As measles spreads, top doctor defies CDC recommendations. Who is Florida’s surgeon general?

UPDATED 2/27/24: Another case reported in Broward County.

A highly infectious and potentially fatal airborne disease is spreading in Florida. Federal and medical professional guidelines recommend certain simple steps to control the spread, but Florida's top doctor defies health experts and instead urges parents and guardians to decide whether to keep their exposed children at home away from other kids.

Previously, that was COVID-19, which to date has infected at least 8 million Floridians and killed over 94,000. Now it's measles, a highly contagious but easily preventable disease that had been eradicated in the United States but has been making a resurgence as rates of vaccinations drop, according to federal data.

Six children at Manatee Bay Elementary School, in Westin near Fort Lauderdale, caught the disease over a week ago. New state health data show three more cases of infected children in Broward County, and an adult in Polk County.

Map: See where measles cases are being reported across the US

Florida Surgeon General Joseph Ladapo sent a letter to the elementary school parents saying it was "normally recommended" for unvaccinated children who have not previously had the disease to be kept home for three weeks "because of the high likelihood" they would get infected. But he also said the state would not mandate such a move, saying the Florida Department of Health was "deferring to parents or guardians to make decisions about school attendance.

"This recommendation may change as epidemiological investigations continue," he said.

Measles is contagious. It is so contagious that if a person has it, up to 9 or 10 people around them will also get it if they are unvaccinated, according to the CDC. It is so contagious that a child can get measles by being in a room or touching a surface where an infected person has been for up to two hours after that person has left. And an infected person is contagious up to four days before showing any signs of the disease.

There is no cure. Health professionals can only treat the symptoms and address complications.

About one in five people who get measles will be hospitalized, the CDC said. One in 10 develop ear infections that can lead to permanent hearing loss. One in 20 will develop pneumonia, the most common cause of death from measles in young children, according to the Florida Department of Health. About one in every 1,000 people who get measles will develop brain swelling (encephalitis) that can lead to brain damage, and one to three of those people will die, "even with the best care," the CDC said.

Measles is also easily prevented by a regular measles, mumps and rubella (MMR) vaccine. But trust in vaccines is down and the number of vaccine exemptions has hit a record level, according to federal data.

Why is the state's leading medical official promoting parental decisions over community health?

Who is Dr. Joseph Ladapo, Florida Surgeon General?

Joseph Abiodun Ladapo, 45, is a Nigerian native and son of a microbiologist who immigrated to the U.S. with his family in the 1980s. Ladapo earned a Bachelor of Arts in chemistry from Wake Forest University and an M.D. and a Ph.D in Health Policy from Harvard University. He worked at different hospitals in New York City and served as a professor at the NYU School of Medicine and a staff fellow with the Food and Drug Administration before becoming a researcher at the David Geffen School of Medicine at UCLA. Ladapo is married, with three young sons.

Ladapo's primary research interests, according to his previous online "about" page with UCLA Health, included assessing the cost-effectiveness of diagnostic technologies and reducing the population burden of cardiovascular disease.

Despite his lack of specialization in infectious disease, he also became prominent in the movement against the mainstream medical community's positions on treatments, vaccines and masking. Ladapo wrote editorials for the Wall Street Journal, USA TODAY and the New York Daily News on the topic, saying masks have “little or no effect on respiratory virus transmission” despite studies to the contrary and recommending treatments such as the antimalarial drug hydroxychloroquine and the anti-parasitic drug ivermectin, which have since been proven ineffective.

Ladapo has been associated with extremist groups such as America's Frontline Doctors and the Tea Party Patriots Action and was a signatory of the Great Barrington Declaration, which criticized most pandemic mitigation measures and instead recommended allowing people to be infected to create a natural, or "herd," immunity, an idea supported by then-President Donald Trump but considered dangerous by researchers and the larger medical community.

Supporters have said he is an intelligent and credentialed scientist and fully qualified. Some of Ladapo's previous colleagues at UCLA have expressed surprise and shock at his views after the pandemic began.

When did Joseph Ladapo become Florida's Surgeon General?

In 2020, then-Florida Surgeon General Scott Rivkees said in public that to fight the growing dangers of the COVID-19 pandemic Florida might need to practice social distancing well into the next year.

This conflicted with Gov. Ron DeSantis' growing message of opening up Florida and getting children back into schools, which turned into claims of governmental oppression and speeches in favor of personal freedom. The state's Surgeon General was kept out of public sight for months, during a global pandemic, before Rivkes retired in 2021. DeSantis replaced him with Ladapo, who had just been hired by the University of Florida College of Medicine, two events that DeSantis said at the time were coincidental.

That employment was later discovered to have been fast-tracked with the help of a DeSantis donor, resulting in the governor-appointed Florida Board of Medicine's approval in only two days rather than the usual 2-6 months. Ladapo was reportedly pushed through the UF hiring process. He also received a 52% raise over Rivkees, making him one of the top ten highest-paid Florida government employees.

Ladapo was quick to support DeSantis' views and provided plenty of his own on social media, at public events and on multiple far-right anti-vaccine podcasts, claiming there was a concerted effort to hide stories of people with adverse reactions to vaccines, accusing the government in general and the former director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, in particular of defrauding the American people, and urging Floridians to follow their intuition over medical professionals.

