Michael Mendoza M.D. saw early on that the COVID-19 pandemic would present new challenges. Little was known about the novel coronavirus, the existing blueprint for stopping pandemics didn’t quite fit and vaccines weren’t on the horizon.
Despite those complications, he was ready to take the pandemic on.
“To say that I was ready (is) simply to say that I was open to learning, and hearing, and listening, and following the science,” says Mendoza, Monroe County’s commissioner of public health. “This is what we do in the Health Department.”
Those qualities have helped Mendoza guide the department’s response to a disease that has infected thousands of county residents so far, and taken the lives of more than 290.
With 240 employees and a budget of more than $65 million, the department provides educational and preventive services, collaborates with community partners and takes a leading role in the field of public health. With its assistance, Monroe County’s health care providers, nonprofits and other relevant organizations can join forces to tackle public health problems, such as the onslaught of serious diseases.
So far, Mendoza’s department has helped reduce the spread of COVID-19 among county residents. Only 7 new infections were confirmed on Sept.2, down more than 86 percent since the height of the pandemic in mid-May. That’s good news, but the county’s top health official admits that the coronavirus is not through yet.
Figuring out a plan
By the time the first coronavirus case appeared in the U.S. on Jan. 19, Mendoza and his staff had been following the disease’s international progress for weeks. His team knew it could eventually make its way to Monroe County, possibly carried by infected educators, students or staff members who had traveled from abroad to one of the area’s colleges and universities.
Though Mendoza believed his training, experience and years on the job had prepared him to take on the pandemic, he recognized the danger of being overconfident.
“Anybody who thinks that they were completely ready is probably underestimating the gravity of this problem,” he says. “We are in the middle of a once-in-a-generation pandemic.”
Still, the Health Department has long had tools for preventing or limiting the spread of a disease like COVID-19, including its 2008 Pandemic Influenza Plan. Created to fight the flu strains that afflict the county each year, the plan describes how the agency can bring multiple government agencies, health care providers and nonprofits together to attack such problems. Mendoza and his team have used it as an outline for fighting the coronavirus pandemic, and employed measures that are used against influenza to take it on.
“The initial approaches are the same, in terms of education, trying to encourage people to wash their hands and to stay home if they’re sick … all of the same things that we did early in the COVID epidemic,” he says.
Other tried-and-true measures also came into play.
“Although COVID was new, the practices of contact tracing, of case investigation that you’ve seen in the last five months—those are things that we’ve been doing for decades,” Mendoza says.
While such tactics have been useful, COVID is not the flu.
“You typically know a lot about influenza. With COVID-19, there was a lot of uncertainty,” Mendoza says.
Unlike with influenza, little was known about the disease at the outset, and researchers scrambled to determine its nature. No COVID vaccine has yet been developed, and medical professionals are unable to give those afflicted more than symptomatic relief.
Initial confusion at the Centers for Disease Control and Prevention regarding the use of masks didn’t help.
“It is true that early the CDC issued some very differing, conflicting guidances as to whether to wear masks or not,” Mendoza says.
On April 6, the CDC finally recommended that U.S. residents wear nonsurgical masks when out in public. That day, Monroe County Executive Adam Bello called upon county residents to follow the CDC’s guidance.
Undaunted by conflicting guidance from the CDC, the lack of definitive knowledge of the virus and the absence of a vaccine, Mendoza and his department took action. Two weeks before the first local case of coronavirus was confirmed, he was talking to local groups about the steps the community needed to take to limit the disease’s spread. Jaime Saunders, president and CEO of the United Way of Greater Rochester, sat through a presentation that Mendoza gave at the nonprofit’s offices just days before COVID-19 hit the county.
“He was training a hundred human service providers on what is coronavirus, how do we prepare (for it), what should we be planning for, what do we do,” Saunders recalls. “He could have sent somebody else out, but he’s the one who did the training.”
As the public health crisis developed, United Way helped government agencies, health care providers and human service organizations come together to combat the virus.
“United Way was actively involved in the coordinated crisis response, and reached out to the public health department,” Saunders says.
Mendoza and his department have been readily available to assist with that endeavor.
“Commissioner Mendoza, both his staff and himself, were critical (in) terms of how to engage the private sector, which had to be part of this coordinated response,” Saunders notes.
Mendoza also reached out to Common Ground Health, a health research and planning nonprofit that serves the Finger Lakes region, for help.
“Where he tapped into Common Ground is recognizing that … it was really going to take a communitywide effort, that it would require not only our clinical but all of the sectors of our community,” says Wade Norwood, CGH’s CEO.
Through the nonprofit, Mendoza was able to talk to the leaders of local faith communities about the ways that they and their congregations could avoid contracting or transmitting COVID.
“It’s that type of attentiveness that has been an important part of really understanding where the different parts of the community exist that can transmit information,” Norwood says.
Mendoza’s parents were Filipino immigrants who met in the U.S. and settled into Downers Grove, a Chicago suburb. His parents divorced when he was in the fourth grade, and Mendoza and his sister were raised by their mother.
“We worked hard to make ends meet. That’s the lifestyle that I carry to this day,” he says.
That view on life took Mendoza to the University of Chicago, where he majored in environmental studies. As a student, he researched the public health effects of pollution and climate change, and sought ways to reduce the risks they pose. Knowing Mendoza’s interests, a mentor advised him to study medicine.
“He said that being a physician in public health would allow you far greater opportunity to influence policy, and the way a community interacts with the environment,” Mendoza says.
Upon completing his undergraduate studies, Mendoza headed off to the University of Chicago’s Pritzker School of Medicine. Though he specialized in the study of family medicine, he also retained his focus on public health.
“I developed an interest very early on in understanding the role of poverty and community and environment on health,” he says.
