Ottawa County, Michigan made national news last year after a MAGA take over of its County Commission. Their first major act? To try to defund their public health department. Abdul reflects on the impending risk of this across the country. Then he sits down with Adeline Hambley and Marcia Mansaray, the leaders of the Ottawa County Health Department to learn what happened — and what they did next.

TRANSCRIPT

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Dr. Abdul El-Sayed, narrating: The CDC is considering eliminating the five day isolation period following a Covid infection. A new malaria vaccine begins to roll out in Cameroon. Two studies cited in a Texas judge’s decision to ban medication abortion have been retracted. This is America Dissected. I’m your host, Doctor Abdul El-Sayed. [music break] Since the murder of George Floyd, there’s been an ongoing call by activists and some politicians to rethink the choices we make about how to invest public funds. Perhaps rather than invest so much money in buying military grade weapons to deploy into our streets, we might instead figure out how to deploy social workers to the scene of domestic disturbances. Or better yet, figure out how to address the cycles of poverty that sit at the heart of too many of them. The redeployment of civic resources away from punishment and toward public welfare, that idea got absolutely demagogued [SIC] by MAGA types. And it led even the most progressive elected officials to cower away from those kinds of policies. Mind you, all of this was in the wake of one of the most horrific acts of police murder ever recorded. I raise this because it’s a helpful contrast to our story today. You might not know it, considering the political tenor of half of our country’s population, but there was a pandemic in which more than a million Americans died in the span of three years. And at the forefront of that response were local health departments. You know, the ones that are underfunded because of how we spend civic resources. Yeah, those guys. Over 3000 institutions working nonstop in their local communities to trace infections, deploy vaccines, and educate the public, all while balancing the rest of their day to day responsibilities, protecting us from all the other diseases that affect us. The pandemic was no cakewalk for any of us. It was a brutal moment in our history, one that none of us ever want to relive. But the politics of our moment did something strange. Rather than orient us around the means of preventing the next pandemic from ever happening again. They did the exact opposite. Donald Trump utterly failed the test of the pandemic. He failed to manage the vast federal public health apparatus at the outset. He failed the basic test of presidential leadership in communicating with the public about what was happening. And though his administration did spur the research and development needed to create a vaccine, they failed to create a plan to coordinate deploying vaccines in the earliest days. But rather than take responsibility for his failure, Trump and his acolytes turned their MAGA movement against the very institutions that could hold him accountable. The institutions of public health. They spun conspiracy theories blaming public health officials for COVID’s origins, or demagoguing vaccines as a tool for global takeover. And even as we emerge from one of the worst public health disasters in the last century. A whole half of America’s public has turned against the very institutions that can protect us. It breaks the mind to have to think about. Police can murder someone, but we should make no effort to rethink policing. And on the other hand, public health saved lives, but we should defund it? Make it make sense. You can’t. And so today, I wanted to bring you a story about what defunding public health looks like, because it’s one thing to talk about in the abstract. It’s another entirely to look it in the eye. Just talk to the folks who are set to lose their livelihoods. All for the crime of staring down the worst pandemic in a century and protecting their communities from it. Ottawa County is home to nearly 300,000 folks in suburban West Michigan. Like many communities in that part of the state, it is staunchly Republican. It has been seemingly forever. And yet until recently, it had one of the state’s best functioning public health departments. Then the 2022 midterms happened. It saw a MAGA takeover of the county commission and item one in their agenda? Installing an HVAC repair guy and avid Facebook anti-vaxxer as their new health officer. Except that the state public health code requires a health officer to have some basic credentials in public health. And needless to say, Facebook anti-vaxxer guy isn’t one of them. The public health code also stipulates that you can’t just fire your health officer because you don’t like public health. The county’s actual health officer, Adeline Hambley, put her foot down, setting up an epic showdown over the future of the county’s health department. But that didn’t stop the commission from trying to flatline the county’s budget for public health, cutting vital programs across the county, including a critical food access program that served thousands. It turns out that defunding public health hurts people. Who’d have thought? Today, I wanted to sit down with the public health leaders at the heart of the fight to protect public health in Ottawa County, Health Officer Adeline Hambley, as well as the department’s deputy director, Marcia Mansaray. They joined me to describe what happened, how they fought back, and what it means for the future of public health in counties like Ottawa across the country. Here’s my conversation with Adeline Hambley and Marcia Mansaray. 

Dr. Abdul El-Sayed: Can you all introduce yourself for the tape? 

Adeline Hambley: Um sure. I’m Adeline Hambley, I’m the health officer at Ottawa County Health Department in Michigan, we’re on the west side of Michigan, right on Lake Michigan. 

Marcia Mansaray: And I’m Marcia Mansaray. Adeline’s deputy health officer. 

Sarah Howard: I am Sarah Howard. I am a civil rights lawyer and the attorney for Addy Hambley and Marcia Mansaray. 

