SLO County’s top health officer has no ‘time for ego’ leading stressful COVID-19 response
In early March, Dr. Penny Borenstein was not yet a household name in San Luis Obispo County.
But the global coronavirus pandemic catupulted her into the spotlight. She has been tasked with helping guide the county through an unrelenting virus that has touched nearly every aspect of life locally since mid-March.
As the county’s top public health official, Borenstein regularly consults with leaders of organizations and agencies — including schools, city governments, churches, health facilities and business groups — and advises the public.
Borenstein has quickly become “the most important person in the county,” according to one San Luis Obispo city administrator.
“I don’t feel that I have time for ego,” Borenstein said, crediting her public health team and a collaborative, mutually informed multi-agency partnership on decisions.
“This is a nasty, nasty illness and it’s spreading further and in different ways than we thought possible in the beginning,” Borenstein said. “There’s absolute certainty that we’ll get back to life as we knew it. But if it takes a year, a year and a half, even two years, for that to occur, we are strong people. We can do this and we need to do this. We have to find some way to coexist.”
Borenstein recently offered a glimpse into her background, personal life and hectic work schedule.
What SLO County’s public health officer does
At work at the county Public Health Department, Borenstein’s days are consumed with emails, meetings, conference calls, guideline decisions and research. At home, she is busy raising two teenage children.
She told The Tribune that she gets about six hours of sleep per night, sometimes less, as she juggles family life, policy decisions and the latest science developments. She monitors her sleep time on her Fitbit.
Borenstein appears weekly at press conferences widely covered by local media organizers and shared on social media, informing residents about local coronavirus developments. She announces the latest COVID-19 case counts, hospitalization numbers and death data, as well as information about closing and opening business sectors.
She’s even demonstrated the proper way to wear a mask.
San Luis Obispo County schools superintendent James Brescia said Borenstein’s communication with county leaders has required her to be more visible and vocal than usual — a challenge she has embraced.
“Dr. Borenstein is very collaborative and collegial,” said Brescia, who now talks to the public health officer three or four times a week. “She’s direct and honest with people, which I greatly appreciate in this very difficult situation. In the years I worked with her before (in collaborative agency meetings), she was usually quiet and in the background. This is different.”
How does Borenstein balance her duties with the stress of taking on a challenge as daunting as COVID-19?
“It is stressful, but I have been surprised by myself and my ability to rise to the occasion and not get as overwhelmed as one might think,” Borenstein said. “I’m incredibly busy and always thinking about (my job). But I think the responsibility is somewhat awesome.
“I don’t have the time to internally reflect. I’m just marching forward and doing the best I can for the community.”
SLO County doctor has background in health
Borenstein, a Long Island, New York, native, spent most of her life on the East Coast, including a 20-year stint in Baltimore.
She has an undergraduate degree at Cornell University, a degree in medicine from Syracuse University and a master’s degree in public health from Johns Hopkins University.
She also worked as a part-time, non-board-certified pediatrician for six years.
During her graduate education and training, Borenstein pursued a path in public health. In California, public health officers must have physician degrees, though that requirement varies state by state.
“I often joke that with a career like mine, there’s so much training, your actual working life is pretty short,” Borenstein said.
Borenstein began her healthcare career as the AIDS crisis was emerging. She has worked in the public health field amid outbreaks of anthrax, severe acute respiratory syndrome (SARS) and swine flu, or, H1N1.
Seeking warmer weather and a new lifestyle, Borenstein moved from Baltimore to San Luis Obispo in 2008 to become San Luis Obispo County’s public health officer.
Aside from infectious diseases, her work in San Luis Obispo County has involved addressing arsenic in soils of school properties and water supply issues.
“My previous experiences in some of those areas makes those sort of look like child’s play” compared to COVID-19, Borenstein said.
She said her training has helped her prepare for this moment.
“In the county’s Emergency Operations Center, there’s a number of people who have had reasonably high-level military positions in their past lives or (in roles as) reserves,” Borenstein said. “And then there’s a couple of us physicians who have been through the rigors of a residency, and sometimes we joke about which is worse. But we acknowledge that past experience probably has played a role in being able to do something like this intensively for a long time.”
Borenstein acknowledged that she’s retained the direct personality of a native New Yorker despite more than a decade in California.
“I often say to the people who work around me, and see my pace, and my dark humor and my sarcasm, you can take the girl out of New York, but you can’t take the New York out of the girl,” Borenstein said.
Parenting presents challenges
Borenstein, who’s currently separated from her husband, has had to juggle her job with parenting duties. She has a 17-year-old son with severe autism and a 14-year-old daughter adjusting to a life with virtual friend interactions and online studies.
Borenstein said her autistic son can’t communicate verbally — so explaining the upheaval caused by the COVID-19 crisis to him is particularly difficult.
She has a team of childcare providers, including specialists for her son, that have helped her through a challenging time. Borenstein said her sister came out from the East Coast during the early weeks of the pandemic to help out.
Borenstein said her daughter ably navigates the world of technology and is well equipped to remain in touch with friends and keep up on school work virtually.
“She did her distance learning, and power to her, she’s taking a Cuesta College class this summer as she’s readying to enter ninth grade,” Borenstein said. “It has given me parental joy to watch her grow in this pandemic — learning how to cook, learning how to help out more around the house. She is fairly self-contained in a lot of ways. We do have those moments where we have to buoy her up emotionally.”
Borenstein said she “doesn’t want to pretend that I have it any worse than so many families who have all kinds of financial stressors.”
“I have the good fortune on my side of putting together the means to manage a difficult situation,” Borenstein said. “I know an awful lot of people are struggling to manage this.”
Health officer must balance safety, economy concerns
Borenstein said she must find a balance between maintaining public health and safety concerns and facing economic challenges, while traversing a political divide on issues such as face masks.
She said the reason that businesses reopened initially was because the financial strains are as consequential as the public health ones. Now some are being shut down again statewide amid increased cases.
“I think people are exhausted emotionally,” Borenstein said. “And we are still nowhere near the end. I would not say it’s surprising, but it’s unsettling to see how we as a community, as a nation, have moved from, at the beginning, so much camaraderie and togetherness, and then that political divide really vanished.
“And now, with impatience, exhaustion, real life problems because of it, people are fraying and showing frustration.”
But Borenstein said “it’s who we are as humans.”
“I know it probably sounds Pollyanna(ish), and I don’t know how it translates into people’s hearts and souls, but people need to continue to recognize that it is not each other doing this to us, but it’s the circumstances,” Borenstein said. “We need to realize that humans can’t conquer everything. We can apply our best thinking and continue to research and understand how we can approach dealing. At the end of the day, sometimes just bad things happen.”
The approach of the county Public Health Department has been intentionally flexible, she said, while trying to avoid absolute decisions that “come down with the hammer.”
“If people tune out on either side, we’ve lost the battle,” Borenstein said. “Sometimes people say ‘You’re making political decisions.’ No, I’m making policy decisions on what’s doable, what’s feasible, what makes sense as a total community to keep people engaged to do the things that are unsatisfying like wearing masks and social distancing.”
“Rather (than) turning on each other,” Borenstein said, “if we can continue to turn on the best mechanisms available to us to solve the issues at hand, that will help get us through.”
This story was originally published July 17, 2020 at 5:00 AM.
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