A County Health Official on the All-Clear That Can't Say "Probably"

Deb Clearwell is the kind of name that makes you check whether a person is real or whether a writer needed a county environmental health director whose surname doubles as a water-treatment term. (A clearwell is the holding tank where treated water sits before entering the distribution system.) As it happens, Deb is not in any county directory. She is a composite drawn from publicly documented roles, regulatory protocols, and the institutional pressures that shape how officials communicate about drinking water. The decisions she describes, the templates she references, and the regulatory mechanics she navigates are all real. She is the fiction that makes them visible.

Nineteen years in county environmental health, starting in food-safety inspections. She has concurred on or directly issued rescissions for more than thirty boil-water advisories across the small and mid-size water systems in her jurisdiction. We spoke in a conference room that smelled like industrial coffee, where she'd spread a manila folder of sample result forms across the table like tarot cards.

You've signed off on over thirty advisory rescissions. What does your signature actually certify?

Deb: That the distribution system tested clean for total coliform bacteria at enough sample sites to represent the service area. That pressure's been restored. Breaks repaired or isolated. Chlorine residual where it should be.¹ Five things. That's the whole list.

That sounds pretty comprehensive.

Deb: It sounds comprehensive because I rattled off five items. But think about what wasn't on that list. Nothing about the plumbing inside your house. Nothing about the hot water heater you haven't flushed since the advisory went up. Nothing about whether the system can keep running at this level next week, or whether the one licensed operator is about to go on medical leave. Nothing about the school that's been closed for nine days with three floors of stagnant pipe.

The rescission covers the water in the main. Everything past the meter is yours.²

Do residents understand that distinction?

Deb: No. And honestly, why would they? The notice they get says, and I'm paraphrasing the template, "the water is now safe to drink without boiling."³ No asterisk. No "safe at the distribution point as of Tuesday's sampling." The regulatory language is binary. Safe or not safe. The rescission flips the switch. If you're a parent reading that on your phone, you're turning on the tap. You're not thinking about premise plumbing.

Could you add a caveat? Something like "safe under current conditions"?

Deb: (long pause) I've thought about this more than I should probably admit. The template language exists because it has to be actionable. You can't tell someone the water is "provisionally acceptable pending continued operational stability." They'll just keep buying jugs forever. There's actual research on this. When you communicate uncertainty about a health risk, a meaningful percentage of people respond with what researchers call ambiguity aversion. They get more anxious, not less, and they freeze.⁴ So you're trying to help by being precise, and instead you've created a population that can't make a decision at all.

So the binary is protective in a way.

Deb: It's protective of action. It gets people to stop boiling, stop buying bottled water, send kids back to school. Those are real costs, financial, logistical, psychological, and they accumulate every day the advisory stays up.

But the binary is also a lie of omission. Not a malicious one. A structural one. The form literally has no field for "I have concerns about next month."

What happens when the advisory comes back?

Deb: That's the part that keeps me up. Because once you've issued the all-clear and then reissued the advisory three weeks later, which happens, especially in systems with deferred maintenance or weather vulnerability, you've taught people that your all-clear doesn't mean what they thought it meant. And now you're in a trust hole much deeper than if you'd just hedged the first time.

Jackson is the public example everyone in my field watched. Governor lifts the advisory in September 2022, says clean water is restored. Same day, the state health official says don't use it for baby formula.⁵ By December, they're back under a boil notice after a freeze.⁶

How many times can you flip that switch before people stop believing the switch means anything?

The CDC's crisis communication framework says to "acknowledge uncertainty" and "be right." But you're describing a system where the rescission template requires certainty. How do you hold both?

Deb: (laughs) You don't. You pick one.

In practice, what happens is the formal notice says what the template says. And then I'm on the phone with the superintendent, or I'm at a community meeting, and someone asks me straight: "Can I drink this water?" And I say yes. And then someone asks: "Is it going to stay safe?" And that's where I either lie by omission or I start a conversation that the notice was never designed to support.

