Colorado Gov. Jared Polis signed a law designed to prevent “doxxing” of healthcare workers.
Doxxing refers to an act that reveals private or identifying information about an individual on the internet, opening them up to harassment or intimidation.
The state Senate passed House Bill 1041 on March 4, after the House passed it Feb. 14. Mr. Polis signed the bill into law March 24.
“(The protected workers) do have a public-facing job, but just because you have a public-facing job doesn’t mean you should have threats against your family or yourself for doing the work you’ve been tasked with doing,” bill sponsor and state Rep. Andrew Boesenecker, said, according toThe Denver Post.
In 2021, Colorado banned doxxing of public health workers. That law, in part, allowed public health workers to seek redaction of their personal information from publicly available government databases, according to the Post.
The new law expands protections to include child representatives, code enforcement officers, healthcare workers, mortgage servicers, and office of the respondent parents’ counsel staff members and contractors.
Under the new law, these individuals are people “whose personal information may be withheld from the internet if the protected person believes dissemination of such information poses an imminent and serious threat to the protected person or the safety of the protected person’s immediate family.”
Personal information includes the protected person’s full name and home address.
Healthcare professionals in Oklahoma who have cared for COVID-19 patients throughout the pandemic are now facing a facility lockdown due to threats made against them.
Mercy Hospital Oklahoma City upped its security and locked down its intensive care unit following online threats against the facility and its staff, mostly revolving around COVID treatments and conspiracy theories, Becker’s Hospital Review reported.
Claims made during a recent protest outside the facility and online included that the hospital had a “Fauci protocol,” and that it received government vouchers for using certain medications or treatments for COVID patients, which Mercy Hospital denied, according to Becker’s.
Hospital officials released a statement to staff on Friday, which they shared with MedPage Today. “There is truly nothing more important to us than your safety. We have a team monitoring these online attacks in real time. Every level of our ministry is deeply concerned and committed to doing whatever it takes to protect our co-workers against these baseless attacks,” they said.
“We are proud to serve with you,” they added. “We know you are tired and weary, but please try your best to put these baseless claims out of your mind. Remember, you are called to serve our patients and each other. We are praying for peace and protection over each of you, as well as the protection of all our patients and visitors, while we take action on your behalf.”
Late last week, the hospital filed a restraining order against the founder and director of an Oklahoma church group that has been protesting outside the facility and making threats against its staff online, Oklahoma’s KFOR reported.
In a recent press release, the church group, known as Ekklesia Oklahoma, called Mercy Hospital an “evil Marxist controlled death camp.”
Court documents stated that the founder of the group called one of the hospital’s doctors a “murderer,” noting that members even posted the doctor’s home address online, according to KFOR.
Hospital officials told KFOR that they are thankful for local police departments that are providing extra security for staff and patients.
Other hospitals across the U.S. have also received threats to the safety of healthcare workers in recent days.
Last week, the Massachusetts Medical Society said it was “angered” over the recent neo-Nazi protest outside Brigham and Women’s Hospital in Boston that targeted two doctors whose work focuses on health equity.
Carole Allen, MD, MBA, president of the society, told MedPage Today that the protest outside Brigham and Women’s was a threat to healthcare workers who were just trying to do their jobs, as well as to patients, and was so disruptive that it “could endanger healthcare in general.”
Lown Institute berates greedy pricing, ethical lapses, wallet biopsies, and avoidable shortages.
Greedy corporations, uncaring hospitals, individual miscreants, and a task force led by Jared Kushner were dinged Tuesday in the Lown Institute‘s annual Shkreli awards, a list of the top 10 worst offenders for 2020.
Named after Martin Shkreli, the entrepreneur who unapologetically raised the price of an anti-parasitic drug by a factor of 56 in 2015 (now serving a federal prison term for unrelated crimes), the list of shame calls out what Vikas Saini, the institute’s CEO, called “pandemic profiteers.” (Lown bills itself as “a nonpartisan think tank advocating bold ideas for a just and caring system for health.”)
Topping the listwas the federal government itself and Jared Kushner, President’s Trump’s son-in-law, who led a personal protective equipment (PPE) procurement task force. The effort, called Project Airbridge, was to “airlift PPE from overseas and bring it to the U.S. quickly,” which it did.
“But rather than distribute the PPE to the states, FEMA gave these supplies to six private medical supply companies to sell to the highest bidder, creating a bidding war among the states,” Saini said. Though these supplies were supposed to go to designated pandemic hotspots, “no officials from the 10 hardest hit counties” said they received PPE from Project Airbridge. In fact, federal agencies outbid states or seized supplies that states had purchased, “making it much harder and more expensive” for states to get supplies, he said.
