‘We had people die that didn’t have to die’

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We don’t talk much about COVID-19 these days. The pandemic rarely comes up in conversation, and when it does, most people use the past tense.

There’s certainly reason for this. The darkest days of the worst pandemic in a century seem to be receding into the distance. Most of us have resumed normal life—getting together with friends and family, attending concerts and events, wearing masks only on long airplane flights or not at all.

Health and government officials have acknowledged this reality. On May 5, the World Health Organization decided that COVID “no longer constitutes a public health emergency of international concern.” Six days later, the federal COVID-19 Public Health Emergency Declaration ended. On July 28, New York, citing the end of the public health emergency and “reduced demand for access to digital COVID-19 test and vaccine records,” discontinued the Excelsior Pass Plus.

We are occasionally reminded that the virus is still here among us and infections could spike again. Nationwide, the most recent data show more than 2,200 daily COVID hospital admissions and around 500 weekly deaths. But these numbers are a far cry from the pandemic’s peak in early January 2021, when more than 26,000 deaths were recorded in a single week, and no one predicts another big wave. What’s more, among those who do get infected, the percentage who become seriously ill has declined sharply.

So, thoughts naturally turn to life after COVID. Yet the pandemic will not be soon forgotten. The disruptions it caused were too severe, the toll in lives too high. Through the end of May, more than 1.1 million Americans had died—341 per 100,000, compared with 135 in Canada and 200 to 250 in much of Europe. In Monroe County, the count was 2,027 lives lost, or 267 per 100,000 residents.

What has this experience taught us? Are there lessons that can help us be better prepared for the next pandemic and more effective in our response to it? I thought that if anyone locally was best positioned to answer these questions, it was Michael Mendoza M.D., Monroe County’s commissioner of public health.

‘The guy on TV’

The son of Filipino immigrants who had settled in a Chicago suburb, Mendoza began his career practicing family medicine on Chicago’s South Side. He moved to Rochester in 2009 to become an assistant professor at the University of Rochester School of Medicine and Dentistry and serve as medical director of Highland Family Medicine, one of the largest family medicine training practices in the country. He continues to see patients as a primary care physician.

Michael Mendoza describes the pandemic as a “life-changing event for everybody,” but in particular for public health officials and staff.
(Photo: Monroe County)

Seven years ago, Mendoza was appointed interim commissioner of public health. His current term, which began in January, runs through December 2028. With a $74 million budget and roughly 250 employees, the department Mendoza leads has a wide array of functions ranging from addiction services and maternal and child health to epidemiology and disease control. Its responsibilities also include being prepared to respond quickly to public health emergencies.

“We practice and we have plans,” he says. “And we talk about these things in sort of the hypothetical sense. But when it becomes reality, that’s when you think, ‘Wow, this is here.’”

For Mendoza, that moment arrived in early 2020. As Monroe County recorded its first official cases and then fatalities, he became “the guy on TV”—for many county residents, the public face of the local fight to contain the novel coronavirus.

Mendoza describes the pandemic as a “life-changing event for everybody,” but in particular for public health officials and staff. They were on the frontlines, one exhausting day after another, struggling to save lives and reduce the spread of the SARS-CoV-2 virus. As the pandemic stretched into months and then years, they also became targets as misinformation and polarization over school closings and vaccinations reached a fever pitch.

“The anti-vax, anti-science movement was powerful,” he says. “And we didn’t have that level of power on the side of science.”

When I spoke with him last week in his ninth-floor office at the Westfall Road office tower that houses the Health Department, Mendoza was thoughtful and frank as he described his personal experience during the pandemic and reflected on what he’s learned. He said he did not regret decisions he made amid great uncertainty, but wished more deaths could have been prevented. And looking ahead, he talked of a sense of foreboding, a concern that as a society we haven’t learned the lessons necessary to do better the next time. (Portions of the interview that follows have been condensed and edited for clarity.)

PAUL ERICSON: Do you recall when you first heard about COVID, and what you thought about it?

MICHAEL MENDOZA: I first heard about COVID in late 2019, back when COVID-19 was still 19. Reading about the individual who contracted COVID, from China, you know, it was at that point very much a China, foreign, distant thing. But then I remember, really, within a matter of weeks, my colleagues, the local scientific community, the national public health community, was really starting to amplify this reality that this is going to become a pandemic. And come January of 2020, we’d had travelers, faculty, staff and such from the university, who were flying back from China that month. And we were already in the depths of quarantining and isolating and all of those realities that became all too familiar, only months later.

