The Local Health Authority: More than a title



Written by Lorelei Day , Communications Coordinator for the City of San Angelo

The local health authority. Sounds official, but what does it mean? A local health authority is a reputable physician appointed by either the health department or county commissioner to implement both state and local laws relating to public health.


San Angelo’s local health authority is Dr. James Vretis, an emergency medicine physician with 41 years of experience in his field and numerous other roles within the medical community. Vretis has served as San Angelo’s local health authority since July 2017.


During the COVID-19 pandemic, Vretis’ position as local health authority is more crucial than ever. Some of his important duties include deciding on and implementing restrictions that the general public has to abide by under law. An abundance of research precedes each and every decision, he said, and every order he issues is in the best interest of the public’s health.


“It’s hard trying to find the right balance between public health, economic health and civil rights and liberties,” Vretis said. “Someone needs to be willing to make the unpopular decisions to protect public health.”


Take the order that limited common space use at hotels and apartments, for example. Employees from Rambler Solar Project (who are from out of town) were staying at local hotels and apartment complexes, but the City Health Department was initially unsure of which ones. Numerous employees had tested positive for COVID-19. Many hotel guests had been congregating in hallways drinking and smoking together, not to mention using other common areas for breakfast. Vretis said he did not want infected employees to be in the same areas as other hotel guests, as that would allow the disease to spread. By restricting that, the chance of COVID-19 spreading at area hotels and apartments was significantly lowered.


Some of Vretis’ responsibilities reside at a more personal level. If someone has been ordered to self-isolate or quarantine themselves, Vretis is the one who not only established those orders but is also tasked with maintaining and enforcing them. So, say someone tested positive for COVID-19. Under Vretis’ authority, that person would be ordered to isolate themselves to prevent spread of the disease. In partnership with the health department, Vretis would monitor the person to make sure they are obeying the orders and make any arrangements necessary to help them comply (such as grocery delivery).


“Dr. Vretis is always available to discuss current cases and to take actions necessary to prevent the spread of COVID-19 in our community,” City Attorney Theresa James said. “His proactive decisions and direction, while not always popular, have allowed us to effectively contain outbreaks of the virus in our community when they occur. His concern and care for our community, combined with his willingness to do what needs to be done, will continue to allow San Angelo to respond to and mitigate the harm to the health of our community that COVID-19 can cause.”


Whatever the situation, Vretis must be ready and willing to protect the health of the citizens of San Angelo. So, the next time you hear about a public health-related decision in place, such as occupancy limits at bars or restaurants, know that a highly qualified medical professional put in much research and thought before making that decision.


Vretis also serves as medical director for the San Angelo Fire Department, Grape Creek Volunteer Fire Department and Carlsbad Volunteer Fire Department. His other roles include serving as Tactical Medical Director for the Tom Green, Concho, Sterling and Reagan sheriff’s offices. In addition, Vretis is a SWAT team physician for the Department of Public Safety and the Texas Ranger Special Operations Group SRT4.


He is board certified in Emergency Medicine and Emergency Medical Services and is on the Board of Advisors for the Committee for Tactical Emergency Casualty Care. He has lectured and presented at many national and international conferences in the recent past, including the Special Operations Medical Scientific Assembly, Western Pediatric Trauma Conference, Pediatric Trauma Society, Committee for Tactical Emergency Casualty Care and the National Association of EMS Physicians Scientific Assembly.

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