The Public Health Officer Emergency
TAMALEE ST. JAMES ROBINSON was working late again. It was fall 2020, and in Flathead County, Montana, where Robinson was serving as interim public health officer, COVID-19 cases had jumped tenfold from the summer. The schools were still open, and new cases meant Robinson routinely worked 10-hour days, even on week-ends. Around 9 p.m., a truck pulled into the empty Health Department parking lot, in clear view of Robinson’s office window. Something about it felt wrong; the truck’s engine was idling and its running lights were on. Robinson decided to move away from the window and take cover behind the two monitors at her workstation. That way, she thought, they can’t get a clear shot at me.
Eventually, the truck left. Robinson wondered if she’d overreacted. She thought about the previous week and realized that she’d been on edge ever since the county sheriff had called her. “Do you know how to shoot a gun?” he’d asked. He told Robinson that a man had threatened her, saying that he wanted to challenge her to a public duel. The sheriff told Robinson that such threats would not be tolerated, but he thought she should know about it, just in case.
This is not what Robinson expected when she moved here. Her original plan was retirement; after two decades working in public health in Billings, Robinson wanted to enjoy the mountains and lakes and relax with her husband. But in 2019, when she was asked to help chair the Flathead County Board of Health, she agreed. Then the pandemic hit, and the health officer, who had been offered another job, asked her to act as the county’s interim health officer while the Flathead City-County Health Department hired a replacement. “You could probably do it part time, maybe three days a week,” Robinson recalls being told. At the time, cases in the area were mercifully low; the pandemic had yet to hit Montana the way it had places like New York and Seattle. Robinson agreed to serve.
But shortly after Robinson took office in July, local COVID-19 cases spiked. The state of Montana issued a mask mandate for businesses, but enforcement was left to local and regional officials. At the same time, the state’s department of education deferred all decisions about masking in schools to local officials, as did the Montana High School Association, which manages school sports throughout the state. “Everything was thrown at local health officers,” Robinson said. “We had to make those decisions. And then when we made those decisions, based on our best information, (other leaders) came out against them.”
Before COVID-19, local health departments were all but invisible to the general public. Their work kept communities running — they handled septic tank regulations, infant and maternal health programs, food safety inspections, air and water quality readings and immunizations — but they rarely attracted attention. “Nobody realizes it day to day, because they don’t have to deal with (those issues) — because we prevent it,” Robinson says. Few citizens knew the names of their local health officers or health department board members.
But the pandemic changed everything. As COVID cases increased in Montana, discussion swirled around what precautions to take, and Robinson became an easily recognizable public figure — and a convenient scapegoat for local citizens’ fears and frustrations. Every day, hateful emails and phone calls accused her of threatening people’s constitutional freedoms and destroying businesses. Protesters lurked outside her office, holding signs that proclaimed “Tamalee is a tyrant” and “Got dictatorial powers? Tamalee does.”
By mid-October, hospitalizations and deaths