Number twoon the institute’s list: vaccine maker Moderna, which received nearly $1 billion in federal funds to develop its mRNA COVID-19 preventive. It set a price of between $32 and $37 per dose, more than the U.S. agreed to pay for other COVID vaccines. “Although the U.S. has placed an order for $1.5 billion worth of doses at a discount, a price of $15 per dose, given the upfront investment by the U.S. government, we are essentially paying for the vaccine twice,” said Lown Institute Senior Vice President Shannon Brownlee.
Webcast panelist Don Berwick, MD, former acting administrator for the Centers for Medicare & Medicaid Services, noted that a lot of work went into producing the vaccine at an impressive pace, “and if there’s not an immune breakout, we’re going to be very grateful that this happened.” But, he added, “I mean, how much money is enough? Maybe there needs to be some real sense of discipline and public spirit here that goes way beyond what any of these companies are doing.”
In third place: four California hospital systems that refused to take COVID-19 patients or delayed transfers from hospitals that were out of beds.A Wall Street Journal investigation found that these refusals or delays were based on the patients’ ability to pay; many were on Medicaid or were uninsured.
“In the midst of such a pandemic, to continue that sort of behavior is mind boggling,” said Saini. “This is more than the proverbial wallet biopsy.”
The remaining seven offenders:
4. Poor nursing homes decisions, especially one by Soldiers’ Home for Veterans in western Massachusetts, that worsened an already terrible situation. At Soldiers’ Home, management decided to combine the COVID-19 unit with a dementia unit because they were low on staff, said Brownlee. That allowed the virus to spread rapidly, killing 76 residents and staff as of November. Roughly one-third of all COVID-19 deaths in the U.S. have been in long-term care facilities.
5. Pharmaceutical giants AstraZeneca, GlaxoSmithKline, Pfizer, and Johnson & Johnson,which refused to share intellectual property on COVID-19, instead deciding to “compete for their profits instead,” Saini said. The envisioned technology access pool would have made participants’ discoveries openly available “to more easily develop and distribute coronavirus treatments, vaccines, and diagnostics.”
Saini added that he was was most struck by such an attitude of “historical blindness or tone deafness” at a time when the pandemic is roiling every single country.
Berwick asked rhetorically, “What would it be like if we were a world in which a company like Pfizer or Moderna, or the next company that develops a really great breakthrough, says on behalf of the well-being of the human race, we will make this intellectual property available to anyone who wants it?”
6. Elizabeth Nabel, MD, CEO of Brigham and Women’s Hospital in Boston, because she defended high drug prices as a necessity for innovation in an op-ed, without disclosing that she sat on Moderna’s board. In that capacity, she received $487,500 in stock options and other payments in 2019. The value of those options quadrupled on the news of Moderna’s successful vaccine. She sold $8.5 million worth of stock last year, after its value nearly quadrupled. She resigned from Moderna’s board in July and, it was announced Tuesday, is leaving her CEO position to join a biotech company founded by her husband.
7. Hospitals that punished clinicians for “scaring the public,” suspending or firing them, because they “insisted on wearing N95 masks and other protective equipment in the hospital,” said Saini. Hospitals also fired or threatened to fire clinicians for speaking out on COVID-19 safety issues, such as the lack of PPE and long test turnaround times.
Webcast panelist Mona Hanna-Attisha, MD, the Flint, Michigan, pediatrician who exposed the city’s water contamination, said that healthcare workers “have really been abandoned in this administration” and that the federal Occupational Safety and Health Administration “has pretty much fallen asleep at the wheel.” She added that workers in many industries such as meatpacking and poultry processing “have suffered tremendously from not having the protections or regulations in place to protect [them].”
8. Connecticut internist Steven Murphy, MD, who ran COVID-19 testing sites for several towns, but conducted allegedly unnecessary add-ons such as screening for 20 other respiratory pathogens. He also charged insurers $480 to provide results over the phone, leading to total bills of up to $2,000 per person.
“As far as I know, having an MD is not a license to steal, and this guy seemed to think that it was,” said Brownlee.
9. Those “pandemic profiteers”who hawked fake and potentially harmful COVID-19 cures. Among them: televangelist Jim Bakker sold “Silver Solution,” containing colloidal silver, and the “MyPillow Guy,” Mike Lindell, for his boostering for oleandrin.
“Colloidal silver has no known health benefits and can cause seizures and organ damage. Oleandrin is a biological extract from the oleander plant and known for its toxicity and ingesting it can be deadly,” said Saini.
