Blaine County's public health nurse resigns

A meeting of the Blaine County Board of Health got emotional Wednesday afternoon with the announcement that County Public Health Nurse and Health Officer Jana McPherson-Hauer was resigning effective Oct. 15.

McPherson-Hauer said her resignation was due to the politicization of the COVID-19 pandemic and the damage it has done to her profession through the curtailing of their authority by the Montana Legislature and the daily stress of having the department's expertise, motivation and evidence-based policies questioned, ignored or rejected.

"I do not fit in a system where I must constantly defend evidence-based best practices to those they are designed to protect," she said in her letter.

The resignation was announced during a meeting in which the board of health approved her recommendation pertaining to recommend but not require quarantine for unvaccinated people exposed to COVID-19.

She said pushback toward her profession has included the insinuation that she and her department don't know anything about the subjects they are trained in, the misrepresentation of her department's goals and motives and a hesitation to allocate resources to her department when needed.

McPherson-Hauer said the pandemic has brought her profession's work to the forefront, and while many have responded with curiosity and support, many more have responded with negativity and disregard.

She said she is not happy leaving the relationships she'd developed in the county over the last seven years, but the situation has made in necessary that she moves on.

Those at the meeting almost universally expressed their regret that the situation for public health has gotten as bad as it has.

Blaine County Commissioner Frank DePriest attempted to read McPherson-Hauer's resignation letter but couldn't finish and began crying, requesting that fellow Commissioner Miles Hutton read the rest.

Commissioner Dolores Plumage, on the other hand, provided a full-throated defense of McPherson-Hauer, her health department and the medical community as a whole.

Plumage said health care was one of the most highly respected professions there was, and now professionals are challenged and disrespected every day by the people they're trying protect, spurred on by a toxic political environment.

She said this environment and the endless negativity born from it have made it difficult to get anything done because, now, everything is up for debate in the eyes of people who are not trained in the subjects they profess experts know nothing about.

She said hospitals around the state are filling up again but people now deny even that observable reality.

Plumage suggested that those professing to know better get their own degrees and become the experts, instead if they feel so strongly about the subject.

She said the fact that the situation has gotten so bad that it cost the county someone like McPherson-Hauer is devastating and she will be sorely missed.

County Sanitarian Ron Andersen expressed similar sentiments and lamented the nature of the environment public health must now operate in.

"I've worked on the environmental side of public health for over 50 years, I've worked with a lot of public health nurses in 12 counties, large counties, and Jana is at the top of the list, if not the best public health nurse I've ever worked with," Andersen said. "... It's going to be difficult to replace a public health nurse, and impossible to replace Jana."

McPherson-Hauer said she appreciated everyone's support and impressed upon them how serious she was in her letter when she said she will leave with good relationships, developed during her time at the county.

In an interview after the meeting she said there wasn't any one thing that led to her decision to leave, but the last legislative session and the policy changes that came out of it were a turning point for her.

She said in the past two months, her department has noticed a massive increase of people disregarding the department's recommendation and disrespecting its staff, seemingly emboldened by the Legislature's curtailing of its power.

She said staff are cursed out over the phone every single day, hung up on, and accused of malicious intent or incompetence.

McPherson-Hauer said her staff is well-trained and highly knowledgeable, that they know exactly what they are doing, and that their actions and recommendations have always aligned with science and data.

She said she's not alone in her frustration that public health is now being required by "knee-jerk" legislation to follow the direction of people who know little about their jobs or their field of expertise.

Her resignation comes in the wake of multiple other public health officials in the state and the nation resigning during the pandemic.

McPherson-Hauer said the department's staff can't do the things they know need to be done to protect public health, especially supporting schools with making sure students are vaccinated for contagious diseases.

McPherson-Hauer said she's also frustrated with the hesitation to allocate necessary resources and provide guidance to health departments which she said can be seen on multiple levels of government, but particularly the at the state level.

