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False claims. Racist and violent memes. Threats. Physical attacks. Public health advocates across the country face these and more from anti-vaccine extremists when they try to enact policies to halt outbreaks of vaccine-preventable illnesses such as measles and whooping cough.

These extremists have now turned their focus on efforts to prevent the spread of the novel coronavirus — which has killed more than 125,000 Americans — and are using the same playbook of harassment and intimidation tactics against public health leaders charged with protecting our states and localities from Covid-19.

Since mid-April, 27 state and local health leaders across 13 states have resigned, retired, or been fired, some citing threats and pressure from outside groups.

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Public health officers are trained professionals with the expertise to protect the public from preventable injury and death. During outbreaks, they have the authority to act to halt an outbreak from spreading. Unfortunately, extremists who oppose almost every measure to halt the coronavirus pandemic, including stay-at-home orders, wearing masks, contact tracing, and vaccination are engaging in personal attacks on public health officers while too many elected leaders tacitly allow this bullying.

The attack on public health goes all the way to the desk of President Trump, who recently retweeted a post with the hashtag #FireFauci.

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Politicians who politicize the coronavirus pandemic are emboldening extremists who target public health officers like Dr. Nichole Quick, the chief health officer of Orange County, Calif., and Dr. Amy Acton, director of the Ohio Health Department, both of whom recently resigned their public health posts. At an Orange County Board of Supervisors meeting, an anti-vaccine extremist threatened Quick and announced her home address, inciting protesters to visit her house. In Ohio, armed demonstrators marched outside Acton’s home. These missions were straightforward: Bully public health officials into supporting their demands.

This behavior is sadly all too familiar to public health advocates. Anti-vaccine extremists, gun advocates, and white supremacists organized and were prominent participants at anti-lockdown rallies. Black and red anti-vaccine signs, open carry guns, nooses, Trump flags, and red MAGA hats were common sights. The extremists demanded “freedom” to spread disease and denounced government “tyranny” as law enforcement officers looked on without riot gear, tear gas, or weapons in their hands. The few protesters who were arrested for breaking the law were quickly released.

I am personally familiar with these kinds of personal attacks. As a state senator in California in 2015, during a major measles outbreak in the state I authored Senate Bill 277, a law to abolish nonmedical vaccination exemptions and to restore community immunity. I, my staff, and my colleagues were personally harassed by bill opponents and received numerous death threats. Noted anti-vaccine extremist Robert F. Kennedy Jr., compared vaccination to the Holocaust and several legislators’ district offices were closed to protect legislative staff.

After the law passed, anti-vaccine extremists personally stalked me in the State Capitol and at numerous in-person events, including the March on Science in Washington.

In 2019, I authored Senate Bill 276 to provide public health oversight over medical exemptions to vaccines. The attacks became even more personal. Anti-vaccine extremists held signs and wore T-shirts with images of my bloodied face. They shared violent memes that led to two actual physical attacks: A prominent anti-vaccine extremist confronted me on a street and slammed my back violently as I walked past him. Another extremist sitting in the Senate’s visitor gallery threw real blood at me on the Senate floor, splattering many of my colleagues. White supremacists joined anti-vaccine extremists demonstrating outside the governor’s office, and my spouse and children received threats requiring additional security measures.

California is not the only state where legislators and public health advocates have been threatened. Similar intimidation tactics were used in Oregon, Washington, New York, New Jersey, and Colorado. Physicians such as Paul Offit, Todd Wolynn, and Nicole Baldwin have endured personal attacks, including fake practice ratings and death threats, for supporting vaccination. Parents sharing stories of their children who died of vaccine-preventable diseases have faced heartbreaking hatred and bullying from the same extremists, as have individuals who speak out in support of vaccines.

The extremists are crowing about their success in forcing the resignations of Quick and Acton, and are planning to target more public health officers.

We cannot allow this attack on public health to succeed. Public safety demands that public health officials must make recommendations based on science and free from intimidation.

Public health officials shouldn’t have to choose between their own safety and livelihood and the public’s health. Elected officials and community leaders must publicly stand against individuals who personally threaten public servants, thereby endangering all Americans.

Richard Pan is a pediatrician who represents Sacramento in the California State Senate.