One year ago this week, the Public Health Department seemed barely a blip on the minds of 10 million Los Angeles County residents.
Then along came the coronavirus.
Los Angeles County residents and business owners spent their days learning what impact government officials could have on lives and livelihoods.
Public Health Director Barbara Ferrer became a household name. We got to know Chief Science Officer Dr. Paul Simon, County Health Officer Dr. Muntu Davis and Department of Health Services Director Dr. Christina Ghaly, too.
Their decisions brought the county together, helping residents to better understand the threat while watching daily the caseload, the hospitalization count and, sadly, the death toll. They also drove many of us apart, as restrictions on retail and restaurants frustrated business leaders and sent the economy spinning. The mission was clear, even if the waters to attain it were uncharted and murky: Slow the spread, educate, test and vaccinate the public — and save lives.
They didn’t act alone. Some decisions simply aligned with the federal government, more often with Gov. Gavin Newsom and the state.
Frustrated by business restrictions and declaring county leaders out of touch with the cities they serve, some local leaders considered breaking away. West Covina leaders, taking their latest steps toward creating their own public health department since deciding to break away from Los Angeles County’s, will hold a public hearing on April 6 to discuss creating the position of healthcare officer to run the new operation.
At the height of tensions, protesters demonstrated outside of Ferrer’s home during the relentless winter surge. Similar signs of defiance played out beyond the gates of Mayor Eric Garcetti’s home. Gov. Gavin Newsom, meanwhile, faces a recall effort propelled at least in part in response to his pandemic-propelled policies.
With the virus’ growth slowing, hope is strong that the worst is behind us. Businesses are inching toward wider reopening, museums are welcoming guests back inside, students are cautiously returning to campuses. Despite a fitful launch, the drive to vaccinate the county has picked up steam.
But assessments of the response to the crisis — “What did we learn? How should it change us?” — are inevitable. And they will no doubt shape how leaders manage post-pandemic life and how leaders react to future emergencies.
Critics argue that despite the strict public health measures, L.A. County still suffered severe losses. As of this week, more than 23,000 people have died from complications related to COVID-19. In December, the county’s network of hospitals was nearly overrun.
Those who support the public health measures counter by saying that saving any life was worth the effort. L.A. County, for its size and vast diversity, fared far better than experts would have otherwise predicted, according to Dr. Robert Kim-Farley, professor of epidemiology and community health sciences at the UCLA Fielding School of Public Health.
And county health officials could not control those who flaunted the rules that became the outbreak’s norms — stay home when you can, don’t gather with folks outside your household, practice social distancing and wear a mask. Ignoring those rules, especially during holidays, officials said, helped to ignite the crippling winter surge that undid so much of the progress made against the virus.
“We were doing some things right here and our numbers do reflect that,” Kim-Farley said. “With a population this big that’s challenging. It’s not so much our total density but the numbers of people per room per homes. Those contributed to some of our increased cases, but I think we had the right policies in place.”
Kim-Farley said the way people reacted to the pandemic will shape how he teaches public health to his students. One of the biggest lessons, he said, centers around communication.
“Public health requires clear, transparent and consistent messaging and everyone being on the same page,” Kim-Farley said.
“I think that public health officials had a pretty clear intimation fairly early on (about the virus), but unfortunately that message was not being well received at the highest levels of government,” he continued. “So there was beginning to be a rift between public health officials and elected officials.”
Even in L.A. County, that rift was evident, as the County Board of Supervisors on several occasions overruled decisions by the Public Health Officer to open a certain sector or loosen a restriction, for instance.
For L.A. County Supervisor Janice Hahn, who represents the 4th District, the pandemic put her in a position she and many others never imagined they would be in as elected officials. Before the pandemic, the Board of Supervisors was focused on law enforcement, traffic congestion and homelessness. A pandemic was unfamiliar territory.
Hahn said it put her and her colleagues in an untenable position. “I went into public service to help people,” Hahn said. “I never thought I would be in a position where it was just the opposite and the decisions I was making would cause harm emotionally and economically.”
When the initial stay-at-home order was instituted in May, Hahn said it was easy to get behind. But as time dragged on and businesses remained closed, the economic tolls of the decisions became plainly clear. And Hahn heard plenty from constituents about it — the desperate calls from business owners, some that she remembers quite vividly.
“Those weighed very heavily on me,” Hahn said.
But she understands the motivation, she said.
“We pride ourselves on our independence and self determination,” Hahn said. “The fact that your government is limiting your activities and your business activities and the things that you just like to do came as a very big shock for a lot of people.”
Business impacts
“If you would have asked anybody in that department if they had been responsible for livelihoods pre-pandemic, they probably would have shirked,” said Allen Sanford, an entrepreneur in the South Bay who owns The Rockefeller restaurant/gastropub and the Saint Rocke nightclub — currently up for sale — and produces the annual Beach Life Festival. They were all severely impacted by pandemic-spurred restrictions.