Dr. Abdul El-Sayed: Well, I really appreciate you all making the time. Uh. This is a story that obviously, given, uh my proximity in the state, albeit on the other side, we’ve been watching really closely, but it’s a story that I really wanted other folks to understand, because it tells us a lot about the risks to public health institutions in this post-Covid moment, and that you really ought to believe people when they tell you who they are. And um and so you all have experienced that in a pretty profound way. So I wanted to step back and um Adeline, if if we could just start with you, just walk me through the Covid moment in Ottawa County. Um. Take us back to those battle days in 2020, 2021. What’s going on? Obviously there’s a raging pandemic, but give us a little bit about uh the context um and the way that it was experienced in your community. 

Adeline Hambley: Um. Yeah. So at the time, I was the environmental health director at the county and not the health officer. So um my role at the time was to do uh the enforcement of the governor’s orders. So the, the closure of restaurants and then and not gathering, um things like that. I think there was a lot of uh support at the beginning from the community. Uh. There was a lot of, I think people that were scared, uh that didn’t know exactly what this was or what kind of implications it would have um to their health. And um people were scared, and we actually felt like we had a lot of support and um compliance and people wanted to do um whatever they could to stay safe. Um. And that changed over time. And I think Marcia can probably speak to that more as she was in the deputy role um when things um you know, we didn’t have that support in the community. Um. And I know that she was far more involved with um some of the, um the negative impact and blowback that we had for school closures and some other things, a mask mandate in our schools. 

Dr. Abdul El-Sayed: Marcia, do you want to speak to that? 

Marcia Mansaray: Sure. Yeah. I mean, Covid was something that we’ve trained for our whole careers and professions to do something like that, a pandemic. And so it was sobering but historic and something we were prepared for, and an opportunity to do our jobs and help people. Um. But as we got into the schools restarting in the fall of 2020, that’s when we first had the had some pushback and I had what turned out to be the unfortunate um consequence or coincidence, I guess I should say, uh writing a cease and desist order for Libertas Christian School, which happened to be Joe Moss’s children’s school, and he’s also on the board of and the foundation for. And he is now the chairperson of the Board of commissioners in Ottawa county. He became angry at that moment when we received, all in all, total about 15 complaints about this teeny tiny school, and I might get maybe one or two for a huge public school district. And so um it was pretty serious. People were pretty scared. They didn’t want to tell their names. There was a lot going on there. Then I started working with the school and with the headmaster, and we just were not getting anywhere. And they felt that to mask or not to mask was a parent’s decision, and they would not enforce that at their school. They said that point blank. Although I was pretty sure they had rules that they did enforce, but not that one. 

Dr. Abdul El-Sayed: Yeah, I want to, you know, understand a little bit about that, this sort of um moment that that birthed this huge earthquake. It’s hard to sort of step back um given all that’s happened since the fall of 2020. Uh. But if listeners want to follow us there, it was just this moment where we still didn’t quite understand um as much as as we do now about dynamics of Covid. Of course, there weren’t vaccines on board. This wasn’t a thing. Um. And that return to school after, like, the aborting of what would have been the um 2019, 2020 school year. The beginning of that fall of 2020 was one where um you know, there were a lot of really hard decisions to make, and a lot of those decisions were actually actually ended up being made at the state level to be enforced at the, at the county level. And you have this beginning of a pushback, um sort of driven at the top of a we’ll just call it an anti-science, um uh deeply right wing movement. And you’re starting to to hear a lot more and see a lot more conspiracy theory type stuff online. And that was this, this moment. And now you’re in a position where you have to enforce um, this, this mandate, uh and it puts you right up against a school, uh a private school, uh and a private religious school, uh in a way that that sort of sets up this, um circumstance. You talked about, you know, 15 um complaints. Where did it go from there? Uh. Walk us through sort of what happens after this, this first um volley, uh in what what would turn out to be a much bigger kind of conflict?

