FIJ: When public health becomes the public enemy

Tamalee St. James Robinson was working late again. It was fall 2020, and in Flathead County, Montana, where Robinson was serving as interim public health officer, COVID-19 cases had jumped tenfold from the summer. The schools were still open, and new cases meant Robinson routinely worked 10-hour days, even on weekends. Around 9 p.m., a truck pulled into the empty Health Department parking lot, in clear view of Robinson’s office window. Something about it felt wrong; the truck’s engine was idling

Eventually, the truck left. Robinson wondered if she’d overreacted. She thought about the previous week and realized that she’d been on edge ever since the county sheriff had called her. “Do you know how to shoot a gun?” he’d asked. He told Robinson that a man had threatened her, saying that he wanted to challenge her to a public duel. The sheriff told Robinson that such threats would not be tolerated, but he thought she should know about it, just in case.

This is not what Robinson expected when she moved here. Her original plan was retirement; after two decades working in public health in Billings, Robinson wanted to enjoy the mountains and lakes and relax with her husband. But in 2019, when she was asked to help chair the Flathead County Board of Health, she agreed. Then the pandemic hit, and the health officer, who had been offered another job, asked her to act as the county’s interim health officer while the Flathead City-County Health Department hired a replacement. “You could probably do it part time, maybe three days a week,” Robinson recalls being told. At the time, cases in the area were mercifully low; the pandemic had yet to hit Montana the way it had places like New York and Seattle. Robinson agreed to serve.

But shortly after Robinson took office in July, local COVID-19 cases spiked. The state of Montana issued a mask mandate for businesses, but enforcement was left to local and regional officials. At the same time, the state’s department of education deferred all decisions about masking in schools to local officials, as did the Montana High School Association, which manages school sports throughout the state. “Everything was thrown at local health officers,” Robinson said. “We had to make those decisions. And then when we made those decisions, based on our best information, (other leaders) came out against them.”

Before COVID-19, local health departments were all but invisible to the general public. Their work kept communities running — they handled septic tank regulations, infant and maternal health programs, food safety inspections, air and water quality readings and immunizations — but they rarely attracted attention. “Nobody realizes it day to day, because they don’t have to deal with (those issues) — because we prevent it,” Robinson says. Few citizens knew the names of their local health officers or health department board members.

But the pandemic changed everything. As COVID cases increased in Montana, discussion swirled around what precautions to take, and Robinson became an easily recognizable public figure — and a convenient scapegoat for local citizens’ fears and frustrations. Every day, hateful emails and phone calls accused her of threatening people’s constitutional freedoms and destroying businesses. Protesters lurked outside her office, holding signs that proclaimed “Tamalee is a tyrant” and “Got dictatorial powers? Tamalee does.”

By mid-October, hospitalizations and deaths in Flathead County reached an all-time high. There were so many cases that the Health Department announced it could no longer adequately conduct contact tracing. Robinson presented a mitigation plan that would limit the size of gatherings, reduce capacity at bars, restaurants and churches, and introduce a 10 p.m. curfew for businesses that served alcohol. Before the October Board of Health meeting — held on Zoom after maskless protesters began swarming city council and school board meetings — 136 citizens submitted written public comments, about 60% of them in favor of additional restrictions. Dozens of people called into the meeting, and public opinion was split — eight citizens voiced their support for restrictions, while 10 opposed them. Invited experts — a local hospital CEO, the school district superintendent and an infectious disease doctor — all emphasized the seriousness of the recent spike and the need to mitigate the disease’s spread. In her remarks, Robinson spoke of the power of community: Health officers can’t unilaterally make the orders, she said. Rather, it was her job to find mitigation strategies that would protect hospitals and staff while also keeping schools and businesses open.

After Robinson spoke, Annie Bukacek, another Health Board member, said she needed to address some points before they considered mitigation options. Then she launched into a series of misleading comments about COVID testing and the danger the virus presented to children.

“This is ridiculous — we have to fight our own fellow board members to manage the COVID situation?”
Bukacek, a practicing physician, had been a controversial figure in the Flathead community for years, known for her staunch opposition to vaccination and abortion. When county commissioners appointed her to the board in early 2020, they said they hoped her inclusion would help promote a “diversity of opinions.” They got their wish; Bukacek frequently pushed back against the board’s actions, especially after the pandemic hit. She was the only member to vote against a March directive to close gyms, restaurants and bars. In early April, while most of the country closed schools and businesses in an effort to stem the spread, Bukacek organized the city’s first anti-lockdown protest. A YouTube video in which she accused medical professionals of manipulating COVID-19 death certificates went viral.

