The Case of Dr. Edward Simmer and the Shifting Role of Evidence-Based Leadership in South Carolina

In light of South Carolina’s recent public health restructuring, the rejection of Dr. Edward Simmer—once confirmed almost unanimously—offers a case study in how scientific leadership is increasingly shaped by cultural and political tides. This article explores how pandemic-era backlash, shifting policy priorities, and ideological symbolism intersected in one pivotal confirmation hearing.

The Case of Dr. Edward Simmer: From Confirmation to Rejection

In 2021, Dr. Edward Simmer was confirmed by the South Carolina Senate with a tremendous 40–1 vote to lead the Department of Health and Environmental Control (DHEC). Simmer, a Navy psychiatrist with experience in both clinical and administrative roles, was appointed during the pandemic to help stabilize public health leadership at a time of heightened uncertainty. Just four years later, a Senate Medical Affairs Committee rejected his nomination to direct the newly formed Department of Public Health—by a vote of 12 to 1.

This reversal may reflect a broader shift in the political landscape, where public health leadership is no longer viewed as a neutral institution, but as a contested symbol—seen by some as steady and data-driven, and by others as no longer in sync with post-pandemic cultural values such as personal liberty and local self-governance.

Public Trust, Symbolism, and the Role of Expertise

Dr. Simmer, a Navy psychiatrist with a history of composed leadership, became a highly visible figure during South Carolina’s pandemic response throughout his tenure. His recommendations—masking, vaccination campaigns, and other basic public health precautions—reflected national and international best practices at the time. Yet what was once seen as competent, cautious leadership is now being reframed by some legislators as excessive and symbolic of overreach.

This transition reflects a broader recalibration of public sentiment. Senator Tom Fernandez articulated this shift in framing clearly, stating:

“We didn’t have all the information. This is what we did have. We had the United States Constitution. We had personal liberty. We had personal freedom. That’s the best information at any time of any emergency.”

His words reflect a growing ideological divide in how the role of science and evidence is interpreted during public health crises, placing individual autonomy at the center of public health decision making. Expertise is no longer judged solely by training or outcome—but by its perceived alignment with cultural values, even if it does not coincide with medical consensus. 

Simmer’s rejection appears to have less to do with individual performance and more to do with what he came to symbolize: continuity with COVID-era policies, trust in federal guidance, and an adherence to evolving scientific consensus. For some, these traits reflect professionalism and institutional reliability. For others, they resurface unresolved frustrations tied to the emotional and economic tolls of pandemic life—evoking painful memories of isolation, financial strain, and perceived loss of control.

From a behavioral perspective, Simmer’s public presence may have triggered emotional associations for some constituents, particularly those who experienced hardship or loss during the pandemic. For constituents whose history during the pandemic involved job loss, restricted movement, or educational disruption, even neutral or well-intentioned leadership could come to represent something oppressive. His visible alignment with health protocols, though grounded in evidence, may have unintentionally reinforced associations with coercion or loss of agency among constituents who experienced pandemic mandates as personally disempowering.

Though Simmer had a personal stake in protecting vulnerable populations—including his immunocompromised wife—his calm demeanor, while well-suited for crisis leadership, may still have been perceived by some as detached from the emotional and economic tolls many residents experienced. In a post-crisis climate, even neutral expertise can feel distant, and evidence-based decision-making may struggle to resonate with communities shaped by loss, fear, or disruption.

This tension reveals the complexity of public leadership in politically polarized times. What one community sees as principled, another may interpret as passive. What one sees as protective, another sees as controlling. These competing interpretations suggest that Simmer’s rejection was shaped as much by symbolic perception as by his professional record.

Structural Shifts and Political Realignment in SC Health Policy

South Carolina’s health governance is also undergoing structural change. In 2024, the state dissolved DHEC and created two separate entities: the Department of Public Health and the Department of Environmental Services. With this reorganization came new expectations for leadership. It is possible that Simmer, who had already been leading in a centralized system, was seen as less aligned with the newer, more ideologically scrutinized vision for public health leadership.