Marcia Mansaray: So at the philosophy of our department has always been to not be heavy on enforcement, but to be a partner and to be an educator and to give opportunity, um when things look like they’re not going well, to connect and talk. So two complaints come in and I contact the headmaster to inform them, you know, that we have two complaints. They’re anonymous. Um. They say that there’s no masking going on there. They’re concerned about their safety. I don’t know how they’re related to the school, but they’re related in some way. Can you tell me more about this and explain you know, is this really true or not? You know, are you masking, etc.? So I had a really like nice conversation, but they were firm that they were not going to do this. And I said, well, you know what? I’m not going to do anything about this right now. But if I get additional complaints or if there is a situation where we have evidence of an outbreak at your school, um I’m going to have to get a lot more firm and this is going to change. So hopefully I won’t hear any more from anyone and you won’t hear any more from me. Um. But it just took a week, I think, before I got in another one, and within a month, I would say I began getting complaints telling me that there were um people with Covid like symptoms, staff um with Covid like symptoms that um were at school when they were sick. And [sigh] so the the headmaster felt that they had had Covid the year before. And so they were pretty much immune in the school. So this is going to be fine. Um. When I got that tip, the person left a name for me on an answering machine. And so I was able to to look up that name and found out that we did actually have a lab that was positive Covid, but they would not identify their employer. And then I got some additional tips about children, and I was able to look them up and they their parents were not identifying their school. So these are people that would not have come on our radar because we would search by school or by employer to see if we had something that was getting out of hand. And so there was an agreement or at least some kind of tacit something going on, an understanding there that you don’t tell. Um. But somebody was people were they were reaching out to me and and it became clear that we had someone at the school who had been teaching um while they were symptomatic, and we knew that Covid was infectious two days before you’re symptomatic. And so I needed to call the school. And um that didn’t go very well. Um. And then we got a report of a second teacher that was just a couple days after the first one. So we knew that they were holding chapel every morning where they would gather in one room, all of the students. So 12 grades, um and they would sing and recite things without masks. So I felt that it was a matter of just a short matter of time before this would happen. But we we knew that there would be easy, easy spread throughout the school because there there weren’t any significant precautions being taken except hand sanitizer, um was available. So that began some conversations um around we believe there’s an outbreak. We would like your assistance. 

Dr. Abdul El-Sayed: Yeah. And I presume that that also didn’t go very well. 

Marcia Mansaray: No. 

Dr. Abdul El-Sayed: No. 

Marcia Mansaray: That didn’t go very well. Um. They wouldn’t, we said if we can limit, um quarantine people who need to quarantine, if you can help us out with classroom lists and things like that. And that was a no. And then a lawyer was brought in, um at that point. And so things got got really serious really fast. 

Dr. Abdul El-Sayed: So all of this, you know, fast forward a couple of years, all of this sort of starts to to heat up. And um, you have what is a small but very loud constituency organizing around all of the, the terms that they’ve created, medical authoritarianism, etc., etc.. Right um around just the basic effort to mitigate the spread of a lethal disease in the midst of a pandemic. Um. And we get to 2022 when there’s some pretty important um elections. Can you tell us about ultimately what happened and then give us the vantage point of the public health department? Uh. And you all are trying to make sense of what this these new electoral outcomes are going to mean for you all?

Adeline Hambley: Yeah. I think it’s important to note from, um what Marcia was saying is that there were, uh the school ended up having to be closed for two weeks, so we had to do a, um essentially a mandatory um quarantine to try and put a break in the outbreak, right, to stop the spread. Um. And as a result of that, when the lawyers got involved, there were lawsuits. Um. And, so that we went through court and through appeals, um and the appeals court held that the health officer has the authority to be making orders like that to protect public health. Um. And so when we got to 2022, when the Board of Commissioners was up for reelection, that faction of um Joe Moss, who has uh runs a school or is on the board for the school and um some of the other commissioners that he had run under this Ottawa Impact umbrella. Um. They ran on, the idea the old board needed to be removed, that they were corrupt. Um. That they allowed this to happen. That the board hired her. The board can fire her was the statement I think was kind of stated over and over with um the health officer and in regards to the health officer. And this is after the court had already ruled that that’s not the case, that um you know, the health officer has certain protections under law in Michigan. Um. But they were able to organize and ran. And I think it’s important for um people to know that Ottawa County is a very, very, uh Republican county, that people vote Republican. And I think it’s been since, I don’t know, 100 years since there was a Democrat that was voted on by the county or won uh the votes. So um they were able to run a pretty um organized, well, branded. They all looked at all the, all the materials looked the same. Um. Again, they ran on this anger for public health and personal freedoms and um against vaccines um and um parental rights, I think was something that came up a lot. Um. But when they were able to run, because of that Republican um history and, a lot of people just voting Republican ticket. Um. When they ran as the primary, um they were able to primary the other commissioners. Um. And so even by the time we got to November for the election, there weren’t even um opposi– there wasn’t another candidate available to, um in that race in certain areas. So um it was a challenging time, and I, I can say that our long term health officer, uh Lisa Stefanovsky, who um was involved with Libertas and had issued the order for closure. Um. Announced, uh that she was going to be retiring. Um. And so the health officer position was posted. Um. And they did a national search in um the fall and we had the hiring panel, and we went through all of the I went through all this interview process and was hired on in the board. Because in Michigan, there you have to be approved and then approved by the state for the position because you’re an officer of the county, you’re not just an Atwell employee. And um that went through in December, and then immediately on January 3rd when this new board was sworn in and took an oath um they immediately voted to uh demote me from my position and appoint uh uh someone that was uh similarly anti-science and anti-vaccine– 

Dr. Abdul El-Sayed: I’m going to I’m going to go ahead and–

Adeline Hambley: –um into the role. 

