Interview with County Public Health Office Dr. Frank James

Posted August 1, 2020 at 11:57 am by

The San Juan Update is pleased to reprint this inter­view by Minor Lile with San Juan Coun­ty Pub­lic Health Offi­cer Dr. Frank James as pub­lished 7.30.2020 in Orcas Issues News & Views

Dr. Frank James - Contributed photo

As Pub­lic Health Offi­cer for San Juan Coun­ty, Dr. Frank James has played a promi­nent role in the com­mu­ni­ty response to the Coro­n­avirus pan­dem­ic. This past Tues­day we talked for about an hour in a con­ver­sa­tion that touched on a wide range of top­ics, includ­ing the most sig­nif­i­cant COVID-relat­ed chal­lenges fac­ing the Coun­ty, reli­able sources of infor­ma­tion, the bal­ance between pub­lic health and eco­nom­ic health, tourism, prospects for a vac­cine, the open­ing of local schools, and oth­er topics.

The inter­view has been edit­ed for clar­i­ty and conciseness.

Minor Lile: My first ques­tion is what is the role of the pub­lic health officer?

Dr. James: The Pub­lic Health offi­cer is the one per­son in the coun­ty who is legal­ly respon­si­ble for pub­lic health deci­sion mak­ing, par­tic­u­lar­ly in an emer­gency. So in every coun­ty, there’s a health offi­cer and a Board of Health. And they are giv­en broad pow­ers and in emer­gen­cies extreme­ly broad pow­ers to con­trol dis­eases that might impact everybody’s health.

Pub­lic Health Offi­cers also have a role in the day to day work of pub­lic health in terms of con­trol­ling com­mu­ni­ca­ble dis­eases that might not rise to the lev­el of being an emer­gency. For exam­ple, if there’s an out­break of measles, per­tus­sis or chick­en pox. Those are things that can become quite seri­ous if not con­trolled and so we cer­tain­ly have a role in that. And then we super­vise all the clin­i­cal staff and reg­is­tered san­i­tar­i­ans that do the health and hygiene stuff in restau­rants and sep­tic sys­tems and all that. And we also super­vise the nurs­ing staff and oth­ers that pro­vide com­mu­ni­ty health ser­vices. That might be immu­niza­tions for kids or oth­er pub­lic inter­ven­tions, or the Link pro­gram. Things like that are all in the health department.

Would you share some of your background?

In addi­tion to being the Pub­lic Health Offi­cer for San Juan Coun­ty, I do have a num­ber of oth­er jobs. I have an active clin­ic that pro­vides ser­vices to two large cor­po­ra­tions. We pro­vide all their pri­ma­ry care. I also have a clin­ic that takes care of peo­ple who trav­el inter­na­tion­al­ly, with immu­niza­tions and advice about malar­ia and that sort of thing. I’m also the health offi­cer for the Nook­sack tribe. And I also do research and teach­ing. I’m on the fac­ul­ty at the Uni­ver­si­ty of Wash­ing­ton School of Pub­lic Health and I’m an adjunct pro­fes­sor at Yang-Ming Uni­ver­si­ty in Taipei. For the past twen­ty years I’ve also worked in India, Nepal and East Tim­or. The health offi­cer job is about eight hours a week. I’m also on call 24 hours a day, sev­en days a week for any emergency.

You’re clear­ly not a per­son that lets dust gath­er under your feet.

Not much.

How long have you served as the pub­lic health offi­cer for San Juan County?

It will be 29 years in Decem­ber. Bet­ty Gilson had the job before me. She had been my men­tor in med­ical school. And she was a pub­lic health MD and PhD, a bril­liant per­son. And always some­body I had very much respect­ed. Bet­ty called me and asked me if I would do the work out there, and I said, “Bet­ty, I don’t have time.” At the time I was the direc­tor and health offi­cer for the What­com Coun­ty Health Depart­ment and also ran the com­mu­ni­ty clin­ic. Even­tu­al­ly, over about six months, she kept at me and final­ly she called and said “Frank I’m not going to work on Wednes­day and I expect you to be there.”

(laugh­ter)

She knew bet­ter than I did because I’m not doing any of the oth­er things I was doing then and I’m still doing this.

