Detroit health chief talks building a health provider network ‘literally overnight’ during COVID-19 crisis

By: - June 9, 2020 8:57 am

Detroit Chief Public Health Official Denise Fair | City of Detroit photo

Denise Fair has led the city of Detroit’s Department of Health since last September during one of the most tumultuous times in history. 

As chief public health officer for Michigan’s largest city, her tenure has been significantly affected by the COVID-19 crisis that has resulted in the Motor City being one of the world’s coronavirus hot spots. 

Mayor Mike Duggan| Andrew Roth

“We’re thinking about keeping her,” Detroit Mayor Mike Duggan said jokingly when asked about Fair. “Hasn’t she been amazing? Director* Fair came in at a really tough time. She has been pulling that department together, and it was then hit with [COVID-19]. I think that she has been doing an outstanding job.”

State health officials have consistently reported that roughly one-third of Michigan’s confirmed cases were African Americans and Blacks accounted for about 40% of coronavirus deaths. African Americans make up only 14% of the state’s population and the city of Detroit is 80% Black. 

Fair, a 37-year-old Ypsilanti native and current downtown Detroit resident, now leads an effort to help her city beat the virus. 

Throughout the crisis, Fair has been charged with communicating with residents and being part of the city’s daily press briefings. But she said that part of her job doesn’t come naturally.

“It’s interesting because I am actually an introvert. I am very much shy,” she told the Advance. “I know people don’t believe that, but trust me. And if you knew the thoughts that were going in my head before taking the mic, it’s like, Oh my God, I’m so nervous. My heart is beating, but this is what I signed up for. And it’s up to me to really make a difference and to communicate a message. So as soon as I start speaking, those nerves literally dissipate.”

Dr. Joneigh Khaldun and Gov. Gretchen Whitmer give an update on COVID-19 | Gov. Whitmer office photo

Before joining local government and replacing Dr. Joneigh Khaldun, who left to join the Michigan Department of Health and Human Services as chief medical executive and chief deputy director for health, Fair served as a group practice director at Henry Ford Health System, where she provided executive oversight for primary care clinics and multi-specialty medical centers. 

Prior to that, she worked as senior consultant and program administrator for Trinity Health System. There, she managed a broad portfolio of operations including ambulatory clinics and urgent care facilities.

Fair earned a bachelor’s degree from the University of Michigan, a master’s in public health from the University of California at Berkeley, and recently a master of business administration in finance from the Mike Ilitch School of Business at Wayne State University.

The Michigan Advance talked with Fair last week about how her department has changed, the challenges of getting residents tested, how to make a homemade mask, dealing with loss during the pandemic and more.

The following are excerpts from the interview: 

Michigan Advance: Your leadership of the department obviously comes during this COVID-19 pandemic. I’m really curious about how it’s altered or affected your department, particularly because you had only recently come into the leadership of it.

Detroit Chief Public Health Official Denise Fair

Fair: I was appointed by Mayor Mike Duggan in September of last year. And, I took this job knowing that this wasn’t going to be a job, it was going to be an opportunity to make a difference. I’ve always been in a position where I’ve had the opportunity to make a difference and to influence, either a population, or a generation, or to a set of people. 

And so in the city of Detroit, with almost 700,000 [residents], what an experience. So I met with the team, shadowed a lot of the staff. And then within six months, my job changed overnight where now I’m literally making sure that lives are saved.

In the public health department, our role is to provide communication, education, surveillance, and emergency preparedness. So we stay ready. And when the first [COVID-19] case hit in early March, we had to adjust our priorities. 

My team includes medical and public health professionals; epidemiologists; communicable; disease experts. And again, we were prepared. There are more than 200 people in the health department. And so when COVID hit, we had to shift and nearly all of my team was reassigned to focus on COVID-19 efforts. 

So we had stopped what we were doing. Some of the staff switched jobs to focus on scene investigation. Some were placed in our rapid testing clinic. Some were placed in our outreach and education.

Michigan Advance: Talk to me about the challenge that the city faced because the opportunity to be tested was a barrier for many residents.

Fair: So the first case hit in early March and we had about, oh my goodness, 30, 40 cases in the very beginning. And then we started to get hundreds of cases reported every single day. 

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Mayor Duggan decided that he wanted to make sure that every Detroiter who needed to get testing to get a test. So we had to develop a really large scale strategy to provide testing for all. And so we decided to partner not only with the residents, but the tri-county area. Wayne, Oakland and Macomb and hospitals really stepped up like Trinity, DMC [Detroit Medical Center], and Henry Ford and they were testing 500, a thousand people, per day.

