(While we have been investigating the Wuhan coronavirus pandemic’s disproportionate effects in Los Angeles County and exposing the social justice agenda of the Department of Public Health’s director, Barbara Ferrer, we have been in contact with several confidential sources in various county departments and private medical facilities to develop stories. As a result of that ongoing investigation we’ve received the following open letter from public health professionals in Los Angeles County exposing serious issues in the department that have led to the unnecessary deaths of hundreds of Angelenos.)

Open Letter from Local Public Health Professionals on Los Angeles Pandemic:
Failing to Protect the Most Vulnerable

While the firestorm of the Pandemic in Los Angeles County continues in our nursing homes and accounts for at least half of all COVID-19 deaths in the county, we need to step back and ask, “Who led us into this mess and why have the most vulnerable populations been needlessly exposed to this virus?” Most heads will turn towards Barbara Ferrer, PhD in social welfare, the current Director of the Department of Public Health (DPH). Initial reports to staff touted her as having come from the Kellogg Foundation and, before that, the Boston Health Department as a commissioner there. But, in truth, none of her experience qualified her for the job here in Los Angeles where over the years we have faced and effectively managed serious communicable disease health crises.

As Ms. Ferrer stepped into the role of Director, she replaced a career employee in the Department, Cynthia Harding, who has a very strong epidemiology background, and who had ably done the job as “acting” director for over two years with Dr. Jeffrey Gunzenhauzer as Acting Health Officer for the same time period, following the retirement of Dr. Jonathan Fielding. During Ms. Harding’s tenure she consistently deferred to the Health Officer as the face and lead medical decision maker for communicable disease outbreaks in our communities, utilizing some the of country’s top epidemiology and infectious disease physicians in DPH as well as very experienced field Public Health Nurses. Dr. Fielding’s legacy of open and active participation of experienced staff and managers during public health threats, while also intervening to alleviate health disparities in disadvantaged and high-risk populations, is no longer the case in DPH under the current leadership. Communicable disease control is no longer a departmental priority.

Once Ms. Ferrer was appointed as Director, one of her first moves was to notify all department program directors that she was to be the ONLY voice and contact with the Board offices. This broke down a chain of communication in place for many years that allowed local public health managers to assist constituents that contacted their local Board offices about a variety of health issues and act quickly on public health threats. Ms. Ferrer is the ONLY control point for Board questions and communication in the department. Even now, many managers complain that they don’t know what’s going on and are not being well utilized for the pandemic. Her only communication with them are occasional “chips and salsa” sessions or virtual town halls.

Perhaps these questions need further investigation once the pandemic has quieted:

1. Why did Barbara Ferrer leave the Boston public health department and why did she leave the Kellogg Foundation, where she indicated she was sidelined for months prior to getting the job in LA?
2. Why were lead departmental managers stripped of direct reporting employees while she hired friends from Boston who knew little of LA and its complex of communities?
3. Why, during the meningococcal outbreak in 2017-18, did Barbara Ferrer refuse to vaccinate paramedics, fire and police until a police union official called her out on it at a public Board meeting?
4. Why have a series of highly experienced managers been transferred, mysteriously loaned out of DPH to other departments, or retired?
5. Did Barbara Ferrer mandate a large budget cut to the Communicable Disease Control unit in the months just prior to the pandemic?

But here are the most important questions NOW as we are in the middle of this mess here in LA:

1. Why did Barbara Ferrer ignore early warnings from infectious disease physicians within the department and broader public health community?
2. Why was the LA Marathon allowed to take place?
3. Why isn’t County Health Officer Muntu Davis, MD, in charge of the public health response?
4. Why is Barbara Ferrer the “Incident Commander” for the Pandemic as well as the chief spokesperson?
5. Why weren’t the nursing homes an early point of control for the spread of SARS-CoV-2, particularly after seeing the reports of what happened in the nursing home in Washington state?
6. Why were nursing home employees allowed to work at multiple nursing home facilities at the same time even before any testing was available and continue to do so even now?
7. Why did DPH direct nursing home operators to accept COVID-19 patients rather than utilize the reactivated St. Vincent’s hospital?
8. Why were nursing home staff who were asymptomatic but tested positive for SARS-CoV-2 allegedly allowed to remain at work?
9. Why did DPH give the Mayor a recommendation to house homeless in city rec centers against CDC recommendations?
10. Why didn’t Ms. Ferrer request National Guard medical corps from the Governor to assist in disease control in these nursing homes?
11. Why did she hire an outside firm to process the data she uses rather than rely on highly experienced internal epidemiology staff?
12. Why don’t we have sufficient data on nursing home deaths, including at the state level?
13. Why did the County extend a contract to an outside MD to manage testing rather than rely on staff with successful community organizing for mass vaccination and community outreach efforts?

We have a public health department leader that expects a relatively small cadre of physicians and public health staff to control well over 400 nursing home outbreaks involving thousands of nursing home patients, and outbreaks in shelters serving nearly 60,000 homeless in our county. Current staff engaged in these outbreaks are exhausted and carry on valiantly without consistent department-level leadership, instead relying on what they understand as good public health practice, working long hours and making headway in this effort. They deserve our support and thanks.

Anyone with a depth of public health experience in dealing with outbreaks will tell you that controlling hot spots such as nursing homes would have been first on the list of community controls to stop the spread of COVID 19, instead of making such pronouncements as “you can walk on the wet sand, but not the dry sand at the beach.”

Deeply concerned,
Local Public Health Professionals