Stateline: Politicians Shunt Aside Public Health Officials

A Republican state representative called Acton a “globalist” on Facebook, which the Anti-Defamation League denounced as an anti-Semitic trope.

Acton’s governor, Republican Mike DeWine, had backed her and put her forward as the face of the state coronavirus response. She will continue to advise him.

In rural Colorado, Rio Grande county commissioners fired Emily Brown, director of the county public health department. They were at odds over the release of COVID-19 data and her resistance to quickly relaxing restrictions. She was threatened on social media.

In Orange County, California, Nichole Quick, the county’s health officer, abruptly quit last week after finding herself at odds with county commissioners over her COVID-19 policies, including a requirement that people use face masks as the county reopened. She had also been the target of public venom. At one public meeting, in which one participant mentioned Second Amendment rights during the pandemic, another revealed Quick’s home address. Protesters picketed her home.

Republican Gov. Ron DeSantis’s administration fired Florida’s former chief coronavirus data officer Rebekah Jones in May after she said she refused to manipulate data that justified the state’s aggressive reopening plans. She has now created her own COVID-19 tracking site, and claims the state is still hiding important data.

Ignoring Science

In relaxing Georgia’s stay-at-home order, the governor ignored public health officials and even declared that local governments couldn’t impose restrictions more severe than the state’s.

Even Maryland Gov. Larry Hogan, a Republican who received high marks from public health experts for his aggressive steps to contain the virus, has recently departed from the advice of health advisers.

When Hogan last week announced a new phase in reopening, Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security and a health adviser to Hogan on the pandemic, took to Twitter to voice his objections. Allowing restaurants, gyms, malls and other indoor venues to reopen, he said, risked situations “where this virus has great capacity to spread widely.”

In response, a Hogan spokesperson insisted to the Baltimore Sun the governor had taken “a cautious, data-driven approach,” and that “key statewide health metrics continue to trend in a positive direction.”

The public outrage directed at some health officials during this pandemic may be unusually broad and intense, but controversy is often unavoidable in the profession, said Dr. Lynn Goldman, the dean of George Washington University’s Milken Institute School of Public Health.

She said public health officials also faced blowback when they sought to curtail smoking, resisted calls to quarantine those with AIDS and proposed needle exchange programs to prevent the spread of HIV. They also faced resistance when they launched lead paint abatement programs, and when they proposed, over the objections of agricultural interests, bans on pesticides harmful to humans.

But this time is different, said Jeffrey Levi, a professor of health policy and management also at George Washington University, mainly because many public officials, following the president’s lead, aren’t listening to the scientists.

“This is irresponsible at a level of magnitude that I don’t think we’ve ever seen before,” he said. “Politicians are putting public health officials in untenable positions.

“Public health officials are trained to put up with disgruntled responses to their advice, but in the past political leaders have backed them up, and that is not happening in a lot of communities.”

Out of the Loop

One example of a core public health function that has been usurped in many places by governors and other elected leaders is contact tracing. The decades-old, painstaking method of reaching out to people who test positive for an infectious disease to determine whom they’ve been in contact with and asking those people to quarantine, is often viewed with suspicion by local residents.

Many consider it an intrusion of privacy, and in some communities, where mistrust of government and the medical community run high, reaching people by phone or in person requires local knowledge and sensitivity.

That’s why David Harvey, director of the National Coalition of STD Directors, said he was dismayed when governors in some states, including California, Maryland, Massachusetts and New York, began contracting with private organizations to launch major contact tracing initiatives to prepare for reopening their economies.

“Many governors didn’t know that contact tracing and disease intervention specialists were part of the public health system and have been for decades,” he said. “It’s always been a local function that requires cultural competency.”

Instead of large-scale outsourcing, Harvey suggested, state and local governments would be better served to invest in their local health departments where the needed competency already exists. “That way the agencies would be stronger and better prepared for the next outbreak,” he said.

According to Freeman of the public health association, people have been fed a false dichotomy that communities either open and risk more sickness and death or stay in quarantine and tank the economy. Public health officials always have had to balance those two things, she said.

“We can do both. It’s not between getting your life back or having the disease. Local health officials are just as interested in getting back to normal as the rest of us,” she said. “We just want everybody to be as safe as possible, so we can get back to a new normal, wearing masks, washing hands and safely distancing.

“But we all have to follow along, because if parts of the community believe it’s a barrier to their freedom, we’re all going to suffer.”

Benjamin, of the American Public Health Association, said public health professionals should be receiving plaudits, not condemnation. “People who have been clapping every night for front-line doctors should be clapping for public health workers too,” he said. “They are saving hundreds of thousands of lives.”

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