But I remember giving a talk at the university. And, you know, it was very much in the press at that point. And one of the physicians said, “So, who’s gonna lead this thing for the county?” And that was when it dawned on me, that could be me. Or at least I could be among that group. But it was very much a surreal thing. We practice and we have plans. And we talk about these things in sort of the hypothetical sense. But when it becomes reality, that’s when you think, “Wow, this is here.”

ERICSON: When did it become clear to you this was going to be a public health crisis like nothing you’d ever experienced before?

MENDOZA: When I started rereading the CDC guidelines on how pandemics evolve, there are these steps leading up to a pandemic. The so-called non-pharmaceutical interventions that the CDC had written in their materials, it takes two to three weeks before we consider—the global “we”—consider these non-pharmaceutical interventions like distancing, and masks and all the non-vaccine things, because we didn’t have a vaccine at the time. And I was thinking to myself, oh, maybe I have a two- to three-week runway on this. And this was March 10. And then it was really two to three days. That two- to three-week thing did not pan out, like the CDC thought it would. So, this is not going to be influenza—this is going to be way bigger than influenza. And that’s when I knew.

ERICSON: Recently I went back and looked at a video of a briefing you gave on Feb. 27, 2020, with Adam Bello. You were trying to describe what was known as the time. Things like the virus was spread primarily through respiratory droplets turned out to be the case. But you also said that at that time, it seemed pretty clear that it was spread through symptomatic exposure. And, of course, later on, we learned (about asymptomatic spread) and it made me think about just how difficult was it dealing with a novel coronavirus, something that the world had not seen before.

MENDOZA: It’s not unlike what we handle in medicine, which is uncertainty. We have diagnostic uncertainty all the time. We have treatment uncertainty all the time. I didn’t appreciate at the time how important communication about uncertainty would become. And I’m still appreciating that even now, as we deal with new uncertainties. But, yeah, I had to learn how to be wrong. I had to learn how to say I don’t know, in different ways. I say it all the time with my patients. But when you have a community that you have to say, “I don’t know, we don’t know. We’re learning about this.” I found creative ways to say I don’t know. That was new.

Do I have regrets about how we approached things? No, we were dealing with a lot of uncertainty. I remember reading a book (“Apollo’s Arrow”) by Nicholas Christakis, and he talks about pandemics. He’s a mentor of mine from the University of Chicago. And he’s a very distinguished professor now at Yale, and he talks about pandemics. And he didn’t know that this was coming either. He just happened to be writing a book about pandemics. And he said that a pandemic, one of the fundamental criteria that makes something a pandemic is that it becomes a polarizing force in society. It’s a necessary component, to become a pandemic, that it has to be polarizing in some fashion. And we certainly saw that. But yeah, the novel part was the hardest part.

ERICSON: Looking back over the last 3½ years, what are some of the key lessons? What are some of the things you think we did right, you did right?

MENDOZA: Key lessons. For me, it was the importance of communication; communication relationships in a community. It really amplified that notion that change is local. Because, you know, local was different from county to county, from city to city. And what my colleagues went through in the surrounding counties was very different from what we had to go through. And so certainly, there was communication coming from the federal government, the state, even among us as an association of county health officials, but the reality is that it was very local, and the local communication paved by, hopefully, good relationships among the Health Department and other community agencies, between us as individuals and our colleagues in the medical field and other nonprofits, the stakeholder community, that’s what mattered a lot. Because when we had to communicate about uncertainty, and about all the things we didn’t know, it was nice to not to have to get to know people in the middle of a crisis, that I could call on people that I had a chance to meet, even casually, if not in depth, before the pandemic. That helped a lot.

So, communication really was the most important thing. And it underscored for me how important it was that the media was welcome, in my view, to ask questions, to be a part of this. That was key, because the media had to get it right, I thought, and our job was to help feed them with accurate information as much as we knew it. The media would play an important role in helping to allay the fear of those early weeks and months. I thought there was no role for, you know, coverups and hiding things; we just needed to have open conversations.

ERICSON: Are there things looking back that you would do differently?