“Just check in with your gut. Who do you think you can trust, and go with those individuals,” Ladapo told First Class Fatherhood podcast host Alec Lace.

Dr. Joseph Ladapo's controversy timeline in Florida

September 2021: Within a day of being hired, Ladapo signed new rules allowing parents to decide if children exposed to people who tested positive for COVID had to quarantine or if they could go to school, eliminating the previous requirement for exposed students to quarantine off campus for at least four days. "Fear is done," he said during a press conference.

October 2021: Ladapo refused to wear a mask at a meeting with Democratic state Sen. Tina Polsky even after she told him she had a serious medical condition (later confirmed as breast cancer) and was at a higher risk for serious complications from COVID. After she asked him to leave and word got out, a firestorm erupted with Democrats and members of the medical community castigating him for endangering her life. Ladapo issued a statement nearly a week later saying he was saddened by her diagnosis but didn't think he could communicate effectively with a mask on.

Ladapo appeared at DeSantis' side in public appearances, promoting monoclonal antibody treatment, supporting the governor's views on blocking vaccine and mask mandates and accusing the public health community of fearmongering. Critics accused him of spreading misinformation that led to people being hesitant or afraid of vaccines.

December 2021: The Florida Department of Health rejected a complaint about Ladapo that said he violated state medical laws by publicly casting doubts about COVID vaccines and promoting unproven treatments.

January 2022: Senate Democrats all walked out of Ladapo's confirmation hearing before the Senate Health Policy Committee after what they said was a lack of honest answers about his qualifications and the current state of the pandemic during a lengthy interview.

At a press conference that month, DeSantis and Ladapo told Floridians who weren't showing symptoms not to get tested. “If you don’t have symptoms, you are not a case," Ladapo said.

According to the CDC, asymptomatic people with COVID can still pass it on to more vulnerable people and they may still develop debilitating long COVID themselves weeks later. Epidemiologists were also quick to point out that early diagnosis means early treatment, and researchers use testing to track infection paths and variant strengths.

February 2022: During his confirmation hearing Ladapo dodged questions about vaccine effectiveness, how much time he actually spent at UF, whether he had been vaccinated himself, and his connections with "fringe medical group" America’s Frontline Doctors. He was ultimately confirmed along party lines.

April 2022: Ladapo's FDOH cited a study by an Australian pediatrician to support restricting transgender health care. The pediatrician, Dr,. Ken Pang, strongly objected to the medical board, saying his research was misrepresented and showed exactly the opposite. "To be seeing the research we've done being utilized in this way — I was just dismayed by that,” Pang told VICE.com.

June 2022: DeSantis and the FDOH, under Ladapo, refused to pre-order COVID-19 vaccines for children under five when they became available, the only U.S. state to do so, citing the lack of need and the risks. Ladapo appeared before Congress to defend the state's decision and said the state didn't recommend vaccines for children under 18.

October 2022: Ladapo urged men younger than 40 to avoid the Pfizer and Moderna mRNA vaccine and booster shots because of the "abnormally high risk of cardiac-related death among men in this age group," citing an anonymous non-peer-reviewed analysis from the FDOH. The move prompted a backlash from doctors, researchers and the federal government. At the time, Florida was leading the country in COVID deaths for the third month in a row.

January 2023: A task force of UF medical school doctors concluded that the FDOH recommendation against COVID vaccines for young men was of “highly questionable merit" and that Ladapo cherry-picked data to support his stance. Politico went further and, after examining different drafts of the analysis, reported that Ladapo had personally changed the study to remove data that contradicted his views. Ladapo has denied this.

March 2023: In response to a letter from Ladapo demanding answers based on his own research on vaccine safety, the FDA and CDC asked him to stop disproportionally focusing on the small number of adverse effects in the studies of 13 billion COVID shots given around the world while ignoring the number of people the vaccines have saved. "Unfortunately, the misinformation about COVID-19 vaccine safety has caused some Americans to avoid getting the vaccines they need to be up to date," the letter reads.

April 2023: The FDOH under Ladapo stopped reporting COVID infections and deaths to the federal government

September 2023: Ladapo recommended against anyone under the age of 65 getting the new COVID-19 vaccine booster the FDA approved to combat new, more infectious variants, directly contradicting CDC guidance. He claimed that the mRNA boosters altered human DNA, which the CDC and multiple studies have said is false.

November 2023: After a two-year battle over COVID public records, the FDOH under Ladapo settled a lawsuit about withholding COVID data and released information spanning the entire duration of the pandemic on the state's FLHealthCHARTS.gov site. However, the agency also stopped providing cumulative totals, percentages, new case positivity, data on booster doses and overviews that made it easier to see trends.

January 2024: Ladapo made headlines again by "calling for a halt to the use of mRNA COVID-19 vaccines" because he said he didn't receive an adequate response from the FDA about the safety of vaccines. Meanwhile, Florida was seeing a spike in new COVID cases and hospitalizations.

This article originally appeared on The Daytona Beach News-Journal: Joseph Ladapo: Florida surgeon general at odds with CDC over measles