JEFFERSON COUNTY, Colo. — Dr. Dawn Comstock is the new executive director for the Jefferson County Public Health (JCPH), replacing Dr. Mark Johnson, who retired after holding the position for 30 years.
Johnson had planned to retire in early 2020 but stayed on to guide the county's response to the COVID-19 crisis.
As Comstock steps into the new role, 9NEWS spoke with her about her experience and the challenges she faces.
What was your thought process when deciding whether to take this role?
Comstock: I think I like a challenge! But more honestly, as the COVID-19 pandemic started advancing across the world and across the United States, I found myself teaching my classes using examples from the pandemic: Teaching them how to calculate a case fatality rate using numbers from different provinces of China, for example. It finally struck me that teaching the next generation of public health professionals is very rewarding, but I felt like I needed to do more, I wanted to do more.
I had the opportunity to join The Colorado Department of Public Health and Environment over the summer and helped them through the fall on COVID response activities. That just reignited my interest in applied public health. I had started my career as a Centers for Disease Control Epidemic Intelligence Service officer and worked in the Iowa Department of Public Health and with the Oklahoma State Department of Health. When the position was posted to replace Dr. Mark Johnson, I just realized it was something that I thought I would enjoy. I thought it would be challenging. Most importantly, I thought it was an amazing way to serve my community to serve Jefferson County.
What do you think that your biggest challenge is going to be this year?
Comstock: The biggest challenge obviously is to continue to address the emergency response to the covid-19 pandemic.
Following that, we'll have to plan out our shift from that emergency response to the longer-term response. We have to start planning the recovery from COVID both for our community, for our health department. The dedicated staff at Jefferson County Public Health have been working incredibly long hours every day of the week for really a year now, and it's going to take as much time for the staff to recover as it will for our communities to recover economically, personally, socially, and from a health perspective.
Talking specifically about the pandemic, what is your biggest challenge?
Comstock: Our big focus as we move forward over the next several months will be to really address the equity concerns. We know for example, even here in Jefferson County, there's a big disparity between the proportion of our white non-Hispanic 70-plus population who have been vaccinated compared to our Latinx population that has been vaccinated who are over 70. So, our next big push will be to address those disparities.
How will you address those disparities?
Comstock: We have a great team here at Jefferson County that's working with our community partners to identify all of the current ways that we can best address these disparity issues, and it's going to be multifaceted. We know, for example, that we have some homebound, non-institutionalized, 70-plus population members who can't get to a drive-through vaccination site, or it's very difficult for them to get to the pharmacy. So, for those individuals, there's a need to do door-to-door, individual, one-on-one vaccination in other parts of our communities.
It will mean partnering with a community organization to do either a small standing clinic that the community can be aware of, or do pop-up clinics. There isn't going to be one answer, because there are so many different groups of people that still need our assistance and are still struggling to get vaccinated.
Many people have had a hard time signing up for vaccination appointments. Do you have any plans to make that process easier moving forward?
It is definitely a challenge, and I can speak from personal experience. My 80-year-old mother-in-law lives in St. Louis, Missouri, and today she drove three hours round-trip to go to a rural community to get her vaccinations. Obviously, that's not ideal. We want to help everyone in our community access vaccination. We have several resources on the Jefferson County Public Health Website that will provide assistance and guidance for people trying to seek out an opportunity to be vaccinated. We also have a call center.
Is your call center able to handle the volume of people who may be calling?
Yes, our goal is that every call gets answered and if someone doesn't answer right away, that someone will return your call if you're able to leave a message. The wait time varies from day to day, and different times during the day. But yes, there are call center staff working really hard to make sure that everybody that needs assistance can get assistance.
Are you a part of conversations about what vaccinating the general population will look like?
Comstock: We’re working very closely, of course, with our partners at CDPHE. This is a massive collaborative effort. This is not just Jefferson County Public Health providing vaccinations to our community members. It's our partners in the healthcare systems, the retail pharmacies, and eventually, hopefully, there will be enough vaccine to get into individual primary care physicians' offices.
This is a big lift that requires a huge team effort and a big collaborative effort. So, Jefferson County will continue to play a role helping to coordinate that effort helping to provide guidance and advisory, and of course viewing our own vaccination clinics as well. We have vaccinated thousands of people ourselves just as Jefferson County Public Health, and will continue to do so with a specific focus on trying to address some of the equity disparities that we've seen.
You have a drive-through vaccination site. Do you think similar vaccination efforts will be an important part of the general roll-out?
Comstock: There are plans for some much larger sites. FEMA is coming into certain places within Colorado, the state health department is doing some large vaccination sites, some of our health system collaborators are doing large vaccination sites. So yes, we are going to see a combination of many different approaches from very large vaccine sites, like Coors Field, down to, quite literally in some of our rural communities here in Jefferson County, we have already had teams that have gone door-to-door to get vaccinations to those homebound 70-plus individuals.
