Austin Public Health Team

When reports of a novel coronavirus in China first started trickling through U.S. news outlets in early January, Austin’s three most senior public health officials were preparing for a pandemic. For Stephanie Hayden, Janet Pichette and Dr. Mark E. Escott, the threat of a pandemic has always loomed and a virus of this magnitude was—according to Escott—“probably long overdue.”

As the director of Austin Public Health, the city’s chief epidemiologist and the interim medical director and health authority, respectively, their joint challenge was preparing the city without sparking panic. When the trio first heard about COVID-19, the course of the new virus was still unknown, but their backgrounds in infectious disease and emergency preparedness equipped them to realize the potential for crisis.

The first significant obstacle was South by Southwest. In late February, Austin didn’t have any recorded COVID-19 cases, but in talks with other jurisdictions, the health team kept hearing the same message: We waited too long; don’t make the same mistake. So without local data or positive cases to back up their recommendation, Hayden, Pichette and Escott asked Mayor Steve Adler to trust them that canceling the festival was the right call.

Seven days after the SXSW cancelation rocked the city, Governor Greg Abbott declared a statewide emergency. As the nation slowed to a stop, Hayden, Pichette and Escott started working around the clock. While less publicly recognized than first responders, the three have led the city’s COVID response for the past 11 months, advising on mask policies, school reopenings, football seasons and everything in between.

“I always say we’re the invisible guardian of the community,” Pichette says. “If we’re doing our job, everything’s OK, but if something goes wrong, they’re knocking on our door, hounding us.”

Self-dubbed “the Three Amigos,” the team has worked together nonstop since January, usually working seven days a week. The three represent hundreds of employees at Austin Public Health, who work alongside them to monitor the virus, collect data and advise local leaders.

The trio’s diverse medical backgrounds uniquely equip them for this moment. One of Pichette’s specialities is respiratory diseases, and she has been in public health for several decades, working in epidemiology at the state level before becoming Austin’s chief epidemiologist. Hayden’s background in social work and her previous experience heading APH’s health-equity department informs their care for communities of color disproportionately affected by COVID-19.

The newest member of the team, Escott took on the role of interim medical director and health authority in October 2019. “When asked me to take this interim job, she never mentioned anything about a pandemic,” he jokes. Escott also serves as the EMS system medical director, and his background in emergency and disaster management allows him to quickly make decisions with limited information—a valuable skill Pichette and Hayden say complements their methodical thinking.

In preparation for a pandemic, they consistently ran drills and studied past health crises like H1N1 and Ebola. A lack of funding and outdated equipment have been frustrating (but expected) barriers to fighting COVID-19, but a surprising obstacle has been the increased politicization of the virus and the spread of misinformation. During one of their weekly press conferences, Escott candidly shared that he’s a Republican doctor working alongside a Democrat-led government, reiterating that “this is not a political issue. This is science.” He said he was nervous to include something personal about his own political leaning, but hoped it helped anyone who believes COVID-19 is a “Democrat-led conspiracy.”

“Let’s choose something else to be polar about, but it can’t be this. This is too important,” Escott says. “Now we’ve got more than 200,000 Americans dead, with many more projected by the end of the year.”

Like many Austinites right now, the work-life balance is nonexistent for Hayden, Pichette and Escott, but after close to a year of nonstop work, they’re finding ways to manage stress. Pichette finds her weekly Saturday meetings with other epidemiologists cathartic and, for the first time since January, spent a recent weekend cleaning her house; Hayden has a strict boundary of no phone in the bedroom and starts each day with a morning walk to clear her mind; and Escott is still navigating how time off factors into a crisis-driven work schedule, but he’s making time for normal family life. Case in point, he was up until 1:30 a.m. recently helping his child with algebra homework.

Hayden has taken on the role of team cheerleader, encouraging her colleagues to take breaks. Their fight against COVID-19 is a “marathon,” she says. “We know we’re going to be headed into another six months, and we’ve got to build in.”

“I just feel fortunate to be part of this Three Amigo team that really represents hundreds and hundreds of people working behind the scenes to get the job done,” Escott adds.

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