MENDOZA: The one thing I would have done differently was talk about masks and how important they are earlier. I remember early on we said, because the CDC advised that we say so, that we would reserve N95 masks for health care workers. And fundamentally, that made sense, because in the health care field where I was seeing patients until roughly early March, we needed to keep ourselves healthy, because we didn’t know what was coming. So, on one hand, that made sense. On the other hand, it highlighted for astute citizens that doesn’t make sense. Why would it? Why would it work for a health care worker, (and) not for all of us? I wish we had gotten in front of that, because that was, I think, the first example of how we needed to tighten up our communication. Because the public is smart, and they understand, they see through when something isn’t, you know—if we’d just said, “We don’t have enough of these, we got to save them for the nurses, or the doctors or the ER staff,” I think the public would have gotten that. But for the CDC to come out and say we need to reserve these for the health care workers with no real justification, in my view that was a mistake.

ERICSON: Nationwide, 105 million cases, more than 1.1 million deaths. In Monroe County, nearly 200,000 cases, more than 2,000 people…

MENDOZA: Over 2,000 died, yeah.

ERICSON: When you hear those numbers, what are your thoughts?

MENDOZA: It didn’t have to be that way. It didn’t have to be that way. We could have prevented so many of those deaths. And many of those cases.

You know, we can get into the “did you die of COVID or with COVID?”—we can get into all that kind of stuff. But the reality is that the World Health Organization has been tracking excess deaths. Those are the deaths above and beyond what would be expected globally, due to all of the causes. And when you have excess deaths, you’ve got to look for a reason. And globally, we can’t blame the opioid crisis, because that’s not a global problem. The pandemic was the reason for the excess deaths, and only recently did that number go to zero. And so, as much as we wanted to say that the pandemic was behind us last year or the year before, really it wasn’t, it hasn’t been behind us very long. I wish we could have prevented so many of those deaths.

ERICSON: It’s interesting, but maybe not surprising, that what you’re saying is very similar to something that Dr. Anthony Fauci said recently, in an interview with the New York Times. He said, “Something clearly went wrong. And I don’t know exactly what it was. But the reason we know it went wrong is that we are the richest country in the world, and on a per-capita basis we’ve done worse than virtually all other countries.”

MENDOZA: It’s true. It’s true.

ERICSON: So, you don’t find that too harsh a judgment?

MENDOZA: It’s backed by the science. That is a factual statement. When you look at the decline in life expectancy in the United States—it’s confounded by the reality that we have an overdose crisis that we’re in the middle of, which predates the pandemic—but the fact that other countries have been able to return to their pre-pandemic life expectancy and yet we haven’t underscores that reality. That we declined faster and further in terms of life expectancy lost during the pandemic is proof of what Dr. Fauci is saying. I mean, that’s the data. It’s hard to refute that data. So, I don’t think that’s wrong. I don’t think that’s an overstatement. I think that’s a reality.

ERICSON: I suppose we can feel good in Monroe County, our numbers per capita are better than nationwide. But still, when you compare it to Canada, Mexico, all of Europe, they’re not. Are there particular cultural factors that explain the difference?

MENDOZA: Every country has politicization or polarization. I think every country has disparities in—you name the health outcome. But we have it more than the average developed nation. When you look at life expectancy in general, pre-pandemic, when you look at infant mortality rates, pre-pandemic, our numbers don’t compare. They don’t jive with the reality that we are the most expensive health care system in the world. One key fact is that we only spend 5.4 percent of our $4.1 trillion health care budget on prevention. That is unique among developed nations. That we don’t value prevention, I think, is probably one of the greatest hindrances to our ability to get through a pandemic, and that we didn’t learn from previous pandemics.

This is not to paint a political picture, but President Obama had the option of developing a national influenza pandemic response plan, and he declined. The absence of that plan ended up hurting us because the next administration didn’t have a plan. And it was made worse by misinformation being espoused at the highest levels. That I had to issue a social media tweet and (do) more interviews that we reassure the public not to drink bleach was not something that I had ever thought I’d have to do. And that is unfortunate.

ERICSON: The first official case (in Monroe County) was announced March 11, 2020. Nine days later, Cuomo announced the stay-at-home mandate. All non-essential businesses were ordered to close, and this continued until early May when the four-phase reopening plan took effect. From a public health standpoint, do you think the lockdown was the right call? Should it have started earlier? Should it have lasted longer?

