Letters to the Editor • Opinion
The coronavirus pandemic is not over
Letters to the Editor • Opinion
We already know how to prevent pandemics
Amy Acton, Ohio's top health official during the early days of the coronavirus pandemic, became a lightning rod for criticism of the state’s decision to close businesses. (Tony Dejak/AP)
6 min

Local health officials handling the day-to-day response to the coronavirus crisis have faced hostility like never before, according to a new study of 1,499 episodes of harassment during the first year of the pandemic.

Of 583 local health departments surveyed by Johns Hopkins University researchers, 57 percent reported episodes of staff being targeted with personal threats, doxing, vandalism and other forms of harassment from 2020 to 2021.

From the early months of the pandemic, former president Donald Trump, Fox News personalities and right-wing commentators on social media unleashed a wave of criticism and specious claims against Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and many other officials who were promoting the use of face masks, vaccines, shutdown measures and social distancing.

Fauci has faced death threats and has been under stepped-up security protection since 2020. But the threats and denunciations are not limited to federal and state health officials.

Beth Resnick, assistant dean for public health practice at the Johns Hopkins Bloomberg School of Public Health and senior author of the study, said federal and state officials are more accustomed to rolling with the punches of politics.

“But in these small communities, this is all brand new, it’s really shocking, and it’s never happened before,” Resnick said. For a local health department with two or three employees, losing any employee could be “devastating.”

The researchers found that 222 health officials left their posts at local or state health agencies, more than one-third of them alongside harassment reports. The pandemic’s strain was not the only reason for these departures, however, which also included chronic underfunding of health agencies and the increasing partisan polarization in public health.

Local health officials reported that they abruptly went from being viewed as trusted neighbors to bossy villains in some of their communities and that their expertise on other health issues such as extreme weather events and vaping injuries also had been eroded in the public eye.

“Particularly in rural communities, health officials described challenges in being the public representative of a policy that was not always within their authority to decide,” the study says.

“Think about if you’re in a small community and you go to the grocery store, and someone starts yelling at you,” Resnick said. “This is really detrimental to our field, to our culture, to our public health community.”

Experts said the findings, published Thursday in the American Journal of Public Health, should serve as a wake-up call. The attacks on public health officials, and the ensuing staff drain and recruitment difficulties, may leave Americans more exposed to diseases, pandemics and other communal health risks, they said.

Michael Fraser, chief executive of the Association of State and Territorial Health Officials, said health officials and agencies always have faced some measure of controversy, “but this has really become personal, it’s become dangerous — we have to have health officials with state police, with armed guards.”

Previously, the work of public health agencies was respected, Fraser said. “Now, folks are harassed, ridiculed, questioned for decisions based on the best science we have at the time,” he said.

In Ohio, Gov. Mike DeWine (R) in 2019 enlisted Amy Acton to be the state’s top health official. She soon became a lightning rod for criticism of the state’s decision to close businesses in the first year of the pandemic.

“After Acton, who is Jewish, mentioned hosting a virtual seder, for Passover, protesters showed up at her home, with guns, wearing MAGA caps and carrying ‘TRUMP’ flags,” according to the New Yorker magazine. “Their signs read ‘Dr. Amy Over-re-ACTON’ and ‘Let Freedom Work.’ They brought their children. … Acton was assigned executive protection — a rare measure, for a public-health official — along with a retinue of state troopers.” She left the post in June 2020. DeWine announced a replacement, but that person withdrew the same day of the announcement, citing concerns for her family.

Writing in the Journal of the American Medical Association in 2020, three doctors noted that political leaders could help tone down the rhetoric but that Trump and conservatives “have displayed hostility toward experts inside and outside of government.”

“Social media amplifies such attacks, with the #FireFauci campaign providing an early template,” the doctors wrote. “Joining these attacks may be an easy outlet for people under stress from economic disruption and social isolation. One Facebook network of 22,000 users organized protests on the front lawns of health officers.”

An analysis by Temple University’s Center for Public Health Law Research showed that by late last year, at least 19 states had restricted state or local authorities from safeguarding public health amid the coronavirus pandemic.

In Florida, Gov. Ron DeSantis (R), a potential presidential candidate in 2024, has appointed a state surgeon general who says coronavirus vaccines should not be given to healthy children, contrary to the scientific community’s recommendation. A county health commissioner backed by Republicans in Idaho has recommended ivermectin for covid-19 patients and advises against vaccination, defying well-established science in both cases.

The Centers for Disease Control and Prevention surveyed 26,174 state, tribal, local and territorial public health workers, finding in a December study that 53 percent “reported symptoms of at least one mental health condition in the past 2 weeks,” including depression, anxiety, post-traumatic stress disorder or suicidal thoughts. More than 92 percent of people who took the survey said they had been working on covid-19.

“Traumatic and stressful work experiences related to the COVID-19 pandemic might have played a role in elevating the risk for experiencing symptoms of PTSD among public health workers,” the CDC study says. Twelve percent of public health officials reported receiving job-related threats because of work, and 23 percent said they felt bullied, threatened or harassed because of work.

Fraser said the attacks on public-health officials were a symptom of something larger: distrust in government. Francis S. Collins, who until recently was director of the National Institutes of Health, said he, too, has received threats.

“It’s not been serious enough so far for me to require the same kind of 24-hour security detail that Dr. Fauci requires,” Collins told The Washington Post last year. “Those who are doing so really ought to stop and ask yourselves, ‘What am I doing here? Why is this the right thing to do?’”

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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