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Madison health director endures during COVID-19, despite 'no off-switch'
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Madison health director endures during COVID-19, despite 'no off-switch'

Heinrich at podium

Janel Heinrich, director of Public Health Madison and Dane County, addresses the media during a press conference. Being a local health official has been challenging during the COVID-19 pandemic, Heinrich said. "Everything comes with a ripple effect," she said.

Emails have called her and her staff “Nazis” and “evil.” A tweet said they should “watch your backs.” Protesters gathered outside her home. Her sons, ages 8 and 14, wonder why she can’t spend much time with them.

Janel Heinrich’s life as director of Public Health Madison and Dane County has not been easy during the COVID-19 pandemic. But while the job has been demanding in ways she never imagined when she started eight years ago, Heinrich is showing no signs of joining other health officers in Wisconsin and around the country who have resigned or been fired.

“There’s no off-switch ... We are more public than we have ever been. We have had to make decisions that impact everyone in ways we’ve never had to before,” said Heinrich, 44. But, “what keeps me going is I love this community. I’m committed to the work, to the health of the community.”

Of the nine local public health orders issued since Dane County confirmed the state’s first case of COVID-19 on Feb. 5, the most difficult one came Aug. 21, when the department required schools to start grades 3-12 online, Heinrich said.

“I want the kids in school; we all want kids in school,” she said. But, “I feel like it was the right decision to support the overall health and well-being of the community.”

Heinrich up close

Janel Heinrich became director of Public Health Madison and Dane County in 2012, after joining the department in 2008.

The state Supreme Court temporarily blocked the order on Sept. 10, but the health department continues to recommend online classes for grades 3-12. The Madison School District, where Heinrich’s sons are enrolled, has been online for all grades this school year and recently said the arrangement will continue at least until Jan. 22.

Protesters demonstrated against the schools order outside Heinrich’s home — a small group, peacefully, as is their right, she said. But the taunting emails take a toll, as does the verbal harassment at least one staff member encountered while wearing a face mask bearing a department logo at a gas station.

“That’s hard,” Heinrich said. “We’re still people, and we’re doing a really hard job right now.”

Business concerns

One vocal critic has been Zach Brandon, president of the Greater Madison Chamber of Commerce. He took issue in September with a health department Facebook post saying anyone who lives or works Downtown should assume they’ve been exposed to COVID-19 and a plan to start fining bars and restaurants that violate capacity limits or other restrictions.

“We feel an increasing shift of blame to businesses without data that backs that up,” Brandon told the State Journal last month. “We need a roadmap for progress.”

He said the health department should release more specific COVID-19 data, on where patients hospitalized in the county come from and about coronavirus clusters, since two or more cases at a workplace could involve employees who have been working separately from home.

Instead of limiting restaurant capacity to 25%, as is required now, before considering a planned jump to 50% if COVID-19 cases decline, the department should look at “microtuning” at 33% or 40%, he said.

But while Brandon said Heinrich’s agency has had “messaging stumbles,” he blamed city and county leaders for what he said is inadequate consideration of economic stability and consumer confidence when making COVID-19 policies.

“She was hired to protect public health,” he said. “Others were elected to balance all that together.”

Firings and resignations

In early September, Milwaukee Health Commissioner Jeanette Kowalik resigned to take a job at a health policy think-tank in Washington, D.C. “I was micro-aggressed, man- and ‘Karen’-splained beyond belief, and subject to major passive-aggressive outbursts, and plenty of double standards,” she wrote in the Daily Beast.

Sauk County Health Officer Tim Lawther resigned in mid-September, saying he had been called a “liar, a communist, a fascist” and more.

“Political gamesmanship” led some county supervisors to “demand retraction of evidence-based public health guidance,” Lawther wrote in his resignation letter.

Heinrich with Parisi

Public Health Madison and Dane County Director Janel Heinrich, with Dane County Executive Joe Parisi. Heinrich grew up in Wales, Wisconsin, and got bachelor's degrees in Spanish and international relations at UW-Madison before pursuing degrees and a career in public health. 