MENDOZA: This is one of those things where, you know, it’s funny; you said nine days, because it felt like longer than (that). We have to look at these decisions on a prospective basis. Because retrospective was a very different perspective. It was a very important perspective. But when you’re sitting there on March 14, you don’t have the benefit of what was going to happen on March 24 to inform your decision making.

So, first of all, I’ll say that when the school superintendents decided to close the schools down, I think we were lucky that our first locally acquired case was a school employee. We were lucky in that it impacted our schools first. So, they had really no other choice but to have to close the schools down probably earlier than other counties did in our region, and certainly across the state. Was it the right or the wrong thing? Didn’t know at the time, but the fact is that when everybody else closed down, we decided, well, at least we were ahead of that pack. And, you know, assuming as we did, that closing schools down was the right idea then, because we didn’t know much of anything then, I felt like that was lucky. That was good.

The studies on whether and when they should have reopened, you know, Florida has studies, everybody has studies now. Everybody’s looking at this reality. And, the question of educational loss is a very real one, the impacts on mental health (are) very, very real. But was it the right decision? I think it was the right decision at the time. Was it an easy decision? Absolutely not. But it was the right decision.

ERICSON: Schools became one of the huge flashpoints, the debate over schools, and there’s been a lot of retrospective looks at it. And even some people who were in favor of closing schools for quite a period of time now say that we probably kept them closed too long. Do you think that, in terms of schools but (also) generally, we underestimated the harm that can be caused by social isolation, especially mental health?

MENDOZA: I don’t think anybody, I don’t … I didn’t underestimate it. I knew that that was a big deal. We’ve been looking at studies on social isolation among older adults, the geriatric medicine community has been paying attention to this for decades. You know, was it real? In a tangible sense, not yet. Because we were dealing with the mechanics of implementing all of the things that we were implementing. So it was, to some degree, an abstract thing, in my view, because I was very busy dealing with very here-and-now kinds of things.

But no, the mental health part and the social isolation part were always a big deal. You didn’t know how to measure it; we still don’t know how to measure it all the time. It was easy to defer. And I think there was a hope that it wouldn’t be bad, which, depending on who you ask, is either not bad or really too bad. But I think in the moment, it wasn’t as much of a reality, at least from my standpoint. Now to the community and the mental health (community), they had different perspectives and sure, it was a big deal. We tried to listen to those perspectives as best we can, we could; we went out of our way to convene roundtables, and Zoom conferences and had thousands of people on these things and try to get as much of the input we could, but a lot of these things were done at the state level. The timing was, well, on one hand, we don’t know if it’s right or wrong, but at least somebody with authority, the state Health Department, CDC, was coming down, you know, be it from expert panels and opinions versus actual data, or somewhere in between. These were the guidance statements that were coming down. And as a scientific community, when we don’t have randomized controlled trials, we look to best guess, you know, scientific (opinion).

ERICSON: Access to reliable real time data is clearly critical. And in some respects, it’s been a revelation to see how much data can be produced, how quickly, and how much was shared with the public. But at the same time, some people have pointed out that in comparison to some other countries, our data collecting has been lacking. Again, taking a step back, what do you think? Did you have the kind of data you needed to make truly informed decisions? Or were you looking for more?

MENDOZA: Both. We had data on cases and results. And we had access to data, the types of data that we don’t have during times outside of a national public health crisis. I can’t access equivalent data around chronic illnesses, mental health, the whole host of things that we handle as a health department. I can’t access that stuff nearly as quickly as I was able to access COVID data. Because it was a national public health emergency, because so many of the privacy laws were suspended during that time, we were able to get information.

Now, was it enough? You know, did we know the difference in April 2020 of time with COVID versus dying from? Not like we do now. But based on what we knew at the time, we had better access to COVID data than we had to any other data. Was it enough? No, we didn’t have access to race/ethnicity data. We didn’t have access to gender data. We didn’t even have access to some of the basic age demographic data, for even COVID. So, even if we could get the COVID information, when the race/ethnicity box was left blank for longstanding reasons, we didn’t have the data. And we had to triangulate, to find other ways to get those data to have a full picture about the disparity that COVID would inflict upon his community. We didn’t have that data until May. And we took it on the chin on that, because we couldn’t paint an accurate picture without those data. We didn’t have them.