But there is vaccine need now. Jefferson County teachers rushed to the National Western Complex in the beginning of February after hearing about the possibility of getting a leftover vaccine dose. Teachers told 9NEWS part of the reason it was so hectic was because they did not trust they were being taken care of. What is your message to them?
Comstock: Our message to K-12 Educators and licensed child care providers is the same: be patient, but please get that vaccination as soon as you are eligible. We know that there is more demand than the limited amount of vaccine that is available. But everyone is working really hard to get those vaccinations into arms as soon as the doses come into our state and into our counties.
I know that there's a lot of anxiety. I appreciate that. I understand that. I've been worried for my mother-in-law every single day until today when she could finally go and get her appointment for her vaccinations. Just keep patient in the meantime.
Jefferson County Public Schools (JPS) is considering a transition to in-person learning soon. What is your opinion about that?
Comstock: Jefferson County Public Health has been consulting with JPS. We've been providing some public health guidance to them as they make this very difficult decision. We all understand the importance of in-person learning to our student population. We know that it's not just important from an educational standpoint, but also from a social and emotional standpoint. We support a safe return to in-person learning as soon as it is responsible to do so and we're working with JPS as they make those tough decisions. I will note that we do also support the position that in-person learning must take priority over extracurricular activities and non-essential businesses. It's most important to get all those kids back in school.
When you say you support in-person learning, you say you support it when it’s “safe and responsible.” Is it safe and responsible to return during the spring semester?
Comstock: We do anticipate that Jefferson County will move into the blue area of the dial relatively shortly, and at that stage, CDPHE has advised that it is safe to return to in-person learning. So as I said, we've been working closely with JPS. I know that they are very intent on ensuring that the return to in-person learning can occur safely and responsibly, and we appreciate that approach.
What is your message to the 1,500 JeffCo students, teachers and parents who signed a petition saying they do not feel comfortable returning to in-person learning?
Comstock: Safety really depends upon the acceptable risk to an individual. What I consider safe and what you consider safe might not be what one parent considers safe or another parent considers safe.
My message to them is that the state health department and local public health departments are working very closely with school districts across the state to ensure that all precautions are taken and in-person learning can resume as responsibly and safely as possible. There is of course some risk of infection associated with any activity that brings people together. The goal is to reduce that risk to the lowest possible level, and we've seen the science bear out that when schools and educators are able to follow a very specific list of safety protocols, the likelihood of transmission within the school, and the likelihood of community spread being driven by schools, is very, very low.
Public health officials across the country, and here in Colorado, have been victims of doxxing, harassment and threats. Your predecessor has talked about this happening to him. Was this a consideration in making the decision to take this job?
Comstock: I spoke with my predecessor this week, and we had a group of Jefferson County facilities managers walk around our building and help us do a risk assessment and a threat assessment. I have personally spoken with the police chief about the risk and safety of our employees. It's disappointing. I think the issue is that most people don't truly understand or appreciate exactly who we are as public health professionals and what we do day in and day out to protect our communities.
Our mantra is: healthy people, healthy places. Most people don't think about public health until there's something that goes wrong. But every day, the dedicated staff at Jefferson County Public Health make sure the air we breathe is clean, the water we drink is safe, the food that we consume is healthy and safe, and that the physical spaces where we work, play, go to school, recreate are healthy and safe. They do that day in and day out, and are an incredibly dedicated group of people. The vast majority of the population probably doesn’t really understand the wide scope of efforts that public health has. It’s only now, during a public health emergency, when people are paying attention.
I'm proud to say that the vast majority of people have been incredibly supportive and appreciative of the great work that the Jefferson County Public Health staff is done. The few individuals that are not as pleased with it and have taken it to the extremes of threatening behavior, that's just so discouraging and so disappointing. I guess my take-home message is that our job is to protect all of you even if you don't like it and even if you don't appreciate us as we do it.
What’s your general message to the people of Jefferson County?
My message is one of cautious optimism, but also reinforcement of those messages that I truly understand you're starting to be fatigued by. Everything is looking good. We're going in the right direction. Restrictions on our businesses are starting to be lowered, schools are discussing returning students to in-person learning, things feel good, but we can only keep them there if we continue to do the right thing.
It’s just imperative that people continue to wear their masks, maintain that social distance, avoid gathering in large groups, wash their hands, and get vaccinated as soon as they're eligible to do so and can get an appointment. As long as we work together, we can keep these trends going in the right direction.
My fear is that the combination of fatigue coupled with this good news that we're hearing now about lower incidence rates, low positive test results, and more and more people getting vaccinated… I truly fear that combination will somehow give individuals a sense that they can return to normal.
One of my division directors has a great saying: ‘lowering on our place on the dial means fewer restrictions, but not a free-for-all.’ We need people to continue to follow public health guidance and continue to help us protect you, your families and your communities.
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