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How Do You Lead a State’s Coronavirus Response? Ask Her How Do You Lead a State’s Coronavirus Response? Ask Her
(8 days later)
— Dr. Ngozi Ezike, director of the Illinois Department of Health— Dr. Ngozi Ezike, director of the Illinois Department of Health
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A few weeks ago, Dr. Ngozi Ezike’s four children — ages 17, 16, 13 and 11 — sat her down to deliver a PowerPoint presentation they had put together.A few weeks ago, Dr. Ngozi Ezike’s four children — ages 17, 16, 13 and 11 — sat her down to deliver a PowerPoint presentation they had put together.
It was a detailed assessment of how she was doing in her job as the leader of the Illinois Department of Public Health.It was a detailed assessment of how she was doing in her job as the leader of the Illinois Department of Public Health.
“It was like, ‘Well, we’re really proud that you’re doing this important work. It’s cool that you’re on TV,” recalled Dr. Ezike, “‘But now we’re totally over it.’”“It was like, ‘Well, we’re really proud that you’re doing this important work. It’s cool that you’re on TV,” recalled Dr. Ezike, “‘But now we’re totally over it.’”
Their main complaint: She was never home anymore. While family friends were filling the gap, checking in on them and dropping off treats every now and then, they felt like they hadn’t seen their mom in weeks. And when she did get home, she was on the phone late.Their main complaint: She was never home anymore. While family friends were filling the gap, checking in on them and dropping off treats every now and then, they felt like they hadn’t seen their mom in weeks. And when she did get home, she was on the phone late.
“They were breaking it down for me from their perspective,” said Dr. Ezike in a recent phone interview, which happened to take place on the same day as her youngest child’s birthday. “It hurt.”“They were breaking it down for me from their perspective,” said Dr. Ezike in a recent phone interview, which happened to take place on the same day as her youngest child’s birthday. “It hurt.”
“But I hope they’ll understand better with time why I had to sacrifice so much time away from them.”“But I hope they’ll understand better with time why I had to sacrifice so much time away from them.”
Like Dr. Ezike, women across the country have been at the forefront of states’ round-the-clock, all-consuming emergency responses: More than 60 percent of state health directors are women, according to the Barbara Lee Family Foundation.Like Dr. Ezike, women across the country have been at the forefront of states’ round-the-clock, all-consuming emergency responses: More than 60 percent of state health directors are women, according to the Barbara Lee Family Foundation.
As appointed officials, state health directors typically play a behind-the-scenes role, identifying, tracking and planning interventions around public health risks.As appointed officials, state health directors typically play a behind-the-scenes role, identifying, tracking and planning interventions around public health risks.
But this crisis has catapulted them into the spotlight, standing side by side with governors and mayors, quickly turning them into some of the country’s most recognizable faces. (Ohio’s Dr. Amy Acton, for example, has become something of a local icon, with fan clubs and merchandise dedicated to her.) It is up to state health directors to corral data and come up with policy proposals for advising governors and the rest of the state on things like when to shut down, how to reopen businesses safely and where to set up testing sites.But this crisis has catapulted them into the spotlight, standing side by side with governors and mayors, quickly turning them into some of the country’s most recognizable faces. (Ohio’s Dr. Amy Acton, for example, has become something of a local icon, with fan clubs and merchandise dedicated to her.) It is up to state health directors to corral data and come up with policy proposals for advising governors and the rest of the state on things like when to shut down, how to reopen businesses safely and where to set up testing sites.
But, in a combustible environment of heightened anxiety and increasingly partisan clashes over the emergency measures put in place, their every move and statement is scrutinized and dissected from every angle.But, in a combustible environment of heightened anxiety and increasingly partisan clashes over the emergency measures put in place, their every move and statement is scrutinized and dissected from every angle.
