Board backs health officer, but not health order

Asking for community backing to fight the coronavirus pandemic, the county’s top doctor got plenty of praise from Lincoln County Health Board members Dec. 9, but no endorsement for future measures.

“I need the board’s support,” said Dr. Brad Black. “I feel like I haven’t seen it yet. I’ve seen a lot of discussion. I’ve taken a lot of jabs — and that’s OK.”

Black was back before the board for the second time in as nearly many weeks with an updated local health order. The proposal would bring the county’s pandemic measures in line with Gov. Steve Bullock’s tightened restrictions.

But as coronavirus cases have mounted in Lincoln County, residents have increasingly split over how to respond to the crisis, which has left more than 291,000 dead nationally. The divide has left elected leaders carefully threading the needle. Black’s call for support came after a concerted effort by a group of residents purportedly several hundred strong to either force him out or appoint a health board willing to oust him.

Since the pandemic began, Bullock has given local health officers the ability to either match or exceed state restrictions. Under state code, officials like Black wield wide-ranging authority in the face of the imminent public health threat. Each time Bullock has adjusted the state’s measures, Black has followed with a local health order, but never with the express support of the health board.

Black first came to the board Nov. 23 with a proposal for an updated set of pandemic restrictions incorporating Bullock’s most recent changes. Health board members narrowly voted against supporting the measures, instead tabling it for future discussion. Residents in attendance, when not accusing Black and board members of adopting authoritarian tendencies, panned the order on the grounds that it focused too heavily on enforcement. Several members of the board shared those objections.

Returning to the board Dec. 9, Black said he had spent the intervening weeks wrestling with what he heard in November. He considered rescinding the local order, which would leave Lincoln County following whatever directives Helena issued.

“I went back and looked at that,” Black said. “I said, ‘You know what? Your goal, your job, is to make sure you’re doing the right thing for the community.”

He offered to peg his local order to the status of the governor’s directives, meaning that if Bullock or Gov.-elect Greg Gianforte lifted restrictions, like the face mask requirement, they would no longer apply in Lincoln County.

Eureka’s representative to the board, Debra Armstrong, welcomed that idea. She has in the past criticized the law that gives Black final say on when the coronavirus crisis has passed.

“It should have an ending point,” said Armstrong. “That would make me feel a lot better.”

But Jim Seifert, the Troy representative to the board, wondered what would happen were Gianforte to remove all restrictions even if the virus were still active in the community.

“I have a funny feeling we’re probably going to have no order,” Seifert said. “What’s going to happen from that point on?”

Black said it would leave him with a hard decision. He told the board he was prepared to act in the best interest of the county if restrictions were lifted prematurely.

“I think it’s all going to be dependent what’s going on in our county,” Black said. “I will always deal with our county on a local level. If I see a problem with public health that the governor doesn’t agree with, I’ll do what I think is right for the county.”

But it would not work as well if he lacked support from the board and county leadership, Black argued. He pointed out that he does not need the group’s approval for his orders, but would prefer to have their blessing.

“This is an order I can do,” he said. “I don’t need the health board — I want the health board’s support. I want the health board’s support in saying [to me], ‘We trust you to make good decisions that are good for the community related to COVID-19,’ and I haven’t heard it yet.”

To that, Black got a round of tempered acclaim. Board members Sara Mertes and Laura Crismore both extended their support and full backing.

“You feel responsible for our community and residents and that’s a pretty large job,” said Crismore, who pledged to support any measures Black deemed necessary.

Armstrong and outgoing board member George Jamison also offered Black praise, but said they could not support any mandates or restrictions. Armstrong said residents should decide what if any precautions they take in the face of the pandemic.

“I appreciate that you feel responsible for the community’s health,” she said. “I think the community, in the end, is responsible for our own community health.”

Whereas residents opposed to pandemic measures often point to enforcement as the source of their ire, board members debated the efficacy of mandates. County Commissioner Mark Peck (D-1), who recently stepped down from the board, has criticized top-down mandates since the pandemic began. He has argued that state officials should have launched a public awareness campaign, akin to the nation’s anti-smoking effort, to encourage mask use, social distancing, basic hygiene and other precautions.

County Commissioner Josh Letcher (D-3), who took Peck’s spot on the board earlier this month, echoed the sentiment.

“[We are] questioning whether we mandate love or not,” Letcher said, saying the health order essentially compelled residents to look out for one another. “I think people are allowed to make their own choices.”

Seifert argued that residents accept mandates for the common good in other areas of life.

“We can’t go out and have six drinks and drive because we’ll get a DUI and get thrown in jail,” he said. “We’re mandated to wear a seatbelt; we’re mandated that you can’t smoke in a public restaurant. That’s a mandate. Some of these mandates are for the good of all in the society.”

Armstrong warned it was slippery slope. As a diabetes educator, she said she knew plenty in her industry that wanted to mandate lifestyles.

“We have to be really careful here,” she said.

Regarding the coronavirus, specifically, Black pointed to countries where masks and other measures have not been mandated. There have been consequences, he said.

“You look at Sweden and they tried to back off and let people [make] their own judgment,” Black said. “They didn’t do very well.”

The Scandinavian nation is rethinking its coronavirus policies as the crisis worsens. Officials there initially offered mostly voluntary pandemic guidelines, though not for masks. When cases dropped dramatically in the summer, even skeptics of the approach took another look.

That’s changed since October, according to the Los Angeles Times. Now its health care system is operating at nearly full capacity in some areas and about 7,300 out of a population of roughly 10 million have died. The Times reported that the country’s prime minister has lightly criticized the public for failing to follow the recommendations.

Much closer to home, in nearby Idaho, Gov. Brad Little last week beseeched residents to comply with pandemic guidelines. The state is nearing a point where officials may have to consider rationing care for the sick, given the stress on the health care system, according to the Idaho Press.

Still, Little told reporters that he wants residents to choose to don masks and take other precautions.

Back in Lincoln County, Seifert made a motion to show support for Black. He wanted to see his fellow board members give the embattled health officer a vote of confidence.

It was not to be. Letcher pointed out that the action item before the board was on Black’s proposed health order and not whether its members supported him, personally, or his policies. Seifert later withdrew his motion.