By Paige Williams, The New Yorker, November 2, 2020
On January 13, 1919, as the third wave of the so-called Spanish-flu pandemic began, the governor of Ohio, James Cox, delivered his inaugural address. Propagandist bulletins from the U.S. Public Health Service had called the virus “a very contagious kind of ‘cold,’ ” but Cox used his speech to note the “appalling” number of fatalities—the United States ultimately lost some six hundred and seventy-five thousand people. The federal government was of little help. Only five of Ohio’s cities employed full-time health officers. “And then when the outbreak was acute outside the municipalities, conditions were even worse,” Cox said, referring to an earlier wave. “In fact, they were well-nigh unspeakable.” Cox urged the “radical reorganization” of Ohio’s more than two thousand separate health jurisdictions and said that the need for “scientific resistance” to public-health emergencies was “second in importance” only to fighting in the First World War.
Exactly a century later, a new governor, Mike DeWine, took office. DeWine, a Republican, was Ohio’s former attorney general, and, in the early two-thousands, he had been a U.S. senator. The state’s public-health system now consisted of a hundred and thirteen independent programs in eighty-eight counties. The population was largely older, and there were many smokers; opioid addiction alone had recently killed tens of thousands of Ohioans. “Public health had been ignored for decades,” DeWine told me. “It was something we took for granted.”
Ohio does not require the state’s top health official to be a physician: when DeWine took office, in 2019, the most recent directors had been a lawyer and the former head of the Ohio Turnpike Commission. DeWine wanted a medical doctor for the cabinet position, one who could both lead a large staff and, he told me, “communicate to the people of the state of Ohio about health issues in general.” His top adviser, Ann O’Donnell, recommended Dr. Amy Acton, whom she knew through the Columbus Foundation, one of the country’s largest community charitable organizations.
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