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 and its running lights were on. Robinson decided to move away from the window and take cover behind the two monitors at her workstation. That way, she thought, they can’t get a clear shot at me.
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.”
“Tamalee is a tyrant.”
“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.”
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.
“People don’t like to be told what to do.”
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 pandemic was a great time for anti-government militia groups.”
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’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.
It’s no coincidence that protesters targeted Lachiondo and Epperly in these protests: Out of the health board’s seven members, they were both known for their consistent support of public health directives. Fifteen people appeared outside Epperly’s house, yelling, flashing strobe lights through the windows, beating cymbals, pounding on drums and garbage cans. When his wife walked out through the garage to see what was going on, the protesters chased her back inside.
At Lachiondo’s house, protesters carried airhorns; one also held a bullhorn, which he used to blare clips from the movie Scarface. They set off car alarms and banged on Home Depot buckets with sticks and chalked “NO LOCKDOWN” on the sidewalk outside the house. Susan Lang, who livestreamed the event on her Facebook page and later wrote about the protest on the People’s Rights website, let out a guttural Tarzan-esque howl. “Lockdown Lachiondo lies!” Lang shouted. “Diana Lachiondo is trying to steal our rights!” she yelled, breathing heavily. “You guys, sometimes I admit I feel a little bit aggressive and PISSED OFF! I don’t know, there’s just something about having my constitutional rights stolen, I go a little nutty!”
Lachiondo’s sons, then 9 and 12, were home alone; their grandmother had gone out to walk the family dog. The older son called to ask what to do. “I felt that I had let my kids down,” Lachiondo recalled. “The sound of my son’s voice — he was terrified. It was just such a helpless feeling.” The next day, the protesters were back; after footage of Lachiondo’s tearful signoff from the board meeting made national news, they staged a second protest, which Bundy himself attended.
“The sound of my son’s voice — he was terrified. It was just such a helpless feeling.” The next day, the protesters were back.
Bundy and his People’s Rights network have been a regular presence in the network of anti-COVID-restriction demonstrators during the pandemic. They’ve targeted other public health officers, including Spokane’s Bob Lutz and Bozeman’s Matt Kelley, and they’ve been a mainstay at the Idaho State Capitol, staging protests and crowding into the building without masks despite the building’s mandate. In August 2020, after Bundy repeatedly entered the building without a mask, troopers removed him from it using a wheeled chair. He was then arrested and barred from entering the Capitol for the next year.
In the end, the targeted political pressure worked. Commissioner Lachiondo was voted out of her position in the fall and replaced by Ryan Davidson, a far-right political activist who was recently investigated by the Idaho attorney general for approaching a judge on Ammon Bundy’s behalf to ask whether “any accommodation could be made” for Bundy and his followers’ refusal to wear masks in court. (The attorney general concluded that Davidson’s actions, “while disconcerting, did not constitute a crime.”) With Lachiondo also off the Health Board, Davidson and two other Ada County commissioners replaced her with Raúl Labrador. Labrador is a former congressman who flew to northern Idaho to support a brewery that reopened in May in defiance of the governor’s COVID restrictions. He is known to be sympathetic to the Bundys and their various causes.
At the end of June, Epperly’s appointment as the board’s physician was set to expire. Just a few days before it ended, he learned he had not been reappointed, marking the end of his 15-year tenure. In August, the Ada County commissioners replaced Epperly with Ryan Cole, a staunch opponent of mask and vaccine mandates who has publicly called vaccination “needle rape.” He has also faced criticism for claiming that mRNA vaccines can cause cancer. (They do not.)
Epperly, who was born and raised in Idaho, says it no longer feels like the state he knows and loves. A retired Army colonel, he says that the last year feels like a war. The pandemic “brought out a lot of the nastiness that either I didn’t see before, or has actually kind of been imported from multiple people moving into the states that are far right — because Idaho has always been a magnet for the far right,” he says.
