Health Care

Health Commissioner Mark Levine reluctantly fills the spotlight

Mark Levine
Health Commissioner Mark Levine has led the way in Vermont’s Covid-response with a data-driven approach and a focus on the basic tenets of basic public health. VTDigger photo illustration

On July 22, Health Commissioner Mark Levine peered toward a national TV audience, bending his 6-foot 5-inch frame toward the laptop screen as if ducking through a doorway. 

If there was a moment for stardom, this was it. CNN host Becky Anderson praised Levine as an example to the nation, dubbing Vermont “an island of stability in what seems like all of this chaos.” 

What, she asked, was his secret to success?

The commissioner, blinking into his computer screen, didn’t miss a beat. 

Vermonters are “staying home when they’re sick, washing their hands when you’re sick, keeping physically distanced, and wearing a facial covering,” he said matter-of-factly. As Anderson tried to inject controversy about the federal government’s stance on school reopenings, Levine plunged on with a detailed explanation that was, well, boring: Reopening the economy has been “so graduated that it does give us time to really reflect on the data,” he said.

The audience might have let out a collective yawn.

It was pure Levine: data-driven, reliant on the basics of public health, and utterly lacking in drama and sound bites.

As Vermont has led the nation in quelling the worst pandemic in a century, the 67-year-old has stepped to the helm of the effort with a distinctively nerdy aplomb. While health commissioners across the country have clashed with public officials and angry constituents, faced hate mail and accusations of poor leadership, Levine has sidestepped politics. Instead, he’s diligently stuck to his public health talking points, cooled tensions, and served as a fount of the latest scientific research and health updates at Gov. Phil Scott’s twice-weekly press conferences.

“You don’t know what someone’s going to be like when you get into a situation like this,” said former Gov. Howard Dean, who was a University of Vermont medical resident with Levine in the 1980s. Levine has avoided political gaffes or unnecessary controversy with his humble approach. “He doesn’t say things he doesn’t know about. He never gets out in front of himself,” Dean said. “He never misses.”

VTDigger is underwritten by:

Since March, 58 Vermonters have died of the virus, a nationwide low. In early September, the percent of people in Vermont who tested positive for Covid remained below 1%.

The case counts speak for themselves, said Harry Chen, Levine’s predecessor as health commissioner. When it comes to Levine’s work, “the proof is in the pudding.”

Levine works 14-hour days from his office at the Health Department in Burlington, sliding between Zoom meetings: coordinating with colleges, nursing homes, and hospitals, advising the governor on reopening the economy, speaking at press conferences, meeting with doctors and policymakers, and addressing outbreaks and fears that arise.

For months, it was nonstop, “making phone calls and putting your finger in the dike here and creating a policy there,” Levine said. 

He’s gradually, hesitantly, adjusting to the spotlight. “It’s not like I asked for this,” he said of his new role at center stage. “I didn’t ask to have to be the health commissioner at the time of a once-in-a-century pandemic.”

A data man

Before Covid-19 hit, Levine worked in relative obscurity — even within state government. In late January, when the virus had not yet been reported in the U.S., Levine briefed Scott’s cabinet on the virus. “That was probably my first time really knowing who he was,” said Mike Pieciak, commissioner of the Department of Financial Regulation, who has been in charge of Covid-19 modeling for the administration.

He was articulate and had done his research, Piecak noticed. “Even off the bat, you had a great deal of trust and faith in him.”

But Levine was already working behind the scenes on Covid response. 

In February, his department opened up the Health Operations Center to monitor Vermonters who had returned from China, where the virus originated. After a guest who had attended a party in White River Junction tested positive for Covid, Levine and Scott announced the creation of a coronavirus taskforce.  

“Now is the time for Vermonters to prepare mentally and logistically for possible disruptions to our daily lives,” Levine said at the Feb. 28 press conference. 

Indeed, those disruptions would set in two weeks later, when Gov. Phil Scott issued his “Stay Home, Stay Safe” order. Schools closed, employees worked from home, restaurants, bars and theaters shuttered. 

Levine’s work ramped up. 

He set aside the state’s traditional public health work to focus on the pandemic. Instead, he coordinated with hospitals, navigating supplies of personal protective gear, and testing materials. He worked with hospitals to create surge plans, and later, reopening strategies. In April, he started meeting weekly with university presidents and other officials to plan for college reopening in the fall. He helped create a contact-tracing team, and managed the department’s response to outbreaks. 

He has been the governor’s go-to source and key team player.

VTDigger is underwritten by:

“I have been able to rely on him to parse through new information, make solid recommendations, and help me share information directly with Vermonters in a way they can understand,” said Scott, praising Levine’s “expertise, reliability and calm leadership.”

Levine has leaned on data whenever possible — a challenge when addressing the spread of a new virus, said Wendy Davis, Vermont’s health commissioner from 2008 to 2011. As a doctor with a background in academia, Levine “understands as well as anyone how to look at medical literature, then translate that into the lessons that need to be applied,” she said. 

