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    Trump health cuts create ‘real danger’ around disease outbreaks, workers warn

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    Mass terminations and billions of dollars’ worth of cuts at the Department of Health and Human Services (HHS) have gutted key programs – from child support services to HIV treatment abroad – and created a “real danger” that disease outbreaks will be missed, according to former workers.Workers at the HHS, now led by Robert F Kennedy Jr, and in public health warned in interviews that chaotic, flawed and sweeping reductions would have broad, negative effects across the US and beyond.While Donald Trump’s administration is cutting the HHS workforce from 82,000 to 62,000 through firings and buyouts, grant cuts by Elon Musk’s so-called “department of government efficiency” (Doge) have also had a stark impact on state governments – and resulted in firings at state public health agencies.At the South Carolina department of public health, for example, more than 70 staff were laid off in March due to funding cuts.“Disease surveillance is how we know when something unusual is happening with people’s health, like when there are more food-poisoning cases than usual, or a virus starts spreading in a community,” an epidemiologist at the department, whose role was eliminated, said. “It’s the system that lets us spot patterns, find outbreaks early, and respond before more people get sick.”“When you lose public health staff, you lose time, you lose accuracy, you lose responsiveness, and ultimately that affects people’s health,” they added. “Without us, outbreaks can fly under the radar, and the response can be delayed or disorganized. That’s the real danger when these roles get cut.View image in fullscreen“It’s invisible work, until it’s not. You may not think about it day to day, but it’s protecting your drinking water, your food, your kids’ schools and your community.”A spokesperson for South Carolina’s public health department declined to comment on specifics, but noted employees hired through grants are temporary. “When funding for grants is no longer available, their employment may end, as happened with some temporary grant employees who were funded by these grants,” they said.In Washington, the HHS has been cut harder by Doge than any other federal department. Hundreds of grants to state, local and tribal governments, as well as to research institutions, have been eliminated, worth over $6.8bn in unpaid obligations.The HHS receives about a quarter of all federal spending, with the majority disbursed to states for health programs and services such as Medicare and Medicaid, the insurance programs; medical research; and food and drug safety. Trump’s budget proposal calls for cutting the department’s discretionary spending by 26.2%, or $33.3bn.RFK Jr, who has a history of promoting conspiracy theories and medical misinformation, was nominated by Trump and approved by the Senate along party lines, with Mitch McConnell the sole Republican dissenter.Following a reduction in force of 10,000 employees on 1 April, Kennedy Jr claimed 20% of the firings were in error and that those workers would be reinstated, though that has not happened.An HHS spokesperson blamed any such errors on data-collection issues, and did not comment on any other aspects of the Guardian’s reporting.Aids relief program ‘dismantled’At the Centers for Disease Control and Prevention, an operating division of the HHS, employees working on maternal and child health at the President’s Emergency Plan for Aids Relief (Pepfar) program were shocked to be included in the reduction in force, as earlier in the administration their work had received a waiver for parts of the program from federal funding freezes.All federal experts on HIV prevention in children overseas were fired as part of the reduction in force.“Our concern initially was that it was a mistake with the name. We hoped around that time it came out that there were 20% errors, that we would be included,” said an epidemiologist who was included in the reduction in force, but requested to remain anonymous as they are currently on administrative leave. They also noted that they were in the middle of planning and delivering a new pediatric HIV treatment medication set to be dispersed this year, and that that work was now at risk.View image in fullscreenThey said 22 epidemiologists in the branch of their CDC division had been fired. Pepfar was created in 2003 by George W Bush to prevent mother-to-child HIV transmission and credited with saving 26 million lives.“We were very shocked on April 1 that we were put immediately on admin leave,” said another epidemiologist affected by the reduction in force at the CDC. “We really feel our branch being cut was a mistake. The state department had said services were a priority and needed to continue, but then we were cut by HHS.”They noted HIV treatment had already stopped in regions of countries that had been reliant on USAID programs, such as Zambia.“It is one of the most successful global health programs in history, data driven with high levels of accountability and the dollars spent achieve impact. Our concern now is, yes, they are continuing Pepfar in name, but they are dismantling all the systems and structure that allowed it to succeed,” they added. “The US made a huge investment in this program in 20 years and a lot of it is now undone. We’ve now disrupted those systems that could have reduced and eventually removed US investment in these programs.”‘Long-term impact’ on US familiesInside the HHS, the Administration for Children and Families is responsible for enforcing court-ordered child-support payments. For every dollar it receives in federal funding, ACF says it is able to collect $5 in child support.A child-support specialist with the HHS, who requested to remain anonymous for fear of retaliation, said reductions in force at the department have increased workloads on those who were not fired by multiple times, making it so state and tribal agencies have no way of ensuring they are compliant with federal requirements.“The regional staff with direct oversight of the program are gone,” they said. “There are entire regions that have two staff members managing a quarter of the work for the program with no management, no support, no knowledge of the program.”After the Trump administration took office, the agency was under an unofficial stop-work order, where staff were not permitted to provide guidance or support to grantees or even answer phones, until late February, the specialist said. A reduction in force followed on 1 April, when, the child-support specialist claimed, about half the ACF staff working on child support were fired.Their department is responsible for overseeing child-support programs at state, tribal and local levels. States “could very well lose millions of dollars in funding” if ACF does not provide key training and assistance and the states do not have qualified staff, the specialist cautioned. “And that is the long-term impact to vulnerable children and families in the country.”They added: “The entire function of the program is to give economic stability to children and families, so that they do not depend on any other government program, or their reliance on these programs is lower, because the children are supported by both parents.”‘A living hell’At the Centers for Medicare and Medicaid Services, also within the HHS, one of 300 workers terminated as part of a reduction in force claimed it had been illegal, and had not followed any proper procedures. The National Treasury Employees Union has filed a grievance over how the firings were carried out, including incorrect information on notices.They explained that, on 1 April, they received a generic letter informing them of an intent of reduction in force. Hours later, they were locked out of their government logins. “We started emailing the management that was left, trying to get clarification on what our status was. Nobody could give us an answer,” the worker said.On 7 April, they discovered through their paystub that they had been placed on administrative leave, despite never receiving a notice. They didn’t receive an RIF notice until weeks later, after requesting it.“Based on my tenure, and as a disabled veteran, I should at least have a chance of reassignment,” they said. “I’m not mad about losing my job. It happens. I’ve been laid off. The first time was in the private sector, and it was way more humane, more empathetic, and I was given different offers.“This, on the other hand, is unbridled hate. This administration has gone out of their way to make it a living hell for all of its public servants.” More

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      How ‘revenge of the Covid contrarians’ unleashed by RFK Jr puts broader vaccine advances at risk

