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During a recent talk with medical students at the 91̽�� Heritage College of Osteopathic Medicine, Acton gave a behind-the-scenes look at the first six months of the pandemic in 2020, and how she navigated her leadership role in those fraught times. 

“I’m a very ordinary person, not unlike you in many ways, that just ended up in a moment in the crosshairs of history,” she said. 

Acton earned her medical degree from Northeast Ohio Medical University and spent seven years at The Ohio State University teaching global health. She was working at the Columbus Foundation, a nonprofit that helps organizations with their charitable giving, when she was surprised by an out-of-the-blue call from Gov. Mike DeWine.

“My career would not have put me in a political place. As a matter of fact, I’m very intentionally not political,” she said. “I always stayed out of politics.”

When they met, Gov. DeWine asked her about her childhood. She told him she was raised in Youngstown, Ohio, but her early years were difficult with periods of homelessness, including living in a tent in the middle of winter. In seventh grade, she was removed from the situation. By luck, she said, her circumstances changed, yet her friends who were left behind were just as smart and kind. That was when she first started to understand that the conditions around us have a profound impact on our outcomes and health.

As COVID-19 headed to American shores, Acton said Ohio got ahead of it early. She was convinced the virus was already here, and when she saw that Wuhan didn’t have it under control, the state started to act by doing things like drills to prepare. She acknowledged that on the front end of a crisis like this pandemic, one can feel like “Chicken Little.”

“That’s how I felt. I was begging everyone, please pay attention to this, and you are destined to feel like you didn’t do enough,” she said.

After returning from a briefing at the White House in February 2020, Acton and Gov. DeWine made a promise that they would tell the people of Ohio what they knew as they knew it. She told students that one of the hardest parts of adaptive leadership is giving people bad news at the rate they can accept it. She felt her childhood had prepared her for that moment.

“In a crisis,” she said, “You want that kind of truth. And I could feel everyone yearning for that… The second we told the truth, the best people in the world started coming to us. So, our ability to run the response got so much better.” With truth, she said, no matter how hard, people could begin to make decisions and take action.

Through daily news briefings to share the latest information on COVID-19, Acton became a familiar face far beyond the borders of Ohio, using transparency, empathy and hope to reassure Ohioans that with the help of science and medicine and by working together to take the necessary steps, the pandemic could be contained. She broke down complex science concepts in ways the general public could understand. She also recognized the courage of first responders. 

The news briefings, which were unscripted, gave her and Ohio’s leadership the opportunity to share what they knew and be present. “The being with and holding space is profoundly powerful,” she told the students. “Please don’t forget the holding spaces we create are powerful medicine.”

To navigate the pandemic, Ohio operated off a playbook developed during the presidency of George W. Bush, who in 2005 was reading a book about the 1918 influenza pandemic. He told his administration to prepare a national strategy in the event of another pandemic. As Ohio took the lead in managing the outbreak, other countries began using the state as an example of how to effectively manage the virus. Acton said the real goal “was pulling everybody up on the life raft. How do we get everyone to safety?”

She said initially the mortality rate for early hospitalized patients was over 50 percent. We weren’t sure how to treat the virus in a population that wasn’t entirely immune, she explained. By June 2020, we were starting to see the results from the initial sacrifices that had been made in an attempt to keep hospitals and health care workers from being overwhelmed and to provide time for the development of a vaccine and better treatment protocols. The mortality rate had dropped to five percent, Acton said, and continued to drop because we had a better idea how to treat it. 

“We flatlined the curve in Ohio on COVID,” she said.

She explained to students that another critical trait of leadership is vulnerability. She said she felt the extreme responsibility of her role, which included advising Gov. Mike DeWine as tough decisions, such as closing schools and major events, were made to slow down the spread of the virus and prevent more people from dying. As the pandemic dragged on and politics undermined trust in leaders and the medical community, she also became a target of anger.

Her husband, who is a schoolteacher and coach, told her, “You’re not afraid, you’re determined.” She said those same words to the public during a news briefing. Courage, she said, comes from facing fear.

And in 2020, Acton had more than COVID to be concerned about as militia groups began plotting to harm her and others, and protestors camped out at her home and stalked her children, requiring constant protective surveillance. 

“You don’t get to pick a war with COVID. It’s like your worst science fiction nightmare,” said Acton, adding that it doesn’t matter which party you belong to, a humanitarian disaster cannot be managed by politics. 

Despite the protestors, Acton has a great respect for Ohioans. “The love was profoundly greater than the hate,” she said, adding that the real story of Ohio is that Ohioans did what they needed for each other during the crisis. However, as politics continues to influence the narrative about the pandemic, Acton advised students to connect with their communities, see the good in one another and be intentional.

“We don’t live in ideologies and politics; we live in communities,” she said.

On a national level, she worries that the country has yet to conduct a federal post mortem on the COVID response to understand what approaches worked and what didn’t and how the country can better prepare for and manage the next pandemic.

Acton’s talk at the Heritage College coincided with the release of a PBS four-part documentary, , which examines how public health has saved lives throughout U.S. history. Acton is one of several experts featured in the series, and she reflects on the early days of COVID.