LUBBOCK â Katherine Wells was tapping her phone.
It was the last week of January, and the director for the Lubbock Health Department had a jam-packed schedule. She was working with her team to put in place the new community health plan. Flu cases were on the rise. She had media interviews lined up to talk about stopping the spread.
She refreshed her email again. And there it was â confirmation that someone in nearby Gaines County had tested positive for measles. It was the first for the region in 20 years.
She took a deep breath.
Two months later, with more than 400 cases across Texas, Wells is the first to admit things feel eerily similar to the COVID-19 pandemic. And just like then â when police guarded her home after she received death threats â Wellsâ work is facing questions from skeptics.
âPeople accuse me of creating the measles outbreak to make the health department look more important,â Wells said. She laughed as if she was used to it.
The reputations of public health institutions have taken a beating in the last five years as the pandemic became a political flashpoint. Some people saw public health leaders as heroes for urging people to wear masks, stay away from big crowds and get the vaccine. Others saw them as villains bent on robbing Americans of their freedoms.
Wells has served as the public health director for 10 years. Long before the measles outbreak and COVID, she navigated situations like Lubbockâs high sexually transmited infections and teen pregnancy rates. Lubbock is the largest city in Texasâ South Plains, with nearly 267,000 residents. Itâs also largely conservative. More than 69% of Lubbock County voted for President Donald Trump last November.
Lubbock also stands as a critical medical hub for the South Plains, and Wells is the leader. With a dearth of rural hospitals, physicians, and limited care at clinics, people from all over the region flock to Lubbock for health care. This is how Lubbock became entangled in the measles outbreak. Most of the cases have been recorded in nearby rural Gaines County, where 280 cases have been identified. Patients have sought medical care in Lubbock.
Like many public health directors, most people didnât know Wells until March 2020, when the city and the rest of the country was upended by the COVID pandemic. As she led the city through the crisis, she became a household name â for better or worse.
Dr. Georges Benjamin, executive director of the American Public Health Association, said public health directors work behind the scenes to stop bad situations from happening. They are invisible shields, he said, which can make their work challenging when itâs suddenly pushed into the public eye.
âWhen something really bad happens, like with COVID, the fundamental trust wasnât there,â Benjamin said. âThey didnât have a relationship with the community.â
Misinformation has played a large role in eroding trust in public health institutions. Most adults are uncertain whether health misinformation they have heard is true or false, according to a recent KFF survey,. Another KFF survey found that between 81%-84% of Republicans trusted only four people to make the right health recommendations â their doctor, Trump, Secretary of Health Robert F. Kennedy, and Dr. Mehmet Oz, Trumpâs pick to lead the Centers for Medicare and Medicaid Services.
Wellsâ job is not likely to get easier any time soon.
A Lubbockâs children hospital is now treating children with severe measles who also suffer from vitamin A toxicity. This comes after Kennedy, a vaccine skeptic, directed the Centers for Disease Control and Prevention to update the measles guidance to promote the vitaminâs use, which most health experts object to. The Trump administration is eliminating pandemic-era grants that were used to boost the departmentâs response to the measles outbreak, including paying for employees. And Wells is navigating what could arguably be an even more delicate line than COVID â managing the outbreak of an eradicated, preventable disease, with a worn-out staff and a growing distrust from the public.
âYou canât fix public health overnight,â Wells said. âItâs not like the fire department. I canât run in, put the fire out and theyâre all proud of me. Itâs totally different.â
Since the first measles case, Wellsâ life has a new daily routine. First, she meets with the state health department. Then she meets with other public health leaders from around the state. Later her staff about new cases or exposures.
Unlike during the pandemic, however, the health departmentâs other work isnât on hold. Wells and her team have pulled double duty, also working on STI rates, waning flu cases and substance use prevention.
Wells herself is working seven days a week. Itâs given Wells, and her family, deja vu.
âMy daughterâs been so sad lately and I asked her what was wrong,â Wells said. âShe finally told me, âMommy, this measles thing feels like COVID again. I donât get to see you.â
Wellsâ work â and sacrifices â are driven by a belief that everyone deserves good health.
âPublic health should be part of the community,â Wells said. âPublic health is all about talking to community members and figuring out what we need to do to make things better.â
Before moving to Lubbock, Wells lived in Austin and worked at the state health department for 14 years. She moved to Lubbock in 2012, still working for the state health office, with the goal of rebuilding the cityâs public health system.
Despite her passion, Wellsâ work has been far from easy. When Wells started in 2015, she had 10 staff members and an underfunded department. She created a strong team â one that started preparing for COVID two months before it was detected in the U.S.
By 2020, Wells had the support of city leaders. She appeared in weekly virtual COVID briefings for the media and public alongside former Mayor Dan Pope and other Lubbock officials. They worked quickly with first responders to create the vaccine clinic in the cityâs civic center.
