Meet the New Bosses Preventing CovidKaiser Well being Information

VIRGINIA STADT, Mont. – Emilie Sayler’s roots are deep in southwest Montana. She serves on a nearby city council and on the board of the local Little League. She attended college in a neighboring county and regularly volunteers in the schools of her three children.

Just months into her new job as Madison County’s Public Health Director, she had hoped these local connections would make a difference, that the fewer than 10,000 residents spread across this agricultural region would see her familiar face and efforts would help to contain the Covid-19 pandemic that is rampant here.

That has largely not happened. School authorities have rejected even minor outbreak prevention measures, vaccination rates are falling, and the Centers for Disease Control and Prevention rates infection rates in rural counties as high. Parents, said Sayler, send sick children to school.

In addition, a resident called her office and said to one of her employees, “I wish you would suffer from Covid and die.”

“People used the term ‘free for all’ and I hate to admit that it feels like that,” said Sayler.

Nationally, KHN and The Associated Press have documented that more than 300 public health executives tired of abuse and questioning of their expertise have resigned or retired as the country struggles to get out of the worst of the pandemic recovering for a century. They have been replaced by people like Sayler, who are often inexperienced but tasked with restoring the confidence of a polarized and exhausted public.

At least 26 states have passed laws or regulations this year that restrict the powers of public health officials.

Montana passed laws that are believed to be some of the most restrictive. This year, the state legislature restricted the powers of health officials, including quarantining infected citizens or isolating people who are in close contact with them. Legislators also prevented public and private employers from requiring workers to be vaccinated and gave local elected officials the opportunity to overturn public health orders.

Now, Montana is at or near the low end of many national statistics depicting the spike in Covid – new case rates, hospital admissions, and deaths – that’s happening in counties both large and small.

Lori Christenson is the new health officer for Gallatin County, east neighbor of Madison County and the seat of the City of Bozeman and Montana State University. In June, she replaced Matt Kelley, who had become a political punching bag before he resigned as the county mandated masks in public places and restricted business hours and crowd size. Social media protesters called for his overthrow; a couple of pickets in front of his house. Christenson served in the health department for seven years and worked closely with Kelley prior to her promotion.

While her office still hears from frustrated citizens “on both sides” on a daily basis, she said the vitriol is not quite as malicious as it has been in the past. This is in large part because the new laws, which have taken power away from their department, have shifted criticism to other institutions like local school boards, which are still empowered to mandate measures like the wearing of masks.

“Sometimes it can be quite frustrating not being able to make some immediate changes that previously helped slow down the broadcast,” said Christenson. “We just don’t have the tools we had before.”

This reality, she said, was “morally challenging”.

“I have a duty to protect the community. You want to do the right thing, but you also want to do the legal thing. In this situation it didn’t go together. “

Joe Russell doesn’t envy health workers who are new to their positions. He retired as head of Flathead City-County’s Health Department in 2017, but returned in December after the interim director resigned over a “toxic environment” ignited by “ideological prejudice” by local politicians.

“In a crisis like Covid-19, remember to take on a brand new profession in a leadership role you’ve never been before,” said Russell. “It would be miserable.”

He said his experience – 30 years in the Flathead Department of Health, including 20 as director – made it easier to navigate the pandemic in one of the most populous and conservative counties in the state, even though the case rate there remains high and the vaccination rate low.

His tenure, he said, gave him the credibility to confront officials who question the seriousness of Covid or the safety and effectiveness of vaccines.

“If someone is doing this nonsense, who better to stand up and give them the science-based evidence and tell them they’re full of crap?” said Russell. “I love it when that happens at a public gathering.”

Although Montana laws essentially prevent public health officials from following many CDC guidelines, Christenson said they still have useful tools at their disposal to help fight the virus: testing, tracing, vaccination, communicating with the public.

“That’s what I’m concentrating on,” she says. “We can do that.”

Christenson believes it has the support of the community. She noted that while some people were protesting outside of Kelley’s house, the crowd countered that criticism by lining Bozeman’s Main Street and cheering for support on his drive home.

“Not to say that every day is rosy,” she said. “That would be naive. But you can feel that the employees here are still trying to move forward, and that’s a success for me. “

In Madison County, Sayler said she is taking an “olive branch” approach to turning things around by making recommendations rather than orders as her staff work to raise vaccination rates from the current 48%. She doubts this will reduce Covid quickly.

In September, the county recorded about 200 new cases – about 20% of all infections since the pandemic began – and had more residents than ever hospitalized with the virus.

While Sayler’s first few months on the job filled the pandemic, she looks forward to focusing on other ways the health department can restore the public’s faith and help Madison County, such as providing baby car seats or nutritional advice for mothers-to-be .

“A lot has to be rebuilt here because this whole office has been consumed by Covid for so long,” she said. “I still see long-term goals for us and what we can do for this community. It’s not just a goal. That is a need. “

Her office has occasionally persuaded Covid sufferers, even those who insisted the virus is not serious, to seek medical help. “Tell your story,” said Sayler, advising these Covid survivors. “Make sure everyone knows how sick you were.”

But then there are more difficult encounters, such as when a mother cursed her on the phone for recommending that her child be quarantined. A week later she saw the woman playing her daughter’s volleyball game.

“She sat there and looked straight at me and then away,” said Sayler. “It made me feel better. You really don’t feel that way. At that moment you only expressed frustration. “

That experience left her cautiously optimistic about the difficult task she faces with the pandemic that will enter her second winter.

“It’s comforting that there is potential here. We can still work with these people, ”she said. “We just don’t want to be a punching bag either.”

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