Ingham County Health Officer Linda Vail is used to 18-hour days as she monitors mid-Michigan's COVID-19 case counts, runs vaccine clinics and issues health orders.
But even when she’s exhausted, rest doesn’t come easily.
“I can't sleep anymore without taking something to help the anxiety and depression that overrides me every single day," Vail said. "And I get up in the morning and get past it. But then I go to sleep at night, and it takes over and it becomes a cloud of darkness.”
Vail worries about her physical safety. She recently installed a home security system and she says she’s received threatening mail at her house. She gets vulgar emails from people angry over mask orders and quarantine rules.
“It is a nationwide problem, the threats, the intimidation," said Lori Freeman, who leads the National Association of County and City Health Officials.
Since the start of the pandemic,more than 300 state and local public health leaders in the U.S. have resigned, retired or been fired. That’s according to a database from Kaiser Health News and The Associated Press.
Freeman attributes the exodus to a combination of underfunding and the politicization of public health.
In the Grand Rapids area, Health Officer Adam London emailed Kent County commissioners in August pleading for support after he says an angry driver tried to run him off the highway twice. He described the incident as one in a chain of threats after he ordered masks inside pre-Kindergarten through sixth grade classrooms.
Michigan Gov. Gretchen Whitmer has declined to back a statewide school mask order this fall. She says those decisions are best made on the local level and she’s encouraging local health departments and school boards to adopt their own mandates.
But the Michigan Association for Local Public Health says statewide requirements are necessary. The advocacy group says a patchwork system has left local officials vulnerable to threats and intimidation.
During one public meeting in Lower Michigan this September, a resident named Kati Moss likened a school mask order covering Barry and Eaton counties to child abuse as she confronted Health Officer Colette Scrimger.
“Maybe we should go get muzzles and padlocks and force them on your children," Moss said to cheers. "Maybe you need to be put in a gas chamber.”
That meeting reached a boiling point when a man accused Scrimger of violating the Constitution and said he was placing her under citizen’s arrest.
No one arrested the health official, and the board of health adjourned the meeting after a few minutes of confusion. Scrimger ended up reversing her school-related orders a week later, citing concerns about language in the new state budget that restricts local departments from requiring masks for children. The governor and other Democrats say that provision is unenforceable.
The Van Buren/Cass health district has not issued local mask or quarantine rules. But Danielle Persky, who leads the west Michigan department, says the possibility of such orders is provoking confrontations.
“We have logo apparel that we sometimes wear," Persky said. "And myself and our team, we don't like to wear it outside of the office.”
Persky says the department has adjusted security after someone threatened to blow up their building. And staff are leaving the office in pairs.
"We have experienced some drive-by heckling," Persky said.
Near Flint, Medical Health Officer Dr. Pamela Hackert sometimes feels leery of going out in public. A criminal case is pending against a woman charged with making death threats against Hackert and her deputy.
Hackert says she’s been coping with the stress of her job with counseling and by reading kind emails from residents. Still, there’s a sense of whiplash.
“I don't know how we have, as a society, gone from having public health workers are heroes to public health workers are the villains," Hackert said.
Hackert says she feels a sense of duty, but wonders if she’ll reach a breaking point.
She’s sticking around. For now.
