(CNN)Joshua Embry took over as public health director in Grayson County, Kentucky just weeks before US officials announced the first case of coronavirus in the country.

In the past 12 months, Embry and his staff have worked tirelessly to protect their community and promote measures to curb the spread of Covid-19. Yet their service has come with an unexpected price: They’ve received warnings — often from a small but loud part of the community upset at public health guidelines — and Embry has received a death threat. “There was a time when I really needed the role of my spouse. I came home and I was like, ‘I don’t know if I can keep doing this,'” said Embry, who reported the death threat to his supervisors. “You have a lot of responsibility on your shoulders. And then to not know what’s going to happen when you’re walking to your car … It’s been very heavy.” Joshua EmbryJoshua EmbryJoshua EmbryIn Washington state, Okanogan County community health director Lauri Jones installed a new security system and asked for police patrols around her home following repeated online threats. Read More”Someone said, ‘Let’s find out where she lives, we’ll post her address,’ those types of things,” Jones told CNN. “Not being an elected official or anything, I mean, I wasn’t used to that and it did make me really kind of fearful.” The two are far from alone. In Los Angeles County, a Facebook user said last year that public health director Dr. Barbara Ferrer should be shot. In Kentucky, the governor announced in early January that public health commissioner Dr. Steven Stack’s home had been vandalized. And the nation’s top infectious disease expert, Dr. Anthony Fauci, has faced threats serious enough that one source previously told CNN he required personal security from law enforcement at all times. Lauri JonesLauri JonesLauri JonesHealth leaders from coast to coast shared similar stories: As they sprung to action to help combat rising coronavirus infections, they became the target of public anger and were harassed by groups who accused them of lying and limiting their freedoms.”Overall, the community has been very supportive but I was very concerned about the minority in the community being so vocal,” Embry said.The impact has been devastating — not only on health leaders’ physical and mental health but on a struggling public health field that was already in desperate need of its officers. More than 180 health officials have resigned, retired or been fired during the pandemic, according to the National Association of County and City Health Officials (NACCHO), which represents the country’s nearly 3,000 local health departments. “Losing leaders now at that rapid rate is extremely alarming,” NACCHO CEO Lori Tremmel Freeman told CNN. “We have to stop the bleeding now so that we can continue through this response but also be prepared for the next time we have to deal with a public health emergency.” Dr. Fauci opens up about threats against him and his familyDr. Fauci opens up about threats against him and his familyDr. Fauci opens up about threats against him and his familyJUST WATCHEDDr. Fauci opens up about threats against him and his familyReplayMore Videos …MUST WATCH

Dr. Fauci opens up about threats against him and his family 02:59Threats and drive-by recordings The hardest hit have been health officials in smaller — and often rural — communities, with limited resources and staff and who were already juggling several job titles before the pandemic. In Dickinson County, Kansas, Brian Holmes is a family physician, director of the emergency room and emergency medical services, coroner and county health officer. He described the past year in one word: “hell.””My whole life has been consumed with Covid since this all hit,” he said. Some public health officials are resigning amid threats during the Covid-19 pandemicSome public health officials are resigning amid threats during the Covid-19 pandemicSome public health officials are resigning amid threats during the Covid-19 pandemicHolmes updated the community on coronavirus numbers and recommendations through his Facebook page, via local news outlets, text messages and helped push a mask mandate that remains in effect, even though he says some groups in the community refuse to abide by it. It’s been disappointing to watch, he said, seeing residents he long respected turn on him because of his medical advice. “I’ve kind of gone from small-town kid who goes home to his hometown to practice medicine to this villain, and I don’t comprehend how that’s occurred,” he said. “My role has been to try to keep people healthy and save lives.” Some residents created Facebook groups calling for his firing and left ugly messages on social media. A friend of his recently joked Holmes should be wearing a flak jacket. His children, who have often stood up for their dad’s recommendations at school, have told him they wanted to leave town. “People need to take a step back and take a deep breath and try to look at this from the health officers’ and the healthcare workers’ standpoint,” he said. “We are all overworked, overwhelmed, exhausted, mentally and physically.”About 120 miles away, in Wilson County, Jennifer Bacani McKenney has served as the health officer for nearly a decade, “for a whopping $600 a month.” When the pandemic first hit, the department’s four full-time employees felt their first line of defense should be education. Jennifer Bacani McKenneyJennifer Bacani McKenneyJennifer Bacani McKenneyAnd, as often is the case with small towns, they were constantly available to the community, McKenney says — in the grocery store, in the school line waiting for their children, on Facebook, at their office. “We were just working 24 hours a day, seven days a week, whenever someone had a question,” she said. Things began getting complicated when Kansas lifted its statewide stay-at-home order in the spring and residents were eager to see a return to normal, but McKenney continued pushing for safety measures like social distancing and mask mandates. While the majority of the people in her community were supportive, she said, McKenney and her coworkers became the targets of “loud, outspoken dozens” who heavily opposed masks “because of their rights and liberties.” Some called her a dictator. Another person compared a mask mandate to the Holocaust. Another, she said, drove by her home and filmed her. Following a public mask hearing in November, McKenney was approached by sheriff’s deputies, who asked to escort her for safety reasons as she made her way to her car. “It’s sad because these are people that I’ve grown up with, and I’ve known them my whole life,” she said. “You’re just like, ‘Come on guys, you know me, you trusted me with your medical care up until this point. How is this different now?'” Health worker quits over repeated threatsHealth worker quits over repeated threatsHealth worker quits over repeated threatsJUST WATCHEDHealth worker quits over repeated threatsReplayMore Videos …MUST WATCH