Lachiondo, who was also born and raised in the state, has also seen change: People are moving to Idaho because they believe it’s a sanctuary for what they call “personal freedoms” — gun rights, lower taxes and lax vaccine laws. The networks they’re tapped into are far-reaching. “I had people protesting at my house on Dec. 8, and it was like, ‘Who are these people?’ These are the same people, the same networks, that were at the Capitol on Jan. 6,” she says. (At least two People’s Rights leaders have been charged in connection with the Capitol attack.) “We are like this weird canary in a coal mine. … People should be paying attention.”
“We are like this weird canary in a coal mine. … People should be paying attention.”
CHERILYN DEVRIES, A COMMUNITY ORGANIZER with Love Lives Here in Flathead, Montana, has been monitoring hate speech in the area for years. Since the early 2000s, a spate of high-profile neo-Nazis have moved to the area, eliciting outcry from the community. The leaders of such movements may have changed over the years, but their attitudes live on in the militia and Patriot movements, and in groups like People’s Rights, which have largely organized online. Lately, the entry points into extremism are shifting, too — all thanks to social media.
According to the Institute for Research and Education on Human Rights (IREHR), People’s Rights had around two dozen Facebook groups with thousands of members until October, when the platform deactivated them. (It also deactivated the personal Facebook pages of several People’s Rights leaders, including Bundy himself.) But there are still many related groups out there: IREHR found that hundreds of People’s Rights group members, including the leaders, also belonged to more than 200 militia-related Facebook groups.
Members clearly value the sense of community in these groups; they enjoy connecting with like-minded neighbors and organizing kickball games, worship services and swap meets. People’s Rights groups on Telegram and MeWe typically have a few hundred members, who bond over their shared views and commiserate about their very real frustrations: the fear of losing their jobs and the sense that their communities are being increasingly polarized. But the groups also serve as a portal to conspiracy theories, misinformation and outright disinformation. Members propagate dangerous falsehoods and direct people to their own often more-extreme pages, or to other hateful groups. Racist screeds and calls for violence are not uncommon. In the echo chamber of social media, this leads users to believe that extremist ideas are more popular — and therefore trustworthy — than they really are.
These online groups can grow rapidly, then coalesce around real-world events, which in turn draw more members. The group organizing the Boise #StoptheMandate protest was created just two weeks before its first rally. (The night before the rally, the group had around 3,000 people; just a week later, that number had nearly doubled. At press time, the group had nearly 11,000 members.) Groups like these play a vital part in rallying people to take action in other ways, including protesting at health board buildings or individuals’ homes, or contacting local government. Internet groups serve as a “trough of misinformation that people are feeding off of,” says DeVries, re-enforcing the values and beliefs that lead them to rally against their local governments and officials.
Travis McAdam says that the Montana Human Rights Network has encountered People’s Rights members who aren’t aware how the group began or even who its leaders are. After an op-ed linking People’s Rights to Bundy appeared in a small Montana paper, the local People’s Rights chapter discussed it. “It was really interesting to see on their Facebook page — all these people, that I think most of which were genuinely saying: ‘This isn’t Ammon Bundy! Ammon Bundy’s not telling us what to do!’” says McAdam. But, he says, that’s exactly what’s happening: “Everyone who signs up as one of their area assistants, as part of their orientation package, sees a video of Ammon Bundy telling them what to do, and how to do it.”
“We all know what the Bundy family playbook is, and we know how that ends: It ends in armed standoffs with the government.”
Anti-extremist experts like McAdam worry that groups like People’s Rights will continue to use the tactics they’ve honed over the course of the pandemic and mobilize their followers to take up arms on a variety of other issues. They fear this could lead to some dangerous places. “We all know what the Bundy family playbook is, and we know how that ends: It ends in armed standoffs with the government,” says McAdam. “This is a ploy by Ammon Bundy to use the pandemic to recruit members into a broader movement. And when the pandemic is over, he will have this whole structure that he can use and move into his whole next thing.”
