On the night of Tuesday, March 17, 2020 Dr. Mark Wakefield was nervous. A urologist by trade, he didn't do much public speaking beyond presenting research at conferences. But on that night, he was one of the medical experts on hand to answer questions about Boone County’s first confirmed case of COVID-19.
MU Health called upon Wakefield, who had some experience with infectious diseases, and had served in leadership positions. He said by March he had seen colleagues in larger cities called up to care for COVID patients. He knew things could get worse.
“It’s one thing to ask your urologist who has other leadership roles to be a public spokesperson for MU Healthcare," Wakefield said. "It’s another thing to say, ‘Well you’re going to go out of your comfort zone and take care of patients that are very sick.’”
The next day, on March 18, the governor announced that the state had suffered its first death from COVID-19: a Boone County resident. Wakefield later found out that he knew the person. He said one of the things that stood out to him was how the community complied with the restrictive measures adopted in the early months of the pandemic.
“They were very effective ... If you look back at the Boone County data, there’s months where there were zero cases for most of the month,” Wakefield said.
According to Wakefield, those measures helped preserve the health system’s capacity, at a time when there were critical shortages of personal protective equipment or P-P-E.
Almost all of those restrictions came from the Columbia/Boone County Public Health and Human Services department. What stood out to health director Stephanie Browning the most was the uncertainty.
“It was stressful," Browning said. "Because you’re doing the best you can to contain the disease and the issues and to keep your community safe and yet it’s so polarizing. It always put a pit in my stomach.”
Browning said having the first death in the state be in Boone County hit the department hard. Since then, more than 19,800 Missourians have died from COVID-19, according to the state Department of Health and Senior Services. Boone County has lost 225 people to the disease.
“Those are all lives that somebody loved and cared about and lives lost too early perhaps," Browning said. "But we also think about all the cases we’ve had, and people who’ve missed work, people that have long-haul COVID. Every one of those is a person.”
Browning’s department drew criticism from some members of the community over restrictions on gatherings, and masking requirements. Browning became the target of harassment, and anger, especially online. The department also drew criticism from others when it later dropped those requirements.
That resentment has driven scores of public health workers to leave the profession. Missouri is on its third health director since the start of the pandemic, and Browning says her department has lost personnel as well. But she says she stayed because she didn’t want COVID-19 to be the last thing she did. She says she wants to be less reliant on the state, improve disease monitoring, and work on health equity.
“The pandemic ... really has shined a light on the disparities in our community," Browning said. "For a long time, it's sort of been, here's the health department, if you want a vaccine, come get a vaccine, but like, we want to get those services out in the community.”
Browning, like Wakefield, said she has learned lessons from the past two years, and that her department is stronger. And with cases once again on the rise in parts of the U.S., those lessons could remain relevant for a while.