Others named by the Lown Institute include Jennings Ryan Staley, MD — now under indictment — who ran the “Skinny Beach Med Spa” in San Diego which sold so-called COVID treatment packs containing hydroxychloroquine, antibiotics, Xanax, and Viagra, all for $4,000.
Berwick commented that such schemes indicate a crisis of confidence in science, adding that without facts and science to guide care, “patients get hurt, costs rise without any benefit, and confusion reigns, and COVID has made that worse right now.”
Brownlee mentioned the “huge play” that hydroxychloroquine received and the FDA’s recent record as examples of why confidence in science has eroded.
10. Two private equity-owned companies that provide physician staffing for hospitals, Team Health and Envision, that cut doctors’ pay during the first COVID-19 wave while simultaneously spending millions on political ads to protect surprise billing practices. And the same companies also received millions in COVID relief funds under the CARES Act.
Berwick said surprise billing by itself should receive a deputy Shkreli award, “as out-of-pocket costs to patients have risen dramatically and even worse during the COVID pandemic… and Congress has failed to act. It’s time to fix this one.”
In late November, Cliff Willmeng’s wife handed him a sealed envelope at their Minneapolis home “with some trepidation,” he recalled. He looked at the sender printed on the front: “Minnesota Board of Nursing.” Willmeng, a registered nurse, openedtheletter and read that the board was investigating his conduct as a nurse at United Hospital in St. Paul, from which he’d been fired in May. Clearly his license was at stake.
Willmeng was disappointed, but not surprised. He believes the review is due to his standing up for his own safety and that of other nurses, and for filing a lawsuit and union grievance against United’s parent company, Allina Health, after his termination.
He also thinks the investigation, like his firing, has been orchestrated to scare other healthcare workers away from reporting safety violations and concerns as the pandemic rages, and to make an example out of the former union steward.
The investigation is being led by a former Allina executive: “It feels meant to intimidate me,” he said.
Taking a Stand for Safety
Willmeng is a 13-year nursing veteran, husband, and father, who began working at United in October 2019.
When the pandemic hit late last winter, managers instructed nurses to use and reuse their own scrubs rather than hospital-issued scrubs. They were asked to launder their scrubs themselves at home.
Willmeng and others worried about bringing the virus home and pressed for the hospital scrubs. These scrubs were available, he said, and healthcare workers were permitted to wear hospital gear at Abbott Northwestern, another Allina hospital in Minneapolis.
In addition, while United managers told staff their laundering co-op could not keep up with demand for all the scrubs, the co-op denied that assertion, said Brittany Livaccari, RN, an ER nurse and union steward at United.
Willmeng addressed his concerns with management, filed state OSHA complaints, and enlisted the Minnesota Nurses Association (MNA). “He was taking action 100% to protect himself and to protect his patients,” Livaccari said.
But management did not change its policy, which was devised before the pandemic, and pointed to early-pandemic CDC and Minnesota Department of Health (MDH) guidelines — even when Willmeng shared emerging reports suggesting the policy was jeopardizing safety.
“It did feel like a pissing match,” Livaccari said. “We didn’t feel like we were being protected. … We weren’t being valued.”
Managers repeatedly wrote up Willmeng and colleagues who wore the hospital scrubs despite the policy. “It definitely felt like an intimidation tactic — ‘You’re going to do this, you’re going to follow these policies,'” Livaccari said. “A lot of staff chose to stop wearing those scrubs because they needed their job, they have families to pay for, they were afraid.”
Willmeng continued to wear the hospital scrubs. “I had to decide whether that policy was most important, or the safety of my workplace and public health and my family,” he said.
On May 8, the hospital terminated Willmeng. He said its stated cause was violating hospital policies regarding uniform code and a respectful workplace.
Two weeks later, the local nurses’ union held a rally that drew hundreds of supporters for Willmeng and blasted the hospital’s scrub policy.
‘I’m Not a Bad Nurse’
In June, Willmeng sued Allina for whistleblower retaliation and wrongful termination. The case is scheduled to be heard next August.
His union grievance is set to be arbitrated in January. He maintains his firing was not for “just cause” because United’s uniform code policy violated standard nursing practices.
Willmeng has been running the website WeDoTheWork, which describes itself as “worker-run journalism.” It’s an independent but union-affiliated publication that “unflinchingly tells our side of the story, and takes the fight to management.”
He’s been publicizing his case on that website. In his Twitter account he notes, “I believe in the working class, democratically run economy, socialism, and revolution.”
Willmeng is applying for jobs, but despite his experience, a national nursing shortage, and reports of severe understaffing as hospitalizations surge again, Willmeng has not even been interviewed by any of the roughly 20 medical centers he has applied to.
