By Erica Wright
The Birmingham Times
Dr. Mark E. Wilson, Jefferson County Health Officer, seldom sleeps. With the specter of COVID-19 troubling him, he can’t.
“Sometimes it is because I’ve stayed up really late, like last night. I tried to get a good night’s rest, went to bed at about 10:30, woke up around 2:30, and my mind started going again, saying, ‘I have to do this. I have to do that,’” he said.
“I got up and decided to write a list so I could go back to sleep, and the list never stopped. I’m thinking about how to do the policy and how to try to find more supplies through the testing. … Ideas like that keep coming up.”
Wilson’s office at the Jefferson County Department of Health is the command center for reducing the harm of the devastating coronavirus disease here.
Wilson, chief executive of the health department, averages about four hours of sleep each night — but staying up late is not new for the county health officer, who is entering his 10th year in the position. His entire career, which began at Cooper Green Hospital, the county’s facility for indigent patients, has been dedicated to improving the health of all of Jefferson County’s residents.
“I care a lot about our community. I care deeply,” he said, emotions catching at his voice. “Regardless of all the public-health lingo and my preaching about [the current crisis] and explaining it to everybody, what we’re seeing right now breaks my heart. I have cried several times since this has started. It’s awful.”
As of Wednesday, there were 1,000 confirmed cases of coronavirus in Alabama, including nearly 285 in Jefferson County. On March 11, there were zero cases.
Since the disease began to spread through Alabama, Wilson has had to take some tough stances, including issuing orders to close nonessential businesses in Jefferson County and limiting the number of people who can gather in one spot. “Social distancing” — the practice in which people physically stay six feet or more apart from each other — is another technique he encourages to help decrease the tide of infections. He spends most of his time on calls, in meetings, and sending emails and text messages regarding the pandemic.
Wilson said he knew early on that the COVID-19 outbreak could become a major health emergency.
“As soon as it became recognized as an outbreak in China, we got involved because the CDC [Centers for Disease Control and Prevention] was responding by checking people at airports and referring those people to the state health department to be monitored and then self-quarantined. As soon as we saw this in China, we started planning.”
Wilson, who oversees a department of 433 employees, has been candid in his assessment of what the region faces.
“We’re going to have a difficult time for at least the next three months with the [virus] going on, people getting sick, and us trying to control things; that is my guess,” he said. “The effect on our economy and our tax revenue is going to take quite a long time to recover.”
Wilson usually begins his day around 5 a.m.
“I’m a runner, so sometimes I go on a long run, eat breakfast afterward, and sometimes get to work a little bit late,” he said. “We start at 7:45 a.m., and sometimes I roll in at 8. [Some days] I have early morning meetings, but my schedule varies a whole lot. I have a lot of meetings with our own staff, but I also spend a lot of time meeting with partner organizations.” Partner organizations include the University of Alabama at Birmingham, the city of Birmingham, the Alabama Department of Health, the Jefferson County Commission.
“Other things I usually deal with a lot involve the work we do in public health to address problems like infant mortality, [lack of access to] healthy foods, [and encouraging people to get more] exercise,” he said.
Even amid the pandemic, Wilson still monitors the area that has been his focus since becoming a doctor: promoting public health.
“We have a lot of core services, like disease control, but we have a lot of clinics and environmental health efforts that are part of our regular business, too,” he said. “I also spend a lot of my time working with organizations like the UAB School of Nursing, where we’ve partnered with them to start the first program of home visitation with first-time moms and their babies.”
“When I’m doing my usual public-health work, when we’re not in a crisis, I’m thinking about all of those things — [access to] healthy food and places for people to exercise, [as well as] social issues like mental health, our homicide epidemic, drug addiction, and education. Education is [a key component of] public health and the economy. If people don’t have money, they are more likely to be unhealthy.”
Wilson said he’s pleased by the quality of the staff he has in place to deal with the area’s health challenges.
“I’ve learned how to depend on people who know how to do things I don’t know how to do,” he said. “One thing I think I have done pretty well is I’ve gotten good people to be part of our leadership. … We have a really good, strong team.”
Wilson, 58, grew up in Charlotte, North Carolina, as the youngest of five children. His mother, Elizabeth, taught preschool, and his father, Mercer, was a skilled laborer who worked in construction.
“She worked with Head Start in Charlotte,” Wilson said. “She also at one point directed a preschool for low-income kids in the city of Charlotte and helped with a summer camp for them, who happened to be mostly black. I think this is remarkable about my mother. This was in the 1960s in the South, and she’s white. My mother was very compassionate and cared a lot about children. My father was hard-working and had no respect for anybody that didn’t work. His kids were going to work and be self-sufficient. We even learned to build houses when I was growing up.”
As a youngster, Wilson was a Boy Scout, played the cello beginning in the fifth grade, and ran track and cross country. He thought he wanted to be a scientist, and by the time he was in high school, he knew he wanted to go to medical school.
“I always liked science, and through my church, I learned about missionaries that were doing work with poor people in other countries, so I thought I might like to be a medical missionary,” he said. “In high school, I knew I wanted to go to medical school. I also thought I might go to some really poor country somewhere.”
Wilson attended East Mecklenburg High School in Charlotte and graduated in 1979. He then attended Georgia Tech in Atlanta, because his father and two older brothers also attended the school. He majored in civil engineering. He met his wife, Marian, in a Christian campus ministry group there, and they married in 1984.
