Trial by fire: new Sonoma County health officer leads front line of pandemic battle

Dr. Sundari Mase returned a reporter’s call at 11:17 on a recent weeknight.

“Long day,” she explained.

That would imply, incorrectly, that Mase has had any short days since being hired March 10 as Sonoma County’s interim health officer. Two weeks later, in a sort of battlefield promotion, the county removed “interim” from her title.

The health officer serves as a kind of physician for the entire county. It’s a critical job that came open at a terrible time. Mase’s predecessor, Dr. Celeste Philip, had announced her resignation March 2, with the coronavirus outbreak on the cusp of becoming a pandemic. On her way out the door, Philip declared a public health emergency in the county.

On March 11, before Mase had so much as unpacked the boxes in her Santa Rosa office, she banned gatherings of 250 or more people, and closed nursing homes to visitors. A week later, her eighth day on the job, she issued the unprecedented stay-at-home order that has drastically altered daily life - and upended business and commerce - in the county. She followed that up by effectively closing local beaches and parks, then advising all public schools to keep students off campuses through May 1. Those extraordinary directives, some of the most restrictive in the nation, are meant to give county residents a fighting chance against this virus that’s taken close to 30,000 lives around the globe since it first took root in China three months ago.

Asked how she’s holding up - Mase is averaging 16-hour work days - the 53-year-old seemed puzzled by the question.

“I’m doing fine,” she said in an interview. “For my entire medical career, this is what I’ve been preparing for.”

Like a relief pitcher rushed to the mound with no warmup, Mase took her $263,316-a-year post without any kind of transition. “We said hello,” recalled Sonoma County Supervisor Shirlee Zane, “and threw her in the deep end.”

Taking a longer view, looking back on the life of the woman tasked with guiding the county through its gravest public health emergency in a century, it seems clear Mase has been preparing for this moment, this battle with this pathogen, since she was a teenager.

She is the daughter of Ramachandran Sastry Ranganathan, a Ph.D. in organic chemistry who came to the United States from India in the mid-1960s as a Fulbright scholar. He moved the family to California when Sundari was 4 years old.

As a freshman at UC Berkeley, she aspired to be an engineer. That plan changed the following summer, when she spent 2½ months at a health clinic in Madras, India. The experience was “eye-opening,” she said. Resources were scarce. Every day she cleaned hypodermic needles with bleach, so they could be reused. One man who frequented the clinic suffered from elephantiasis, a mosquito-borne disease that attacks the body’s lymph system and can cause dramatic swelling of the limbs.

“Every day I debrided his wounds,” she said, using the medical term for removing dead or infected tissue, “and rewrapped his legs.”

Rather than being repulsed, she found her calling. “I loved working with people,” recalled Mase, who speaks fluent Tamil, “and I loved the science of medicine.”

After earning her medical degree from UC San Francisco in 1993, she worked as an internist with Alliance Medical Group in the East Bay. In 2001, she made another life-changing pivot, leaving private practice to take a job with California’s Department of Health Services in its tuberculosis control branch.

She’d enjoyed patient care, but wanted to help on a bigger scale.

“In public health, you can really impact large numbers of people with policies and guidelines that are evidence-based,” she said.

For 18 years, in California, then with the Centers for Disease Control and Prevention in Atlanta, then the World Health Organization, she has been the scourge of tuberculosis, a renowned expert in the battle against a disease that still kills 1,000 people a day.

In Atlanta, she worked with the epidemiologist Suzanne Marks, who described Mase as “one of the most brilliant physicians and researchers that I know,” a team leader who provided guidance to clinicians on the diagnosis and treatment of the most difficult-to-treat TB patients.

“I can’t overstate (her) qualifications,” Marks said.

Among Mase’s duties at the CDC, where she worked from 2008 to 2016, was the supervision of its four “centers of excellence” in the fight against tuberculosis. One of those was directed by her friend and mentor Dr. Lee Reichman, retired executive director of the Global Tuberculosis Institute. He remembers the grace with which she handled potentially difficult situations.

As a relatively young person, Mase outranked many of the older doctors reporting to her.

“She was tough, but in a nice way, and had a great sense of humor,” Reichman said. “She was a mensch. Everybody I know thought she did a fantastic job.”

