Health chief ’s abrupt resignation catches experts by surprise
The abrupt departure of California’s top public health officer Sunday came as a shock to many local leaders at the front lines of the state’s pandemic response, who described Dr. Sonia Angell as helpful and handson but still somewhat of an enigma after less than a year on the job.
Angell resigned a few days after officials revealed a critical failure in the state computer system that collects infectious disease data, which resulted in an undercounting of new coronavirus cases since July 25. Gov. Gavin Newsom had touted a sharp drop in new cases on Aug. 3, saying he was optimistic that the state was starting to pull out of a twomonth surge. State officials said he learned
only that evening about the datacollection glitch.
On Monday, Newsom refused to say outright that Angell’s exit was due to the data error, “but if it’s not obvious, I encourage you to consider the fact that we accepted her resignation,” he said in a news briefing.
“We’re all accountable in our respective roles for what happens underneath us. I don’t want to air anymore than that,” Newsom said. “We accept the resignation if we feel it’s appropriate. And I accepted that resignation.”
The pandemic landed in Angell’s lap just three months into her tenure as director and state health officer with the California Department of Public Health, to which she was appointed by Newsom after working most of her career on the East Coast. Angell, the first Latina in the position, was one of a handful of public faces in the state pandemic response, though she rarely spoke at Newsom’s briefings and had not held any briefings of her own.
Public health experts said Monday that losing the state health officer suddenly and unexpectedly is concerning, especially at a key point in the coronavirus crisis as California tries to wrestle a fresh outbreak back under control. California has about 570,000 confirmed cases — more than any other state — and has struggled to strike a balance between reopening the economy and preventing the virus from spreading.
“Obviously, it’s always better to have stability. You develop relationships with people, and it’s disruptive to lose that working relationship,” said Dr. Bela Matyas, the Solano County health officer. “But it’s also a situation where any one person isn’t playing a more critical role than others. So from that point, it’s not that disruptive. It really is a team on the state level.”
Matyas and other public health experts said Monday they were surprised by Angell’s departure and had not been told why she was leaving. He assumed it was related to the problems revealed last week in the state’s datacollection system, known as CalREDIE.
The state misplaced about 300,000 lab results over about a 10day period, though it was not immediately clear how many of those were coronavirus results and how many were positive cases. The nearly decadeold data system was designed as a clearinghouse for all infectious diseases. Before COVID19, it typically received about 200 reports a day. State officials said it was not holding up under the burden of a pandemic and tens of thousands of daily reports.
Still, state officials clearly had been frustrated to learn of the computer failure several days after the Public Health Department became aware of the problem. On Friday, Dr. Mark Ghaly, head of the California Health and Human Services Agency that oversees the Public Health Department, said he would hold accountable those responsible for the errors.
In an email to state Public Health Department staff on Sunday, Angell gave no hint as to why she resigned.
“It is with deep appreciation and respect for all of this work that I share with you my own plans to depart from my position, effective today,” Angell wrote. “I remain consistently impressed and humbled by the expertise, commitment, passion and kindness demonstrated by all of you daily. We have led with science and data, and with equity at the core of our intentions.”
Both Newsom and Ghaly issued statements on Sunday thanking Angell for her service. Newsom said he had hired Angell because of her longtime passion for addressing race and ethnic health disparities, a topic that she had taken up several times during the coronavirus pandemic.
Dr. George Rutherford, a UCSF infectious disease expert who served as the state health officer from 199395 said he was frustrated that Newsom and other California leaders weren’t more forthcoming in explaining Angell’s departure.
“I find it vaguely unsatisfying that there wasn’t a reason given, right in the middle of this pandemic,” he said. “It’s totally disruptive. Everyone’s in temporary positions now. And somebody’s going to end up taking on three jobs instead of two.”
Angell was hired at a salary of about $275,000. She filled two roles with the state: director of the California Department of Public Health, managing the distribution of federal funding to county health agencies as well as data collection, including birth and death records, and other government tasks; and state health officer, the top medical doctor who leads epidemiological investigations and provides public health guidance.
Rutherford and others said they were encouraged that Angell would be replaced, at least temporarily, by two officials with extensive experience in California public health. Dr. Erica Pan, the former Alameda County health officer, is now acting state health officer. Sandra Shewry, a vice president with the California Health Care Foundation who ran the state department that manages MediCal, is acting director of the California Department of Public Health.
Pan “is incredibly competent, very smart, and has excellent communication skills. She would be at the top of my list to hold this position,” said John Swartzberg, an infectious disease expert at UC Berkeley who has known Pan for years.
Rutherford and other longtime public health experts in California said they hadn’t gotten to know Angell well in her relatively short tenure. She served two stints with the New York City Public Health Department — 200411 and 201419 — and the three years in between with the Centers for Disease Control and Prevention.
But aside from earning her medical degree at UCSF, she did not have any roots in California and was not widely known in the state’s closeknit public health community. Rutherford said that when she was appointed to the California job in October he sent her a note as a former health officer inviting her to lunch, but never got a response.
Dr. Chris Farnitano, the Contra Costa County health officer, said he and his peers spoke with Angell on conference calls several times a week during the pandemic. He said she was attentive and interested in their feedback, and “she was also helpful when I reached out to her individually.”
He and other Bay Area health officers said they were disappointed that she was leaving, but not overly concerned that her loss would create a void in the state’s pandemic response.
“Realistically, who sits at the helm of CDPH isn’t going to change how the pandemic rolls on,” said Solano County’s Matyas.
Dr. Stephen Shortell, an infectious disease expert at UC Berkeley, said bluntly, “I don’t think this will have much effect at all.
“That’s not meant as a criticism of (Angell), it’s just the fact that there’s too much of an organized response. And you have very qualified people stepping in,” he said. “We won’t miss a blip as far as I can tell.”