Experts wary of new state health law
‘Changing the rules of the game right when you’re at a critical point feels really risky’
Science and politics have blurred lines amid the COVID19 pandemic, experts say, and a recent state law is bringing that to the local level.
The new state law requires local health departments that want to take stricter steps than Gov. Eric Holcomb’s executive orders to get approval by their respective legislative body, which in Lake County is the county council and in most other counties is the county commissioners.
Most health and political science experts believe the new law is dangerous, but for different reasons ranging from health officers receiving “unilateral power to impose restrictions” to the future impacts of the law.
Peter Federman, an assistant professor in the School of Public and Environmental Affairs at Indiana University-Purdue University Indianapolis, said county health offices have been around for decades and focus on keeping communities safe, from shutting down restaurants to condemning homes.
Typically, when a health administrator creates the guidelines on how to respond to a public health issue or crisis, politicians don’t review the regulations “with a fine-tooth comb” to decide what to overrule.
“It seems with COVID-19, that’s been happening,” Federman said. “It comes down to politics, in the end. It’s not about any kind of meaningful oversight. (Health) administrators make decisions like this all the time that these councils don’t weigh in on. The fact that they’ve decided to weigh in on this
particular thing ... has to do with the politics that have followed the pandemic throughout.”
Tippecanoe County Health Department Officer Dr. Jeremy Adler, in Lafayette, who is also a member of the Indiana State Association of County and City Health Officials, said the association strongly opposes the new law and challenged it when it was a bill.
The association is very concerned that the law will significantly delay public health measures from going into effect, Adler said. The worst case scenario, he said, is that no actions are taken during a public health emergency if a commission votes against it.
“A delay could lead to measures not being implemented and cost lives,” Adler said.
As a health officer, Adler said he has personally seen the impact of the law. At the start of the school year, two out of three Tippecanoe County school districts voted to follow the Centers for Disease Control and Prevention recommendation to require masks in schools.
But, one school district opted to make masks optional, Adler said, so in response he went to the county commissioners to discuss a mask mandate.
When talking to the commissioners, Adler said he presented them with scientific facts about the dangers of the delta variant, how it is more transmissible, how young children are getting infected and can’t get vaccinated and pointed to recommendations from the CDC, Indiana Department of Health and pediatric associations.
While the commissioners didn’t vote on the matter, Adler said the commissioners “did not express their support for that.” Ultimately, the school district changed position and required masks, Adler said.
“Everything in the end turned out OK” Adler said. “But we could’ve created a dangerous situation for students and school staff.”
At its September meetings, the Lake County Council will consider an order drafted by Lake County Health Officer Dr. Chandana Vavilala to mandate masks in schools.
Unless the law is repealed or amended, Adler said it will impact the response to future pandemics and epidemics.
“It’s about letting people who have expertise in science and medicine steer the ship and not letting politics delay (the response),” Adler said.
The national political decisions around COVID19 have now trickled down to the local level, Federman said. The law “punts” health emergency decisions from experienced health professionals to elected officials “who have no expertise in this,” he said.
“Anyway you slice it, this is new. We have not asked people in these positions to make decisions about our public health before. I can assure you that is not what the voters of a county elected them to do,” Federman said.
While the impact of the law are hard to predict, Federman said it’s “hard to see the positive.” What’s concerning, he said, is that the law seems to cast doubt on health administrators and the decisions they are making.
Health experts have been making science-based decisions to respond to the pandemic, and with or without political oversight the reality of the pandemic and the virus won’t change, Federman said.
“There’s a reason we have health departments. Let’s let them do their job. That doesn’t mean let them run wild and shut down the entirety of the city indefinitely. That’s not what anyone is asking to do,” Federman said.
But, decisions like where masks should be worn and how to keep schools safely open should be left to the health experts, Federman said.
John Bullock, an associate professor of political science at Northwestern University, said decisions that affect a whole state or county should be decided by elected officials.
But, Bullock said he is wary of the arrangement where a health officer makes recommendations to councils because “it may threaten the prestige, the authority of the health officers.” Instead of making recommendations or issuing orders, Bullock said he’d rather see health officers share science-based facts about how to respond to a health emergency.
“If a health officer is making recommendations, not just providing information but making recommendations, about whether people should wear masks, whether schools should open, that health officer is becoming a political official as well as one who a certain kind of expertise,” Bullock said. “I think that the blending of the expertise and the politics doesn’t work well in this case.”
For decades, health departments have been run by nonelected officials that have made decisions on how to keep communities safe and healthy, Federman said. While the pandemic has shown in real time what health experts do, they should be able to continue to make those decisions, he said.
“Changing the rules of the game right when you’re at a critical point feels really risky. When we have an established system for doing this, why are we all of the sudden saying “somebody else should be calling the shots,’ ” Federman said.
In an emergency the health officer should be able to make a decision because a council meeting could delay emergency actions, Bullock said. But, he’s “afraid of that power” because it could be misused.
“Whether that’s going to school, wearing masks, vaccine mandates, what kinds of commercial establishments should be opened or closed, those are political decisions and it’s just an abdication of responsibility on the part of government to let health officials make those decisions or even to make recommendations about those decisions,” Bullock said.