While undergoing a rigorous medical education, Mendoza also earned a master of public health degree. As a newly minted physician, he spent four years practicing family medicine on Chicago’s South Side, a high-poverty area.
Coming to Rochester
In 2009, Mendoza moved to the Rochester area to become an assistant professor at the University of Rochester School of Medicine and Dentistry, and medical director of Highland Family Medicine. That department, which is a part of the University of Rochester Medical Center, came to be seen as an innovator in team-based medical care while under Mendoza’s guidance.
In addition to running his department and teaching, Mendoza spent two years consulting part-time for CGH. In that role, he worked on CGH’s High Blood Pressure Collaborative, which strives to reduce the incidence of strokes, heart attacks and other catastrophic health outcomes that are associated with hypertension. During that time, Norwood came to know Mendoza as a physician and educator.
“I find Mike to be someone who is incredibly brilliant as a clinician, who has the ability to take medical concepts and make them comprehensible to lay people like myself,” Norwood says.
The two became good friends, and Mendoza is a director at Common Ground Health.
Mendoza was working full-time at Highland Family Medicine and teaching when Jeremy Cushman M.D., then Monroe County interim commissioner of public health, approached him about taking over that job.
“I entered medicine more because of an interest in public health, initially, than in medicine. The interim position was a rare opportunity, so I thought I’d dip my toe in the water so to speak,” Mendoza says.
In 2016, former Monroe County Executive Cheryl DiNolfo appointed Mendoza interim commissioner of public health, praising his “extensive expertise and experience in the medical field” and “thorough educational background.” She subsequently appointed him to a full six-year term as commissioner, starting in January 2017.
Saunders met Mendoza during his first full year in office, when she was president and CEO of the Willow Domestic Violence Center. The new public health commissioner came to an event that the nonprofit was hosting.
“He said, ‘I’m the new public health commissioner, Michael Mendoza, and intimate (partner) violence is a public health epidemic,’” she recalls.
Saunders was impressed by Mendoza’s expansive view of public health.
“It was a standout to have a senior public health official validate the far-reaching impacts of complex social issues, and recognizing a family’s health outcomes are impacted greatly beyond the clinical setting,” she says.
Mendoza became a staunch supporter of the Willow Center, and took a seat on its board of directors. Saunders, who later became United Way president and CEO, counts him as a friend.
In addition to his many other duties, Mendoza also co-chairs CGH’s Finger Lakes Reopening Schools Safely Task Force. Local government officials, school district leaders, health care and public health experts from a 13-county area have come together in that group to create safe ways to reopen the region’s schools.
A learning experience
When the virus was raging through Monroe County this spring, Mendoza and his team put in as much as 80 hours a week on the job. Though he had done that before while practicing full-time as a physician, there was a difference.
“We knew that this wasn’t going to end anytime soon,” Mendoza says.
More than 5,226 people in Monroe County have been infected with COVID-19 since the virus appeared, but confirmed new infections have fallen below 30 a day for much of the past month. In contrast, 94 new cases were confirmed when the outbreak peaked here on May 15. For Mendoza, the biggest challenge right now is to make sure people continue taking the precautions that brought down the rate of infection.
“We haven’t seen any sustained trends upward in a long time, and I want to keep it that way,” Mendoza says. “The biggest challenge is we don’t want to let our guard down.”
Though the Rochester City School District plans to teach all classes remotely in the fall, suburban districts have adopted hybrid schemes that involve some in-person instruction. Keeping new infections down has grown particularly important.
“I want that number to be as low as possible to give our schools every possible chance to stay open,” Mendoza says.
Though the COVID-19 pandemic has been a trial for Mendoza, it’s also been a learning experience.
“I’ve learned that with any given problem, it’s always more complex than your reactions might otherwise suggest,” he says.
Mendoza has also learned to pay more attention to his own feelings.
“I’ve got to follow my own emotions, and keep a check on how I’m feeling, and rely on my team members more than I ever have,” he says.
Though COVID-19 is on everyone’s mind these days, Mendoza and his staff have shown their mettle in other ways, as well. Recently, the National Association of County and City Health Officials presented the department with its 2020 Promising Practices Award. NACCHO granted the nationwide honor in recognition of the department’s development of the Accessible Preparedness Training Program, which helps local residents with disabilities prepare for emergencies.
The Rochester Institute of Technology National Technical Institute for the Deaf, UR, the Center for Disability Rights and other local organizations all partnered with the Health Department on the project.
These days, Mendoza puts in “only” 60 hours a week on his full-time job, works part-time as an attending physician at Highland Hospital and teaches at URMC on occasion. On his off time, the married father of two school-age children enjoys spending time with his family, cooking, listening to music, running, bicycling, photography and enjoying good books. What’s he into right now? Rereading John Barry’s “The Great Influenza: The Story of the Deadliest Pandemic in History.”
“Even in 1918, there were a lot of people who were very skeptical of contact tracing, and we have a lot of that now,” Mendoza notes.
At the same time, the story of the 1918 pandemic that killed an estimated 675,000 people in the U.S. offers more uplifting lessons, as well.
“Look at it from the standpoint of how the science of medicine at the time and of public health has developed over the years, and I think there’s a lot of reason for optimism,” Mendoza says.
He also enjoys a good laugh. When Mendoza came to represent the local fight against COVID-19, Donuts Delight, a popular donut and pizza shop, created a pastry in his honor. Customers could bite into the image of Mendoza’s smiling face, depicted in frosting. The Mendoza M&M donuts are available now only by special order, but Norwood hasn’t let his friend forget his place in local culinary history.
“The absolute surest way to needle my dear friend Dr. Mendoza,” Norwood says, “is to remind him he’s so sweet, he’s the only guy in Rochester with his own donut.”
Mike Costanza is a Rochester Beacon contributing writer.