SIOUX FALLS, S.D. — The president and CEO of one of the nation's largest non-profit health systems says he won't be wearing a mask at work because he's recovered from COVID-19, and doing so would only be a "symbolic gesture" because he considers himself immune from the virus.
Kelby Krabbenhoft of South Dakota-based Sanford Health laid out his thoughts about having COVID-19, and why he wouldn't be wearing a mask, in an email sent to health system employees late Wednesday afternoon, Nov. 18, and obtained from multiple sources by Forum News Service.
Krabbenhoft said he is still experiencing "lagging coughs and fatigue," but told employees he was back in the office -- without a mask.
"For me to wear a mask defies the efficacy and purpose of a mask and sends an untruthful message that I am susceptible to infection or could transmit it," he said. "I have no interest in using masks as a symbolic gesture when I consider that my actions in support of our family leave zero doubt as to my support of all 50,000 of you. My team and I have a duty to express the truth and facts and reality and not feed the opposite."
Krabbenhoft's 1,000-word email provides a unique window into the thinking of the leader of the large health system, which has notably not joined cross-town rival Avera Health in supporting a public mask mandate in Sioux Falls, its hometown, even as local and statewide COVID-19 hospitalizations have surged.
Sanford Health employs about 48,000 and has major medical centers and more than 200 clinics in South Dakota, North Dakota and Minnesota.
Krabbenhoft, who is not a doctor, based his decision not to wear a mask on his view that he's developed an immunity to COVID-19.
"The information, science, truth, advice and growing evidence is that I am immune for at least seven months and perhaps for years to come, similar to that of chicken pox, measles, etc.," he wrote, without specifying sources for his claim.
However, the current science is far less clear that Krabbenhoft is immune for seven months, much less years. In South Dakota alone, health department officials announced late last month they were investigating 28 possible cases of COVID-19 reinfection, in people who had previously tested positive at least 90 days before.
State health officials said then they're still waiting for large-scale studies to know if and how long a COVID-19 survivor retains antibodies to the point that they're immune from reinfection.
The Centers for Disease Control and Prevention currently says that in lieu of a full understanding about reinfection, those who have had COVID-19 should join those who haven't in taking steps to reduce the risk of spreading the virus, by wearing masks in public places, social distancing and hand hygiene.
"The duration and robustness of immunity to SARS-CoV-2 remains under investigation," the CDC states, using the technical term for the virus that causes COVID-19, in a summary updated Oct. 19. "Based on what we know from other related human coronaviruses, people appear to become susceptible to reinfection around 90 days after onset of infection."
But Krabbenhoft told employees of his frustrations with the conversation surrounding masking.
"Masks have been a symbolic issue that frankly frustrates me," he writes, arguing the "on-again,off-again" use of masks is absurd.
"On the other hand, for people who have not contracted the virus and may acquire it and then spread it…. It is important for them to know that masks are just plain smart to use and in their best interest," he wrote, underlining the last three words in his email.
Krabbenhoft also noted that some Sanford workers soon would be the first to get a COVID-19 vaccine, as state officials have said it would go first to frontline healthcare workers dealing with virus patients.
Those who get the vaccine will then "have the responsibility to demonstrate confidence, professional poise, and your personal swagger that communicates that we have overcome fear, illness, and misunderstanding to live and engage each other in our communities again," Krabbenhoft wrote.
Full text of Sanford Health President and CEO Kelby Krabbenhoft Nov. 18 email to employees:
Dear Sanford Family,
I have had the virus (COVID-19).
I contracted the virus, felt the uncertainty that accompanied the word “positive,” endured the symptoms, complied with quarantine and all protocols, experienced the lagging coughs and fatigue… but I’m back in my office, working on the priorities of Sanford and most of all focusing on making sure we live up to the expectations of everyone who trusts us with their care, and doing everything I can to support you and thank you for creating the most significant standard of calm, professional, consistently compassionate and steady care for your fellow Sanford Family members and everyone who relies on you for factual, truthful, and common sensed information in today’s chaotic times.
