The Doc in the Hot Seat Dr. Edward Moreno holds firm against his detractors

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By Joe Livernois

His arrival in Monterey County seven years ago barely registered. He’s low-key and many people don’t exactly know what his job entails. But Dr. Edward Moreno just might be the most important person in Monterey County these days.

Moreno is the county’s public health officer, the man responsible for the shelter-in-place orders that are meant to slow the spread of a deadly virus in Monterey County. And he is taking considerable heat these days from a certain Peninsula-centric demographic that is demanding his head on a platter.

Last month, for instance, David Henderson dashed off a six-paragraph diatribe published in something called The Library of Economics and Liberty with the headline: “When Ignorant Bureaucrats Make Your Decisions for You,” referring to Moreno. Henderson is a noted Monterey County libertarian and one of about 100 demonstrators who showed up at last week’s Reopen California Now rally at Windows on the Bay in Monterey.

Also, last week the Carmel Pine Cone ran a full-page advertisement that urged residents to call or write Moreno to tell him “he is overstepping his authority!” The ad was anonymous, with an attribution that only references a group called “Concerned Citizens of Monterey County.”

In addition to its direct attack on Moreno, the advertisement stands out for its generous use of exclamation points and question marks.

“THE SHELTER IN PLACE ORDER IS ILLEGAL!!!” according to the ad, citing a state Appellate Court ruling that was apparently issued after the Spanish Flu pandemic of 1918. “ARE YOU WILLING TO LET OUR ECONOMY CONTINUE TO BE DESTROYED????”

Two weeks ago, former Carmel Mayor Sue McCloud purchased an advertisement, also in the Pine Cone, that was an “open letter” to Moreno and to Monterey County District Attorney Jeannine Pacioni. The ad excoriates them for threatening to prosecute gardeners and contractors if they violate the shelter-in-place order.

“What are we trying to accomplish?” she asked. And, the ad states, “It would seem we have met the enemy and he/she is us!!”

Moreno was also blasted by mayors in Monterey County last week for failing to keep them in the loop at a time when municipal governments are undergoing staggering revenue issues. Moreno pledged more open communication with them in the future.

Moreno has been busy lately — and he was unable to respond for comment for this story because he was reviewing Gov. Gavin Newsom’s latest Stage 2 requirements. But he does make himself available to reporters regularly, showing up to all of the thrice-weekly media briefings via Zoom hosted by the Monterey County administrative office.

In early March, Moreno said he would only issue updates once each week, but a coalition of local media organizations petitioned him to make himself more available. In response, his office offers up daily updates, with new infection numbers and demographic information. He also does the media briefings; those press-availability opportunities generally feature other along other county officials who hope to tell reporters about the measures they are taking in response to coronavirus, but Moreno is always the star attraction as the reporters pepper him with questions ranging from tests availability to modeling to how soon the coronavirus will go away.

For the most part, Moreno is maddeningly matter-of-fact. If he’s feeling the pressure after being accused of destroying the local economy, he doesn’t really show it. He prefaces nearly every answer to inquiries during the media briefings by saying, “That’s a very good question.”

The issue is that Moreno is making public health decisions that impact the entire county, but the prevalence of coronavirus seems to be concentrated in one half of the county and infecting one particular demographic, namely Latinos in the Salinas Valley.

As of Thursday, 247 people in Monterey County are known to have tested positive for coronavirus, resulting in six deaths. Of the total number of infections, 201 of the people who have tested positive live in Salinas or the Salinas Valley. At least 81 are farmworkers. That’s compared to the Monterey Peninsula and Big Sur area, where only 30 people have tested positive for COVID-19.

Len Foster, the county’s former health director, said he believes Monterey County’s response to COVID-19 has been “very appropriate.” He said it’s natural that the Salinas Valley would have more people test positive for coronavirus because so many people are working in essential jobs — agriculture, mainly — “and are forced to work in environments that defy the desired physical separation. Salinas also has the bulk of the county’s nursing homes and senior residential communities.”

Foster said the health officer could probably bifurcate his orders that would be more restrictive in certain parts of the county. But, he said, “in the absence of more test data, why would he? From my perspective, it would be a political decision, not based on sound public health principles.”

Moreno came to Monterey County in 2013 from Fresno, where he spent 10 years as the county’s  health officer. In Fresno County he was regarded as a “leading advocate for the area’s neediest and most vulnerable residents,” according to Vida en la Valle, a publication in the Central Valley.

