Theresa Anselmo on Helping Public Health Agencies During a Pandemic

Theresa Anselmo is leaving her position as executive director of the Colorado Association of Local Public Health Officials. CALPHO’s membership includes virtually every public health agency in the state; its mission is to help those agencies improve the overall health of their respective communities. Anselmo has been dedicated to advancing the health and quality of life for everyone she’s served in her native Colorado.

So why leave is she leaving after just over three years in the Colorado job? We checked in with Anselmo to find out.

Marty Coniglio: You’ve announced you’re leaving CALPHO. It’s a job you trained for, earned an advanced college degree for, and then even moved to California to get the needed experience. Why leave?

Theresa Anselmo: We have all experienced a significant amount of trauma and stress — every person in the country and across the world — related to this pandemic. We are people, too; we have had to be in isolation, we follow the stay-at-home orders, we do all of the same things that community members are being asked to do.
People in local public-health agencies have been working nonstop since February. They may have a few hours on a weekend when they’re not responding to emails or dealing with something.

Their credibility is being questioned, as have the motivations for the recommendations that they’re making related to public-health practice, and that has been demoralizing. They may or may not have a health-care degree, but fundamentally, they are the doctors of their communities. To be questioned at every turn and villainized with “You’re killing my business,” “You’re killing our community by having stay-at-home orders or making us wear masks.” Public-health policy’s purpose isn’t to pick winners and losers; the purpose is to provide advice based on evidence and science about what’s going to stop people from dying. There is a weight to that.
There is also a dismissiveness from the community about what’s valued.

There’s a false dichotomy, a false choice that you can either have public health or you can have business. But the fact is that you can’t have business if there aren’t people to make the products, there aren’t people to buy the products. So you can’t have business without health.

We’ve seen throughout this response, from the top down, this false choice of it’s one or the other. It’s absolutely not one or the other. Health comes first.

All of this together becomes overwhelming. In addition to being leaders within our organizations and feeling the weight of the stress and strain and trauma of the people that we work with, we’re having our own trauma. While I applaud folks who stick in there and say, “I am the one thing standing between what we’re doing and a catastrophic decision,” and being able to toe that line, at some point you have to make a choice about your own health and your own well-being and what ultimately the consequence and sacrifice are of continuing that fight.
A number of us have decided it’s a good fight, it’s a worthy fight, but we just can’t do it anymore. It’s exhausting, traumatizing, it’s demoralizing and degrading, and you have to consider what good you would be if you continue to let yourself be traumatized in that way. So a lot of us have decided to move on.

Where are you going next?

I am staying in public service. I am a nurturer and a health-care provider at heart. I’m going to be the Preventive Programs Administrator at the Colorado Department of Human Services in the Division of Child Welfare. I’m excited about where I’m going; I will still get to engage in and interact with my colleagues and friends in public health.

This past year has had remarkable public-health issues with the coronavirus pandemic. What’s another impactful experience you’ve had?

I was a witness for the change in the vaccine exemption back in June. It’s the wildest experience I’ve ever had at the Colorado Legislature. For our physical safety, we had to be escorted in and out of the building. We had to wait until the building had been cleared to leave; we walked through a gauntlet of protesters who were six inches from our faces, not wearing masks (we were), during COVID, yelling at us that we were poisoning and killing their children.

The protesters often drowned out our testimony because they were screaming so loudly, and we were asked to speak over them — rather than holding the proceedings to quiet them down. I’ve never before had anyone scream in my face, nose to nose, telling me I was killing their children and I should be ashamed of myself.

What’s the difference between my private health, like between me and my doctor, and public health?

Health care is for the individual; public health is for the community, population-wide. We look at a community’s health, and we gather information about what the community’s concerns are, and then work with that community to address those concerns so that the entire community can be healthy.

So all ships rise together, right? It’s not just about you and your access to a dentist or a doctor and your ability to pay for health care. Let’s make sure you’re as healthy as you can be and prevent as much as we can across the entire community so that we’re all healthier.

What do you expect to happen in 2021 with respect to COVID-19?

I will tell you that to a person, every public health-care professional I’ve talked since they started receiving vaccines has said they cried when receiving, or giving, their first vaccine. I cried when I was watching MSNBC and they administered the very first vaccine — because there was such a sense of relief that finally something was happening that really gave us hope that there is an end.

Even in November, you’re looking down a six-month tunnel and all you see is rising cases, rising deaths, people getting fatigued with something as simple as wearing a piece of cloth over your face and making it about politics rather than caring about your neighbor. There’s a huge sense of relief and optimism that we will start to see a significant corner being turned. Now, when that will happen I don’t think we know, because it depends on the availability of the vaccine and how quickly it gets out to the general public.

Still, there’s this sense of hope and a feeling that we will see the end of this, we will come out the other side. There is no “going back to normal.” We shouldn’t want to go back to the normal that we were.

I think COVID will be endemic in the world; there will just always be some COVID-19 running around — partly because we have a significant number of folks who don’t trust vaccinations and would never do it. But also because it mutates and we don’t know enough about the vaccine and how long it conveys immunity, and there are some questions about if it in fact works better in younger people than older people.

There may be a renaissance, I hope, across the world about what’s valuable and what’s important. What could we live without during our stay at home? You could live without me and quite a few white-collar workers, but, boy, if you didn’t have food-service workers, grocery-store workers, custodians and teachers...those are the things that we should think are the most important.

I don’t know if that will shift in this.