Cut Adrift in Covid

The political intrigue and community outrage surrounding the November 5th firing of the Spokane Regional Health District's Health officer, Dr. Bob Lutz, by the Board of Health continues as the Covid-19 pandemic grinds on. Shawn Vestal, columnist for the Spokesman Review penned a scathing column in the Sunday, November 29, paper: The health board hired a replacement, but the void left by Lutz’s ouster remains. (I pasted it in the P.P.S below--but I also recommend a subscription to the paper.)

The SRHD BOH, along with the SRHD Administrator, Amelia Clark, in their ouster of Dr. Lutz, lost legitimacy in their mission to "...protect, improve and promote the health and well-being of all people through evidence-based practices." Dr. Lutz was well suited by education, lifelong interest, and prior service on the Board itself, whereas Dr. Velazquez offers eastern Washington bland generalities in what Mr. Vestal details as Velazquez' "thankless new job." Dr. Velazquz offers us the level of guidance and expertise one might expect of a corporate pathologist gamely willing to step in at the urging of Mr. French, a likely business acquaintance.

The SRHD Board of Health meets tomorrow (see P.S. below for details), but the motions to be considered at the meeting are likely to be only a sideshow. Mostly likely they will officially appoint the Health Officer interim replacement (Dr. Francisco Velazquez) and discuss (in a private Executive Session) the potential legal consequences of what they have done. With their politically motivated ouster of Dr. Lutz they have shown a spotlight on the fallacy of a Board of Health whose members lack expertise in the health, medical, or epidemiological mission they are supposed to manage and advise.

The solution? Like the upcoming change in county governance, the state legislature has the power to "turn the big knobs" by modifying the details of the make up and function county and municipal government. As Mr. Vestal points out, "That’s where Rep. Marcus Riccelli’s proposal for the upcoming legislative session comes in. Riccelli is drafting a bill that would change the nature of health district boards dramatically – requiring that they have at least as many health professionals as political appointees."

This issue needs to be kept alive in the public mind. We can help. Since at least 2016 the Spokesman, along with sponsorship from Numerica Credit Union has solicited nominations for ten "Difference Makers" in the Spokane Community whose stories are presented in the paper during the last days of December. There is a movement to nominate Dr. Bob Lutz as one of this year's Difference Makers. Presenting Dr. Lutz' story to the community is an important component of keeping the Board of Health's political gamesmanship in the spotlight. A feature article that highlights Dr. Lutz' selfless commitment to the mission of public health would help call out the political machinations of the BOH.

ACTION ITEM: Right now take just a few minutes to click on 2020 Difference Makers and help nominate Dr. Bob Lutz for this honor. He deserves it--and the community owes it to him. (Never mind the error in the form that asks for a "2019 Difference Maker") Eloquence in filling out the short form is, I'm sure, not required.

Keep to the high ground,

Jerry

P.S. Tomorrow at 12:30PM, Thursday, December 3, the Spokane Regional Health District (SRHD) Board of Health (BOH) holds its monthly meeting. (Watch here, if you wish, when the time comes.) This is the Board of Health that fired its Health Officer, Dr. Bob Lutz, in a four hour meeting just a month ago, amidst a storm of community protest. At that meeting, there was a shred of hope that the BOH might somehow correct its shameful action. City of Spokane City Council President Breean Beggs offered an amendment to the motion to appoint Dr. Velazquez as interim Health Officer as Dr. Lutz' replacement. The amendment specified that the interim appointment would be brought up for reconsideration at the December 3 [tomorrow's] meeting. With this amendment, Mr. Beggs, who voted against the firing of Dr. Lutz, succeeded in adding a tiny note of caution to County Commissioner Al French's surprise offering of Dr. Velazquez, a man with whom few, if any, members of the BOH were familiar,.as interim Health Officer

The agenda for tomorrow's meeting offers some interesting illumination: Action Item 6a, scheduled for 1PM, is the "Appointment of an SRHD Interim Health Officer." The interim appointment of Dr. Velasques is likely to pass with minimal discussion--an illustration of the power of motion-making. Commissioner French, wise to ways of Boards, did his homework. He swooped into the November 5 meeting of a Board he had rarely attended with two prepared motions, one to fire Dr. Lutz and the other a surprise motion, presented to an exhausted Board, to appoint Dr. Velazquez as interim Health Officer. No one else on the Board having done the homework necessary to offer a replacement for Dr. Lutz, the appointment carried with only minor murmurs of caution. Dr. Velazquez essentially became the incumbent Health Officer in that moment. Incumbency is powerful.

