Metro Health departures part of largest exodus of public health leaders in American history

Data: 181 state, local public health leaders have quit, retired, or gotten fired since April

San Antonio Metro Health has gone through several changes in the past few months. The trend is similar across other public health agencies in the United States.
San Antonio Metro Health has gone through several changes in the past few months. The trend is similar across other public health agencies in the United States.

SAN ANTONIO – The San Antonio Metropolitan Health Department finds itself undergoing another transition during the coronavirus pandemic.

Following the unexpected resignation of Dawn Emerick in June, Assistant City Manager Dr. Colleen Bridger delayed her departure to continue serving as Metro Health’s interim director. After announcing her resignation again in December, Bridger confirmed that she will continue leading city efforts against the pandemic as the COVID-19 Incident Commander while the city begins to recruit a new director for Metro Health.

Dr. Sandra Guerra, who had served as Metro Health’s interim deputy public health director since October, also stepped down from that post and is now helping Metro Health in a part-time role. Family Service President and CEO Mary Garr will be Metro Health’s interim director, while Bridger will oversee the pandemic response.

“We are in a critical juncture in the fight against COVID-19, and asking a new health director to assume responsibility at this stage of the pandemic isn’t in the best interests of the community or the City of San Antonio organization,” said San Antonio City Manager Erik Walsh. “Dr. Bridger and I have reached an agreement that will allow us to maintain continuity and utilize her public health pandemic expertise. Once again, Colleen has answered the call of duty, and we as a community owe her a huge debt of gratitude.”

The turnover at Metro Health is part of the largest exodus of public health leaders in American history, according to an investigation by The Associated Press and Kaiser Health News.

Since April, amid the greatest public health crisis in a century, 181 state or local public health leaders have resigned, retired, or been fired.

One in eight Americans — 40 million people — lives in a community that has lost its local public health department leader during the pandemic.

Many of the state and local officials left due to political blowback or pandemic pressure. Some departed to take higher-profile positions or due to health concerns. Others were fired for poor performance. Dozens retired.

Collectively, the loss of expertise and experience has created a leadership vacuum in the profession, public health experts say. Many health departments are in flux as the nation rolls out the largest vaccination campaign in its history and faces what are expected to be the worst months of the pandemic.

“I’ve never seen or studied a pandemic that has been as politicized, as vitriolic and as challenged as this one, and I’ve studied a lot of epidemics,” said Dr. Howard Markel, a medical historian at the University of Michigan. “All of that has been very demoralizing for the men and women who don’t make a great deal of money, don’t get a lot of fame, but work 24/7.”

In San Antonio, Emerick’s resignation came in June, while COVID-19 cases were beginning to surge. The pandemic further widened what already was a fractured working relationship between Emerick and Bridger.

“Since January 27, 2020, both Dr. Colleen Bridger and I have attempted to work respectfully with one another and produce mutually aligned outcomes for the City of San Antonio and the 2 million people of Bexar County,” Emerick wrote. “It’s been a very difficult journey for both of us.”

Bridger was set to leave her job with the city on Jan. 8, 2021, but Guerra’s departure from the interim director post may have led Bridger to stay on as the COVID-19 incident commander.

“We love Dr. Guerra, we really loved working with her,” Bridger said during Monday’s COVID-19 update. “You know, stuff happens and she let us know that she was no longer able to stay on.”


About the Authors:

Fares Sabawi has been a journalist in San Antonio for four years. He has covered several topics, but specializes in crime, courts, open records and data visualization.