If you have a formal title ahead of a name, then there is no need for
a separating comma and you do capitalize the title. So you do this:
U.S. Surgeon General Tom Izzo said ...
...and NOT this ...
U.S. Surgeon General, Tom Izzo said ...
... in the same way you would say this:
Capt. Crunch said ....
... but NOT this ...
Capt., Crunch said ...
Now, if that title is not being used as a direct title, but as an identifier separate from the name, then do use lower case and commas, like this:
The U.S. surgeon general, Tom Izzo, said ...
... and this ...
Tom Izzo, the U.S. surgeon general, said ...
... and this ...
Crunch, a captain, said ...
... and this, too ...
A captain, Crunch, said ...
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