Dr. Abdul El-Sayed: –and um offer some color here, dude uh was a HVAC repairman, if I know and no, no disrespect to HVAC repair people, like, that’s that’s a really honorable profession. I’m really grateful that we have good HVAC repair people because I have a functioning HVAC. Not the same thing as being credentialed, uh or credible as a county public health officer. And, uh you know, much of what brought this person to the commission’s attention was in effect just their um social media posting about uh about vaccines, masks, etc.. So you got uh HVAC [laugh] uh I’m not. I’m just gonna step back. Um. Let’s just say, like, wack HVAC guy and um and uh, they’re trying to replace someone who’s come up the ranks of the public health department, knows the county with wack HVAC. And um and this is when the story starts to really sizzle. I mean, I remember this is when I heard about it, um and I live on the other side of the state. Um. Spent quite a bit of time in Ottawa county back when I was wearing a different hat. Uh. But um, it was, it was kind of wild. And what was crazy about it was, you know, from my vantage point, this is a whole county commission that wants to defund public health. I mean, like, that was their explicit goal, you know, from the top on down, they wanted to install someone who had no business being a health officer, um and and cut funding to a department because that department was trying to protect people from the pandemic. And Sarah, I imagine that at some point, this is when when you enter uh the scene, um can you tell us a little bit about uh your your experiences with this whole situation? 

Sarah Howard: Sure. Um. I live in Ottawa County and my husband teaches high school there, and I have a civil rights law practice in Grand Rapids in the neighboring county. And I had been watching this situation for a while uh, because I suspected that Ottawa Impact would be able to take over the commission, given the structure and the strength of the Republican Party brand in Ottawa County. And that is what happened. And they had made a lot of threats like this one. I have to say that I did not think they would take any action against the health officer, since those legal issues had really been decided with respect to this particular county. Um. So I didn’t think they would directly attempt to violate the law in the manner that they did. Um. I mean, we all knew they would fire the DE&I director. They had, talked about that. We knew they were probably going to fire the county administrator, the county attorney, uh but the health officers, protection under public health code, and um, I, I didn’t think they would do that. So I, like the rest of the county, was pretty surprised, even though I was anticipating something along these lines. I was pretty surprised by the uh bloodletting in their first moments in their first meeting on January 3rd when they, uh started this coordinated firing, uh left and right of people. Um and so I was not surprised when I started to hear from various employees of Ottawa county, about employment level concerns, and that is when I first met Addy and Marcia. [music break]

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Dr. Abdul El-Sayed: Marcia, you’d been in your role for some time. Um. 

Marcia Mansaray: Yeah. 

Dr. Abdul El-Sayed: As you learned about what the commission was planning to do. What was going through your mind? Walk us through some of their plans and and you know what that would have meant for folks or what that means for folks in Ottawa County? 

Marcia Mansaray: You know, so I was pretty naive. Way more naive than Sarah. So she wasn’t naive at all. And I was shocked that day. And I just couldn’t believe that all these lawsuit outcomes, um that established the law and the clear um, legal opinions that were issued in public meetings about health officer protections that that was just disregarded. And to do all that, there were no agenda items indicating that this was going to happen on that day. And so they they just appeared and it all just happened. And so it was a real knock in the gut, kind of took my breath away. And um, you know, people were crying. All, all throughout the county. They were crying at the health department. And gosh, you know, these are people that we love and work with and have worked with for so long and have worked so hard together during Covid. We’re sort of like battle worn and tested and, and real comrades. And um, I knew how vulnerable that we, we all would be right now. And if if Adeline lost her seat. I just I could not imagine what was going to happen to the community. I was worried about the the public health code in Michigan. Um. And I was worried about the decades that were spent in establishing a wonderful culture in the community and in the department with experts that were so committed, so that in this heavily conservative and Republican community, people would come from other communities in Michigan and say, holy cow, like, you guys are so conservative. All I can see are churches, but you do really progressive things, really innovative things to help your community. And I, I just saw that vanishing just, you know, my whole career legacy, the legacy of the woman who had been there for 32 years right before Addie. You know, and and we all work together. One thing I knew, though, that Adeline Hambley was smart, experienced, wise, uh measured and super brave and super ethical. So I felt very, very comfortable, like walking through this with her. And and I knew that like we would see things eye to eye and we could, we could maybe get through this. But I didn’t know what was going to come. And I was frightened and I yeah. And then she did something unexpected. But it took a few weeks, and I did something unexpected that took a few weeks. And it was probably because of the courage that Sarah Howard gave us. 

Dr. Abdul El-Sayed: And and um Adeline, walk us through that, those, those couple of weeks?

