Public Health Caught Up In National Mistrust Of Government and Science, Ramstrom Says 

Shasta County’s Public Health Officer is facing possible dismissal by county supervisors. Shasta Scout interviewed her after she released a public statement Friday saying she has received no specific information that her job performance has been unsatisfactory. Ramstrom has been the focus of public complaints about county COVID restrictions over the last two years.

Update: During a closed session of their Tuesday, May 3, meeting the Shasta County Board of Supervisors voted 3-2 to fire the county’s Health Officer, Karen Ramstrom, without cause. Supervisors Les Baugh, Patrick Jones and Tim Garman voted for Ramstrom’s termination while supervisors Mary Rickert and Joe Chimenti voted against.

Since early 2020 the country has seen the largest exodus of public health officials in American history. That was already true eighteen months ago when an analysis by Kaiser Health News and the Associated Press indicated that one in eight Americans lived in a community that had lost a public health department leader to resignation, retirement or firing since the onset of the COVID-19 pandemic. The mass exodus has obvious causes. In the midst of the long-term stress of providing public health management during an unprecedented pandemic virus, public health officials, including Shasta County’s Health Officer Dr. Karen Ramstrom, have also faced serious political backlash that has at times included public harassment and threats. 

Last month, Ramstrom was also subjected to an uncharacteristic closed-session employee evaluation by the Shasta County Board of Supervisors. While public health officers are appointed by the board, their employment does not usually revolve around the politics of changes in county supervisor elections. But since Tim Garman replaced former Supervisor Leonard Moty in a pandemic-related recall, the board has evaluated several employees behind closed doors. Those employees including Ramstrom, County CEO Matt Pontes and County Counsel, Rubin Cruse. 

Ramstrom told Shasta Scout during an interview Friday that she has been informed by the county that supervisors will consider discipline/dismissal/release of her at-will employment with the county in closed session during the May 3 supervisor meeting. Under the Brown Act, should the BOS decide to terminate her employment during that meeting they will be required to report it, although other disciplinary actions taken at closed session meetings may remain private.

It’s unclear what particular concerns supervisors have about Ramstrom’s professional performance. In a letter released to the public on Friday, April 29th, Ramstrom wrote that she has no specific information from the Board that her job performance has been unsatisfactory in any way. She included a quote from her supervisor Shasta County Public Health Director Robin Schurig, made as part of her October 2021 employee evaluation: “You have built such strong relationships and inspired such respect that I received an unprecedented 28 peer reviews from a variety of people, all with extremely positive things to say about your performance and your character.”

Schurig confirmed that statement for Shasta Scout Saturday, and said that Ramstrom’s October 2021 evaluation, as well as former evaluations of Ramstrom, have been entirely positive. Schurig, who holds a Masters in Public Health, said she has no concerns about Ramstrom’s job performance and has always been “impressed with her expertise, her dedication, her teamwork and her ability to build relationships in the healthcare sector and with other partners in the community.”

In her letter, Ramstrom referred to herself a public servant saying that she doesn’t want to leave her job, be “muzzled” or terminated. Calling her work with the Shasta County Board of Supervisors a partnership, Ramstrom wrote that she, and others in public health “worked together with the Board (throughout the pandemic) to find the best solutions in the midst of an insurmountable situation” and were never more restrictive locally than required by the state. Citing the dedication and hard work of her staff, Ramstrom said they deserve recognition for the education and support provided to the Shasta County community. 

County CEO Pontes, who has also been subject to a closed-door evaluation by supervisors, recently released a statement, alleging he’s faced blackmail from Supervisor Patrick Jones. Pontes says that Jones tried to force him to resign by threatening to reveal his criminal history which includes a charge of felony theft from almost thirty years ago which Pontes says he disclosed prior to being hired by the county. Supervisors released a statement in support of his leadership after the allegation became public.

Ramstrom said she’s faced no similar threats from Jones or other supervisors. The community will have to decide for themselves, she added, whether statements made about her during public meetings constitute intimidation. 

Complaints against Ramstrom have come from those in the community who don’t see COVID as a real threat to public health or safety and feel federal, state and local restrictions are an imposition on their freedoms. Many also oppose COVID vaccinations on the basis of perceived safety concerns. They are angry because Ramstrom and other local officials, including recalled former Supervisor Moty, followed state mandates and restrictions rather than fighting them. Their complaints echo those of others across the country who have engaged in what many see as an ongoing assault on science, and scientists.

Public Health Director Schurig said that while the COVID pandemic has been politicized across the nation, information being shared by Shasta County’s public health staff is trustworthy because it’s based on data and accepted science. “Accepted science means recommendations and authorizations that have been determined by bodies of scientists,” Schurig detailed, “whose job it is to make such determinations after reviewing data from legitimate studies.”