He was mostly known for promoting preventive efforts to curb diabetes, asthma and obesity in Fresno, a crusade he continued in Monterey County.

In Fresno County, Moreno enjoyed a successful decade as county health officer but left the job after several years of severe cuts in the county health care budget and a string of political battles that divided the community along political, demographic and ethnic lines. He was a strong advocate of extending health services into the county’s large Latino population at a time when Fresno County’s increasingly conservative Board of Supervisors viewed that function as ripe for cost-cutting rather than expansion.

Fresno County, unlike almost every other county in California, spends none of its general fund on health care, financing it entirely out of state and federal aid and private grants.

Former Fresno County Supervisor Henry R. Perea remembers Moreno as “a dedicated and accomplished public servant who avoided politics and always spoke truth to power.”

Perea recalled that one of his board colleagues, Debby Poochigian, led a semi-successful effort to end the county’s practice of treating indigents and the undocumented without charge at the county hospital and later at another hospital operating under county contract. Perea fought against Poochigian’s effort but lost on a 4-1 vote.  In the words of longtime Fresno columnist Bill McEwen, the board at the time was made up mostly of “conservative penny-pinchers” who consistently kowtowed to agriculture — the owners, not the workers.

Perea eventually prevailed, however, when his son, a member of the state Assembly, crafted successful legislation to undo what the board had done.

Moreno began work in Fresno County shortly after county officials created the position of public health officer separate from directorship of the county health department. As health officer, he was able to concentrate on medical and health issues while the health department director managed the  bureaucracy of the health department, which handled everything from vaccination clinics to restaurant and even milk inspections. Moreno left just as the county started a move to combine those functions back into one job.

Fresno County’s current interim public health officer, Dr. Rais Vohra, doubles as an emergency department physician at Community Regional Medical Center and triples as medical director of the Fresno/Madera Poison Control Division.

Moreno, who is 56, grew up in Placentia in Orange County, and holds a medical degree from UC San Francisco. He also attended Notre Dame and CSU Fresno.

During his press briefings he is typically bombarded with questions about his shelter-in-place orders, usually from reporters asking why he seems to be reticent about easing restrictions.

(For the record, I had been asking Moreno a question for an entire week before he finally had an answer. Each time I asked the questions — if he’s trying to discourage out-of-county visitors, why didn’t he expressly forbid golf courses from accepting reservations from people who live outside the county? — Moreno apologized and said he’d have to research the answer. Finally, on Friday, he said the county’s “golf safety protocols” do not tell courses to stop taking reservations from out-of-town players because the rule would be nearly impossible to enforce. He did say he is encouraging course operators to only allow locals to play on their courses.)

Regarding shelter-in-place, Moreno’s counterpart in Santa Cruz County this week quickly declared that she is easing restrictions on business based on Gov. Gavin Newsom’s announcement earlier this week that California is entering “Stage 2” in its coronavirus recovery. But when asked on Wednesday if he’ll be revising his order, Moreno said he wants to read the written guidelines that come with Newsom’s office before he does anything.

Facing questioning during the media briefing, Moreno calmly explained his rationale. “We have a process and I really want to make sure it’s a thoughtful process because anything that I limit or restrict in the health officer order needs to have justification,” he said. He said he understands the need “to protect public health while still allowing for some economic and social benefit to the community. I’m still a strong believer at … making sure that public health is a priority and that we’re not easing restrictions for reasons that aren’t really public health reasons.”

Monterey County Supervisor Luis Alejo said he believes Moreno has been “thoughtful” and “very engaged.”

“All health officers throughout the state receive some criticism by constituents, while also getting praise by others,” Alejo said.

He said he is convinced that Moreno has been listening to residents, business leaders and others while working with the Board of Supervisors. “These are certainly not easy decisions, as this crisis generates a wide range of concerns by our residents,” Alejo said.

Royal Calkins contributed to this report.

Letter: Appreciate decisions based on available science

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Joe Livernois

About Joe Livernois

Joe Livernois has been a reporter, editor and columnist in Monterey County for 35 years.

13 thoughts on “The Doc in the Hot Seat Dr. Edward Moreno holds firm against his detractors

  1. The SIP was intended to flatten the curve … I.e. keeping the infection rate below the capacity of the medical community to treat those infected. The effort is successful. Time to move on. Moreno is over his head.