Joining the fight

Mase’s years in the fight against tuberculosis, Reichman points out, uniquely qualify her to combat the coronavirus.

Though it’s “sort of a forgotten” illness, he said, tuberculosis “is uncannily like COVID-19.”

Mase was working as a consultant in late 2019 when she first heard about a new virus infecting people in China. As the novel coronavirus spread, she itched to join the fray. “I was thinking, I want to get into this, any way I can,” she said.

Mase lives in the East Bay enclave of Orinda, with her husband, the appellate lawyer Gregory A. Mase. They have a daughter at UC Berkeley and a son at UC Davis. Another son is in 10th grade.

Across the bay in Sonoma County, the highly regarded top public health official, Philip, was leaving for a good job - also with the CDC - but at a most inopportune time.

Among the contacts Mase reached out to was Dr. Robert Benjamin, who’d volunteered to serve as Philip’s interim replacement. Benjamin put her in touch with the county Department of Health Services Director Barbie Robinson, who moved quickly to bring Mase aboard.

Mase has earned strong reviews so far.

County Supervisor Lynda Hopkins has been struck, she said, by the health officer’s “strong moral compass,” her combination of intellect and compassion, and her unflappable bearing in the face of criticism: some have suggested that, with the dire measures she’s imposed, Mase may have overreacted in her attempts to contain the coronavirus.

“She understands that it’s not about pleasing people or being political,” Hopkins said. “It’s about doing the right thing, and bringing her expertise to bear in a complex, dynamic situation.”

“Losing your public health official in the midst of a pandemic would be normally be a disaster,” added Supervisor David Rabbitt. “But we haven’t missed a beat.”

Becoming more transparent

As she gains her footing, Mase has not been bashful about reaching out to her professional peers. Among them is Marin County Public Health Officer Dr. Matt Willis, who worked with her at the CDC a decade ago, and who was plagued during a Friday phone interview with a periodic, moist cough. Willis recently tested positive for COVID-19.

“Sundari’s background in epidemiology and public health is super valuable,” he said. “That’s what we need right now. We don’t need someone going with their gut.”

That was an implicit criticism, he admitted, of the erratic, sometimes incoherent federal response to the pandemic.

On state and county levels, meanwhile, officials have taken matters into their own hands. On March 24, Mase followed up her historic county lockdown order with another sweeping edict, this one closing all city, county, state and federal parks.

Unlike, for instance, New York Gov. Andrew Cuomo, who has been vocal and transparent about his state’s needs, and his warning about when he expects a wave of coronavirus cases to hit, Mase and other county officials have been stingy with specifics.

Choosing a strained interpretation of laws intended to guard patient privacy, county officials, including Mase, for weeks withheld demographic information about infected patients, declining this newspaper’s requests for it almost daily. The dismantling of that wall of secrecy began Friday.

Once the county reached 50 confirmed coronavirus cases, Mase said previously, demographic information would be released. With five new cases reported Friday, the county exceeded that milestone by four. True to her word, the health officer made some data public, posting it on the county website. The new information underscored, more than anything, the all-inclusive nature of the virus, which is cutting an indiscriminate swath through all age groups and all sections of the county.

‘There will be relief from this’

Asked Friday when Sonoma County might expect a surge of cases, Mase referred to computer modeling done by the state of California, which “may see some surge in the Bay Area in the next four weeks.”

In the meantime, she said, “we’re working with our emergency operations center to scale up, get supplies in place.” Those projects include identifying alternate care sites, if existing hospitals are overwhelmed, and compiling a list of staff - retired physicians and nurses, if need be - to step up, should the need arise for them to treat an outsized number of ailing COVID-19 patients.

If that need should not arise, Mase’s draconian orders to severely limit public activity for at least three weeks, issued before the virus got a firm grip on the county, will be a big reason why.

Last week she met with a group of local pastors, who reminded her of the importance to their congregants, of gathering for worship.

“Of course I feel for them,” she said. “I feel people’s pain. I know how hard it is to be quarantined, isolated.

“But we are doing the right things,” she said. “There will be relief from this, and we will look back and say, ‘Wow, it was a good thing we put those orders in place. Because we saved lives.’”

You can reach Staff Writer Austin Murphy at 707-521-5214 or austin.murphy@pressdemocrat.com. On Twitter @ausmurph88