Linda Vail is the Health Officer at Ingham County Health Department. Before that, she spent 11 years as Director of Kalamazoo County Health and Community Services.
She recently spoke about how misinformation has impacted health care at our 2022 Michigan State of Reform Health Policy Conference.
In this Q&A, Vail discusses how her work is continuing to be affected by COVID-19, how misinformation affects the health of her county, and her future work with the county.
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State of Reform: What are you focusing your mental energy on in these last few months? What is the most important thing going on in Michigan health care policy from your perspective?
Linda Vail: “The focus is on trying to figure out how and when this pandemic is really going to become endemic rather than pandemic, but we are not there yet. So, we have been watching this virus and trying to anticipate what might happen based on what’s going on in other parts of the world, other variants, vaccines. We are trying to continue to predict what’s going on around COVID, and it’s been very difficult.
Secondly, we are trying to get back to the rest of the public health work, much of which got put on the back burner due to COVID. I still have lots of employees working virtually, which is fine, but we can’t work virtually doing services that we used to provide face to face.”
SOR: How has your work been affected by COVID and how does it continue to be affected by the pandemic?
LV: “The focus was on everything from rules and regulations, guidance, helping businesses and schools, vaccines, access to testing, and more. It was everything from informing the public, to trying to anticipate what was going to happen next, to issuing orders to try to control outbreaks, to dealing with long-term care facilities and infection control and numbers of deaths in long-term care facilities.
As far as where we are with regard to moving from pandemic to endemic, we’re in another uptick of cases. Projections that we saw a couple of months ago saw that cases would come up in April, peak early May, and then go down. Now we’re talking about cases going up through May, peaking late May [and] early June, and then going down. So, will that change again? There have been many surges that we would not have predicted.
Moving forward, we still have the concern on the back burner that we could have these surges again, but now we have a lot of tools that helped mitigate those, including vaccinations. We do know that if you’re vaccinated you can still get COVID, and it actually happens fairly frequently. If you’re vaccinated and get COVID, the data shows very strongly that the likelihood that you’re going to end up seriously ill, in the hospital, and/or dying is extremely rare. That is considerably different from someone who is unvaccinated. So, we have to keep in mind as we go through these surges, that the impact of the surge when we have vaccines is a very different glimpse at a surge than it was prior to those things.
I think the pandemic ends once the pattern of this virus becomes more predictable. I would anticipate this will become similar to flu, where we have very few cases all year round then all of a sudden, it’s flu season and we know to get vaccinated.”
SOR: How has misinformation shaped the way people in your county approach the virus, public health measures, vaccinations, and other care throughout the pandemic?
LV: “It’s been awful. ]We’ve seen everything from resistance to masks in schools to people who feel compelled to spread misinformation about the vaccine because they don’t believe in it. We will have mask battles for I don’t even know how long. We still have people who believe in the masks and will wear them … when case levels are increasing and we’re medium in terms of community transmission, and some people will do that and some people won’t. Similar can be said of the vaccine situation.
The misinformation trickles down into appropriate treatment. People use ivermectin and chloroquine and then reject and dismiss appropriate treatments like monoclonal antibodies. The treatments that we know have been authorized by the FDA continue to get attacked, and then that causes confusion and concern. Those things are not helping, especially in communities where there is already a lack of trust with the medical system. That’s the last thing we need to throw at people who are already vulnerable.”
SOR: What is the most important future project that you’re focusing on right now?
LV: “I think we have to focus on the things that were exacerbated during the pandemic that weren’t directly COVID-related. For example, gun violence, substance use and drug overdose, and mental health concerns. All of those things escalated during the pandemic because of the stress and anxiety caused by COVID. The shutdowns, lack of an income as a result of shutdowns, the concerns over jobs, and more. We really thrust ourselves into a very anxious period of time, and a very difficult period of time for very many people.
We also need to focus on equity. Equity is not equality. Equity doesn’t mean that as a department, everybody gets the same thing. Because not everybody has the same opportunities. Not everybody has the same vulnerabilities. So, when we talk about equity, we’re trying to take an individual or group and provide them with whatever it is they need to have an optimal opportunity for health themselves, which may be very different from what somebody else needs.”
This interview was edited for clarity and length.