That’s a good sto­ry. I would guess with close to three decades of expe­ri­ence, you must be one of the more sea­soned pub­lic health offi­cers in the state.

At this point I am. There are a few of us who began this work at around the same time. Many of them are retir­ing now. I’ll be 70 next year. You start to think about work­ing less.

Look­ing back to when this all began, at what point did you real­ize the Coro­n­avirus was a seri­ous threat?

Pan­demics have been an inter­est of mine for over 20 years. In that time, we’ve had a cou­ple of dust-ups that looked like they might be sig­nif­i­cant. The H1N1 flu, and of course the orig­i­nal Coro­n­avirus, the SARS. I worked for awhile in Hong Kong dur­ing SARS. I keep my eye on these bugs. So this type of virus is not an unfa­mil­iar organ­ism to me at all. I was unsur­prised that the devel­op­ments in Wuhan became the source of a pandemic.

So you saw this com­ing for awhile.

The clas­sic thing is not if, but when. We’ll get past this one and there’ll be anoth­er one down the road. And so I think it’s some­thing we pre­pared for both with SARS and H1N1. We had sim­i­lar expe­ri­ences that were milder than this one. With SARS, the spread was lim­it­ed to about 8,000 peo­ple and 800 deaths and that was large­ly due to the high­ly effec­tive man­age­ment by the Hong Kong gov­ern­ment and health care sys­tem. If it had got­ten more out of con­trol we would have had a sit­u­a­tion sim­i­lar to what we have now. But they stopped it at the source. And this time that wasn’t done in main­land Chi­na, of course.

Which orga­ni­za­tions or indi­vid­u­als do you look to for accu­rate infor­ma­tion and expert insight?

It’s inter­est­ing you would ask that. For years I’ve worked close­ly with the CDC (Cen­ters for Dis­ease Con­trol) and have had many close friends in senior posi­tions over the years. And the CDC, up until now, has been the orga­ni­za­tion every­one in the world looked to for lead­er­ship on these kinds of issues. And it is absolute­ly one of the sad­dest things in my pro­fes­sion­al career to see what has hap­pened to the CDC. Many peo­ple have left. And these are very bright peo­ple, cut­ting edge. The sort of peo­ple who can find oth­er places to work and have, many of them.

What’s dri­ven that change at the CDC?

They aren’t allowed to be inde­pen­dent. These are smart hard-work­ing peo­ple. They aren’t going to put up with peo­ple telling them what to do when it isn’t sci­en­tif­i­cal­ly accu­rate. They’re just not going to do it.

There are oth­er orga­ni­za­tions that work glob­al­ly and nation­al­ly. IHME (The Insti­tute for Health Met­rics and Eval­u­a­tion) is a group based in Seat­tle at the Uni­ver­si­ty of Wash­ing­ton. With sup­port from the Gates Foun­da­tion, they have become one of the glob­al lead­er­ship orga­ni­za­tions in pub­lic health.

The World Health Orga­ni­za­tion (WHO) has been the repos­i­to­ry for coor­di­nat­ing knowl­edge about what’s going on in the world from a health point of view and it’s very dis­turb­ing that the US would with­draw from that. We sim­ply won’t have the kind of intel­li­gence and infor­ma­tion that we need. It is in our own best inter­est to par­tic­i­pate in an orga­ni­za­tion like that. With­out those rela­tion­ships and that knowl­edge, it will be very hard for us to know what’s going on in the world and par­tic­i­pate in con­trol­ling outbreaks.

At any rate, the WHO and CDC are still two of the promi­nent orga­ni­za­tions that I look to for advice. They are the orga­ni­za­tions with the most infor­ma­tion. But it has, in recent years, become politi­cized in a way that I find disheartening.

Turn­ing to the spe­cif­ic sit­u­a­tion here in San Juan Coun­ty, what is the biggest COVID relat­ed chal­lenge that we are fac­ing at the moment?

