KELSEY SNELL, HOST:

As the highly transmissible delta variant spreads across the country, local health officials are having to re-evaluate guidance for their communities. This week, the acting director of the St. Louis County Health Department, Dr. Faisal Khan, spoke in support of a massive mandate at a county council meeting amid an increase in cases there. But things went south quickly. Dr. Khan says he faced a hostile crowd that was baited by a council member who questioned if he was American. And he says insults and racial slurs were hurled at him, all as he was just trying to do his job. We wanted to learn more about this incident and the challenges facing public health officials right now, so we've asked Dr. Faisal Khan to join us. Welcome.

FAISAL KHAN: Thank you. It's a pleasure.

SNELL: Dr. Khan, we know this all unfolded at a St. Louis County Council meeting, which is open to the public. As briefly as you can, can you describe the environment and what you experienced that day?

KHAN: So, you know, as a public official, it is my responsibility to respond to any invitation from the legislative body, which is the county council, to go to a council meeting and answer any questions or concerns or provide any clarifications or data information pertaining to any public health matter. In the context of the pandemic, that is even more important because we imposed a countywide masked mandate on Monday in response to the rapidly deteriorating situation from the coronavirus, in particular the delta variant. The environment was not conducive to an exchange of knowledge. And what ended up happening was that every time I would try to formulate a cohesive answer to something and think through the question being asked, I would get heckled, I would get interrupted. And it just ended up being a very frustrating exercise as a public official.

SNELL: We should note that you did give someone the middle finger as you were leaving this event. You say it was out of frustration and you've since said you regret it. But this seems to follow a pattern of what, you know, a typical - a pattern of what are typically considered non-political civil servant jobs being politicized and becoming dangerous for those who hold it. Can you talk about what it's been like to do this work in this type of political climate?

KHAN: It has been tough, but, you know, I would say public service in general and public health in particular, at least for me - I'm biased, of course - is a calling rather than a job. I look to my idol, Dr. Tony Fauci, and what he and his family have had to put up with over the last 18 months. I mean, what happened to me pales in comparison to it. He's had to deal with things that are a thousand times worse. The alarming part of this, the sad part of this, Kelsey, is that 270 or more of my counterparts across the country have either quit or walked away from their jobs or been forced out for political reasons and for recommending the right thing to do to deal with the pandemic. And that is a loss of intellect as well as expertise that is not easily replaced.

SNELL: This is all happening with the delta variant surging. And it seems like there's new troubling data every day. We've seen an internal CDC document showing that fully vaccinated people might spread the variant at the same rate as unvaccinated people, as well as it being as transmissible as the chicken pox. How is this impacting your community, especially when the county is less than 50% vaccinated?

KHAN: So you're absolutely right, 55% of our population is still not vaccinated. That is a ripe population for the delta virus to run through and create absolute havoc and misery. And we were very worried about what this would mean in terms of the picture ahead, which is why we moved rapidly to put a mask mandate in place. You know, the fact is that the vaccine is safe and effective, but it was only one suit of body armor to protect against the virus. The virus evolved and was able to penetrate that. And so we were forced to recommend an additional coat of armor, so to speak, in the form of a mask.

And we crafted our public health message and our public health order in a very deliberate and lenient manner so as to cause only the most minor of inconveniences by requiring that masks be worn indoors. We did not impose any occupancy restrictions. We did not limit the ability of businesses to operate on their own regular hours, nor did we ask anyone to discontinue or not be able to participate in any religious or business or social or entertainment-related activity. The only thing we asked people to do is put a mask on when you're going indoors in public places, period.

SNELL: What is the status there right now? How are the hospitals? Are you worried about capacity in case there is a bad COVID outbreak?

KHAN: It's already beginning to happen. It is already here. Our ICU occupancy rate has jumped more than double in the last three to four weeks. Hospital admissions are increasing. ER traffic is increasing. Our colleagues who work in ERs and urgent care settings tell us that they're seeing pediatric patients, children present with symptoms consistent with the delta variant, and that some of them have been hospitalized. This is going to get worse if we do not pull together and we do not push for vaccinations and indoor mask wearing. That is the state of this pandemic right now. That is the point in time that we find ourselves in.

SNELL: Are people more open to getting vaccinated with that data and with that information about the current state of affairs?

KHAN: You know, we have seen just a slight uptick. And it may or may not be attributable to fear about what might happen, because people are watching what happened just down the highway literally in southwest Missouri only a few weeks ago. If that helps, sure. However, we are still stalled in the mid-40s, so it is not a significant enough upward increase. We are way behind the target on this.

SNELL: So what do you think would help? What, from your perspective, might actually persuade people to go get the shot, to get more shots and arms?

KHAN: That is a very good question. And, you know, because vaccination rates are stalling across the country in many different metro areas, including St. Louis, we have to change tactics, and we already are by literally going to the grassroots level, meeting people where they are in businesses, barbershops, beauty salons, grocery stores. We are also in the process of working with the county council to get an incentives program off the ground based on the receipt of federal funds recently. But, you know, all these efforts, I wish they were all in effect as of yesterday, because that is the situation we find ourselves in. Time is not on our side. The rate at which this is spreading is more than alarming and, quite frankly, frightening at this point in time.

SNELL: That was Dr. Faisal Khan, acting director of the St. Louis County Health Department. Dr. Khan, thank you for your time.

KHAN: Thank you. Transcript provided by NPR, Copyright NPR.