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    A Bird Flu Pandemic Would Be One of the Most Foreseeable Catastrophes in History

    Almost five years after Covid blew into our lives, the main thing standing between us and the next global pandemic is luck. And with the advent of flu season, that luck may well be running out.The H5N1 avian flu, having mutated its way across species, is raging out of control among the nation’s cattle, infecting roughly a third of the dairy herds in California alone. Farmworkers have so far avoided tragedy, as the virus has not yet acquired the genetic tools to spread among humans. But seasonal flu will vastly increase the chances of that outcome. As the colder weather drives us all indoors to our poorly ventilated houses and workplaces, we will be undertaking an extraordinary gamble that the nation is in no way prepared for.All that would be more than bad enough, but we face these threats gravely hobbled by the Biden administration’s failure — one might even say refusal — to respond adequately to this disease or to prepare us for viral outbreaks that may follow. And the United States just registered its first known case of an exceptionally severe strain of Mpox.As bad as the Biden administration has been on pandemic prevention, of course, it’s about to be replaced by something far worse. Robert F. Kennedy Jr., Donald Trump’s pick to lead the nation’s vast public health agency, has already stated he would not prioritize research or vaccine distribution were we to face another pandemic. Kennedy may even be hastening its arrival through his advocacy for raw milk, which can carry high levels of the H5N1 virus and is considered a possible vector for its transmission.We might be fine. Viruses don’t always manage to adapt to new species, despite all the opportunities. But if there is a bird flu pandemic soon, it will be among the most foreseeable catastrophes in history.Devastating influenza pandemics arise throughout the ages because the virus is always looking for a way in, shape shifting to jump among species in ever novel forms. Flu viruses have a special trick: If two different types infect the same host — a farmworker with regular flu who also gets H5N1 from a cow — they can swap whole segments of their RNA, potentially creating an entirely new and deadly virus that has the ability to spread among humans. It’s likely that the 1918 influenza pandemic, for example, started as a flu virus of avian origin that passed through a pig in eastern Kansas. From there it likely infected its first human victim before circling the globe on a deadly journey that killed more people than World War I.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    How Will Trump’s Covid Contrarians Handle the Next Pandemic?

    President-elect Donald J. Trump had already succeeded in rattling the nation’s public health and biomedical establishment by the time he announced on Tuesday that he had picked Dr. Jay Bhattacharya to run the National Institutes of Health. But amid growing fears of a deadly bird flu pandemic, perhaps no one was more rattled than experts in infectious disease.Dr. Bhattacharya, a Stanford University medical economist and outspoken opponent of lockdowns, masking, school closures and other Covid-19 mitigation measures, and Mr. Trump’s other health picks have one thing in common. They are all considered Covid contrarians whose views raise questions about how they would handle an infectious disease crisis.Robert F. Kennedy Jr., Mr. Trump’s choice for health secretary, has said he wants the N.I.H. to focus on chronic disease and “give infectious disease a break for about eight years.” Dr. Martin Makary, the president-elect’s choice to run the Food and Drug Administration, incorrectly predicted in 2021 that the nation was “racing toward an extremely low level of infection.”Dr. David Weldon, a Republican former congressman who is Mr. Trump’s choice to lead the Centers for Disease Control and Prevention, has espoused the debunked theory that thimerosal, a mercury compound in certain vaccines, causes autism. As a congressman, he introduced legislation that would strip the C.D.C. of its role in ensuring vaccine safety, saying the agency had a “conflict of interest” because it also promotes vaccination.And Dr. Mehmet Oz, the talk show host who has been picked by Mr. Trump to run Medicare and Medicaid, prodded officials in the first Trump administration to give emergency authorization for the malaria drug hydroxychloroquine to treat Covid-19. The F.D.A. later revoked the authorization when studies showed the drug carried risks, including serious heart issues, to coronavirus patients.Robert F. Kennedy Jr. has said he wants to focus on chronic diseases rather than infectious diseases as head of the Department of Health and Human Services. Haiyun Jiang for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    ‘Shoot Me Up With Everything’