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      The US health secretary, Robert F Kennedy Jr, entered office with a pledge to tackle the US’s chronic disease epidemic and give infectious disease a “break”. In at least one of those goals, Kennedy has been expeditious.Experts said as Kennedy makes major cuts in public health in his first weeks in office, the infrastructure built to mitigate Covid-19 has become a clear target – an aim that has the dual effect of weakening immunization efforts as the US endures the largest measles outbreak since 2000.“If his goal is to undermine public health infrastructure, he’s making strides there,” said Dorit Reiss, a University of California Law School professor whose research focuses on vaccine law. “If his goal is combating chronic diseases – he’s not doing very well.”The Department of Health and Human Services (HHS) has been characterized by upheaval since Kennedy and the billionaire Elon Musk’s unofficial “department of government efficiency” (Doge) cumulatively axed 20,000 jobs – roughly a quarter of the 82,000-person workforce.And it appears that turmoil will continue: a leaked budget memo shows the administration poised to propose a budget cut of another $40bn, or roughly one-third of the department’s discretionary spending.Amid the cuts, attacks on Covid-19 infrastructure have proven thematic, and show the administration’s hostility toward work that once mitigated the virus. That’s included attacking promising vaccine platforms and elevating once-ostracized voices to high-level roles.“The Covid-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” a spokesperson for HHS told the Guardian in response to questions about its strategy.“HHS is prioritizing funding projects that will deliver on President Trump’s mandate to address our chronic disease epidemic and Make America Healthy Again.”Gregg Gonsalves, a Yale University associate professor and infectious disease epidemiologist, calls this strategy the “revenge of the Covid contrarians”.“They’re not interested in the science, they’re interested in their conclusions and having the science bend to their will,” said Gonsalves. “They want to create a Potemkin village of their own making that looks like science but has nothing to do with science at all.”Among Kennedy’s changes: attacks on the promising platform that supported Covid-19 vaccine development, delayed approval of a Covid-19 vaccine, the clawing back of grants that provided local immunization support and studied vaccine safety, and elevating one-time critics of Covid-19 policy.“When the new administration came in, we were hearing even within the organization: ‘We can’t say Covid, we’re not allowed to say Covid,’” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials (Naccho), about her members’ conversations.Freeman noted that “we kind of saw the writing on the wall a couple months ago that: ‘OK, they really don’t want anything Covid-related to be pursued any more.’ Everything Covid-related is quite honestly at risk.”In the latest change, Kennedy said this week he may remove Covid-19 shots from the childhood vaccine schedule, which would probably make the shots harder to get by limiting insurance coverage.“The recommendation for children was always dubious,” Kennedy told Fox News. Although a minority of children are vaccinated, the shots are recommended, especially for immune-compromised children.Freeman believes the desire to erase the government’s Covid legacy led to HHS’s decision to claw back $11bn in public health funds from states and localities. In effect done overnight, the clawback gave local officials only hours to lay off workers, cancel immunization clinics and even stop construction projects.“That’s why we feel like the drawback of the funding occurred: Covid,” said Freeman.A spokesperson for HHS characterized this as a savings, and said most canceled awards were for Covid-19-related work.The pullback led to the cancellation of more than 50 measles immunization clinics in Texas, where the measles outbreak has already claimed the lives of two unvaccinated children, to pilot programs such as “Text4Vax”, which sent reminders about pediatric vaccines to parents.Among the canceled grants were also programs that would seem to align with Kennedy’s rhetoric about vaccine safety – among them, a study of the safety and effectiveness of Covid-19 vaccines in pregnant women in California and global Covid-19 vaccine safety monitoring in New Zealand.“If you start to take away people from health departments – the immunizers, the educators, the clinicians – through some of these other funding cuts , it disables the program naturally,” said Freeman. “You can’t put as many shots in arms.”Larger cancelled grants included a $2.25bn grant program to reduce Covid-19’s impact on the people worst affected, which had been sent to states and localities from South Dakota to Florida and the Virgin Islands to Vermont.Under Kennedy’s watch, HHS has also taken the unusual step of delaying an expected vaccine approval, reportedly under the watch of a Kennedy political appointee.The Food and Drug Administration (FDA), which sits under the umbrella of HHS, delayed the expected 1 April approval of the Novavax Covid-19 vaccine. Novavax confirmed to the Guardian that its application remained on hold, and said it would have “no further comments”.Reiss said she doesn’t think “any vaccine that’s in the pipeline is going to go forward under Kennedy” or that “he will let any vaccine go far now”.Dr Tracy Hoeg, a political appointee, was reportedly involved in the decision. Hoeg also appeared as the FDA’s representative at a special advisory committee on immunizations in April, where she took the opportunity to question the efficacy of Moderna’s Covid-19 vaccine.An HHS spokesperson told the Guardian: “The FDA’s independent review process for the Novavax vaccine, like all vaccines, is based solely on ensuring safety and efficacy, not political considerations. Any delays are a result of scientific review, not a lack of priority. It’s important to focus on the facts rather than unfounded speculation.”Scientists have also said they fear for the future of messenger RNA (mRNA) vaccine technology – the platform that underpinned the fast development of Covid-19 vaccines and that held promise for treating and preventing a wide range of diseases.Hoeg served on Florida’s public health integrity committee, which served as a platform for Covid-19 criticism during the pandemic. At the time, it was chaired by the Florida surgeon general, Dr Joseph Ladapo, who has also sown doubt about the safety and efficacy of mRNA vaccines.Hoeg could be further buttressed by insiders such as Dr Matthew Memoli, who, Kennedy said, “is going to be running Niaid [National Institute of Allergy and Infectious Diseases]”. Memoli, whom Kennedy described as “the top flu researcher at NIH”, is known for opposition to Covid-19 vaccine mandates and declined to be vaccinated. In March, Memoli sent an email to NIH grant officials requiring any grant applications that reference mRNA technology to be reported to Kennedy’s office. He also canceled government-backed studies on vaccine hesitancy.The nominee for HHS general counsel, Michael B Stuart, is also well-known for involvement in vaccine fights. Stuart, a former West Virginia lawmaker, in 2023 proposed a bill to exempt virtual public school students from vaccine requirements and allow private schools to set their own requirements, according to Stat.“Dismantling the sort of vaccine infrastructure this country relies upon – that’s been in place for several dozens and dozens of years – only impacts the chronic disease front he’s trying to ameliorate as well,” said James Hodge, a professor of law at Arizona State University and a health law expert who said he worries about the future of vaccine advisory committees. “Acquiring infectious diseases leads to chronic conditions later.”Still, some of Kennedy’s most ardent supporters and reported informal advisers, such as the former cardiologist Peter McCullough, have argued these actions don’t go far enough.“The big threat is that we still have Covid-19 vaccines on the market,” McCullough told KFF Health News. “It’s horrendous. I would not hesitate – I would just pull it. What’s he waiting for?” McCullough did not respond to requests for comment from the Guardian. More

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      The Trump administration is sabotaging your scientific data | Jonathan Gilmour