Local­ly, we’re for­tu­nate that this is such a won­der­ful place to live. We attract excep­tion­al­ly qual­i­fied peo­ple. (Com­mu­ni­ty Health Man­ag­er) Ellen Wilcox has run the nurs­ing and social ser­vices pro­grams for a num­ber of years. She’s very well-trained in both social work and pub­lic health. You’ve seen Mark Tomp­kins (Direc­tor of Health and Com­mu­ni­ty Ser­vices) and Kyle Dodd (Envi­ron­men­tal Ser­vices Man­ag­er and Inci­dent Response Com­man­der for the Emer­gency Oper­a­tions Cen­ter) at the Board of Health and Coun­ty Coun­cil meet­ings. That’s as good as it gets. They have a broad per­spec­tive and are adept at under­stand­ing very com­plex issues. They do an excep­tion­al­ly good job of pre­sent­ing that infor­ma­tion and the pol­i­cy choic­es to the pol­i­cy mak­ers. (Senior Deputy Pros­e­cu­tor) Jon Cain is an amaz­ing legal advi­sor and he has also helped me through some real­ly hard times along the way.

We’ve also been for­tu­nate that vir­tu­al­ly all of the nurs­es who had retired in recent years have come back to help us. That’s just so touch­ing to see them step right up. They were retired and had earned the rest they were get­ting. But they are as good as they ever were.

We have many well-trained and expe­ri­enced peo­ple. We’re very lucky that way.

From my point of view, the biggest chal­lenge is keep­ing this small group of peo­ple vibrant and mov­ing for­ward con­sis­tent­ly and reli­ably. Many of them have been work­ing more than eight hours a day for at least five days a week for months now. Some­times they’re up at mid­night try­ing to sort things out and then have to go to work the next day. And there’s prob­a­bly not going to be an oppor­tu­ni­ty to slow down until at least Jan­u­ary. So it’s real­ly try­ing to get peo­ple time off and rest and also get some addi­tion­al peo­ple added to the team to meet the chal­lenges and vol­ume of work.

Anoth­er chal­lenge is con­tact trac­ing, the inves­ti­ga­tion of pos­i­tive tests. Often times the per­son doesn’t know they are infect­ed until we tell them. And then you have to ask who all the peo­ple in their life are that they might have either got­ten it from or giv­en it to. It may look easy from the out­side, but it’s real­ly com­pli­cat­ed stuff. Often peo­ple are con­cerned that they might have exposed a per­son they care very deeply about. They might think, ‘my God, I’ve exposed my par­ents or my grand­moth­er.’ Or that they might have giv­en it to some­body in the com­mu­ni­ty and that it has spread through work or social interactions.

These are del­i­cate con­ver­sa­tions. They require incred­i­ble sen­si­tiv­i­ty. and abil­i­ties you can’t real­ly teach any­body. That’s the part I think peo­ple don’t real­ly appre­ci­ate, even some of the peo­ple on our own team believe any­body can do that. I’m here to tell you not every­one can. It requires train­ing and knowl­edge as well as a gift for being pro­fes­sion­al and sen­si­tive and empa­thet­ic, so that peo­ple have con­fi­dence in you.

There are oth­er things that are hard, but I think the case inves­ti­ga­tions are at the heart of what we do. That is what allows us to stop the dis­ease. And we’ve done that. Almost every case we’ve had we know where it came from, we know every­body that was exposed and we’ve stopped it. In the fam­i­ly unit most often. And that’s what you have to do to be suc­cess­ful. Once it’s out in the com­mu­ni­ty, it’s a whole dif­fer­ent deal. We haven’t had that in our coun­ty. We’ve real­ly stopped the dis­ease at every turn.

You’ve brought up a num­ber of times at recent meet­ings that there are no known tourist relat­ed COVID cas­es in the coun­ty. Is that —

That’s not exact­ly 100% true. I would rephrase that. There have cer­tain­ly been peo­ple who have moved here to work in tourist relat­ed jobs and there is in at least one case some­body who def­i­nite­ly was a tourist who was vis­it­ing and exposed oth­er peo­ple, so it’s not 100%.

OK

If I could com­mu­ni­cate one thing to the pub­lic that I think is real­ly impor­tant it’s that almost all of our cas­es are friends and neigh­bors, or rel­a­tives com­ing to vis­it the islands, com­ing to vis­it your home and not wear­ing a mask and not being social­ly dis­tanced. That’s where the infec­tions are occur­ring. It’s not the walk­ing down the street, or at the gro­cery store. Those are uncom­mon ways to get the disease.

