Covid Burnout Rises Among Colorado's Public Health Leaders

COLORADO SPRINGS, Colo. (AP) — A few weeks ago, Dawn James’ job as Kit Carson’s public health director was making her sick to her stomach.

After being questioned, threatened with lawsuits and called names at community meetings, the 20-year veteran decided to take an early retirement.

“It just wasn’t fun anymore,” she said. “I felt caught between state and local policy and what I felt my ultimate responsibility was do right for the public.”

With a short resignation letter printed in the local paper Sept. 1, James became Colorado’s 21st public health director to leave her job since the pandemic hit the state in March 2020. According to the Colorado Association of Local Public Health Officials, two interim directors, who replaced a public health director from the same county, have also left and the association, which anticipates that one more will leave.

The loss means that more than 40% of local public health leadership in the state have left their positions, mostly due to COVID fatigue. Many of those leaders oversaw rural areas including Baca, Bent, Rio Grande and Teller counties, leaving some of them to be filled temporarily by people who often have little experience with public health.

Dr. Glen Mays, chair of the Department of Health Systems at the Colorado School of Public Health on the CU Anschutz Medical Campus, says the search to find a qualified person to manage public health in rural areas can take a long time.

“In more urbanized areas, there are leaders one and two levels down in an organization who can play a role in continuity, but in rural areas, there’s not often a lot of people to delegate down to,” he said, adding that it’s a national problem with life and death implications.

“This is a horrible time to be recruiting for new public health leaders. They’re in high demand, and there are few of them with the experience it takes to lead an organization.”

— Where should loyalty lie?

Any reader of the Burlington Record could see that James’ weekly COVID-19 updates changed last spring. What had once been data-filled missives of county resident infection rates from the state health department morphed into reports absent of detailed data — general reports about vaccination clinics, warnings about the potency of the delta variant and words of encouragement to Kit Carson residents to stay healthy.

County commissioners confirm they told James she was upsetting people with her weekly briefs — especially business owners who were worried about losing customers due to concerns over rising numbers. But they say a miscommunication whereby an internal memo was mistakenly published on a Facebook page that named five local businesses with infections was hurting the public rather than helping.

“There is no denying this is a red county,” said Kit Carson County Commissioner Cory Wall. “She was put in a really tough position, but the state health department thinks they call the shots. She (James) doesn’t work for the state. She works for Kit Carson County.”

Wall believes the vaccine mandates in Colorado have been reckless.

“The governor has not asked me personally what’s best for me and my family,” he said. “I think I can make the best decisions for myself.”

Is Wall vaccinated?

“Absolutely not,” the former professional rodeo clown told The Gazette. “It’s great that vaccines keep the elderly from getting ill,” he said, but he’s healthy enough that he’ll take his chances.

A day after James’ exit, the Burlington RE-6J School District experienced an outbreak and switched to remote learning. Superintendent Chuck Smithey said he followed a plan posted on the district website before the start of class.

“I don’t like shutting the school down,” he said. “I want to see kids in school.”

Class starts up again Monday.

The latest numbers from the state health department indicate that Kit Carson County is at the bottom of the state vaccination chart, with 41% of eligible residents having received at least one dose. Cheyenne County, which borders Kit Carson County to the south, has the state’s lowest rate, with 37%.

One hundred percent of eligible people who live in San Juan County on the Western Slope have received at least one dose of the coronavirus vaccine. Gov. Jared Polis reported Monday that the state average is 75%.

— Troubles in Elbert County

Elbert County Public Health Director Dwayne Smith publishes a detailed daily coronavirus update on his website. It was critical high-profile information last December, when his county was the first in the U.S. to report the highly transmissible U.K. COVID variant, which had shown up in a local nursing home.

A 30-year veteran of public health, Smith is not one to back down to elected officials. When he told school leaders in Elizabeth recently that 15-16 students and two teachers at Elizabeth High School had tested positive for the virus, the superintendent said the data was incorrect and insisted the health department refrain from declaring that an outbreak had happened at the school.

“The school district asked for a more prudent look at the data. I was confident that there was an outbreak,” Smith said. He ran the data past two epidemiologists at the state health department, who agreed with him, advising that these were epidemiologically linked cases.

Still, in a note sent home to families, Elizabeth School District Superintendent Douglas Bissonette stressed that he will keep schools open for in-person learning for the entire school year. He also stressed for parents to keep their kids home when they are sick so as not to spread the virus.

Bissonette explained his decisions in an email to The Gazette, stating that “while approximately 18/19 people positive with COVID-19 have been in the school over the last 14 days, all but four individuals are in different classes and have no close contact. There are four individuals who had multiple classes together and sat in close proximity to each other for 3 to 4.5 hours. We believe three of the students likely contracted the virus at school due to this extended close contact.”

Smith said he looks back to last spring when public health officials recommended for the district to transition to remote learning: “That recommendation was not heeded and it resulted in upwards of 50 confirmed known cases.”

Students who are infected will likely bring the virus home to their families, Smith contended.

“Those are the folks who end up in the hospital,” he said.

Smith, James and other public health leaders have been in emergency response mode for 18 months. Despite the extended frustrations, Smith says he’s one messenger who is not going anywhere.

“It’s still my duty and responsibility — not only in my role, but this is my life’s work.”