I have had the virus.
So what does that mean? Every Monday I assemble the best leadership in this part of our nation, around me for our weekly meeting. I am briefed daily about the State of Sanford and this virus, AND the 90% of other patients seeking care for all their concerns unrelated to the virus. But every Monday, I ask what we know about the virus. From the appropriate use of masks, to vaccine development and distribution, to policies on visitation, to staff that are affected by the virus, and the research on immunity and safety… and more.
For 37 weeks, the best infectious disease physicians, immunologists, the President of Sanford Research, the Sanford Chief Medical Officer, the President of Sanford’s Physician Group, the Sanford Chief Operating Officer, and the Sanford Chief Nursing Officer, all answer the same questions I ask every week so I know if the science, the truth, the facts and common sense have changed.
For 37 weeks, some things have changed:
- Do we have enough ventilators (remember that?)?
At first the answer was no, but now we have more sitting idle than we will likely ever use.
- Will we lose a significant number of staff to quarantine?
At first we feared this but now we have solutions, and I knew that even when volumes were low that it would be foolish to furlough and cut back. So I pushed the “other direction” and reinforced job security, confidence, support financially and, as any good family, for those who were disaffected at home. You are feeling the stress of this like all of us, but you are leaders in these times, trained and aware of that, and you are living up to your calling and our reputation. You’ve earned that incredible personal reputation, lets hold it and reinforce it.
- Many other things have changed, most importantly that the majority of you have not contracted the virus and will be first to get the vaccine in just a matter of weeks and will then have the responsibility to demonstrate confidence, professional poise, and your personal swagger that communicates that we have overcome fear, illness, and misunderstanding to live and engage each other in our communities again.
- Masks have been a symbolic issue that frankly frustrates me. Many of you know that I’m an old scrub technician from my youth. For 40 years, I know extremely well the purpose of masks in infectious control and the security of the operating room relative to managing infectious protocols there and on the floors in contagious and dangerous infectious situations. The “on-again, off-again” behavior of mask use by the general population violates every notion of serious infectious management that I was trained to adhere to, so some of this is absurd. On the other hand, for people who have not contracted the virus and may acquire it and then spread it…. It is important for them to know that masks are just plain smart to use and in their best interest.
- Most importantly, do we have everything and everyone we need to take care of those who come to us for care?
The answer is to that has been and is, Yes.
I have had the virus.
What does that mean to me and others that have had it like me?
The information, science, truth, advice and growing evidence is that I am immune for at least seven months and perhaps for years to come, similar to that of chicken pox, measles, etc. For me to wear a mask defies the efficacy and purpose of a mask and sends an untruthful message that I am susceptible to infection or could transmit it. I have no interest in using masks as a symbolic gesture when I consider that my actions in support of our family leave zero doubt as to my support of all 50,000 of you. My team and I have a duty to express the truth and facts and reality and not feed the opposite.
These are serious issues, and they require us to humbly acknowledge that to stand up and honor the truth and advice we know about the virus is lonely, not popular, or subject to criticism. We need to stand on the high ground of science, facts, and truth anyway. These are serious matters. I know that an overwhelming number of you will take this note as intended, that it reflects the best information and advice that we have at Sanford and beyond. I pray we are significantly united in this situation. There is always room for those who might see it differently and, as always, I would hope for a respectful and reasoned opportunity to discuss concerns, either with myself or any of my Executive Team whom you know well.
I am optimistic about our future, we are extremely strong and are experiencing the most significant performance in our history. From the amount of daily care we are giving people in 26 states, to contributions we are making in research and solutions, to our business affairs… we are an incredible organization. My optimism is held quietly, however, because of those who are hurting emotionally by this virus, because we have lost family members to this virus, and that this virus has seemingly found a way to divide so many from a common struggle, that appears to have a remarkably positive outcome.
I have had the virus. A vaccine is being readied for distribution. As a people we have suffered but we have overcome.
Please travel safely, we need you.