This is how we treat each other? This is who we are?
A county health director on the high cost of doing her job…
“I don’t really know if I should be talking about all of this. It makes me worried for my safety. I’ve had strange cars driving back and forth past my house.
I get threatening messages from people saying they’re watching me. They followed my family to the park and took pictures of my kids. How insane is that? I know it’s my job to be out front talking about the importance of public health — educating people, keeping them safe. Now it kind of scares me.
But people need to know what’s going on. It’s happening all over the country, and it’s not acceptable. I know we can do better. We have to do better.
I don’t base our whole response to this pandemic on my own opinion. That’s what makes the backlash so confusing. This job is nonpartisan. I’m not political in any way.
I go off of facts and evidence-based science, and right now, all the data in Missouri is scary bad. We only have about 70,000 people in St. Francois County, but we’ve had more than 900 new cases in the last few weeks.
Our positivity rate is 25 percent and rising. The hospital is already at capacity. They’ve basically run out of staff. We can’t keep up. It’s an uncontrolled spread. I have these moments when it feels like I’m a nurse at the bedside, and my patient is dying, and I’m trying every possible intervention to save them.
More social distancing. More masks. More contact tracing. Warnings and more warnings. What else can we try? But in the end, it doesn’t matter how much you do. Nothing will work, because it almost seems like the patient is resisting your help.
I get the same comments all the time over Facebook or email. “Oh, she’s blowing it out of proportion.” “She’s a communist.” “She’s a bitch.” “She’s pushing her agenda.”
Okay, fine. I do have an agenda. I want disease transmission to go down. I want to keep this community safe. I want fewer people to die. Why is that controversial?
We weren’t set up well to deal with this virus in Missouri.
We have the worst funding in the country for public health, and a lot of the things we’ve needed to fight the spread of covid are things we should have had in place 10 years ago.
We don’t have an emergency manager. We don’t have anyone to handle HR, public information, or IT, so that’s all been me.
We didn’t get extra funding for covid until last month. I’m young and I’m motivated, and I took this job in January because public health is my absolute love. It doesn’t pay well, but would I rather be treating people who already have a disease or helping to prevent it. That’s what we do. We help take care of people.
At one point this summer, I worked 90 days straight trying to hold this virus at bay, and my whole staff was basically like that.
We hired 10 contact tracers to track the spread, starting in August, but the real problem we keep running into is community cooperation. We call everyone that’s had a positive test and say: “Hey, this is your local health department. We’re trying to interrupt disease transmission, and we’d love your help.” It’s nothing new. We do the same thing for measles, mumps, and tick-borne diseases, and I’d say 99 percent of the time before covid, people were receptive.
They wanted to stop an outbreak, but now it’s all politicized. Every time you get on the phone, you’re hoping you don’t get cussed at. Probably half of the people we call are skeptical or combative. They refuse to talk. They deny their own positive test results.
They hang up. They say they’re going to hire a lawyer. They give you fake people they’ve spent time with and fake numbers. They lie and tell you they’re quarantining alone at home, but then in the background you can hear the beeping of a scanner at Walmart.
I’ve stayed up a lot of nights trying to understand where this whole disconnect comes from. I love living in this county. I know in my heart these are good people, but it’s like we’re living on different planets.
I have people in my own family who believe covid is a conspiracy and our doctors are getting paid off. I’ve done press conferences and dozens of Facebook Live videos to talk about the real science.
Even with all the other failures happening, that’s the one thing we should be celebrating: better treatments, nurses and doctors on the front lines, promising news about vaccines. But the more I talk about the facts, the more it seems to put a target on my back.
“We’re tracking your movements.” “Don’t do something you’ll regret.” “We’ll protest at your house.”
The police here have been really great. The elementary school says they’re watching over my kids and they’re on high alert.
I have a security system now at my house. I locked down my email and took all my family photos off of Facebook, but you start wondering: Is this worth it? Could anything possibly be worth it?
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And then it got worse this fall around the whole masking issue. Our hospital was filling up, and they asked if we could do more in terms of prevention and masking.
We put out a press release. We went to businesses and did trainings. We kept encouraging people to mask up, but it wasn’t working.
Only about 40 percent were wearing masks, so the health board decided to push for a mask mandate. Of course I was for the idea. Of course it is the scientific, smart thing to do. But at the same time, I kept thinking: Is this going to blow up my life?
We held a public meeting in the auditorium. I knew it was going to be a circus. I gave my kids an extra hug that night and said the things you never want to have to think about.
I asked the city: “Are you requiring masks in this building? Because this is a public health meeting, and that’s important.” They said yes. But, of course, the first person that walks in the door says: “I go to church here in this same building, and they don’t make me wear a mask.” So that ended up being an ordeal, and they decided to allow him in. I asked him: “Can you please, please, please social distance?”
He told me no. It wasn’t: “I can’t.” It was: “Hell, no. I won’t.” It went downhill from there.
We had more than 100 people show up, and most of them spoke in opposition. We do get a lot of thank-you’s and support for our work, but those aren’t the loudest voices, so sometimes they get drowned out.
Our medical providers were at the meeting in their white coats, and three of them stood up to speak on behalf of masks. These are doctors and nurses who risk their lives to treat this virus.
They are shouldering the burden of this, but the crowd wouldn’t even let them talk. They booed. They yelled. Some of them had come in with guns. They were so disrespectful. I was trying to take notes for our board, and my hands started shaking. Why aren’t you listening? Why do you refuse to hear from the people who actually know about this disease and how it spreads?
The board decided to go ahead with the mandate anyway, but part of the community revolted. We did a survey a few weeks later, and mask-wearing had actually gone down by six percent. We required it, and people became more likely to do the opposite.
How do you even make sense of that? We like to believe we take good care of each other here. This is rural Missouri. We pride ourselves on being a down-home community that sticks together, and now this is how we treat each other? Is this who we are?
I don’t go out in public very much anymore. It’s work and then back home. I don’t want to be recognized. I don’t want my kids to see any of that hate.
The one place where I had to draw the line was that my son plays baseball, and honestly, his games are the most normal I’ve felt all year.
But then, a little while ago, somebody took a photo at a game of me with my daughter. We were outside and social-distanced, so we weren’t wearing masks.
The photo got posted all over social media, and it was the usual comments. “Bitch.” “Communist.” “Hypocrite.” My daughter has had some anxiety. My son said to me: “Mom, why does everybody hate you?”
I went in to work the next day, and one of my nurses came to see me. She’d just had one of those nasty interactions on the phone, and she said: “I’m struggling right now. I need one of your little pep talks.” I told her: “I’m sorry, but I just don’t have it. I’m tired of this. I’m so exhausted.”
I’ve been living with that steady hum of tension and fear for almost a year, and I just can’t do it anymore. I keep saying my family is my number-one priority, so at some point I have to keep my kids safe. I decided to put in my notice earlier this month. My last day is this Friday.
I’ve already accepted another nursing job. I’m not abandoning the community. I’m going to keep fighting this pandemic, but I’d rather not say anything much more specific. I don’t want that target on my back. I’m ready to be anonymous.”
Eli Saslow is a reporter at The Washington Post. He won the 2014 Pulitzer Prize for Explanatory Reporting for his year-long series about food stamps in America. He was also a finalist for the Pulitzer Prize in Feature Writing in 2013, 2016 and 2017.
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