State and local health officials have had a bruising couple of years in New York, where COVID-19, monkeypox and poliovirus have all demanded acute responses. In Orange County, Dr. Alicia Pointer recently took over as the new Commissioner of Health, after previous posts as Chief of Pediatrics at Cornerstone Family Healthcare in Newburgh, Middletown Community Health Center, and Caring Health Center in Springfield, Massachusetts. Dr. Alicia Pointer spoke with WAMC's Ian Pickus.
You've now been in this role for a few weeks. What have you done to make yourself comfortable as the Commissioner?
So, I think a couple of the first things that I did was really get to know our health department. So, our health department does a lot throughout the county. I think I've learned more about that now than I ever knew as a pediatrician. So, I really made an effort to get to know each of our divisions. We have 10 divisions working on a variety of different things, and working with each of our division heads to find out about the work that they've been doing and where they need support moving forward. I've also been talking to some of our community partners, and some of the members of our community to get to know their needs, what's worked well for them in the past, and what they need moving forward as well.
What appealed to you about this position?
So, I'm a pediatrician by training, as you mentioned. I've worked for seven years in Orange County, and over the past few years of my work, you know, I love my patients. I've loved my families. I really enjoyed being a pediatrician, and helping families be healthier. But I had noticed that more and more, I was expanding in my work beyond those clinic walls. I was trying to address some of the health effects of trauma on our kids in foster care, trying to make sure that families had enough food when they went home after our visits, trying to make sure that our county was able to support the mental health of some of our youngest patients. And as I stretched beyond those walls, that really became where my passion was. Finding a way to work with our families and my patients, not just in that short amount of time I had with them in the clinic, but in their communities.
How do you see the county and the state achieving those goals that you've laid out?
It's a challenge, right? We talk a lot lately about health disparities and health equity, and I'm glad that those phrases are being used so much more within public health. But I think we have to remember that when we talk about those things, we're really talking about people having fewer opportunities to be healthy, because of where they're born, or where they live, or their race or ethnicity. And that has very real impacts that could mean premature deaths from a variety of causes that can mean being more likely to have your child born prematurely. It can mean higher lead levels and your kids, you know, being more likely to be diagnosis certain kinds of cancer or being more likely to suffer from asthma. So, all of these are very real health effects. And I think that's the challenge that we face nationally. I think it's a challenge that we face in the state and certainly in Orange County. And I think a big thing that I hope we're realizing is that when we have these public health crises, whether that's weather events or something like COVID, it's those populations that are also most likely to be affected. So, I think one of our big jobs is really preparing these, you know, more forgotten or more vulnerable populations for not only their day-to-day health needs, but these public health crises that seem to keep coming. And I also think we really need to reconnect people with health care. Over the past couple of years, our focus has really been on managing COVID and living with COVID, and that was important, it still continues to be important. But I think we need to reconnect people with their regular screenings, their regular immunizations, their regular doctors, so individual health care, but also all of these other public health impacts that we have that I talked about. Like I said, our public health department is huge, and we really need to refocus on the basics.
We're speaking just after the White House convened a summit on nutrition, which was the first of its kind since 1969, and the Biden administration has laid out a blueprint for achieving a variety of health goals through better eating and activity. What was your reaction to that blueprint?
I think that nutrition was one of the things, one of the successes, that really came out of COVID. It was one of the things that we did well. Certainly, there are still families that were hungry. There were still kids that didn't have access to food once they lost that in school. And so that's not to say that we fixed hunger. But during the COVID crisis, a lot of organizations really came together. A lot of policies were put in place. There was this support for nutrition and making sure that families and children specifically, could continue to get fed and continue to eat healthy, even if they weren't getting that nutrition through their usual means. So, whether that was through school or through their usual food pantries, I see that as one area where a lot of people came together, and like I said, it wasn't just community organizations, it was policy at the state and national level, too. And I'm excited that now that COVID is maybe stabilizing, we're continuing to build on that momentum, to make sure that kids and families have the nutrition that they need. So, I think that this is a great time to make that push, because we've seen that we can be successful and we've seen that we can make an impact there.