“I try to just stick with what’s the right thing to do and let the politicians do what they have to do,” said Dr. Ezike. “No one is positive of the exact right course — we’re building the plane as we’re trying to fly it.”“I try to just stick with what’s the right thing to do and let the politicians do what they have to do,” said Dr. Ezike. “No one is positive of the exact right course — we’re building the plane as we’re trying to fly it.”
The criticism her team receives — and there is a lot, particularly over reopening the economy — is balanced out by the “many letters and cards of support and encouragement” sent to her offices, she added.The criticism her team receives — and there is a lot, particularly over reopening the economy — is balanced out by the “many letters and cards of support and encouragement” sent to her offices, she added.
These days, Dr. Ezike’s itinerary of back-to-back meetings and calls kicks off at 6 a.m., when she gets daily updates from local health departments and emergency management and alternate care sites. Then there’s the televised news conference with Governor J.B. Pritzker, during which Dr. Ezike provides critical updates and takes questions from the news media. On some days, Dr. Ezike’s team takes calls from the White House, the Centers for Disease Control and Prevention and health directors from other states. Her day doesn’t end until about 11 p.m., she said, at which point she tries to go through her emails.These days, Dr. Ezike’s itinerary of back-to-back meetings and calls kicks off at 6 a.m., when she gets daily updates from local health departments and emergency management and alternate care sites. Then there’s the televised news conference with Governor J.B. Pritzker, during which Dr. Ezike provides critical updates and takes questions from the news media. On some days, Dr. Ezike’s team takes calls from the White House, the Centers for Disease Control and Prevention and health directors from other states. Her day doesn’t end until about 11 p.m., she said, at which point she tries to go through her emails.
“But I’m struggling with that,” she confessed.“But I’m struggling with that,” she confessed.
Illinois, while not the country’s worst hot spot, has undeniably been hit hard.Illinois, while not the country’s worst hot spot, has undeniably been hit hard.
On Jan. 30, the first human-to-human transmission of the coronavirus in the U.S. was reported in Chicago — between a wife who had traveled to Wuhan, China, and her husband.On Jan. 30, the first human-to-human transmission of the coronavirus in the U.S. was reported in Chicago — between a wife who had traveled to Wuhan, China, and her husband.
Dr. Ezike visited the couple in the hospital and it became clear to her the kinds of troubles that the country was about to face.Dr. Ezike visited the couple in the hospital and it became clear to her the kinds of troubles that the country was about to face.
“We were waiting for official test results to return from the C.D.C. because we didn’t yet have the ability to run the test at our public health labs in Illinois,” she recalled. “The gentleman was considering ‘releasing himself’ from the hospital isolation — he was concerned about missing work and not providing for his family while sitting in isolation.”“We were waiting for official test results to return from the C.D.C. because we didn’t yet have the ability to run the test at our public health labs in Illinois,” she recalled. “The gentleman was considering ‘releasing himself’ from the hospital isolation — he was concerned about missing work and not providing for his family while sitting in isolation.”
“In those moments, I gathered my first inkling of the challenge to be faced in containing this virus and how one’s personal economic or financial situation would affect decisions that would affect not just the individual but the community as a whole.”“In those moments, I gathered my first inkling of the challenge to be faced in containing this virus and how one’s personal economic or financial situation would affect decisions that would affect not just the individual but the community as a whole.”
Updated July 27, 2020 Updated August 4, 2020
Then on March 21, Illinois became one of the first three states to implement stay-at-home orders.Then on March 21, Illinois became one of the first three states to implement stay-at-home orders.
“I think that significantly helped,” Dr. Ezike said.“I think that significantly helped,” Dr. Ezike said.
