The GOP’s War on Public Health Officials

In rural Ohio, local health commissioners face not only a raging pandemic, but also threats and intimidation from conservatives and an exodus of staff.

Jim Watkins believes that his county is about to be hammered by the COVID-19 Delta variant—and that there’s not much he can do about it. “In four weeks, we’ll be Florida,” the Williams County health commissioner told me. (Last week, Ohio was posting about 6,000 new COVID-19 cases per day, surpassing last winter’s peak.) He can’t sleep. Unexplained pains have wracked his fingers and hands—the result of stress, he thinks.

Meanwhile, the top health official of another Ohio county has taken to sipping bourbon during the day to cope with the stress. Tuscarawas County Health Commissioner Katie Seward wrote an appeal to her county’s residents after she received threats for quarantining exposed students and advocating masks and vaccines. Angry residents posted photos of her infant daughter to social media. She wondered whether her career was endangering her loved ones. Geauga County’s health commissioner was fired a few days ago after suggesting (sarcastically, he said) that insurers should not pay for COVID-19 treatment for vaccine refusers. Across the United States, public health workers are in bad shape. Over 61 percent say they have received job-related threats, and more than half report at least one mental health symptom.

Ohio, like some other Republican-controlled states, is dismantling by attrition infrastructure that was once a keystone to its social and economic life: a system of public health. A new law, SB 22, passed over the veto of Republican Governor Mike DeWine, handcuffs the governor and local health departments from fighting health emergencies by giving the legislature (now controlled by a GOP supermajority, the result of gerrymandering) the power to rescind emergency health orders.

The new law and hateful rhetoric from Republican state legislators who backed it has inspired attacks—including gunshots—intimidation, and threats against health officials like Watkins. As a consequence, staff members in public health departments are leaving.

Local health commissioners describe the state’s health office as “a mess.” A year ago, DeWine hired Joan Duwve, a doctor from South Carolina, to take over Ohio’s Department of Health, following the resignation of Amy Acton, who stepped down after protestors with guns showed up at her house. But then, the same day DeWine announced the hire, Duwve declined it, citing the harassment Acton had faced.

“Look at the exodus!” Watkins said. “Ohio pays very little to state public health workers, so why do it? People do have a passion for the work, but that fades after you’re beat up so many times.”

Republican officials and conservative activists attacking the public health infrastructure in the middle of a raging pandemic might seem like an obviously bad idea, but it’s a symptom of a more generalized mass delusion that has infected a significant part of the country and has, in turn, eroded one of the best assets America has enjoyed for a century.

In Ohio, two laws passed in 1919, the Hughes Act and the Griswold Act, created a system of local public health offices. This was the era of progressive health innovation, and Ohio wanted to be part of it.

Soon, Williams County witnessed how well the system could work. In 1924, an outbreak of smallpox forced the health commissioner to close the public schools. The new health department instituted an organized program of inoculations, and the number of cases quickly dropped from 149 to one. Classes resumed in full by the start of the next school year.

Public health offices across the country played important roles in extending American life and health expectancy. They took on sanitation, food safety and nutrition, and child car seats. Most health commissioners were respected, trusted, even revered, no more so than with the advent of polio vaccines, when millions of schoolchildren lined up for Salk’s shots and Sabin’s sips.

Today, though, it’s a different story. A couple of miles off the Bryan turnpike exit, you begin to see the yard signs and flags: “Impeach DeWine,” “President Trump, We’ve Got Your Back,” “Beijing Biden.” Some contain obscenities. A significant portion of Williams County’s residents have fallen into the delusion that the 2020 election was stolen, that vaccines are Satan’s work, that health orders are communistic, or socialistic, or Nazi-like.

The sad truth is that the people who installed those signs are victims. They’ve been groomed into what’s become a suicide cult by national, state, and local leaders—Williams County Commissioner Brian Davis, for example, is a vaccine refuser—and by a “conservative” media seeking financial payoff.

The 37 percent of the county’s eligible residents who are fully vaccinated—one of the lowest rates in a state with low rates—obviously disagree, but they’re at the mercy of the majority in a county that, not coincidentally, has one of the highest case rates in the state. Hospitalizations are rising. More people will die.

Last week, Watkins held phone meetings with local school officials and medical providers. His message was clear: You’re on your own. The health department can’t help much. “Everybody knows now. They realize nothing is coming. No mandates from us. So they have no cover anymore whether they are a school or a business; if they make a decision they own it. They can’t blame the health department.”

As health departments have been neutered, the health of Buckeyes has declined. Only nine other states have worse infant mortality rates, most of them in the South. Life expectancy is declining in Ohio, as it is in the U.S. as a whole.

COVID-19 will pass someday—or become just another illness. But there will be other epidemics or pandemics. Whatever the disease, health commissioners know that a deliberate propaganda campaign to cripple the authority and credibility accrued over a century has decimated their ability to fight it.

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Brian Alexander

Brian Alexander is the author of The Hospital: Life, Death, and Dollars in a Small American Town.