On Thursday, NACCHO released a report on its 2020 Forces of Change survey, which focused on the effects to local health department infrastructure caused by COVID-19. More than half of local health departments reported that their leaders and staff were targets of harassment in response to COVID-19 protection measures during the first year of the pandemic. The survey also found strained financial and staffing capacities hindered a robust response to COVID-19, forcing health departments to suspend public health services, and exacerbating already existing health inequities. The 2020 survey provides one of the only mid-pandemic pictures of the circumstances surrounding the local public health response to COVID-19. This report also includes an infographic that visualizes the survey results.