Over the last couple of months, public health officials have been put in the hot seat as communities and the world at large attempt to get a handle on a virus of which we have little knowledge and no remedy.
As of yet, we have no vaccine. Even more important, we can’t even be certain who might be carrying the disease either because they are asymptomatic or because we don’t have the capacity to do what we have come to know as “contact tracing.”
The sole known method for controlling its spread is to create and then enforce practices that limit the transmission from person to person.
As a country, the last time we really experienced this level of health crisis was about 100 years ago, when the so-called “Spanish flu” ravaged the planet, killing an estimated 20 million to 50 million people worldwide. Its impact was so great it has even been credited with causing an early end to World War I.
When we look back at that time, communities had different approaches to the epidemic. Some choose to be very conservative and tried to limit the spread of the disease by ordering that people not gather — in schools, in churches or in businesses. Others decided to be less conservative and keep those institutions up and running with few or no restrictions.
Communities that took the less conservative approach showed much higher rates of infection and death, while communities that were more conservative, like St. Louis, showed much lower rates — that is, until Armistice Day 1918.
At that point, even St. Louis and other surrounding areas, including Boone County, opened up, celebrating the end of the Great War with parades and other festivities. Schools were called back into session, and church services resumed at their regular times and spaces.
And then, U.S. communities felt the second wave of the pandemic, as hundreds of thousands more died, reaching an estimated total of more than 675,000 Americans.
That is part of what I believe informs decisions made by public health professionals in our country and across the world. It is the knowledge, not the speculation, that, when we let down our guard, a virus like the one causing COVID-19 will come back with a vengeance.
From the beginning of this public health crisis, Director Stephanie Browning and her colleagues across the world have been and continue to be engaged in a delicate balancing of interests — public health versus economic health and practical necessities. Look at the orders issued here in Boone County and in so many other jurisdictions.
None of Browning’s orders, nor those of any of her colleagues in this country, ordered everyone in a particular jurisdiction to have no contact with anyone within what is believed to be the incubation period.
Instead, as they carefully crafted their public health orders, they implicitly acknowledged the economic and practical needs of their communities.
They acknowledged, by creating exceptions, by giving explicit guidance, that certain businesses and activities must continue.
For instance, day care businesses were, from the outset, part of the essential fabric of a community’s life.
Public health professionals knew that for hospitals, grocery stores, gas stations, fire departments and many more agencies and offices to continue to function, those workers needed a place where their kids could be cared for.
And, in making that decision, they balanced, through their orders, the risk of putting children and caregivers into the same space. Also, through their orders, they knew they could potentially keep many businesses functioning, many people employed, and still, in most cases, keep children, caregivers and the families of all of those people safe despite the contacts.
As more people have been tested and as the numbers of active cases in each community decrease, public health officials are adjusting the balance.
They are, by analogy, moving further out on the teeter-totter, hoping to keep the numbers of cases low while expanding the activities in the business community.
This is not an easy task. This involves keeping a constant eye on the data, not just from our county but from surrounding counties.
Why? Because we are a mobile nation — people who work in Boone County may live in Howard or Cole counties, and people who work in Cole or Randolph counties often live in Boone County. If, as the public health professionals hope, the numbers of active cases continue to decline, the balance can and will be adjusted again. In the meantime, they will watch the data. They will follow best practices. They will do what is best for our community.
While the County Commission is ultimately responsible, we do not possess the public health knowledge or experience to know the wisest course of action to be taken during this pandemic or the timeline on which it should occur.
We also do not possess the necessary epidemiological expertise. We would have been foolish to not rely on the person with the knowledge and expertise to guide us.
That person is Stephanie Browning, the director of the Columbia/Boone County Department of Public Health and Human Services.
Director Browning loves this community. She has brought every ounce of her professional competence to bear on these issues as she has worked to balance the health, economic and basic needs of our community at large.
Instead of attacking her and the orders issued, we should all be thankful that she is protecting our interests so that, hopefully, our health, our economic interests and our basic needs can soon be met. I fully support Director Browning as we all work together to meet — and overcome — this challenge.
Janet Thompson is the Northern District Commissioner for Boone County.