Across the country, they are quitting and the exodus is particularly pronounced in rural Kansas where opposition to mask mandates and other public health edicts remains strong.

Transcript

AUDIE CORNISH, HOST:

Public health workers exhausted by the pandemic and the politics swirling around it are quitting in droves. Their departure is threatening to weaken public health systems in dozens of states, including Kansas, where Jim McLean of the Kansas News Service is tracking the exodus.

JIM MCLEAN, BYLINE: Nick Baldetti was the director of the Reno County Health Department, not far from Wichita, but he quit in July. Baldetti says he feels guilty but cites a host of factors that drove him from the job.

NICK BALDETTI: Fatigue, the political maelstrom, and then the threats that I personally and my family and my health department received. I had local police watching my house. There's a period of time where I had escorts to and from work.

MCLEAN: Baldetti is one of 27 local public health officials in Kansas who have retired, resigned or been fired since the first cases of COVID-19 were confirmed last spring. Nationwide, the number of departures also continues to grow. In Washington state, nearly a quarter of the county health director positions are vacant. Gianfranco Pezzino is stepping down after 14 years as the health officer in Shawnee County, Kan., where Topeka, the state capital, is located.

GIANFRANCO PEZZINO: I'm tired emotionally. I'm tired physically. I don't think I have in me the energy to do another year like this.

MCLEAN: He says he's worn out by nonstop battles with elected officials. At a recent county commission meeting, he urged commissioners to step up efforts to counter a spike in COVID cases. But commission chair Bill Riphahn pushed back, arguing that more government restrictions are more dangerous than the virus itself.

(SOUNDBITE OF ARCHIVED RECORDING)

BILL RIPHAHN: What's the recovery rate in Shawnee County?

PEZZINO: Commissioner, that's the same question you asked me about 18 times in the last...

RIPHAHN: And I never get the answer.

PEZZINO: I am not - I always give you an answer. I'm here to answer questions about the...

RIPHAHN: What is the percentage?

PEZZINO: Excuse...

MCLEAN: Dr. Jennifer Bacani McKenney has faced similar resistance in her rural county. After medical school, she returned home to Fredonia to join her father's practice. On the side, she serves as the county's health officer, a $600-a-month position that put her on the front lines. At first, she says, people embraced policies aimed at slowing the spread of COVID. But when those policies cost jobs, McKenney says, people got angry.

JENNIFER BACANI MCKENNEY: Everybody hates the virus, but they cannot hate a virus that they can't see. So they hate the people that are imposing the rules because of the virus, and I believe that's us.

MCLEAN: Simmering tensions in the county, which votes overwhelmingly Republican, reached a boiling point recently when McKenney called for a mask mandate. The county commission rejected it, but McKenney persisted, triggering more threats, some from people she considered friends.

MCKENNEY: They're the people that I thought I knew better. And then they turn out to be so rude and hurtful. And it hurts your heart - like, it really does - because you've lost friends. Relationships are broken. And it's hard to come back from that.

MCLEAN: That hostility was evident at a recent public hearing where several people, including Patti Timmons and Donovan Hutchinson, decried McKenney's proposal as an assault on their liberties.

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PATTI TIMMONS: Once our freedom of choice is taken, they will come after more.

DONOVAN HUTCHINSON: After our guns, after our kids. Is this America?

MCLEAN: Dozens walked out in protest when it became apparent that the commission was set to reverse course and approve a 30-day mask mandate as a compromise. Andy Miller, a conservative Republican commissioner who reluctantly voted for the compromise because of climbing case rates, says it's hard to find middle ground.

ANDY MILLER: I'm - probably got a dozen emails or so that are just - it's either a mask or you're just a killer. There is no in between.

MCLEAN: While Jennifer McKenney is pledging not to leave, many others are. And those departures will weaken a public health system that forms the first line of defense against this and any future pandemic.

For NPR News, I'm Jim McLean.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Tags: health officials  COVID-19  health workers  public health  Series: The Coronavirus Crisis