Wes Nakagiri

Livingston County Commissioner 

Email from Mr. John O'Malley to Commissioner Nakagiri


Chairman Nakagiri,

Please find attached a letter of support from Michigan Medicine and St. Joseph Mercy Livingston Hospital/St. Joseph Mercy Health specifically Dr. David Miller and myself that supports the $ 1.5 million that is available for the Livingston County Health Departments immunization efforts, contact tracing, case investigation and infection control measures. We hope the Board of Commissioners will reconsider the decision to not accept this valuable funding so that the Livingston County Health Department has the resources necessary to address this recent surge in our county. Thank you for your consideration.



John F. O'Malley, MSA, MBA, FACHE

President, Administration
St. Joseph Mercy Livingston Hospital & Brighton Health Center

Pronouns: he/him/his


620 Byron Rd.
Howell, MI 48843

trinity-health.org | Facebook | Twitter | LinkedIn


Email response from Commissioner Nakagiri to Mr. John O'Malley

September 17, 2021

John F. O'Malley, MSA, MBA, FACHE
President, Administration
St. Joseph Mercy Livingston Hospital & Brighton Health Center

Dear Mr. O’Malley

Thank you for contacting me. I am always interested in listening to different perspectives. I look forward to a continued dialogue on this and other important public policy matters.

I believe my responses below adequately address the concerns expressed in your letter dated September 3, 2021. If not, please do not hesitate to reach out to me again.

Patient Care

First, you stated your concern regarding the “ability to care for both Covid and Non–Covid patients in our hospitals this Fall.” I share that concern. Forcing employees to get vaccinated necessarily reduces the number of qualified persons that St. Joseph’s has to choose from. Additionally, your policy could lead to the departure of qualified employees, thus degrading your ability to respond to COVID. I am concerned about the potential for the situation to worsen and impact your ability to care for both COVID and Non–COVID patients in your hospitals this Fall. I urge you to reconsider your policy.

Immunization Efforts

You also expressed concern that turning down the State grant would negatively impact our “immunization efforts,” which are “are essential to Livingston County Health Department's response to the COVID 19 pandemic.” I am open to reviewing the analysis that led you to draw this conclusion. However, vaccination statistics published by the State of Michigan do not support your assertion.

vaccine capacity graph

Figure 1

As shown in Figure 1, private-sector locations throughout Livingston County have recently been administering 200 doses per day. Our private sector partners, of which there are about 50 listed at vaccine.gov, have demonstrated the capability to administer at least 1500 doses per day. Thus, private sector partners in Livingston County now have minimum reserve capacity of at least 1300 doses per day. This is 6.5 times more capacity than today’s need.

Because of strings attached by the State of Michigan, the bulk of the proposed new grant funding can only be used to expand our already ample vaccination capacity. Restrictions such as this prevent us from delivering customized medical services to address the specific needs of our citizens.

I am thankful that you agree with me that vaccinating homebound seniors is important. But Livingston County already has more than adequate resources to accomplish this.  I estimate we would need less than one-tenth of one percent (0.1%) of the ARPA funds to address this important need. Further, by using ARPA funds we are not constrained by state mandates or requirements that limit our ability to tailor our services to the needs of the community.


You also state, “We are now in the fourth surge of the virus across our state and are continuing to see an increase in COVID cases and hospitalizations.” This statement prompted an updated look at COVID statistics for our county.

Data published by the State of Michigan and Johns Hopkins enabled a comparison of COVID case counts between Livingston County and the country of Denmark. Denmark was chosen for this comparison as it recently declared COVID to be a disease which is “No longer a critical threat to society.” With this declaration, the government of Denmark removed all COVID related restrictions.

This comparison indicates Livingston County also has the potential to lift all COVID restrictions, just as Denmark has done. While the CDC currently categorizes our county as having a High Risk for COVID transmission, this comparison challenges CDC orthodoxy.


denmark covid graph

Figure 2

Figure 2 shows that during the four months prior to removing all COVID restrictions Demark averaged 13.39 COVID cases per day per 100,000 persons, while Livingston County averaged 7.79 cases per day per 100,000 persons during this same time period.

While COVID still deserves our attention, this comparison suggests that our efforts are producing results that are not reflected in the CDC rating. Our case count results merit the relaxation or outright removal of harmful policies such as quarantining healthy school children. Livingston County parents would greatly appreciate your help in advocating for a child-friendly COVID policy that enables healthy children to remain in school.

Monoclonal Antibody Treatments

Accepting grant funds from the State requires Livingston County to spend time and resources on only those COVID responses approved by State bureaucrats. As with any one-size-fits-all approach, sub-optimum results can be expected.

With their grant funds, State bureaucrats attempt to incentivize local governments to implement more vaccines, the solution favored by Lansing. However, central-planners were likely not aware of the excess vaccine capacity previously discussed in this letter, nor were they aware of the shortage of monoclonal antibody infusion centers in our county.

According to the National Infusion Center Association website, Livingston County has only one location where COVID patients can receive this life-saving COVID treatment. Wouldn’t public health have been better served if this grant funding could have targeted the greatest needs rather than expanding the supply of already abundant vaccines?

The media has reported that Social Vulnerability Index (SVI) is now being used to allocate monoclonal antibodies. SVI uses social science not medical science to determine who is eligible to receive this life-saving treatment. Earlier this year, SVI medical discrimination was used to deny vaccines to Livingston County citizens with lighter skin color. I am concerned that SVI will again be used to discriminate against our citizens.

With your interest in health policy I’m a bit surprised you did not write to the Board of Commissioners conveying your concerns when SVI medical discrimination was being used to deny Livingston’s most vulnerable citizens their fair share of vaccine. Nonetheless, any future support you could provide in battling medical discrimination would be appreciated. In particular, it would be great if you could help increase the availability of monoclonal antibody treatments in Livingston County. Expanding access for this treatment may require that you speak out against the federal government’s use of the SVI.


The grant from Lansing provides funding for things we already have, such as vaccine capacity. With $37 million in ARPA funding, Livingston County is well-situated to deal with potential COVID concerns while addressing underserved treatments such as monoclonal antibodies.

Best regards,

Wes Nakagiri
Commissioner, District 3