By 2024, the atmosphere was different. There were new faces on the City Council, including a new mayor, Mark McBrayer. As the health department was preparing to open a new facility, McBrayer was working on a no-new-tax revenue rate for the cityâs budget. He was considering cuts to the health departmentâs budget, among others, to achieve this. Amid the threats and public outrage, the grand opening attracted a major crowd â more than were at Wellsâ wedding, she said.
The health departmentâs budget wasnât cut, but there have been other bumps in the road. More recently, Wells faced pushback over the Community Health Improvement Plan, a report that provides the city with recommendations to improve the health of its residents. It focused on improving accessibility to health care, educating the community, and strengthening coordination amongst servicers.
Some members of the new council hesitated to approve it, calling the plan an excuse to justify expanding government spending on health care. It led to a long meeting with hours of public comment. David Glasheen, one of the council members against it, said it was redundant because hospitals are mandated to provide indigent care. Council member Tim Collins said part of the plan would help the department become nationally accredited, which would help the city get more grants in the future.
Council member and Mayor Pro-tem Christy Martinez-Garcia supported approving the plan. She told The Texas Tribune some of the members were misinterpreting the planâs purpose.
âOnce they understood why this was so important for future opportunities and grants, it helped,â Martinez-Garcia said. âBut, itâs something weâre going to have to face moving forward again, because of the political environment of our society.â
Martinez-Garciaâs view of Wells has come a long way since the early days of the COVID-19 pandemic. Martinez-Garcia is the owner and publisher of Latino Lubbock Magazine, one of only two media outlets â along with El Editor â that cater to Lubbockâs Hispanic community. About 38% of Lubbockâs population is Hispanic.
During the weekly press conferences, Martinez-Garcia would press Wells about getting information out in Spanish. It was important, but also personal for Martinez-Garcia. She lost seven family members to COVID-19, because she says a plan wasnât in place to help the community. Martinez-Garcia said Wells was receptive to the criticism and made changes. She placed vaccine stations in East and North Lubbock, making it accessible to impoverished and out-of-reach communities.
âShe was trying to make it as equitable as possible for everybody,â Martinez-Garcia said.
Last month, Wells prepared an article about measles from the health department for Latino Lubbock Magazine. It was written in English and Spanish.
The community health plan was eventually approved, with Glasheen being the lone vote against it. Wells said she didnât know where the pushback was coming from, but blamed herself for it. She said she didnât do enough to reach out to the newer members and explain what her department does.
âIt looks like weâll have some opportunities in the future to explain that,â Wells said.
As the health department in a major medical hub, Wells has a responsibility to support the smaller health departments. Her team has worked with the South Plains Public Health District, a multi-county health department that provides vaccines, STI treatments, and other basic health care. It includes Gaines County, the epicenter of the measles outbreak. Wells and her team have helped craft news releases, providing staffing and information as needed. Wells said their duty is to talk about the measles to the public and calm fears.
She also said their job is âto talk about what we need to do to respond, whoâs at risk and put the vaccinated people at ease.â
Misinformation has inflamed the outbreak. Benjamin, from the American Public Health Association, said vitamin A has no role in preventing measles, and public health leaders have to try and correct the misinformation. Covenant Childrenâs Hospital in Lubbock said they admitted fewer than 10 pediatric patients who were initially hospitalized due to measles complications but also have elevated levels of vitamin A. This is causing abnormal liver function for patients.
âItâs a therapy if youâre already vitamin deficient,â Benjamin said. âIt has to be given carefully, and itâs something doctors do in the hospital because these are very sick people. Itâs not something at the grocery store.â
Wells doesnât see the measles slowing down anytime soon. After researching other measles outbreaks, Wells thinks this one could go on for a year.
âWe identified this outbreak with two children in the hospital,â Wells said. âWhich means there was measles circulating in certain pockets. So we were behind the eight ball in the initial response.â
Vaccination is the most effective way to stop the disease from spreading, but Wells knows itâs a choice people have to make. The city arranged several drive-up vaccine clinics quickly after the first case was identified. She says public healthâs role is to counter the messaging around why people are scared of vaccines.
Now Wells is concerned about what else could come back. The measles outbreak shows the potential other diseases such as mumps and polio could have on unvaccinated populations.
âYou see measles first because itâs the most infectious,â Wells said. âIt doesnât mean weâre not going to see outbreaks of other childhood viruses.â
As these public health crises have unfolded, Wells has been quietly working on her doctorate. It could be what sets Lubbock apart during the next pandemic. And last week, she successfully defended her dissertation on building public health systems in Texas, and is now Dr. Wells.
Article originally published by The Texas Tribune. To read the originally published article, click here.