California’s first surgeon general on Covid: ‘Greatest collective trauma’ of a generation

When Dr Nadine Burke Harris was first appointed California surgeon general, she set out to address the toxic stress and trauma plaguing the state's most vulnerable residents.

Then the pandemic hit. Suddenly, she found herself having to guide millions through statewide shutdowns, and persuade scared, skeptical Californians to get vaccinated against Covid-19 and wear masks to prevent the virus' spread.

Burke Harris, who resigned this month, said the pandemic is "probably the greatest collective trauma of our generation," and she, like all Californians she was sworn to serve - will have a long road ahead processing the last two years.

Reflecting on her three years as surgeon general of the most populous US state, Burke Harris warned that "the health consequences of this pandemic will continue, even after the virus itself is contained."

More than 82,000 Californians have died from the virus, and during Burke Harris' last week the state continued to tally about 200 deaths a day. The state, which was the first to enact stay-at-home orders two years ago, has seen the coronavirus overwhelm hospitals, exacerbate health inequities and disproportionately burden Black and brown Californians.

When Burke Harris was named the state's first-ever surgeon general in January 2019, she stepped into a historic role - one that California governor Gavin Newsom created just for her. Only three other states have surgeon generals. Drawing on her expertise as a pediatrician who specialized in recognizing and treating early childhood trauma, she made it a priority to screen children across the state for signs of extreme stress.

By early 2020, her office had just launched an initiative to train health providers across the state to screen for childhood trauma and abuse and respond with appropriate care. When Covid-19 hit, "everyone had to put a lot of things on pause, to respond to the pandemic", she said. Her office decided they couldn't delay the training program. "Because we're desperately going to need it," she said.