He thinks he is being blackballed. “I’m not a bad nurse,” he said.
The board letter cited these concerns: “On April 16, 2020, you received a written warning for not following the uniform policy,” reads one item, citing a report shared with the board. “On May 5, 2020, you were issued a final written warning for repeatedly violating policy. … On May 8, 2020, you were terminated from employment based on violating hospital policies, behavioral expectations, code of conduct, and not following the directions of your manager.” The letter asks Willmeng to respond to eight questions.
“This looks like it was taken right out of my HR file,” he said. The board will not reveal who reported him, citing confidentiality policies. But he is certain — given the detail in the letter — that it was Allina/United management.
The nursing board cannot comment on Willmeng’s review to protect confidentiality, said executive director Shirley Brekken, MS, RN. The board receives about 1,200 complaints annually and first determines whether a complaint would merit disciplinary action if true. If so, it launches a review.
Allina declined to answer questions via a spokesperson, citing the lawsuit. “We cannot appropriately retain employees who willfully and repeatedly choose to violate hospital policies,” according to an emailed statement. Throughout the pandemic Allina has been following CDC and MDH guidelines, “which do not consider hospital issued scrubs as PPE [personal protective equipment].”
“In the early days of the pandemic, our local and national supply chain was extremely stressed,” the statement continues. “Our practices are aligned with other local and national hospitals … and have enabled us to allocate the appropriate supplies for daily patient care and ongoing care for COVID-19 patients.”
But United healthcare workers still lack hospital scrubs and enough N95 masks, Livaccari said, and the hospital is severely understaffed as the patient load increases. “We hear, ‘It’s a pandemic. You have to do more with less,'” she said. “It’s a really bad situation.”
Retaliation and Intimidation
Some think Willmeng’s review was initiated primarily to retaliate against him, not to protect public health and safety.
“Hospitals, they want a docile workforce, they want a workforce they can control,” said John Kauchick, RN, a retired 37-year nursing veteran who advocates for workplace rights. They do so “by fear and intimidation,” he added. “A nurse’s number one fear is to be turned in to a board of nursing for anything.”
“If you’re a whistleblower and you speak truth to power, that will get you a disciplinary hearing even more so than if there is patient harm.”
The letter was drafted more than six months after Willmeng was fired, and after he filed the lawsuit and union grievance. Just before he received the letter, he was elected to the MNA board. The timing strikes Willmeng and Kauchick as significant.
“If you think there’s been a violation, you are supposed to report that in a much shorter time period,” Kauchick said. Kauchick thinks Allina filed the complaint as leverage, to persuade Willmeng to drop the grievance and lawsuit.
But Livaccari noted the process can take up to six months, and that every firing is supposed to be reported to the board.
Like Kauchick, she takes umbrage with the review’s leader: Stephanie Cook, MSN, RN, a board nursing practice specialist who spent 24 years as a director with Allina. She was a member of multiple Allina committees, including its ethics committee, according to reports. She was with Allina as recently as 2018. Brekken confirmed her employment with Allina, noting that it’s “a very large system.”
Regardless, that’s a conflict of interest, Kauchick and Livaccari said, arguing that Cook should not be part of the review. “It’s just so blatantly obvious. How are you going to look at this with an unbiased lens when you worked for the organization that says Cliff was in the wrong?” Livaccari said. “It’s so inappropriate.”
This is not uncommon, Kauchick said, noting state nursing board reviews are “really just designed to get rid of whistleblowers. It’s like a buddy system. They hire higher-ups from big hospital systems. It’s just incestuous.”
Brekken was aware of Cook’s background before a colleague assigned this review to Cook, she said, noting the board vets staff for personal involvement in cases. Brekken “might consider” removing Cook from the review given her connection to Allina, she said, but added: “Many individuals on our staff may have worked for a particular health system throughout their career.”
The board could throw out the complaint or take action. Such actions typically range from a reprimand to revoking a nurse’s license, Brekken said. A staff member and board member together will review the report and Willmeng’s response, but she said the board itself makes final decisions.
Willmeng is also focused on the grievance, which asks Allina to provide full back pay and reinstate him.
“I would not feel comfortable; I’d feel very anxious” going back, he said. “But I’m an ER nurse. I belong in the ER…. It’s important for a frontline healthcare worker to demonstrate that when they stand up and speak truthfully and assertively about working conditions and patient safety, that they can’t just be triangulated.”
His salary — about twice his current unemployment benefits — is also a draw, he acknowledged.