There are hints that this is already happening. In the Flathead, anti-COVID restriction activists used their momentum to put together a slate of anti-mask candidates to run for the school board; ultimately, one of them was elected. Just as activists targeted health board meetings, they also targeted school board meetings; people showed up unmasked, and the meetings had to be moved to Zoom.
Ambitious politicians with extremist views have also rallied activists opposed to COVID restrictions. Idaho Lt. Gov. Janice McGeachin, who is well-known for her ties to extremist groups, is running for governor in 2021, and has connected with voters over COVID-19 politics. In May, when Gov. Brad Little was out of state, she tried to issue an executive order banning mask mandates, a stunt the governor condemned. McGeachin has participated in two Telegram groups related to the #StoptheMandate movement, sharing her press releases and crowdsourcing information from members.
Ultimately, that’s why Bundy campaign signs appeared at the #StoptheMandate protest; anti-COVID vaccine activists have become an important part of his base. In his campaign documents, Bundy — who promises “health freedom” — warns that the government is taking control of people’s bodies, using words like “tyranny,” “force,” and “immoral.” That July afternoon in Meridian, Bundy himself appeared, wearing his own blue #StoptheMandate shirt. He greeted a supporter and stopped to shake hands with a man holding a book called Adverse Effects of Vaccines. And while political pundits doubt that Bundy could win the election, his campaign serves as an end in itself: With his name in the news and his views becoming part of the public discourse, militia talking points are becoming part of the political mainstream.
ONE JULY AFTERNOON, Tamalee Robinson took a break from entertaining out-of-town guests to meet me in her old office in Flathead. They’d been hiking, golfing, boating — finally, Robinson was enjoying the retirement she initially imagined when she moved to the valley. It had been seven months since she’d been in this room, and she marveled at the posters of Glacier National Park on the wall. A painting of two black Labs hung by the window where protesters used to appear. “I didn’t put anything up on the walls, because I thought I was going to be here for maybe three months,” she said. She ended up being the interim health officer for half a year, and when she resigned, she had no idea who would take her place.
Ever since the departure of Robinson’s predecessor, the last health officer, the Flathead City-County Health Department had struggled to find a permanent replacement. After months of interviews, it offered the job to two applicants, both of whom declined, given the area’s skyrocketing housing prices and the tense political climate. “When those two candidates turned the job down, it was like, I don’t know if we’ll ever get someone,” she told me.
Just as Robinson finished speaking, the new health officer walked into the room. Or more accurately, the county’s old health officer: Joe Russell started at the department in 1987, working his way up to become health officer in 1997, where he served until he retired in 2017. When Robinson resigned, Russell was asked to come back.
Few communities in Flathead County’s position are lucky enough to have an experienced former health officer who is willing to come out of retirement to take the reins again. In many places, vacant positions have gone unfilled. In others, interim officers serve as temporary replacements, but lack the necessary requirements for a permanent position.
NACCHO CEO Freeman is worried about the turnover. “We’re losing leadership,” she says, “and there aren’t many public health experts left to fill those positions.” Freeman has seen this in her own field: Friends are leaving their jobs, retiring early, or taking time off to deal with professional burnout. “That is scary, because these are true, trusted, longtime professionals that have a lot of institutional knowledge, a lot of expertise,” she says. “The long-term impacts of these departures, I think, are going to be felt for some time.”
Once the pandemic emergency wanes, communities will need public health experts to tackle other issues, many of which have been neglected over the last 18 months. The decline in immunizations means more cases of preventable diseases, like whooping cough and measles. Lack of attention to mosquito and vector control leads to the unchecked spread of serious diseases like West Nile virus. Reduced capacity for drug surveillance means more overdose deaths. Freeman mentioned a local health official who was worried about the area’s opioid programs. “They worked really hard for two years to reduce their opioid-related deaths by 20%, and they’re back right up again,” she said. These are the programs that have to go on — and the ones that risk serious failures if communities can’t find qualified experts to replace the officials they ousted.
