COLUMBUS, OHIO — Dr. Amy Acton is running unopposed in the Democratic primary for Ohio governor, setting up a likely general election matchup with Republican Vivek Ramaswamy. No Democrat has won the office of Ohio governor in the past 20 years.

Acton, a physician, served as Ohio's public health director when the coronavirus reached the United States in early 2020. Wearing a white medical coat, she became a household name throughout Ohio during daily COVID-19 briefings with Governor Mike DeWine, where she explained the virus' trajectory, hospitalizations and deaths and provided guidance to residents.

In early 2020, Acton signed public health orders that closed schools, shuttered businesses, restricted sporting events and suspended voting in the 2020 primary at the urging of DeWine. Ohio ranked 22nd among the states in per capita death rate from the virus during the pandemic's first year, according to data from the U.S. Centers for Disease Control and Prevention. Acton left her position as Ohio's public health director halfway through 2020.

A Dr. Amy Acton Fan Club was formed in 2020 with yard signs, a bobblehead doll and a proposal to honor her with a state holiday. Republicans have criticized the public health orders she signed, and at Republican events around Ohio, mention of her name elicits boos. On the campaign trail, Acton sometimes avoids using the words COVID-19 or coronavirus when discussing her time as health chief.

During the briefings, Acton urged residents to take precautions, telling viewers, "Ohio, don the mask, don your cape." Noting she had worked for or advised five different governors, she later said, "So I'll work with anyone who wants to solve a problem rather than make one."

"I had the honor and the privilege, the privilege, of serving in a very tough moment. I'm proud of Ohioans, because together we flattened that curve, we saved a lot of lives." Acton said in a separate statement on her record.

Ramaswamy, the front-running Republican in the race, is financing his campaign with a personal fortune and is airing ads capitalizing on lingering anger over the election order that suspended the 2020 primary. At rallies, he has accused Acton of spreading "COVID ideology."

As CEO of Roivant Sciences, Ramaswamy worked with the lieutenant governor as an adviser on COVID-19 during 2020, according to a 2021 op-ed. Jon Husted, then Ohio's lieutenant governor, regularly participated in the daily briefings with Acton and DeWine. In early 2023, Ramaswamy stepped down from the Roivant Sciences board and removed reference to his service on Ohio's "COVID-19 Response Team" from his Wikipedia page. He said the panel never met and described the removal as a correction. He said his support for a COVID registry and discussions with Husted were aimed at getting the economy going again. During the pandemic, Ramaswamy received a COVID-19 vaccine and advocated mask-wearing, but said he did not support government mandates for vaccines or mask-wearing.

In a podcast interview, Ramaswamy said, "As a decision maker, you have to weigh the costs and benefits of your actions."

"Dr. Acton is proud of the work she did alongside Governor DeWine to put public health over politics, save lives and keep Ohioans safe," campaign spokesperson Addie Bullock said. "It is unfortunate that Vivek Ramaswamy wants to play politics on this issue."