Leaders of Idaho’s most populous county were deluged with constituent emails last month as they prepared to choose the newest member of a once-obscure regional health board.
The Republican commissioners of the county — which encompasses the state capital, Boise — said they welcomed Ryan Cole’s “outsider” perspective and willingness to “question” established medical guidance. They appointed him over the protests of their lone Democratic colleague.
To critics, Cole’s elevation to a public health-care role is an extreme example of GOP-driven resistance to not only mandates but basic medical guidance, as the pandemic overwhelms Idaho’s hospitals like never before.
The covid-19 patients filling hospital wards and prompting statewide rationing of care are almost all unvaccinated. Yet Idaho’s lieutenant governor recently suggested, falsely, that vaccinated people are more likely to die, and some officials in the heavily conservative state — where many preach “freedom” from government — consider even recommending the shots to be an overreach.
As the delta variant fuels a new wave of coronavirus hospitalizations and deaths nationwide, some see Idaho as just the latest example of a pandemic response hobbled by politics and a year of intense backlash against public health restrictions.
“To watch my state implode over political decisions that have adverse consequences on health is horrifying to me. … That’s the tragedy that I’m watching unfold,” said Ted Epperly, Cole’s predecessor on the Central District Health Board, which can make broad rules such as mask mandates but had some of its authority stripped this year.
David Pate, a friend of Epperly and a former CEO of Boise-based St. Luke’s Health System, said that if there is no political will or ability to enact mask mandates, authorities need to at least give people good information. He said the combination of decreasing public health officials’ powers and then allowing them to spread falsehoods is “the worst possible outcome.”
He just learned that a charter school he successfully urged to require masks has changed course — after hearing a presentation from Cole.
A lifelong Republican and member of the governor’s coronavirus advisory group, Pate marveled that a segment of the right has been spreading misinformation that he said will be most deadly to their shot-spurning base.
“The America that I know and love … yes, we’re going to have intense debates,” Pate said. “We’re going to have different views of things. But any time we’ve faced an existential threat, we’ve pulled together. … We do whatever we need to do to protect our fellow man and our country. And I think it’s terrifying that that doesn’t seem to be how we’re handling this.”
About 40 percent of Idaho’s population is fully vaccinated against the coronavirus, one of the lowest rates in the country and significantly below the national figure of 54 percent.
Cole said in an email that the news media “has disastrously and disingenuously mischaracterized me,” but he did not respond to further questions.
Rob Howarth, a division administrator for the health district, said staff will give Cole “every benefit of the doubt,” but he acknowledged that there is “a sense of nervousness.” Another board member has been pushing for more control over health district guidance to the public.
Howarth said some staff are wondering: “Can I continue to say what I believe needs to be said? Can we relay information from the CDC?”
Idaho is one of many states where GOP lawmakers have responded to early-pandemic restrictions with moves to limit public health powers, arguing that the measures paved the way for alarming incursions on people’s rights. A state law passed this March gave county leaders veto power over some orders from health boards — like the mask mandate that drew fury and demonstrations in Ada County last year.
Former Ada County commissioner Diana Lachiondo (D) said she was used to “working quietly in the background” as a member of the region’s Central District Health Board. They monitored West Nile virus and made sure toxic algae blooms didn’t grow in lakes. Then, she said, the pandemic made public health explosively political.
Opponents of mask mandates showed up outside her home with air horns, at least one firearm and audio clips from the movie “Scarface,” in which actor Al Pacino famously says, “Say hello to my little friend,” as he uses a grenade launcher and fires a barrage from an assault rifle.
The protests outside Lachiondo and others’ homes were organized by a network founded by Ammon Bundy, a prominent name in Idaho’s history of anti-government activism.
People “are truly afraid that their liberties are being taken away,” said Lachiondo. “And if you dismiss that, then we’re never going to be able to grapple with how we come together as a community.”
Lachiondo lost her county commissioners seat in last November’s election to Ryan Davidson, a former chairman of the Ada County Republican Party. Davidson’s victory meant that the GOP would take the majority on a three-person commission, and Lachiondo stepped down from the health board preemptively.
“The minute I lost, it was very much, ‘We won. … We’re going to shake up the health board,'" Lachiondo said.
Her replacement on the board is Raúl R. Labrador, a former Republican congressman, who opponents noted once declared that “nobody dies because they don’t have access to health care.” Soon after, the county commissioners had also decided not to renew Epperly, who is CEO of an Idaho health-care system.
Explaining Epperly’s removal this June on Facebook, Davidson denounced his support for “ill-conceived restrictions” and said that “none of the doomsday predictions ever came true.”
This summer — amid a new nationwide coronavirus surge that would push Idaho hospitals to the brink — the Ada County commissioners picked Cole to fill Epperly’s spot, which must go to a licensed physician.
Epperly’s reaction: “You got to be kidding me.”
Cole is a pathologist who runs a medical testing center in Boise and whose public appearances have come to focus on covid-19. The doctor — who, according to his résumé, used to present mostly to medical conferences — has made most of his 2021 appearances at statehouses and on right-wing media, often disparaging the shots proved safe and effective in large trials.