  2. Nicely researched piece, giving a positive sense of who Moreno might be… however, omitted is the incoherent forecast Dr. Moreno appears to be relying upon, that MoCo will have well over 30,000 cases & 900 deaths by early June. That the County Sups accepted this so unquestioningly leaves one wondering.

  3. We’re paying this man $350,000 a year to keep us locked in our homes as we lose our jobs, prevent our kids from going to school, and destroy our businesses…in the name of’ “health?” Really?
    Dr. Moreno, you should be fired immediately!. I for one, own a home and pay heavy taxes for this privilege. I am also an American and pay handsomely for that privilege as well. You are a wrecking ball. When you are finished we will be lucky if there’s anything left of our dear Carmel or any of our other towns. We have suffered long enough. Time to quit fear mongering and encourage people to walk in the light and smile and be happy again. For this is how you have a healthy society. I guess they don’t teach that in medical school.

  4. I think Dr. Moreno is doing a great job— he’s following complicated, often changing state guidance, working closely with state and local elected officials and basing his steady response locally on a careful, often difficult balance between the science of the pandemic and local political/economic imperatives. Most residents of Monterey County support him I believe— the silent majority in fact.

    Essential workers who face the greatest exposure to Covid 19, including our farm workers, are not out protesting to open the golf courses or whine about not being able to have their hair cut or their nails done. They’re not paying for full page ads in the Carmel Pine Cone, nor writing hateful screeds in letters to the editor that somehow their liberty has been violated because they can’t hang out in a crowded bar during car week.

    Yet it’s these uncomplaining essential workers whose lives have been on the line these past eight weeks, serving the very same privileged group of angry, insulting letter writers. They’re the ones actually taking the risks, often without much choice in the matter if they want to support themselves and their families.

    Most Monterey County residents I’ve met are staying home, wearing masks, washing hands and coping, even in the face of unemployment and economic upheaval. They’re anxious and frustrated, like everyone else, but realize that the SIP mandate has worked. The steps we were asked to take are precisely what helped keep our rates of infection relatively low and our deaths in the single digits.

    On the 75th anniversary of V-E day, I’m reminded of my grandparents and parents who served in the Red Cross and in the Army, who also survived the 1918 flu epidemic and the Great Depression. They were strong people. I’m glad they’re not around to see the new Americans, who chose to divide in hateful ways our nation at a time of national crisis— much less those having meltdowns and tantrums because they’ve been advised to stay home to avoid spreading a deadly virus. They’re behaving like spoiled brats, and should be ashamed of themselves.

    Note to T. moo: Educate yourself on pandemic modeling before you go after Dr. Moreno. You could start with this article at fivethirtyeight https://fivethirtyeight.com/features/why-its-so-freaking-hard-to-make-a-good-covid-19-model/. But there are many, many articles written for laymen like ourselves that explain how they function. Surely you’ve got time to read about them.

  5. If you are inclined to dump on Moreno, I support the dumping; however, you may want to consider this also.
    The county supervisors ran away from the county law which assigned them virus emergency responsibilities and authority.
    They saw the virus coming. They saw the agony caused by the virus decision making. And they did not want to face the political criticism that goes along with that decision making. So, the ran for the exit; but, realizing on the way out that someone had to give shutdown orders. So , they gave Moreno the authority to give shutdown orders which they, by county law, were required to give. Think of it this way: the supervisors erased virus management from their job description and gave it to Moreno. Moreno ends up making shutdown decisions and takes all the decision making heat – instead of the supervisors. In summary, Moreno was designated by the county supervisors as the official Monterey County pandemic pinata. All in all, a cowardly act by the supervisors. But, hey, Moreno seems to be adjusting nicely to that role.

    1. With respect … Do you believe a global pandemic is best managed by politicians? Or by medical experts trained in the science of epidemiology?

      1. Politicians. No question about it.

        Epidemiologist, virologist have a very narrow focus – the virus. They do not involve themselves with the destructive side effects of their recommendations.

        If their recommendations save a life that’s good to them.

        If, however, their recommendations shuts a business down, or causes an employee to lose a job, causes someone to struggles for income, leads to a suicide or other some other form of agony, that’s not on them. Someone else needs to address that. And they know it.

        Enter the politician. He/she needs to see and understand the destruction on both sides and make a decision. And is willing to take the heat for that decision. That’s called leadership not medical expertise. Which, I hope, is what you look for when you cast your ballot. It ain’t happening with the Supervisors who, despite what their resume says, are hiding.

