This Q&A originally appeared in the Aug. 18, 2021, edition of the Iowa City Press-Citizen and is reprinted with permission. The Q&A was conducted by Press-Citizen reporter George Shillcock.
Danielle Pettit-Majewski is set to take the reins of the Johnson County Public Health Department as director amid rising COVID-19 cases due to the surging delta variant and while residents prepare for the return of classes at local schools and the University of Iowa.
An Iowan and a UI grad, Pettit-Majewski became the director of neighboring Washington County’s public health department in March 2013 and eventually held dual roles after being elected in July 2018 as a city councilor in Washington.
She starts her role officially today, on Aug. 18, and will take over for Sam Jarvis, who served as acting director after Dave Koch stepped down in November. Jarvis will be taking a new role in Johnson County as the community health division manager.
In an interview with the Iowa City Press-Citizen, Pettit-Majewski said she feels public health shouldn’t be politicized, especially in the middle of a public health crisis like the country currently faces. She also spoke about her goals for the position, her thoughts on COVID-19 in Johnson County and about her time in Washington County.
This conversation has been edited for clarity and length.
Why did you choose the University of Iowa?
Pettit-Majewski: I knew that they had a really good biology program and I didn’t want to go too far. I knew state school would be far more cost-effective. Ultimately, I loved Iowa. I loved how ingrained the university is to the community. I felt like there was such a good opportunity and there was so much diversity. Growing up in a small town it was the first opportunity for me to meet people who were different from me and I just loved that.
What brought you to Washington County and what got you in city and county government?
I worked in family practice after graduation and I knew I wanted to work in public health. I was looking for different opportunities, trying to find the right job. I saw the ad for director in Washington County and I applied. … It’s been such an excellent experience. I’ve gotten to meet so many excellent people, make a lot of partnerships and get a lot of work done.
What made you run for Washington City Council?
Sometimes, unless you’re the one making policy it is hard to get things done. My city councilmember had vacated his seat and he had a year and a half left on his seat. So I gave it a shot.
I’m really into politics and I’ve learned how much local politics impacts your day-to-day life, but ultimately it is the local politics that people ignore, unfortunately. I will say too, most of it is pretty unsexy. You’re talking about water mains, infrastructure projects… but it is that kind of work that is necessary to make communities livable and walkable. Nobody wants to invest in infrastructure but everybody wants their toilets to flush and clean water to come out of their sinks.
All of those things are important to public health and I wanted to be in the seat of making decisions from a public health perspective.
What was it like working both of those jobs at the same time?
It was actually pretty interesting. I think sometimes people run for office and they don’t understand how government works… but for me, I can kind of bring that perspective of I work for government and I understand. I wanted to make sure I was supportive to our department heads.
So much of the work that we do is in partnerships with municipalities. I had good relationships with our city administrators to get things done for our communities that not only benefitted our community but benefitted public health as well.
Prior to the COVID-19 pandemic, what was it like working in the Washington County Public Health Department?
We were fairly large for a rural county, but it was awesome from my perspective. There were so many things that we got to do.
When you’re smaller and you’re a rural county you get to wear a lot of hats in your role. Whether it was wellness, or community health needs assessments or emergency preparedness or immunizations. All of those things allow you to meet different partners.
Whether it is cities, small businesses, main street, the chamber, economic development, the schools, the hospital. You can get a lot of work done by working with decision-makers. You knew who the players were.
How did COVID-19 hit Washington County early on?
The first cases were in Johnson County. We had a lot of people who were exposed and we had orders for quarantine right from the beginning. When the pandemic was first kicking off in Iowa and our hospital was one of the only places that was testing, it just kind of exploded.
We had an outbreak in our nursing home right away. End of March 2020. We just started getting cases. Boom. Boom. Boom. Boom. And at that time, how we responded to COVID was really different. We monitored the patients for 14 days, take their temperature every day.
I remember talking to Ann Garvey at IDPH and just saying ‘We can’t continue to sustain this. If cases continue to explode I’m not going to be able to contact these patients twice a day.’ Because we were doing some of these investigations early… we were able to learn more about symptoms than others.
It almost helped, and I hate to say this, it helped we had those cases first because in April then we had that explosion of outbreaks. Our numbers just skyrocketed. We were able to learn at the beginning and be able to offer guidance and share that with our counterparts.
How have you been dealing with the trauma of COVID-19 and leading Washington County through the pandemic?
I’m going to be honest: Therapy. It was getting to the point where I couldn’t breathe when I walked into my office. I wasn’t sleeping. I tried to continue to exercise every day. I have a very tight-knit group of friends, who probably saved me.
My colleagues, honestly, a lot of public health professionals were dealing with this trauma and this feeling of helplessness. Especially as things changed. We talked a lot, on Zoom weekly and we called each other. My husband was a constant form of support for me. Taking the dog for a walk every day to try and decompress. Trying to think about how we have to do this again is… it’s pretty devastating truthfully.
How does the pandemic impact the field of public health?
I was diagnosed with PTSD. I think it is really important that we talk about that. There is not shame in that. If you think about a school shooting or a fire that law enforcement would have to respond to, they do critical incident stress debriefing for a reason. And public health professionals were responding 24-7 for 18 months and there has been nothing offered to public health professionals.
We are going to be facing about a 40 percent retirement rate in the next five to 10 years for Iowa’s public health workforce and I know some of my colleagues who want to retire early or leave the health care field entirely.
We’ve always been the silent partners; working behind the scenes and not caring who gets credit. These people and this workforce are amazing and they are so committed. We shouldn’t take advantage of them and we should get them the resources they need to do their job.
Can Iowa schools defy the state’s COVID mask ban like Florida and Texas schools are? And do you feel all of you are getting adequate support from the community?
