Today's episode of The Daily, the New York Times podcast, is about the toll the pandemic has taken on public health officials, with something of a focus on rural places, like Wilson County, Kansas. There, in the southeast corner of the state, the public health officer had grown up in the community, gone away to medical school, and was wearing multiple hats as a clinician and public health official when the pandemic struck. As a local "kid," she initially had the community's confidence, but that started to wane by May, 2020. The entire episode is well worth a listen, with Mike Baker of the Seattle Bureau as Michael Barbaro's guest. Rural lack of anonymity and community issues play out, especially near the end of the episode, as the community turns on the home-grown doctor, even as a man she went to high school with assures her it's nothing personal. Also noted is a county in Idaho, unnamed, where the county officials hired a less qualified doctor who was essentially a covid denier, over a professional trained in epidemiology.
The episode helpfully touches on the long-term impact these trends are likely to have on public health because changes being made to laws and regulations undermine the ability of state and local health officials to deal with outbreaks of "old" diseases that still crop up.
On the same topic, this NPR piece from last month, focusing on Montana, is very good. Kirk Siegler reports from Sanders County, in the northwest part of the state. Here's an excerpt from the story, which features a local physician's assistant who was also playing the role of public health officer:
When Nick Lawyer, a physician assistant in Sanders County, Mont. was asked by local leaders to take on the voluntary position of county public health officer, it felt like the right thing to do to serve his community in a crisis.
"I kind of think I was one of the few who expressed any interest in the position who had any reasonable qualifications for the job," Lawyer says.
Lawyer had worked as a PA at the 14-bed Clark Fork Valley Hospital in Plains, a town of about 1,000 people in a relatively remote river cut basin in northwest Montana, since 2013. When he agreed to take on the extra duties, he decided to also begin a master's program in public health at the University of Montana to further boost his qualifications.
Little did he know, those qualifications would soon become a mark on him in the eyes of some local activists.
We've certainly seen public health officials take heat in California, especially in rural and mixed rural-urban counties like Yuba, Sutter, and Placer. In the latter county, the public health officer left her job in that county and moved to neighboring Yolo County, which skews more progressive because of the presence of UC Davis. Both are metropolitan counties, but with significant exurban and rural populations.
Meanwhile, coronavirus cases are spiking in some states where public health officials have been maligned and sidelined, including Wyoming, Montana, and Colorado.
Post script: A new story out of Western Montana about a quack, with deceptive credentials, is here.
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