The COVID-19 pandemic has revealed serious weaknesses in the nation's healthcare infrastructure, and deep differences in how people react to a national health crisis. As Jim McLean of the Kansas News Service reports, those differences are taking an emotional and physical toll on the public health workers who form the nation's foremost line of defense against disease outbreaks.
By Jim McLean, Kansas News Service
FREDONIA, Kansas — Nick Baldetti resigned as director of the Reno County Health Department in July. He left to head an effort to establish a school of health at McPherson College. It was a good opportunity, Baldetti said, but he likely would have stayed to see the department through the pandemic if not for the 80-hour work weeks, the hostile political environment and the threats to his family.
“I had the local police watching my house because my family was home and I was not,” said Baldetti, who also served as the department’s health officer. “There was a period of time that I had escorts to and from work.”
Baldetti, like his counterparts across the state, spent years preparing to deal with a public health crisis like the COVID-19 pandemic. He never imagined that when the moment arrived he would encounter such antagonism for simply doing his job. “By the end of the day, you just felt like you were on an island by yourself,” he said. “Whatever decision I made, 50% of people were going to be upset because it was too ‘restrictive’ and the other 50% were going to be upset because it wasn’t restrictive enough.”
Baldetti wasn’t alone. The pressure of dealing with the pandemic and the politics surrounding it triggered an exodus of public health workers across the state. In the nine months since the state’s first documented coronavirus infection, 27 county health officials have left their posts. Some retired but others resigned or were fired. The Kansas Department of Health and Environment says that number includes 15 county health department administrators and 18 health officers. Six of those leaving held both positions.
The same pressures are thinning the ranks of local public health officials across the country. Many are leaving because they’ve been physically threatened or “politically scapegoated” for doing their jobs, Lori Freeman, chief executive of the National Association of County and City Health Officials, told National Public Radio.
Vicki Collie-Akers, a professor of public health at the University of Kansas Medical Center, said many of the health officials in Kansas who are leaving are doing so “because they can’t manage both the pandemic crisis and the harassment and denigration that’s come with it.” The long-term impact of the exodus on the state’s already undermanned and underfunded public health system, Collie-Akers said, will be profound.
Lee Norman oversees the public health system as secretary of KDHE. Recently assigned a security detail, Norman said the departure of so many frontline workers is “disheartening and cause for concern.”
Frustration, fear and fatigue
Gianfranco Pezzino recently announced that after 14 years as the health officer of the Shawnee County Health Department he would step down at the end of the year. “There’s a lot of burnout, anger and frustration,” Pezzino said. A doctor and public health researcher, Pezzino said months battling county commissioners over how to contain the coronavirus had worn him out. “I’m tired emotionally, I’m tired physically,” Pezzino said. “I don’t think I have the energy … to do another year like this.”
The amount of misinformation spread on social media — much of it emanating from the White House — politicized the nation’s response to the pandemic, Pezzino said. “If there had been a unified message coming down from the federal government to the state and local levels,” he said, “it would have been much easier for everybody.”
Mask mandate backlash
Jennifer Bacani McKenney is also tired and frustrated. Nevertheless, she’s fighting to stay on as Wilson County’s health officer. McKenney, a doctor, grew up in Fredonia, the county seat. She returned about a decade ago to join her father’s medical practice. Initially, she said, citizens of the county in the southeast corner of the state embraced orders issued by Gov. Laura Kelly and her department aimed at slowing the spread of the coronavirus. Those orders sequestered people in their homes, closed schools and some businesses. “That first probably two months we were everybody’s best friend,” McKenney said. “We were here to take care of you.”
But support for those policies eroded as the number of unemployed Kansans grew to levels not seen since the Great Recession. Republican legislative leaders responded by reining in Kelly’s emergency powers and those of local health officials. The legislative changes allowed county commissioners to opt out of Kelly’s mask mandate and gave them authority over all local policies aimed at containing the virus. As the political debate grew more heated — nationally and in Kansas — hostility towards public health officials, like McKenney, increased. She got threatening emails and was the target of personal attacks on social media. “It hurts your heart, it really does,” McKenney said. “It’s not only that people are mean, it’s that you’ve lost friends. Relationships are broken.” During the worst of it, McKenney said, she often sat alone in her office and cried after seeing her last patient of the day. “There’s nothing else to do,” she said.
Andy Miller, a Wilson County commissioner, said McKenney brought some of the criticism on herself by disparaging President Donald Trump’s handling of the pandemic in social media posts. “When you start getting political,” Miller said, “you’ve created a storm.” When that happens, he said, the attacks run both ways. “I’ve probably got a dozen emails or so that are just, ‘it’s either a mask (mandate) or you’re a killer,’” he said. “There’s no in between.”
Early last month, commissioners rejected McKenney’s proposal for a mask mandate. But as COVID-19 cases in the county and across the state surged and Kelly called for a statewide policy they agreed to consider a compromise. They scheduled a rare evening meeting to hear from the public. Most of the 80 people who showed up opposed the mandate as an assault on their personal liberty. “My fear doesn’t happen to be the COVID virus but the overreach of national and state officials who believe because of their positions or ego that their opinions are fact,” said Charles Fox, a Fredonia veterinarian. Donovan Hutchinson, the owner of the Dry Creek Saloon in Neodosha, said giving in to a mask mandate would lead to further abuses of government power. “What will they come after next, our guns, our children?” he said.
Burt Carlson, a 70-year-old retiree from Fredonia, recently spent a week in the hospital for COVID-19 but opposed the mandate. Despite more than 265,000 U.S. deaths it has caused, Carlson said the coronavirus isn’t as bad as health officials claim. “It’s no more than a super bad flu,” he said. When it became apparent that the commission was ready to approve the compromise — a 30-day mandate — several people walked out in protest.
Sheriff’s deputies escorted McKenney to her car after the meeting.
Still, she doesn’t want to add her name to the growing list of local public health officials calling it quits. “That’s not me,” she said. “I can’t have this knowledge and ability to help people and just walk away.”
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The Kansas News Service is a collaboration of Kansas Public Radio, KCUR, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.