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      United States science has propelled the country into its current position as a powerhouse of biomedical advancements, technological innovation and scientific research. The data US government agencies produce is a crown jewel – it helps us track how the climate is changing, visualize air pollution in our communities, identify challenges to our health and provide a panoply of other essential uses. Climate change, pandemics and novel risks are coming for all of us – whether we bury our heads in the sand or not – and government data is critical to our understanding of the risks these challenges bring and how to address them.Much of this data remains out of sight to those who don’t use it, even though they benefit us all. Over the past few months, the Trump administration has brazenly attacked our scientific establishment through agency firings, censorship and funding cuts, and it has explicitly targeted data the American taxpayers have paid for. They’re stealing from us and putting our health and wellbeing in danger – so now we must advocate for these federal resources.That’s why we at the Public Environmental Data Partners are working to preserve critical environmental data. We are a coalition of non-profits, academic institutions, researchers and volunteers who work with federal data to support policy, research, advocacy and litigation work. We are one node in an expansive web of organizations fighting for the data American taxpayers have funded and that benefits us all. The first phase of our work has been to identify environmental justice tools and datasets at risk through conversations with environmental justice groups, current and former employees in local, state, and federal climate and environment offices, and researchers. To date, we have saved over a hundred priority datasets and have reproduced six tools.We’re not fighting for data for data’s sake; we’re fighting for data because it helps us make sense of the world.The utility of many of these datasets and tools comes from the fact that they are routinely updated. While our efforts ensure that we have snapshots of these critical data sources and tools, it will be a huge loss if these cease to be updated entirely. That’s why we are “life rafting” tools outside of government – standing up copies of them on publicly accessible, non-government pages – hoping that we can return them to a future administration that cares about human and environmental health and does not view science as a threat.The second phase is to develop these tools, advocate for better data infrastructure, and increase public engagement. There’s a question of scope – if the government stops sharing National Oceanographic and Atmospheric Administration data, we don’t have the resources to start monitoring and tracking hurricanes. For many of these critical data sources, the government is the only entity with the resources to collect and publish this data – think about the thousands of weather stations set up around the world or the global air pollution monitors or the spray of satellites orbiting the earth. On the other hand, we do have the expertise to build environmental justice tools that better serve the communities that have borne the brunt of environmental injustice, by co-creating with those communities and by building from what we have saved from the government – like the Council on Environmental Quality’s CEJST, the Environmental Protection Agency’s EJScreen, and the Centers for Disease Control and Prevention’s Social Vulnerability and Environmental Justice tools.A common refrain of the saboteurs is that if these functions that they are targeting are important enough, the states or the private sector will step in to fill the gap. While some of these functions of the federal government are replicable outside of government, privatization will render them less accessible, more expensive and subject to the whims of the markets. The states can also step in and fill some gaps – but many of the biggest challenges that we’re facing are best tackled by a strong federal government. Furthermore, many states are happily joining this anti-science crusade. The climate crisis and pandemics don’t stop politely at state borders. If data collection is left up to the states, the next pandemic will not leave a state untouched because it dismantled its public health department – but such actions will leave a gaping hole in our understanding of the risks to the residents of that state and its neighbors. What’s more, some states do not have the resources to stand up the infrastructure required to shoulder the burden of data collection. Coordination between federal and state governments is essential.Data is being stolen from us; our ability to understand the world is being stolen from us. Americans will die because the Trump administration is abdicating its responsibility to the people – this censorship regime will have dire consequences. That’s why we must stand up for science, we must be loud about the importance of federal data and we must put the brakes on Trump’s un-American agenda.

      Jonathan Gilmour is a data scientist at Harvard’s TH Chan School of Public Health, a fellow at the Aspen Policy Academy, and coordinator at the Public Environmental Data Partners. More

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      ‘A case study in groupthink’: were liberals wrong about the pandemic?

