In the midst of a global pandemic, Ohio's health director has risen from obscurity to widespread acclaim, providing strength, intellect and candor for an isolated and anxious state.

This pandemic is not a war, nor a wildfire, nor a violent storm. It’s quiet, invisible—a poisonous secret. Until recently, life still seemed normal, even as it burrowed into people’s lungs. The novel coronavirus is now defined by absence: the sounds of beeping machinery as hospitals prepare empty beds for the surge, the whoosh of buses along vacant Downtown streets.

We work away from workplaces, and far too many people can’t work at all. Schools are closed. Sports are gone. Restaurants are empty, and the bars, salons and gyms are dark. People don’t leave their houses for days on end, and everyone is waiting. And waiting. And waiting. And sometime around 2 each afternoon, Dr. Amy Acton comes on.

The Statehouse’s daily briefings are the only collective respite for the newly disconnected population, and though Gov. Mike DeWine has been lauded for his leadership, Acton has emerged as the voice of Ohio. The state health director has become the soother of a nervous public through her calm delivery, candor, compassion and unwavering resilience and hope. Her style blends stark warnings with impromptu asides—she once demonstrated proper form for setting a pick in basketball—often to the delight of DeWine and Lt. Gov. Jon Husted, who look on with a mixture of amusement and wonder. Government press conferences—the blandest of all broadcasts—are now appointment TV for people who are restless and scared and confused and angry and holding their breath.

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Acton has also guided the administration’s policymaking for an outbreak with few answers. While other states struggled against disbelief and inertia, Acton was an early proponent of “flattening the curve” through physical distancing. During the March 12 press conference, at a time when Ohio had only five confirmed cases of COVID-19, she walked over to her chart of epidemiological curves to explain the radical notion that the state should basically shut down. She pointed to a severe yellow arc, representing China’s trajectory, next to a gentler blue curve, her hopeful path for Ohio, and repeated the message she’d been telling her staff.

“Would you like a big monster or a small monster?” she asked. “There’s no scenario now where there is no monster.”

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A few years before this crisis began, Acton applied for her dream job as a community research and grants management officer with the Columbus Foundation. In her 2017 application, she wrote a letter that resonated with CEO Doug Kridler, who read passages to me over the phone. “As a young child, I didn’t have a voice,” Acton wrote. “Growing up in poverty in Ohio, too often adults in systems look the other way. I realize now that my life’s work has been dedicated to ensuring that no one is invisible, that everyone has a chance to be heard.”

She landed the job and loved it, focusing many of her efforts on addressing youth homelessness, and Kridler says she planned to spend the rest of her career with the foundation. But, unknown to Acton, her work with one of the foundation’s supporting nonprofits had impressed longtime DeWine adviser Ann O’Donnell. DeWine had been searching for a new Ohio Department of Health director, but he was coming up empty. “I knew what kind of person I wanted, I just didn’t know who it was,” DeWine says.

In February 2019, when O’Donnell arranged for Acton to meet with DeWine and his inner circle, his first question was about her childhood, Acton says. She told him about her traumatic upbringing in Youngstown, then grew more excited as she began talking about the problems facing kids today and how the systems to help them were falling short. She got so animated that she reached out and touched DeWine’s arm, then froze, turned to everyone in the room and said, “Don’t touch the governor”—her note-to-self spoken aloud. She laughs about her faux pas now, and it clearly didn’t affect DeWine’s decision. He’d found his director.

His certainty didn’t ease her decision. She discussed the governor’s offer with Kridler and Dr. Kelly Kelleher of Nationwide Children’s Hospital, who had worked with Acton at the hospital’s Center for Injury Research and Policy. They both recall the same concerns: She wasn’t a political animal—her trusting tendencies could be a problem in that environment—and she was worried about being able to lead a department of 1,100 people. Her state agency experience was limited to a brief stint at ODH in the mid-1990s while completing her master’s degree in public health at Ohio State.

