As she departs, Alaska’s top doctor reflects on the challenges and high points of leading the state’s pandemic response

Dr. Anne Zink is stepping down Friday from the position of chief medical officer, a role that involves providing clinical advice to the governor and to Alaska’s health department.

Over the last four years, Zink, an emergency room physician, became a household name in Alaska for her role in leading the state’s pandemic response — and later, a target for attacks by a growing anti-vaccine movement and other critics of COVID-19 measures.

Besides helping lead the state’s coronavirus response, Zink since 2019 has also helped guide the response to other major health concerns facing the state: a youth mental health crisis, rising rates of substance misuse and opioid overdose deaths, increased rates of sexually transmitted infections and increased health care costs.

Her successor is Dr. Robert Lawrence, a longtime leader of Alaska’s correctional medical system. He started this week.

During her last week on the job, Zink spoke with the Daily News about the highs and lows of her tenure — and shared her thoughts on what she views as some of Alaska’s biggest health care challenges.

In a wide-ranging conversation, Zink said she was proud of the work she did to help bridge the divide between public health and clinical practice, including overseeing a split of the former state Department of Health and Social Services into two agencies.

She said she was also proud of the ways and moments that Alaskans came together during the pandemic, even when times were tough.

“The thing that I’m in many ways most proud of, it wasn’t about what (the health department) could or couldn’t do,” Zink said. “It was what Alaskans did to care for their neighbors, to care for their elders, to care for each other.”

This interview has been edited and condensed for clarity and length.

ADN: How are you feeling about leaving?

Zink: It’s mixed emotions, for sure. This has just been the opportunity of a lifetime in so many different ways. I’m gonna miss huge parts of it, but it also feels like it’s just time.

ADN: Could you say more about what that means to you — the “opportunity of a lifetime”? What has this job meant to you?

Zink: The emergency department is where I think we see all good public policy come to fail. And I felt like to be able to care for my patients, I needed to really care for bigger systems of health, to be able to make change in a way that I wouldn’t have in other ways. It’s also been an honor because individual tribes, families and community members have let me into their lives and their homes in ways that I wouldn’t have ever expected. And that’s been an incredible learning opportunity.

ADN: You started this job shortly before the coronavirus pandemic began. If you could go back in time, what would you tell that version of yourself? What advice would you give?

Zink: I think I would tell myself the same advice that an attending physician gave to me early in residency, and that was really, “Do what’s right for the patient, and the rest is noise.” And I would tell my past self that there will be a lot of noise. There will be a lot of frustration. There will be a lot of anger. There will be a lot of new information that has to be processed rapidly, and change. But just to continue to stay focused on, how do you think you can best serve the health and well-being of Alaskans? And the rest will work out.

ADN: Throughout the pandemic, there were points where there was a lot of noise, and a lot of people who disagreed with you. How did you navigate that?

Zink: I really appreciated the criticism. Honestly, in many ways, I think it made us better. I think the way that our systems are set up don’t offer the opportunity to listen as much as we should. And if I were to, again, give advice to my former self or to someone who would be in this role again, I would just really encourage them to continue to find opportunities to listen to a large diversity of thoughts and opinions and voices, because you’ll be better off the more you hear.

There was one time where I started to get this big rash of death threats. And I kind of knew of an event that had likely gotten people really riled up, and had resulted in a bunch of those death threats. And I knew the person who had organized the event.

And so I called the guy who organized it, and I said, “Listen, I’m getting all these death threats. I’m sure you and I disagree on the best course of action, but I don’t really believe in my heart that you think I should be getting death threats.”

And to his credit, he called all of the people who were giving me death threats and said, “That’s not who we are. And that’s not what we do.” So I feel like even in the height of it, there was opportunities to find common ground.

ADN: Did you feel political pressure a lot throughout the pandemic?

Zink: I think that as the pandemic continued, there was clearly more and more partisan divide as a country. And so I started to see patients more and more be divided.

I remember having this one patient, and he was like, “I don’t literally know a single person who has been vaccinated” — like in his entire community, no one had been vaccinated. And clearly, politics played a large role in that.