She said the department is keeping pace with the COVID-19 surge for now, getting in touch with close contacts within a day, but her department staff are working long hours and getting worn out and overwhelmed.

McPherson-Hauer said public health has always been around, though largely unseen, ensuring people are properly immunized, providing health care to children and mothers, evaluating the community's health needs and beyond.

But, she said, the politicization of the COVID-19 pandemic has emboldened a significant number of people to ignore the advice of public health no matter how much evidence they are provided of its efficacy, and she worries for the future of public health even after the pandemic ends.

"I'm a very proud public health nurse, and I think we did a really good job here, and I think that will continue. But the legitimate public health efforts have been undermined in enough ways that it has taken away our creditability, while it shouldn't, because there are very good reasons for us responding in the way that we are." she said. "When we give good sources, evidence-based sources and research and data, that doesn't seem to matter to a large group of the population. Until that matters again, not just public health but a lot of professions will lose credibility because, now, either everyone is an expert or nobody is."

She said people need to look at the full breadth of research regarding masks, vaccination and other public health measures, not just a single paper that already agrees with what they already believe.

McPherson-Hauer said the scientific method works not by proving what the scientist believes, but by attempting to disprove what they think they know, and that is why it works. If the belief can't be disproven, it is accepted unless further research changes that.

She urged the community to get vaccinated, wear masks in public and engage in all the measures that health officials have been recommending for the past two years.

She also pleaded for people to go to the hospital if their symptoms start becoming unmanageable.

She said the department has been seeing people question whether they are sick enough to go to the hospital for fear that they won't be seen due to the rapidly filling beds.

McPherson-Hauer said people need to seek medical attention if their symptoms start getting bad and they will be seen.

Policies implemented and discussed at meeting

During the meeting, the board also approved the implementation of the health department's recommended quarantine and isolation policies.

McPherson-Hauer said the department's way of handling of quarantine and isolation is, in line with Montana House Bill 702, to recommend that people exposed to COVID-19 quarantine based on guidance provided by the Centers for Disease Control and Prevention.

This is a matter that has become controversial recently because HB 702 prevents public and private entities from "discriminating" against the unvaccinated, which prevents health departments from issuing quarantine orders based on their vaccination status.

However, recent guidance from the state indicates that health departments can recommend people follow the CDC guidance which has different guidance based on people's vaccination status.

McPherson-Hauer said quarantine is an age-old practice in public health to prevent people from spreading communicable disease, not some invention created for COVID-19.

"They did not magically appear when the pandemic began," she said. "They've been on the books for hundreds of years."

She said quarantine is also not, as many have insisted to her and her staff, "keeping healthy people home," but preventing the spread of disease by people who are asymptomatic, which many diseases and viruses, like novel coronavirus 2019 which causes the disease COVID-19, are capable of doing.

She said the recommended policy is in line with Montana's laws, including those recently passed by the Legislature, and is similar to what almost every other county in the state is doing.

The health board voted 4-1 to implement the practices recommended by McPherson-Hauer with Hutton voting against.

The board also briefly discussed changing the makeup of the health board from its current form, three commissioners and two members of the public, to a new one, one commissioner and four members of the public.

DePriest said it has been pointed out that new legislation requires that actions taken by the health board be approved by the commission, so having three commissioners on the board is redundant as they now have the responsibility of approving the board's recommendations.

This potential restructuring will be discussed in more detail at the board's next meeting.

The board also unanimously passed changes to board's bylaws to bring them in line with the Legislature's new laws.

Most of these changes had to do with the new law that requires the commission to approve actions taken by the board.

Board members and county officials also provided updates on their organizations' activities during the meeting.

McPherson-Hauer said the health department set a goal in June to have every age group in the county at least 50 percent vaccinated by the end of summer, and they came very close to meeting that goal.

She said the only age group that didn't make 50 percent was the 18 to 29 bracket, which is still a few points behind.

She said she's proud of the staff for doing as well as they did and hopes that work will continue now that the long-predicted surge has arrived.