And it was based on those who had symptoms. So we set up a call center with the support of Quicken Loans. We focused on communication to make sure that everyone knew about the state fairgrounds. It was really impressive, you know. In order to get a test, you had to go to the state. You had to get a prescription from your doctor. What we found is that there are a lot of Detroiters who don’t have doctors. 

So my team and I were making phone calls, personal phone calls to doctors saying, ‘Hey, are accepting new patients? Do you want to join our provider network?’ And we built a provider network literally overnight. And within about a day or two, we had 30 providers who were accepting new patients, whether residents had insurance or not.

Michigan Advance: You recently demonstrated how to make a homemade mask. Tell me a little bit about how that happened and  what went into it? 

Fair: So I’m a visual person. And you know, if you think about masks it’s hard to find one. It is, and there are a lot of people who are price gouging. And so, the [U.S.] surgeon general had just produced a video about how to make your own mask. 

And, you know, I don’t know how many people saw it, but I wanted to make sure Detroiters saw it. And so I was talking to the mayor maybe about 45 minutes before the press conference. So he says, ‘Well, great. You ought to come today to the press conference and make your own mask.’ I said, ‘Are you kidding me?’ He was like, ‘Yeah, you can handle it.’ And so usually when he says you can handle it, I get this burst of competence. I feel like I can just run a marathon.

And so I ran to my team and said, ‘We need to find a T-shirt. We need rubber bands. We need scissors.’ I did practice a couple times and then it’s go time. And that’s what we did. I thought it was really great. And then afterwards, we went back to my office and I used my iPhone and just recorded a massive video. 

And within about two or three days, that video went viral. Right now, there are, I believe, almost 600,000 views, including a grandson from Alabama. He says, ‘My grandmother received a notification about your mask and it really helped her.’ Oh, well, we got the message across.

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Michigan Advance: How have you been affected personally or professionally by COVID-19?

Fair: I’m usually very kind of straightforward. I’m extremely honest. I will tell you that COVID-19  took a toll on me personally. It is very difficult to share the number of deaths every day during the press conferences, because these are not just numbers. These are people, these are our neighbors, our family, our friends, our loved ones.

I always think if there is something else I could have done to prevent that one person from dying and you know, it’s very much stressful. But it’s part of my journey and it’s an honor and a privilege to serve in this role. 

I’ll tell you, I had to close my door about two, maybe about three weeks ago. I had just heard that one of the employees in the health department had passed away from COVID. I closed my door and burst into tears. I don’t think I’ve ever cried at the office. But I felt so much pain and so much responsibility. 

Her name was Antoinette Bell. She worked in the immunization clinics. She was finishing up her senior year at Wayne State. You know, at that moment, it really hits home. 

In the last few months I have lost several members of my community to COVID and a couple of friends and family members who have been impacted. I have an aunt, a grant aunt, who’s in the hospital right now. So it hits home, but it also really encourages me to keep moving forward.

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Michigan Advance: What is it like working with the state and Dr. Joneigh Khaldun? What’s the relationship like? Do you talk at all?

Fair: Yes. She has been a great resource, of course, along with the state. I text her and call her at least once or twice a week. So we are in regular communication. … So we definitely have a connection. She’s been a great mentor and I really look up to her, and I think she’s doing an incredible job in her role.

Michigan Advance: Do you have any hobbies?

Fair: Yes. I am a runner and I love to run when I can. I love to run on the [Detroit] RiverWalk. I haven’t run probably about a week or so. Running is therapy for me. And so I have a lot of times when I’m running, I’m thinking. I’m strategizing. I’m preparing. And that’s what I love to do while I’m running. I’ll listen to music every now and then. It is a time for me to just center myself. 

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Ken Coleman
Ken Coleman

Ken Coleman covers Southeast Michigan, economic justice and civil rights. He is a former Michigan Chronicle senior editor and served as the American Black Journal segment host on Detroit Public Television. He has written and published four books on black life in Detroit, including Soul on Air: Blacks Who Helped to Define Radio in Detroit and Forever Young: A Coleman Reader. His work has been cited by the Detroit News, Detroit Free Press, History Channel and CNN. Additionally, he was an essayist for the award-winning book, Detroit 1967: Origins, Impacts, Legacies. Ken has served as a spokesperson for the Michigan Democratic Party, Detroit Public Schools, U.S. Sen. Gary Peters and U.S. Rep. Brenda Lawrence. Previously to joining the Advance, he worked for the Detroit Federation of Teachers as a communications specialist. He is a Historical Society of Michigan trustee and a Big Brothers Big Sisters of Metropolitan Detroit advisory board member.