• Missouri is especially vulnerable due to underfunded and understaffed public health departments
  • Amber Elliot's last day as a public health director is Friday. 
  • Health workers are emerging as one of the resources most difficult to replace in the pandemic

As the COVID-19 pandemic continues to ravage the South and Midwest, doctors are praised, but less commonly spoken about are the medical professionals outside the hospital. Public health workers like Missouri public health director Amber Elliot face not only the grueling task of mounting a communal defense against COVID-19 but also abuse from the very people they’re trying to protect.

“I get the same comments all the time over Facebook or email. ‘She’s a communist.’ ‘She’s a [expletive].’ ‘She’s pushing her agenda,’” Elliot wrote in a Washington Post article. “Okay, fine. I do have an agenda. I want disease transmission to go down. I want to keep this community safe. I want fewer people to die. Why is that controversial?”

Elliot faces a difficult task, even among public health workers. She says Missouri has the worst funding in the nation for public health, and her office is severely understaffed. During one stretch this summer, she worked 90 days straight.

“It’s a huge burden. For my staff, this has intersected all of their lives. We’ve worked around the clock for eight months, and it’s just not sustainable,” Elliot said in an interview with CNBC.

US health care workers and other first responders have been under intense strain as they battle to stem the spread of the coronavirus pandemic
US health care workers and other first responders have been under intense strain as they battle to stem the spread of the coronavirus pandemic AFP / Angela Weiss

Those factors are compounded by a community that refuses to cooperate with efforts to combat COVID-19. When Elliot’s small team of contact tracers calls people who have been exposed, around half are combative. Elliot says that number was maybe one in a hundred before COVID-19. Now, she says, they will outright lie to her, giving her fake names and numbers for people they’ve contacted or telling her they’re at home alone while a Walmart checkout machine beeps in the background.

And that was all before the threats started.

“I’ve stayed up a lot of nights trying to understand where this whole disconnect comes from. I love living in this county. I know in my heart these are good people, but it’s like we’re living on different planets,” Elliot says. “The more I talk about the facts, the more it seems to put a target on my back. ‘We’re tracking your movements.’ ‘Don’t do something you’ll regret.’”

With persistently low mask usage, her department decided to call for a mask mandate. They couldn’t even speak at the town hall they organized because the crowd was shouting at them. Some people had brought guns to the event. Someone followed her to her son’s baseball game to take pictures to post online with abuse.

In the end, it was more than she could take. Friday is Elliot’s last day as public health director. She can’t justify putting her kids at risk. She’s still committed to fighting the virus, but she won’t be doing it from a public position.

“I just can’t do it anymore,” Elliot writes. “I’ve already accepted another nursing job. I’m not abandoning the community. I’d rather not say anything much more specific. I don’t want that target on my back. I’m ready to be anonymous.”

The Missouri Department of Health and Senior Services has reported 262,436 cases of COVID-19 and 3,537 deaths from the virus so far this year, according to local ABC affiliate KMBC. The state of Missouri's public health dashboard notes that the state is currently averaging 3,718 new cases a day with 26,027 new positive diagnoses from Nov. 11 through Nov. 17.