The director of the Wyandotte County Public Health Department is no longer with the agency, a spokesperson confirmed Tuesday. It comes after turmoil during the handling of the major tuberculosis outbreak, shown by emails obtained by the Kansas News Service.
Elisha Caldwell had been head of the local health department while an outbreak of TB grew in the Kansas City area, becoming one of the largest in recent U.S. history. He started at Wyandotte County’s health department in October 2023.
The emails obtained by the Kansas News Service through an open records request show conflict between the local health department, state and federal officials.
The conflicts centered around things as basic as the use of Wyandotte County office space and escalated from there. The state ultimately took over the TB response as outbreak-related numbers ballooned to 67 active cases, including 60 in Wyandotte County and seven in Johnson County.
Caldwell said he would not comment right now on his departure from the health department.
“I just think it’s not the right time to talk,” Caldwell told the Kansas News Service in a brief phone conversation Tuesday. “I’m very passionate about public health and this community.”
Facts about the outbreak
Dr. Allen Greiner has served as the public health officer for Wyandotte County’s health department for more than 20 years. He’s also a family practitioner for the University of Kansas Health System.
At the beginning of the outbreak in early 2024, Greiner helped diagnose and treat patients. He said he believes the outbreak is winding down now despite the troubled response.
“We've been very lucky that things have worked out the way they have given the sort of rocky road that's gotten us to this point,” Greiner said in an interview.
The first cases associated with the outbreak were recorded in January 2024. Things reached a fever pitch in the late spring and early summer, when new cases of tuberculosis were rolling in at high numbers.
“We were getting sometimes 10 or 20 new cases from a testing event,” Greiner said.
Greiner and multiple other public health officials said the general public is not at risk of catching tuberculosis from this outbreak. Tuberculosis takes close, repeated contact to contract.
When the cases started to spike last summer, the Centers for Disease Control and Prevention and the Kansas Department of Health and Environment came to Kansas City, Kansas, to assist the Wyandotte County Public Health Department with the outbreak.
Conflicts shown in emails
According to Griener and hundreds of emails obtained by the Kansas News Service, things started out smoothly between leadership at the CDC, KDHE and the Wyandotte County Public Health Department. Emails were cordial and welcoming.
But that relationship began to sour as disagreements about how to contain the outbreak and treat patients arose.
“Sometimes there's too many cooks in the kitchen on these kinds of things and different people think they have the right idea,” Greiner said.
In the beginning, CDC and KDHE staff were temporarily housed at the Wyandotte County Public Health Department. On Aug. 15, Caldwell sent an email to Lauren Swensson, the state’s TB controller and director of KDHE’s Bureau of Disease Control and Prevention and Ashely Goss, KDHE’s deputy secretary. The email was addressed to Swensson.
He said he did not like how he was addressed regarding the use of the county’s meeting spaces.
“While I value our collaboration and am eager to continue working together, I am not one of your staff,” Caldwell told Swensson.
Caldwell told Swensson and Goss that moving forward, they’d need to reserve meeting spaces in advance for KDHE use. He assigned a designated space for them to use otherwise. Goss responded, apologizing for the last minute use of their conference room.
“This does not give Lauren the right to speak to me in any manner she chooses,” Caldwell responded in an email. “I have had ongoing concerns about issues with interpersonal communication, and this behavior cannot continue without potentially impacting our working relationship.”
The next day, Caldwell sent Goss another email and copied Janet Stanek, KDHE’s secretary. He urgently requested a meeting with Goss, her staff and the CDC representatives.
“It has come to my attention that CDC and State representatives have been conducting calls in our health halls with their phones on loudspeakers,” Caldwell said in the email.
He continued, accusing CDC staff of entering Wyandotte County offices and “occupying spaces” without permission. Caldwell said he’d also received complaints from his staff saying CDC employees had been rude.
“If this behavior continues, we will have no choice but to ask the CDC and State representatives to find alternative office space outside our facility,” he said.
Goss responded saying she’d spoken to her staff and they all knew to stay in the room they were assigned or go outside.
“Our teams need to stay together,” Goss told Caldwell.
In another email thread on Aug. 29, Caldwell asked Goss about funding for the outbreak. After trading emails, Caldwell said his questions weren’t answered and pointed out his teaching experience
Stanek, who must have been forwarded the email thread, sent an email to Goss and Caldwell, perhaps mistakenly.
“His staff must be really complaining. I am ready to talk to him when u advise. His notes about teaching etc are so off point,” Stanek said in the email.
Caldwell responded a few hours later at 10:55 p.m.
“Well, I am ready to talk any time with KDHE because your staff created a toxic workplace environment for my teams.” Caldwell wrote. “My email is not out of place, and KDHE will not rule our health department.”
Several people spoke to the Kansas News Service on the condition of anonymity because they are either current employees of the Wyandotte County Health Department and are fearful of losing their jobs or they recently left the health department and do not want to damage their careers.
All of them were involved in containing the tuberculosis outbreak that started last year. They said this type of back-and-forth between Caldwell and KDHE staff happened a lot.
The state takes over
KDHE ultimately took over work on the outbreak after several months. Greiner, the Wyandotte County public health officer, said the change happened abruptly in November 2024.
He said there was not a lot of communication to Wyandotte County staff, which he feels was abnormal in a situation like this.
“Literally within minutes, folks came and took all the medications and took all their supplies, and people (at Wyandotte County’s health department) were locked out of the epidemiologic tracking system,” Greiner said.
Greiner said the transition was difficult for patients. He said health workers at Wyandotte County’s health department (himself included), had spent months gaining the trust of the community experiencing the outbreak and had developed relationships with them.
“I don't think we've done the best job of serving these patients, the families, this community or the broader community of Wyandotte and Johnson counties,” Greiner said.
A KDHE spokesperson confirmed the transition.
“In an effort to provide efficient and quality care to those individuals affected by the outbreak, KDHE assumed responsibility for the coordination and distribution of testing, treatment and medical consultation in Wyandotte County,” the spokesperson said in an email to the Kansas News Service.
The sources who spoke to the Kansas News Service said when KDHE took over there was a lot of confusion. Multiple people came to the health department for treatment but were turned away and directed to a parking lot mobile unit where KDHE and the CDC were working.
Greiner said thankfully, to his knowledge, the leadership shakeup did not result in missed tuberculosis cases or patients discontinuing treatment.
Greiner said regardless, it’s important for public health officials to maintain trust with communities in Wyandotte County because ultimately, there could be other outbreaks in the future.
“Trust is really hard to develop and maintain without continuity and stability,” Greiner said. “Developing longitudinal trust would be good even if this outbreak sort of ends.”
Bek Shackelford-Nwanganga reports on health care disparities and access for the Kansas News Service. You can email her at r.shackelford@kcur.org.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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