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In the best of times, county public health departments are underfunded, undermanned and often under-appreciated. They run dozens of health and environmental safety programs, scramble for grants to supplement their often-meager budgets and do their job without complaining. But when COVID-19 blew up into a pandemic last March, the public health applecart threatened to be overturned. This was true everywhere in Colorado, not just in Chaffee County.

With resources stretched thin, an unknown virus with no cure, and cases exploding, state and local governments retrenched; clapping on ‘stay at home’ orders that a portion of the population saw as draconian, calling the pandemic a hoax and politically-motivated. Many refused to comply, complaining about their rights and privileges, even as public health departments were buried under trying to acquire test supplies, COVID testing, contact tracing.

Chaffee County Director of Public Health and, COIVD-19 incident Commander Andrea Carlstrom gets her first dose of OCVID-19 vaccine at the Fairgrounds last week, given by CCPH nurse Tanya. Courtesy photo.

“Colleagues of mine have been threatened, their offices and cars attacked, called names on social media. Some of them have resigned or been fired,” said Chaffee County Public Health Director Andrea Carlstrom, who is also the Chaffee COVID-19 Incident Commander. “Public health is just that — keeping the public safe.  It’s hard to do this job when you’re under attack. I’ve been threatened.”

Given her non-stop, seven-days-a-week schedule, it has taken a few weeks for AVV to interview Carlstrom about what this time has been like; breaking it into short phone calls and text questions. She usually bubbles with optimism, especially now that there are two COVID-19 vaccines — Pfiser and Moderna — even when explaining serious things. “The state has launched a COVID vaccine dashboard….we aren’t doing a local one. The governor wants focus on the first tiers [of the vaccine phases]. As a public health system we have to be thinking four weeks out – how to fold in both first and second doses.”

“The good news is the next two vaccines are getting close – they are one-dose vaccines, which will make lives easier. And here’s another piece of good news: HRRMC said we have had no flu cases in CC this season. None. There have been other things, but its everything but the flu, so that is good.”

Chaffee County Public Health (CCPH) has been taxed by the COVID-19  pandemic like no other time in its history, but unlike so many other Colorado counties where  public health departments have been vilified for simply doing their jobs, the team lead by Carlstrom has remained strong and received community encouragement.  Her team worked without a day off for months, setting up testing, contact tracing, filing application after application to the state to attempt to keep Chaffee county in a COVID Dashboard color zone that would allow businesses to continue to operate during the critical summer season.

It worked. Chaffee finished a successful summer season in the yellow zone. She credits not just “my amazing staff,” but the Chaffee Leadership Roundtable established early on in the pandemic for helping her keep her head up in the pandemic chaos. That doesn’t mean there has not been stress.

‘How much more can you guys take?’

Courtesy photo

“That’s the million dollar question,” answered Carlstrom after a pause. “Many of my peers are at their wits end – I’m proud of our effort, We are proud of strong coordination, our leadership roundtable is a fantastic model. It’s an open mechanism to communicate with members of the media, and we push out our situation reports religiously. We hold town halls, and we push out so much info on social media, and do the other parts of our jobs too.”

“But some days, we wonder how much more we can do,” says Carlstrom. “Then — we just — keep going.”

While she chooses not to dwell on the dark side, Carlstrom is well aware of the dangers posed by irrational anger at her and public health departments. “Some of my peers are getting death threats. I hope we don’t experience that here in our county. I’ve always felt that here we support each other. But that doesn’t mean I don’t take security for my staff seriously, especially out at the fair grounds for those reason. I know how hard the public health system has worked and this [threats to public health staffers] just tears at my heart.”

She went on to describe an event in one county where, “One particular political group went to a COVID test site and ripped the power cord from the cooler, and tests were wasted. What I heard on the [state public health staff] call was thousands. Unreal!”

Over the course of the past ten months, Carlstrom’s unfailing calm, good humor is most often mixed with resolve and efficiency, never more so than this past week, when she herself received the COVID vaccine.

“On Monday of last week, CCPH nurse Tanya gave me dose one of my COVID-19 vaccine. My vaccination took place at CCPH’s first COVID-19 vaccine clinic, intended for some of our county’s healthcare workers, COVID-19 responders, and other individuals who fall into the highest risk category. I felt encouraged to be part of this huge endeavor and at this phase of the fight against COVID-19. I have had no adverse reactions,” said Carlstrom.

She presents this positive view against the background of several members of local first responder groups who have refused to take the vaccine. Carlstrom says her department knew there would be some. While some hesitation might be chalked up to concerns over vaccines generally, or phobias over needles, or because some are viewing vaccines as political, she hopes that over time they can be won over. The undercurrent appears to be coming from law enforcement, some fire department crew members, even some nurses, and staffers at Columbine, who are refusing to take the vaccine.

“When we run into that, we’re filling in, calling those who have indicated they can come to the fairgrounds on a moment’s notice and get the vaccine dose. None of it is going to be wasted.”

While the Board of County Commissioners debated whether or not they needed a staff policy about this a few weeks ago (and backed off establishing one) the public could ask; if we the people pay these salaries through our taxes and mill levies, do we have a right to ask that these first responders don’t infect us due to their exposure or require us to pay workers comp when they get sick and can’t work?

For her part, Carlstrom is concerned about the minority of Chaffee businesses that have refused to comply with public health orders. She clarified the quandary: “We are getting more demand for calling these businesses out in public. Is there some middle ground?”

The goal is compliance; to protect public safety.  The dilemma; how to get everyone playing by the same set of rules.

“We are hearing it, walking in the door and seeing it, and having [business noncompliance] reported to us,” said Carlstrom, who pointed out that dozens of other Colorado counties have taken steps to sanction, fine and even shut down businesses that didn’t comply with public health orders. “We need to move in the direction of accountability. If it is a cease and desist and a fine – some businesses have said, just give me the fine.”

But there is this issue of fairness: “A few who are complying have asked me why aren’t we ostracizing the businesses who aren’t … I’ve held out, we want to work with business, but it doesn’t feel right.”

As the county slogs through the 11th month of pandemic, Carlstrom remains positive and hopeful. “I’m proud of everything we’ve thought of to provide strong communications…’s the sunlight on all this. It helps that there’s  strong camaraderie and a strong leadership network in our county….. that clearly sets us apart from what other communities are dealing with.”

“I’m incredibly proud of my entire team and beyond honored to be a part of these critical moments in history, which are altering the face of the pandemic,” added Carlstrom. “However, please remember that it’s going to take months for countywide vaccine distribution to be completed. I want to thank Chaffee County, for your patience now and over the past 10 months. I’m grateful to be part of such a caring, supportive community.”

Featured image: Chaffee County Public Health Director and COVID-19 Incident Commander Andrea Carlstrom grins after receiving  her COVID vaccine shot on Monday from CCPH nurse Tanya. Courtesy photo.

Whatever you’re going through, crisis counselors and professionally trained peer specialists are available to help. Call Colorado Crisis Service’s hotline at 1-844-493-TALK(8255). There is no wrong reason to reach out.