Difference Maker: When a pandemic came to town, Dr. Bob Lutz had to make tough choices

Dec. 31—It was mid-March, and Dr. Bob Lutz stepped up to the podium — not his favorite activity.

He appeared somber, and it seemed obvious that his decision would bring with it consequences in the community and for the foreseeable future. Flanked by city, county, emergency and public health leaders, on Friday, March 13, Lutz canceled a high school basketball tournament and all large gatherings in the county, citing a pandemic on its way.

Not a single case of COVID-19 was confirmed in Spokane County at the time, but Lutz had seen the writing on the wall, as had many public health experts in the nation. With case counts beginning to grow in the Puget Sound, it was only a matter of time. The very next day, an epidemiologist would call Lutz with the news: the first confirmed cases in the county.

Thus began the grind of 2020, a year in which public health, traditionally in the shadows, was forced front and center with Lutz, the Spokane County health officer, at the helm.

Lutz is an introvert, never inclined to public speaking or socializing. In fact, he doesn't own a cellphone, save for his district-owned device when he was on the job. As the medical director of Bloomsday, organizers gave him a TracFone to do his work.

Reflecting on the early decision to act even before the governor's order to close schools and large gatherings by a few hours, Lutz recalls feeling afraid.

"It was scary, and I knew what it would lead to," Lutz said. "It was just a matter of time."

While declaring public health emergencies and making decisions accordingly is a part of the health officer's job, it's not usually front of mind. Lutz took cues from his counterpart at the time in King County, Dr. Jeff Duchin, who warned him that he wished he had taken action sooner.

He asked Duchin what he would do. Lutz recalled that Duchin said, "'I'd be a lot stronger in my enforcement from the start,'" Lutz said. "He said, 'We're underwater over here, and if I'd known then what I know now, I would have clamped down much harder and faster.'"

In hindsight, Lutz said preparations could have been better.

"We were prepared, but a lot of plans were dusty," Lutz said, noting that the federal misdirection and miscommunications about the seriousness of the virus also hindered public health response.

Even still, the Inland Northwest appeared to have benefited from the early lockdowns in the spring, not experiencing the surge in cases seen in the Puget Sound.

Local health care providers recognize and appreciate his early actions.

In her nomination of Lutz as a Difference Maker, Dr. Cynthia Cilyo said Lutz's early actions were vital to the region's ability to keep the virus mostly at bay.

"When Seattle and other U.S. cities were doing poorly early in this Pandemic, Dr Bob Lutz guided Spokane County onto a safer path, such that we had many fewer cases, hospitalizations, and fatalities than other cities," Cilyo wrote in her nomination. "I was very proud of Spokane's self discipline and Dr. Lutz's leadership."

For his part, Lutz read and stayed up to date with state health officials and modelers as the virus spread through communities, and he got on Facebook Live on an almost daily basis to update community members about the virus at the beginning.

When summer approached, reopening was the focus, and Lutz approved the county's move to Phase 2 just before Memorial Day. Since then, the case counts in Spokane County have been on an upward trajectory, each holiday spurring on more outbreaks and virus transmission.

In mid-June, county commissioners asked Lutz to ask state health officials for permission to move the county into Phase 3 of the governor's reopening guidance. Lutz declined. He stands by that decision and said it's a recommendation he's proud of.

"It impacted the economy, but it did save lives," he said.

As public health officials monitored case counts, outbreaks and virus transmission, Lutz felt the weight of decisions he had to make on a day-to-day basis, as well as the state's oversight of others.

"The fact that every day a decision I am making or not making is impacting the lives of the citizens in Spokane — that's many and many a sleepless night," Lutz said.

He said he wrestled constantly with what he could have done differently.

Previously, he was in the Navy for four years, serving in both the Desert Shield and Desert Storm campaigns. Originally from Pennsylvania, Lutz moved to Spokane in 2004 and worked as an urgent care physician locally for eight years in addition to a hiatus between his tenures to do program evaluation and consulting work on physical education. He joined the Board of Health in 2009 and was appointed health officer in 2017.

One of his goals as public health officer, he said, was to build up the infrastructure locally between public health, health care and academia. There was nothing like a pandemic to bring the three to the table.

Former competitors, including big hospital groups Providence and MultiCare, came to the table immediately, setting competition aside, to solve critical infrastructure issues in the community like testing in congregate facilities.

"I think we have great people in leadership right now that recognize that partnership collaboration is essential," Lutz said.

Lutz also strove to make public health more visible when he was health officer, he said, writing op-ed articles in The Spokesman-Review and working with various organizations throughout the community.

Public health had traditionally played the role of a health care safety net for the community, but Lutz wanted those services and that mission to be showcased more during his time as the health officer. He created an advisory council to connect the health district to the community. Acknowledging the social determinants of health, like education, poverty, shelter and access to good food and water, is something Lutz focused on in his work.

"Those societal factors prevent people from being healthy, and it creates an unstable foundation on which you have, kind of, like, quicksand; people don't have the foundation upon which they can deal with stressors in their lives," Lutz said.

At the heart of these issues, Lutz said, is racism.

"People don't realize that the society we live in is one that's built upon structural racism — and that is a problem and people are paying for it," he said.

He backed up these sentiments with action this year when he marched with thousands of others in Spokane this summer protesting against police treatment of Black Americans.

Lutz's participation in that march and his editorials in The Spokesman-Review would come up again later in the year when Spokane Regional Health District Administrator Amelia Clark fired him at the end of October.

Clark brought a list of complaints against Lutz to the Board of Health, saying they warranted his removal from the district. After effectively firing him, Clark asked the Board to make it official.

Lutz responded to all the accusations in writing, and the community overwhelmingly showed support in hundreds of public comments and rallies for the health officer, all to no avail. Even a month after his firing, The Spokesman-Review received 149 nominations for Lutz as a Difference Maker, by far the most of any one individual.

The Board of Health fired Lutz on Nov. 5, effectively ending his public health leadership, locally at least. Just a month later, the state Department of Health confirmed that Lutz had taken a role assisting the department with its COVID-19 response.

Lutz still serves as the Asotin County Public Health Officer, a role for which leaders there applaud him.

"Through this incredibly stressful time Dr. Lutz has been an immeasurable asset to us and our community," Brady Woodbury, Asotin County Health District Administrator, wrote in a letter of support sent to SRHD board members and Clark ahead of his official dismissal. "We have relied on Dr. Lutz to answer our call anytime, day or night. He has attended school board meetings, provider meetings, Board of Health meetings, conference called in anytime we have asked. He has gone beyond what seems possible for one man to do."

Lutz also serves on the WashingtonBoard of Health, which is a role he will continue in as well.

Hospitals in the Inland Northwest began vaccinating health care workers on Dec. 18, a welcome bright spot to end a dark year. However, the pandemic is still far from over.

"You can't just think you'll get a vaccine, and we're going back to the way things were," Lutz said. "We will be wearing face coverings for the near future."

As for his future work, Lutz said prioritizing more funding for public health and always focusing on equity will be at the forefront of what he does.

"I believe we have been irresponsible in ensuring the health of our community, which is why I got into public health, and that is what drives me and keeps me going after all this," he said. "My work isn't done."

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Arielle Dreher's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.

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