For Russell, the on-the-ground response to COVID has been easy, but navigating local politics remains tricky. He showed us the angry letter he’d received after he issued a cease-and-desist order for serving food without a license. The vendor in question believes that food safety laws are unconstitutional. “I’m dealing with a constitutionalist that wants to sue me for about a million dollars,” he said — something that never happened to him when he was health officer in the ’90s, 2000s or 2010s. “What COVID did was polarize — it polarized this community a ton. And that’s been hard; it’s gone past COVID.”
That polarization has led to major limits to public health’s powers. In spring 2021, Montana passed two bills. House Bill 121 gives county commissioners and city councils final say on declaring health emergency orders and health regulations and fees, and gives those governing bodies power to appoint health officers. The other, HB 257, prohibits local public health departments from enacting ordinances that would limit customers’ access to businesses or events at any place of worship. At least 14 other states have introduced or passed similar legislation, and in many states, including Montana, Washington and Idaho, the language of those bills appears to be heavily influenced by the American Legislative Exchange Council (ALEC), a well-funded legislative group known for developing model bills that advance conservative interests.
Montana’s HB 121 means that long-held public health regulations are more vulnerable to political pressure, especially if corporate interests and money are involved. Russell gives the example of septic systems, a decidedly unsexy but crucial part of public health infrastructure. Flathead County has strict septic system regulations: Whatever bordering counties recommend, Flathead County requires. That results in a higher level of water treatment, designed to maintain high water quality. But if commissioners are under pressure to change that — if, for instance, local business owners decide they don’t want to adhere to such strict standards — they could try to force elected officials to loosen policies by threatening to vote them out of office, much the way groups like People’s Rights rallied citizens to protest pandemic restrictions. “Water quality is one of the most important things we have here,” says Russell. “I don’t think they would ever go after that, but you never know.”
Bills like these also mean that public health officials have less authority to do their jobs. HB 257 prohibits public health officers from issuing quarantine orders, an essential aspect of controlling infectious disease. “If you ban quarantine, you’re removing one of the basic tenets of public health infection,” says Freeman. She worries that giving final power to local lawmakers could put people’s lives at risk. After all, as she notes, legislators are not in session year-round, meaning that they could be slow to respond to a public health emergency. “If you aren’t able to act quickly — immediately — then people get sick, people die, while you’re messing around making this decision.”
As the delta variant spreads throughout the U.S., health officials are once again wondering how their communities will react. Freeman fears another wave of officers might get pushed out of their positions, or end up resigning or retiring early to escape harassment and intimidation.
So far, in the Flathead, Russell says he has yet to face the harassment Robinson did. But even if he does, both Russell and Robinson remain hopeful that the most vocal extremists are not in the majority in their community. “The loudest people are the fringe,” says Robinson. Russell mentioned a petition he received, where the signees stated that they were against all public health actions. Forty-eight people signed it; Russell contrasts that with the 18,000 Flathead residents who have been vaccinated so far. “I’ll put my 18,000 people that want to get vaccinated, and have, against those 48 any day,” he says.
For now, the pandemic drags on, along with ever-changing guidance on how best to protect the nation’s citizens. Freeman says militia activity is ramping up again; in the #StoptheMandate group, organizers are encouraging their followers to pressure the Central Health District Board. But the work of public health continues. As the end of the workday neared, Russell excused himself to answer some emails. As we said our goodbyes, Robinson turned to Russell. “If it goes into another cycle of vaccinations, I’d be happy to help you vaccinate,” she said. “Or if we see uptakes in cases and you have to do some more clinics, just call me. I’d be happy. I’m here.”
Jane C. Hu is an independent journalist who writes about science, identity and the outdoors. She lives in Seattle. Follow @jane_c_hu
We welcome reader letters. Email High Country News at editor@hcn.org or submit a letter to the editor. See our letters to the editor policy.
This story was supported by a grant from the Fund for Investigative Journalism and by contributors to the High Country News Research Fund.
This article appeared in the print edition of the magazine with the headline The Public Health Officer Emergency.
Republish our articles for free, online or in print, under a Creative Commons license.