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      Were conservatives right to question Covid lockdowns? Were the liberals who defended them less grounded in science than they believed? And did liberal dismissiveness of the other side come at a cost that Americans will continue to pay for many years?A new book by two political scientists argues yes to all three questions, making the case that the aggressive policies that the US and other countries adopted to fight Covid – including school shutdowns, business closures, mask mandates and social distancing – were in some cases misguided and in many cases deserved more rigorous public debate.In their peer-reviewed book, In Covid’s Wake: How Our Politics Failed Us, Stephen Macedo and Frances Lee argue that public health authorities, the mainstream media, and progressive elites often pushed pandemic measures without weighing their costs and benefits, and ostracized people who expressed good-faith disagreement.View image in fullscreen“Policy learning seemed to be short-circuited during the pandemic,” Lee said. “It became so moralized, like: ‘We’re not interested in looking at how other people are [responding to the pandemic], because only bad people would do it a different way from the way we’re doing’.”She and Macedo spoke to the Guardian by video call. The Princeton University professors both consider themselves left-leaning, and the book grew out of research Macedo was doing on the ways progressive discourse gets handicapped by a refusal to engage with conservative or outside arguments. “Covid is an amazing case study in groupthink and the effects of partisan bias,” he said.Many Covid stances presented as public health consensus were not as grounded in empirical evidence as many Americans may have believed, Macedo and Lee argue. At times, scientific and health authorities acted less like neutral experts and more like self-interested actors, engaging in PR efforts to downplay uncertainty, missteps or conflicts of interest.It’s a controversial argument. Covid-19 killed more than a million Americans, according to US government estimates. The early days of the pandemic left hospitals overwhelmed, morgues overflowing, and scientists scrambling to understand the new disease and how to contain it.Still, Macedo and Lee say, it is unclear why shutdowns and closures went on so long, particularly in Democratic states. The book argues that in the US the pandemic became more politically polarized over time, after, initially, “only modest policy differences between Republican- and Democratic-leaning states”.After April 2020, however, red and blue America diverged. Donald Trump contributed to that polarization by downplaying the severity of the virus. Significant policy differences also emerged. Ron DeSantis, the Republican governor of Florida, moved to re-open physical schools quickly, which progressives characterized as irresponsible.Yet in the end there was “no meaningful difference” in Covid mortality rates between Democratic and Republican states in the pre-vaccine period, according to CDC data cited in the book, despite Republican states’ more lenient policies. Macedo and Lee also favorably compare Sweden, which controversially avoided mass lockdowns but ultimately had a lower mortality rate than many other European countries.The shutdowns had foreseeable and quantifiable costs, they say, many of which we are still paying. Learning loss and school absenteeism soared. Inflation went through the roof thanks in part to lockdown spending and stimulus payments. Small businesses defaulted; other medical treatments like cancer screenings and mental health care suffered; and rates of loneliness and crime increased. The economic strain on poor and minority Americans was particularly severe.Covid policies escalated into culture wars, amplifying tensions around other social issues. Teachers’ unions, which are often bastions of Democratic support, painted school re-openings as “rooted in sexism, racism, and misogyny” and “a recipe for … structural racism”, the book notes, despite the fact that minority and poor students were most disadvantaged by remote learning.These measures also had a literal price. “In inflation-adjusted terms,” Macedo and Lee write, “the United States spent more on pandemic aid in 2020 than it spent on the 2009 stimulus package and the New Deal combined” – or about what the US spent on war production in 1943.View image in fullscreenYet of the $5tn that the US Congress authorized in 2020 and 2021 for Covid expenditure, only about 10% went to direct medical expenses such as hospitals or vaccine distribution, according to the book; most of the spending was on economic relief to people and businesses affected by shutdowns. Ten per cent of that relief was stolen by fraud, according to the AP.The pandemic was an emergency with no modern precedent, of course, and hindsight is easy. But In Covid’s Wake tries to take into account what information was known at the time – including earlier pandemic preparedness studies. Reports by Johns Hopkins (2019), the World Health Organization (2019), the state of Illinois (2014) and the British government (2011) had all expressed ambivalence or caution about the kind of quarantine measures that were soon taken.“We take a look at the state of the evidence as it was in early 2020,” Lee said. “It was clear at the time that the evidence was quite unsettled around all of this, and if policymakers had been more honest with the public about these uncertainties, I think they would have maintained public trust better.”The Johns Hopkins Center for Health Security hosted a wargaming exercise in October 2019, shortly before the pandemic began, to simulate a deadly coronavirus pandemic; the findings explicitly urged that “[t]ravel and trade … be maintained even in the face of a pandemic”. Similarly, a WHO paper in 2019 said that some measures – such as border closures and contact tracing – were “not recommended in any circumstances”.“And yet we did all of that in short order,” Macedo said, “and without people referring back to these plans.”He and Lee also believe there was a strong element of class bias, with a left-leaning “laptop class” that could easily work from home touting anti-Covid measures that were much easier for some Americans to adopt than others. Many relatively affluent Americans became even wealthier during the pandemic, in part due to rising housing values.At the same time, the laptop class was only able to socially isolate at home in part because other people risked exposure to provide groceries. Stay-at-home measures were partly intended to protect “essential workers”, but policymakers living in crisis-stricken major metropolitan areas such as New York or Washington DC did not reckon with why social distancing and other measures might be less important in rural parts of the country where Covid rates were lower.Lockdowns were intended to slow Covid’s spread, yet previous pandemic recommendations had suggested they only be used very early in an outbreak and even then do not buy much time, Macedo said.View image in fullscreenPolicymakers and experts often embraced stringent measures for reasons that are more political than medical, Macedo and Lee argue; in a pandemic, authorities are keen to assure anxious publics that they are “in charge” and “doing something”.In strange contrast, policymakers and journalists in the US and elsewhere seemed to take China as a model, the book argues, despite the fact that China is an authoritarian state and had concealed the scale of the outbreak during the crucial early days of the pandemic. Its regime had obvious incentives to mislead foreign observers, and used draconian quarantine measures such as physically welding people into their homes.When the WHO organized a joint China field mission with the Chinese government, in February 2020, non-Chinese researchers found it difficult to converse with their Chinese counterparts away from government handlers. Yet the WHO’s report was “effusive in its praise” of China’s approach, the book notes.“My view is that there was just a great deal of wishful thinking on the part of technocrats of all kinds,” Lee said. “They wanted there to be an answer – that if we do X and Y, we can prevent this disaster. And so they’re kind of grasping at straws. The Chinese example gave them hope.” She noted that Covid policymakers might have been better served if there had been people assigned to act as devil’s advocates in internal deliberations.Lee and Macedo are not natural scientists or public health professionals, they emphasize, and their book is about failures in public deliberation over Covid-19, rather than a prescription for managing pandemics.But they do wade into the debate about Covid-19’s origin, arguing that the “lab leak” hypothesis – that Covid-19 accidentally leaked from the Wuhan Institute of Virology, rather than spontaneously leaping from animals to humans – was unfairly dismissed.The Wuhan Institute studied coronaviruses similar to the one responsible for Covid-19, had a documented history of safety breaches, was located near the outbreak, and is known to have experimented on viruses using controversial “gain-of-function” methods funded by the US, which involve mutating pathogens to see what they might look like in a more advanced or dangerous form.Perhaps because Trump had fanned racial paranoia by calling Covid-19 the “China virus” and rightwing influencers were spreading the notion that it had been deliberately engineered and unleashed on the world by China, many scientists, public health experts and journalists reacted by framing the idea of a lab leak – even an accidental one – as an offensive conspiracy theory. Dr Anthony Fauci and other top public health figures were evasive or in some cases dishonest about the possibility of a lab leak, Macedo and Lee say, as well as the fact that a US non-profit funded by the National Institutes of Health allegedly funded gain-of-function research at the Wuhan Institute.Since then, though, the CIA and other US intelligence agencies have cautiously endorsed the lab leak theory, and the discourse around Covid has softened somewhat. The economist Emily Oster sparked immense backlash by arguing against school closures in 2020. Now publications such as New York Magazine and the New York Times have acknowledged the plausibility of the lab leak hypothesis, for example, and there is growing consensus that school closures hurt many children.The reception to In Covid’s Wake has been more positive than Macedo and Lee expected – perhaps a sign that some of their arguments have penetrated the mainstream, if not that we’ve gotten better as a society at talking about difficult things. “The reception of the book has been much less controversial [and] contentious than we expected,” Macedo said.Yet the wounds fester and debates continue. Some readers of the New York Times were furious when The Daily, the newspaper’s flagship podcast, recently interviewed them, with subscribers arguing that the episode was not sufficiently critical of their stance. And some coverage of the book has criticized it for underplaying the danger of the disease.Macedo and Lee said that a few of their colleagues have expressed concern that their critique could fuel political attacks on science – a worry that crossed their minds too. “Our response is that the best way to refute criticisms that science and universities have been politicized is to be open to criticism and willing to engage in self-criticism,” Macedo said.“We need to make sure these institutions are in the best possible working order to face the challenges ahead. And we think that’s by being honest, not by covering over mistakes or being unwilling to face up to hard questions.” More

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      ‘The goal is to disassemble public health’: experts warn against US turn to vaccine skepticism