I think we still need to wor­ry about tourism, we need to be very dili­gent about it. Typ­i­cal­ly if you get a case the first thing you do is as, “where is the off-island con­tact?” And it’s always going to be an off-island per­son because we don’t have it in our community.

We’ve had the strongest mask­ing pol­i­cy in the state in place since May. And that’s a big part of what has allowed us to be successful.

The facial cov­er­ing order is one of at least two times that I’m aware of – the oth­er being your order lim­it­ing the use of tran­sient accom­mo­da­tions – when you issued orders that were more restric­tive than what the State was requiring.

Ini­tial­ly I want­ed that mask­ing order to be aimed at indi­vid­u­als. And I want­ed the sher­iff to enforce that mask­ing order with a $1,000 fine and up to 90 days in jail. The sher­iff very kind­ly told me he didn’t have the staff to do that. So we changed direction.

Our mask­ing order is not tech­ni­cal­ly direct­ed at the tourist or the indi­vid­ual com­ing into the store. It’s the respon­si­bil­i­ty of the busi­ness own­er to not allow any­body in with­out a mask. That turned out to be an even bet­ter way to do it, because the store own­er, the busi­ness oper­a­tor, they’re smart. They’re pro­tect­ing them­selves, they’re pro­tect­ing their employ­ees, and they’re pro­tect­ing their patrons. And they get to blame me for doing it. It’s perfect.

(laugh­ter) As long as you can take the heat.

Well, I’m not there, nobody is going to shoot me. It’s actu­al­ly turned out to be a very good way of doing things. Nobody else has repli­cat­ed that and I think they were fool­ish not to. I’ve actu­al­ly asked my fel­low health offi­cers around the State why they don’t have a sim­i­lar rule. And they’re all afraid of a dozen peo­ple hol­ler­ing at them. And there were peo­ple that hollered at me. So they holler, big deal. If you can pro­tect people’s health, if you can save their lives, that takes precedence.

And we’ve had almost no prob­lems with it at all. But it has put an addi­tion­al bur­den on the gro­cery stores, the phar­ma­cies, and oth­er busi­ness­es. They’ve also had to find ways to deliv­er those ser­vices at the curb­side, for peo­ple who don’t want to come in. Or by deliv­er­ing things to their homes. Our busi­ness­es have been very cre­ative in doing that.

With tran­sient accom­mo­da­tions, there was no way to turn the flow of peo­ple com­ing here off, except by lim­it­ing camp­ing and tran­sient accom­mo­da­tions. And we did that for a num­ber of months. Then we real­ized that we real­ly need to loosen up on this a lit­tle bit because a lot of peo­ple are going to go bank­rupt. And so we began to look at how we can relax those requirements.

And I think we’ve done – peo­ple will be crit­i­cal no mat­ter what you decide – but I think we’ve done a remark­ably good job in bal­anc­ing the pub­lic inter­est and those pri­vate inter­ests. Peo­ple need to make a living.

How do you see the bal­ance between pub­lic health and eco­nom­ic well-being?

I’ve nev­er felt more pres­sure in my life than when I’ve had to make the deci­sions that real­ly bal­ance liveli­hood and life. Those are the hard­est deci­sions that any­one will ever be asked to make. Because peo­ple do go bank­rupt, peo­ple do lose their home. There are big eco­nom­ic con­se­quences for indi­vid­ual peo­ple. And I’m just hop­ing to find that balance.

Like with the sum­mer camps. We’ve got a lot of sum­mer camps in our coun­ty. And I had to sit down with all of them and say ‘can you make it if we don’t allow you to open this year.’ Every one of them said that they would sur­vive to the next year. And that gave me great hope that we were going to do some smart things that would impact them but that they were all going to still be here next year.

Anoth­er chal­lenge is that almost half of the indi­vid­u­als in our coun­ty are high risk. And that’s a very sober­ing thing. We have to do what­ev­er we can to keep the virus out. At the same time, peo­ple have to make a liv­ing or they’re not going to be here next year either.