The agenda for tomorrow's meeting also offers a (supposedly) fifteen minute Executive Session out of the public eye: "Review of Qualifications of Applicant for Public Employment Pursuant to RCW §42.30.110(1)(g) and Litigation/Potential Litigation Pursuant to RCW §42.30.110(1)(i)" By Washington State law the BOH can contemplate the potential legal consequences (including the cost) of the action to fire Dr. Lutz. It is likely we have not heard the end of this story.

P.P.S. Shawn Vestal's November 29 column:

Dr. Francisco Velázquez – the hastily drafted interim health officer of the Spokane Regional Health District – showed up the day before Thanksgiving at his third public press conference, 25 days into the worst month of the pandemic and 16 days into his thankless new job.

At his first such appearance, at the district’s weekly Facebook Live event for the public on Nov. 13 – as local case numbers were reaching new peaks – he introduced himself, discussing his career at length and give a lot of kudos to the hard-working district team.

He didn’t talk specific cases or strategy.

At his second, Nov. 18, Velazquez focused almost entirely on a single metric: the fact that cases among the very oldest county residents had fallen since July. Good news!

At his third press conference Wednesday, right after we reached a new daily case peak of 499, Velazquez made a few exceedingly brief, exceedingly general remarks. He did not give a statistical picture of the current state of the pandemic in Eastern Washington. He did not provide information about local hotspots, the state of contact tracing or testing, or anything more detailed about what officials are seeing on the ground.

He did not – apart from some quick “we-all-know-this-stuff” mentions – drive a powerful message about masks and social distancing.

He very much emphasized people should continue to seek health care for non-COVID reasons if they need to, and reminded people that the governor’s “rollback” on the pandemic precautions would be expected to have an effect in the near future. He introduced two hospital executives who talked about hospital capacity.

He said we all have a lot to be thankful for this season.

“We can still have holidays,” he said. “We just have to plan them a little differently.”

You probably know the ways he means, and that’s good because he barely mentioned them.

In all, it was a genial, general, only glancingly informative appearance, in which Velazquez resembled a master of ceremonies, introducing the main acts and thanking everyone for their hard work.

Sadly, that’s been characteristic of the communications reality that has descended since the leaders of the health district rashly, irresponsibly and ineptly drove out Dr. Bob Lutz, a widely admired public health expert, because he was expressing views they didn’t like.

The result – at a moment of crucial importance – has been an unnecessary loss of one of the most vital leadership tools in any public health crisis: A reliable, consistent, specific source of information and expertise.

The district has continued to compile and release statistical information about the pandemic, almost entirely by press release. Many others have engaged with the press and the public in efforts to get out the word about the pandemic and best practices for fighting it. But the face of the pandemic fight is gone.

That’s what administrator Amelia Clark and the reckless politicians on the health board so casually trashed. Lutz was not a figurehead or cheerleader. He was deeply knowledgeable and had served as the district’s public face for months and months, steering our understanding of what was happening. He was before the public continually, providing details, answering questions and giving unequivocal guidance on health precautions.

On those grounds, he has simply not been replaced.

This is not meant as a knock on the district itself, whose epidemiologists, public health nurses and others have been doing valiant work. Neither is it meant as a knock on Velázquez himself, who by all accounts is a nice guy with a wide range of medical experience as a doctor and health care executive – though not, perhaps, a lot of experience specific to this role.

No, this is a knock on the health board and Clark, who could not have fashioned an uglier, less competent, more nakedly obvious political excommunication of Lutz. That they did so in a rushed fashion, seemingly without even a basic understanding of the law governing the hiring and firing of health officers, when there was no emergency and with no replacement plan, made it even worse.

There was simply no health rationale for doing what they did. None. The excuses from the political hit squad – who objected that Lutz wrote an op-ed column about racism, had marched in a mask at a Black Lives Matter rally and had contacted legislators about gun safety, among a raft of other petty and controlling complaints – were ludicrous.

It was a travesty. It was also nearly a month ago now, and we’ve had that time to get an even stronger sense of what we’re missing. It has only strengthened the sense that change is needed in the way the health district is run.

That’s where Rep. Marcus Riccelli’s proposal for the upcoming legislative session comes in. Riccelli is drafting a bill that would change the nature of health district boards dramatically – requiring that they have at least as many health professionals as political appointees.

Our board now has nine elected officials and three citizens representatives. None of the politicians are medical professionals. One of the citizen reps is a dental hygienist. Another is Jason Kinley, a naturopath who has shared conspiracy nonsense about the pandemic at a Matt Shea rally.

And he voted to keep Lutz!

It is impossible to imagine that a board with more health expertise would have done what this board did. We’re living with the consequences of that now.

Maybe when the next crisis rolls around – when fluoride or vaccinations find their way back into the public eye, say – we won’t have to.