He wanted to get vaccinated, but it really felt to him like abandoning his whole family and his identity, and how much politics had become an identity to him and to his family. And that was now tied into his health care decisions, which I think is a phenomenon more of our recent times. And that really worries me.

I think people used to make health decisions for health, and politics decisions for maybe business or schools or just worldview perspectives, but I think the pandemic really tied health and politics together in a different way. So I do think there was pressure in different ways, but I would say it more came from national media and from patients than it did from politicians.

I told (Alaska Gov. Mike Dunleavy) at the very beginning, “I’m not going to tell you something different than I would tell my family or the public — I’m gonna be consistent across all three.” And to his credit, he always said, “I’m never gonna tell you what to say.”

And that was not the case for a lot of people in my role, for sure.

ADN: I’m curious about the lasting impacts of the pandemic on Alaska health care. What have you noticed?

Zink: I think that the way that our health care system has become really broken has made it really hard for people to trust health care. I also think a lot of health care providers feel as though the public turned on them during a time when they felt like they were putting their lives on the line.

I see more of an emotional disconnection between providers and patients now than I had before. This sense that, “Before, I was willing to sacrifice a lot for my patients, but my patients and society weren’t there for me when I needed them. And so I’m not going to sacrifice as much for my patients or for the system as I used to.” And I think that is going to have really long-term implications.

ADN: What have you learned about how to get through to people who feel wary of vaccines, or are distrustful of the advice their health care provider is giving them?

Zink: I think it’s always a work in progress. And I don’t think it’s about having people see it the way I do — I think it’s about understanding what their concerns are and trying to best meet patients where they are. And sometimes that means: What can they do to protect themselves even without vaccines?

I think vaccines are an incredibly important tool, but I think it’s false for us to say it’s the only tool. And I think we have to look at a whole person and what makes them healthy, and in some ways, it’s a little bit like politics, where they say, “You’ve got to push a log where it’s going to move.” And I think the same thing with a person: Where are they willing to go to promote their health, and how can you support them in that direction, rather than just focusing on an area that’s stuck?

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ADN: You and I have spoken before about how the pandemic both revealed and exacerbated many inequities in the health care system. What do you think are some of Alaska’s biggest health care challenges right now?

Zink: The high health care costs are a huge component. I also think that the way that we’ve disconnected health care from the social aspects of our health is a really big deal. Eighty percent of our health is determined by things outside of health care — like, do we have housing? Do we have a job? And while the Department of Health itself can’t be responsible for all of those things and be effective, I think we can really continue to look at a person as a whole person.

ADN: Do you look back and think that the pandemic caused some missed opportunities as far as other public health concerns in the state? To what extent were you pulled from those other tasks?

Zink: COVID clearly became a big part of everyone’s focus for some time. I do think in some ways, COVID allowed us to see the brokenness of systems, and are forcing us to find solutions now. So I think that there is a degree of silver lining with that. That being said, this is a devastating year for fentanyl. We have the most overdoses ever. There’s so much work to be done.

ADN: When talking about Alaska health care, it can feel like there’s so many negatives: The costs are so high and there’s not enough options. What are some of the things that you think Alaska is doing right, or that you’re most proud of?

Zink: One thing I would say is a connection to history, community and culture. The ability to hear from Alaska Native elders about the 1918 pandemic — the impacts on them, and the solutions that came about — was, in many ways, a gift: being able to hear and remember the history of infectious diseases.

Syphilis is a good example. It used to be required in almost every state that you got tested for syphilis prior to getting married. And our syphilis cases really plummeted. When I was training, I never saw syphilis cases. And now syphilis cases are just skyrocketing.

When we forget about the public health measures that are needed to help control diseases, we forget about the diseases, and then they come back. Remembering history is a strength that I hope we’re able to lean into more.

I think my biggest fear is that we’ll forget, and then we’ll repeat our mistakes. I’ve often said, it’s less how we responded to the pandemic and more how we recover from it that will determine our future.

Daily News photojournalist Marc Lester contributed reporting.