Chicago’s top doctor, Allison Arwady, is still standing
Frayed public health leaders left their posts in droves as the pandemic wore on. Not Arwady — she is steeling herself for her next front.By Courtney Kueppers
Dr. Allison Arwady walks into a small windowless room on the third floor of City Hall just moments before her weekly Facebook Live show is slated to start. She has a lot of ground to cover in the broadcast.
COVID-19 cases in the city are up and the mayor has recently tested positive for the virus. Days earlier, two students were fatally shot outside a Chicago high school and lead in an elementary school has alarmed teachers and parents.
On this day in late December, Arwady quickly greets her guest, Chicago Public Schools CEO Pedro Martinez.
“I love talking about lead because there’s so much misunderstanding,” Arwady tells Martinez in a brief pre-show exchange as they take their seats. Three studio lights illuminate an otherwise dark room that feels like where a high school AV class would record morning announcements. A couple of half-used bottles of hand sanitizer sit on a table.
Hector Perez, a city videographer, counts down to go live, 5-4-3-2-1.
“Good morning, Chicago,” says the doctor who was confirmed public health commissioner just nine days before the city’s first COVID case was announced.
The pandemic made Arwady, 46, a household name among worried Chicagoans, and the city’s top doctor still logs a weekly Facebook broadcast on public health. For 36 months now, she has been tracking a fast-changing virus and its mitigations, calmly tackling questions from panicked viewers and confidently taking on trolls.
COVID-fatigued public health leaders across the country have fled in record numbers, driven out by political frustrations, long days and nights and public pushback. But Arwady is still standing. In some ways, the Yale-trained pediatrician is beginning the year the way she ended the last one: leading the city through an ongoing pandemic. But she’s also capitalizing on the audience she’s built during her regular COVID-19 messages to try and tackle the city’s persistent mental health crisis, which is at the root of so many other issues, from homelessness to violence.
Back in the taping room at City Hall, Perez tells Arwady they’re clear as the show wraps. She relaxes a bit, debriefing with both Martinez and her top aide. Then, she puts a KN95 mask back on and turns to me. For an hour, she answers my questions about surviving three years of COVID and steering the city through what’s next now that the pandemic isn’t demanding her attention 24/7.
“It’s not the moment of the pandemic anymore, but it’s this next part that is going to set us up for the next 20 years,” Arwady says, nodding to the public health agenda she’s finally unspooling. “I’ve never been one to run away from a fight.”
In many ways, Arwady was as ready as anyone could have been for the pandemic: Her specialty is infectious diseases, and she deployed to Africa during Ebola outbreaks.
When the moment came to lead the country’s third-largest city through a pandemic, “she was the right person for that job,” said Dr. Emily Landon, an infectious disease specialist at the University of Chicago. “Nobody has been perfect, everybody’s made mistakes. But I thought she was so graceful about how she incorporated new data and new information.”
She’s also been insistent on keeping her “Ask Arwady” segments on social media going, long after other public health officials receded from the spotlight. Even Dr. Anthony Fauci has left his role at the national level — although Arwady is quick to note in our interview that his retirement comes only after a 50-year career. Perhaps if she were an octogenarian, she too would bow out.
Her staying power has, in some ways, expanded her public health celebrity. One viewer left a comment on a recent video saying they watch from Georgia because they appreciate the information.
Taking on the “troll-ish”
A regular Facebook Live segment was Arwady’s idea. At the beginning of the pandemic, “people were scared and they had a lot of questions, so I think it just came down to what’s the best way to reach people directly? And that was how we came up with the Facebook Live,” said Andy Buchanan, CDPH’s director of public affairs.
That decision to venture into the throes of social media has often attracted trolls armed with misinformation.
During her first show of the year, for example, Arwady chuckled a bit before reading out loud a question about quarantining students: “C. Davi on Twitter says, ‘Do you think you should go to jail for knowingly and illegally quarantining healthy students in Chicago knowing you are denying them their due process rights?’ ”
“No, C. Davi, I do not think I should go to jail,” she began in response, looking a bit amused. Then, more seriously, added: “And I do not knowingly or illegally quarantine Chicago students, and neither does anybody else … and I think you probably know that, if you are writing that kind of a question.”
