WA health secretary talks pandemic, polarization of public health

Four years after arriving from Texas, Dr. Umair Shah is on his way out of the state Department of Health.

Shah announced last month he would not seek another term as Washington’s secretary of health, becoming one of six members of Gov. Jay Inslee’s executive cabinet who plan to step down before Gov.-elect Bob Ferguson takes office in January.

Shah, 53, moved to the Pacific Northwest in late 2020 to helm the state health department, arriving around the same time as some of the first COVID-19 vaccines. He replaced Dr. John Wiesman, who had run the department since 2013 and has since taken a position at the University of North Carolina at Chapel Hill.

“It’s bittersweet,” Shah said in a recent interview. “You have so many amazing team members in our department, and we’ve really gone through thick and thin. It’s been such an honor to have been able to lead a health agency that supports the work that’s happening on the ground.”

Shah’s departure will be effective Jan. 15, when Ferguson takes office.

In an interview, Shah reflected on the last four years, his biggest accomplishments and the state of public health. The transcript has been lightly edited for length and clarity.

What’s behind your decision to step down from this role?

It was time. Gov. Inslee had brought me in from a different state, and I learned so much. I recognize how partisan things have gotten, and I worry about how that’s going to play out in the next several years. I want to help build bridges. It’s the right decision at the right time.

It’s also about focusing on my family and my kids. The time ahead will be difficult, and I just want to be mindful of what that means for me and my family, while I’m also focused on continuing to advance the work we’re doing.

What are you most proud of in the last four years?

One of them, obviously, was helping lead the response to COVID-19. As you know, I arrived essentially at the time when COVID vaccines were arriving, and there was a transition from the previous health secretary to me, and we didn’t want to miss a beat.

The second thing was our Transformational Plan that we launched in August 2022, when we were still in the midst of different waves of COVID-19. We were going to communities and having conversations with our partners about what are the things that are important, and they were wanting us to give a lighthouse for a future that was brighter than where we were. (The plan includes a road map for five DOH priorities: health and wellness; health systems and workforce transformation; environmental health; emergency response and resilience; and global health.)

And then just a few months ago, we finally were able to launch Be Well WA. Be Well WA was really our way of saying that health and wellness is so important for all of us. It’s not one side of our state or one kind of community; it’s for everyone. And movement, nourishment, emotional well-being and social connection — those are four pillars that we can all get behind.

What more needs to be done when it comes to health and wellness?

We always pay attention to emergencies. We always pay attention to infectious diseases. We’re always worried about the next thing that’s going to impact all of us, but the next thing that’s impacting all of us is the real concern around chronic conditions — diabetes, high blood pressure, heart disease, mental health.

There are so many conditions that every single day we do not even appreciate are impacting everyday Washingtonians. The problem is we don’t invest enough in responding to the everyday, and that’s where health and wellness is so critical.

I always equate public health to the offensive line of a football team. When we think about health, we think about hospitals, nurses, emergency rooms. We don’t think about that offensive line that’s protecting the quarterback and allowing the quarterback to be successful.

We have to really remind everybody that we have an invisibility crisis in our field, and we need to raise the visibility of our work.

Let’s talk about the pandemic. What were some of the biggest COVID challenges?

When we reopened the state, there was a tremendous amount of, “We’ve made a move in the right direction,” and then we had another wave and another wave come. And it just felt like every time you took the step forward, you had some evolution of the virus that would make it harder to respond and communicate.

People saw us in public health say something one day, and then the next day, something on the ground changed, or some evidence changed, or some new literature emerged, and people would say, “Well, that means that you were wrong yesterday,” or “You were not telling us the truth yesterday.” The reality is that we were learning things because it was a novel virus.

We’ve also seen a tremendous amount of change in public health. From 2018 to 2022, we had a third of our field leave. The estimates are that we’re going to have another third of our field leave again in the next four years. We’ve had a lot of negativity toward health officials who have, by and large, dedicated their lives to helping protect people. While we should have focused on how to fight the virus, unfortunately, we got into, “How do we fight each other?” That’s been a real tremendous legacy of how the pandemic played out in our country.

But one thing I’m very proud of: By and large over the last year, our executive team at our agency has stayed constant. For the most part, our team stayed together and stayed focused on the work at hand. That’s the other legacy I hope I have. Regardless of my time, I’m proud that I’m leaving behind this incredible leadership team that is strong and committed.

What do you think DOH and other public health leaders should better focus on in the future?

Public health is inherently political, but it does not have to be partisan. I think that is really my message. I’ve always been about building bridges, and I worry about especially with the Trump administration coming in, what the policy changes may be at the federal level.

Obviously, our governor-elect has also got his own ideas and his policies, but it’s going to be a tough time. Everyday people are really wanting government to work for them, and we have to figure out a way to do that. And we have to do that in a time where public health has increasingly not gotten the investment that it needs to do its job.

But while I’m the first to say I have concerns, I’m also the first to say we don’t know what’s going to happen. And so we also need to do our best to figure out how we can both protect our communities but also work with those who are going to be in those positions because we have to.

What about state-specific impacts of potential new federal policies?

We have to be very concerned about everything that’s related to health. We want to make sure that people are healthy, and we want to make sure we advance the health of not just our current generation but also the future generations. I do worry that when we are so unwilling to talk to each other, unfortunately, what happens is that oftentimes those solutions become one-sided.

Regardless, we want to focus on the science, we want to focus on evidence and we want to focus on how public health has really advanced lives. In the past, it was improvements in sanitation, it was vaccines, it was seat belts — basic things that we have for a century seen public health be at the forefront of. And we shouldn’t be distracted by now trying to re-look at every single advancement and say, “Wait a minute. Are we going to continue to support this?”

What’s next for you? Are you planning to stay in Washington?

I don’t actually have the “what’s next,” and that’s OK. It’s funny, when I was in high school, I knew I was going to medical school. When I was in medical school, I knew I was going to an internship. Then I knew I was going to residency. For a couple decades, I’ve always known what the next thing is. And now I don’t know what the next thing is, and I’m OK with that. It’s going to be about spending time with family, recharging, resting. It’s also about exploring other parts of me and my career, and I’m excited about that.

We’ve made so many connections in Washington, and our hope is to be able to stay here. It’s such a great place. How many other places do you have waterfalls or water or other nature that you can get to within minutes of where you are?

Any last thoughts?

We need to make sure we’re connecting with each other regardless of how we see the world. That’s the most important thing in our field. We must make sure to connect all our communities. That’s so critical to our overall success. You can’t advance health and wellness in only one part of your state, or one part of your nation.