and showed no signs of a pending departure.
“People are shocked and pissed,” said one agency official, who would only speak on background and not for attribution. “Normally an acting [commissioner] is named if a vacancy occurs. To have someone take the place as an external hire so quickly? This is orchestrated.”
But another staffer said Barbot’s role had become so diminished, she was relegated to beginning a blog called “COVID-19 Heroes” to recognize the work of her staff. The person said that, contrasted with her absence in high-level meetings, indicated her loss of influence.
In a mass email July 10, she acknowledged to staff the blog would not be able to properly recognize every effort she deemed worthy of the honor.
“To truly give space to everyone at DOHMH I consider a COVID hero, I would need far more time,” she concluded.