Santa Clara Public Health Director Sara Cody ’85 Wins Zale Award for Public Service
Santa Clara County Health Officer and Public Health Director Sara Cody ’85 received Stanford’s Public Policy Program Zale Lecture and Public Service Award on Tuesday. During his acceptance speech, Cody discussed his role at the forefront of the Bay Area’s COVID-19 response, explaining that extension shelter-in-place orders were intended to prioritize equity and emphasize the importance of working alongside community leaders.
Cody ordered the country’s first local shelter-in-place order in March 2020, alongside other Bay Area officials.
“It was the only way we knew at the time to protect communities that were going to be disproportionately affected,” she said, pointing to those in high-exposure jobs in nursing homes, public transport or grocery stores which often have multigenerational problems. families with elderly people living in the same household.
Working with community leaders was especially important when implementing a testing and immunization strategy, Cody said. In Santa Clara County, 76.2% of residents 12 and older have received at least one dose of the COVID-19 vaccine, and 63.5% are fully vaccinated, according to Cody.
However, she acknowledged that immunization rates are uneven among different populations – a disparity that hits minorities and low-income people hardest. She highlighted access, transportation and working hours as some of the barriers to higher immunization rates in marginalized communities and suggested bringing mobile immunization units to familiar communities on weekends and in the evening to help.
The lowest vaccination rates are found among Latinos and African Americans, which Cody says has more to do with many generations of historic mistrust of government than with the logistics of accessing a vaccine. She said that since demand for vaccines has fallen since April, it is very important that people promoting the vaccine in underserved areas are “from the community” and “can share their experience.”
Over the past year, and especially as vaccination rates have risen and cases have plummeted, Santa Clara County has worked to gradually lift restrictions, starting with easing external regulations by responding to new evidence of outside transmission last June and shifting resources from restrictions to vaccinations later. in December.
“We wanted to relax enough to allow as much activity as possible without increasing cases, because once the number of cases starts to increase, you can risk returning to exponential growth,” she said.
Reopening schools has also remained a priority from the start, Cody said, explaining that “we really wanted everything else to be stopped and the only activity to be in-person education.” Most of the county’s schools have reopened partially or fully by the end of March 2021.
Just over a year earlier, Santa Clara County had been one of the first jurisdictions to see cases. The county’s decision to limit gatherings in early March 2020 looked like a “huge problem,” especially as it feared it would scare the public.
However, she felt the biggest decision she made was to issue a shelter-in-place order alongside her Bay Area colleagues.
“It was very clear at that time that we had huge problems,” she said, explaining that at this point there were very few tools such as testing, contact tracing. and the personal protective equipment available to protect the public.
The unique relationship between health workers in the Bay Area enabled them to make a decision quickly. Many officers are part of the Association of Bay Area Health Officials, which came together in the 1980s to fight the AIDS and HIV epidemic. Since then, they have kept in touch, meeting monthly or bi-monthly for dinner outside of COVID times.
“If we hadn’t known each other and spent years building relationships and building trust, we could never have moved forward so quickly,” she said. “There was no play manual and there was no plan to issue a shelter-in-place order.”
The Santa Clara County governance structure has also placed Cody in a unique position: here, health workers report to the county executive rather than directly to elected politicians. She said it gave her a “level of protection and support” that she didn’t think other public health workers had.
Many health workers who have made unpopular decisions and held accountable to elected politicians have been forced to resign or have been fired due to the “very political and very passionate” nature of the pandemic. Nonetheless, Cody said she felt able to stick with subject matter expertise.
This expertise began during Cody’s time at Stanford. At the undergraduate level, she specialized in human biology, focusing on the political, economic and social determinants of health care delivery. Her academic orientation has allowed her to examine public health issues in many different dimensions – an experience she attributes to her motivations for entering the public service. She also spoke about her experience on the club’s undergraduate rowing team, comparing her ability to stick with the sport despite being far from her comfort zone to dealing with the pandemic.
Cody said she rediscovered her love for public health during medical school and residency, eventually earning the Epidemic Intelligence Service Fellowship with the Centers for Disease Control and Prevention, where she spent time investigating the epidemics of infectious diseases.
As for how Cody’s role will evolve as the pandemic begins to subside, she said the next challenge will be tackling a workforce exhausted by long hours and trauma.
“I’m starting to shift my attention to the department redesign, but I would say I’m still probably 80% focused on COVID,” she said.