Wilson earned a bachelor’s degree in civil engineering from Georgia Tech and went on to gain his medical degree from the University of North Carolina at Chapel Hill. He did his first year of medical residency at Emory University in Atlanta, working at Grady Memorial Hospital, before moving back to Charlotte to finish his last two years of residency in internal medicine.
Wilson had wanted to go to Haiti to be a medical missionary, but because of unrest in the country and his wife being pregnant, he decided not to make the trip. Still, he wanted to do some type of medical mission work.
“I had some experience during medical school, working in a clinic in inner-city Washington, D.C., for a month as a medical student, and there were some things that happened that made me think more about doing medical mission work or ministry in a low-income, urban setting,” he said. “I came to Birmingham with that in mind.”
When Wilson moved here in 1991, he took a position at Cooper Green Hospital, the Sixth Avenue South facility that served as a safety net for the county’s indigent and homeless populations. His original plan was to work there temporarily until he could join a clinic that was opening in Fairfield, but he stayed at Cooper Green for more than 20 years. While there, he served as a primary care doctor, also doing inpatient medicine and inpatient teaching with UAB residents. He became medical director of clinics after being at the hospital, which has since been downsized, for two years. In 2011, he became Jefferson County health officer just as the county was facing bankruptcy.
“I had a rough time when I got here because I had never been a CEO before,” Wilson said. “I had been a leader but never an administrator, so I had to learn my job. The county was in bankruptcy, and it took me a long time to get my footing to where I was in my proper role and letting other people do their jobs.”
While it might have required long hours, leading the county health department through a financial emergency could not have prepared Wilson — or anyone else — for the current health crisis.
On March 13, he issued an order of no large gatherings with more than 500 people. It would be only days before the coronavirus was detected in Birmingham, and tangible steps had to be taken immediately.
“We had several people here at the health department talk about how we would respond,” he said. “We started issuing quarantine orders, which were emailed to people with positive tests. If they didn’t acknowledge, we had to hand-deliver them.”
One recent morning, Wilson came into the office to participate in a conference call with mayors, county commissioners, fire and police chiefs, and other health professionals.
“I was on a call to say, ‘Here is what is going to happen if we don’t act now. This is our future every day if we don’t act now—and it’s going to cost lives,” he said. “I had the head of infectious disease from UAB on the call, and she told them we’re concerned that if we don’t get this under control we’re going to be overwhelmed. We got the mayors’ attention, and they understood. I told them what I was going to do, and none of them pushed back.”
Later that day at a press conference in City Hall, Wilson spoke about the JCDH’s efforts to address the coronavirus crisis and reminded residents of best practices. After the press conference, he spent some time answering questions from school and city officials and some City Hall employees before heading back to his office at JCDH headquarters, where he was part of another conference call, this time with infectious disease experts and health professionals from the city, the county, and the state.
Elected officials across the area will say publicly and privately many of the decisions they make are based on the doctor’s orders.
Part of being health officer means making tough decisions.
Just this week the communications director for the Alabama Nursing Home Association said he was caught off guard by a letter from the county health department telling them to take in residents who are recovering from COVID-19 and still test positive.
“For the past month, Alabama nursing homes have been doing everything they can to prevent COVID-19 from entering their buildings,” said John Matson, communications director for the Nursing Home Association. “Now, Jefferson County Health Officer Dr. Mark Wilson wants nursing homes to accept patients who have tested positive for COVID-19 even though they still exhibit symptoms and have not fully recovered.”
In a statement, JCDH said it is only following the CDC guidelines for treating COVID-19 patients in healthcare settings. “We are also working in conjunction with the Alabama Department of Public Health as it relates to relevant state guidelines,” according to the statement.
Wilson has also issued an order to close businesses and nonessential services like barber shops, hair salons, and entertainment venues, such as night clubs, theaters, museums, galleries, and more than a dozen other types of facilities. For Wilson, it was not an easy decision, but he knew it was necessary, keeping the end goal in mind — saving lives.
“When people say, ‘Why are you doing this? You’re making people lose their jobs,’ that’s really huge because we’re trying to save lives. I get teary thinking about it,” he said. “We’re trying to, in the long-term, save lives and make the damage to the economy less. We’re trying to save your grandmother or grandfather’s life, or your brother who has diabetes, or what have you. … They can die from this. We’re having to take really, really drastic, painful measures now to avoid that later — and to save a whole bunch of lives.”
Wilson is also concerned about hospitals in the community.
“If we don’t act now, they are going to get completely overwhelmed with people who can’t breathe, who have pneumonia or COVID-19, and they won’t have enough beds, ventilators,” he said. “The health care workers will be put at risk because they won’t have enough supplies like masks and gowns to protect themselves.”
He uses a medical analogy to make his deadly serious point: “We’ve got a cancer that we’ve discovered. If we don’t cut it out now, it’s going to kill us, and—I don’t want to be overdramatic here—we might have to start out with a butcher knife, and it’s going to hurt really bad when we take that butcher knife out. It’s crude. The policy is crude. Getting people to understand this and then individually take responsibility and stay at home when they don’t need to be out … is hard. Getting the tumor margins out with a finer scalpel, it all hurts some, but it’s to keep us from having a really bad hurt later.”
Despite some concerns about closing businesses, Wilson said the support countywide has been overwhelming: “I have gotten dozens and dozens of texts and emails saying, ‘I’m praying for you,’ ‘I’m pulling for you,’ ‘Let me know what you need,’ ‘I appreciate what you’re doing for our community.’ … I’m very grateful.”
Click one of the links below to read more COVID-19 related stories.