“We build the plane when we try to fly it.”
– Dr. Ngozi Ezike, director of the Illinois Department of Health
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A few weeks ago Dr. Ngozi Ezike’s four children – ages 17, 16, 13 and 11 – deliver her a PowerPoint presentation that they had put together.
It was a detailed assessment of how she did her job as leader of the Illinois Department of Public Health.
“It was like, ‘Well, we’re really proud that you’re doing this important work. It’s cool that you’re on TV, “Dr. Ezike recalled,” “But now we’re all over it.”
Their main complaint: She was never home anymore. As family friends filled the gap, checked them in and released candy every now and then, they felt they had not seen their mother in weeks. And when she got home, she was on the phone late.
“They’re breaking it down for me from their perspective,” Dr. Ezike in a new phone interview, which happened to happen the same day as her youngest child’s birthday. “It hurt.”
“But I hope they will understand better over time why I had to sacrifice so much time away from them.”
As appointed officials, state health directors usually play a role behind the scenes and identify, track and plan interventions on public health risks.
But this crisis has catapulted them into the limelight, standing side by side with governors and mayors, quickly turning them into some of the country’s most famous faces. (Ohio is Dr. Amy Acton, for example, has become something of a local icon, with fan clubs and merchandise dedicated to her.) It is up to state health directors to correct the data and come up with policy proposals to advise governors and the rest of the state things like when to shut down, how to open companies safely again and where to set up test sites.
But in a combustible environment with increased anxiety and more and more partisans are clashing over the emergency measures being taken, their every move and statement being scrutinized and dissected from every angle.
“I’m just trying to stick to what is right to do and let the politicians do what they have to do,” Dr. Ezike. “Nobody is positive about the exact right course – we build the plane when we try to fly it.”
The criticism her team gets – and there is a lot, especially over resumption of the economy – balanced by the “many letters and cards for support and encouragement” sent to her office, she added.
Today, Dr. Ezike’s journey of back-to-back meetings and calls starts at 18, when she receives daily updates from local health departments and emergency management and alternative care locations. Then there is the television broadcast conference with Governor J.B. Pritzker, under whom Dr. Ezike provides critical updates and takes questions from the news media. In a few days, Dr. Ezike’s team receives calls from the White House, Centers for Disease Control and Prevention and health directors from other states. Her day does not end until 11 o’clock, she said, as she tries to go through her emails.
“But I’m fighting it,” she admitted.
Illinois, although not the country’s worst hotspot, has undoubtedly been hit hard.
Dr. Ezike visited the couple at the hospital and it became clear to her what problems the country was about to face.
“We were waiting for official test results to return from C.D.C. because we haven’t yet had the ability to perform the test at our public health laboratories in Illinois, “she reminded. “The gentleman was considering” releasing himself “from the hospital isolation – he was worried about missing work and not providing for his family when he was in solitary confinement.”
“In those moments, I gathered my first interest in the challenge that would face this virus and how one’s personal financial or financial situation would affect decisions that affect not only the individual but society as a whole.”
So far, there have been more than 100,000 cases of coronavirus in Illinois and more than 4,900 deaths, bringing the state’s mortality to about 39 deaths per 100,000. That number is well below the nation’s three best threat spots: New York, which has a 150 deaths per 100,000, New Jersey, where the rate is about 125 per 100,000, and Connecticut, which has a rate of about 105 per 100,000.
These concerns were always conscious, Dr. Ezike. Prior to becoming Illinois health director, she spent 15 years at the Cook County Department of Public Health and was medical director of the Cook County Juvenile Temporal Detention Center so she had seen the gaping socio-economic differences between communities and how that gap could have a knock-on effect on access to health care.
“This virus did not create differences in health,” she said. “It just magnifies them.”
From the beginning, she got her eye trained on the most vulnerable, including important workers, many of whom come from minority communities. She has incorporated their needs into all the state’s response proposals, from getting P.P.E. to those who need it most to provide targeted messages and information. Dr. Ezike itself delivers its updates during the daily news conference in English and Spanish.
The virus has affected Dr. Ezike’s own circle also: Extended family members and family members of her co-workers have been infected, she said.
In February, before the coronavirus hit the world we know of, Dr. lost Ezike’s father, an immigrant from Nigeria who spent most of his life in Los Angeles.
“I buried him. We had very elaborate ceremonies for him in three cities and two continents, ”she said by phone.
She added: “But I think about how people can’t do it now and how difficult it can be. I think about it every time I think about the deaths we report every day. “