She says the stress of public hostility over the last two years of the pandemic has impacted both her and her staff making them wonder if the community, and current supervisors, will support the broader work of public health. Regardless, she’s committed to staying engaged in the work inspired by: “The knowledge that public health is about protecting and improving the health of all, not just those who support us and the knowledge that our community has experienced a lot of adversity and needs and deserves our support in being as healthy as they can be.”

“What keeps me engaged in the work is a few things: the passion and talent I see every day in Public Health’s staff, the knowledge that public health is about protecting and improving the health of all, not just those who support us, and the knowledge that our community has experienced a lot of adversity and needs and deserves our support in being as healthy as they can be.”

Shasta County Public Health Director Robin Schurig

Ramstrom said that she understands public concerns and fears related to COVID restrictions saying that the community, like she and her staff, have struggled to keep up with the evolution of the science related to COVID over the last two years. Those constant changes in government recommendations, while data-based, have reasonably proved frustrating for the public, she said.

“Part of me feels it’s not really my work (the public is concerned about),” Dr. Ramstrom explained, “but my role and the role of public health and how we have been caught up in the politics of national mistrust of government and science.” 

As public health workers, she said, she and her staff face the needs of the county’s most vulnerable populations every day and have a different perspective than many in the community on how COVID restrictions can protect those people. But she also acknowledged that California’s size and diversity have made the state-wide approaches to COVID problematic for Shasta County. On top of those factors, Ramstrom said, came the local political upheaval of a county supervisor recall, that shifted the ground for the community, and public health, yet again.

In Shasta County, there have been over 30,000 COVID cases and over 600 deaths from COVID since the pandemic began. But transmission of the virus within the county is currently low, and Ramstrom says it’s time to move forward towards focusing on the broader public health needs of the community, and the additional strain on the community’s health and resiliency caused by the pandemic and back to back wildfires.

Current data from the County’s COVID dashboard.

Despite the many challenges to public health and to her role, Ramstrom says she’s been inspired to continue her work with the county largely by her staff’s unparalleled drive and commitment to the protection of the community. Also encouraging to her are the many community partnerships with public health that have arisen in response to the pandemic. 

“People have come together to try to do everything we can to work together to come to the best solutions possible,” she said. “That’s what feeds me and keeps me doing this work.  It’s exciting to see the potential those partnerships provide to address other complex public health issues in our community that need some attention.” 

Shasta County PUblic Health Officer Karen Ramstrom

Schurig agreed, that communication and collaboration with community partners during COVID has led to stronger relationships than ever before. “Dr. Ramstrom started the Roadmap to Recovery Advisory Group in 2020,” Schurig said, “to help establish a channel for two-way communication about COVID between Public Health and partners in business, local government, law enforcement, faith, healthcare, education, and more, and that group is still meeting because they value the relationships that have been built there and the information and guidance they can get from one another.”

As the county’s COVID work scales back, both Ramstrom and Schurig agree that it’s time to focus on other critical public health topics that desperately need attention. Those include substance use, mental health, trauma, and sexually transmitted diseases, among others, many of which present complicated and interconnected challenges to public health, Ramstrom said. In addition to meeting immediate public health needs, she said, public health must also address complex social issues through an “upstream” approach that focuses on the contributing conditions that people live and work in, also known as the social determinants of health.

“The trauma from all these events, from the fires, from the pandemic is real,” Ramstrom says, “so how do we as a community build in natural ways for our community members to find and receive services and supports to help them to recover and be able to withstand these events and future issues that will come along? We’ve got to get on(with) those things because there is a lot of need and a lot of people interested and willing to help with that work.”

Ramstrom said while she’s sad and disappointed by ongoing opposition, she feels supported by family, friends, colleagues and community members. Unlike many other public health officers across the country, who’ve resigned in response to threats, opposition and unprecedented stress, Ramstrom is game to continue her work. 

“I am a public servant,” she wrote in her letter Friday, “ I would like to continue serving Shasta County if given the chance.”  

Amidst the reality of so many pressing public health issues in Shasta County, Schurig said she is concerned that it will become increasingly difficult to find public health staff should the board choose to terminate Ramstrom’s employment.

“When prospective job applicants search Shasta County online they’re already seeing the divisiveness that exists here,” Schurig said. “The opportunities for outdoor recreation in our area is often what draws people here, but that will not be enough to overcome a lack of support for our Health Officer by a majority of our Board.”

Annelise Pierce is Shasta Scout’s Editor and Community Reporter covering government accountability, civic engagement, and local religious and political movements. You can contact her at [email protected]

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