Florida Department of Health emails show agency struggled to manage algae crisis

With toxic algae fouling Southwest Florida’s inland waterways and coastline last year, state health officials faced a flood of worried questions as people turned to them for crisis leadership.

Some were specific: Were Caloosahatchee blue crabs safe to eat? Was it dangerous to breathe near the algae-choked canals? How about swimming in the Gulf?

Others were systemic: Who posts warning signs? Was any agency monitoring illness reports? Would water and air be tested for toxins?

As red tide devastated wildlife in the Gulf of Mexico from Sarasota to the Ten Thousand Islands, a simultaneous outbreak of blue-green algae contaminated the Caloosahatchee watershed. Images of bloated dolphin carcasses and people jet-boating through algae blooms filled news reports. Social media seethed with rumors and petitions. Former Gov. Rick Scott declared two states of emergency — one for each bloom. 

In case you missed it:Toxins, possible blue-green algae indicator showing up in local water quality samples

More:Rooney to CDC: Tell us what you know about how toxic algae blooms affect health

Yet through it all, the Florida Department of Health stayed largely in the background. It refused The News-Press' interview requests and delayed responding or outright ignored emailed questions. To try to understand its internal workings, The News-Press obtained more than 2,500 emails from May 25 to Sept. 26. They reveal a hunkered-down agency scrambling to keep its message straight as the environmental calamity deepened. 

Since then, the department hasn't responded to a number of requests made over multiple weeks for an interview that might offer insight into the department’s stance throughout the crisis and its future goals. That invitation is still open. 

The public records request sought correspondence from the two officials whose names appeared in the infrequent news releases the department issued about the situation: Kendra Goff, state toxicologist and chief of the Bureau of Environmental Health; and Andy Reich, scientific adviser for the bureau.

Each of the 2,661 emails was reviewed by the department’s legal team and sensitive information redacted. What remains in the cache, which The News-Press still is analyzing, chronicles a range of concerns. When worried residents, persistent reporters and other government entities turned to the agency for guidance, they often came away with more questions than answers.

Ability, capacity and responsibility: Which agency does what?

Responsibilities and runarounds were common topics, even when officials from other agencies wrote the department.

In August, for example, the Department of Environmental Protection’s John Calhoun asked about hot spot air testing: ”We are getting lots of calls from citizens requesting air testing around ponds with algae blooms. We usually refer to the County, who refer them to the local Health Dept, who refer them back to us and our Division of Air. Unfortunately, our Division of Air only does static monitoring of specific locations and doesn’t have the equipment to do local testing like that. Does DOH have any ability & capacity to do such localized air testing?”

Goff answered: “Unfortunately, we do not have any capabilities to perform air testing, localized or not. For more information on harmful algal blooms, people can be directed to our website. In general, we advise folks to take precautions around water bodies that may have harmful algal blooms. Happy to chat further.”

When the public emailed with questions, officials didn't always answer. And when they did, some of their correspondents, such as Ralph Quillen, found the exchanges frustrating.

Concerned for the health of his two young daughters, Quillen pressed Angela Smith, who administers Lee's health department, to tell him whether Sanibel Island was safe for his girls. She responded with generalities and gave him some informational links. They went back and forth a couple of times until Quillen had enough.

"Thank you for your response but you did not answer my question. Is it safe for my family to live in these conditions with these algae blooms and this red tide?" he wrote. "Why can't I get a straight answer?"

After that, Smith didn't write back.

Dagmar and Steve Martin, who live on a dead-end Cape Coral canal contacted the department in July about the algae's foul smell.

"We are permanent residents and have no other place to stay," the Martins wrote. "We don't know how toxic the algae is. ... We are hoping to get help as soon as possible!”

The email wound up in Reich's queue, but he did not write the Martins back.

Aug. 22, 2018, Pam Cox sent the department what she called a plea "to acknowledge the conditions with the Red Tide/Blue Green Algae crisis. Your website and silence on the current health situation is gross negligence ... PLEASE, PLEASE, PLEASE ... whoever is monitoring this mailbox, bring it forward to others in your office. Don't just send an automated reply and delete it."

Reich wrote back: “Dear Ms. Cox Thank you for your email to Florida Department of Health. The Department's role in responding to red tide events relates to health concerns. You can find information on health effects of algal blooms on our website. Sincerely, Andrew Reich"

On Aug. 17, JoEllyn Bavosa wrote, asking, "When will you help? When will you start testing? When will you issue warnings to the public about Cyanobacteria? This is not just Red Tide anymore and has not been for a very long time. With hope that your agency will step forward and help.”

Reich didn’t write Bavosa back, but he did send a colleague this: “There really is nothing we can say to address this email. Andy.”

Other correspondence included:

► Reich’s response about whether freshly hunted alligator meat from an area of bloom is safe to eat: “It’s my best guess that the toxins would not accumulate in the muscle tissue but without data, there is no way of knowing for sure.”

► Goff telling epidemiology department chief, physician Russell Eggert, July 12, “We would like to discuss how we are going to handle these inquiries and we will need some help.  We are not used to this volume of inquiries.”