These are dif­fi­cult times. I’m very fear­ful of sub­stan­tial future eco­nom­ic impacts that we haven’t real­ly begun to appre­ci­ate yet. So I think we need to be as healthy eco­nom­i­cal­ly as we can be because there are like­ly to be more hard times ahead.

So that’s the hard­est thing for me. I can’t say too many good things about the busi­ness peo­ple in our com­mu­ni­ty who are car­ry­ing that load, who’ve said, “I’m going to do the right thing. Tell me what the sci­ence says.” I haven’t had irra­tional oppo­si­tion from any­body. Peo­ple real­ly ask how can we make this hap­pen. And for that I am eter­nal­ly grate­ful. What makes us suc­cess­ful and makes it work for the com­mu­ni­ty is that willingness.

Busi­ness­es have been very — in many ways they’re the heart and soul of our response. Peo­ple are crit­i­cal of them for want­i­ng to make a liv­ing. But they are also doing what they need to do to pre­vent this from get­ting worse. And pro­vid­ing real lead­er­ship and hon­est partnership.

Many peo­ple have my phone num­ber, but I have the phone num­ber of lots of com­mu­ni­ty lead­ers too. And I can call local busi­ness lead­ers and ask them what’s prac­ti­cal. It’s got to be that way to be successful.

There’s a good bal­ance too with regard to our elect­ed offi­cials. All three of our com­mis­sion­ers are strong per­son­al­i­ties. They are advo­cates for their island and their com­mu­ni­ty and they’ve pro­vid­ed strong lead­er­ship too. They’ve pro­vid­ed the resources that we need in a real­ly hard time. I think they’re $2.5 mil­lion in the hole right now and they are try­ing to fig­ure out how to bal­ance that bud­get. And they are still try­ing to find resources we need to get the job done.

We’re for­tu­nate that we have such sol­id peo­ple in those roles. We don’t agree about every­thing. Polit­i­cal inter­ests and med­ical inter­ests are often the same, but some­times they are dif­fer­ent and we cer­tain­ly have dif­fer­ences. But the fact is that they’re com­mit­ted to a civ­il process of learn­ing and prac­ti­cal accommodation.

I’m sure they’ve been unhap­py with some deci­sions I’ve made. I make all my deci­sions inde­pen­dent­ly and I don’t ask for their approval. In an emer­gency I can write some­thing down and sign it and it’s the law. If you ever want to be intim­i­dat­ed think about what that would be like.

That’s a lot of respon­si­bil­i­ty to have on your shoulders.

It’s huge.

The thing some peo­ple occa­sion­al­ly for­get is that we have to play by the virus’s rules. It wants to repro­duce by infect­ing as many peo­ple as it can. That’s the only log­ic it’s got. And it isn’t going to change because we want it to change. We have to be smarter than it. Until we get a vac­cine or med­ica­tions, we’re going to have to keep doing some pret­ty dra­con­ian things to keep this bug at bay. We’re going to have to lim­it people’s free­doms. And those are hard things.

We’re real­ly for­tu­nate that we have a com­mu­ni­ty that’s cohe­sive, that real­ly sees the greater good and wants to pro­vide for the greater good. I feel grate­ful every day that we have a com­mu­ni­ty like that. There are many com­mu­ni­ties where there is seri­ous dis­cord and disfunction.

What did you think about the Depart­ment of Health deci­sion to return the county’s phase three appli­ca­tion? It seemed like a it was a bit of a relief to every­one that the State made that decision.

You prob­a­bly know that I asked the Coun­ty to drop our appli­ca­tion. And the rea­son for that kind of got lost — I’m not sure it was ever clear­ly enough understood.

What had hap­pened between our appli­ca­tion being sub­mit­ted and before it was act­ed on was that a big body of data, that I knew was in the works, final­ly fell. And it made real­ly clear that there is aerosol spread of the dis­ease. And up to that point, the under­stand­ing had been that aerosol spread didn’t hap­pen. So that’s the main thing that was dif­fer­ent and I real­ly thought we need­ed to bring that appli­ca­tion back and rethink it. And I think I got out ahead of the Coun­cil in terms of under­stand­ing that.

