BISMARCK — North Dakota Gov. Doug Burgum is looking to appoint a new state health officer for the second time this month after Dr. Paul Mariani resigned the position last week just 11 days into the job.

Mariani's departure on Friday, Sept. 25, came a day after the state rescinded an order requiring close contacts of known COVID-19 cases to quarantine. Burgum and other top Republicans faced harsh backlash after the order was expanded Wednesday, Sept. 23, and ultimately pushed for its retraction.

Burgum's critics on the other side of the aisle point to the Mariani episode as evidence that the governor is injecting politics into public health decisions, and they say Burgum will have a hard time filling the newly vacant position with a qualified candidate. Meanwhile, a notable Bismarck plastic surgeon has already expressed interest in taking on the role.

The state's move to rescind the order broke with guidelines from the Centers for Disease Control and Prevention, though the state still recommends that close contacts quarantine when possible.

Mariani said in a Friday news release that "the circumstances around the handling of the order made my position untenable." He declined to comment on his resignation when contacted by Forum News Service. Burgum spokesman Mike Nowatzki also declined to comment on Mariani's resignation.

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The Fargo doctor's departure came after two of his recent predecessors left the state's top public health role under mysterious circumstances.

Last month, Dr. Andrew Stahl stepped down from the same position amid disagreements with the governor's office over the state's COVID-19 risk level designations. Burgum said Stahl resigned because of family and career considerations, but Stahl has never publicly commented on the matter beyond an initial news release.

Mylynn Tufte abruptly resigned in May, and Burgum repeatedly refused to directly answer whether she had been asked to leave the role.

The recent series of resignations has raised red flags for state Sen. Tim Mathern, D-Fargo, who says the dramatic rate of turnover in the position and lack of autonomy given to public health officials during the pandemic is unprecedented in his 34-year legislative career.

Mathern said he suspects Stahl and Mariani quit after the governor asked them to compromise their professional ethics. He charged Burgum, who is running for reelection, with bringing political concerns into matters of public health and micromanaging the state's COVID-19 response. Mathern said the governor's job is to steer the ship and allow trained experts to handle their duties.

"We hire people with expertise, with ethics, with a robust experience and knowledge and we pay a high salary for that as we should," Mathern said. "If we don't actually permit them to use all of those qualities, it's bad for our state, it's a waste of money and it's a destruction of their professional ethics."

Mathern added that "we might as well hire high schoolers" if top health officials like Stahl and Mariani are not allowed independence from politicians.

When asked for comment, Nowatzki referred Forum News Service to previous news releases about the resignations of Stahl and Mariani, which made no mention of the governor asking state health officers to violate their professional ethics. However, Burgum has said he weighs political risk in forming the state's public health response.

On Mathern's charge of micromanaging, Nowatzki said Burgum has been working since the beginning of the pandemic with a group of experts that include University of North Dakota School of Medicine Dean Dr. Joshua Wynne and Adjutant General of the North Dakota National Guard Alan Dohrmann.

"Governors are expected to lead and to consider emergencies holistically, and that’s what Gov. Burgum continues to do to save lives and livelihoods," Nowatzki wrote in an email.

Mathern has proposed an unconventional way around what he views as "a lack of clear leadership" from the governor's office. He said the state Health Council should exercise its legally endowed authority to more actively guide the next state health officer and stabilize North Dakota's COVID-19 response. The lawmaker called for a special meeting of the council in a letter to its nine members.

Health Council Chairman Duane Pool said he had received Mathern's letter, but didn't want to comment on it before vetting it more thoroughly.

The council, which meets only three or four times a year, wields a significant amount of power in public health decision-making, according to state law, but it has historically deferred to the governor, his appointed state health officer and the Legislature. The governor also appoints the members of the council.

However, Burgum will ultimately make the call on who serves as the next state health officer. Nowatzki said the application deadline for the position is Wednesday, Sept. 30, and one of the applicants will be hired after that. He added that the role "is currently one of the most demanding jobs in government, and filling the position at any time during this pandemic is a challenge."

Shelley Lenz, Burgum's Democratic-NPL challenger in the November election, said last week she doesn't know how Burgum will find a qualified state health officer after the recent resignations, but Nowatzki said the governor's office has already received applications. He said the office does not comment on applicants as a practice.

Plastic surgeon and Republican state Rep. Rick Becker has publicly declared his desire to be the next state health officer, but only if Burgum agrees to follow his COVID-19 plan that defies measures laid out by public health experts.

The founder of the Legislature's ultra-conservative Bastiat Caucus, who holds a medical degree from the University of North Dakota, submitted his unofficial application for the position in an open letter to Burgum shortly after the announcement of Mariani's resignation on Friday. Nowatzki said the governor is aware of Becker's letter, but the office has not received a formal application from him.

Becker, who unsuccessfully ran for governor against Burgum in 2016, acknowledges there's no way his former opponent would actually appoint him to the position, but he wanted to give the governor the opportunity. The lawmaker has been a harsh critic of Burgum before and during the pandemic, even calling him "#DeceitfulDoug" and "Boss Burgum" on his Facebook page.

"It’s not even that I want this position, but I would be willing to take it if the governor would change course," Becker said. "The last thing I want is a bureaucratic government job."

Becker's 10-point plan, dubbed #FreedomNotFearND, involves:

  • Stopping all mass testing in favor of testing only symptomatic residents.
  • Shutting down contact tracing operations, which he says don't help during "ubiquitous pandemics."
  • Putting all children back in school five days a week, with mask-wearing optional.
  • Ending all marketing campaigns aimed at encouraging mask use and social distancing.
  • Eliminating all criminal penalties for not following Department of Health orders "because we aren't China."

Rick Becker
Rick Becker

The lawmaker said the ideas forwarded in his plan stem from his belief that there is little evidence to suggest measures taken by the state to prevent the spread of COVID-19 have positive net effects. Some of Becker's assertions are rebutted by national and state health experts, including North Dakota Field Medical Officer Dr. Joan Connell, who said earlier this month that recent studies prove that mask mandates are effective.

The plan also diverges with strategies Burgum has employed. The first-term governor has heavily emphasized mass testing and contact tracing, where North Dakota ranks near the top in the nation. He has also encouraged mask-wearing and social distancing, even while repeatedly refusing to mandate the practices.

Forum News Service reporter Adam Willis contributed to this report.