But DeWine’s proposal held plenty of appeal. He envisioned an elevated role, part health director, part state surgeon general, an expert who could talk directly with people about all manner of concerns. Acton had previously taught global public health at OSU and understood that it had been neglected a long time, in Ohio and beyond. She accepted the job, with considerable trepidation, and became the final member of DeWine’s cabinet.

In late February of 2019, she began the task of modernizing Ohio’s system, focusing on the social determinants of health—poverty, food access, housing—which she’d been working on with Kelleher for years. Ten months later, she heard the first reports of a strange disease circulating in China.

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Todd Franko had been the editor for The Vindicator in Youngstown for a dozen years by summer 2019, when he found out the newspaper was being sold and the last issue would go to print Aug. 31. For his final article, he wanted to feature one more local hero, his niche during a three-decade career. Someone told him about a woman from Youngstown with a “magical” backstory who’d recently been named health director.

Franko contacted Acton’s office to see about getting a phone interview. Instead, she told him she’d drive there from Columbus. He believes she wanted to talk in person because of “her genuine need to connect in the most human way possible.”

Over about an hour and a half, she told him the harrowing story of her early life. As detailed in his article, Acton’s parents divorced shortly after her brother was born, when she was 3, and her mom got custody. They bounced around Youngstown—18 homes in a dozen years, she estimated—including one that was just a bed in a basement. Her mom eventually remarried, to a man who abused Acton. The family was living in a tent in a campground when officials took the kids away, awarding custody to their father. The last time Acton saw her mom was in a courthouse, shortly before she and her husband skipped bail. But Acton’s life finally began to stabilize. She eventually earned her medical degree from Northeastern Ohio Universities College of Medicine, fulfilling a childhood desire.

Franko thinks Acton was so open with him because she sensed her story could be a beacon for others. He wrote it as the coda for his journalism career, and the last copies of The Vindicator hit the presses on Aug. 30. The final edition went out the next morning, and the article was posted to the publication’s website for just one day, until the paper officially went dark at midnight. An archival website was set up some time later, but Acton’s story was buried in 20 years of articles. It would have remained in obscurity if not for the public’s embrace of her.

***

When the COVID-19 press conferences began on March 7, there were no major updates or confirmed cases in Ohio, yet there was a briefing on a Saturday. Acton’s opening statement explained why. “We know, once again, that there’s a lot of fear, a lot of confusion out there, so we thought if we shared with you a little more about the testing process and what we know now, it might help your viewers, the people out there watching this, have a better understanding.”

DeWine, Acton, Husted and a rotating cast of other officials have gone to great lengths to explain the data and the guidance they hear from experts. They talk about why they’ve made their decisions and preview the ones to come. “I’m one of those people [who likes] to know the ground I’m standing on, and I sort of have assumed that other people feel that way too,” Acton tells me.

Her portion of the daily briefing often resembles a condensed college seminar—she has 11.7 million students now, DeWine says. The former professor teaches about virology, logarithmic spread or whatever subject may be relevant that day (to make a symbolic point about challenging times, she invoked the mythological writings of Joseph Campbell). She uses relatable, offbeat analogies, once comparing the state’s imperfect but progressively effective measures to stacked layers of Swiss cheese. At that first presser, she beamed and said how great it was to have a governor who “wants to go to all these wonderful places with you,” by which she meant indulging her fantastic geekiness in explaining the state’s testing capacity for communicable disease.

These are not the kinds of lessons the general public tends to consume with any sort of fervor, or even mild interest. But the stakes are so high and the uncertainty so great, her statewide audience is rapt. She has further endeared herself by offering personal details about her husband Eric—a middle school teacher in Bexley, where the couple lives—her six children, her rough childhood. Acton can be emotional. She laughs a lot—especially for a bureaucrat, even a green one—and isn’t afraid to show sadness and worry. She also provides rallying cries, as she did on March 22, a day when the state was shutting down nonessential businesses and her mood seemed bleak, though resolute: “I don’t want you to be afraid. I am not afraid. I am determined.”