The CDC guidance is good. It really is. "Be first, be right, be credible."⁷ But it was written for communicators who have room to narrate. A rescission notice is not a narrative. It's a checkbox.

What about buildings that have been closed during the advisory, schools and businesses? The rescission doesn't cover them?

Deb: Connecticut actually has separate guidance for businesses after an advisory lifts. Run hot water for fifteen minutes minimum at every faucet, thirty minutes if you've got a large tank.⁸ That's after the all-clear. Because the all-clear is about the main, not about what's been sitting in your building's pipes for two weeks growing biofilm.

And the Legionella research from the COVID building shutdowns showed that even thorough flushing only works temporarily. Within a month, contamination levels can rebound in buildings that were already colonized.⁹

So the rescission lifts, the school reopens Monday, and whether anyone ran every faucet for fifteen minutes on Friday? That's on the building manager. Not on my form.

You've described a system where everyone is doing their defined job correctly and the resident still ends up with an incomplete picture.

Deb: Nobody's lying. The operator ran the tests. I reviewed the results. The template said what the template says. The resident read it the way any reasonable person would read it.

If you could redesign the rescission notice, what would it say?

Deb: (stares at the sample forms on the table for a while)

Two sentences the current form doesn't allow. First: "This notice certifies conditions in the distribution system as of [date]. It does not certify conditions inside your building." Second: "The system's ability to maintain these conditions depends on [list: staffing, equipment, weather, power], which are outside the scope of this test."

But I also know that if you put those sentences on a notice, half the county calls my office asking what it means, and the other half never comes off bottled water. So maybe the answer isn't a better form. Maybe it's a better conversation, something between the binary and the caveat that nobody's figured out yet.

Last question. When you sign the rescission, what are you actually feeling?

Deb: Relief that the samples came back clean. And a small, quiet dread that I'm about to promise something I can't guarantee.

Footnotes

1. Georgia EPD, "Standards Operational Protocols and Guidance for Boil Water Advisories." https://epd.georgia.gov/document/publication/bwa-guidance-drinking-water-systemspdf/download ↩

2. EPA, "National Occurrence and Assessment of Boil Water Advisories, 2021," EPA 810-R-24-003, May 2024. https://www.epa.gov/system/files/documents/2025-01/10586_boil-water-advisories_final_rtc_20240603_admin.pdf ↩

3. ScienceDirect, "Clear or Compliant? The Tension Between Regulatory Requirements and Public Comprehension in Boil Water Advisories," 2025. https://www.sciencedirect.com/science/article/pii/S2212420925008064 ↩

4. Garfin, D.R. et al., "Communicating Scientific Uncertainty About the COVID-19 Pandemic: Online Experimental Study," Journal of Medical Internet Research, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064708/ ↩

5. NPR, "A boil-water notice has been lifted in Jackson, Miss., after nearly 7 weeks," September 15, 2022. https://www.npr.org/2022/09/15/1123264927/jackson-miss-boil-water-lifted ↩

6. WJTV, "Jackson Water Crisis: The latest updates," December 2022. https://www.wjtv.com/news/jacksons-water-crisis/jackson-water-crisis-the-latest-updates/amp/ ↩

7. CDC CERC Manual, 2018 edition. https://www.cdc.gov/cerc/php/cerc-manual/index.html ↩

8. Connecticut DPH, "Boil Water Notice Concluded: Return to Service, Businesses." https://portal.ct.gov/-/media/departments-and-agencies/dph/dph/drinking_water/pdf/boil-water-notice-concluded-business.pdf ↩

9. Grimard-Conea et al., "Impact of recommissioning flushing on Legionella pneumophila in a large building during the COVID-19 pandemic," Frontiers in Water, October 2022. https://www.frontiersin.org/journals/water/articles/10.3389/frwa.2022.959689/full ↩

10. Minnesota Department of Health, "Drinking Water Risk Communication Toolkit." https://www.health.state.mn.us/communities/environment/water/toolkit/aboutriskcomm.html ↩