Shortly after, board member Michael Nicosia resigned, writing in a letter that he could not, “in good conscience, continue to serve as a member of the Board of Health alongside Dr. Bukacek.” Board members came to expect that Bukacek would shoot down any public health proposal. “Every initiative or anything we tried to do, Annie fought against,” says Robinson. “And I said, ‘This is ridiculous — we have to fight our own fellow board members to manage the COVID situation?’ ”

The week before the heated October meeting, Bukacek’s Facebook posts encouraged opposition to the board’s recommendations. She uploaded a photo from a protest in Kalispell, Flathead County’s seat, which she captioned “RESISTSANCE (sic) to TYRANNY in the FLATHEAD.” Around the same time, the county commissioners issued a statement saying they lacked the power to enforce the governor’s mask mandate and would support “the Constitutional rights of Montanans” to choose whether to mask up.

Ultimately, the Board of Health voted 5 to 3 against implementing any mitigation strategies. In the following weeks, the state pursued legal action against Flathead County businesses that refused to comply with the mask mandate. But with local officials unwilling to enforce the state mask mandate, let alone adopt new precautions, Robinson felt her recommendations were useless. Even worse, she feared they were putting her in danger. Robinson had worked through anthrax scares, smallpox outbreaks, H1N1, even Ebola, but she had never faced protests or been threatened like this. “None of those were politicized the way this was,” she said.

The day after Thanksgiving, Robinson resigned. In her letter, she detailed the “lack of support” for public health personnel and the “toxic environment” in which she worked. “It’s clear that the underlying motivation by several members of your groups is more closely aligned with ideological biases than the simple desire to do what’s best for the health of the community,” she wrote.

Robinson is just one of dozens of public health officers and board members in the Western U.S. — and at least 250 across the nation — who have left their positions over the course of the pandemic. Many, like Robinson, resigned, including the entire four-member staff of Montana’s Pondera County, who quit en masse in November, citing a lack of support from the county. Lori Drumm, the health officer in Montana’s Powell County, described her resignation in a Washington Post article: “I am part of a larger wave of public health officials resigning across the country, threatened with violence, facing political pressure to change guidelines or just burned out from the stress.”

Other officials have been abruptly ousted from their positions. Emily Brown, then-director of the public health department in Rio Grande County, Colorado, was fired in May. In Spokane County, Washington, health officer Bob Lutz was fired in November 2020; the circumstances are under investigation by the state, and Lutz, through his attorney, has called the decision politically motivated. In response, roughly half of the Spokane Health Advisory Committee resigned, writing that they “will not be complicit in supporting administrators who have worked to subvert the public’s health.”

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Lori Freeman, CEO of the National Association of City and County Health Officers (NACCHO), says the departures started soon after the pandemic took hold in the U.S. Three NACCHO board members resigned in a six-week period, either because they quit or were fired from their positions as health officers.

Freeman began to track firings and resignations across the country. Her data show that around 40% of them took place in seven Western states: Wyoming, Montana, California, Colorado, Washington, Oregon and Arizona. The departures point to an underlying theme, says Freeman: “People don’t like to be told what to do.” The U.S. has a long history of anti-science sentiment, but COVID-19 created new opportunities to politicize science. Once public health advice was reframed as a threat to personal freedom, officials like Robinson could be vilified as “tyrants,” harassed and intimidated by their own communities.

The public outcry against pandemic restrictions may appear to be a grassroots phenomenon, but it’s not that simple: Regional and national networks have been hard at work organizing opposition in local communities. Freeman agrees with anti-extremist experts that after COVID-19 hit the U.S., public health was targeted by militia groups and a constellation of far-right, anti-government activists who have long tried to claim the American West as their haven.

“I JUST GOT MY FIRST MIDDLE FINGER,” says one woman to another, laughing. It’s a sweltering day in July, the sky tinged the sickly yellow of smoke from Oregon’s Bootleg Fire. The two women are among about a thousand protesters gathered outside St. Luke’s hospital in Meridian, Idaho. Cars speed by the people lined up on the sidewalk; most honk in support, but not all. “Your first ever?” the other woman asks, incredulous. “No,” says the first woman. “My first today. I was involved with the recall effort for the Boise mayor, and I got it all the time!”

St. Luke’s, one of Idaho’s largest hospital systems, is among several that have announced that all employees will have to be vaccinated. The day after that announcement, dissenters created a Facebook group to plan a series of rallies; this is their second. Through this Facebook group and its sister groups on Telegram, organizers discussed logistics. Some participants, worried that cars parked at St. Luke’s might get towed away, recommended parking on nearby streets and walking over. “The commie-Nazis at (St. Luke’s) won’t stop us!” one commenter wrote. Merchandise was for sale, too; the two women protesters are wearing identical royal blue shirts with the phrase “#StoptheMandate” emblazoned across the front, advertised on Facebook and Telegram groups for $10 a pop.

If not for the political chants and signs, the protest would resemble any other community gathering. Children play soccer on the well-tended grass surrounding the hospital parking lot; friends hug and strangers complain about “fake news.” Protesters in medical scrubs display their hospital badges, chanting, “I will not comply.” Others demonstrate in solidarity with what they see as an infringement on those workers’ rights, and what it might mean for their own freedom: “What will they mandate next?” one sign reads.