Meanwhile, he continues applying for other jobs. His life insurance cost doubled and his family switched to his wife’s lesser health insurance plan, he said. A fourth-grade teacher with a local public school system, her salary is the primary support for themselves and their two children.
Willmeng also just hired an attorney at $250 an hour to help him respond to the board letter. “It’s not something I take lightly,” he said. “There’s cause for real concern. That’s my nursing license, that’s everything.“
As people across the country refuse mask mandates, public health officials are fighting an uphill battle with little government support.
DR. MEGAN SRINIVAS was attending a virtual American Medical Association discussion around the “Mask Up” initiative one evening in July when she began to receive frantic messages from her parents begging her to confirm to them that she was all right.
“Somebody obtained my father’s unlisted cell phone number and spoofed him, making it look like it was a phone call coming from my phone,” she told Des Moines’s Business Record for a November profile. “Essentially they insinuated that they had harmed me and were on the way to their house to harm them.”
This malicious hoax, made possible by doxxing Srinivas’s private information, was only the most severe instance of abuse and harassment she had endured since she became a more visible proponent of mask-wearing and other mitigation measures at the beginning of Covid-19 pandemic. A Harvard-educated infectious disease physician and public health researcher on the faculty of the University of North Carolina, Srinivas currently lives and works in Fort Dodge, her hometown of 24,000 situated in the agricultural heart of northwest Iowa.
Srinivas is not just a national delegate for the AMA, but a prominent face of Covid-19 spread prevention locally, appearing on panels and local news segments. Fort Dodge itself is situated deep within Iowa’s 4th Congressional District, a staunchly conservative area that simply replaced white supremacist Rep. Steve King with a more palatable Republican.Join Our NewsletterOriginal reporting. Fearless journalism. Delivered to you.I’m in
Basic health measures promoted by Srinivas in Iowa since the beginning of the pandemic have been politicized along the same fault lines as they have across the rest of the country. Some remain in the middle ground, indifferent to health guidelines out deep attachment to “normal” pre-pandemic life. Others have either embraced spread-prevention strategies like mask-wearing or refused to acknowledge the existence of the virus at all. In a red state like Iowa, an eager audience for President Donald Trump’s misinformation about the dangers of the coronavirus has made the latter far more common, which has made Srinivas’s job more difficult and more dangerous.
“It was startling at first, the volume at which [these threats were] happening,” Srinivas told The Intercept. “I know people get very heated about politics and the issues that people advocate for in general, but especially on something like this where it’s merely trying to provide a public service, a way people can protect themselves and their loved ones and community based on medical objective facts. That’s surprising that this is the reaction people have.”
“I have trolls like other people, I’ve been doxxed, I’ve gotten death threats,” she said. “When you say anything people don’t want to hear, there will be trolls and there will be people who will try to argue against you. The death threats were something I wish I could say were new, but when I’ve done things like this in the past, I’ve had people say not-so-nice things in the past when I’ve had advocacy issues.”An untenable pressure has been placed on public health workers thrust in a politicized health crisis — and that pressure only appears to be worsening.
At the same time, as an Iowa native, Srinivas has been able to gain some trust through tapping into local networks like Facebook. Though she has encountered a great deal of anger, she’s also seen success in the form of a son who’s managed to convince his diabetic father, a priest, to hold off on reopening his church thanks to her advice, and through someone who’s been allowed to work from home based on recommendations Srinivas made on a panel.
“At this point, almost everyone knows at least one person that’s been infected. Unfortunately, it leads to a higher proportion of the population who knows someone who’s not just been infected, but who’s had serious ramification driven by the disease,” Srinivas said. “So it’s come to the point where, as people are experiencing the impact of the disease closer to home, they’re starting to understand the true impact and starting to be willing to listen to recommendations.”
Without cooperation and support at the state level, however, what Srinivas can accomplish on her own is limited. Even as the number of Covid-19 cases grew and put an increasing strain on Iowa’s hospitals over the past few months, it took until after the November election for Iowa’s Republican Gov. Kim Reynolds to tighten Iowa’s mask guidance. And board members in Webster County, where Srinivas lives, only admitted in November that she had been right to advocate for a mask mandate all along. Though Trump lost the election nationally, he won Iowa by a considerable margin, which Reynolds has claimed as a vindication of her “open for business” attitude and has continued downplaying the pandemic’s severity.
“The issue with her messaging is it creates a leader in the state that should be trusted who’s giving out misinformation,” Srinivas said. “Naturally, people who don’t necessarily realize that this is misinformation because it’s not their area of expertise want to follow what their leader is saying. That’s a huge issue under the entire public health world right now, where we have a governor that is spreading falsehood like this.”
