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Worker Exodus Could Leave Lasting Impacts On Public Health Services

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More Montana public health workers are quitting their jobs as they face mounting stress, and in some cases, threats, because of their work during the pandemic. The loss of experience could complicate the work of health departments now and in the future.

Former Pondera County Health Department Director Nicky Sullivan was working 90-hour weeks in October just to keep up with managing her three staff members, contact tracing and tracking quarantine and isolation orders. That grueling pace led Sullivan and all but one of her staff to announce their resignations in early November.

"That was one reason, but the main reason that I resigned was just the lack of support from our county officials. They were some of the toughest ones I was fighting against to wear a mask and be those role models in our community."

Sullivan says individuals and businesses have refused to follow quarantine or isolation orders, and local political figures didn’t back up her former office's health guidance. That’s on top of the harassment Sullivan says she and her family have experienced on social media and in the community. She says it was gut wrenching to leave her seven-year career in public health. 

"We have no nurse in the office right now, and so, that really affects the community as far as getting vaccinations, our WIC program, especially being right in the middle of flu season, getting flu vaccinations."

The ripple effect from the loss of public health workers goes much further than changing how local governments can respond to the pandemic. Public health departments also run programs for low-income mothers, restaurant inspections, childhood vaccine services and handling measles or whooping cough outbreaks in schools.

According to the one count from the Montana state health department, about 9 leaders of city and county public health departments have quit their jobs since the start of the pandemic. 

Todd Harwell with the Montana Department of Public Health and Human Services says even more workers within those departments have left their jobs, too. 

"With the leadership that have left now, that’s going to make things even worse. We don’t have a tabulation on it, but there are other management and other support staff that have left, just because they've kind of had enough."

Harwell and other public health experts say these employees who are leaving have handled past public health events such as the H1N1 flu vaccine rollout. Losing that experience now is a big blow to health departments planning for COVID-19 vaccine delivery.

Head of the Montana Public Health Institute Hillary Hanson says while it isn’t yet clear when public health departments will begin playing a role in distributing COVID vaccines, she says it will be harder to do so with fewer staff on hand.

"As local health departments are dealing with lack of capacity to do COVID contact tracing and monitoring, it’s going to be hard for them, regardless of what issues they’ve had with staffing, to add onto it vaccine distribution."

Tamalee Robinson resigned from her post as the Flathead County Public Health Officer in late November after about six months on the job. She says during the course of the pandemic a dozen others at the Flathead Health department have also quit because of long hours and lack of support for health measures from county commissioners and health board members. She says this exodus will have lasting impacts on public health systems.

"We’ve hired some of those positions, but they’re starting out in COVID, as opposed to starting out in what their job will be next summer or whenever COVID is over. I think it will be a rebuilding period of public health all over the nation."

That could mean a complete reboot for other programs in the public health system.

Robinson adds that recruiting will likely be hard as many have seen news reports of public health workers dealing with protests outside of their homes or receiving physical threats for just doing their jobs.

"I’ve never experienced such daily hate mail and phone calls."

Robinson says public health departments and local governments need to provide new workers with the support and training they need, a initiative the Public Health Institute says it's working on. But Robinson says departments are desperately trying to hold onto the staff and experience they still have.

Joe Russell, who’s coming out of retirement to again lead the Flathead City-County Health Department, says that will be one of his main charges.

"I guess when I walk out the door the next time, I want to turn around and go, ‘I did everything I could to build the very best system for Flathead County, and hopefully a model, in some aspects, for the rest of Montana."

But with months to go until vaccines are widely available that will be a tall order.

Copyright 2020 Montana Public Radio. To see more, visit Montana Public Radio.

Aaron is Montana Public Radio's Flathead reporter.