► Martin County environmentalist and former Commissioner Maggy Hurchalla writing: “This is Florida’s Flint, Michigan — ignoring a problem because it is too scary and difficult to deal with.”

► And in one of Goff’s email threads, Martin County Commissioner Ed Fielding wrote presciently: “It portends to be a long, disastrous summer.”

Internally, officials repeatedly emphasized the need for a unified front.

In July, after then-Gov. Scott declared a state of emergency, Eggert, the epidemiology chief, asked Reich if the declaration should be discussed during a regular conference call with the epidemiology staff of the state's county health departments.

"Yes," answered Reich. "I think the issue of health impacts might become more important. Should (epidemiology and environmental health departments) discuss together to make sure we have a consistent approach? "

In August, Reich convened a phone conference with county health leaders and spokespeople statewide to “facilitate coordination and consistent messaging.”

Once warning signs became a source of concern, the department changed course. In June, it told a News-Press reporter that signs were not its responsibility. Then in August, it told the same reporter, “We’ve posted hundreds of signs.”

The reporter responded: "Back in June, I started asking the local DOH about just that, and was told in no uncertain terms that posting blue-green algae warning signs is not the department’s role. Attached please find emails saying just that, and contradicting what you wrote. So, I’m not sure who’s mistaken here, but I’d like to know what the case is."

Spokesman Brad Dalton later wrote back: "After speaking with the county office I believe the issue is that the work done in the community concerning signage was performed after the communication between you two."

In their emails, department officials regularly discussed media coverage both local and national — from The Wall Street Journal to The New York Times — with Reich expressing relief that he hadn’t appeared in a Times story. “Glad my name didn’t show up,” he wrote a colleague.

They criticized some of the local stories. After a TV segment appeared, Goff wrote:

“It is a shame that we can be misquoted so easily. No wonder we get the calls that we do from citizens confused on this topic. Angela, you and I have chatted about those challenges and sometimes backfiring with the media even if we are trying to provide the most accurate and current scientific information. Totally understand it's sometimes beyond our control how the Department is quoted. I think we are only seeing the beginning of this if this article is any indication.”

Shortly after one of The News-Press' stories about the department came out, one official included this comment with an online link: “FYI This article does not portray FL DOH in a positive light.”

More:Florida toxic algae a long-term health concern, according to scientists, researchers

More:Florida's toxic algae crisis: Lee Health outlines response plan

Bloom season approaches: What's been done; what's left to do

As the next steamy summer season approaches, the potential for more outbreaks looms and it's unclear how the department would handle another crisis 

A number of its key positions are vacant — a recently requested organizational chart shows no surgeon general, chief of staff or head of the legislative planning office.

Some of its approaches have changed since last year.

It has rolled out an informational web page on cyanobacteria, it has ramped up its outreach on aquatic toxins and it appears it's now taking responsibility for posting warning signs.

Gov. Ron DeSantis has called for a harmful algal blooms task force and emphasized a science-based approach to fighting toxic algae outbreaks, but his office hasn't answered calls or emails asking about the administration’s goals for the health department.

A patchwork of nonprofit organizations, educational institutions and citizen initiatives are filling the leadership void. FGCU and Florida Atlantic University quickly received emergency funding to study the potential health effects of cyanobacteria. Lee Health began collecting data from its patients about exposure to blooms and symptoms. Several social media groups disseminate news and outbreak information. And Calusa Waterkeeper got a grant from the Southwest Florida Community Foundation specifically to do what the department hasn't: engage with health care workers and decision-makers about cyanobacteria's effects with a series of public events.

Calusa Waterkeeper John Cassani offered a to-do list he'd like to see the department tackle, including:

• Raising the department's public profile in the media so that people can easily determine potential health risks from exposure to algae.
• Increasing the number of monitoring stations for airborne algal toxins.
• Posting comprehensive toxin concentrations and health guidelines about various forms of exposure in cooperation with Florida Department of Environmental Protection water-body monitoring. 
• Establishing a clear policy on how and when health advisories will be made; including sign guidelines. 
• Creating a citizen hotline on the blooms.
• Developing an interagency public health working group to advise the department on the most current information about health effects of blooms.

Connect with this reporter: @amySWFL on Twitter. 

Join the Save Our Water Facebook page. 

To Whom It May Concern

After a three-week vacation in early August, health coach Ralph Quillen had returned home to Sanibel to find the island hemmed in by red tide, as toxic cyanobacteria flowed down the Caloosahatchee.

Alarmed, Quillen wrote city government – “I need to know if it is safe for my family, specifically my 3 and 6 year old girls to live in these conditions” – and was directed to the Lee County branch of the Florida Department of Health.

His question was simple: “Is it safe for my family to live on Sanibel in these conditions?”

Angela Smith, who administers Lee's health department, wrote back: “We are not aware of any long term negative effects of red tide. For most people, symptoms are temporary and resolve when the person leaves the proximity of the impacted water. Unfortunately, I cannot comment on your family specifically due to the fact that K. brevis impacts individuals so differently.  Some individuals experience “red tide tickle” while others do not. Still other individuals with existing pulmonary issues may experience more severe reactions.I would encourage you to speak with your healthcare provider if you have specific questions regarding your family’s health.”

