Before 2020, the head of the San Antonio Metropolitan Health District was similar to any city department director position. The coronavirus pandemic has made that job one of the most demanding and public-facing roles in San Antonio.
Claude Jacob, who was appointed by City Manager Erik Walsh in April and has been on the job since July 6, said Thursday he’s honored to lead the department through the pandemic and beyond.
“While the focus has been on all COVID, all the time for the last year and a half, … there are chronic diseases, climate change, [and] just the conditions that we are required as a governmental public health enterprise to assure the health of all, regardless of the ability to pay,” said Jacob, who previously served as the chief public health officer for the City of Cambridge, Massachusetts.
“I’m battle-tested, but contrary to popular belief, I did not have a full head of hair before COVID,” he said in jest, referencing his bald head and 14 years of experience at Cambridge, which included spearheading the region’s pandemic response. “I’m embracing the experience [and] the challenge.”
Jacob takes the helm as COVID-19 positivity rates have risen to their highest level in months and case numbers have spiked, driven by the spread of the highly transmissible delta variant of the virus among unvaccinated people.
“Let’s be clear, the party’s not over,” he said. “The message stays the same. We are reminding folks of the importance of being vaccinated” through the citywide “Do it for SA” campaign.
Jacob, 53, sees the increased scrutiny public health departments are getting because of the pandemic as an opportunity to highlight the importance of other issues the city is tackling, including diabetes, asthma, teen pregnancy, and domestic violence.
“It’s a good problem to have at the end of the day and we have an incredibly talented crew,” he told reporters during an introductory meeting Thursday. “This is a great city and I’m honored to be here to at least help them guide this enterprise.”
In addition to battling the pandemic, Metro Health has had to weather a series of leadership changes, starting with the abrupt resignation of former Director Dawn Emerick last summer amid a sharp rise in local coronavirus infections and hospitalizations. She had the job for less than five months.
Colleen Bridger, who served as director of Metro Health before being promoted to assistant city manager in 2019, delayed her retirement from the city several times in order to help lead the city’s pandemic response, including the rollout of vaccines. Bridger’s last day with the city was July 20.
Amid the unsettled leadership, executives within the health department — including Medical Director Dr. Junda Woo, Assistant Directors Dr. Anita Kurian and Mario Martinez, and Deputy Director Jennifer Herriott — have provided stability, Walsh said.
Typically, City of San Antonio department directors report to a deputy or assistant city manager, but Jacob will report directly to Walsh.
“It’s too critical, both in terms of COVID, but also in terms of our eye on the horizon in terms of the Strategic Growth Plan,” Walsh said. “I want to make sure that we stay on path.”
One of the top priorities for that recently expanded plan is developing a more coordinated approach to mental health services and hiring a “chief mental health officer” to oversee the work. Another top priority is access to care.
“The guiding principles for this expansion are very much centered around health equity and social justice,” Bridger told a City Council committee last month.
In August last year, after the police killing of George Floyd sparked worldwide protests, City Council declared racism a public health crisis. Hundreds of cities across the U.S. have adopted similar resolutions.
The San Antonio Report asked Jacob how he envisions Metro Health’s role in addressing that crisis.
“It’s a national conundrum,” Jacob said. “Sadly, the George Floyd tragedy of last May became an accelerant during COVID. And so we do have an Office of Health Equity anchored to our department [and] we are working with our city partners, just to make sure we pay closer attention. We have a strong tie to the work of SAPD, just making sure that we can at least message this and approach this differently.”
Jacob and his wife, Nicole, have three teenage children: Alex, Ania, and Max.
“I’m not a clinician, nor do I play one on TV,” he said, but noted that he comes from a family of clinicians.
Jacob holds a master’s degree in public health from the University of Illinois at Chicago School of Public Health and a bachelor’s degree in Liberal Arts and Sciences from the University of Illinois at Urbana-Champaign. He is pursuing a doctoral degree in health leadership from the University of North Carolina at Chapel Hill Gillings School of Global Public Health.
Jacob comes from a municipality of just under 120,000 to an area with a population of nearly 2 million that is culturally and demographically quite different.
“In the Commonwealth of Massachusetts, population 7 million, over 98% of folks have some form of health insurance,” Jacob said.
About 29 percent of Texas adults under 65 didn’t have health insurance in 2020, according to consumer health advocacy group Families USA.
But when it comes to the pandemic, Jacob said, “Apples to apples, we are in the same fight. … At the end of the day, our strategies — our mitigation strategies — mirror one another: Mask up, maintain the appropriate social distancing, [encourage] folks to [get] vaccinated.”
Jacob pledged to make decisions about halting the spread of COVID-19 based on data.
“Although there is not a [mask] mandate, we are recommending that folks continue to mask up, especially if they are immunocompromised,” he said. “So just be wise — you don’t lose your cool points by wearing a mask.”