And yet we have the most expensive health care system in the world and in this community 70 percent of our market is on the same electronic health record. If any county could have done it, we should have been among the first. And because of all the firewalls between health care and public health, and schools, primarily, and social services, sort of the fourth bucket, we weren’t able to share data like other countries. And I think that speaks not just to our pandemic response, but to our preparedness. We didn’t have the level of preparedness in this country that other countries did.

ERICSON: I think there’s pretty general agreement that one of the really remarkable achievements during the pandemic was the development of vaccines in less than a year. I also think many people hoped and perhaps believed that once we had vaccines, this would be victory over COVID. Clearly, we’ve learned that’s not the case. Again, looking at the numbers. I think more than three times as many people have died since the vaccines rolled out as before. Again, was this inevitable?

MENDOZA: No, it shouldn’t have been. We should not have treated that as inevitable. I mean, the fact that three times more have died speaks to the longevity of this thing, and how quickly we got from index case to vaccine. You know, how much time was that from March 11 in this community—Dec. 28 was when I got my vaccine. So that was months. And we’re coming up on three years since then. I don’t think it was inevitable. If this was any other vaccine, that didn’t get as polarized as this did, if we didn’t have to fight misinformation as much as we did…

The trust issues among certain communities that have been traditionally underserved or alienated from health care; that’s real. We needed to do a lot of work and more to earn the trust among those communities. But when we have people amplifying messages on social media—the anti-vax, anti-science movement was powerful. And we didn’t have that level of power on the side of science. So, those influencers, even in this county, when you look at the east/west side disparity between the vaccine rates, the hospitalization rates and the case numbers, they’re all correlated. When you have a ZIP code with a higher vaccine rate, they had a lower hospitalization, lower death rate. It’s clear. What predicted that was access to education and access to resources. Those are the two primary drivers for getting the vaccine. The higher education level, the higher your SES or socioeconomic status, the more likely you were to get the vaccine. It didn’t have to turn out the way it did even here.

ERICSON: Yeah, what you are pointing to, (when you look) at all the data, you see this disparity. Asian residents of Monroe County, I think it’s a 93 percent vaccination rate (for Asians), among (whites and) Hispanics in the 70s, and among Blacks it is less than 60 percent. Clearly, there was a difficulty in reaching, as you say, certain communities and persuading them why they should get vaccinated.

MENDOZA: I think it’s important to realize that even within those demographics, there’s a lot of diversity, within Asian, within Latino. I think that’s where leadership matters. You know, we have local leaders from each of these communities—particularly, honestly, the Hispanic and Black communities—we had local leaders speaking very vehemently against the vaccine, not just in the beginning, but even well into the pandemic. And that was unfortunate.

ERICSON: And, of course, with the vaccines, usually the highest rates were with the first round. But as we’ve gone and gotten down to the latest round, I mean, we’re down what the 20s, 30 percent?

MENDOZA: Yeah, the most recent booster from fall of ’22. Older adults were the most highly vaccinated, and that’s been true across the pandemic. But among adolescents and adults under 40, the rates are well below 20 percent. And, to some degree, that’s acceptable, because the severity of the illness is not what it was in 2020. We haven’t had a new variant. We’ve been with the Omicron variant now for almost two years. And the reason for that is because the impact on the average individual is lower than it was in 2020. So there, it’s understandable.

From a health care standpoint, we all think, well, the risk is low on the vaccine. And even if the benefit is low, still makes sense, because the risk is lower. Benefit greater than risk equals take action. Yeah, it’ll be interesting to see what happens this fall. We have another vaccine. The FDA is unlikely to recommend it for all age groups; they’ll generally recommend it, but they’ll say strongly recommend for older adults and high-risk populations and so forth. But

I anticipate that the vaccine uptake rate will be analogous, if not worse, than the usual influenza rate, which is 50 percent. And you’d be lucky to get more than 50 percent in this county vaccinated for COVID.

ERICSON: Is an element of this a little bit of COVID fatigue on the health care side as well, just trying over and over again to get people to get vaccinated?

