In the past 20 years, Nevada County’s deputy public health officer has seen several pandemics and national public health emergencies. But when COVID-19 exploded in early 2020, Dr. Glennah Trochet for the first time saw a federal response that she characterized as incompetent and at odds with standard practices proven to reduce disease.
As a result, many Americans lost trust in the steps they were being asked to take, Trochet said. Many people have died needlessly.
Dr. Glennah Trochet, M.D.
Nevada County deputy health officer
– Medical doctor, University of Pennsylvania School of Medicine
– Residency in family medicine, Baylor College of Medicine, Houston, Texas
– California Physicians Alliance member
– Heroes in Healthcare award, Ingram’s magazine, 1997
– Other awards and recognitions from bodies including U.S. Congress, Federal Bureau of Investigation, California State Senate, Sacramento County Board of Supervisors & Sacramento City Council
The experience shows the importance of leadership that has “the best interests of the whole country at heart,” Trochet concluded. The United States of America did not have that kind of leader for the pandemic’s first year, she argued. Instead, mixed messages and confusion prevailed, and they proved fatal.
“Leadership really matters,” Trochet added, “and it matters in a big way.”
Isolation & quarantine worked, but people grew impatient
In the early months of the novel coronavirus pandemic, Nevada County kept cases and deaths relatively low: 41 cases through May 2020, according to the county’s COVID-19 dashboard. Those figures prove that measures ordered by the county Public Health Department — quarantines and isolations, business shut-downs, masks, handwashing and physical distancing — slowed the contagion.
An example of that success is the county’s Wayne Brown Correctional Facility in Nevada City.
Trochet is a medical doctor and former health officer for Sacramento County who began working for Nevada County early in the pandemic. During that time, she worked with local institutions where large groups of people live together, especially nursing homes, assisted living centers and the county jail. She helped managers there create plans for how they would respond, should a COVID-19 case appear or if a staff person were exposed to the virus. Nevada County was a step ahead when the state of California later mandated such plans, Trochet added.
“Unlike most jails, the Nevada County jail has not had an outbreak, because they have been very strong about quarantining all their new inmates, testing, and isolating people who show symptoms,” Trochet said. Although individuals have tested positive, the practices of testing, quarantine and isolation have prevented sickness from spreading. “The jail is a stand-out compared to any other correctional institution in California,” she said. Other local group residences avoided outbreaks for many months by taking similar precautions, Trochet added.
“In the absence (at the time) of knowing how to treat this disease, isolation and quarantine really worked to stop it,” Trochet said.
But people grew impatient.
Their impatience was stirred by what Trochet called “mixed messages” about how to stay safe. “You need to give a consistent message all up and down the public health hierarchy,” she said. That’s what Trochet saw at the federal level during previous pandemics, regardless of the political party in power. But during the former Trump Administration, she said, “people became extremely confused when we had people at the federal leadership say the opposite of what we were saying at the local level, and in the end, people didn’t trust anyone. Anything you said, people discounted it.”
In April and May 2020, cases were surging in New York and Los Angeles, where hospitals were overwhelmed. In contrast, Nevada County cases stayed fairly flat.
“A lot of people started saying, ‘Oh, there’s no surge!,’ that (the shutdown) was all wrong, when, in fact, what happened was, the shutdown worked,” Trochet argued. “The fact that nothing happened (in Nevada County) was a success. But nobody, nobody, looked at it that way.”
“We wish we had opened slowly after that,” Trochet added, “but folks started discounting all the measures that should have continued to be in place.”
Missing: Concern for public good at highest level, Trochet says
As a result, and combined with seasonal celebrations, COVID-19 cases rose steadily through the summer of 2020. In October, as weather cooled and people gathered in closed spaces, cases soared.
On Dec. 7, 2020, the county reported a record 134 new cases. The 7-day running average of daily new cases peaked at 61, with a total of 1,776 confirmed cases since the beginning of the pandemic, according to the county’s COVID-19 dashboard.
Deaths spiked from a total of 9 people by Nov. 30 to 50 dead by Dec. 31, county data shows.
The pandemic so far has sickened nearly 5,000 people and claimed 75 lives in Nevada County, according to county figures. Nationwide, more than 33.6 million Americans have gotten sick, and more than 604,000 have died, according to the Johns Hopkins University Coronavirus Resource Center.
“The only way we could have prevented (those deaths) is if we had had someone in the leadership who had the best interest of the country at heart, and I don’t believe we did. That was the difference between all the other pandemics and this one. (In previous pandemics,) the leadership really did have the best interests of the whole country at heart,” Trochet said.
“It wasn’t political parties. It was leadership that cared about the American people.”
Previous pandemics, different results
Trochet came to the Sacramento area in 1980 and practiced family medicine for 15 years before shifting into public health. She was the doctor for the faith-based Loaves and Fishes, the largest homeless services provider in Sacramento County; medical director of the county-run medical clinics; and in 1999, she became the Sacramento County health officer.
During those years, Trochet watched both Republican and Democratic presidents respond to public health emergencies. In 2001, anthrax bacteria sent through the U.S. Postal Service marked the first acts of biological terrorism. “That’s when public health went into overdrive,” Trochet recalled.
In 2002, the first cases of a coronavirus causing serious illness in people (rather than in animals) emerged in China to cause SARS, or severe acute respiratory syndrome, according to research published in the U.S. National Library of Medicine.
In 2009, the swine flu pandemic appeared; it was caused by a variant of the H1N1 influenza virus that had unleashed the pandemic of 1918-19. (Both are “influenza A” viruses.) The 2009 variant was found first in the United States, and is genetically related to other flu viruses that infect people, birds and pigs, according to researchers.
In 2012, another coronavirus arose causing MERS, or Middle East respiratory syndrome. The first outbreak was detected in Saudi Arabia, and the virus may have originated in camels, according to the World Health Organization.
New health concerns came in 2014, when the first Ebola virus infection was reported in the United States. Discovered in 1976 in the Democratic Republic of the Congo, Ebola-type viruses are believed to have originated in apes or bats, according to the U.S. Centers for Disease Control and Prevention.
During each of those events, “we had competent leadership all the way up the line, through the federal government,” Trochet recalled. “Anyone who came from any country (where there was an outbreak) had to be quarantined.” The CDC identified sick people and told local health departments, which were required to monitor patients for two weeks to limit the diseases’ spread.
During the SARS epidemic, Trochet monitored about 70 people in the Sacramento, she said. In 2009, a case of swine flu led her to close down a Sacramento-area school, and her office monitored 194 families for a week. That outbreak was held to three cases, and when vaccinations became available, people received them eagerly, she said. Other global outbreaks had little effect on the greater Sacramento region, she added.
Regardless of which political party was in the White House, the response to each health emergency was coordinated and consistent among different levels of government. As a result, cases were fairly limited and deaths relatively few. “There was great leadership from the local through the state through the federal” levels during those outbreaks, Trochet recalled.
Latest federal response ‘not like the others’
But in early 2020, just before she went to work for Nevada County, Trochet noticed something very different in the federal response to early news from China of the new coronavirus striking there. “We knew Italy was having an outbreak, but the federal government only stopped people coming from China and had them quarantined. Not a single person coming from Europe was quarantined,” Trochet recalled. “We said, ‘What about people from Italy?’… That was my big ‘a-ha!’ moment. This federal response was not like the others…
“Having experienced competent responses, it was very hard to be (a public figure) and not be very critical of the federal response,” Trochet concluded. “It was very hard, because it was so bad. So bad.”