His long association with the former agency—coupled with a procedural, operations-centered approach shaped in part by a personal commitment to protecting vulnerable populations—may have conflicted with a new political appetite for leaders who not only act, but visibly signal alignment with narratives of personal liberty and local control.

As the first nominee to lead the new Department of Public Health, Simmer may have carried symbolic weight from the pandemic era. For some lawmakers, confirming his leadership may have felt like preserving continuity with not only the policies of that time, but also with its communication style and governing philosophy. Though his approach was moderate, his association with state-driven COVID-19 responses was perceived by some as incompatible with a climate increasingly defined by cultural signaling and post-pandemic realignment.

Retrospective Blame and the Effect on Leadership

Senator Matt Leber, another opponent, criticized Simmer not for any specific misconduct, but for failing to oppose minor symbolic measures—such as plexiglass barriers in schools or traffic flow controls in grocery stores. Many of these decisions were made at the local or institutional level, yet Simmer was expected to have publicly resisted them.

This pattern of post-crisis evaluation raises important questions: To what extent are public health leaders being assessed based on outcomes shaped by evolving knowledge and unprecedented conditions? In the absence of clear emotional resolution following a collective trauma, it’s not uncommon for leaders to become vessels for public projection—absorbing frustration, grief, and disillusionment that have no obvious outlet. Empathy, then, is not just a moral ideal. It becomes a necessary tool for understanding how fear and powerlessness can distort perception, shifting the focus from systems to representations, and from nuance to blame.

Such retroactive framing creates a dangerous precedent—one in which leaders are penalized not for errors in judgment, but for failing to embody a politically resonant stance at the right moment. It reveals a growing discomfort with technocratic or science-based leadership that favors measured neutrality over ideological affirmation. If principled decision-making can be reframed as passivity, and calm expertise as complicity, we risk fostering a climate where integrity becomes a liability rather than a professional asset. What kind of leadership are we truly asking for? And more significantly—what will that mean when the next public health crisis arrives?

Implications for the Future of Public Health

Simmer’s rejection has implications beyond South Carolina. It reflects the broader politicization of public health roles in the United States and raises serious concerns about recruitment, retention, and trust in leadership. If a physician who received near-unanimous approval in 2021 is rejected in 2025 for following consensus-based practices, what precedent does that set for future crises?

This isn’t the first time a public health official has faced ideological backlash. During the COVID-19 pandemic, national figures like Dr. Anthony Fauci became scapegoats for public frustration—praised by some as voices of reason, and vilified by others as symbols of government overreach. Even at the state level, health directors in places like Ohio and California resigned under pressure due to threats, political tension, or accusations of partisanship. These patterns suggest that what Dr. Simmer experienced is part of a broader trend: when science intersects with fear, uncertainty, and political polarization, public health leadership can become a proxy battleground for larger cultural conflicts.

The danger lies not only in the politicization of science, but in the chilling effect it may have on future leadership. If a figure with broad bipartisan support in 2021 can be rejected for the same actions in 2025, what does that reveal about the evolving standards for public service? Will capable professionals begin to retreat from public roles for fear of ideological backlash? And what becomes of long-term public health planning in a system where leadership is this vulnerable to symbolic interpretation and scapegoating? The erosion of institutional memory under such conditions doesn’t just weaken trust—it threatens the responsiveness of our public health infrastructure when the next emergency inevitably arrives.

Conclusion

Viewed through an analytical lens, the rejection of Dr. Edward Simmer reflects more than a political decision—it signals a broader shift in public sentiment and the growing fragility of health governance. Regardless of one’s view on his decisions, the surrounding context suggests that leadership is no longer evaluated solely on merit or public health outcomes, but increasingly on its alignment with cultural and ideological narratives. While respecting personal autonomy and cultural values is essential in any democratic society, overreliance on ideological conformity risks compromising the effectiveness and integrity of systems designed to serve the public good.