MENDOZA: I think we lump it into just general fatigue. COVID fatigue is real. But the fatigue around trying to educate people is, I think, the greater force that we have to contend with going forward. How do we reach out, how do we communicate about health and science to a skeptical population? I think that’s the challenge.

I think the medical community is much more tolerant of COVID fatigue than the average population. I mean, mask wearing in health care settings—most of us are still wearing masks, because it wasn’t a big deal to us, because we’ve always worn masks. So, there are parts of COVID fatigue, that, you know—we’re tired of saying vaccines work. That’s something we shouldn’t have to say as much as we had said. So, there’s that bit of fatigue. But I think most health care workers just see this as part of our job.

ERICSON: You’ve touched on misinformation, but maybe you could talk a little bit more about this at the local level? How much of a problem was that?

MENDOZA: How much of a problem was it? From my standpoint, it was a problem enough that we had people die that didn’t have to die. I mean, that’s a big problem to me. I wish that we had had more trust. And I personally own the reality that we didn’t have all the trust that we could have had. I mean, that people didn’t know that there was a Health Department until March 11, many people, was a reminder to me that maybe I should have done more before March 11 to educate the public about whatever. The Health Department was more than just inspecting restaurants for things. I take that as a lesson.

Could we have done more? I always believe that we could have done more. Because I’m just not satisfied with good enough. But it was a problem. The misinformation was a problem even locally. Social media became such a huge way of getting information out there. We were all personally attacked, professionally attacked, you know, death threats, security—these were real realities that none of us in health care ever thought we’d have to deal with. That it got to that level. There’s still people yelling at me when they ride their bike down my street, yelling at me about the vaccine. I mean, so here we are. They’re misinformed. These people are misinformed. This person was attacking me for a mandate that wasn’t even my mandate. But that’s part of the job.

ERICSON: Yeah, but it has to take a toll.

MENDOZA: It does. It absolutely does. This was a life-changing event for everybody. You know, everybody’s got a different perspective on how it’s changed their life. But I think public health officials have a pretty unique perspective on how this has changed our lives.

ERICSON: I imagine you would agree with medical experts who say that COVID is not the last pandemic we’re going to have in this country, and very likely it isn’t the worst. That future pandemics could be worse. Do you think we have learned enough to do a considerably better job the next time around?

MENDOZA: I think that the people—you know, I’m surprised we’ve gone 32 minutes, and I haven’t had an opportunity to talk about the people in this Health Department. People look to me as the guy on TV. And I wish people knew the team behind the guy on TV better than they know me. Because that’s the team that got us through this. We kind of speak nostalgically of those hours, 11 and 12 midnight downstairs in our headquarters room. The public didn’t appreciate, and I certainly didn’t do enough to highlight that work enough. But those are the people that have the memory. And as much as we’d like to think it’s not going to happen (again) on our watch, it could. And if it does, and I have the same people in place, I feel good. Not because of what we know, but because of how we will learn what we don’t know. I think the group of people who are in place during this pandemic, regardless of where they are, have a respect for what is unknown now better than we ever did before.

Sure, there’s experience, there’s knowledge. I still have all my files. I mean, I can plug and play to certain degrees. But the point of novel is that we haven’t seen it before. There’s going to be nuances to everything that happens. And we had a little bit of this when we had the mpox, the monkeypox, when that came along, we thought, oh, geez, sounds really familiar. When the air quality crisis came out, we didn’t know what that was going to turn into. Turns out that’s another new normal. You know, the fact that that climate change is real, that we’ve seen two of the hottest months on record in a row, leading to fires in Canada that didn’t have nearly the impact that they have now. That we’re seeing increases in viruses that now thrive, because the environments in which these vectors, mosquitoes, ticks and the like live is warmer,

it won’t be a surprise when the next pandemic hits. And that it’s going to happen with greater frequency is not going to be a surprise.

So, have we learned enough locally, I think, remains to be seen. If I’m still on the seat, I’ll feel pretty comfortable that we can go through this again. It’s gonna be a lot of work, sure. But I also think that succession planning in the Health Department, I’ve got to make sure that I’m paving the way for future leaders, my successor, to make sure we don’t lose step with what we’ve learned. So, that means building in systems that remember things, data, processes, procedures, all the sort of boring stuff that managers and leaders have to do in a department. We’ve got to do that work.