Adeline Hambley: Um. Yeah, I can’t say um, I don’t know, I’m probably, I don’t know if it’s naive or I guess more um pessimistic. So I had anticipated that it might be attempted, I think, before that board or uh the new board took their oath. I think we had there were similar things making the news on in school boards throughout the country, right. That uh, there would be these um super, right, ultra right um factions taking over and then just dismissing everybody. Um. And so I thought it could happen. Um. When it did, it was um yeah. Uh. It was a little bit of a scramble, again I think it’s really important um coming out of Covid, we had staff that would work um so many hours. So many hours um to try and protect their community, the I think um, it’s important to note that the staff that we have are they’re highly educated, highly trained in high demand fields. Um. Nurses can go to a hospital system around here and get a huge signing bonus at another job. But but they stayed here because they were committed to their community, and they felt like what they were doing mattered. And so to come out of Covid, everybody’s feeling a little battered um to have that immediately happen, um was just uh terrible for the morale of people that are really trying to help their community. And so as that unraveled, um I think that, uh I had we had a brand new administrator who had never been an administrator, um who was also a sort of John Gibbs, who had lost his congressional race, um that they installed. And so there were these meetings that happened in the first little bit, um after this and um there was nothing done as far as uh leadership wise as far as the board or anything else to reassure any staff in the county. So um and of course, uh the board members and I think the administrator, had no experience at county government sort of even knowing how anything ran. Uh. So it was um, I don’t know, uncharted water. And there was just no boundaries. It didn’t seem like um, I think I routinely got referred to as uh interim health officer at that time, uh that they were going to submit for the HVAC um I think he was a safety, HVAC safety person, um who they appointed or tried to appoint to my role. Um. And then as things went, um I you know, I had been in discussions with Sarah pretty immediately, um as that happened, because Marcia and I are familiar with the public health code. Um. Again, I think I’ve seen in the news around here, it should be noted that I think that I’m some um activist operative. And I think it’s really important to note um, that I’ve been at the county for almost 20 years now and started as an inspector and worked my way up. So certainly if I had that level of, of like, um soothsaying I would probably be wealthy enough that I wouldn’t be working. If I can see 20 years in the future that this is my secret agenda. Um. And it’s it’s insane, uh that I think that public health is especially the public health officer is not political. Right. We should be making science based decisions that are the best decisions to prevent spread of disease. And so to have be tossed into this political waters and to be, uum like a political punching bag, um is a challenge. And then when you defend yourself with science or um good public health practices, it’s interpreted as being political. Um. So it’s it’s been a challenge, um and all of the time and um energy spent. I’m a lifelong resident of this area too so um invested in helping the community. It’s just um so to have in those first, that first month, uh to have that all questioned or accusations uh leveled um that uh you aren’t, uh or that you are something completely different is, is a challenge. And at one point, I believe um because of that, uh I there was a meeting changed to a weird time, and I think the new attorney that again, um I believe is some sort of family friend or relation to Joe Moss um invited to that meeting is when I um, had given Sarah a heads up that I think I’m going to be fired um today, because it was just enough weird circumstances. And so, Sarah was, that’s our first action that we took in court was to have um, you know, some protective order in place so they couldn’t remove me from my position. Um. So that was kind of the first step. 

Marcia Mansaray: That step that was an unprecedented stat like no one else has done that. Sued the local governing entity, um for removing a health officer or attempting to remove a health officer from their position or even demoting them. We could not and cannot. And Sarah could speak on this probably some more, find anyone else who’s done this. [laugh] 

Dr. Abdul El-Sayed: Yeah. 

Marcia Mansaray: Um. 

Dr. Abdul El-Sayed: I mean, really, it’s it’s truly unprecedented. Um. Sarah, walk us through through um the some of the legal questions here. Um. How how does the public health code defend or protect health officers? And what was the commission specifically doing uh that would have been against that code?

Sarah Howard: So, uh probably among this interview, I know the least about the public health code. Um. I had to learn about it, uh when we started working together. But the public health code essentially provides a just cause standard to uh terminate uh public health officers. So it’s a it’s a unique position in state law. The county government, through the commission, typically hires the health officer. The state Department of Health and Human Services has to approve of the qualifications of the health officer. And uh once they’re hired, they have a number of independent powers to enforce the public health code. And that is because sometimes they are doing things that are incredibly unpopular, not just pandemics, they deal with all kinds of things that have the ability to create controversy. Um. And so they’re subject to a just cause standard. They can only be fired for a good cause. There’s a um, number of different misconduct, malfeasance, um neglect of duty in the statute. And you have to provide due process to the person who’s been accused of those things. And so when they demoted her on the first day and said she’s the interim now, we’re appointing this other individual. We’ve held no interviews, we’ve not posted the position. We have not fired Addy. We’ve not found anything wrong with what she’s done because we’ve been in the job for about an hour at this point. Um. They that is under the law that’s a termination by saying she’s going to be terminated, she’s the interim. Um. And we’ve hired this other person, um with no public interview, no posting of the job. We are just announcing to the public who he is. Um. And so when they did that, they immediately violated the public health code. Um. You cannot remove a public health officer like that without a hearing and without just cause. And it became clear to me, um that what I think the immediate plan was, was to install this person to whom they’d promised the job and have Addy do a lot of the work of the job. Um. So um, and he would be the political figurehead, and she would be doing a lot of the actual work of the job. And um, it they were picking fights with the public health department regularly, um and over a lot of things besides the pandemic. So a lot of cultural issues that they felt the public health department was involved in was, um there began to be signs of immediate conflict all over the place. 