    For a reporter who covers infectious diseases, vaccines are an indispensable news gathering tool.Vaccines are an indispensable news gathering tool. They permit reporters to travel to areas where fatal or debilitating diseases are prevalent; exactly the places that warrant coverage by The New York Times.That’s why the Museum at The Times displays a carton that once contained the vaccine Ixiaro. It prevents Japanese encephalitis, which is related to yellow fever, dengue and West Nile virus. Mosquitoes spread the disease. It is considered endemic in much of Southeast Asia and the Western Pacific region.“The symptoms can be anything from a mild fever to, in rare cases, seizures and death,” Donald G. McNeil Jr. wrote in an email last week. “There’s no treatment. The vaccine isn’t recommended for most travelers to Asia, but if you go to rural areas and sleep in rooms with no A.C. or window screens — as I sometimes did — it’s protection.” He donated the Ixiaro carton the museum.Mr. McNeil is the author of “The Wisdom of Plagues: Lessons From 25 Years of Covering Pandemics” and is a frequent contributor to the website Medium. He worked for The Times from 1976 to 2021, covering many infectious diseases, most recently Covid-19.Many of his Times assignments took him to tropical areas. In 2014, aware that new vaccines had been approved by the Food and Drug Administration, he went to the New York Center for Travel and Tropical Medicine.“Shoot me up with everything,” Mr. McNeil said.Five jabs followed: Ixiaro; RabAvert, for rabies; Typhim Vi, for typhoid; a booster shot of a vaccine for tetanus, diphtheria and whooping cough; and probably an inactivated polio vaccine. (The clinic didn’t enter the fifth injection on Mr. McNeil’s yellow vaccine record card.)“I don’t remember any bad side effects,” Mr. McNeil wrote. “The worst side effect I’ve ever had from a shot was from my second shingles shot — and all it did was make me feel sort of nauseous and flu-ish and I went to bed without supper. I’ve been very lucky that way.”“The rabies shot was one of those ‘it wouldn’t hurt to have it’ decisions. I’m not a dog cuddler, and I definitely don’t pet strays. But they’re often hanging around in poor countries, and I did have to get up close to village dogs in rural Chad for a piece on how Guinea worm, a human parasite, was establishing a reservoir in dogs. And in some of the places I’ve slept, it wasn’t unthinkable that I might be bitten by a rat or a bat.” More

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    Trump’s Choices for Health Agencies Suggest a Shake-Up Is Coming

    The picks to oversee public health have all pushed back against Covid policies or supported ideas that are outside the medical mainstream.A longtime leader of the anti-vaccine movement. A highly credentialed surgeon. A seven-term Florida congressman. A Fox News contributor with her own line of vitamins.President-elect Donald J. Trump’s eclectic roster of figures to lead federal health agencies is almost complete — and with it, his vision for a sweeping overhaul is coming into focus.Mr. Trump’s choices have varying backgrounds and public health views. But they have all pushed back against Covid policies or supported ideas that are outside the medical mainstream, including an opposition to vaccines. Together, they are a clear repudiation of business as usual.“What they’re saying when they make these appointments is that we don’t trust the people who are there,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an adviser to the Food and Drug Administration.Some doctors and scientists are bracing themselves for the gutting of public health agencies, a loss of scientific expertise and the injection of politics into realms once reserved for academics. The result, they fear, could be worse health outcomes, more preventable deaths and a reduced ability to respond to looming health threats, like the next pandemic. “I’m very, very worried about the way that this all plays out,” Dr. Offit said.But other experts who expressed concerns about anti-vaccine views at the helms of the nation’s health agencies said that some elements of the picks’ unorthodox approaches were welcomed. After a pandemic that closed schools across the country and killed more than one million Americans, many people have lost faith in science and medicine, surveys show. And even some prominent public health experts were critical of the agencies’ Covid missteps and muddled messaging on masks and testing.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Dr Martin Makary Chosen to Head the FDA

    President-elect Donald J. Trump announced on Friday that he would nominate Dr. Martin A. Makary, a Johns Hopkins University surgeon with a contrarian streak, to be commissioner of the Food and Drug Administration.In a post on social media, Mr. Trump said: “F.D.A. has lost the trust of Americans and lost sight of its primary goal as a regulator.” He said that Dr. Makary would work under Robert F. Kennedy Jr., the president-elect’s choice for the cabinet-level role as health secretary, to “properly evaluate harmful chemicals poisoning our nation’s food supply and drugs.”“I am confident that Dr. Makary, having dedicated his career to high-quality, lower-cost care will restore the F.D.A. to the gold standard of scientific research and cut the bureaucratic red tape at the agency to make sure Americans get the medical cures and treatments they deserve,” Mr. Trump said in a statement.Mr. Trump announced two other top health picks on Friday evening as well. He chose Dr. Dave Weldon, a physician and former congressman from Florida, to lead the Centers for Disease Control and Prevention.For years, Dr. Weldon championed the notion that thimerosal, a preservative once used widely in vaccines, caused an explosion of autism cases around the world. In 2007, he backed a bill proposing to take vaccine safety research out of the hands of the C.D.C. Health officials reject the idea that research shows any link between thimerosal and autism.Mr. Trump also put forward Dr. Janette Nesheiwat, a physician and Fox News contributor, to be surgeon general. She worked caring for patients after Hurricane Katrina, an announcement from Mr. Trump said, and on the front lines of the Covid pandemic in New York City. She also markets vitamin B and vitamin C dietary supplements.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    ‘Witches’ Review: Redeeming the Wicked Witch