Sanford said he sympathized with those who were forced to make tough decisions. His main desire was for more transparency and well-communicated, science-supported justification, especially as it related to closing outdoor dining, he said.
“Some of the decisions I feel were made without data or the proper background,” Sanford said. “And it seemed there was a vacuum of leadership.”
Despite facing financial losses of his own, Sanford and his team rallied together leading up to the July 4 weekend to build 15,000 square feet of outdoor dining decks for restaurants throughout the beach cities in what turned out to be an uplifting show of community spirit.
“Some people thought I was crazy because I was enabling my competitors,” Sanford said. “But times were so dark. I think if I didn’t have my team working on something and we didn’t have a positive focus, then despair sets in.”
For restaurants, the future may look familiar but it will certainly be different, according to California Restaurant Association President and CEO, Jot Condie. Outdoor dining may be here to stay, but restaurants are going to need help, Condie said.
“Over the past year, California restaurants have fought to survive in the face of unprecedented circumstances,” Condie said. “Each month brought a new round of uncertainty for restaurants. From indoor and outdoor dining bans, to confusing restrictions, to mounting fees, restaurants faced mounting odds with determination. Restaurants survived through sheer creativity and resourcefulness driven by necessity, not riches. Unfortunately, many restaurants did not make it. Today, many are still just hanging on.”
Business owner Alice Kao, who runs Sender One Climbing with a location near LAX, struggled with her feelings about the health department. Kao’s business is categorized as a fitness gym, so they have been closed since March with just a brief three-week reopening in June. When the county moved into the red tier on Monday, March 15, Kao reopened the doors with excitement.
Kao did everything she could to keep the business afloat over the past year, including hosting a childcare center and a COVID-19 testing site in the parking lot. Like so many others, Kao has suffered deep losses, ones that right now she is hoping the business will be able to make up in the year to come.
“I totally recognize that what is happening right now is not under anyone’s control. Who knew a year ago we would wake up and there was a pandemic? Their job is really difficult because they have to balance a lot of things,” Kao said. “We are in the middle of a public health crisis so they are the right people to lead us through this.”
As a business owner, however, Kao said she would have appreciated better communication. She has disagreements with the way climbing gyms are categorized in the state’s tiered system. So Kao’s gym and about 100 other climbing gyms have formed a coalition in California to be heard by state officials as they consider the reopening guidelines. Climbing gyms — like fitness centers — opened this month at 10% capacity. But Kao and others believe climbing gyms can safely accommodate more since climbing walls utilize vertical space.
“We are people who follow the science and the data and we want to do the right thing,” Kao said. “That’s why we’ve done the research and are working with the state to get the guidelines changed.”
Lessons learned
Ultimately, Kim-Farley said public health should be a reflection of how far society is willing to go. Even tougher questions may lay on the horizon. What happens when another virus comes along that’s 10 times more deadly than the coronavirus?
“We don’t have a societal norm as to what is acceptable or not,” Kim-Farley said. “What this has done is brought the issue to the fore. I think the current administration is finding this pathway.”
David Smith, professor of economics at Pepperdine Graziadio Business School, said few people could have predicted how much impact the coronavirus pandemic would have on the economy.
“Maybe true historians had a little more foresight for what could come to bear,” Smith said. “I don’t think we ever anticipated a potential drop in GDP in the magnitude we’ve seen would occur.”
The Bureau of Labor Statistics estimated a 9.1% drop in gross domestic product in the second quarter of 2020.
However, Smith said he sees a U.S. economy in significant economic recovery in the middle to late part of this year.
“So much of economics is self-reinforcing,” Smith said. “If people aren’t working, they aren’t spending money and businesses are not investing. It’s critical to keep that positive momentum going. I think we could still face a real prolonged economic slowdown if we are not smart in the weeks or months to come.”
As for Hahn, the biggest lessons she said that’s been learned centered around being better prepared with equipment and patching up the holes in the social safety net.
“This pandemic shined a spotlight on things that were already wrong with our society,” Hahn said. “There were many people falling through the cracks and this pandemic highlighted that.”
When she discusses her department’s response, Ferrer circles back to the baseline goal: Slow the virus, save lives.
“I think it’s hard measuring worth when people are dying form a deadly disease that we can prevent the spread of,” Ferrer said. “It’s not just the deaths, it was what was happening to our hospitals. We were already overwhelmed beyond anything we could manage.”
Asked recently whether the public health restrictions were worth the cost, Ferrer remained steadfast.
“My answer is absolutely it was worth it,” she said, “to do everything you can to slow the spread of a deadly virus that wrecks havoc on people’s lives and nearly brought down the L.A. County hospital system.”