Has society learned enough? I think so. I don’t think there’s an individual in this county that wasn’t impacted in some way by this. Now, did we learn lessons? That’s another question.

I think that’s the question for the ages. You know, that we’re still revisiting some of the very fundamental truths of the pandemic, in ways that other countries are not, is foreboding to me.

I’m worried that we didn’t learn enough (lessons) as a society.

ERICSON: One last question. Have you had COVID?

MENDOZA: Yeah. I got COVID Labor Day weekend of last summer.

ERICSON: Everybody has their own experience of the last three and a half years. My own perspective, (I returned from Europe) on March 16 (of 2020) and on the 18th I started feeling chills. I was sick for about nine days. At that point, you couldn’t get tested; unless you are really sick, they said just stay at home. I remember that experience and just how much was unknown. And how rapidly it was moving. I mean, two days later, the whole state shut down. It was a strange period.

MENDOZA: First of all, I’m glad you made it through there, glad you got home.

It turned out, at least in my experience, that people who got COVID and people who got hospitalized from COVID, some people didn’t take it serious until that moment, whether you had a mild illness or ICU stay. I was actually attending at the hospital on service, the week that Omicron was at its peak in January. And that was unplanned. That was just luck of the draw, you know; when we do our schedule, I had that week of January 2022. And every patient I admitted at the hospital had COVID. And some of them knew me as the guy on TV, and some people weren’t awake enough to know who’s talking to them. And I said, so how do you feel about the vaccine now? And all of them said, I wish I’d gotten the vaccine. And that was when it was bittersweet. Because on one hand, yes, finally, somebody took the illness seriously enough to know the importance of the vaccine. But it was bitter in that I wish they didn’t need to experience that to understand the value of the vaccine.

And I wish I had done more. I wish we had done more. I wish (it) didn’t have to be that way. Because these people were very sick. And some of them we lost. And, you know, some of these individuals said to me, “If I could do it all over again, I would have gotten the vaccine. I wish I didn’t listen to ‘blank.’” And that was sad.

ERICSON: The thing that has always been hard for me to understand is the people who have gotten gravely ill and, in many cases, died and still to their last breath, “I don’t believe it. It’s all made up.”

MENDOZA: I lost my uncle to it. And his last words were, “I can’t breathe.” Coinciding with the summer when there was George Floyd, right? Whose last words were “I can’t breathe.” And it was poignant to me. (My uncle was) highly educated and fell down a rabbit hole of listening to unreliable sources. And his last words were “I can’t breathe.” It was before vaccines. He wasn’t wearing a mask; he thought all of that was phooey.

ERICSON: Is there anything else that I haven’t asked you about?

MENDOZA: I think the one reality that we’re still grappling with is, what does it mean to be in public service? What does it mean to be in government—public health or government in general? In times of crisis, wars, you see a surge in interest among young people to join the ranks of public service. We’re not seeing that now. We’re certainly not seeing it in public health. And that may be fine. But even across other areas of public service, we’re not seeing that. We’re not seeing a surge of people wanting to go into the military, or you name it.

Where I know the most is in public health. You know, we’ve lost almost half of our roles in terms of county health officials in the state, since the pandemic. There’s always a bit of turnover, but it’s never half in that amount of time. And talk about are we prepared for the next one, we’ve got 35 individuals out there, who know a lot of stuff that may never get put to use again.

And, you know, if you’ve seen one pandemic, you’ve seen one pandemic. But there’s a lot of experience that I just worry we have lost. And we didn’t have the time to prepare; we’re still preparing for the next one. That’s one of those realities I wished didn’t have to happen. Many of my colleagues were fired, straight fired, because they talked about how vaccines work. And that’s unfortunate. Those communities suffer because of that. These are dedicated human beings, not necessarily of any political stripe, scientists who want to do the right thing. They’re retired at 50.

So, we move on. The fight goes on.

Paul Ericson is Rochester Beacon executive editor. The Beacon welcomes comments and letters from readers who adhere to our comment policy including use of their full, real name. Submissions to the Letters page should be sent to [email protected]

9 thoughts on “‘We had people die that didn’t have to die’

  1. Excellent article/interview. Thanks so much. Dr. Mendoza is amazing. Leaves me feeling so sad that our species has the ability to be terrified by and thus ignore/distort reality, leading to such terrible results. I wish Americans could recognize that we aren’t “better than every other country,” and there is much to learn from more effective approaches to public/private health.

