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Meet the Transgender Doctor Leading Pennsylvania's COVID-19 Response

Dr. Rachel Levine

Dr. Rachel Levine serves as Pennsylvania's secretary of health. She and Gov. Tom Wolf have been praised for the Keystone State's response to the COVID-19 epidemic. In the past few weeks, these officials have worked swiftly to enact necessary measures like closing public schools and rolling out stay-at-home orders in order to stem the spread of the virus.

Along with Wolf, Levine is one of the public faces of the state's response to the crisis. She regularly appears on television to reassure residents and provide them with updates and health guidelines. "Stay home, stay calm, and stay safe," Levine advised Pennsylvanians during one of these daily briefings.

Long before COVID-19, however, Levine was a respected figure in Pennsylvania's political and health communities. She joined the Wolf administration as the state's physician general in 2015, a position to which she was unanimously confirmed by a predominantly conservative state Senate. In 2017, she was named acting secretary of health, and she was confirmed in the position the following year.

Her credentials are sterling. A graduate of Harvard College and the Tulane University School of Medicine, Levine trained in pediatrics and adolescent medicine at New York City's Mount Sinai Medical Center. In addition to her government posts, she is president-elect of the Association of State and Territorial Health Officials and a professor of pediatrics and psychiatry at the Penn State College of Medicine. She is a trusted national speaker on issues ranging from the opioid crisis to LGBTQ health issues.

Levine also happens to be a transgender woman. Just prior to Transgender Day of Visibility, Pennsylvania's secretary of health discussed her role in the fight against COVID-19 and how her visibility can make a difference in the fight against anti-LGBTQ stigma. See the conversation below.

The Advocate: What your duties and responsibilities are as secretary of health during the COVID-19 response? What does your day-to-day look like?
Dr. Rachel Levine: I am tasked by the governor to lead the public health response for Pennsylvania for COVID-19. Everything is a team effort. We've had to move our offices for our core team to the office of the Pennsylvania Emergency Management Association, where we have our location of our Bureau of Public Health Preparedness and our Bureau of EMF. We have formed a command center, which involves all of those persons — of personnel, the public health preparedness, epidemiology, the leadership of our public health nurses — all working together with the staff of the Pennsylvania Emergency Management Association to deal with this response. Key members of the governor's office are here, including the chief of staff and others. And so we are all working together to direct, under the governor's leadership, the response to this global pandemic.

My day is busy. I get here at 7 and prepare for my day. Our meeting starts at 8, where first I talk with my team for an hour and then I go and speak with the senior staff of the governor's office. And then the senior staff and I and the FEMA director have a meeting and then it goes from there.

I have a daily press conference … sometimes by myself or with the governor to update the public on the status of COVID-19 in Pennsylvania and the response of our administration. I often speak with legislators and other stakeholders. And then we have a 5 o'clock sum-up meeting till 6. And then I go home and do emails.

No “stay at home” for you, then.
No stay at home. And right now it is seven days a week. So we've been at this pace for a while. We're going to do whatever is possible, whatever it takes to protect the public health of Pennsylvania.

And what is Pennsylvania's plan for its response to COVID-19?
I would say our response from a public health point of view is in three different categories. The first is mitigation. What we're trying to do is to mitigate or prevent the spread of COVID-19 in Pennsylvania. We're trying to do that by practicing social distancing. So the governor, a number of weeks ago, closed the schools. … We closed all nonessential, non-life-sustaining businesses. And now we're going region by region doing stay-at-home orders, or sometimes called shelter-at-home orders, where we really want people to stay at home. The best way that we can prevent the spread is through these social distancing and mitigation efforts.

Second is we're working on expanding testing. So that is testing for priority populations such as health care workers, nursing homes, etc., to our public health laboratory. But then we also have worked with hospitals and health systems to [set] up testing centers. And a lot of those tests are either done by the health system or through the commercial laboratories such as Quest or LabCorp. ...

And then the third of the triad is working to make sure that the health care system is prepared for the expected surge of patients that will be coming over the next number of weeks. And through the mitigation efforts, we're hoping to take off the peak of that surge so that our hospitals and health systems can manage it. We'll know we're coming out the other side when we start to see a decrease in the number of new cases — a sustained decrease in the number of new cases. And then we'll be reassessing all of our strategies. But we're not there yet.