To date, there have been more than 100,000 cases of coronavirus in Illinois and more than 4,900 deaths, bringing the state’s fatality rate to about 39 deaths per 100,000. That number is far below the country’s top three hot spots: New York, which has a fatality rate of 150 deaths per 100,000, New Jersey, where the rate is about 125 per 100,000, and Connecticut, which has a rate of about 105 per 100,000.To date, there have been more than 100,000 cases of coronavirus in Illinois and more than 4,900 deaths, bringing the state’s fatality rate to about 39 deaths per 100,000. That number is far below the country’s top three hot spots: New York, which has a fatality rate of 150 deaths per 100,000, New Jersey, where the rate is about 125 per 100,000, and Connecticut, which has a rate of about 105 per 100,000.
But Illinois also has some of the country’s largest black and Hispanic populations — communities that, according to the C.D.C., are at a greater risk of dying from the disease, in part because of longstanding inequalities that have made access to health care harder. Thirty percent of the people who have died in Illinois are African-American, according to the state’s public health department.But Illinois also has some of the country’s largest black and Hispanic populations — communities that, according to the C.D.C., are at a greater risk of dying from the disease, in part because of longstanding inequalities that have made access to health care harder. Thirty percent of the people who have died in Illinois are African-American, according to the state’s public health department.
Most of those communities are largely concentrated in Cook County, which includes Chicago and its suburbs. The county currently has the most confirmed cases in the entire country, according to data from Johns Hopkins University. And, in early April, Cook County Jail became one of the country’s largest coronavirus clusters, with more than 1,000 infections among inmates and staff and six deaths.Most of those communities are largely concentrated in Cook County, which includes Chicago and its suburbs. The county currently has the most confirmed cases in the entire country, according to data from Johns Hopkins University. And, in early April, Cook County Jail became one of the country’s largest coronavirus clusters, with more than 1,000 infections among inmates and staff and six deaths.
These concerns were always top of mind, Dr. Ezike said. Before becoming Illinois’s health director, she spent 15 years at the Cook County Department of Public Health and was the medical director of the Cook County Juvenile Temporary Detention Center so she had seen the gaping socioeconomic disparities between communities and how that gap can have a knock-on impact on health care access.These concerns were always top of mind, Dr. Ezike said. Before becoming Illinois’s health director, she spent 15 years at the Cook County Department of Public Health and was the medical director of the Cook County Juvenile Temporary Detention Center so she had seen the gaping socioeconomic disparities between communities and how that gap can have a knock-on impact on health care access.
“This virus didn’t create health disparities,” she said. “It’s just magnifying them.”“This virus didn’t create health disparities,” she said. “It’s just magnifying them.”
From the outset, she had her eye trained on the most vulnerable, including essential workers, many of whom are from minority communities. She has incorporated their needs into all of the state’s response proposals, from getting P.P.E. to those who need it most to providing targeted messaging and information. Dr. Ezike herself delivers her updates during the daily news conference in English and Spanish.From the outset, she had her eye trained on the most vulnerable, including essential workers, many of whom are from minority communities. She has incorporated their needs into all of the state’s response proposals, from getting P.P.E. to those who need it most to providing targeted messaging and information. Dr. Ezike herself delivers her updates during the daily news conference in English and Spanish.
The virus has touched Dr. Ezike’s own circle, too: Extended-family members and family members of her co-workers have been infected, she said.The virus has touched Dr. Ezike’s own circle, too: Extended-family members and family members of her co-workers have been infected, she said.
In February, before the coronavirus upended the world as we knew it, Dr. Ezike lost her father, an immigrant from Nigeria who spent most of his life in Los Angeles.In February, before the coronavirus upended the world as we knew it, Dr. Ezike lost her father, an immigrant from Nigeria who spent most of his life in Los Angeles.
“I did bury him. We had very elaborate ceremonies for him in three cities and two continents,” she said over the phone.“I did bury him. We had very elaborate ceremonies for him in three cities and two continents,” she said over the phone.
She added: “But I think about how people can’t do that now and how difficult that can be. I think about that every time I think of the deaths we are reporting each day.”She added: “But I think about how people can’t do that now and how difficult that can be. I think about that every time I think of the deaths we are reporting each day.”
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