The embattled situation in which Srinivas has found herself is the new normal for public health officials attempting to stem the tide of a deadly viral outbreak, particularly in the middle of country where the pandemic winter is already deepening. Advocating for simple, potentially lifesaving measures has become a politically significant act, working to inform the public means navigating conflicting regulatory bodies, and doing your job means making yourself publicly vulnerable to an endless stream of vitriol and even death threats. The result across the board is that an untenable pressure has been placed on public health workers thrust in a politicized health crisis — and that pressure only appears to be worsening.
DESPITE THE FACT that Wisconsin’s stay-at-home order was nullified by the state’s Supreme Court in May, the Dane County Health Department has used its ability to exercise local control in an attempt to install mitigation measures that go beyond those statewide. By issuing a mask mandate ahead of a statewide rule and advocating for education and compliance efforts, the department currently considers itself in a good place regarding health guideline compliance.
These actions have drawn a lot of ire from those unhappy with the regulations, however. According to a communications representative for the department, anti-maskers have held a protest on a health officer’s front lawn, a staff member was “verbally assaulted” in a gas station parking lot (an incident that prompted the department to advise its employees to only wear official clothing to testing sites), and employees performing compliance checks on businesses have been told to never perform these checks alone after “instances of business owners get a little too close for comfort.” They’ve also received a number of emails accusing health workers of being “Nazis,” “liars,” “political pawns,” and purely “evil.”
In Kansas’s Sedgwick County, Wichita — the largest city in the state — has been considering new lockdown measures after a November surge in coronavirus cases has threatened to overwhelm its hospitals. Though Democratic Gov. Laura Kelly attempted to instate a mask mandate in July, 90 of the state’s 105 counties rejected it, including Sedgwick, though the health board issued its own directive and Wichita had installed its own at the city level.
Now, with cases surging again, just as Srinivas saw the number of believers rising as more got sick, counties in Kansas that previously resisted mask mandates are changing their tune after Kelly announced a new mandate. But Sedgwick County health officials see an intractable line in the sand when it comes to who’s on board with mitigation measures and are focused more on what those who are already on board need to be told.
“It seems like a lot of the naysayers are naysayers and the supporters are supporters,” Adrienne Byrne, director of Sedgwick County Health Department, said. “There’s some people that are just kind of whatever about it. We just remind people to wear masks, it does make a difference. As we’ve gone on, studies have shown that it works.”
“I think it’s important to acknowledge to people that it is tiring, to acknowledge and validate their experience that people want to be over this stuff, but it’s important to reinforce that we are in a marathon,” she said. “In the beginning, we all wanted to hear that we would reach a magical date and we would be done with this stuff.”
Sedgwick has managed the streams of angry messages but has seen her colleagues in rural counties endure far worse, including death threats. She knows of one public health worker in Kansas who quit after being threatened, and others who have cited the strain of the politicized pandemic as their reason for leaving the public health profession.
“We’re certainly losing some health officials, there’s no question about that,” said Georges Benjamin, president of the American Public Health Association. “In the long arc of history, public health officials are pretty resilient. And while it absolutely will dissuade people from entering the field, we all need to do a better job of equipping them for these issues in the future.”
Benjamin would like to see institutional and public support for public health workers resemble that given to police or firefighters, government professionals who are well-funded, believed to be essential to the functioning of society, and wielding a certain level of authority.
“For elected officials who are charged with protecting the officials and their public officials, our message to officials then is that they should protect their employees,” Benjamin said.
IN RURAL NEBRASKA, the situation has presented even more complex challenges to public health workers. Outside of Omaha, the rural expanse is ruled by a deeply entrenched conservatism and, like Iowa’s governor Reynolds, Nebraska’s Republican Gov. Pete Ricketts has resisted a mask mandate. The Two Rivers Public Health Department, which oversees a wide swath of central Nebraska and its biggest population center, Kearney (population 33,000), is a popular pit stop along the Interstate 80 travel corridor and home to a University of Nebraska outpost.
Prior to the pandemic, Nebraska’s decentralized public health system had seen significant atrophy, according to Two Rivers Health Director Jeremy Eschliman, and was wholly unprepared for this level of public health event. There were few epidemiologists to be found outside of Omaha, though the department was able to hire one earlier this year. It also became clear early on that, despite the department’s traditionally strong ties with local media, messaging around the pandemic would be an uphill battle to get people to adapt new habits, especially when the president was telling them otherwise.
“There was one clear instance I remember when I caught a bit of heckling when I said, ‘Hey, this is serious. We’re going to see significant death is what the models show at this point in time,’” Eschliman said. “[The station said], ‘Are you serious? That seems way out in left field’ or something to that effect. That station had a very conservative following and that was the information they received.”