Health worker quits over repeated threats 03:03Some have resigned, others have been fired In Kansas alone, more than 30 health officials have left their posts since the pandemic’s start, a Kansas Department of Health and Environment spokeswoman told CNN. Facebook takes down videos targeting California public health officersFacebook takes down videos targeting California public health officersFacebook takes down videos targeting California public health officersAmong them is Gianfranco Pezzino, who served as the Shawnee County health officer for nearly 14 years. He had been tracking the novel coronavirus when it was first detected and still recalls the chilling moment he found out about the first case in the US. “I remember sitting at the table, the kitchen table, with my wife and holding my head in my hands and saying, ‘This is it. This is the big one that we have been waiting for.'” While the community was fearful at first and abided by the initial lockdown and school closure orders, what followed was months of pushback from county leaders about other mandates and recommendations, he said. Pezzino resigned in December, after county commissioners decided to relax the rules on one of his public health emergency orders — which, he said, came at a time the county was seeing its “worst” coronavirus numbers since the pandemic’s start. “There was a continuous scrutiny and questioning of everything we were doing. And so that became really difficult to manage and frankly, emotionally draining. These were already days where I, like all the other people on my team, were working eight, 10, 12 hours a day and that alone could be enough to burn out just about anybody.”Public health official on why he resigned: This was the last strawPublic health official on why he resigned: This was the last strawPublic health official on why he resigned: This was the last strawJUST WATCHEDPublic health official on why he resigned: This was the last strawReplayMore Videos …MUST WATCH

Public health official on why he resigned: This was the last straw 03:05The commissioners’ decision to adjust his order, he says, was “the last straw.” A Shawnee County spokesperson told CNN, “We appreciate and are grateful for Dr. Pezzino’s service to the citizens of Shawnee County during his time” as the health officer. In Wyoming, Edward Zimmerman was fired just days after he signed a mask order. Zimmerman, an emergency medicine physician, is the former Washakie County public health officer. County commissioners, he said, were not supportive of “any kind of masking mandate.””I’ve been here 12 years. If a house burns down and people need help, (residents) will go out of their way to do it. If there’s a fundraiser for someone in recovery from cancer, people come out of the woodwork. They’re willing to help their neighbors,” he said. “When people are told they have to do something, especially something they’re not used to being told about, that’s when there’s immediate pushback.”Linda Vail Linda Vail Linda Vail The announcement of his firing came after what he says had already been a “rough” year: His children were harassed at school because of his position, his wife was confronted at the grocery store, and he was criticized on social media. CNN reached out to the Washakie County commissioners for comment but did not hear back. “You have to have thick skin to be a leader or a physician in a rural town anyway, but this has been worse than most,” he said. For those who have stayed on the job, the support of local officials has been essential. “It’s been really, really, really hard. I work seven days a week, sometimes 16, 18 hours a day,” said Linda Vail, the health officer in Ingham County, Michigan. The support of her local commissioners, Vail said, has kept her going. “They let me do my job,” Vail said. “You’re seeing health officers that are being asked to compromise their ethics, compromise their expertise, have the knowledge of what we’re supposed to be doing and what’s the best course of action and then having other people interfere and say, ‘well, you can’t do that.'”On top of her own long hours and constant coronavirus work, Vail said she’s also been the target of harassment. Vail’s been told she should be in jail, labeled draconian, accused of overstepping her bounds and once received an envelope at home that enclosed an image of a Nazi soldier. In addition, someone messaged her threatening “we came after Whitmer, we’ll come after you too.”Michigan Gov. Gretchen Whitmer was the target of an alleged kidnapping plot last year. “The threats come in and the ugliness comes in and the hate emails come in, it happens a lot,” Vail said. “You just do your best to keep your chin up and keep going.”

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https://www.cnn.com/2021/01/31/us/us-local-health-officials-pandemic/index.html

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