Lafayette County Health Director Elizabeth Townsend was recently fired and Shawano-Menominee County Health Officer Vicki Dantoin resigned, according to media reports. Health officers in the city of Cudahy and the counties of Burnett, Langlade, Polk and Vernon have also departed during COVID-19, said Eric Ostermann, executive director of the Wisconsin Association of Local Health Departments and Boards.

State Health Officer Jeanne Ayers said she was asked to resign in early May and told the Milwaukee Journal Sentinel she was not told why. At least 49 state and local public health leaders have resigned, retired or been fired since April across 23 states, Kaiser Health News and The Associated Press reported in August.

Asked if she has considered quitting, Heinrich said, “I’d be a fool to say ... I haven’t had the question. It’s human to think, ‘Holy cow, this is a place we’d never thought we’d be. There’s an incredible amount of pressure. Can I handle it?’”

But she has had “a lot of support” from city, county and local health care leaders, and has never seriously thought of stepping down, she said. Her husband, laid off in April, has been a “rock star,” helping at home when she can’t.

New demands

Still, Heinrich now oversees 360 employees, up from 155 before COVID-19, with most of the newcomers involved in contact tracing and testing. Animal control, restaurant inspections, immunization clinics, testing for sexually transmitted infections, nutrition programs for women and infants, violence prevention, and efforts to reduce opioid misuse and infant mortality continue, though some services have been reduced.

With an electorate desperate for a silver bullet to end the health crisis, President Trump has used the possibility of a COVID-19 vaccine, before Election Day, as his trump card. With politicians of all stripes using the vaccine as a political weapon, a look at what this will mean for a vaccine once one is approved.

She hasn’t had a full day off during the pandemic, continuing to hold meetings and answer emails on her few attempted vacation days and often working on weekends.

Her sons, especially the younger one, ask why life can’t return to normal. “He’s the first to say, ‘Turn off your phone. How many meetings do you have today?’” Heinrich said.

Some situations have put Heinrich in a particularly hard spot, such as a pointed debate in September between Dane County Executive Joe Parisi and UW-Madison Chancellor Rebecca Blank over how to handle a COVID-19 surge among students.

Parisi urged the university to move all classes online and send students in dorms home. Blank instead quarantined two of the largest dorms and paused in-person instruction for two weeks, which helped reduce cases. Currently, about 30% of classes have some form of in-person instruction.

Heinrich largely avoided the fray, saying in an interview that her authority over a unit of state government is “not clear.” Once students returned to campus and coronavirus cases mounted, there was “no good answer” on what to do, she said.

“If I could have waved my magic wand, I would have really liked to not see folks come into dorms in the first place,” she said.

As for criticism of her department’s shift in September to fining bars and restaurants up to $1,000 for disregarding orders, Heinrich said the previous gentler approach of trying to educate them about compliance was no longer working.

“How long do we talk about the right things to do and how many complaints come in that perhaps are indicating those things aren’t happening?” she said.

Pandemic response

Malia Jones, an infectious disease epidemiologist at UW-Madison, became a different type of critic of the health department this summer when she advocated unsuccessfully for an immediate ban on nonessential, high-risk gatherings. That could allow schools to reopen in person more quickly, according to a letter signed by 363 people from Jones, the mother of two elementary students.

Jones said last month she understands why the schools order in August called for online classes and thinks the county’s outbreak is still too heavy for in-person classes but hopes that can come soon.

Heinrich and other local health officers are in a difficult position because the federal government, notably the Centers for Disease Control and Prevention, is supposed to lead during a pandemic but hasn’t, Jones said. At the state level, Republicans have challenged most orders by Democratic Gov. Tony Evers, overturning some.

“We’re really down to making decisions at the local level, which is really hard to do,” Jones said. “The fact that (Heinrich) is hanging in there is really to be commended.”

Heinrich, who presents a calm, steady demeanor during public appearances, used the passive voice of diplomacy when referring to the politics.

“Science has become questioned,” she said. “The foundation of what we do is being questioned.”

She said she continues to follow her agency’s mission. “We’re trying to support keeping people as healthy as possible to the greatest extent possible,” she said.

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