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      As vaccine hesitancy increases in the US, isolated, tight-knit and religious communities have frequently been at the center of high-profile outbreaks.Such is the case in west Texas, where a rural community is the center of an expanding measles outbreak that has already claimed the lives of two Americans – the first deaths from the disease in nearly a decade.However, as the conspiracy theories of Maga conservatism marry the bugbears of the US health secretary and vaccine skeptic Robert F Kennedy Jr, the one-time fringe view of vaccines has become increasingly mainstream – with activists in right-leaning population centers taking lessons learned from the Covid-19 pandemic into the realm of childhood inoculations.One need look no further than Sarasota, Florida, for a full-throated political denunciation.“Generally, people are weak, lazy,” said Vic Mellor, an activist based near Sarasota, and a close ally of former Trump national security adviser Michael Flynn.Mellor owns the We the People Health and Wellness Center in nearby Venice. Mellor, in a shirt that shouts “VIOLENCE MIGHT BE THE ANSWER”, is a self-professed attendee of the January 6 insurrection at the US Capitol.“And that lazy part just makes them ignorant … Covid has proven that obviously this is true. I mean, all the facts are starting to come out on Covid now – that it was a hoax. That is just an extension of where this hoax began decades earlier with the vaccines, OK? This is all a money grab, this is all a power grab.”The pandemic was real, and it started Mellor down the road of questioning vaccines. Where he once opposed only the Covid-19 shots, he now opposes vaccines entirely – arguing they harm children despite experts on vaccines considering them one of mankind’s greatest medical achievements.“This is not an isolated, rural, religious community, which I think is what a lot of people associate with an anti-vaccine mentality,” said Kathryn Olivarius, the author of Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom, and a historian of disease at Stanford University. “This is in the heart of everything.”Sarasota has become a proving ground for the Maga right. Among nail salons, mom-and-pop Cuban restaurants and roadside motels lining US 41, known locally as the Tamiami Trail, a visitor can find the gates of New College. This was once a public university prized for its progressive liberal arts education. Now it is part of the new conservative experiment in remaking higher education led by activists aligned with Donald Trump and the Republican Florida governor, Ron DeSantis.Along the same road is the Sarasota memorial hospital, an aberration in American healthcare – it is publicly owned with open board elections. The normally sleepy election became contentious when insurgent “health freedom” candidates, supported in part by Mellor, entered the race. Three won seats on the nine-member board in 2022.Even the name of this stretch of sun-bleached asphalt is up for debate. This year, a state Republican lawmaker – who has also introduced bills to limit vaccine requirements – briefly proposed changing its name to the “Gulf of America Trail” – a nod to Trump’s renaming of the Gulf of Mexico.Arguably the most salient artifact of this activism in Sarasota is the least visible: vaccination rates against measles.Measles vaccination rates for kindergarteners have plummeted over the last two decades – from 97% in 2004 to 84% in 2023, according to state health records. Sarasota is roughly on par with the vaccination rates in rural Gaines county, Texas – the center of the ongoing measles outbreak that sickened 279 people in in that state alone. Notably, both Gaines county and Sarasota have large home-schooling communities, meaning vaccination rates could in fact be lower.It is well known in research circles that right-leaning states across the US south and west have worse health metrics – from obesity to violence to diseases such as diabetes. That reality was supercharged during the pandemic; as vaccine mandates became a fixation on the right, Republican-leaning voters became more skeptical of vaccines. In turn, places with politically conservative leaders experienced more Covid-19 deaths and greater stress on hospitals.Measles is one of the most contagious diseases known to medicine. At least 95% of the population needs to be vaccinated to prevent outbreaks of the disease. But despite a supremely effective vaccine that eliminated the disease from the US in 2000, vaccine hesitancy has increasingly taken hold.skip past newsletter promotionafter newsletter promotionConservative activism alone can’t be blamed for declining measles vaccination rates. The measles vaccine in particular has been subject to a sustained firehose of misinformation stemming from a fraudulent paper linking the vaccine to autism in 1999. For years, this misinformation was largely nonpartisan. And Florida’s anti-vaccine movement was active even before the pandemic – with a vocal contingent of parents arguing against strengthening school vaccine standards in 2019.What appears new in Sarasota is how local conservative activists have brought opposition to vaccines into the heart of their philosophy. By Mellor’s telling, he and a loosely affiliated group of Maga activists began to adopt anti-vaccine beliefs as the pandemic wore on – helping organize major health protests in the area in recent years, such as mask mandate opt-outs and the “health freedom” campaign for hospital board seats.Mellor said his nearby property, the Hollow, was a gathering place during the pandemic (it is also a part-time gun range). He cites ivermectin, an anti-parasitic drug that became a fascination of the right, as the reason “we didn’t lose people at all” during the height of the pandemic. Available clinical evidence shows it is not effective against Covid-19.Kennedy has fit neatly into this realignment. He enjoys trust ratings among Republicans nearly as high as Trump, according to polling from the health-focused Kaiser Family Foundation. Kennedy has already spread dubious information about measles vaccines in public statements (notably: from a Steak ’n Shake in Florida) – a response one vaccine expert said “couldn’t be worse”.“While children are in the hospital suffering severe measles pneumonia, struggling to breathe, [Kennedy] stands up in front of the American public and says measles vaccines kill people every year and that it causes blindness and deafness,” said Dr Paul Offit, the director of the Vaccine Education Center and an attending physician in the division of infectious diseases at the Children’s Hospital of Philadelphia. Severe side effects from the vaccine are possible, but they are much rarer than disability and death from measles.“This is what happens when you have a virulent anti-vaccine activist, a science denialist, as the head of the most important public health agency in the United States,” said Offit. “He should either be quiet or stand down.”The same poll found trust in public health agencies has fallen precipitously amid Republican attacks. More than a quarter of Republican parents report delaying childhood vaccines, the poll found, a rate that has more than doubled since 2022. There is no analogous trend among Democratic parents. Despite how claims espoused by vaccine skeptics can be easily refuted, their power has not been undercut.“The anti-vaccine business is big business,” said Offit, pointing to the myriad unproven “treatments” offered by promoters of vaccine misinformation, some of which are offered at Mellor’s We the People health center. “We have been taken over by a foreign country, and the goal of that foreign country is to disassemble public health.”The misery of measles did not take long to appear in Texas – measles-induced pneumonia has already led pediatricians to intubate children, including at least one baby, according to the Associated Press. About one to three people out of 1,000 who are infected by measles die from the infection, and one in 1,000 suffer severe brain swelling called encephalitis, which can lead to blindness, deafness and developmental delays.“We actually don’t have the perspective people in the past had on these diseases,” Olivarius. “I have spent many, many, many years reading letters and missives from parents who are petrified of what’s going to happen to their children” if there are outbreaks of yellow fever, polio or measles, Olivarius said about diseases now largely confined to history – thanks to vaccines.“The lesson from history is these are not mild ailments,” she said. “These are diseases that have killed hundreds of millions of people – and quite horribly too.” More

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      ‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts

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      This year the world should have been “talking about the virtual elimination of HIV” in the near future. “Within five years,” says Prof Sharon Lewin, a leading researcher in the field. “Now that’s all very uncertain.”Scientific advances had allowed doctors and campaigners to feel optimistic that the end of HIV as a public health threat was just around the corner.Then came the Trump administration’s abrupt cuts to US aid funding. Now the picture is one of a return to the drugs rationing of decades ago, and of rising infections and deaths.But experts are also talking about building a new approach that would make health services, particularly those in sub-Saharan Africa, less vulnerable to the whims of a foreign power.The US has cancelled 83% of its foreign aid contracts and dismantled USAid, the agency responsible for coordinating most of them.Many fell under the President’s Emergency Plan for Aids Relief (Pepfar) programme, which has been the backbone of global efforts to tackle HIV and Aids, investing more than $110bn (£85bn) since it was founded in 2003 and credited with saving 26 million lives and preventing millions more new infections. In some African countries it covered almost all HIV spending.View image in fullscreenThere is a risk, says Lewin, director of Melbourne University’s Institute for Infection and Immunity and past president of the International Aids Society, of “dramatic increases in infections, dramatic increases in death and a real loss of decades of advances”.There is no official public list of which contracts have been cancelled, and which remain. It appears that virtually no HIV-prevention programmes funded by the US are still in operation, save a handful principally providing drugs to stop pregnant women passing on the infection to their babies. Countries report disruption to the most basic measures, such as condom distribution.Some treatment programmes have been spared, but not those whose focus conflicted with the Trump administration’s war on “gender ideology” or diversity, equity and inclusion (DEI), such as those working with transgender communities. Doctors, nurses and other healthcare workers have been laid off, while worried patients are hoarding drugs or stretching supplies, according to UNAids surveillance. UNAids itself has lost more than half of its funding.Even programmes that have survived the cull have faced turmoil since February, with instructions to stop work rescinded but with no certainty that funding will continue.View image in fullscreenIn only one example, the Elizabeth Glaser Paediatric Aids Foundation says it has had to halt HIV treatment for 85,000 people in Eswatini, including more than 2,000 children, and tests for thousands of pregnant women and babies to prevent transmission and begin life-saving medication.Access to drugs represents an “immediate crisis”, Lewin says. “If people with HIV stop the medications, then not only do they get sick themselves, which is tragic, but they also then become infectious to others.”As clinics on the frontline of treating the disease scrabble to secure access to basic drugs, scientists at this month’s Conference on Retroviruses and Opportunistic Infections in San Francisco were hearing that HIV might soon be preventable with a once-a-year injection.The drug lenacapavir was already generating huge excitement in the field, after trial results showed that a six-monthly jab could prevent HIV. New results from the manufacturer Gilead suggest that a tweak to the formula and how it is given could see its protective effects last even longer.Nevertheless, Lewin says, the mood at the meeting, packed with many of the world’s leading HIV specialists, was “dire”.As well as programme cancellations, there are “huge concerns around science and what’s going to happen to the [US] National Institutes of Health, [whose] funding of science has been so significant on every level”, she says.Some scientists in receipt of US funding have been told to remove their names from DEI-linked research, she says, even though DEI is fundamental to the HIV response.View image in fullscreen“I don’t mean that in a sort of touchy-feely way, I mean that’s what we need to do: you need to actually get those treatments to these diverse communities.”In 2022, 55% of all new HIV infections were within “key populations”, such as gay men, other men who have sex with men, sex workers, transgender people, prisoners and people who inject drugs.Prof Linda-Gail Bekker, of South Africa’s Desmond Tutu Health Foundation, has seen US funding for three trials of potential HIV vaccines involving eight countries cancelled and only reinstated after an appeal to the US supreme court.“We’re running around like chickens without heads to at least get one going, because the vaccines are sitting in the fridge and will expire,” she says.She led the lenacapavir trial that showed it offered 100% protection to young women in sub-Saharan Africa, but now worries about HIV/Aids prevention “falling off the radar completely”.The global community had been making headway towards the United Nations’ goal of ending Aids by 2030, she says, with a five-year plan to use “amazing new innovative tools and scale them up”, which would have led to “less dependence on foreign aid and more self-reliance” as new infections fell and attention shifted to maintaining treatment for people with HIV.“All of that is hugely at risk now because, without these funds, our governments will have to step up but they will concentrate on treatment,” she says. “We know they will do that, because that is what we did for the first 30 years.”Efforts to control Aids were entering “the last mile”, which was always likely to be more expensive, she says. “The people who were happy to come into health facilities, they would have come into health facilities.”It would be difficult to rely on government funding to reach the remaining groups, she says, not only because of fewer resources but also because in some countries it means targeting groups whose existence is illegal and unrecognised, such as sex workers or sexual minorities, and young girls may be reluctant to use government clinics if they are not supposed to be sexually active.“I feel like the odds are very stacked against us,” says Bekker, adding: “We’re obviously going to have to re-programme ourselves [and] formulate a different plan.”Pepfar had pledged funding to the Global Fund to Fight Aids, Tuberculosis and Malaria, to deploy 10m doses of lenacapavir in low-income countries. While the Global Fund has promised to maintain its commitment, it might receive fewer than the planned number of doses, Bekker fears.“Six months ago, I was saying the best thing we can do with lenacapavir is offer it to everybody in a choice environment. [Now] I think we’re gonna have to say who needs [injectable] prep,” she says, “and the rest have to do the best they can.“How do we make that decision? And what does that look like? It is back to sort of rationing.“When we started ARVs [antiretroviral drugs] way back in 2000,” Bekker recalls, “you would go, ‘you get treatment; you don’t, you don’t, you don’t’.“It feels terrible … but you have to get over that. You have to say it will be infection-saving for some people. And we’ve got to make it count.”View image in fullscreenFor Beatriz Grinsztejn, president of the International Aids Society, the disruption is critical and threatens many vulnerable people. But, she adds, it could present “an important opportunity for ownership – otherwise we are always left in the hands of others”.She worries about the impact of cuts to funding on younger scientists, with their potential loss from the research field “a major threat for the next generation”. But, she adds, the HIV community is “powerful and very resilient”.There have already been calls for new ways of doing things. It is “time for African leadership”, members of the African-led HIV Control Working Group write in the Lancet Global Health. There are now plans for Nigeria to produce HIV drugs and tests domestically.Christine Stegling, deputy director of UNAids, says it began “a concerted effort” last year to develop plans with countries about how their HIV programmes could become more sustainable domestically “but with a longer timeframe … now we are trying to do some kind of fast-tracking”.Governments are determined, she says, but it will require fiscal changes either in taxation or by restructuring debt.The goal of ending Aids by 2030 is still achievable, Stegling believes. “I think we have a very short window of opportunity now, in the next two, three months, to continue telling people that we can do it.“I keep on reminding people, ‘look, we need to get back to that same energy that we had when people were telling us treatment can’t be available in the global south, right?’ And we didn’t accept it. We made it happen.“We have national governments now who are also very adamant, because they can see what can happen, and they want to make it happen for their own populations.” More

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      The pink protest at Trump’s speech shows the Democrats aren’t coming to save us