    The director Elizabeth Sankey’s experience with postpartum depression anchors this documentary about the pop-cultural representation of witches.The arrival of “Witches,” a documentary streaming on Mubi, seems strategically timed. The director Elizabeth Sankey’s contribution is part essay film, part personal testimony, though like Jon M. Chu’s musical blockbuster “Wicked” she, too, starts in the land of Oz.As a child, Sankey explains in a voice-over, she wanted to be Glinda the good witch. But her experiences dealing with mental illness made her see an unsettling correlation between the wicked witches of the world and the women who, like her, have had trouble performing traditional domestic roles.The first part of Sankey’s documentary plays like a cultural history of the witch onscreen, weaving together clips from TV shows and movies across the decades to illustrate a somewhat stale point: that stigmas around women’s health have informed the characterization of witches. When Sankey shares her personal story — weaving in interviews with other women and experts who also have firsthand experience of postpartum psychosis — the details of her illness take on an eerie new light next to pop-cultural images of madwomen, like Mia Farrow in “Rosemary’s Baby” and Isabelle Adjani in “Possession.” Based on the real women’s accounts, the fictional renderings don’t seem outlandish — the satanic underpinnings of witchcraft, clearly a superstitious, and deeply misogynistic, justification.“Witches” eventually explores other parallels — for instance, the demonization of midwives and natural healers with the advent of modern medicine — but the maternal madness framework dominates the bulk of the run time to diminishing effect. The clips also veer from the occult and take on a more generalized creepiness that feels bleary and arbitrary. If all women behaving badly can be summed up as witchy, then Sankey’s documentary too often works like a game of associations.WitchesNot rated. Running time: 1 hour 30 minutes. Watch on Mubi. More

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    Jared Polis Wants to Win Back the Hippies

    It’s such a bother when politicians have to go and complicate your clean narrative about why they’re succeeding.Last week, I spoke to Jared Polis, the Democratic governor of Colorado. Polis’s state was, if not a bright spot for Democrats, a less-dark one. In New York, Democrats lost 11 points off their 2020 margin; in New Jersey, 10 points; in Massachusetts, nine and a half points; in California, nine points (though votes are still being counted); in Illinois, seven points. In Colorado, the difference was two and a half points. What is Polis, who won re-election in 2022 by a 19-point margin, doing right?One answer — and this, to be honest, was the answer I’d gone looking for — is focusing relentlessly on the cost of living. “You can’t just do one policy and expect, somehow, people will know it,” Polis told me. “But they generally understand the drumbeat of 30, 40 things you’re doing, each of which reduces costs in a different way. And so that’s been our strategy: to flood the zone with this work to reduce costs.”Polis points with pride to his successful efforts to expand pre-K and kindergarten and get a public insurance option onto the Colorado health exchanges — but also to his rejection of proposals to add benefits that would drive up costs. He’s happy to brag about reducing the tax rate for both businesses and individuals, walking me through every decimal-point reduction he achieved, and the many bills he’s signed to make it easier to build homes.“When you say something a lot, it means you generally believe it,” Polis said. “So here’s a line I often use: We want the best solutions from the left and the right to save people money.”But during our conversation, and in the days after, another answer emerged — and for Democrats this one is a little more challenging. Polis is a dissenter from the trends that swept through Democratic governance during the pandemic. He was unusual among Democratic governors for the emphasis he put on both personal responsibility and personal liberty. Colorado opened early, sparking a tourism boom, and Polis tried to rely more on information than compulsion.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    How Robert F. Kennedy Jr. Could Destroy One of Civilization’s Best Achievements

    Even among the chaos generated by Donald Trump’s recent cabinet picks, one stands out for the extensive suffering and lasting institutional damage it may cause: his choice of Robert F. Kennedy Jr. to lead the Health and Human Services Department.Modern public health is one of civilization’s great achievements. In 1900, up to 30 percent of infants in some U.S. cities never made it to their first birthday. Since that time, vaccines, sanitation and effective medications have eliminated many previously commonplace illnesses and consigned others to extreme rarity. It’s easy to take much of that for granted, especially as those days have receded from living memory, but those achievements are fragile and can be lost.The danger isn’t merely that Kennedy — who has almost no experience in government or large-scale administration, and who has shown a sometimes breathtakingly loose connection to the truth — would be incompetent or misleading. At the helm of a department with over 80,000 employees and a $3 trillion budget, one that oversees key agencies such as the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health, he would have control over the nation’s medicines, food safety, vaccines and medical research. With that power he could inflict significant harm to the public health system — and to the public trust that would be needed to rebuild it once he’s gone.Kennedy has brought attention to some worthwhile public health concerns, such as the downsides of ultraprocessed foods and the value of exercise. But beyond those reasonable issues, he has filled the internet and the airwaves with views on vaccines, food safety, medicines and supplements that are a mix of grave misrepresentations and far-fetched conspiracies.His opposition to vaccines has attracted the most attention. He doesn’t say just that they merit closer scrutiny, as some “vaccine skeptics” claim. Last year he told a podcaster that “there’s no vaccine that is, you know, safe and effective.” When it later became expedient, he denied that he had ever said such a thing. The truth is that he has long promoted the lie that vaccines cause autism, and the extravagantly false claim that “researchers have done very little to study the health” of children after they get shots for once-common diseases.Outside of the medical community, few people still know about all the diseases whose safe and effective vaccines he is lying about, so let me remind you about one of them: diphtheria. Once known as “the strangling angel of children,” it causes its young victims to slowly and painfully suffocate, turn blue and gasp as a thick film fills their throat. They lie dying for many agonizing days. The disease has been all but wiped out, but in Spain a few years ago, it cost the life of an unvaccinated boy of 6. His distraught antivax parents promptly vaccinated their surviving child.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More