Eschliman has taken a realistic stance to promoting mask-wearing, thinking of it as akin to smoking. (“You could walk up to 10 people and try to tell them to quit smoking and you’re not going to get all 10 to quit,” he said. “Fun fact: You’re not going to get more than maybe one to even quit for a small period of time.”) Over the summer, he traveled just over Nebraska’s southern border into Colorado, where he was struck by the night-and-day difference between his neighbor state’s adoption of mask-wearing and Nebraskan indifference to it, each following the directives of their state leaders.“It’s become very difficult to do the right thing when you don’t have the political support to do so.”
Home rule is the law of the land in Nebraska, and there’s been strong rural opposition to mask mandates, despite more liberal population centers like Lincoln and Omaha installing their own. It’s taken Kearney until November 30 to finally install its own after outbreaks at the college and in nursing homes. Public health care workers have also been left on their own to make controversial decisions that have caused political friction. In May, the local health board voted not to share public health information with cities and first responders due to what they decided were issues of information confidentiality.
“Mayors, county board members, and police chiefs ran a sort of a smear campaign against me and the organization,” Eschliman said. “So when we talk about resiliency, that’s what we’re dealing with. It’s become very difficult to do the right thing when you don’t have the political support to do so.”
Even having a Democratic governor doesn’t necessarily ensure that support. In Hill County, a sparsely populated region of Montana’s “Hi-Line” country along the Canadian border, Sanitarian Clay Vincent supports Gov. Steve Bullock’s mask mandate, but doesn’t understand why it exists if it’s not enforceable. The way he sees it, if laws are made, they should create consequences for those who refuse to follow them.
But Vincent and the Hill County Health Board also saw what happened elsewhere in the state, in Flathead County, where lawsuits were brought against five businesses who refused to follow Bullock’s mask mandate. After a judge threw the lawsuit out, those businesses launched a countersuit against the state, alleging damages. In order to bring businesses in Hill County into compliance with the mask mandate, the health board is considering slapping them with signs identifying them as health risks or, barring that, simply asking them to explain their refusal to comply.
“These are community members. Everybody knows everybody and [the board isn’t] trying to make more of a division between those who are and those who are not, but I come back to the fact that public laws are put there for the main reason to protect the public from infectious diseases,” Vincent said. “You have to support the laws, or people sooner or later don’t give any credence to the public health in general.”
Regardless of whether they can push the Hill County businesses into compliance, the political winds are already changing in Montana. Republican Gov.-elect Greg Gianforte will take power in January and likely bring the party’s aversion to mask mandates with him. President-elect Joe Biden will take power at the same time, and even if he attempts to install a nationwide mask mandate, it will likely be difficult to enforce and may end up meaning little out in Montana. It will also likely exacerbate ongoing tensions in communities throughout the state. The building that houses Hill County Health Department in the town of Havre was already closed this summer out of fear that a local group opposed to the mask mandate and nurses doing contract tracing are routinely threatened in the course doing their jobs.
Regardless, Vincent is determined to encourage and enforce public health guidelines as much as it’s in his power to do so, no matter the backlash. He sees protecting the public as no different than preventing any other kind of disease. “I don’t care if it’s hepatitis or HIV or tuberculosis or any of these things,” he said. “You’re expected to deal with those and make sure it’s not affecting the public. Otherwise you have a disaster.”
With voting underway across the U.S., officials are bracing for a day of mischief and mayhem—polling hiccups, malfunctions, voter intimidation and civil unrest—here’s what’s happened so far.
KEY FACTS
Election officials across the country are warning of an unidentified robocall advising Americans to “stay safe and stay home” on Election Day, which has reportedly reached out to 10 million voters in the past several weeks.
The FBI is investigating those robocalls, according to CNN, which reported on air that calls have been received by voters in New York, Iowa, Michigan, Nebraska and North Carolina.
In Pittsburgh, a poll worker was ordered to be removed after fellow elections staff complained that the worker was looking at ballots prior to their scanning and taking video of the polling place, according to a Pittsburgh Post-Gazette reporter.
Also in Pittsburgh, one polling place wasn’t able to open on time since an election official’s car was stolen that contained a suitcase with a polling book, keys and other materials, according to the Post-Gazette reporter, but the site was later able to open with authorities arresting five suspects.
In Philadelphia, the district attorney’s office rebuked allegations circulating online about a pro-Democrat campaign poster on the outside of a polling station, calling misinformation about what would be an illegal violation “deliberately deceptive.”
