Dr. Wilma Wooten, San Diego County’s public health officer and director, retires after 17 years on the job.
Less than two years after she was named San Diego County’s public health officer in 2007, the H1N1 pandemic hit, filling emergency departments nationwide and giving Dr. Wilma Wooten her first taste of what it takes to manage a large-scale public health threat.
But H1N1 turned out to be a warmup for an even bigger threat that would arrive in late 2019.
Swine flu and COVID-19 were two big bookends for a 17-year career spent being responsible for protecting all aspects of the public’s health in San Diego County.
It ends Thursday, when the 67-year-old Wooten retires.
Sitting in her office Monday afternoon, Wooten said that H1N1 forced the department to hone behind-the-scenes systems that helped handle everything from a measles outbreak that started at Disneyland in 2014 to a flare-up of hepatitis A infections among San Diego’s unhoused residents in 2017.
Though no response to infectious disease is ever considered perfect, and Wooten has sometimes faced public criticism, she said that she is proudest of her organization’s ability to evolve.
“We’ve learned from each outbreak, each incident, so that we can be better the next time around,” Wooten said.
The key, she added, is understanding that the government itself cannot always do its job directly, especially when the work requires educating residents on sensitive topics such as vaccination. Working with trusted messengers who already have strong reputations in their communities is key to convincing the skeptical.
“The Public Health Department cannot do anything by itself,” Wooten said. “It has to rely on collaboration with the community.
“Whether it’s the education system or the health care system, you have to have collaborative partnerships.”
Dr. Suzanne Afflalo, a retired Kaiser Permanente physician now serving southeast San Diego through myriad health- and faith-related volunteer efforts, is one of those trusted voices who worked with the county during the COVID-19 pandemic.
Afflalo and others in the South Bay were not shy about demanding more from the county — more testing, vaccination and outreach to those in marginalized communities, some with a natural distrust of government emissaries.
Though it took some insistence, the physician said that those closest to the community were able to convince the public health department to do things a little differently in South County, tailoring service availability to accommodate service workers whose schedules put them at a disadvantage to those able to work from home.
“Kudos to her for allowing us to put a little spin on how we did the work in southeast San Diego,” Afflalo said. “In community education, in testing, in vaccinations, they allowed us to do the work without much hindrance.”
That, she added, included soldiering on through a barrage of nasty public attacks, including derogatory references to her African American heritage and a speaker at a county board meeting twice shouting her home address during broadcast public comments.
“Through the name calling and the hate and the venom, she put on her suit of armor, kept her nose down, and just kept working hard,” Afflalo said.
How did she handle those very personal attacks, especially those that were racially targeted?
“I considered it background noise,” Wooten said. “It’s there, but it can’t impact my day-to-day operations or my day-to-day activities.”
Though some continue to question the wisdom of pandemic-era actions, especially the stay-at-home orders that significantly disrupted the economy, Wooten said that she stands by the actions taken by the public health community.
“Our percentages for deaths alone were lower compared to other entities, and I do not regret any of the health officer’s orders or decisions that were made, not at all,” Wooten said.
San Diego County did fare well compared to its peers.
According to statistics compiled by The New York Times, San Diego County experienced 181 deaths per 100,000 residents compared to 252 per 100,000 in Orange County, which has almost exactly the same number of residents, slightly fewer of whom live in poverty.
But it has been clear, with some public speakers still deriding her work at county meetings even after the pandemic has receded, that many in the public don’t see that comparison as valid.
What has kept her in her job despite criticism?
Her love of her job away from the limelight, Wooten said, has kept her putting in long hours when many other county public health officers quit amid public backlash.
Running a department with more than 700 employees, one charged with everything from detecting infection trends to preventing chronic diseases, she said, provides plenty of work to focus on when the background noise volume knob is stuck at 11.
“I’m a planner, I love putting something in place and then watching the fruit of your labor grow,” Wooten said. “I like checklists, saying you’re gonna do this, and it gets done.
“To me, it’s exciting to do that work.”
While outbreaks get the public’s attention, Wooten’s work has gone much deeper. Her department currently has long-range initiatives to eliminate HIV, hepatitis C and tuberculosis. Since it was approved in 2018, she has pushed the county to participate in the state’s perinatal equity initiative, which seeks to erase long-standing disparities in health outcomes for black infants.
“There really is a lot of great work being done by the great staff that we have across the branches,” Wooten said.
Dr. Eric McDonald, former medical director of the county epidemiology and immunization services branch and more recently serving as interim health and human services director on his path toward his own imminent retirement, said that Wooten’s focus on follow-through, on measuring the effects of programs after they’re implemented, has helped sustain the department’s reputation as one of the best in the nation.
“One of her strengths is strategic planning and visioning and then following up to create the infrastructure that allows you to achieve those goals,” McDonald said. “That’s not the stuff that makes headlines, but if you have those structures and policies in place, you can quickly respond when something is detected that’s not in the normal range.”
Of course, a willingness to stay at one’s desk after everyone else goes home also helps.
“I’ve just gotta say, there is nobody who works harder than she does,” McDonald said.
Wooten’s work extends beyond California. She has served as a director of the Public Health Accreditation Board almost since its inception in 2007. The nonprofit confers its stamp of approval on those local public health departments that can meet its standards, and Wooten serves on its executive committee.
Dr. Claude Jacob, director of the San Antonio Department of Health, said he came to know Wooten well during their time serving together on the PHAB board. She was always the group’s procedure expert, he said, but also became known for sharing the details of programs underway in San Diego.
“That’s a model that a number of us are trying to replicate … and I will say that her reach is far,” Jacob said. “While she does serve in California, and has served specifically in San Diego, she has been an influencer of a number of us who are still in the trenches doing this work.”
Wooten received the Beverlee A. Meyers Award for Excellence in Public Health last month in recognition of her 23-year career, which started in 2001 when the county hired her as a deputy health officer. Born in rural Alabama, she is the first in her family to pursue higher education, earning a biology degree from Spelman College and her master’s of public health and medical doctorate from the University of North Carolina at Chapel Hill.
Dr. Ankita Kadakia, a deputy public health officer at the county, will take over as interim public health officer on June 21. On June 30, the county will stop taking applications from those who wish to fill Wooten’s position permanently.
Travel, including an upcoming trip to Zanzibar, figure significantly among Wooten’s retirement plans.