Off-screen, Meghan Marth, the commissioner’s senior aide, scans social media and adds questions to a Google doc that’s also open on Arwady’s computer a few feet away. Confrontational questions get marked with a comment: “troll-ish.”
Why take these questions at all? Arwady sees it as an “interesting challenge.” “I always keep in the back of my mind that anybody who is watching and writing in is really engaged in this,” she said.
Landon describes Arwady’s approach as good bedside manner. When a patient is angry or frustrated, “you get so much further by just dealing with it head on,” Landon said.
“That’s something that good doctors are able to do and I think that she does it,” Landon said. “But it’s hard to do it in public, right? It’s really different to do it on a show than it is in a room with just you and one other person.”
Since the questions keep coming, so will the answers.
“I like the Facebook [show] because I don’t really have to prepare for it,” Arwady said. “It has become just a part of my week.”
Arwady has frequently been the messenger of heavy topics in a stressful age, but she also weaves levity into public announcements. On Halloween last year, she dressed as a wizard, because “I feel like everybody in Chicago is wanting me to predict the future,” she said while waving a wand at a crystal ball and encouraging people to get a “BOO-ster.”Maybe because of her sense of humor and her visibility, viewers don’t shy from asking about her personal life. Arwady responds by talking about her nieces and nephews, especially when discussing vaccines and encouraging the shots for kids. During a recent schools-themed update on the show, she also referenced her mother, a former music teacher.
“Maybe a little bit of teacher in you too?” I ask her after the show.
“Maybe a little bit,” she agrees with a laugh. “Exactly.”
On Dec. 6, as Chicago’s political sphere was chattering about the flood of mayoral candidates challenging Arwady’s boss, a viewer posed a timely question: Would she ever run for mayor?
“No,” she responded definitively. “A. It is past the timeline to turn in the petitions to run for mayor, but B. I can guarantee to you, I cannot imagine doing that job.”
An agenda beyond COVID
COVID-19 is still one of the first things Arwady thinks about in the morning. Many days, she’s the first presenter on an 8 a.m. call with the mayor and senior staff where she still gives a COVID-19 update. But it’s no longer the only thing on her agenda.
While she still has a “relatively larger soapbox,” Arwady is determined to use it to call attention to mental health, substance abuse and violence, persistent city issues that “have been indirectly impacted by COVID in dramatic ways,” she said.
In a recent op-ed in the Sun-Times, Arwady wrote that her “2023 wish for Chicago is that we all talk more about mental health, every day, not just after a crisis. Mental health is health, and I don’t want people’s struggles with it to go unspoken.”
She herself could have used mental health treatment as a young doctor, but didn’t seek help, she told WBEZ’s Reset.
In recent years, community organizers have criticized the city’s lack of mental health access for low-income residents and called for Mayor Lori Lightfoot to reopen neighborhood clinics shuttered by her predecessor, Rahm Emanuel. Arwady started the year trying to convince the public there’s a different way forward and that’s by embedding specialists throughout an array of services.
“It’s about meeting people where they are,” she said.
In the year ahead, Arwady said Chicago will launch a program that would give unhoused people with untreated mental illness access to a shelter where they can get care on-site. There are also plans to launch a 211 phone center that will connect residents with social services, including mental health care, and to expand a program that sends out mental health professionals in response to 911 calls.
But there are serious obstacles facing public health leaders like Arwady in the years ahead. It’s not only the attention that’s fading — so is the funding.
“I am quite concerned about what public health looks like over these next few years, as a lot of the funding that has come for COVID runs out,” she said. “We have this bad history in this country of funding after a disaster has hit, building systems and then taking them apart.”
That’s why Arwady sees herself staying in her position for another few years at least. While she admits someday the lure of international work may draw her back, she says the work in Chicago feels unfinished.
“I would like to do this job without the pandemic hanging quite so heavily over it,” she said.
Last March, when Dr. Ngozi Ezike announced she would leave her role as the director of the Illinois Department of Public Health, Arwady told WGN Radio she felt “a little jealous of her getting a real vacation.”
But Ezike isn’t surprised the commissioner has remained in her role.
“[She] was doing this work well before any pandemic,” said Ezike, who is now the president and CEO of Sinai Chicago. “This is the path that she chose a long time ago.”
Courtney Kueppers is a digital producer/reporter at WBEZ. Follow her @cmkueppers.