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R.I. health director Dr. Nicole Alexander-Scott stepping down

An appointee of former-governor Gina Raimondo, Alexander-Scott said she’ll continue to serve for the next two weeks as the state looks for a replacement director for the state Department of Health

Dr. Nicole Alexander-Scott, Director of RI Dept. of Health addresses the media in November 2021.MARK STOCKWELL FOR THE BOSTON GLOBE

PROVIDENCE — Dr. Nicole Alexander-Scott, the director of the state Department of Health, is stepping down, the state announced Thursday.

Alexander-Scott, an appointee of former governor Gina Raimondo who led the department through two pandemic years and two administrations, said she’ll continue to serve for the next two weeks as the state looks for a replacement. Alexander-Scott has served in her role since 2015, staying on after Governor Dan McKee took over when Raimondo became US Commerce Secretary in March 2021.

Alexander-Scott has been one of the state’s most high-profile officials throughout the COVID-19 pandemic. A New York City native, she did a four-year combined fellowship in adult and pediatric infectious diseases at Brown University, and also has a master’s in public health from Brown.


“Serving as the Director of the Rhode Island Department of Health has been the most rewarding experience of my career,” Alexander-Scott said in a statement.

Alexander-Scott will also serve as a consultant for the Health Department for three months after taking one month of leave. She is one of only five state health directors to serve as long as she has, the state said. The exhaustion of two pandemic years has led to many public health officials leaving their roles even before this latest wave of COVID-19 infections.

“Dr. Alexander-Scott has been a steady, calm presence for Rhode Island as we’ve worked together to fight the COVID-19 pandemic,” McKee said in a news release, saying he accepted her resignation “regretfully.”

Alexander-Scott was serving in her second Senate-confirmed five-year term, which was to run through 2025. She did not say what her next steps would be.

The state is currently dealing with a high level of COVID-19 infections, although the state’s models show the peak could be soon.

Her departure comes after months of behind-the-scenes tensions between the Health Department and other parts of McKee’s team. Those tensions never quite burst into public view, but sources on both sides of the rift describe a Health Department that often urged McKee to act more aggressively than he was willing to, and a governor who was concerned about the effects his action could have on other interests, like small business. On masks, for instance, Alexander-Scott had recommended an indoor mask mandate weeks before McKee eventually put one in place.


Publicly, McKee has sought to tamp down any talk of tensions. When the Twitter hashtag #AppreciationForDrNAS took off in October after a McKee-friendly radio host bashed her, McKee himself joined the Twitter conversation.

But the two have never been close and Alexander-Scott was not in McKee’s inner circle.

On Thursday, McKee’s office said that McKee had not asked her to leave. In fact, Matt Sheaff, a spokesman for the governor, said when Alexander-Scott approached McKee about potential other opportunities over the past few weeks, he asked her to stay.

Dr. Michael Fine, a former director of the state Department of Health, said Rhode Island was losing a “courageous and calm” leader at a difficult time.

“We face an extraordinary moment of what feels like the abandonment of public health by the public and by the government at a time when we need public health most,” Fine said, citing the exodus of local public health officials around the country. “And it’s that clear voice inside the state government that is so critical for all of us.”


Alexander-Scott has been that clear voice, Fine said. He said he is confident McKee will name a replacement who will also serve that role.

As the state faces surging COVID-19 case totals, Fine said he “can’t say that I’m convinced we did the best of anybody.”

“Yet,” Fine added. “Maybe we still can.”

On public health measures, the director can only advocate, and decisions are ultimately up to the governor, who has different interests to balance, Fine said. He didn’t have direct insight into what was going on in state government, he said, but he was sure any public health expert would have been pushing for things like social distancing and aggressive masking.

“If we had intervened — and hindsight is always 2020 — we might have been able to stem this tide,” Fine said. “For whatever reason, we didn’t go in that direction.”

United Way of Rhode Island chief impact and equity officer Larry Warner, who serves on the state’s COVID-19 vaccine subcommittee and the COVID-19 Equity Council, said Alexander-Scott’s departure was another example of a Rhode Island leader of color whose tenure was cut too short.

“Unfortunately, it’s a pattern of leaders of color either taking an early transition in their careers, or just straight up retiring,” Warner said.

Warner said in his view, Alexander-Scott and the broader public health leadership have not been given the resources and freedom they need throughout the pandemic, both in the Raimondo and McKee eras. It’s played out differently of late, but the problem has always been there.


“We’ve been responding to a five-alarm public health crisis for two years, and it’s clear that the public health chief has not been in charge,” said Warner, a former firefighter.

Alexander-Scott is widely respected in the Department of Health. Her departure led to an emotional day among the staff there. According to a source familiar with the call, in a department-wide remote meeting Thursday, Alexander-Scott asked if anyone had any questions about her departure. 

“How do I get my staff to stop crying?” one colleague asked.

Appreciation for Alexander-Scott poured in after her resignation was announced.

“Dr. Nicole Alexander-Scott has led Rhode Island’s Department of Health through unimaginably trying times, and I am grateful for her thoughtful, pragmatic leadership,” House Speaker K. Joseph Shekarchi said. “She has been a steadfast and trusted resource for all of us.”

Shekarchi said he talked to Alexander-Scott Thursday morning and encouraged her to stay.

“While the pandemic is far from over, Dr. Alexander-Scott has set forth the framework to ensure that our state is on the path to recovery,” Shekarchi said.

Senate President Dominick Ruggerio said the state owes Alexander-Scott a “deep debt of gratitude.”

“Dr. Nicole Alexander-Scott’s steadfast leadership during these unprecedented times has been invaluable for our state, and she will be sorely missed,” Ruggerio said.

Dr. L. Anthony Cirillo, the former chief of the center for emergency preparedness and response at the state Department of Health, said Rhode Island was losing someone who’d done “amazing work” both before and during the COVID-19 pandemic.


“Losing a leader who has demonstrated success, that always creates challenges,” said Cirillo, who did not serve under Alexander-Scott but still lives in Rhode Island and practices emergency medicine. “But the strength of the department is the people who work under the director’s leadership. The work that needs to be done doesn’t change. The people who have been fighting this for two years are going to continue to do so.”

Said Dr. G. Dean Roye, chief medical officer of Rhode Island Hospital: “I want to express my immense gratitude toward her. I and other chief medical officers [in Rhode Island] have the utmost respect for the work that she has done dealing with this crisis and navigating the waters that she has with grace and diplomacy. She has done a wonderful job and I wish her all the best.”

Dr. Ashish Jha, dean of the Brown University School of Public Health, called her departure a “huge loss.”

Alexa Gagosz of the Globe staff contributed to this report.

Brian Amaral can be reached at brian.amaral@globe.com. Follow him @bamaral44.