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Out in Front on COVID-19: Local Health Officials Are Used to the Spotlight

WHEELING — Daily reports received and filed, constant phone calls, and needing to serve as their county’s spokespersons for the COVID-19 response has been the reality for several officials with local health departments.

Ohio County’s health administrator, Howard Gamble, views his role in the pandemic as the same one he’s taken in decades past. Since the 90s, Gamble said, he’s been at the helm leading the public health response for measles, anti-smoking efforts, H1N1 and, now, COVID. Gamble’s had practice at this role, even if the COVID crisis has started to stretch on longer.

“Since the pandemic began, the number of calls, inquiries, questions, is dramatically larger,” he said. “But over the years, in my time in public health, public health always had a problem, crisis, issue, or a new something that we roll out that gets people’s attention.”

Gamble said the role of public health is to handle the three “P”s — protection, promotion, and prevention, and that model has remained constant, whether it’s promoting vaccines against the contagious disease du jour, managing damaging health practices, or preventing a public health crisis.

“I can remember going to restaurants where there’s smoking, and then half-and-half, and now, if you go to a place that has smoking, you think the place is on fire,” he said. “That got us into the spotlight, because people had opinions and passions for both sides.”

Gamble said the COVID pandemic has been more challenging than previous public health crises compared to prior health concerns such as SARS and H1N1. COVID’s rapid spread among the American population led to myriad ideas and reactions among the public before the health community could form a united front against the disease, which complicated matters.

“With any new topic, it always is (difficult to combat misinformation), because the public gets a conclusion a whole lot faster than we actually have data and can get it out correctly,” Gamble said. “Even when it comes to smoking, we all knew what smoking did back to the ’50s, when there was research that said, yes, it was causing problems. But everyone had an issue.

“When we have a vaccine-preventable disease, … we formulate our opinions, although public health knows the science. With this, the public was formulating their conclusions in how to solve that faster than we could say, here’s the problem, here’s the science, here’s what you need to do.”

Gamble recalled that toward the beginning of the pandemic, the advice was for sick people to wear masks, as was common practice. It wasn’t until the number of the sick increased dramatically across the country that the recommendation shifted for everyone to wear a mask to prevent the spread of disease.

“You were then working with ‘Everyone needs to be protected,’ instead of, ‘We need to protect ourselves against the ill,'” Gamble said. “Then, people go, ‘They told us one thing, now it’s another,’ they’re trying to build an excuse and trip you up, to say I’m right, you’re wrong, when in the end it’s about, ‘This is what we need to do in this moment.'”

Gamble said that any time a new vaccine had been developed, there’s always pushback and hesitancy regarding perceptions that the vaccine is “untested,” something Gamble compared to refusing to buy a car until it could be proven that it would never be involved in an accident.

He added that the protracted length of time that the COVID pandemic has gone on has impacted the health department’s ability to operate at their full, normal capacity.

“It’s been a challenge, as far as that part goes, but I have to admit, that’s what public health is supposed to do,”Gamble said. “When you jump into public health, you realize you’re going to have to deal with a public health issue. That could be disease, establishing something to prevent a disease, like a restaurant inspection program, or lead, or radon (testing).

Marshall County Health Administrator Tom Cook said that while the workload was stressful on his end, his philosophy was to keep the work coming without stopping to reckon with the scope of the issue.

“There is a lot of stress, but it’s really just a matter of having to keep moving forward,” Cook said. “You don’t have time to reflect, you just keep moving forward. … You have to just keep on progressing.”

Marshall County Threat Preparedness Director Mark Ackermann said that needing to be at the vanguard of the COVID response is difficult at times, especially in times of changing policy, such as the Centers for Disease Control and Prevention handing down new definitions which may affect how local businesses operate.

“It makes it more difficult at times, especially right now. Everything’s changing once again so quickly, and it’s just hard to keep up with all this information, try to process it, and get it out,” he said. “We just got notifications from the CDC within the last 24 or 48 hours finally defining what these areas of high or severe levels of spread is, and now we’re going to have to go back and find out where we’re at, and what the recommendations are … for whether or not they’re recommending people wear masks indoors again.”

Cook said it’s currently up to businesses to mandate whether or not masks are required inside, but for the health department’s side, masks are once again required, though walk-ins and visitors are still welcomed.

Ackermann said he has over 40 years in the medical field, and Cook more than 30 in various capacities. Both men were hired with the health department in the latter half of 2019, with Cook starting in August and Ackermann in November.

The health department’s staff, Ackermann said, are preparing to put their noses back to the grindstone, as the trend toward more numerous COVID cases continues, with around 10 new cases announced each day. Staff are tasked with keeping up with their normal daily duties, many of which involved catching up on tasks put on hold during the height of the pandemic, while also accepting a renewed COVID workload.

“The staff are gearing up, once again, to become very busy. Not only, this time, are we going to be gearing up toward potentially dealing with the variants and increased cases, but we’ve got the clinical staff upstairs right now who are doing a lot of work with back-to-school activities, and vaccinations,” Ackermann said. “We’re hopeful that they’re going to be going back to school, plus dealing with this increased caseload.

“It’s a little stressful for them, because they know how it’s going to come down on them — and we know these cases will continue to rise.”

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