Dr. Abdul El-Sayed: Yeah, I want to I want to ask a little bit about some of the programs that they cut. They proposed a, you know, across the board funding cut and ultimately ended up cutting some of the most cherished programs that the department runs. Can you tell us a little bit about what they’ve cut and what the impact has been? 

Adeline Hambley: Yeah. So. Um. Throughout the year leading up to the budget season, I think, uh there were numerous, like, attacks on uh some of our programs. So we do sexually transmitted infection testing, um some family planning. We get title ten dollars to provide family planning. Um. We have immunization clinics. There was a lot of conflict at us attending uh pride festivals in the community to provide, um MPOX uh vaccine and STI testing, um at those, at those festivals as uh I think we were called groomers and pedophiles, um for attending those. And so when we got to the budget, initially, it was wrapped up and sold as returning to pre-COVID levels. Um. And uh Marcia did an amazing job of uh analysis. Marcia’s an EPI by back, by trade. So her data analysis is top notch. And so she provided a bunch of data on our, our funding history and our over the years, um and showed that what they were proposing to go back to was pre-2001, numbers. And so, um some of the things that I think were originally proposed to cut, they wanted to cut immunizations, they wanted to cut STI testing, our STI program, uh things that are uh mandated and enshrined in law in Michigan, to be provided. So um and then there’s funding requirements around those, what was originally funded uh I guess what we ran into over and over again is no matter how much information, data, rules, statutes, MCLs, mandates that we would try and explain and educate on, uh it was not seemingly believed or heard. Um. And so the funding that originally was suggested, by Chair Moss was, $2.5 million total from the general fund. And so that amount happened to be low, so low that it was beyond below our thresholds for all these minimum, um funding requirements for the that the state has for to be a health department in Michigan for Ottawa County. And so um, after numerous times of trying to educate about that uh Moss chair Moss put out a his own uh PR, I suppose about 2.5 million and this is where the budget’s set. And so at that point, we responded through our social media channels. My opinion as the health officer that this is a threat to public health in the community and how I have a duty to communicate that threats to public health to the community under the law. And so when uh, the funding proposed is going to close the health department and 2.5 million would close the health department, we would no longer qualify for all the state funds for our mandated programs. Um. We would no longer be able to operate. We would have to close. And so the loss of a local health department in the community is certainly a threat to public health. Um. So now when we communicated those things, um eventually we did get our funding, uh at least they kind of moved back up to the minimum, the very minimum um amounts that are required in order to receive that funding. Um. So but in the I guess in the course of that, uh they uh were not pleased about us communicating with the community again, which we’re as health officer I’m required to do in the law, um and removed all of our access to all those communication channels as well. 

Dr. Abdul El-Sayed: Hmm. 

Adeline Hambley: So. 

Marcia Mansaray: Which we still don’t have. 

Dr. Abdul El-Sayed: Wow, Marcia, walk me through what the impact has been on the morale in the department and in the trust from the community?

Marcia Mansaray: So on the morale in the department, I think, you know, Addy and I regularly make the rounds and talk to our staff and tell them, like, what’s happening and what we think we’re going to do about it and what strategies that we have and why there might be hope. So trying to and and acknowledging like how hard this is after Covid to go right into something like this. But we have had a turnover that we going back I went back about 11 years, which was the the best data that I could get and not counting the temporary employees we brought in for Covid. This has been an unprecedented amount of turnover. I’ve not seen it before. And so a little bit more than 50% of our staff that we have in place right now are in a new job that are either brand new– 

Dr. Abdul El-Sayed: Wow. 

Marcia Mansaray: –to our health department. They’ve never worked in public health before, or they’ve been promoted because someone has left so smart health departments in Michigan and and surrounding states went, oh out of county people. You know? [laugh] And so some of our staff went and got promoted and got great jobs elsewhere at the state and in other health departments um because they, they don’t have protections. Um. A union was started for the hourly staff. It’s not been ratified yet, but it put some, some bit of some breaks on what the commissioners were trying to do. But our supervisors, our managers, our directors, they don’t have that. And it’s an at will state. And so they knew that if if the board felt they could get away with it without significant lawsuits, they would fire them. 