How do you personally keep healthy as you're leading this response?
I'm trying to get enough sleep and I'm trying to eat well as best I can. I'm trying to practice what my message is, which is stay calm. I can't stay home because I have to be here, but staying safe. But really, I'm not going out anywhere except here and then home. So not too much exposure outside of here at the Pennsylvania Emergency Management Association. But it is very important to stay calm and focused in the midst of emergencies. And you know, that's what I learned in my clinical years during my training and then at my time at Mount Sinai and then Penn State when we would see very ill children and adolescents. In those emergency clinical situations, it's important to stay calm, and so that's what I do now.

We know that LGBTQ people are at risk for many health issues. One of them is this strain of coronavirus. What message or advice do you have for members of our community in this scary time?
I think that the message would be the same. I think that our community is certainly at risk from COVID-19. This is a novel coronavirus, which means it's new, no one has any immunity to it. There is no accepted treatment, and we have no vaccine. So that is why it's such a public health threat and why we're seeing a global pandemic.

Overall, our community is vulnerable in general, though, because of the stigma that sometimes we face. I think that there has been a lot of concerns about stigma in the health care community. And so when members of the LGBTQ community need health care, we worry about how we will be received. And so I think that that adds just yet another stress to what everybody is feeling now in these very uncertain times. I think it's critically important that members of the LGBTQ community feel as comfortable as possible accessing medical and health care when necessary, and but I know that that's a worry.

In that vein, we're seeing some religious leaders making headlines blaming LGBTQ people for the spread of the virus. How can we fight against that kind of stigma and misinformation?
That’s the key. I think through fantastic journalism, such as The Advocate and yourself and through other LGBTQ journalists and publications and social media, we have to continually try to get past the stigma that sometimes our community faces. This is not in any way a religious issue. Some people find comfort in their faith. But otherwise, this is a medical and public health issue. And that's how it needs to be. That's how it needs to be addressed. I hope by my being there every day in the trenches with the work that I'm doing, that hopefully demonstrates to the public that members of the LGBTQ community are really just here to work for the public health and for the common good. And hopefully, that means something.

You are one of the public faces of the fight against COVID-19. You're also transgender. What do you hope your visibility achieves in a time when trans people, in particular, are still being demonized and painted as being dangerous to society?
It doesn’t make any difference what my gender identity is. All that matters is my professional work. When I was nominated — first as physician general and then as secretary of health — I was unanimously confirmed as physician general, overwhelmingly confirmed the first time as secretary and then unanimously the second time. I want to be judged upon my work in medicine and in public health and in this difficult time, in my work to help to protect the public health in the face of this global pandemic. It doesn't make any difference what someone's gender identity or sexual orientation is. We're really all in this together.

We’re hearing a lot of doom and gloom from the media. A lot of it is very needed to wake people up to the crisis. But I'm curious as to what gives you hope during this time.
These are very challenging times. They really are. This is a global pandemic that we have not seen in many, many years. And it's understandable that people would certainly be anxious and would have fears and concerns.

What we are trying to do is to ask people to stay very calm and to not fear. I’m a positive and optimistic person and have hope for the future. We're going to come out of this hopefully stronger. That we are hopefully banded together and don't have the different stigmas that separate us. And then hopefully, from a medical perspective, [develop] a stronger public health system, because we know how important public health can be. But I think it's important for our community to stand together and really, for all of us to stand together because nothing [else] shows us how everyone is the same in the face of a pandemic like this.

Do you have a key message, something that you wanted to get out there that you haven't heard through all the noise in the media?
Hope is such an important thing. I think that we have to have hope for the future. I think we have to have hope for the future of our commonwealth in Pennsylvania, hope for the future of our nation. And in relation to some of the things we're talking about, hope for the future for the LGBTQ community. I firmly believe that we have made progress. We have been under challenges and faced a lot of challenges with this current administration. But hopefully, as I said, this will show us how we are all human. We're all in this together and we have to get past petty differences and prejudices that that tend to keep us apart. I hope that there'll be a light at the end of the tunnel and that the future after COVID-19 is even better.

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