Health Officials Had to Face a Pandemic. Then Came the Death Threats. - The New York Times

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CHICAGO — Leaders of local and state health departments have been subject to harassment, personal insults and death threats in recent weeks, a response from a vocal and angry minority of the public who say that mask requirements and restrictions on businesses have gone too far.

One top health official, Dr. Barbara Ferrer, the director of the Los Angeles County Department of Public Health, issued a statement on Monday condemning attacks on public health directors and disclosing that she faced repeated threats to her safety.

“The death threats started last month, during a Covid-19 Facebook Live public briefing when someone very casually suggested that I should be shot,” Dr. Ferrer said in a statement. “I didn’t immediately see the message, but my husband did, my children did, and so did my colleagues.”

“It is deeply worrisome,” she added, “to imagine that our hardworking infectious disease physicians, nurses, epidemiologists and environmental health specialists or any of our other team members would have to face this level of hatred.”

Across the country, many public health officials entered the coronavirus pandemic with bare-bones staffs and strained budgets, leaving them ill-prepared to handle a mounting crisis. Before the pandemic, they had focused on illness prevention, contact tracing for communicable diseases, vaccinations and campaigns against smoking and vaping.

Now some of them, suddenly facing the public with regular television briefings about efforts to fight the coronavirus, are choosing to leave their positions entirely.

Lori Tremmel Freeman, the chief executive of the National Association of County and City Health Officials, said last week that dozens of top health officials have resigned or been fired since the pandemic began. At least four state health directors have resigned from their posts; Dr. Amy Acton, the state health director of Ohio, stepped down this month after enduring anti-Semitic attacks and demonstrations by armed protesters on her front lawn.

Dr. Umair A. Shah, the executive director of the public health department in Harris County, Texas, which includes Houston, described a tense new role. “Now that we’re quite visible and we’re part of very difficult decision-making, naturally those decisions are having an incredible impact on community members in a very specific way,” Dr. Shah said. “That’s where the problem comes in.”

Not all of the officials have said why they are leaving, and some have cited personal reasons or planned retirements, but Ms. Freeman said she had heard many accounts of harassment.

“There’s a big red target on their backs,” Ms. Freeman said. “They’re becoming villainized for their guidance. In normal times, they’re very trusted members of their community.”

Some critics of the public health directors have said that they believe that allowing businesses to operate is worth the risk of spreading the coronavirus, and that health directors are too cautious about reopenings. Others have cited conspiracy theories that claim that the coronavirus is a hoax; that the development of a vaccine is part of a massive effort to track citizens and monitor their movements; and that wearing a mask or cloth face covering is a practice that impedes personal freedom.

In Washington State, where rural counties are struggling with new outbreaks and trying to warn residents to take basic precautions to stem the spread of the virus, pleas from local health officials have often been answered with hostility and threats.

In Yakima County, which has more than six times as many cases per capita as the county that includes Seattle, hospitals have reached capacity and patients were being taken elsewhere for medical care. Gov. Jay Inslee warned over the weekend that “we are frankly at the breaking point,” and has said he would require Yakima residents to wear face coverings in an effort to slow the virus’s spread.

“I’ve been called a Nazi numerous times,” said Andre Fresco, the executive director of the Yakima Health District. “I’ve been told not to show up at certain businesses. I’ve been called a Communist and Gestapo. I’ve been cursed at and generally treated in a very unprofessional way. It’s very difficult.”

The Coronavirus Outbreak

• Frequently Asked Questions and Advice

  Updated June 22, 2020

  • Is it harder to exercise while wearing a mask?

    A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

  • I’ve heard about a treatment called dexamethasone. Does it work?

    The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

  • What is pandemic paid leave?

    The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

  • Does asymptomatic transmission of Covid-19 happen?

    So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

  • What’s the risk of catching coronavirus from a surface?

    Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

  • How does blood type influence coronavirus?

    A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

  • How many people have lost their jobs due to coronavirus in the U.S.?

    The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

  • My state is reopening. Is it safe to go out?

    States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

  • What are the symptoms of coronavirus?

    Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

  • How can I protect myself while flying?

    If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

  • What should I do if I feel sick?

    If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

  • How do I get tested?

    If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

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In California, angry protesters have tracked down addresses of public health officers and gathered outside their homes, chanting and holding signs. Last week, a group called the Freedom Angels did just that in Contra Costa County, Calif., filming themselves and posting the videos on Facebook.

“We came today to protest in front of our county public health officer’s house, and some people might have issues with that, that we took it to their house,” one woman said in a video. “But I have to tell you guys, they’re coming to our houses. Their agenda is contact tracing, testing, mandatory masks and ultimately an injection that has not been tested,” she said, apparently referring to a vaccine even though none have been approved.

Dr. Nichole Quick, the chief health officer for Orange County, Calif., resigned as protests and harassment intensified after an order to require face masks in certain businesses, including grocery stores and pharmacies. Emily Brown, director of the Rio Grande County Public Health Department in rural Colorado, was fired when she encountered community resistance to the stricter rules she had encouraged.

The departures across the country have prompted industry officials to ask whether a dearth of leadership is ahead for health departments, even as they combat the pandemic.

“We’ve never seen this level of vitriol before,” said Kat DeBurgh, the executive director of the Health Officers Association of California. “I’m worried not just about the present but about the future. When they’re subject to such harassment, who is going to step into these jobs?”

Mitch Smith contributed reporting.

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