Michigan’s new top doctor had to consider violence against health officials before taking job ⋆

When Dr. Natasha Bagdasarian was considering accepting an interim position as Michigan’s chief medical executive, the stream of public health officials who have faced a barrage of vitriolic criticism and threats over COVID-19 health mandates weighed heavily on her mind.

“Before taking this role, that was one of my considerations,” Bagdasarian said in a Friday telephone interview with the Advance. “I had to sit down and speak with my family to see if they felt safe with me taking this role. This isn’t the way it should be.”

Bagdasarian, who replaced Dr. Joneigh Khaldun as the state’s top doctor on Oct. 1, is no stranger to the pandemic landscape. A specialist in internal medicine and infectious disease, she has overseen Michigan’s COVID testing strategy as the senior public health physician at the state Department of Health and Human Services (DHHS). Most recently, she was taking a sabbatical from that position to work on COVID-19 planning at the World Health Organization.

This, however, is the first time that Bagdasarian — who will serve as the interim chief medical executive while the state conducts a national search for Khaldun’s replacement — is taking on an intensely public role during COVID. 

Dr. Joneigh Khaldun and Gov. Gretchen Whitmer give an update on COVID-19 | Gov. Whitmer office photo

Khaldun, who left DHHS to become the chief health equity officer at CVS, was one of the state’s most recognizable faces during COVID; she routinely joined Gov. Gretchen Whitmer to give COVID updates throughout the pandemic. Like health officials across the state, Khaldun also reportedly faced bullying and threats during the pandemic.

Now, Bagdasarian occupies a place that has become deeply troubling and downright dangerous for public health officials — the space where health policy, communication about COVID and the public collides. 

It is here that health officials, attempting to keep the public safe by implementing such COVID mandates as school mask orders for children not yet about to get a vaccine, are inundated with an onslaught of death threats and verbal assaults. They’ve faced GOP lawmakers pushing to pull local health departments’ funding over COVID requirements — something Republicans ultimately failed at but which nonetheless led some health departments to rescind mask mandates over budget concerns. And health leaders across the state have spoken of widespread burnout and plummeting morale among health department employees.

“My team and I are broken,” Kent County Health Department Director Adam London wrote in an Aug. 22 email to county commissioners. In that email, London detailed the threats he has received and a woman attempting to twice run him off the road after he announced a school mask mandate.

“I’m about done,” London wrote. “I’ve done my job to the best of my ability. I’ve given just about everything to Kent County, and now I’ve given some more of my safety.”

In an effort to mitigate the stress health officials are facing — and deter a mass exodus of health department workers — Bagdasarian said DHHS is “having regular meetings with our local health department partners.”

“We’re taking this very seriously,” she said. “The people coming forward and telling these horrific stories are our colleagues and partners. In many cases they’re our friends. We’re doing everything we can to support them.

Dr. Natasha Bagdasarian | Courtesy photo

“It shows how polarized things have become in our country,” Bagdasarian continued. “This should not be anything that has to do with political affiliation or anything other than science and data. We’re trying to follow the science. There’s really no need for all of this hate.” 

Many of those who have lashed out at health officials and against COVID policies are conservatives, including Republican lawmakers. After London detailed threats against himself and other health department employees, GOP Kent County commissioners have, for example, refused to sign an official statement condemning violence against public employees. 

And Republican leadership inserted boilerplate language into the Fiscal Year 2022 budget that threatened to cut funding from health departments if they implemented mask orders for children — something Whitmer said when signing the budget was unconstitutional and not enforceable.

While local health and school officials dealing with this wave of anger have said they were certainly accustomed to fielding frustrations from the public before COVID, the pandemic has left them feeling as though they’re being suffocated by public ire and that they’ve been largely abandoned by a DHHS that has not issued a Michigan-wide school mask mandate this year. 

The governor issued a  statewide school mask mandate last school year. State lawmakers revoked her ability to implement COVID-related health requirements this past summer, but DHHS remains able to issue such mandates — including one requiring masks in schools. The department has not done so and instead has left it up to local officials to institute such policies. Whitmer has said state officials are focusing on local health departments and school districts implementing their own school mask policies because they believe residents will be more likely to follow those requirements than if they came from the state. 

Local officials, however, have said this has translated to mounting public anger against them.

“The lack of a public health mandate puts all the pressure and all the politics on superintendents and school boards,” John Helmholdt, a spokesman for Grand Rapids Public Schools, said in an August interview with the Advance.

Linda Vail, the chief health officer for Ingham County, told the Advance in September that local health departments started to feel the heat from anti-vaccination and anti-mask Michiganders when the governor dropped the statewide mask mandate on July 1. 

“When I issued a mask order last October, it was not that big of a deal compared to what we saw … after the mask requirements went away and then trying to put them back in place,” Vail said. 

Despite the anger towards local officials and recent data announced by the DHHS last week that shows students in K-12 schools without mask mandates are far more likely to be diagnosed with COVID, Bagdasarian said there remain “no plans for a broad epidemic order.”

“We’re watching the data very closely, and we continue to recommend schools have smart mask policies in place,” she said. “The data shows [with masks], there’s less transmission, and kids are safer.”

According to DHHS, there were 73 COVID cases per 100,000 students by late September in school districts without mask mandates, which is 62% higher than the case rate in schools with mask requirements. In districts that mandate masks, the rate of infection was 45 cases per 100,000 students by the end of September, DHHS said.

We’re watching the data very closely, and we continue to recommend schools have smart mask policies in place. The data shows (with masks), there’s less transmission, and kids are safer.

– Dr. Natasha Bagdasarian

A little more than half a million children in Michigan — 504,627 —  in 311 school districts across the state are attending districts with no mask mandate, DHHS reported. There are 748,181 students attending 222 school districts with mask requirements. Thirty-six of the state’s 533 school districts have rescinded their mask mandates this year. In addition to masks mitigating the spread of COVID, mask advocates have emphasized children under the age of 12 cannot yet access a vaccine.

The opening of schools at the end of the summer and the spread of the highly contagious Delta variant has led to Michigan being one of a handful of states struggling with sustained COVID case growth despite new cases continuing to trend downward nationally, Bagdasarian said. The doctor added she’s especially concerned that COVID combined with the arrival of the flu season could result in significantly strained pediatric hospitals. 

“We’re not at a place where we want to be right now,” she said. “We’re heading in the wrong direction. … We worry about our pediatric population and our pediatric hospitals.”

Currently, Michigan’s COVID case rates are highest among 10- to 19-year-olds. There are now 474.8 cases per million people in that age group, compared to Michigan’s average of 304.4 cases per million people, according to the DHHS. Children ages 0 to 9 have the lowest case rate, the department said.

As of Monday, the state reported 58.8% of Michiganders eligible for the COVID vaccine are fully vaccinated. Bagdasarian noted that about 68.4% of Michiganders ages 16 and above have at least begun getting vaccinated. Michigan still has a goal of vaccinating at least 70% of its population, the percentage at which public health experts say a community could reach herd immunity. Bagdasarian did not say when she expects Michigan to hit that 70% threshold.

“We’re making slow but steady progress here,” she said. “We’ve talked a lot about that 70% number; that’s very within reach right now.”

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authored by Anna Gustafson
First published at https%3A%2F%2Fmichiganadvance.com%2F2021%2F10%2F19%2Fmichigans-new-top-doctor-had-to-consider-violence-against-health-officials-before-taking-job%2F