As the press conferences grew in popularity—dubbed “Wine with DeWine” and “Snackin’ with Acton” sessions—someone in the governor’s office found Franko’s story about her troubled childhood and tweeted it out, where it fed the public’s appetite for all things Acton. Franko, now working for the nonprofit Report for America, told me on March 20 that he’d been receiving a handful of emails every day about his final story. Supporters have honored her with driveway chalk art, saintly renderings on snack bags, a Lego diorama and several locally produced T-shirt designs. In mid-March, the Dr. Amy Acton Fan Club popped up on Facebook. By early April, it had more than 125,000 members.

At the March 30 press conference, Acton responded to a fan letter from 9-year-old Ruby Owens of New Lebanon, part of which mentioned that the young girl was happy to see a woman in charge. In the age of the Women’s March, Acton’s presence has tapped into the same sentiments among others. For those who longed for Hillary Clinton or Elizabeth Warren to ascend to the presidency, Acton represents a full-throated rebuke to the notion that a woman can’t lead as well as a man in times of crisis. Through the early phases of the worst pandemic in a century, she has been steady, graceful, humble and strong.

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Susan Shapiro became friends with Acton during a different sort of crisis. Hurricane Katrina had just ravaged New Orleans, and the two women volunteered to prep donated homes in Bexley for the survivors who would move to Central Ohio. Shapiro says Acton was one of the primary organizers. “Just from a personality standpoint, I think Amy is perhaps the most empathetic person I know,” says Steve Shapiro, Susan’s husband. “She really feels things very deeply.”

Acton’s friends and acquaintances describe someone who is dedicated to helping however she can. She was a founding board member of the Columbus Jewish Day School, and she served as the president of CISV Columbus, the local chapter of an all-volunteer international organization that brings kids together to share their cultures in summer camps called villages. Acton was in charge in 2010 when local members hosted their first monthlong camp, attended by 11-year-olds from a dozen countries. Lynn Vottero, the chapter’s co-founder, and Scott Jones, another CISV volunteer, both describe Acton as a calming presence, echoing the praise of her current role.

“You know that person you see on TV every day? That’s her. She is real, and she always has been,” says June Gutterman, the former CEO of Jewish Family Services, who met Acton through the day school.

Many people laud her authenticity and lack of political aspirations, but her world is increasingly political. After all, it’s her name on the orders that have upended public life, and though she and DeWine have been widely hailed, the chaos around the late cancellation of in-person voting for the March primary caused some consternation. The administration has also taken heat for failing to clarify the rules for abortion clinics during the ban on nonessential surgical procedures.

Kridler says Acton has focused on “the business of helping others.” That is her strong suit, and she’s particularly attuned to those in precarious situations, Kelleher says. Her concern for the most vulnerable motivates her pleas for compliance with Ohio’s restrictive measures, so resources can go to the elderly, immunocompromised patients and health care workers. She rooted her work in youth homelessness in that same concern, perhaps stemming from her tumultuous childhood looking out for herself and her younger brother as they struggled on the margins.

Her past has made her tough, says Gordon Hecker, whose children went to the day school alongside Acton’s. “There’s a fierceness there,” adds his wife, Donna. Acton’s life experience, caring nature and intellect have prepared her for the direst circumstances, says Susan Couden, a founding teacher at the school. “Sometimes you almost think a person is born to be in a place, you know? That all the sum total of all their experience makes them particularly capable in this important moment.”

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Her days begin before the sun rises, between 4 and 5. Acton likes time to think and read, and she keeps a stack of books by her bedside. Once others are awake, she begins texting and calling, trying to squeeze in a few extra meetings. There’s a daily call with DeWine and others at 7:30 a.m., another at 8, and on it goes. Around 2 p.m., they go in front of the cameras for the daily update.