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      Pretty (pathetic) in pinkHappy International Women’s Day (IWD), everyone! I’ve got some good news and some bad news to mark the occasion.The bad news is that a legally defined sexual predator is leading the most powerful country on earth and we’re seeing a global backlash against women’s rights. “[I]nstead of mainstreaming equal rights, we are seeing the mainstreaming of misogyny,” the UN secretary-general, António Guterres, said in his IWD message.The good news, for those of us in the US at least, is that the Democrats have a plan to deal with all this. Or rather, they have wardrobe concepts of a plan. On Tuesday night, Donald Trump addressed a joint session of Congress at the US Capitol. Some members from the Democratic Women’s Caucus (DWC), including Nancy Pelosi, decided to protest by … wait for it … wearing pink.“Pink is a color of power and protest,” the New Mexico representative Teresa Leger Fernández, chair of the DWC, told Time. “It’s time to rev up the opposition and come at Trump loud and clear.”The pink outfits may have been loud but the message the Democrats were sending was far from clear. They couldn’t even coordinate their colour-coordinating protest: some lawmakers turned up wearing pink while others wore blue and yellow to support Ukraine and others wore black because it was a somber occasion.Still, I’ll give the DWC their due: their embarrassing stunt seems to have garnered at least one – possibly two – fans. One MSNBC columnist, for example, wrote that the “embrace of such a traditionally feminine color [pink] by women with considerable political power makes a stunning example of subversive dressing”.For the most part, however, the general reaction appears to have been that this was yet another stunning example of how spineless and performative the Democrats are. Forget bringing a knife to a gunfight – these people are bringing pink blazers to a fight for democracy. To be fair, there were a few other attempts at protest beyond a pink palette: the Texas representative Al Green heckled the president (and was later censured by some of his colleagues for doing so) and a few Democrats left the room during Trump’s speech. Still, if this is the “opposition”, then we are all doomed.Not to mention: even the pink blazers seemed a little too extreme for certain factions of the Democratic party. House Democratic leadership reportedly urged members not to mount protests and to show restraint during Trump’s address. They also chose the Michigan senator Elissa Slotkin to give the Democratic response to Trump’s speech. While Slotkin tends to be described as a sensible centrist voice by a lot of the media, she’s very Trump-adjacent. Slotkin is one of the Democratic senators who has voted with Trump the most often and, last June, was one of the 42 Democrats to vote with the GOP to sanction the international criminal court (ICC) over its seeking of arrest warrants for Benjamin Netanyahu and other Israeli leaders for destroying Gaza. Human rights advocacy groups have warned that attacking the ICC like this undermines international law and the ability to prosecute or prevent human rights violations across the world. It speaks volumes about the US media and political class that a senator standing against international law can be called a centrist.This whole episode also speaks volumes about the Democrats’ plan for the future: it’s growing increasingly clear that, instead of actually growing a spine and fighting to improve people’s lives, the Democratic party seems to think the smartest thing to do is quietly move to the right and do nothing while the Trump administration implodes. I won’t caution against this strategy myself. Instead, I’ll let Harry Truman do it. Back in 1952, Truman said: “The people don’t want a phony Democrat. If it’s a choice between a genuine Republican, and a Republican in Democratic clothing, the people will choose the genuine article, every time.”Anyway, the upshot of all of this is that the Democrats are not coming to save us. We must save ourselves. That means organizing within our local communities and learning lessons from activists outside our communities. It means being careful not to normalize creeping authoritarianism and it means recognizing the urgency of the moment. The warning signs are flashing red: we need to respond with a hell of a lot more than a pink wardrobe.Make atomic bombings straight again!DEI Derangement Syndrome has reached such a fever-pitch in the US that a picture of the Enola Gay aircraft that dropped an atomic bomb on Japan has been flagged for deletion at the Pentagon. Apparently, it only got the job because it was Gay.Can a clitoris be trained to read braille?The Vagina Museum addressed this very important question on Bluesky.One in eight women killed by men in the UK are over 70A landmark report by the Femicide Census looks at the deaths of 2,000 women killed by men in the UK over the last 15 years and found that the abuse of older women hasn’t had as much attention as it should. “We have to ask why we see the use of sexual and sustained violence against elderly women who are unknown to the much younger men who kill them,” the co-founder of the Femicide Census told the Guardian. “The misogynistic intent in these killings is clear.”Bacterial vaginosis (BV) may be sexually transmitted, research findsWhile this new study is small, its findings are a big deal because BV is super common – affecting up to a third of reproductive-aged women – and has long been considered as a “woman’s issue”. Treating a male partner for it, however, may reduce its recurrence.How astronaut Amanda Nguyen survived rape to fight for other victimsAfter being assaulted at age 22, Nguyen got a hospital bill for $4,863.79 for her rape kit and all the tests and medication that went along with it. She was also informed that it was standard practice for her rape kit to be destroyed after six months. “The statute of limitations is 15 years because it recognises that trauma takes time to process,” Nguyen told the Guardian in an interview. “It allows a victim to revisit that justice. But destroying the rape kit after six months prevents a survivor from being able to access vital evidence.” After her traumatic experience, Nguyen successfully fought for the right not to have your rape kit destroyed until the statute of limitations has expired, and the right not to have to pay for it to be carried out.Female doctors outnumber male peers in UK for first timeIt’s a significant milestone in what has traditionally been a male-dominated profession.There’s an Israeli TikTok trend mocking the suffering of Palestinian childrenThis is one of those things that would be front page of the New York Times if it were directed at Israelis but is getting relatively little attention because of how normalized the dehumanization of Palestinians is. It’s also just the latest in a series of social media trends mocking Palestinian suffering.Florida opens criminal investigation into Tate brothers“These guys have themselves publicly admitted to participating in what very much appears to be soliciting, trafficking, preying upon women around the world,” the state attorney general said.The week in pawtriarchyJane Fonda, a committed activist, has always fought the good fight. But she’s also apparently fought wildlife. The actor’s son recently told a Netflix podcast that Fonda once “pushed a bear out of her bedroom”. While that phrase may mean different things to different people, in this instance it was quite literal. Fonda apparently scared off a bear who had entered her grandson’s room and was sniffing the crib. Too bad nobody was there to snap a photo of the escapade – it would have been a real Kodiak moment. More

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      Mitch McConnell condemns petition to revoke approval of polio vaccine by RFK Jr adviser