  2. Thanks for this very interesting article. Tremendous belated thanks, Dr. Mendoza, for all that you have done to help us during the pandemic. I have really appreciated your thoughtful decisions and regular communication with Monroe County residentsduring the worst period of the crisis. I’m sure many others agree.

  3. Can you clarify with Dr Mendoza what he meant in his final comments “Many of my colleagues were fired, straight fired, because they talked about how vaccines work. And that’s unfortunate. Those communities suffer because of that. These are dedicated human beings, not necessarily of any political stripe, scientists who want to do the right thing. They’re retired at 50.”

    Specifically, who were fired; who were retired at 50 and why? Did this happen locally?

  4. Missing from this interview is any acknowledgment that there were effective solutions for saving lives beyond masks and vaccines. We DID have people die who didn’t need to die. But our review of this period should start with the failure to communicate and prioritize individual health as the #1 strategy to improve outcomes. Where was the daily encouragement for people to get outside and walk and exercise, with the specifically stated objective of improving cardiovascular health (and losing 10-15 pounds where warranted). We knew very early on that the morbidity rate was drastically higher among overweight individuals, but instead we closed gyms and parks. Where, also, was the call to eat better, including zinc and Vitamin D supplementation? We knew very quickly that the vast majority of those who died from Covid were Vitamin D deficient (a key factor in the immune system). For a fraction of the money spent advertising the vaccine, we could have provided free vitamin D to the masses, which would have saved lives (particularly in the hard-hit Black community where vit D deficiency is significantly higher). Where, finally, was the honest acknowledgment of the greater impact on society resulting from the shutdown of the economy? Hundreds of thousands of businesses were destroyed and millions of lives deeply wounded (or worse) due to our singular focus on one input of a much more complex social and economic ecosystem. Finally, there can be almost no debate regarding the inexcusable disservice we did to young people, who were at virtually no risk. Masking children in schools as long as we did was an abomination, resulting from a cowardice by the adults in charge to stand for what was right (and, ironically, science-backed). Until these gross errors are fully acknowledged by the experts, feedback like this from public health officials cannot be taken seriously. Ignoring or, worse, dismissing the importance of diet, exercise, and weight loss in significantly mitigating risk was irresponsible and anti-science. The real lesson that must be taken from this ordeal is that we can never allow a handful of unelected officials to make unilateral decisions on behalf of an entire population, without regard for the greater impact, economically and socially. We painted everyone with the same brush, forcing a single solution without nuance or honesty with respect to those we knew were at much, MUCH higher risk (the elderly and overweight). Those who sadly died from/with Covid had an average of 4(!) co-morbidities, and the average age of those who died almost equaled our nation’s average life-expectancy. Where is the honesty in sharing those relevant statistics in any post-mortem about our response?

  5. Where to begin, without exceeding my allotted word count. We lost our father to COVID. He was in a nursing home. He was 101, but relatively heathy and clear of mind. On the last day of his time on this planet he was hurting. He had no trouble breathing but he said that it was as though someone had beaten him with a rubber house. He was, so we thought and hoped, in a quality nursing home. Unfortunately their infection control was beyond pathetic. The “bug” entered the nursing home through employees and eventually hit the floor. Couple that with the pathetic leadership shown by then Governor Cuomo, nursing homes were decimated. Then there was this thing called ‘trust”. The government has never been very good practicing what they preach. Trust is absent period. With the pandemic the government took the lead on the issues. As politicians they didn’t have the knowledge to make policy. They listened to those who fell in line with THEIR thinking and not the medical community. But that is all looking in the rearview mirror if life. In the end we lost our father at age 101, a WW II medal recipient and a stellar family leader. His last words to us were, “has my COVID check been deposited into my account yet.” Was his Dutch mind clear and with the times, oh you bet. We will remember him and my mother, those pioneers from The Netherlands fondly. Semper Fi.

  6. Thanks for all of your hard work, Dr. Mendoza. One question: You said, “Many of my colleagues were fired, straight fired, because they talked about how vaccines work.”

    What were these colleagues saying about the vaccine that got them fired? Do you mean they were skeptics, or that nobody was allowed to talk about vaccines at all? I didn’t understand that one.

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