And it was also a dif­fi­cult thing because if the Coun­cil with­draws it, it doesn’t start again unless I start it. And then it goes to the Board of Health, who can actu­al­ly change what I rec­om­mend, but then when it goes to the Coun­cil it’s just thumbs up or thumbs down. So I think they liked the prod­uct they had and want­ed to keep that option open. I hadn’t had the oppor­tu­ni­ty real­ly, to help them under­stand ful­ly why I didn’t think that was a good idea. And I think it was a relief to every­body. A lot of these things, once they hap­pen, peo­ple say, oh, that wasn’t so bad.

What’s your view on local schools open­ing in the fall?

I met with three of the four super­in­ten­dents in the coun­ty on Mon­day and I think we are on the same page. And I’ve exchanged infor­ma­tion with the oth­er super­in­ten­dent and I think she’s also on board. Of course, it’s the school boards and not the super­in­ten­dents that make these deci­sions, but I think the con­sen­sus, at least at the super­in­ten­dent and my lev­el, is that it real­ly isn’t going to be safe with the cur­rent lev­el of spread to open schools like they were open in the past. And I think we’re going to have to find a way to do that online learn­ing part. So I think that there’s going to be a dis­tance learn­ing pri­mar­i­ly for all the schools in the coun­ty. I think that peo­ple are large­ly on board with that.

The risk to kids is prob­a­bly not very great. We know a lot about mor­tal­i­ty, kids don’t die much from this at all. There hasn’t been a death under 19 years of age in the State yet. But we know less about the mor­bid­i­ty (lin­ger­ing effects). There may be long term impacts. With oth­er dis­eases, like measles, we know that the immune sys­tem is debil­i­tat­ed for a peri­od of years after­wards. Not weeks or months. There may be things like that with this virus that we don’t know about yet.

So I think it’s a very pru­dent thing to do and I think most places are think­ing about not open­ing up ful­ly. A full spec­trum school, with kids in the build­ing, prob­a­bly not until Jan­u­ary. This idea of groups of 30 walk­ing down halls and fil­ing off into rooms and then fil­ing out and mix­ing up with more peo­ple, that was designed to spread dis­ease. Clear­ly there are some kids who need to have face to face inter­ac­tion, who are only going to learn if they have that avail­abil­i­ty. It’s going to have to be an orga­nized effort with each school.

Anoth­er thing about schools that peo­ple in edu­ca­tion don’t talk much about is hav­ing a safe place for kids to go while their par­ents are work­ing. That’s a very impor­tant crit­i­cal func­tion of schools. So I’m try­ing to work with the super­in­ten­dents to find ways to keep kids engaged in a sys­tem that pro­vides for safe places for kids to be while their par­ents are work­ing. I think they can do that a lot eas­i­er if they are not mix­ing it up with the cur­ricu­lum. We need to assure that func­tion, not just the edu­ca­tion­al func­tion. Each island will find its own solu­tion to that ques­tion of where a safe place is for kids and they are com­ing up with very cre­ative and neat solu­tions that are real­ly indi­vid­ual to their community.

On Orcas, you’re real­ly lucky. Ork­i­la is a great facil­i­ty where there can be dis­trib­uted edu­ca­tion in small groups and build­ings all over the place if they can work out the details. On Lopez they are build­ing these two or three fam­i­ly bub­ble units and kids will just kind of stick in there and spend time with that in and out of school, which I think is real­ly a smart idea as well. There are lots of great ideas com­ing forward.

It requires think­ing out­side the box, find­ing ways to social­ize that gets kids togeth­er and do it safe­ly and then com­part­men­tal­ize that aca­d­e­m­ic piece and do it through online cur­ricu­lum. I’ve been very impressed by the work that our super­in­ten­dents are doing to devel­op plans that real­ly make sense. Because if we don’t do that, if peo­ple just go back to their bricks and mor­tar school, I think we’d see the biggest wave we’ve seen of the dis­ease. Hon­est­ly, I’m not ready for that. I don’t want that to happen.

Through the UW, I’m on a com­mit­tee for one of the lead­ing vac­cines that’s being devel­oped, so I’m pret­ty famil­iar with sev­er­al of the lead­ing vac­cines. If every­thing goes well, they’ve got a very good chance of being in a usable form and proven safe and effec­tive by Jan­u­ary. Once we have that, most of the experts agree that between 40% and 60% need to be pro­tect­ed to stop the epi­dem­ic and we can all go back to a more nor­mal life. And that could be pret­ty quick­ly achieved with a vaccine.