Adeline Hambley: And that’s the first time unionizing in 20 years. We were a union, a union previously. I think one thing that’s really important. So besides I, the overall attack on public health, the other thing that’s really made people nervous or concerned is that, uh any time we’ve had staff that’s had to go before the board for a grant or other funding, uh it has been uh an interrogation and an attack. So while other departments can have someone go to request funding and it’s a five minute, ten minute conversation, friendly banter, we’ll have someone up there and they’re it’s an hour, of just um not friendly banter and and and it’s an interrogation and it’s, uh seems especially cruel. And the fact that it does not seem as though there was ever any intent um to approve the funding. I think a perfect example of of what we’re against here is that we had a suicide prevention grant for it was man therapy. It was for educating um and specifically targeting men for um to help prevent suicide. And so the grant, um the was ultimately turned down because one of the commissioners found a uh link to the Trevor Project, which is a suicide prevention for LGBTQ youth. Um. And so besides the fact of, like, the staff getting attacked anytime they go in front of the board, um it doesn’t leave people feeling, um like they’re able to do the work they want to do to help their community when what is essentially being said is that we can’t support preventing suicide in men, because it might also prevent suicide in LGBTQ youth. I mean, that’s essentially what’s being said. And it’s like if you’re truly a public servant that wants to serve your community, how do you do that in an environment like that? Um. And so I think it’s not just us. It’s like these, these other things, like that. Um. You know, I’m going to pride Festival again help people and and be called groomers and pedophiles is I just I’ve never seen anything like this ever. 

Dr. Abdul El-Sayed: I want to ask you, stepping back, you know, um this has been from the relative vantage point that I have as a fellow health officer in the state. It has been quite a cautionary tale. And there’s a lot that I personally have learned. And I think the public health community in Michigan has learned. But as you reflect on your experiences, what do you think are the real lessons about the risks of this moment for the broader work of public health? Both in Michigan but most importantly, you know, across the country?

Marcia Mansaray: There’s a lot of loopholes in the laws that we didn’t imagine had them. So for what commissioners can get away with and do, and also in the public health codes, so I think both sides of that law in Michigan and and those loopholes allow for flexibility when you have good willed people um working those positions. Um. We found out we probably legislators just didn’t imagine this [laugh] could possibly ever happen. When you have people that don’t have good will who who don’t feel that everyone belongs or that everyone deserves services, um those loopholes are dangerous. 

Dr. Abdul El-Sayed: I want to just um first of all sort of reflect on the the bravery that it takes to stand in and fight for folks who are most vulnerable. Right. Because you have a very loud minority who have um, leveraged, as you call them, loopholes to seize a level of power and then strip away government protection from folks they explicitly choose not to represent. Now, you know, you think about the democratic project and I say, you know, lowercase d democratic project. The idea is that you you have majority rule and minority rights and it is true. Uh. Our governments have often failed to represent all of us in the ways that we would want. You know, whether you’re a person of color, you’re LGBTQIA identifying, um you’re a person of of minority faith or no faith at all. You’re a woman. All of these groups have have haven’t had the same kind of representation, but it’s a new thing to actively try to to to pull away the, arms of government that are intended to protect the most vulnerable people. Like, this is a pretty new thing, at least in the United States. You know, a lot of failed protections have existed. But but this level is pretty new. And I I you know, I don’t say it’s unparalleled in American history. I mean, we all uh have, have read our history books, or we all should have read our history books. You know, when it came to uh the rights of women and and enslaved people and the Reconstruction period. But but we’re seeing a sort of resurgence. And in our lifetimes, this is certainly new. And it is a scary thing to think about what it means to take the next step. Right? It’s one thing to say, you know, we’re not going to fund a grant that prevents um suicide because uh it links to um protections for LGBTQIA people, what then is the next step? Right. Um. And it feels like this is the, the next step is is explicit targeting. And so there’s a, huge amounts of bravery, um on your part to stand in and say that we’re going to continue to uh to fight for uh a government that protects people even when it’s elected officials are actively trying uh to do the opposite. And um it is a a and a really important message that you all send because unfortunately, Ottawa County is not unique um in in this country. There are a lot of other communities. Uh. You mentioned school boards, uh that could face very similar dynamics. Um. And will put public health in the crosshairs. Um. As we we step out, and I, I always want to finish these conversations um with a word of hope. And I wanted to ask, you know, in this moment, you all are obviously standing in, and you’re facing uh the challenge. What gives you hope in this moment? 

Adeline Hambley: Oh we talk about that, Marcia and I a lot. Um. I can say it has been remarkable, the um community support um that we have the the amount of rallying around us um that the community has done. And, I know that the commissioners will specifically say that the media is leftist uh Marxists. I don’t know whatever else, but I can say I’m grateful for the a level of coverage I can’t even imagine, uh what this would look like if it wasn’t so much in the public eye, uh the actions they’re taking and what they’re attempting to do. And but the amount of community support, as I, just been unparalleled. And I don’t think that, uh they I guess that has been really heartening to our staff as well. Um. That level of support and I mean, we had people rally around us for the budget. We had people protest, I think, at the hearings. Um. And I think you’re seeing it now, we have with people announcing candidacies to run against these Ottawa Impact commissioners in the next election. I don’t know that we’ve really ever had multiple candidates in our commissioner races. So, the level of engagement from the community has has really been a positive. 

Marcia Mansaray: I I agree with all of those things and the strength and courage of our staff. Um. The fact that they show up at commissioner meetings with, nevertheless she persisted, T-shirts on. [sigh] And public health signs and they’re willing to be seen protesting, knowing that they’re vulnerable. Their jobs, their livelihoods, their families, their mortgages are vulnerable is, makes me so proud. Makes me so proud of them. 

