After Bay Area county leaders ordered residents to stay home to stem the spread of the coronavirus on March 16, residents packed into parks, supermarket aisles and beaches the next weekend. That pushed one public health officer seemingly near to the edge.
“If you decide you want to do your own thing and follow your own rules, you disrespect us all,” wrote Dr. Scott Morrow, public health officer for San Mateo County in a letter posted Monday to the county website. “You spit in our face, and you will contribute to the death toll that will follow.”
Morrow’s missive astonished some of his peers and constituents, but it also reflected the pressure health officials face in the Bay Area and elsewhere as the pandemic takes a rising toll. As of Saturday evening, there were 1,700 cases and 38 deaths in the Bay Area, the early epicenter of the virus.
Health officials are racing to protect diverse communities from a virus overwhelming much of the world. As they do, they are paying a steep price.
On Monday, Marin County’s public health officer, Dr. Matt Willis, announced in a video that he had contracted the virus.
“Stay at home. Shelter in place. And limit anything outside the home to only essential trips, because we’re seeing signs of our responders being exposed and being pulled away from duty,” he said from his home, accompanied only by a potted plant.
Willis has quarantined himself away from his wife and children, and according to a county spokeswoman, still had symptoms, as of Saturday.
Meanwhile, some officials are feuding with each other. On Wednesday, San Jose officials announced projections of more than 2,000 coronavirus-related deaths in the next 12 weeks. That prompted Santa Clara County officials to shoot back — declaring that “the model shared by the city of San Jose … was not produced, reviewed, or vetted by the county of Santa Clara.”
Under California law, public health officers hold extraordinary powers to affect everyday life. Violations of the Bay Area’s shelter-in-place orders, for instance, could result in criminal charges.
Yet the scope and intensity of this disease is leaving officials without an established road map to follow, according to former public health officers and experts.
“This is becoming an unremitting, 24-7 incredibly stressful job,” said Robert Benjamin, 77, who once served as interim health officer for the city of Berkeley, worked 27 years for the Alameda County health department, and is now semiretired, working part time for the Sonoma County health department.
“Anyone who says this is not a big deal and asks why are we doing this (social distancing) needs new glasses,” said Dr. Benjamin, who has been on regular conference calls with the Bay Area’s health officers during the outbreak.
Federal, state and local authorities are issuing a patchwork of public orders to their communities, and health officers are being overwhelmed, several experts said. It doesn’t help that these officers lack adequate testing, data and protective equipment.
“There are both programmatic as well as personal stressors involved,” Benjamin said. “The folks we are seeing on television and the press representing the greater Bay Area counties are doing just a Herculean job.”
“Remember, for these men and women, the population is their patient,” said Dr. Jonathan Fielding, professor emeritus for UCLA’s Fielding School of Public Health, which was named for him. “They are there to prevent, respond, evaluate and monitor the health of a whole community, in much the same way a doctor will for a single patient.”
Although health officials prepare for pandemic events, doing simulations, taking classes with accredited state and national health officer networks, and receiving training from the Centers for Disease Control and Prevention, reality almost never exactly mirrors a simulation, the experts said.
“You have to learn that every decision you make, when it comes to an emergency public health decision, is going to be made with inadequate information,” said Dr. Richard Jackson, who served as California’s state health officer, under Gov. Arnold Schwarzenegger, and who served for nine years as the director of the CDC‘s National Center for Environmental Health.
Over the years, officers in the Bay Area have established a strong network. They talk on a daily basis, filling one another in, assessing the situation and presenting ideas, decisions and concerns.
“I hate to make it sound all ‘Kumbaya,’” said Dr. Lisa Santora, Marin County’s deputy health officer, who has stepped in for the infected Willis. “But we really do work well together, collaboratively, and most often with consensus.”
Officials and experts say California’s public health offices are unique, with stronger authority than one sees in states such as New Jersey. There, health officials are appointed by a mayor, and are replaced with each iteration of new local government, Jackson said.
On Friday, Rush Limbaugh, a conservative syndicated radio host, suggested to listeners that government health officials were “deep state” agents, who are driving around local communities ratting on people who are socializing.
“They’re just assumed to be the best because they are in government,” said Limbaugh, who is undergoing treatment for advanced lung cancer.
Such sentiments anger many frontline health officials, given the long hours and risks they face.
In Willis’ case, he said he started feeling feverish on Friday with a worsening cough. After he had a swab taken at a drive-through coronavirus testing facility, the test came back positive last Sunday .
As for San Mateo’s Morrow, he declined to speak with The Times.
Dr. John Swartzberg, a UC Berkeley infectious diseases expert, said the health officer’s outburst reflects the general frustrations of a profession “under enormous stress and without adequate resources.”
Jackson, the former state health official, agreed, although he added that Morrow could have toned it down a bit.
“It’s an asset to be a strong leader,” he said. “I kind of don’t agree with beating people up.”