The day Acton and I spoke, DeWine ended the press conference with a video compilation of young girls pretending to be like her. (She says she had no idea it was coming and spent the duration of the clip bawling, relieved the cameras weren’t on her.) She’s honored to receive those reactions from people, though she finds it somewhat scary to have this much influence, and she attributes her popularity to a craving for transparency in society right now. In the press conferences, she often points out that she’s just the public face of thousands who are working around the clock statewide to control the spread.

DeWine praises the behind-the-scenes work the public doesn’t see—her long hours to stay on top of a crisis in constant flux and to run a health department with 113 local branches. “She carries that burden with her,” he says. “But she has remained cool, and she makes the decisions.”

The critical decisions to cancel civic life and close businesses were driven by the realization that, just like the 1918 influenza pandemic, the sooner the administration acted the more it would alter the virus’ trajectory. In the absence of a vaccine or cure, that meant throwing the economy into a deep freeze, which comes with its own set of “cascading consequences,” as Acton puts it. When unemployment numbers and poverty surge, they increase the potential for long-term public health problems, especially for those already on the fault lines. The viral response will need its own response.

As part of her public health system modernization, she’d already planned to invest in prevention related to social determinants—factors like employment and economic status. That effort will be even more critical now, and she has an unexpected opportunity to sell her vision. To spur the action—or lack thereof—needed to flatten the curve, she has hammered home that two-thirds of everyone’s health happens at the collective level: The 30-year gain in life expectancy in the last century is largely thanks to child labor laws, universal education, clean water, immunizations and other policies. That message dovetails with her long-term goals for the system.

Acton’s challenge is daunting: Ohio ranks 47th in public health funding, according to a study cited in a recent Columbus Dispatch article. But the governor is on her side, and if the state manages to avoid the outbreak’s full fury, Acton and her boss could earn political capital for their vision of a more preventative system.

But that’s a big if. Although Ohio appeared to be having success flattening the curve in early April, the world has been aware of the virus for all of five months, and even the experts are still learning. Acton often talks about tolerance for ambiguity—there are few answers and no guarantees. At the March 13 press conference, the day after she caused a stir by announcing her estimate that 100,000 Ohioans were already carrying the virus, she talked about the pitfalls of her work. “On the front end of a pandemic, you look a little bit like an alarmist. You look a little bit like a Chicken Little—the sky is falling. And on the back end of a pandemic, you didn’t do enough.”

***

The first Saturday in April is idyllic—pale blue skies, sunshine, birds chirping. People are in their yards, the parks and the streets, desperate to get outside after days or weeks of isolation indoors. Some are still complying with the orders, some not.

The virus has laid bare our interconnectedness, and how difficult it is to sever those ties, even temporarily. Even as New York struggles under its weight, with reports of people dying in hospital hallways while waiting for ventilators, only to wait for space in overcrowded funeral homes. Even as the virus shows itself in Ohio, with confirmed cases racing above 5,500 and deaths climbing over 200 by the second week in April.

Acton has talked about the differences between Bergamo and Lodi in Italy, and St. Louis and Philadelphia in 1918, and the comparisons between the cities that acted early or late. Timing is everything, and she has concerns about fatigue. Starting restrictive measures too late can be catastrophic, but enacting them too early can exhaust the public will. At a press conference in early April, she talked about how there are still empty hospital beds, and we’re just waiting. “But my biggest worry is that, in the quiet before the storm, we forget how important every one of our choices is and how many lives we’re impacting by what we’re doing.”

When we spoke at the end of March, she mentioned a conversation she had with the people at Homage about the T-shirt they were making in her honor, which benefits Huckleberry House’s youth homeless support services. The shirt reads, “Not all heroes wear capes.” She said she told Homage, “I’ll come and go in this storyline, but there will be a million more stories.” Yet hers is at the center of the response, and people are embracing who she is, especially her concern for others. She said she has always felt like a catalyst for collective action—that is her urgent challenge now. Timing is everything.

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