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Reflections On The Pandemic From Pitkin County's Outgoing Public Health Director

Dec 4, 2020

Karen Koenemann, Pitkin County public health director, will spend her last day in the position on Friday, Dec. 4. She has held the position since the department's inception in early 2017. Koenemann spoke with Aspen Public Radio about the ups and downs of guiding the department through the pandemic. 


What has been the greatest challenge of your time here? What has been the hardest obstacle to overcome?

Obviously the COVID-19 pandemic is the greatest challenge of the globe. On a personal level for many people, it’s one of the biggest challenges that they might be facing. As well as on a professional level for me, it’s certainly has been a huge challenge. It's a global pandemic. It has touched every single person on this planet in some form or fashion, and to be able to be on the forefront of that work – we in public are the first responders to this pandemic and it has brought with it challenges and successes. I certainly can't imagine anything more challenging in my career.


Has it been tough being a public figure in public health at a time when your entire sector is under completely unprecedented levels of scrutiny?

Pre-COVID, the public health system in the country had been severely underfunded for about 10 years. I think about it as walking in as a public health system into a response where we were already emaciated. We didn't have the resources that we needed to begin with, to just do basic core public health services. And that comes from funding from the [Centers for Disease Control and Prevention], down to the state, down to the local.

We were really just very underfunded from a federal and then down through the state and then to the local level. So we walked into a pandemic without the resources that we even needed to do basic core public health services, and then to be thrown into a pandemic in which the pace is unrelenting. We've been asked to run at a sprint, where really, this is an ultramarathon.

A lot of your work is behind the scenes, dealing with inputs and factors that people don’t always see. What about your job over the last eight or nine month do you just wish people had known – things that would help people understand the work you do, and the decisions you made?

We operate in an ecosystem – an interconnected ecosystem – and that includes everything that's happening at the local level to what's happening at the state level, to what's happening at the national level. And that's all intertwined. We're not a bubble. We know our communities are intertwined with our partners and Eagle and Garfield. We know our community is intertwined internationally. We saw that in the first stages of the pandemic.

We know that we have to work within these systems that can constrain us. Because we were all in the middle of a pandemic, some of those systems weren't very well articulated or communicated. And so there were constraints that we had that were really hard to explain to the community.


What is next for the public health department and a director who will be entering at a turbulent time for public health?

Certainly COVID-19 response is still the primary response of the department. Many of the things that we were doing pre-pandemic – some of those things have continued. And some of them, we just had to put on hold because we had a small department that really had to pivot very quickly into a full-scale response.

We also identified, in 2021, work that we had been doing pre-pandemic that we really felt like was really critical work around mental health. That will continue in 2021 as an additional priority alongside the COVID-19 response. We recognized that that work was critical before the pandemic, but even more critical now.

What was your greatest accomplishment in Pitkin County? What are you most proud of in your time here?

I came to Pitkin County with the desire to have equity as a foundation to the work that we would do as a public health department, and to really look at the root cause of why people might have health inequities in their life, and to address the things that get at positive health outcomes. What has been unique about that vision and about that work is that we only had less than three years to figure out how to articulate that. What has happened through the pandemic response is that that work has become more ubiquitous within the way that the team does their work, the way that the County  considers equity and cultural competency and other aspects of equity, and then folding that into their COVID response. It has happened so much more quickly through the pandemic.

I believe that that's because of the voice and because of the work that we've pushed to do. So it is very much engagement with the Latinx community or ensuring that we have gender-neutral bathrooms in the county building, or ensuring that we're producing every meeting in Spanish and in English. And that's all been a product of public health work and the work.