        I suggest you dig a bit into the Monterey County Disaster Council. It places virus leadership onto the Supervisors. You’ll see according to that Monterey Code, the Supervisors are supposed to be issuing orders, not Moreno. Care to guess why they’re not following their own code? Their own legal code?

        I think it’s worth keeping in mind that a medical expert epidemiologist created and set this destructive virus in motion, not a politician.

        Thanks for asking. Like the website.

        1. completely agree with Rick Ricci. Ask a doctor and you will get only a medical answer. A narrow, myopic focus. A public health officer is not qualified to oppressive decisions that effect myriad components of our society, from economics to education. Dr. Moreno does not have the qualifications to wield this much authority. No one person should ever have been handed this overarching power. Reopen Monterey County immediately. Let people return to work. Let children return to school. Doing so doesn’t mean that the vulnerable subsets can’t still continue to shelter!

        2. Perhaps Ricci and other armchair experts (describing all of us here) might have a more nuanced view of the hard decision-making if they read this recent article describing the difference in approaches taken in Seattle and NYC, one by scientists working with politicians, one by politicians, who begrudgingly accepted advice from the experts. The difference in outcomes is easily measured, sadly, in lives lost.

          First, you should know there is an accepted national protocol for responding to pandemics. Public health experts throughout America study them at the Epidemic Intelligence Service (EIS).

          I think the Supervisors followed the EIS protocol on how to handle pandemics by giving prominence to Dr. Moreno’s expertise. And it is that very process that has resulted in an extremely low infection rate so far. Both the Dr. Moreno and the Board deserve credit— as do the majority of non-whining Monterey County citizens who’ve been complying in good faith by staying home, wearing masks when out among others and practicing hygiene.

          I do think Board members have let Moreno take way too much heat from the hyper-partisans orchestrated by the Fox News dwellers at the Pinecone. Only Mary Adams had the grace to defend the decision process that I could see in all those outraged letters to the editor that were no doubt solicited.

          Now is the time to regroup as a County, to help each other through the next phases of this crisis as best as we can, economically as well as from a public health perspective. Let us not devolve into hair-on-fire conspiracy proponents, nor initiate frivolous lawsuits at a time of budget cutbacks, nor follow the fault lines dividing the rest of the country. We have been lucky so far— let’s keep it that way.
          .

          1. “I think the Supervisors followed the EIS protocol on how to handle pandemics by giving prominence to Dr. Moreno’s expertise. ”

            Your not up to speed on what’s happening.

            The Supervisors did not give Moreno “prominence.”

            The Supervisors gave Moreno their authority.

            Show me in the EIS protocol where it says the authority of an elected County Supervisor to issue orders during a pandemic is voided. And that authority to issue orders during a pandemic is transferred to an un elected county employee. Where does it say, anywhere, that Moreno gives the orders to the citizens of Monterey County during a pandemic?

            “I do think Board members have let Moreno take way too much heat…”

            You’re getting closer to the truth, here.

            Read up on Monterey County Office of Emergency Services. There you will find County law which says the Supervisors are supposed to issue orders during a pandemic, not Moreno. Under County law, the Supervisors are supposed to be issuing orders and taking the heat which, so far, has been directed at Moreno. The Supervisors have ignored all that law.

            Are you getting the picture? The Supervisors have set Moreno up as the decision maker so they can escape the heat. In effect, designating Moreno as the official Monterey County Pandemic Pinata.

            Surprisingly, he seems to be adapting, nicely, to that status.

            Incidentally, your references below are jumbled gobbledygook.

          2. Except for big part regarding public health that Dr Moreno is missing is engagement. More importantly it’s the engagement with the public that matters, building repore and trust. Key fundamentals needed in a leader, especially during a crisis. I remember Dr. Moreno from Fresno. The guy isn’t budging. Trust me. We will be the last county to officially make it to the last phase, if ever. The public needs to see and hear more from him, after all he’s in charge of PUBLIC HEALTH.

  6. This COVID-19 is no question a concern for all of our well being not just the essential workers. The community has a right to question everything that is going during this SIP. This has nothing to do with whining. We are asking how long are we going to stay quarantined in our home? How long are businesses going to be closed? You can’t keep living in fear to go out or we will never leave our homes or property. Last I checked there are 355 cases found by testing and 254 recovered cases with 8 deaths. No county wants deaths but people did die and we can not shutdown and live in a ghost town full of fear for too long. We will have other health issues when people quarantine too long because our immune system will be compromised for future health problems to come.

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