Voters in Michigan and Iowa have been receiving threatening live calls telling them to stay home or face arrest at the polls, according to the office of Michigan’s attorney general, while Flint residents have also been targeted with robocalls advising them to vote on Wednesday because of long lines (those votes would not count).
In Kansas City, Missouri, a World War I memorial being used as a poll location was vandalized with the words “Don’t vote” and “Fight revolution” overnight; this comes after gravestones in a Jewish cemetery in Michigan were spray-painted with the words “TRUMP” and “MAGA” and residents of Roseville, Calif. reported “creepy” blue dots on the front homes with Biden-Harris campaign signs.
A federal court ordered the U.S. Postal Service to “sweep” postal facilities to locate any lingering ballots in battleground states, which have seen delays in the days leading up to the election, to be sent out immediately.
Republicans in Pennsylvania asked a federal court to block Democratic-leaning Montgomery County from contacting voters to correct issues with their mail-in ballots and requested the county throw away any defective ballots or those that have been cured in a Tuesday lawsuit.
In a move that’s expected to delay statewide reporting of election results, North Carolina’s State Board of Election voted to keep four polling places open longer because of early morning delays.
In Harris County, Texas, the state’s most populous county which includes Houston, all but one of 10 drive-thru voting locations were shut by county clerk Chris Hollins, who didn’t want the votes—at the center of a so-far failed legal challenge—to be jeopardized.
Pennsylvania’s Lancaster County has said it will delay counting mail-in ballots arriving after 8 p.m. on Election Day in case the U.S. Supreme Court rules to overturn a three-day extension to count ballots previously green-lit by both the Pennsylvania Supreme Court and the U.S. Supreme Court (the Supreme Court could agree to hear these arguments, but only after Election Day).
KEY BACKGROUND
The coronavirus pandemic has had a significant impact on the voting process, resulting in new procedures that may complicate Election Day. According to the Associated Press, around 300 lawsuits have already been filed about the election, including many concerning coronavirus-induced changes like drop boxes, signatures and secrecy envelopes. Local officials and police are also preparing for disruption and violence throughout the day, including the potential emergence of thousands of partisan poll watchers called for by President Trump. The Armed Conflict Location and Event Data Project (ACLED) has warned of heightened militia activity in key battleground states, including Michigan, Pennsylvania and Wisconsin. In anticipation of unrest, businesses in many U.S. cities have boarded up their storefronts, while a “non-scalable” fence has been constructed around the White House.
Dr. Anthony Fauci, the nation’s top infectious disease expert, said he and his family are getting death threats because people don’t like what he says about COVID-19.
“Getting death threats for me, and my family, and harassing my daughters, to the point where I have to get security is just — I mean, it’s amazing,” Fauci said during an interview with CNN’s Sanjay Gupta on Wednesday.
“I wouldn’t have imagined in my wildest dreams that people who object to things that are pure public health principles, are so set against it and don’t like what you and I say, namely in the world of science, that they actually threaten you.”
He noted that crises like COVID-19 has brought out the best of people but also the worst of people.
Fauci’s notoriety has been elevated by COVID-19, as he is often on TV offering a blunt portrayal of the state of the pandemic in the U.S.
Fauci, 79, is one of the world’s most respected infectious disease experts, having advised six presidents on HIV/AIDS, Ebola, Zika and other health crises. He has earned a reputation for being blunt and willing to correct the president.
Fauci also reflected on what he says is a degree of “anti-science” sentiment in the U.S. that is making it difficult to get people to do things to slow the spread of COVID-19 like wearing masks.
“There is a degree of anti-science feeling in this country, and I think it is not just related to science. It’s almost related to authority and a mistrust in authority that spills over,” he told Gupta.
“Because in some respects, scientists, because they’re trying to present data, may be looked upon as being an authoritative figure, and the pushing back on authority, the pushing back on government is the same as pushing back on science.”
He said the scientific community should be more transparent and reach out to people to underscore the importance of science and evidence-based policy.
“I know when I say that if we follow these five or six principles, we can open up we don’t have to stay shut…There are some people that just don’t believe me or don’t pay attention to that. And that’s unfortunate because that is the way out of this,” he said.
President Trump has repeatedly undermined Fauci, questioning the White House coronavirus task force member on Twitter and in interviews with the media.
Over the weekend, Trump tweeted out a video of a portion of Fauci’s testimony explaining why the U.S. has recorded more cases than European cases and called it “wrong.” Trump has falsely claimed several times that the U.S. has more cases because it is doing more testing.
Trump has also retweeted multiple messages that question Fauci’s expertise, including one last week that said he had “misled the American public.”
HENRY KOTULA 