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How OC’s public health system changed during the pandemic

March 31, 2023

The coronavirus pandemic has changed communities in many ways, and for the doctor who helped lead Orange County through its darkest periods of illness, among the most important has been the lasting changes seen in the public health system.

Dr. Clayton Chau, who was the county’s public health officer through much of the pandemic and remains today the director of its OC Health Care Agency, announced this week he will be leaving as of June 1, timing his decision to take some time to address his own mental health to the upcoming end to the federal public health emergency declared when COVID-19 began its destructive spread across communities.

Looking back at the last three years, Chau said the “frail infrastructure” of the public health system was flipped on its head by the global health emergency. And though the official declaration of a pandemic emergency is sent to end here in the U.S., COVID-19 will continue to be around for a few years and people need to continue to protect themselves.

Just two weeks ago, Orange County surpassed 8,000 COVID-19-related deaths reported; on Thursday 16 people were in Orange County intensive care units because of the virus.

“We’re doing great, (COVID-19) is definitely on the wane,” said Andrew Noymer, a UC Irvine professor of population health and disease prevention, but added that the virus “at some low level …is going to be the new normal.”

In preparing for this “new normal,” Chau said he is pushing his team at the OC Health Care Agency to continue to raise awareness and educate the community on how to protect one’s self and the county’s most vulnerable populations from the virus, as well as emphasize the effects of “Long COVID.”

Post-COVID-19 symptoms such as shortness of breath, fatigue and headaches can persist for weeks, months or even years after infection. Health professionals are learning how to treat these Long COVID conditions, which Chau said is affecting about 25% to 30% of people who have tested positive.

Chau said the biggest change he’s seen within the public health sector in the last few years is the county’s greater collaboration with local community organizations, which helped address inequalities in the health system and to reach communities that were most impacted by the pandemic.

“The public health system in our country had been pretty much desecrated, and so I don’t think anybody was ready to respond to such a large-scale pandemic,” Chau said. “When that time (came), when we needed other people to work with us, whether it be community-wide testing or vaccination, everyone from all the corners of Orange County stepped up and participated.”

The Westminster-based nonprofit Abrazar provides various services in Orange County’s lower-income communities such as after-school programs, transportation for seniors to medical appointments and distributing food. CEO Mario Ortega said the pandemic hit hard in the high-poverty and monolingual communities her organization serves, the same residents who were also less able to access county resources because of technological barriers.

“They didn’t have access to a lot of the programs that were rolling out because a lot of them require technology or use of the internet,” Ortega said. “Because we’ve been doing this for so long, we know how to connect with the community. Our team is part of the community.

“We said, ‘We need to be able to provide them access to information.’ The traditional means to get the information out to the community, you can’t use that, it’s not working. So we said, ‘Let us be a part of the solution. You have an issue, that’s what we’re here for.’”

Before the pandemic, there was more of an “arm’s length distance” kept between the health care agency and nonprofits, Ortega said, crediting Chau’s leadership with bridging that gap.

“This was one of the first times where they said, ‘We hear what you’re saying and we agree,’” she said. “I think it really is because of Dr. Chau, as he elevated the respect of the work that (we do), and realizing that we could reach the community much more effectively than any of the means that the county would try to do.”

Chau said thanks to federal and state funding and support from the OC Board of Supervisors, the public health department was able to provide funding to community-based organizations that typically would not get a lot from the government to help reach OC’s vulnerable communities.

Third District Supervisor Don Wagner said he hopes to see the collaboration between the county and local organizations continue in the future.

“I think Dr. Chau and the men and women of the health care agency really did work overtime to do the very best that they could, in their judgment, for the people of Orange County, and I thank them for it,” Wagner added.

The public health sector, even outside of Orange County, continues to face the challenge of finding and keeping workers. Chau said it’s a key focus for the OC Health Care Agency and will continue to be after he leaves in June.

“The burnout issue is very real, not only for the public, but also for the private side. Hospitals struggle with keeping and retaining the workforce,” Chau said, and added that OC will receive $25 million from the federal government over the next five years to help with building out the public health workforce. “We are working with our community partners, academic institutions, our community clinic and hospital, as well as our board, to come up with a concrete plan on how we’re going to utilize $25 million to build up our workforce.”

While Chau takes time off to take care of his health and spend time with family, he said he is confident the team he has built over the last three years will take good care of the community and will collaborate with local organizations to continue addressing inequalities throughout Orange County that the pandemic helped put a spotlight on.

His advice to current and future public health workers? “Work closely with the community. Understand what is relevant to the community’s needs,” he said.

“Collaborate with partners out there. We cannot do it alone, the pandemic has shown us that,” he said. “Keep your finger on the pulse of the community and then be open to continuing the partnership outside of the county to ensure that we have a system that is whole.”

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How OC’s public health system changed during the pandemic

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