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      US Senate minority leader and polio survivor Mitch McConnell has condemned attempts to undermine the polio vaccine after reports that a lawyer affiliated with Robert F Kennedy Jr – the health secretary pick for Donald Trump’s second presidency – petitioned for the Food and Drug Administration to revoke its approval of the vaccine.In a statement reported by numerous outlets on Friday, McConnell, who contracted the disease as a child in 1944 – 11 years before the licensing of the world’s first polio vaccine – said: “The polio vaccine has saved millions of lives and held out the promise of eradicating a terrible disease. Efforts to undermine public confidence in proven cures are not just uninformed – they’re dangerous.”The 82-year-old went on to add: “Anyone seeking the Senate’s consent to serve in the incoming administration would do well to steer clear of even the appearance of association with such efforts.”McConnell’s latest comment comes after the New York Times first reported that Aaron Siri, a lawyer helping Kennedy select incoming health officials for Trump’s second White House term, filed a petition in 2022 in which he called on the FDA to revoke its polio vaccine approval. Trump has nominated Kennedy, an avowed vaccine skeptic, as health secretary for his incoming administration – a move widely criticized by health experts.According to the New York Times, Siri filed the petition on behalf of the Informed Consent Action Network, a major anti-vaccination organization in the US. Siri has also asked federal regulators to withdraw or suspend vaccines for hepatitis B and 13 other vaccines, the outlet reported.Kennedy’s anti-vaccination beliefs have been widely debunked, including the unsupported link between vaccines and autism.Polio, also known as poliomyelitis, is a highly infectious viral disease that mostly affects children under five years old. Transmitted through contaminated water, food or contact with an infected person, the poliovirus destroys nerve cells in the spinal cord, in turn causing muscle wasting and paralysis.Since 1988, polio cases have decreased by more than 99% across the world, the US Centers for Disease Control and Prevention stated on its website, adding that polio vaccines have prevented approximately 20m cases of paralysis in children since then.skip past newsletter promotionafter newsletter promotionIn response to the reports, a Trump spokesperson for Kennedy Jr told the Washington Post that Siri “has never had a conversation about these petitions with Mr Kennedy or any of the [health and human services] nominees at any point”.Among other things, the spokesperson added that the vaccine “should be investigated and studied appropriately”, which it already has been. More

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      Trump pick for US health agency proposed ‘herd immunity’ during Covid

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      Jay Bhattacharya, an unofficial Covid adviser in Trump’s first administration, has been selected as the director of the National Institutes of Health (NIH), one of the leading biomedical research institutions in the world.The choice of Bhattacharya, a Stanford economist whose proposal for widespread Covid-19 infection was backed by the White House, signals a return to controversial and scientifically questionable health policies in the second Trump administration, experts say.Bhattacharya, an economist who attended medical school, has called for an “an absolute revamping of the scientific community”.He has questioned the safety of vaccines, testified against the effectiveness of face masks, and argued that NIH officials should not be involved with scientific policy.Bhattacharya did not respond to requests for comment.In early 2020, Bhattacharya downplayed Covid’s deadliness, and he soon joined two other scientists in a recommendation to let Covid spread with “focused protection” – a proposal on the scientific fringes that soon became politically mainstream.After the Trump administration adopted the strategy of “herd immunity” through infection, millions of Americans were disabled and killed, with a vastly higher mortality rate than peer nations.In April 2020, Santiago Sanchez, then a first-year student at Stanford Medical School, wanted to do something to help as the novel coronavirus swept the nation and brought the world to a standstill.That’s how he found himself volunteering in a makeshift laboratory in the ballroom of the Palo Alto Sheraton, carefully squeezing droplets of blood samples into rapid tests for 10 to 12 hours a day.The research project was an attempt to see how many people had already gotten sick from Covid. If more people than previously known had already gotten sick and recovered, that would mean the virus wasn’t as severe as it seemed, and it might also mean there were enough people out there with immunity to help stop the virus from spreading, Sanchez hoped.But as he saw negative result after negative result, Sanchez felt his optimism curdle. After two days, the volunteers had conducted more than 3,300 tests, but fewer than two dozen turned positive, as Sanchez remembers it.That’s why he was puzzled when one of the senior researchers of the study, Jay Bhattacharya, stepped into the ballroom, saw the handful of positive tests alongside stacks of negative tests, and said, “there’s definitely signal here,” according to Sanchez’s recollection.“That was my first sinking feeling, because I was like, ‘That is not how I am interpreting this experiment,’” Sanchez said.The ensuing preprint study estimated that between 2.5% to 4% of people in the region had been infected – a rate vastly higher than previously thought, and a figure significantly higher than the number of positive tests Sanchez says he saw.Bhattacharya became a fixture on Fox News and other networks, proclaiming the opposite of what Sanchez now believed: that many more people had the virus than anyone thought, and that meant the US should reopen.“He was everywhere during the pandemic except hospitals,” said Jonathan Howard, associate professor of neurology and psychiatry at NYU Langone Health and author of the book We Want Them Infected. “He didn’t treat a single Covid patient himself and became famous despite having no real-world responsibility that way.”Scientists quickly discovered significant errors in the study: the people who gave blood weren’t a random sample; the positive tests may well have been false positives; and the study was sponsored in part by an airline founder who was an avid proponent of reopening in the midst of Covid’s strongest grip.Despite criticism, the study results “spiraled out of control”, Sanchez said. “I and many others who worked on this study had this shared feeling of being taken advantage of, like we had been pawns in an obviously ideological project that did not meet scientific muster.”A few months later, Bhattacharya and other skeptics of Covid precautions met with President Trump at the White House, at a time when Trump had stopped speaking with his chief medical adviser, Anthony Fauci.Bhattacharya and two other scientists, Sunetra Gupta and Martin Kulldorff, soon unveiled a plan, known as the Great Barrington Declaration, to let the virus spread unchecked among the general population while attempting to protect the vulnerable. The authors believed this approach could stop the pandemic within three to six months.“This is not mainstream science. It’s dangerous,” said Francis Collins, then director of the NIH.Yet the day after the proposal was released, the authors met with Alex Azar, then the secretary of Health and Human Services, who confirmed that the proposal echoed the Trump administration’s policy of reopening.Within months, the worst wave of deaths of the entire pandemic crashed into the US. The strategy of protecting the vulnerable never materialized; even Trump, perhaps the most protected person in the nation, was hospitalized with Covid.“He was a pro-infection doctor,” Howard said of Bhattacharya. “He said that parts of the country had reached herd immunity in summer 2020 … He said that one infection led to permanent, robust immunity, and he treated rare vaccine side effects as a fate worse than death.”In the past four years, Bhattacharya has testified in state and Canadian courts, as well as US congressional hearings. Bhattacharya has said that public health has become a “tool for authoritarian power … a political tool that’s been used to enforce the biosecurity state”, and that the field needs to be rebuilt.When Sanchez sees patients who say they don’t need a Covid booster, he wonders if they’ve been influenced, directly or indirectly, by Bhattacharya’s messages.And he sees a direct line from the economist’s Covid advice to his possible appointment at the NIH.“They handed Trump a huge gift. They gave him a way to talk about the pandemic that obviously reached a lot of people, that let them, in their own minds, compartmentalize what had happened and feel that it was okay to tolerate the amount of disability and death,” Sanchez said of the researchers.“It totally obfuscated people’s ability to even assess risk, to the point that we have well-established, highly efficacious childhood vaccines that are now being denied – to the point that measles is coming back in some parts of the United States.”With trust in public health greatly diminished, the repercussions could be long-lasting and tragic in coming years, particularly as Trump’s health nominees erode trust in the safety and effectiveness of vaccines and other public-health precautions, Howard said.“Every measles outbreak, every pertussis outbreak, will be on them.” More