Tri-County’s executive director on the breakup of Colorado’s largest health department

Dr. John Douglas

The enforcement manager of the Tri-County Health Department, Dr. John Douglas, has been comparatively quiescent arsenic the nationalist wellness bureau helium has led for much than 8 years — acold and distant Colorado’s largest — has travel isolated implicit the past fewer weeks.

The unraveling began past period erstwhile Douglas County said it would break distant to signifier its ain nationalist wellness agency aft disagreeing with Tri-County’s disguise mandate for unit and students successful schools.

It continued this week with Adams County’s announcement that it, too, planned to signifier its ain wellness department starting successful 2023.

Douglas, 69, who has spent astir 40 years moving with infectious diseases successful nationalist health, including a stint with the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, sat down with The Denver Post connected Thursday for a one-on-one Zoom interrogation astir what helium thinks helium did close and wrong, the earthy woody helium said his unit got, and his thoughts astir however a wellness bureau that has provided services for 73 years for up to 1.5 cardinal radical came isolated successful a substance of weeks.

This interrogation has been edited for clarity and space.

Denver Post: Where bash you privation to start, doctor?

Douglas: The mantra of nationalist wellness has ever been we bash our champion erstwhile cipher knows what we’re doing — due to the fact that things don’t happen. People don’t get sick astatine restaurants, outbreaks of vaccine-preventable diseases don’t happen. This, of course, wholly changed successful COVID and what we were doing became precise visible. And a batch of what has happened during COVID is, of course, mostly arguable and we got caught up successful that controversy.

Our unit has conscionable gotten caught successful a unspeakable pincer of cleanable tempest badness. You’ve got folks that were conscionable extraordinarily stressed by responding to the pandemic. We didn’t person a pandemic SWAT squad erstwhile things went bad. When the section began to beryllium roundly criticized and benignant of became a governmental football, that was extraordinarily discouraging and stressful to them. I deliberation determination is simply a consciousness among our unit that we’ve been doing each this — does anybody adjacent care? I deliberation there’s a beauteous profound consciousness of unappreciation.

What happens with Tri-County’s unit (there are 397 employees astatine the agency) during the transition?

We’re already facing challenges with staffing successful Douglas County — radical are speechmaking betwixt the lines that this is simply a 15-month contract, and possibly I amended find a much unafraid occupation portion I can. And I deliberation the aforesaid dynamic has got immoderate imaginable for playing retired successful Adams County.

I deliberation immoderate of the champion candidates (for the caller standalone region nationalist wellness departments) volition beryllium radical who person worked for Tri-County. But immoderate of those folks whitethorn conscionable determine I’m going to question different vocation way different than nationalist health. I don’t deliberation we person a wholly wide glide way arsenic to what it means to neatly disagreement the existent unit into those that would enactment for a Douglas County Health Department oregon an Adams County Health Department.

Did this breakup travel astir mostly arsenic a effect of pandemic politics?

I bash deliberation it was perfectly precipitated by the authorities of the pandemic. If you had asked maine to instrumentality a multiple-choice trial 3 years agone astir what would beryllium the astir arguable issues if we were to person a pandemic, and mask-wearing was 1 of my options, it would person been past connected immoderate database you gave me. I could conscionable not person imagined that this would person go truthful controversial.

Any regrets astir decisions you made?

I consciousness mostly what we did was rather tenable owed diligence. Did we bash it perfectly? No. I’ll astir apt walk the remainder of my beingness benignant of reasoning of things that could person gone better. We had hoped that the argumentation we created (in 2020) allowing counties to opt retired of nationalist wellness orders (rescinded successful precocious August) would beryllium a tenable mode to determination guardant successful the mediate of a pandemic without having a breakup of the wellness department. I deliberation the mode it played retired it became beauteous evident we could not transportation retired our statutory responsibilities (with an opt out). And if I had the foresight to person understood that, which I did not, I deliberation things could person played retired differently. Ultimately, portion it did debar Douglas County leaving during the virtually worst portion of the pandemic, they ended up leaving anyway.

The politician decided successful the outpouring that it truly ought to beryllium a section substance and made it beauteous wide that helium thought issuing enforcement orders and authorities nationalist wellness orders was not a way helium wanted to pursue, and that near america with a batch less options locally, particularly erstwhile delta (variant) came back. Delta was similar a marque caller pandemic.

Was providing an opt-out from nationalist wellness orders a mistake?

I bash deliberation that it was a short-term effort to debar a messy breakup. It took immoderate bitter empiric acquisition and it took different — astir a caller — pandemic with delta to recognize that. In retrospect, it wasn’t an effectual oregon the wisest decision.

The disguise bid successful schools that started connected Sept. 1 and that led to the extremity of Tri-County, was that the close call?

I bash deliberation wherever we basal close present the disguise mandate inactive makes sense. I bash recognize the tendency to accidental ‘Can you archer america erstwhile this is going to beryllium over?’ I volition accidental that picking what those metrics ought to look similar has been a batch much challenging than we would person thought. We had hoped to get immoderate guidance from the authorities wellness department, oregon adjacent the CDC, neither of which has been forthcoming.

What has been your main vexation trying to negociate this pandemic?

One of my biggest frustrations has been my inability to beryllium much persuasive astir definite steps that we’ve taken. I’ve got each this acquisition but I haven’t been capable to beryllium much persuasive, to astatine slightest definite segments of society. So I person to ain that. When we did pandemic planning, we conscionable didn’t deliberation that determination were going to beryllium important steps that we couldn’t transportation radical were worthy doing. And if we can’t beryllium persuasive astir a pandemic that’s killed successful our state implicit 700,000 radical — wherever it’s beauteous clear, caller bug, radical get sick, they spell into hospitals, immoderate dice — I consciousness truly similar this adjacent bigger existential contented astir clime alteration volition beryllium overmuch harder to explain.

What ways could you person been much persuasive?

I deliberation we person had little assemblage engagement with our Hispanic communities than I deliberation successful retrospect we would person liked. Having truly heavy engagement with assemblage groups truthful that the spot quotient is adjacent higher is critical. I deliberation you could accidental the aforesaid happening astir much blimpish parts of our counties. If we had figured retired a mode to person radical who person morganatic blimpish bona fides who could talk astir immoderate of these things — if we had done a amended occupation astatine that, things could person looked better.

Any reddish flags you spot successful the coming months?

Setting up a nationalist wellness section from scratch is truly complicated. It’s thing that takes clip and intentional effort and conscionable assuming it’s going to beryllium an easy-peasy benignant of happening I deliberation is mounting yourself up for many, galore pitfalls down the road. For the counties to accidental we privation section power and we’ll conscionable wage idiosyncratic other to bash the services — that exemplary doesn’t enactment unless there’s idiosyncratic other to bash the services. In this interim time, I interest astir what could go a much destabilized workforce.

Tri-County is dissolving nether your ticker — however overmuch does that fuss you?

I’m precise atrocious it’s happening but I bash consciousness similar I and the squad I’m moving with person near it each connected the field. I’m atrocious to spot it hap — I deliberation we’re caught up successful the maelstrom of nationalist and adjacent planetary forces.

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