Giv­en your pri­or expe­ri­ences in the coun­ty what lev­el of accep­tance do you think there will be around use of a vac­cine if and when one becomes available?

I think we would be look­ing at 50% par­tic­i­pa­tion, and that’s prob­a­bly going to work. Our vac­cine accep­tance lev­el is low­er than in oth­er places, but when there’s actu­al­ly been an out­break, such as with measles, most every­body lines up and gets immu­nized. There are very few peo­ple that don’t. So there’s some hes­i­tan­cy but that can be over­come by knowledge.

The big­ger wor­ry for me is that because of the inter­rup­tions in rou­tine immu­niza­tions I think there is a real risk for per­tus­sis, for measles, for chick­en pox in the fall among the school age pop­u­la­tion. Hope­ful­ly, we’re going to have a milder year with the flu because every­body is walk­ing around with masks and wash­ing their hands, so that can pre­vent a flu out­break this year essen­tial­ly. It would be nice not to have that on top of this because they are sim­i­lar in their clin­i­cal pre­sen­ta­tion and that would be a real challenge.

My last ques­tion is about what this expe­ri­ence has been like for you on a per­son­al lev­el. What you do to try and main­tain a sense of bal­ance through all of this?

For more than 30 years I’ve had a cou­ple of habits. I get up in the morn­ing and I do about a 20-minute yoga rou­tine that I do just by myself. I get an aer­o­bic pump, I get stretched and it qui­ets my brain down. Then I sit and med­i­tate for 25 min­utes or so. That 45 min­utes of time is my gift to myself every day. That real­ly reju­ve­nates me and I can start my day more effec­tive­ly because of that. It’s always been impor­tant to me, but it is real­ly impor­tant to me now. For that space of time, I can live in the present moment, and the present moment isn’t so bad. Not wor­ry­ing about the past, not wor­ry­ing about the future. I find that 45 min­utes to be extreme­ly help­ful in tak­ing the bur­den off. I try to do it every day, if I miss a day my wife is on my case about it.

And then there’s the incred­i­ble sup­port of our com­mu­ni­ty. Of course, the staff I work with as a team. We sup­port each oth­er. And the emails and tele­phone calls I get from peo­ple are real­ly uplift­ing. Who knows why they call or send an email when they do? But it means the world to me. Some days I’ll be doing some­thing real­ly hard, I’ll be emo­tion­al­ly exhaust­ed, I won’t have got­ten enough sleep, and I’ll get these emails from peo­ple just say­ing, “I know what you’re going through. We’re sup­port­ing you and you’re doing the right thing. Keep going.” I get a lot of those and it real­ly helps.

So the very fact that we have com­mu­ni­ty. It’s real­ly impor­tant to me. What allows me to keep going at a strong pace is the team that I work with and the com­mu­ni­ty that sup­ports us. And the com­mu­ni­ty is the ones doing the work – putting on the masks, mak­ing the finan­cial sac­ri­fices. They are the peo­ple that are mak­ing this possible.

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One comment...

  1. Dr. James, as stat­ed in the inter­view, has great pow­er in our island com­mu­ni­ty and I’m glad to hear more of his respon­si­bil­i­ties, per­spec­tive and cre­den­tials. I feel we’re in good hands with him and the rest of the team mak­ing these hard deci­sions, for the bal­anc­ing act between the econ­o­my and the poten­tial spread of the bug is not one I’d wish to carry. 

    And, final­ly, I’m hear­ing what is so log­i­cal to me, that there could be lit­tle to no flu sea­son this year because of our new habit (should have been in place all along) of wash­ing our hands, not touch­ing our face, and using masks and per­son­al space dis­tanc­ing to avoid get­ting sick, no mat­ter the bug! Like he says, with all the prob­lems of rec­og­niz­ing Covid-19, we don’t need the com­mon cold or flu com­ing along and mess­ing with our minds and med­ical staffs.

    Comment by Jim on August 13, 2020 at 6:45 am

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