You get people who thank you, but then you get people who yell at you. They blame you for the economy. People threaten you. I never in my wildest dreams imagined that.
What are some things that people don’t know about health care workers and what they have gone through in this pandemic?
We cried for them. We grieved for them. We prayed for them. Our only goal was to keep people well. There’s no money in it for us. Most people were working way beyond what they were ever getting paid for. Donating their time because they care about their community. Because they wanted this to stop, for kids to go back to school, because we wanted businesses to be open.
We didn’t want to see our communities struggle. We wanted to see this end. We got the calls when the patients died. And we grieved. We grieved when there were no resources to help people.
I didn’t have all the answers for people and that killed me. There was no joy in this. It was a very fine line to walk because you would get accused of fear-mongering by people. I don’t know what had to happen for people to stop doubting when we said ‘People are dying.’
How does it feel leaving Washington County after what you’ve been through?
Leaving is bittersweet because I’ve had such amazing partners, amazing friends who started off as colleagues. I built actual relationships. I’ve been really happy with what I was able to build upon. Washington County Public Health was really strong when I came in and its been fun and a great opportunity to build and learn from the people there and in the community.
These were our community members. This was a small town. When people died and got sick, you knew them. They weren’t just numbers. They were our neighbors.
I feel like we did a good job and I’m proud of our community. I’m proud of the people I worked with. There are things we could’ve done better and there are things I’ve added to the pandemic plan before I left. Our pandemic plan was based off of H1N1 and that was a lot different than COVID.
What made you want to apply to Johnson County?
Doug Beardsley had been my mentor when I was a young administrator. He had told me ‘When I retire you should apply to my job,’ and I remember Doug from when I was a student there. I thought that I wanted a new opportunity and a new challenge.
I didn’t know what more progress I could make. Maybe someone else could come into (Washington County) and make more of a difference than I could make.
What are you looking forward to about this new position?
I’m really excited. It’s going to be a great opportunity to get to learn from new people up there. I know the brilliance of those who work there.
How are you preparing for any rise in COVID-19 cases due to the delta variant and back-to-school?
I am worried. I think about what happened in September of last year when we had layered mitigation efforts. We had masking, we had social distancing. We had some schools hybrid and some schools online completely. We still saw our cases in the state and in our city skyrocket.
We would be fooling ourselves if we didn’t think that we would see that again. I wish I had something optimistic to tell you. A virus does what it does. Even in our pandemic plan, it says you have to anticipate the response taking two to three years. We are a year and a half into it. We should be prepared for the delta variant, to see it spread.
I hope that we will be able to make decisions based on science and public health-based practices and do the best things for Iowans and Johnson County residents to keep us safe.
When you have people in close-quarters and who aren’t vaccinated, that is a great opportunity for the virus to multiply and spread. And the more it spread, the greater opportunity we have to get a variant that our vaccine can’t fight.
Will Johnson County’s high vaccination rate help?
The vaccination rates will help. They are higher than a lot of other places in the state, which is amazing. That will cocoon some of our unvaccinated population a little bit. But unless we start to see an inoculation to start getting our younger kids vaccinated soon, I do worry.
How do you feel about the Iowa Board of Regents’ decision to not require masks, specifically how it affects the University of Iowa?
I think it would probably be wise if we required masks, at least for the first semester. You’ve got people coming from all over the country. People coming in close-quarters in dorms and classrooms.
This virus is impacting younger healthy people too. And I hate to think about the long-term chronic health impact on a lot of these young people getting COVID-19. What does that do to their lung capacity? What does that do their heart health? To their cardiovascular health? I have a lot of concerns about the University of Iowa and the Board of Regents’ decision. I think it is a big risk.
What has public health learned from the pandemic?
Public health professionals all knew about the inequities in our system. COVID-19 shone a light on those to others. We are all in the same storm, but we are not all in the same boat. Some people are in a yacht and some people are hanging on to a buoy.
Some people didn’t have access to food. How were they going to pay their bills when they had to stay home with their kids to quarantine?
We saw our Latinos being disproportionately impacted, our people of color being disproportionately impacted and dying. We also felt this in our workforce.
I often said, I don’t know how I could have responded if I was the mother of a young child. We put off having a child because we couldn’t with COVID. That wasn’t something we had time for.
We need to be focusing on some of those issues. We need sick time, we need to incorporate child care and we need equal access to care for everyone.
How will Johnson County be able to move past COVID-19?
We need to have people do the simple, slightly inconvenient things so that we don’t have to do the very hard, difficult things later. So that we don’t have to go back to being six feet apart, that we don’t have to go back to being at home or shutting schools down.
That was miserable. We know that. That also contributed to a lot of trauma for people and hardship and lost jobs.
If we can get people to wear a mask when they’re indoors, even when they’re vaccinated; if we can get people over the age of 12, who haven’t been vaccinated to get vaccinated… that is how we get past this.
Is there anything else that you want people to know about you?
We had to walk a really fine line as public health professionals to not say things that would be perceived as political. I remember telling elected officials during the pandemic that I never give advice based on politics. I give advice based on public health evidence. I would say ‘If that makes your job hard, that is not my problem.’
I am never going to give advice that is contrary to public health best practices just to appease politics. And to me, my integrity is everything. You get into public health to serve. Your job is to serve the public.
There are times when we felt the public gave up on public health, but we did not give up on them. I will do everything within my power to make sure that we don’t get those phone calls telling us we lost people.
I give the guidance and will do my best to save lives every day. No matter who it frustrates. I have to do that.
George Shillcock is the Press-Citizen’s local government and development reporter covering Iowa City and Johnson County. He can be reached at GShillcock@press-citizen.com and on Twitter @ShillcockGeorge