It started with a March talk at the Idaho Capitol, for a series hosted by the lieutenant governor, where Cole said mRNA vaccines using similar technology to coronavirus shots have led to cancer and autoimmune diseases. Asked for evidence later by a fact-checking site, he cited a paper whose lead author emphatically rejects Cole’s claims.
Video of that talk and another one at the Capitol later in the month racked up more than a million views.
At a San Antonio event this summer, Cole had the same message: “I don’t even like calling it a vaccine,” he said.
“Fake vaccine!” someone from the audience suggested.
“A fake vaccine,” Cole said. “Okay. I can — the clot shot, needle rape, whatever you want to call it.”
Asked about that moment later on news station KTVB, Cole said he was being “tongue-in-cheek” but maintained that he and his family would not get vaccinated against the coronavirus. He has said he does not oppose vaccination in general.
Cole made these statements despite not being an epidemiologist. His application to the board says he is a diagnostic pathologist with experience in clinical medicine.
The county commissioners who voted to appoint Cole defended their pick in interviews with The Post. Davidson said he wanted someone “who would absolutely not go the route of shutdown.” Commissioner Rod Beck (R) said that “with this whole vaccine thing, we haven’t taken other alternative viewpoints.”
Beck said he has been vaccinated against the coronavirus and believes the shots “are working” — but also said people should not look to the public health department for any guidance on coronavirus vaccination beyond “consult with your doctor.”
Megan Blanksma, a Republican state lawmaker who sits on the Central District Health Board, echoed that broadly recommending vaccination, even with a talk-to-your-doctor caveat, seems “too far.”
“People don’t want the government telling them what to do,” she said.
Meanwhile, other elected officials are sowing misinformation.
A recent newsletter from Lt. Gov. Janice McGeachin (R), who has clashed with the state’s more moderate governor over covid-19 measures, claimed falsely there is “clear” evidence that people “may be significantly worse off health-wise if they get vaccinated.”
News outlets quickly pointed out that she was misreading data. People without full vaccination this spring and summer were 11 times more likely to die of covid-19 than the vaccinated, according to studies published by the Centers for Disease Control and Prevention.
But McGeachin — who is running for governor with the slogan “Make Idaho Free Again!” — has not backed off.
“I remain clear in my position on the vaccines. If you want the vaccine, go get the vaccine,” she said in a statement to The Post, without directly addressing the newsletter or her speaking invitations to Cole.
The office of Idaho Gov. Brad Little (R), who has urged vaccinations but denounced mandates, did not respond to requests for comment.
The Biden administration’s sweeping new vaccination requirements for many employers and government workers have drawn outrage in Idaho and other conservative-led states.
As all of Idaho falls under “crisis standards of care” — in which hospitals can prioritize patients for limited resources based on who is most likely to recover — many health leaders are putting their hopes in urgent messaging rather than mandates.
One member of the regional health board in hard-hit northern Idaho said that even if they were to reimpose a mask mandate, not enough people would follow it. So many people believe they are useless that “mask mandates were never effective in our region,” said Dick McLandress, a family medicine physician. Idaho Hospital Association CEO Brian Whitlock said that he believes mandates do not change behavior as much as “understanding the reason behind the behavior.”
But hospitals can only do so much.
“I don’t know how we can articulate any clearer the fact that the sickest of the sick in our hospitals are the unvaccinated,” Whitlock said in an interview. He warned of a looming regional crisis in hospital capacity as Idaho’s situation only worsens, with neighboring states “not far behind.”
Lachiondo, the former health board member from Ada County, worries what hard decisions her doctor husband may have to make as resources stretch thinner. He normally does outpatient work, she said, but just switched to helping swamped hospitals. He gets notifications each time one of his patients is admitted with covid-19.
“It’s been hard and sad to watch,” Lachiondo said. “He will come home very demoralized sometimes, because you’re just continuing to roll this rock up the hill, trying to convince people to get vaccinated.”
On Wednesday, just before Idaho allowed hospitals statewide to use crisis standards of care, Cole was back at the state Capitol. Live-streamed on the lieutenant governor’s Facebook page, he cast fresh doubt on coronavirus vaccines and decried “censorship” of covid-19 treatments while agreeing that the state’s situation is dire. “Hospitals are full,” Cole said. “They are. Patients are dying, staff is leaving. … Something has to change.”
The next day — with covid-19 hospitalizations higher than ever and still climbing sharply — Idaho reported 55 covid-19 deaths. That surpassed the state’s single-day record from November of 2020, before vaccines were widely available.
Coronavirus: What you need to know
Where do things stand? See the latest covid numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people.
The state of public health: Conservative and libertarian forces have defanged much of the nation’s public health system through legislation and litigation as the world staggers into the fourth year of covid.
Grief and the pandemic: A Washington Post reporter covered the coronavirus — and then endured the death of her mother from covid-19. She offers a window into grief and resilience.
Would we shut down again? What will the United States do the next time a deadly virus comes knocking on the door?
Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.
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