CHO Stands for City Health Officer

NEIGHBORHOOD POLITICS-While earthquakes and wildfires may provide more dramatic images for television coverage, our world has been dominated by an emergency of a different kind for the past year. 

Of course, news coverage was able to find photos of people in mourning, of people getting their vaccine but outside of the fear of those living through it, it doesn’t have the drama of collapsing bridges or flames engulfing someone’s home. 

But as our lives return to normal, we have to consider that Los Angeles needs someone to oversee and coordinate medical emergencies – a City Health Officer. 

The City’s Emergency Management Department (EMD) has plans for most every conceivable emergency which is why Los Angeles was able to respond so quickly and effectively at the beginning of the pandemic. 

They did not have plans – perhaps some need to be developed – on how to handle people in denial of a reality they don’t like, who refuse to follow protocols. 

They did not have the ability to force feed the federal government the common sense to establish and enforce national guidelines to avoid the deaths of millions of Americans. The United States has 4% of the world’s population and 25% of its deaths from COVID-19. 

They did not have the power to give the State government the backbone to stand up against business leaders who could sequester themselves at home while insisting their workers – grocery store checkers, pharmacists, nurses and doctors, assembly line workers in food processing and packing, all those “essential” workers who were most at risk for contracting and spreading the virus – get back to their jobs without proper protocols or protections. 

They did not have plans to generate money for a City dependent on a booming economy to fund its services. 

And they did not have a point person in place to oversee the medical aspects of the emergency. 

Health issues may not be specifically the City’s responsibility but, given how little viruses, communicable diseases, drug abuse, tainted food and medicines, poison and airborne pathogens respect delineation of jurisdictions drawn on maps, the Los Angeles City government is its stakeholders’ first line of defense in any emergency involving medical components. 

Especially when Los Angeles County’s planning lags far behind the City as it did through various phases of the pandemic. 

Los Angeles, the city, entered the COVID crisis better prepared than many other jurisdictions. The EMD’s plans on how to handle epidemics included an annex on pandemic response that had been approved a year earlier, on January 17, 2019. 

As with their plans on other types of emergencies, these had been shared with City departments and updated over the years including the implementation of each department’s role in the event of a disaster. 

And disaster it has been. 

The City had some warning. International news about Wuhan began breaking in November 2019 but it was not perceived as a possible threat to the United States until the Center for Disease Control started investigating the potential impact of the outbreak in early January. 

The initial known cases in the country were not in California although awareness and concerns built quickly with the influx of travelers between China and Los Angeles in conjunction with the Chinese New Year on January 25. 

On February 29, the City put out that it was “reviewing the City’s Pandemic Annex and working with City Departments to review their Continuity of Operations Plans in the event of a local outbreak.” It also noted that while, at the time, the City was addressing COVID-19 as a health risk, “current global circumstances suggest[ed] it [was] likely that this virus will cause a pandemic.” 

On March 4, 2020, the Mayor declared an emergency and directed Emergency Operations to take steps to protect the life, health and safety of the City, and departments to dust off their Continuity of Operations Plans and work with the Emergency Management Department. 

Eight days later, the departments were directed to start implementing these plans. 

On March 15, four days after the World Health Organization characterized COVID-19 as a pandemic, the Mayor put the City into a two-week lockdown. 

Since the start of the pandemic the EMD has run the City’s Emergency Operations Center, coordinating information, public health efforts, housing the unhoused, collecting and dispensing donations, supplies and other resources for agencies and stakeholders; and providing citywide situational awareness as it evolved for all the other departments as well as the Mayor’s office. 

Their focus during this time has been less a 24/7 oversight of disaster response and more the day-to-day business of coordinating resources and public information for recovery. 

EMD had a plan but did not envision a pandemic of this magnitude nor the enormity of the economic impact arising from the City’s loss of income over not just weeks but months and years. But that’s another story. 

The EMD is joined in the response to emergencies to a greater or lesser degree by the Mayor’s office and other City departments, primarily the police and fire departments. 

The Los Angeles Fire Department (LAFD) embraces its mission as a full-spectrum life safety agency protecting more than four million Angelenos through fire prevention, firefighting, emergency medical care, technical rescue, hazardous materials mitigation, and disaster response. Over 80% of their calls are for emergency medical services. 

During the pandemic, the LAFD has been front and center on public health with testing and vaccine administration. After the County said it would not do testing, the LAFD took over. In a very short time, it was able to ramp up and operate large-scale testing and then vaccination facilities not only for those of us living in the city proper but for everyone who wanted help. 

Wuhan, listeria and E. coli, Fukushima. 

Viruses, waterborne pathogens, and nuclear contamination do not respect geographical boundaries. To defend against emergencies with a medical component, everyone has to work together. With so many ever-changing components, there needs to be one person in charge who has significant experience in the delivery of medical responses tapped into all points of the City. 

Their experience on the front line of the pandemic, whether responding to those who fell ill, testing or working with police to inoculate people in the face of anti-vaxxers, the LAFD recognized the need for a City health official which it recommends fall under its jurisdiction given its current medical mission. 

Not only would this position be important in any future pandemic, but it would be key in addressing disease outbreaks and bioterrorism, and coordinating with counterparts at the County, State and Federal levels. 

To increase its ability to survive the next medical emergency, Los Angeles needs a Chief Health Officer. 

The EMD should continue to maintain the plans for responses citywide but work closely with the LAFD on the implementation of medical aspects whether pandemic, poisoned water supply or the injuries resulting from terrorist attacks or natural disasters. 

If people are interested in exploring the Emergency Management Department’s plans for potential disasters, you can check them out here.


Liz Amsden is a member of the Budget Advocates, an elected, all volunteer, independent advisory body charged with making constructive recommendations to the Mayor and the City Council regarding the Budget, and to City Departments on ways to improve their operations, and with obtaining input, updating, and educating all Angelenos on the City’s fiscal management.) Photo top: LA Daily News. Prepped for CityWatch by Linda Abrams.