When the data hasn’t been available, he’s done his own research. Levine conducted impromptu surveys on mask-wearing when he went to the supermarket or out to do errands, counting the number of people who came to the store unmasked. He’d come into work and share his findings with his colleagues, said Deputy Health Commissioner Tracy Dolan.

Department officials have occasionally tried to rein in his proclivity for sounding like a technocrat. “Trying to get Dr. L to say masks – what everyone else says – instead of facial coverings,” Department of Health communication director Nancy Erickson wrote in a July email. Other times, they urged him to use more aggressive language in pushing back against false information.

‘A delicate touch’

Levine has presented an aura of calm to the public, even in the midst of conflict, scarce resources, or uncertainty. 

In March, while the state had just days’ worth of Covid testing supplies, Levine and state epidemiologist Patsy Kelso dodged questions from this reporter about the shortages.

“We can do 26 every day, if we have that many tests, and by next week, we’ll be able to do 50 a day and then more beyond that,” Kelso said, while Levine listened in. The next week, Levine said testing capacity “has always been and will continue to be for the near future a mixed picture and far more balanced on the side of optimism,” he said. 

The state ultimately got its tests from a surprising benefactor: William Roy, who at the time worked at the Federal Emergency Management Agency and had previously lived and worked in Vermont, took pity on the state and had the agency send along a batch of testing materials. 

“I mean, we were going with what we had,” said Human Services Secretary Mike Smith of Levine’s public stance. He praised Levine for moving forward with testing even during the shortfall, allowing the state to continue tracking the spread of the virus.

Levine has repeatedly eschewed both conflict and politics. 

In July, some of Levine’s department staff expressed frustration when Manchester Medical Center propagated concerns of a Covid outbreak in southern Vermont, according to emails obtained by VTDigger. The Medical Center reported 65 positive Covid cases using an antigen test, but only four of that total were confirmed by the department’s preferred PCR nose-swab test. 

Levine said there was no outbreak, but declined to excoriate either the medical center or the antigen tests. 

“Our credibility as a health dept. must be preserved,” he wrote in a July 16 email to staff. “We don’t want to engage in combat re: the test and the clinic (though I will let them know our concerns on HIPPA and some of their Facebook posts), and I will take the high road publicly.”

When Manchester Medical Center leaders continued to insist their results were accurate and the Department of Health was wrong, “I really would have let them have it,” said Dean. “But Mark, you know, doesn’t do that. He doesn’t burn bridges.

“That’s a delicate touch.”

Critics suggest that political expediency may have something to do with it. Democratic officials pressed Scott for a mask mandate in June and July, criticizing his administration for not acting sooner. Around the same period, former commissioner Chen said he called Levine and told him it was time to require masks. 

In spite of the pressure, Levine never came out publicly opposing Scott’s laissez-faire stance on masks. Even in private, he never asked Scott to require them, he said in a July interview with VTDigger. “I think the governor kind of knew what I would have said if he asked me if I thought this was a good idea,” Levine said. 

Dolan said her boss has earned the respect of the public because data, not politics, drives his decision.  “He’s not a maverick, he’s not going to just sort of shoot from the hip or come up with an idea,” she said. When Scott needs advice, “he’ll come to the [DOH] team, and ask them to do some research and then he’ll come forward. And I think because he does that he’s trusted.” 

A curious student

Levine steps up to the podium at the governor’s twice-a-week press conferences with a studied earnestness. 

In many ways, he’s a caricature of himself, with the protruding features of a claymation character and a wholesome lifestyle befitting a public health official. He gets up in the early morning hours to ride his exercise bike. (He used to run outside no matter the weather — “I’m not as crazy as I was, you know.”) He eats dinner with his wife every evening; these days it’s not until 8 p.m. He decompresses in the evenings by reading medical journals or Time Magazine. 

Even after six months of interacting regularly with the media, he talks about himself only abashedly in interviews. Whenever possible, he reverts back to public health, giving lengthy, detailed explanations of the latest research on Covid transmission or child immunization rates.

Some of his favorite exclamations are “Geez” and “Oh my!” 

“There’s no scandalous memories, because he’s not a scandalous guy,” Dean said, who used to occasionally have dinner with the Levines. “They are just incredibly nice, thoughtful, smart people.”

Levine hails from Sharon, Massachusetts, the son of an IRS worker and a homemaker. He described himself as a curious kid who excelled in school. 

After degrees from the University of Connecticut and the University of Rochester School of Medicine, he came to Vermont for his three-year internal medicine residency, where he was top of the class, making him eligible to become chief resident.

He spent 10 years at Geisinger Medical Center in central Pennsylvania, first as a doctor, and then training young doctors. 

He moved back to Burlington with his wife, Nancy, a nurse, in 1992 to raise their two kids. He took a gig at UVM overseeing young internal medicine residents, as well as teaching and practicing. Working in internal medicine, the patients he saw often had chronic conditions stemming from years’ worth of health problems. The prospect of addressing the underlying conditions at a more systemic level sparked his interest in public health.

