TABLE 3—
State and Local Public Health Officials’ Perspectives on COVID-19 Related Public Backlash: United States, March 2020‒January 2021
| Theme | Illustrative Quote (Region) | Employment Status (Time in Position) |
| Underrecognized expertise | “I leave my post today with deep disappointment that during the most critical public health crisis in our lifetime, the health department’s incomparable disease control expertise was not used to the degree it could have been. Our experts are world renowned for their epidemiology, surveillance, and response work. The city would be well served by having them at the strategic center of the response not in the background.” (East) | Resigned August 2020 (4 y) |
| “Matchsticks and Scotch tape” infrastructure | “This has been an extraordinarily humbling and challenging event. We have this system that sometimes feels like it’s made of matchsticks and Scotch tape. We’re trying to put this enormous, heavy burden on this pretty underdeveloped infrastructure. Not surprisingly, it breaks.” (West) | Remains in position |
| “I feel like I’ve been very transparent about those challenges and a lot of them go back to an outdated IT infrastructure where not a lot of things are automated. Also, we don’t have a very deep bench. The public health professionals we have are fantastic, but they’re exhausted and overworked. I think what we’re seeing is a symptom of underfunding public health for decades.” (South) | Resigned July 2020 (< 1 y) | |
| “We were really just very underfunded from a federal and then down through the state and then to the local level. So we walked into a pandemic without the resources that we even needed to do basic core public health services, and then to be thrown into a pandemic in which the pace is unrelenting. We’ve been asked to run at a sprint, where really, this is an ultramarathon.” (West) | Resigned December 2020 (3 y) | |
| The lifesaving villain | “I’ve kind of gone from small-town kid who goes home to his hometown to practice medicine to this villain, and I don’t comprehend how that’s occurred. . . . My role has been to try to keep people healthy and save lives.” (Midwest) | Remains in position |
| “I was trashed on Facebook, like, every day. My kids were accosted at school. They would get e-mails about the fact that their dad was shutting down restaurants and requiring masks. So, you know, people talked to my kids. My wife was accosted at the grocery store. I know one county health officer, south of me, who ended up with a death threat. And so it’s surprising the amount of anger that came out over this. They’ll still buckle your seat belt, they’ll put their tray table up when they’re on the airplane, they’ll give their kid an MMR shot before they go into sixth grade. And all of a sudden the mask becomes this huge invasion of their private liberty and so that was surprising.” (West) | Fired November 2020 (10 y) | |
| Politicized public health | “It’s shocking how politicized this has all become. And hard to understand from my point of view, just because I look at it as such a health thing. And I don’t know why people are so against, you know, the mask thing, when to keep things open—which is what they want economically—that they won’t wear a mask. And then that’s really—we’ve learned that that’s the only way to really keep things open when you can’t socially distance.” (West) | Resigned July 2020 (3 y) |
| “We did everything we could, but the governor is the one who made these choices and these decisions. If we lost funding, there would be no response to COVID, there would not be any contact tracing, any investigation, no response to this at all. For [the state] to threaten to pull that, that was going to hurt the community as a whole even more. It was a tough balance.” (West) | Resigned August 2020 (3 y) | |
| Disillusionment | “At the very start of the pandemic—early March—I had some optimism that this would be an opportunity for the broader public to see the value of what public health does and hopefully push for a better system—that we would transform the system. And at this point, I worry that things will be gutted even more and there will be even less willingness to have a strong infrastructure.” (West) | Fired May 2020 (6 y) |
| “I get threatening messages from people saying they’re watching me. They followed my family to the park and took pictures of my kids. 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 . . . when they start photographing my family in public, I have to think—is it really worth it?” (Midwest) | Resigned November 2020 (1 y) | |
| “You care about community, and you’re committed to the work you do and societal role that you’re given. You feel a duty to serve, and yet it’s really hard in the current environment. . . . We are driving a great aunt’s Pinto when what you need is to be driving a Ferrari.” (South) | Resigned June 2020 (2 y) |
Note. IT = information technology; MMR = measles, mumps, rubella.