Amid an exodus of county-level public health leadership around Colorado, El Paso County Public Health’s new interim medical director is splitting his time between local needs and the Pueblo Department of Public Health and Environment. 

Dr. Chris Urbina, a former director for the Denver public health department and the state health department, took over as El Paso County’s medical director following Dr. Robin Johnson’s resignation in December. She left after three-and-a-half years to pursue other professional opportunities, spend more time with family and focus on her health.

Johnson was also part-time but worked more hours during the pandemic, El Paso County Public Health spokeswoman Michelle Beyrle said.

Urbina is not expected to split his time 50-50 between El Paso and Pueblo counties, but rather divide his time based on pressing needs and priorities, she said. 

“In the context of the pandemic, the medical director stays informed of local, state and federal developments and requirements, providing clinical direction and expertise to guide public health recommendations,” she said. 

El Paso County has not implemented any COVID-19 mandates outside of those required by the state and the county commissioners have opposed any mask or vaccination mandates. The commissioners’ opposition to vaccine mandates prompted the Board of Health to pass a ceremonial resolution in December supporting voluntary vaccinations. The Board of Health’s action prompted hours of vitriolic public opposition over two meetings. 

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The medical director is also the department’s liaison to the local medical community, works on clinical procedures and policies, writes prescriptions to prevent disease and briefs department leadership on issues that require clinical expertise among other duties, Beyrle said. For example, the medical director advises and updates the Board of Health.

Johnson also became a public figure who regularly updated residents on the spread of the disease. 

El Paso County Public Health doesn’t have a hard timeline for filling Johnson’s role with a permanent replacement, saying the job will be posted until filled. 

“We are committed to finding the right skills and expertise needed to serve in this role,” she said. 

The job was posted on Sunday offering a pay scale of $100 to $115 an hour. 

County public health departments must have medical directors who are doctors, if the leader of the department isn’t also a doctor, and it’s historically been a tough role to fill, said Cara Bradbury, executive director at the Colorado Association of Local Public Health Officials.

Statewide, public health departments have seen an exodus of leadership, with 23 department directors leaving their positions since start of the pandemic, including three interim directors. The total count includes a few firings and early retirements. Burnout has also played a major role in the number of people departing. 

The trend leaves massive gaps in institutional knowledge, she said. 

“It’s frankly devastating,” Bradbury said. 

Many public health departments started the pandemic understaffed because they never recovered from the recession and have added new people to help manage the pandemic. Many of those people came without public health experience, she said. Some public health tasks, such as contract tracing, have also become controversial, and the staff have to manage residents who are combative, she said. 

Bradbury expects more turnover among public health leadership because of the high stress, although some may be aiming to get their departments through to the end of the pandemic before leaving.