“Most of the work you do there doesn’t happen overnight,” he said. Persuading a patient to quit smoking or improve their eating habits doesn’t happen in an office visit. “I have to talk to them, like for 10 years of office visits.”

His profile among the medical community grew, as he joined a public health working group, and helped lead the  Vermont Medical Society, and the Vermont chapter of the American College of Physicians Board of Regents. He rubbed shoulders with former commissioners and state officials, including Harry Chen, his predecessor who recommended him for the job.

He was appointed to be commissioner by Scott in 2017. 

Mark Levine
Vermont Health Commissioner Mark Levine has been a key player in the state’s coronavirus response. Photo by Mike Dougherty/VTDigger

He showed the same poise early on that he has exhibited during the pandemic, said Al Gobeille, who at the time was secretary of the Agency of Human Services and Levine’s boss.

In his first week of the job, Gobeille took Levine to the St. Johnsbury state office complex, where the state had found dry cleaning chemicals in the soil. Worried and scared employees plied Levine with questions, and at one point, a mother holding a 3-month-old baby in her arms asked the new commissioner whether her baby would be safe. 

“He carefully went through exactly the situation and explained to her why her baby is healthy, and what she should do and how she should think about it in talking with her doctor,” Gobeille recalled. The tension in the room evaporated. “She was happy and comforted,” Gobeille said. “That was when, I was like, ‘this guy has it.’”

When Levine was working to persuade public officials to pass measures against vaping, he brought a creme brulee vape pen to a meeting with Gobeille and Scott. He passed it around and had them smell it, Gobeille said. 

The pitch worked. In early 2019, Scott backed a 92% tax on e-cigarettes. According to Gobeille, “Mark is the only one who convinced the governor to raise taxes.” 

Other times, the health commissioner has drawn criticism for refusing to take a stand in politically charged situations. 

When Douglas Kilburn died after he was punched in the head by Burlington police officer Cory Campbell, the death was ruled a homicide. Then-Burlington police chief Brandon del Pozo reached out to Levine in April 2019 questioning the chief medical examiner’s decision. Many said that del Pozo was inappropriately seeking to change the determination.

Levine dodged the question, saying people should “draw their own conclusions” on whether the email del Pozo sent was an attempt to influence the medical examiner’s determination.

When Levine testified in front of the Legislature on decriminalizing buprenorphine around the same time last year, he said he would support decriminalization in any other state except Vermont. At the time, he worried that people with buprenorphine prescriptions might give or sell the medication to others, and that it could lead to dependency by casual users. 

Brenda Siegel, a former candidate for lieutenant governor and an activist for substance use treatment, said it could have been because the governor opposed the measure. 

She called Levine’s approach to the opioid crisis “antiquated.” “There was this life saving measure that would be sure [to help] some people would survive,” she said. 

Since March, those issues have taken a backseat to Covid. It’s a good week when Levine can spend 20% of his time on his previous duties, he said. Most of the time, it’s less. 

Covid cases in Vermont have continued to remain low. The week of Sept. 3 brought only 30 new cases, and the state continues to be the safest in the region. Only 38 of 42,100 tests run on college students were positive over the past weeks. 

Vermonters have lauded Levine for his efforts. He’s gotten a slew of cards, he said, and now people come up to him in the grocery store to offer thanks. 

But for Levine, the workload isn’t letting up. He’ll tamp down outbreaks as they arise, and his inbox is still flooded with questions on myriad topics. The winter may bring a second wave of Covid. At a press conference Friday, he fielded questions on school reopenings, recent Covid studies, and the prospect of a vaccine. It was one of the few times Levine waded into politics, assuring Vermonters he would proceed with caution.

“The Vermont Health Department is keeping a close watch on the vaccine development process, to be sure that we can trust that politics do not trump science,” he said.

Even Halloween planning fell into his purview. “We do need to take this seriously,” he said. He urged families to think creatively about how to limit large groups, and find ways to hand out candy that didn’t involve kids digging their hands into a basket of treats. 

Levine couldn’t help himself from inserting a public health-style Dad joke, which he telegraphed. “I don’t want to create too much of a joke here but everyone must wear a mask,” he said with a small smile, pausing for effect. The reporters on the call offered a gratuitous guffaw. 

Don't miss a thing. Sign up here to get VTDigger's weekly email on Vermont hospitals, health care trends, insurance and state health care policy.


Katie Jickling

About Katie

Katie Jickling covers health care for VTDigger. She previously reported on Burlington city politics for Seven Days. She has freelanced and interned for half a dozen news organizations, including Vermont Public Radio, the Valley News, Northern Woodlands, Eating Well magazine and the Herald of Randolph. She is a graduate of Hamilton College and a native of Brookfield.

Email: [email protected]

Send us your thoughts

VTDigger is now accepting letters to the editor. For information about our guidelines, and access to the letter form, please click here.


Recent Stories

Thanks for reporting an error with the story, "Health Commissioner Mark Levine reluctantly fills the spotlight"