Meridian is 500 miles south of Kalispell, but the signs echo the talking points repeated by Annie Bukacek and other Kalispell citizens. A variety of related political beliefs and causes appear in other signs: Between two trees hangs a banner that reads “Free the D.C. Prisoners of Biden,” with a link to a fundraiser to support those charged for participating in the Jan. 6 insurrection. One man waves a large black flag that proclaims “Rigged election,” while several others carry the Gadsden flag, a symbol popular with far-right militias. Members of the Proud Boys, an organization the Southern Poverty Law Center has designated a hate group, stand on a corner, dressed in their usual matching black-and-yellow Fred Perry polos and hats. (Proud Boys founder Gavin McInnes has disputed this designation, filing a libel suit against the SPLC; the suit is currently pending in Alabama federal court.)

An LED sign outside the hospital reads 95 degrees. Families take refuge in the shade of the trees, fanning themselves with their signs. Two men walk the demonstration’s perimeter, placing trash cans along the sidewalk; one wears a shirt with the slogan “CLAIM USE AND DEFEND / PEOPLE’S RIGHTS.” They unload bags of ice and bottles of water from a pickup truck without license plates, filling the trash cans with them as protesters rush over, eager to enjoy a cool beverage. A campaign sign is affixed to the front of each drink-filled trash can: “Ammon Bundy for Governor.”

Bundy is best known for his leadership in two armed standoffs with government officials, first at his family’s ranch in Nevada in 2014, and then at Oregon’s Malheur National Wildlife Refuge in 2016, where one person died. He and his family espouse the (legally dubious) belief that the U.S. Constitution does not allow the government to own land. For years, the Bundys publicly decried what they saw as federal overreach on public lands. After Malheur, Bundy moved to Emmett, Idaho, a bedroom community just outside of Boise. When the pandemic struck, he focused his militant energy on COVID-19.

That April, Bundy convened a small group of dedicated followers, who discussed how best to shift public concern away from the virus and toward “our freedoms and our rights.” The following week, the group grew to several dozen, and Bundy saw the start of something bigger — an opportunity to build a new network focused on defending constitutional freedoms, during COVID and beyond. “One of the things we’ve done, we’ve put a way that people can basically join, if you wanna call it that, People’s Rights, or whatever you want to call it,” he told the group. “We have a contact list that’s now probably over 300 people, so that’s a good little start.”

The name People’s Rights stuck, and within weeks, the organization created Facebook groups, a text line, email lists and a website, complete with onboarding materials for new members and local leaders. They allied with other groups, like the anti-vaccination activists of Idahoans for Vaccine Freedom and the Idaho Freedom Foundation, to stage events and protests. The group seeded dozens of chapters across the U.S.

To experts studying extremism, the rise and popularity of People’s Rights comes as no surprise. “The pandemic was a great time for anti-government militia groups,” says Travis McAdam, the director of Combating White Nationalism & Defending Democracy at the Montana Human Rights Network. “They were really able to use the pandemic, the frustration and anger at public health directives, as a way to sort of recruit people into their movement.” People like Bundy and Bukacek, a member of the radical right-wing Liberty Fellowship, have long denounced “government overreach.” Now, by focusing on pandemic shutdowns, they have tapped into a reserve of people newly sympathetic to what they see as a fight for their “constitutional freedoms.”

THREE MILES FROM WHERE THE PROTEST took place and seven months earlier, Idaho’s Central Health District hosted its December board meeting. Cases in the county had approached an all-time high, so the agenda was focused on COVID. The board would be briefed by local physicians and then vote on whether to expand the mask mandate from two of the district’s counties to four.

The meeting began as usual: The chair took roll over Zoom, calling the names of the commissioners and health-care professionals representing each county. When Ada County Commissioner Diana Lachiondo’s name was called, there was a brief pause while Lachiondo tried to compose herself. “I’m sorry,” she said. “I just got a text from my neighbor saying that there are protesters at my house, so I’m going to step off for just a moment to call the police, because my kids are there.”

“I’ve also got protesters outside my house,” said Ted Epperly, the board’s designated physician. Nevertheless, the meeting continued: The chair finished roll call, and an invited guest began a presentation on COVID’s impact on health-care workers. Epperly stood up and peered through the blinds on the window behind him as if there was something on the other side, while Lachiondo, phone held to her ear, wheeled on and off the screen as she made multiple calls. Suddenly, she began to cry and disappeared offscreen. When she returned, she unmuted herself, her voice wavering: “Can I interrupt you for just a moment?” She explained that the protesters were banging outside, and that she needed to leave to make sure her sons were safe.

The district director also left his screen to make sure his staff was aware of the situation. After he returned, he waited a few minutes before interrupting the physician. “I’m sorry, but I got a call from the mayor, and it sounds like the police and she are requesting that we stop the meeting at this time because of the intense level of protesters in the parking lot,” he said. Outside the Central District Health building, hundreds of people had gathered at a protest planned through the local People’s Rights chapter.

Read whole story by Jane C. Hu is an independent journalist who writes about science, identity and the outdoors. She lives in Seattle.