From what you've seen has the approach by the state and most local school districts this fall to keep kids in school and not shut everything down when there's a COVID positive case, does that seem to be working? And for people listening right now, what do you think they should know about the state of that pandemic, as we head into another, you know, fall season?
Yeah, so I just mentioned that, you know, COVID is stabilizing, but I want to make very clear, that doesn't mean that it's gone. So, in Orange County, you know, our 10-day rolling average continues to be in like the 120-140 cases per day. We have seen a slight increase in the past couple of weeks. We're still having deaths from COVID. We're still seeing COVID out there, and it's having real impacts on people. And so, I think we can't let down our guards completely. In the county, about two thirds of us are fully vaccinated, but under half of us are vaccinated and boosted. And I think you mentioned kids going back to school, I think, especially as we get into the Fall where kids are back in school, people are back in their workplaces, we need to continue to protect ourselves. And the best way to do that, is really to make sure that we're getting vaccinated, but we're getting boosted that we're getting our flu shots, because that's another respiratory illness that can also keep us out of school and out of work. That's still killing people too. So, I think one thing for people to know is that COVID is still out there and we still need to be aware. And a lot of that, you know, I have kids in school too. I know how excited they are to be able to go every day. But we have to remember that we need to keep protecting the kids that are in school. So, a lot of that is if a child is sick, making sure that we keep them home. If they do have COVID We need to follow the guidance of keeping them home and then making sure when they come back their mask for those full 10 days. We still have to continue to be vigilant while we're trying to get back to normal and that's hard. That's a challenge for parents and children in school districts. Certainly.
On another note, New York state declared polio and imminent threat to public health after the summer case in Rockland, which was the first in the United States in about a decade. Wastewater sampling and other downstate counties has shown the spread of the virus, if not cases, but Orange County is one of the counties that has a lower than the state average vaccination rate for polio. So, in your role, how do you hope to address that?
So, you're right. Polio continues to be an issue in Orange County, we continue to have polio in our wastewater, while we haven't had any cases of paralytic polio, but that does mean that we have circulating polio in our county. And as you mentioned, vaccination is the best form of protection, there's no cure for polio, treatment is supportive. And vaccination is the best way to protect yourself from paralytic polio, which is the thing that we're all really scared of. I think there are lots of reasons for lower vaccination rates. Certainly, there are disinformation campaigns, as we talked about before, a lot of people have been disconnected from health care for the past couple of years, adults and children. And I think there is a lack of trust, in some cases. There's a lot of fear and frustration over the past couple of years and those are the things that we really have to work on. You know, we're public health, and we talk a lot about our community partners, but really the community themselves, they're our biggest partner. We need them and we need to have that mutual trust in order to succeed. So that's where our efforts have really been, is working with our communities, working with the people closest to them. So, healthcare centers, other community agencies, you know, preschools, trying to rebuild that trust, trying to give people the education and information that they need, but also being available to answer their questions and address some of their concerns.
Why did you become a pediatrician?
That's a great question. I think there are lots of reasons that I love medicine. So, one is I just find the body really fascinating how vulnerable it can be, but also how resilient it can be. I find that dichotomy really fascinating. I love that in medicine, I'm always learning. I'll never have all of the answers. There's always more information coming out and I like that idea that a lot of times, I don't know something, but I can find out I can learn more. You know, part of why I became a pediatrician, I love kids, you know, everyone loves to be able to spend their day, well not everyone, but I love to be able to spend my day with kids and families. But one thing about pediatrics that I think, I don't know if this is why I became a pediatrician, but that's something this is something I grew to love as a pediatrician. Is you and the family and the child and, you know, my nurses, medical assistants, schools, everyone wants what's best for this child. You're really a team in helping this child be healthy. Maybe you have different ways of going about it. Maybe you have different thoughts as to what that looks like, but we all we all share this goal, which is helping a child be as healthy as possible. I don't know that adults always want that for themselves. But we all want that for these kids. And so, that striving together toward this goal, which it's hard to think of a higher goal than that children's health. That's something that I really loved about being a pediatrician.