Quillen replied: “Hello Angela, Thank you for your response but you did not answer my question. Is it safe for my family to live in these conditions with these algae blooms and this red tide? We have over 100 children on Sanibel and the island is surrounded with this poison. Should the school be handing out filter masks? What are the long term effects? Will this affect our children's health in the future. Why can't I get a straight answer?”

Smith wrote back to tell him, among other things, that "For sensitive individuals, wearing a particle filter mask may lessen the effects, and over-the-counter antihistamines decrease symptoms." She also referred him to the Florida's Fish and Wildlife Conservation Commission and to Mote Marine's online beach report.

By now, Quillen said, he was getting frustrated. “Hi Angela, Thanks for your response but I think I am going to have ask this question again. It is a yes or no question. Is my family safe to live on this island? Is the air safe? Also, has Lee county been running air quality tests? Are the tests available to review? Have you been out to the island to see the devastation? … I look forward to your response.”

But after that, Smith never responded, even though she blind-copied Quillen’s emails up the chain of command until they reached Reich.

Quillen's conclusion?. “The emails speak for themselves. They basically did nothing. And we’re still left with no answers."

The News-Press repeatedly queried the department as well, even finding an email this reporter had sent to a university professor (who doesn't work at the department) about the department’s ongoing silence in Reich’s queue: “I’ve had a devil of a time communicating with the Florida Department of Health. Among other things, I’ve been asking about whether local fish catches are being monitored or tested, as well as non-fin fish seafood, especially blue crabs. Most importantly, though, I wanted them to tell me if there’s any kind of epidemiologic surveillance plan in place – or being discussed – for short- and long-term human health impacts, whether it’s something the DOH would do, or if not what agency would.” His receipt of the email notwithstanding, Reich never responded to her.

Other citizens who wrote got shorter responses – if they got any. Here are some excerpts:

July 11, Dagmar and Steve Martin of Cape Coral wrote:

“We live at the end of a canal … The algae's smell really bad. We can't sit outside or even work in the backyard … The smell is already in the house. We are concerned about our health. It's impossible to live like that! There are small children living in the neighborhood as well.  We are permanent residents and have no other place to stay. We don't know how toxic the algae is. We experience a dry and scratchy throat and believe it has to do with the bad smell.  We don't know if there are injured or dead fish or other wild life.  We are hoping to get help as soon as possible!”

No return email was included in the public records The News-Press received.

Aug. 17, JoEllyn Bavosa wrote:

 “As a resident of Florida for over 20 years it is a huge concern of mine to find that our waters have not and are not being tested for Cyanobacteria. As we are NOW in a state of emergency and our canals, bays and gulf are filled with "green slime" and our marine life is dead or dying, I was wondering when exactly we would start testing for Cyanobacteria and the toxin it releases? I have asked our local Sarasota Board of Health and the response was and still is, we only test what we are told to test. Another concern is that the County and State Officials make it perfectly clear that our beaches are open, and have never closed, and "sure you can go out there, however I would not." (City of Sarasota 6/16/18 video) When questions are asked of our "Officials," they refer us to Mote marine, who does not even staff a Cyanobacteria specialist or to your Department. Cyanobacteria, as I am sure you are aware, risks the very health, lives and water we drink, of the people exposed to it for prolonged periods of time. When will you help? When will you start testing? When will you issue warnings to the public about Cyanobacteria? This is not just Red Tide anymore and has not been for a very long time. With hope that your agency will step forward and help.”

No return email was included in the public records The News-Press received, but Reich did send a colleague this: “There really is nothing we can say to address this email. Andy.”

Aug. 22, Pam Cox wrote:

“This email is a plea to the team at the FL Department of Health to acknowledge the conditions with the Red Tide/Blue Green Algae crisis. Your website and silence on the current health situation is gross negligence on the mission of your department "“to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts”. I have to believe that people who work at the FDOH are members of the communities who are impacted by this man-made ecological disaster. There are many scientists who have researched and provided evidence of the health risks. The citizens of Florida are getting sick and are outraged that the state is not doing anything. I realize this is not an easy situation and politics are playing a huge role in determining what employees of the state are willing to say. However, this issue is attacking the health of people in Florida and the FDOH needs to get involved. PLEASE, PLEASE, PLEASE .... whoever is monitoring this mailbox, bring it forward to others in your office. Don't just send an automated reply and delete it. Read my words, feel the tears and despair that I and my fellow Floridians are feeling. Help us by acknowledging the issues and standing with us to request attention and funding from the state.”

Reich wrote back: “Dear Ms. Cox Thank you for your email to Florida Department of Health. The Department's role in responding to red tide events relates to health concerns. You can find information on health effects of algal blooms on our website: http://www.floridahealth.gov/environmental-health/aquatic-toxins/index.html Sincerely, Andrew Reich".