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Thursday's vote reflected lingering anger over his handling of South Carolina's response to the pandemic. Simmer recommended people get the COVID vaccine, and he often wore masks well after the worst of the pandemic had passed, saying he wanted to protect his wife, who has a compromised immune system.

Defending his record

Simmer defended his record, pointing out that in two years under his leadership of the old agency, South Carolina improved from 45th to 37th among U.S. states in overall public health measures and that COVID now takes up only a tiny percentage of his time.

“Sometimes a small amount of people can make a lot of noise. I think that's what we’re seeing here," Simmer said. “But I also hope you can look at my overall record, where we are going as a state."

The Department of Public Health last year, and Gov. Henry McMaster nominated Simmer, a retired U.S. Navy psychiatrist, to run it. But the governor's support came with a backhanded knock on the federal government’s COVID response

“He’s not a Dr. Fauci,� McMaster said, referring to , the infectious disease expert who advised Presidents Donald Trump and Joe Biden on the pandemic.

Angry questions

Several Republicans aggressively questioned , reading aloud excerpts from his email in which he strongly encouraged people in 2021 to get the COVID vaccine and wear masks. Simmer said he was only following the best science at the time and said he never thought anyone should be required to be vaccinated. He walked senators through the importance of following peer-reviewed studies.

There was a simple solution to all the angst over COVID, Republican Sen. Tom Fernandez said.

“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," Fernandez said.

Sen. Matt Leber asked why Simmer didn't push back on schools buying Plexiglas barriers or grocery stores putting arrows on floors to encourage one-way traffic up aisles. “Sometimes where there is chaos there is a vacuum of leadership,� Leber said.

Simmer’s critics both at the Statehouse and on social media have derisively called him for wearing two face masks even after he explained that his wife has underlying medical conditions that make COVID especially dangerous for her.

He was maskless for hearings both last month and on Thursday but said he “will wear a mask again without hesitation if that is what it takes to protect the woman I love.�

COVID hindsight

The lone Republican to vote for Simmer asked his colleagues to go back to 2020 and 2021 when many of them also organized COVID testing and made sure their constituents could find places with COVID vaccines.

Sen. Tom Davis said punishing Simmer for what could only be known at the time was a terrible precedent. “If he’s guilty of some dereliction of duty in that regard, then I am derelict as well,� Davis said.

The Senate’s longest serving member, Republican Harvey Peeler, asked if Simmer would be willing to run the state Department of Mental Health if his nomination failed.

“Fauci blew up. You got hit by the shrapnel,� said Peeler, a senator since 1981. “You talk to my constituents. They see you, they think Dr. Fauci.�

What's next

The vote doesn’t kill Simmer’s nomination. But the full Senate, dominated by Republicans, would have to vote to pull it out of committee and send it to the floor.

The only real mention of anything other than COVID during the hearing came from Democrats.

One questioned him about how South Carolina was monitoring in other states.

A second asked about a mobile maternity care center set to hit the road in 2026. South Carolina is near the bottom in the nation in infant and maternity deaths and has a number of poorer counties where getting to the nearest obstetrician can involve at least a 50-mile (80-kilometer) drive.