Dr. Abdul El-Sayed: Well, we’re all really proud of you, and we’re grateful for the the battle you’re fighting. Uh. And, um obviously, you know, you got you got friends out in a in Wayne County. So, uh we appreciate you, uh grateful for what you’re doing and grateful that in the midst of all this, you take the time to share your experience with all of us. Our guests today were uh Adeline Hambley, Marcia Mansaray, and Sarah Howard. Uh. Adeline and and Marcia are uh officials with the Ottawa County Public Health Department. Uh. And Sarah Howard is a um civil rights attorney, uh based in Grand Rapids. Thank you uh for your time and for uh for joining us today. 

Marcia Mansaray: Thank you Abdul. [music break]

Dr. Abdul El-Sayed, narrating: As usual, here’s what I’m watching right now. In Covid news:. 

[clip of unspecified news reporter] The CDC is reportedly considering a big change in isolation guidelines for people with Covid. The Washington Post–” 

Dr. Abdul El-Sayed, narrating: The CDC is reportedly considering a change in its current isolation guidelines from at least five days to at least one day fever free. Reportedly, in an effort to bring guidelines in line with other viral respiratory illnesses. Except this isn’t just another viral respiratory illness. This is the viral respiratory illness that has killed over a million people in the last three years and was killing more than a thousand people a week until just recently. Here’s what bothers me about this, the physics of this virus hasn’t changed. It remains a highly transmissible, highly deadly virus. Now, someone might argue that influenza is as well. And to that, I’d say we do a lot better to have better isolation protocols for flu too. So what is motivating this? Pressure from business groups who wish people would just come to work already. And there are two obvious issues with that logic. First, business groups shouldn’t be making decisions about public health protocols. Sure, they’re an important stakeholder, but caving entirely to their pressure, that would have led us down some dark paths in public health. You know who really didn’t want to see child labor laws? Yeah. But second, do you really want people to come to work and risk getting yet more of your workforce ill? Because there or not there, sick people don’t do their best work. And as someone who runs a large organization by day, I really just don’t want my sick employees coming to work. Please stay home, get well, come back when you’re healthy again because I don’t want to catch your illness and neither do any of your coworkers. I’d hoped that rather than try to bring Covid in line with recommendations for other illnesses, we’d use this opportunity to rightsize our workplace policies based on what we learned during Covid. But hey, late stage capitalism, am I right? You probably haven’t heard this news, which is why I’m sharing it. Cameroon began to roll out the new malaria vaccine, which can cut the risk of malaria by 75% over a year. They are the first country outside of the initial pilot program to bring vaccines to their people at scale. Malaria takes tens of thousands of lives a year, mainly of poor children. For decades, the quest for a vaccine has been inconclusive until now. This is a game changer, but there’s always a catch. And that’s that people actually have to take it. Needless to say, we don’t have a great recent history with new vaccine rollouts and the endless demagoguery over the Covid vaccines, coupled with the overwhelm of the public health infrastructure in lower income countries. It’s led to far lower rates of baseline vaccinations. So we’ll wait and see, but with bated breath, because this could save tens of thousands of children’s lives. Last week, SAGE, the publisher of both the journals Health Services Research and Managerial Epidemiology, retracted two studies cited by Texas District Court Judge Matt Kacsmaryk in his ruling remanding the APA’s nearly quarter century long approval of the medication abortion drug Mifepristone to take it off the market. The ruling has since been stayed pending an ultimate decision by the Supreme Court. The studies were plagued with, and I quote, “fundamental problems with the study design and methodology, unjustified or incorrect factual assumptions, material errors in the author’s analysis of the data, and misleading presentations of the data that demonstrate a lack of scientific rigor and invalidate the authors conclusions in whole or in part.” The decision, along with the spate of recent high profile retractions, highlights the fragility of the academic literature. Ideologues and corporations have long exploited the poorest peer review process to pack journals with bunk or skewed studies, to then be able to cite them as objective evidence. So I’m glad the publishers did the right thing here, but I’m not glad that they continue to profiteer off of a publishing industry that’s so gamable by ill motivated people. Come on, do better. That’s it for today. On your way out. Don’t forget to rate and review. It really does go a long way. Also, if you love the show and want to rep us, drop by the Crooked store for some America Dissected merch. Don’t forget to follow us at @CrookedMedia and me at @abdulelsayed no dash on Instagram, TikTok, and Twitter. [music break] America Dissected is a product of Crooked media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emma Illick-Frank. Charlie Landes mixes and masters the show. Production support from Ari Schwartz. Our theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Leo Duran, Sarah Geismer, and me. Dr. Abdul El-Sayed, your host. Thanks for listening. [music break] This show is for general information and entertainment purposes only. It’s not intended to provide specific health care or medical advice, and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and his guests, and do not necessarily represent the views and opinions of Wayne County, Michigan, or its Department of Health, Human, and Veteran Services.