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Southern California’s public health leadership turned over during coronavirus pandemic

California counties have gone through a lot of generals in their war against the coronavirus.

Since the pandemic started in earnest in March 2020, 18 local public health officials across California have left their posts, along with two senior leaders of the California Department of Public Health and the head of the state’s Health Care Services department, according to the Health Officers Association of California.

In Riverside County, Public Health Officer Dr. Cameron Kaiser was relieved of his duties Tuesday, March 23. Following protests outside her house, Orange County Public Health Officer Dr. Nichole Quick resigned in June, two months after the county’s director of public health services retired.

Both top health positions in San Bernardino County have changed hands amid the pandemic.

Dr. Michael Sequeira, a former president of the San Bernardino County Medical Society, became public health officer in November. Dr. Erin Gustafson had filled the position on an interim basis since the pandemic’s early days, after Dr. Maxwell Ohikhuare retired.

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And Corwin Porter, director of San Bernardino County’s Public Health department will retire Saturday, March 27, leaving a department he’s led since shortly after the pandemic began. Longtime director Trudy Raymundo resigned in May, after a decade as head of the department.

While none of the departures are connected, public health leaders nationwide have become the focus of increased scrutiny — and public vitriol and violent threats — for their actions and advice to stop the spread of a virus that’s killed more than 546,000 in the United States, including almost 36,000 in Los Angeles, Orange, Riverside and San Bernardino counties.

While many public health tasks — shutting down unsanitary restaurants and testing for sexually transmitted diseases, for example — don’t inspire public backlash, “COVID actions have made things more salient,” said Richard Carpiano, a professor of public policy and sociology at UC Riverside’s School of Public Policy.

“COVID really shows the political pressures that come with … providing health care services and looking out for the well-being of the public.”

Leaders of local public health agencies, who are typically trained in their field and appointed to their roles, became key figures early in the pandemic.

Kaiser, for example, was front and center at Riverside County press briefings on the virus. He underscored the pandemic’s severity when he ordered schools closed, cancellations of the Coachella Valley Music and Arts Festival and Stagecoach Country Music Festival and face coverings to be worn in public.

He soon became a target of ire from residents upset with business closures and convinced the pandemic was a hoax or overblown. Board of Supervisors’ public hearings in May became vehicles for speakers to call Kaiser a tyrant and blame him for costing them money.

After the hearings, the board asked Kaiser to rescind his health orders, including his mask mandate. He did so the next day.

In recent months, Kaiser became less of a public presence as others, including Director of Public Health Kim Saruwatari and Dr. Geoffrey Leung of the county-run Riverside University Health System, took the lead in briefing the board on COVID-19 matters.

The board on Tuesday afternoon tapped Leung to replace Kaiser, who was let go that morning by County Executive Officer Jeff Van Wagenen. Kaiser could not be located for comment.

Supervisor Karen Spiegel, the board chairwoman, declined Thursday, March 25, to go into details about Kaiser’s departure. She said Leung has overseen the county’s vaccine rollout and “he’s been the face of public health. (The change in public health officers) won’t change anything we do in public health.”

Leung “provided health officer (advice) and consultation to county teams and city staff while Dr. Kaiser was unavailable last year,” county spokeswoman Brooke Federico said Friday, March 26, via email, adding that’s standard practice when the health officer is unavailable.

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Carpiano said Kaiser’s ouster “seems really odd in the sense of how un-transparent that was … If anything, he was ahead of the curve on the masks.”

Kaiser faced pushback from county supervisors “who (haven’t) shown a very concerted effort to operate consistently with thinking about the best evidence and science (on the virus),” Carpiano added.

Speakers at board meetings criticized Kaiser as recently as Tuesday, though at this point, business closures and restrictions are mainly out of counties’ hands. The state mandated how and when businesses can open through the four-tier Blueprint for a Safer Economy, which eases or tightens restrictions based on how widespread the virus is in a county.

Earlier in the pandemic, the situation became ugly for some Southern California health officials.

Quick, the former Orange County public health officer, got tough questions in public from some Orange County supervisors over her mask order. She also got heightened security due to threats.

A severance agreement between the county and Quick paid her $75,000 and promised her that County Executive Officer Frank Kim wouldn’t criticize her in exchange for her promise not to criticize the county or the Board of Supervisors.

In June, Los Angeles County Public Health Director Barbara Ferrer reported that she and her staff had been getting death threats since March 2020. Someone casually suggested Ferrer should be shot during a Facebook Live briefing, she said.

Ferrer at the time said she led daily briefings to shield her team from attacks.

“It is deeply worrisome to imagine,” Ferrer said, “that our hardworking infectious disease physicians, nurses, epidemiologists and environmental health specialists or any of our other team members would have to face this level of hatred.”

Porter, the retiring San Bernardino County public health director, did his job well, said Curt Hagman, chairman of the San Bernardino County Board of Supervisors. After a 33-year career included 32 years with San Bernardino County, Porter told the board he wanted to retire six months earlier, Hagman said.

The Public Health Department is filled with other good people, and residents shouldn’t notice any shortcomings during the search for a permanent replacement, he said.

County residents — and board members — have often criticized state officials for their response to the pandemic, but Porter seldom came under fire personally, in contrast to officials in other counties. That’s likely because Porter kept lines of communication open with both the Board of Supervisors and the public, Hagman said.

He also spent less time in the spotlight than his counterparts in other counties.

“I think that’s a conscious choice we took,” Hagman said, referring to the Board of Supervisors. “The residents elect the board to represent them, and I wanted them to hear from the people they elected. Not to cut the Public Health director out, but to speak directly on our policies and the global picture, to hear more from the board on the effects it’s having on businesses and include that context.”


Source: Orange County Register

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