Time passes and things change. Just last October I was writing about COVID-19 developments and the measures that could restrain the virus and reduce the growing toll of Long Covid. Back then, one could even imagine that political pressure—perhaps juiced by a latter-day equivalent of ACT UP—might lead national leaders toward sensible policies. But that was before national health policy turned into the Mad Hatter’s tea party.
But new COVID-19 research keeps coming out, and much of the news is not encouraging. One recent study reported that “children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls.” Another, which followed nearly half a million pediatric COVID patients, found they were at higher risk of developing either new kidney disease or having existing kidney disease worsen than among those who hadn’t had COVID.
A different study, published in The Lancet at the beginning of April, adds to the growing evidence that the virus disrupts our immune systems. The analysis of patients in the Department of Veterans Affairs database found that in the year following having COVID-19, COVID patients had higher rates of both viral and bacterial infections than those who had tested negative for COVID.
But these findings and others giving worrying signals about the long-term impact of even “mild” COVID-19 cases got little attention when they were released—kind of the way one might pay less attention to a broken window after realizing that arsonists have doused the house with gasoline and begun lighting matches. And the arsonists are indeed at work.
Part of what overshadowed the new COVID-19 research was what can only be called a campaign of deliberate destruction by Trump, his spending hatchet man Elon Musk, and Health and Human Services Secretary Robert F. Kennedy Jr., aimed at eviscerating what had been the most successful and accomplished public health and medical research infrastructure in the world.
At the Centers for Disease Control and Prevention, the brutal cuts and mass layoffs were described by the Journal of the American Medical Associationas “the decimation of a nearly 80-year-old agency that has been a global leader in public health.” Firings tallied by JAMA included the entire staff of CDC’s STD Laboratory Reference and Research Branch, which tracks things like drug-resistant gonorrhea, as well as programs addressing asthma, tobacco use, violence prevention, lead poisoning, reproductive health, global health threats, birth defects, and disability and injury prevention. The CDC’s own medical advisory committee wrote that the mass firings “compromise many of our nation’s best efforts to attack the leading causes of preventable death and illness.”
These mass firings, carried out by Musk’s DOGE team, were so swift and overwhelming that agency leaders reportedly didn’t even know who had been fired, and were left to find out by contacting individual workers to find out who had been axed. Such an approach could be called many things, but “efficient” does not seem to be one of them.
The cuts have also disrupted some of the “Epi-Aid” teams CDC sends to help localities dealing with local outbreaks, including one sent to deal with elevated lead levels in Milwaukee children. And, a recently retired longtime CDC physician reminded me, “Note that because of the hiring freeze no one can be replaced.”
HHS also abruptly cut off $11.4 billion in CDC funding that had first been allocated to state and local health departments at the height of the COVID-19 pandemic, issuing a condescending and inaccurate announcement stating, “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.” The funding, while initially designed to bolster local responses to COVID, was also being used to upgrade and strengthen all sorts of public health infrastructure, including testing and monitoring programs for other respiratory diseases as well as vaccination efforts.
Writing about the impact in Minnesota, which lost $220 million, John Besser, a retired CDC and Minnesota Department of Health staffer wrote, “ Withdrawing funds 14 months before they were scheduled to expire put MDH in a terrible position. It effectively ended efforts to modernize not only COVID tracking systems, but also tracking of all the other diseases that use the same systems. MDH had no opportunity to identify alternate sources of funding, to phase out activities and to reduce personnel through attrition. Instead, MDH had to immediately and brutally lay off approximately 170 employees who represented the next generation of experts.”
Meanwhile, after Kennedy proposed a sweeping restructuring of HHS that would eliminate multiple agencies and left public health experts scratching their heads, someone leaked the administration’s draft HHS budget. Under the proposal, overall HHS spending would shrink by a staggering 30 percent. Some of that would be achieved by assuming an end to Affordable Care Act Subsidies, likely meaning millions would lose their health insurance. The CDC and National Institutes of Health would each get a 40 percent cut. CDC programs targeted for complete elimination include its Ending the HIV Epidemic Initiative, the Minority AIDS Initiative and domestic HIV/AIDS prevention and surveillance activities.
HIV/AIDS organizations denounced the proposed cuts. The HIV prevention advocates PrEP4All quickly issued a statement saying, “The scale of what is being lost is staggering… This is a slash and burn operation that has nothing to do with efficiency or effectiveness.”
And the damage isn’t just limited to health and disease prevention services. In mid-April, Wired reported that “much of the IT and cybersecurity infrastructure underpinning the US health system is in danger of a possible collapse following a purge of IT staff and leadership at the Department of Health and Human Services,” per several anonymous current and former employees.
As bad as all of the above is, the long-term impact of the Trump/Musk/RFK Jr. campaign to eviscerate federally funded medical and public health research, and especially to obliterate any research that doesn’t fit into the administration’s narrow ideological parameters, may be even worse. By most counts, at least 700 ongoing research grants have been abruptly cancelled, halting studies in their tracks, while a significant chunk of NIH internal staff that supported the entire research process has been let go.
One of the first batches of cancellations that came to light involved some 40 grants for research looking at vaccine hesitancy and how to increase vaccine acceptance, seemingly in furtherance of Kennedy’s longtime anti-vaccine activism. But that proved to be just the start. Also in the ideological crosshairs, presumably in the name of Trump’s campaign against diversity, equity, and inclusion, is anything that seeks to investigate the health of marginalized communities or attempts to understand any shortcomings the healthcare system has in reaching them.
Pediatrician and Harvard Ph.D. candidate Logan Beyer recently provided a telling example. His study aimed at identifying neighborhoods with the highest percentages of housing- and food-insecure families was abruptly defunded. He was notified via an astonishing letter, that seems to mirror what other researchers whose work might be interpreted as connected to DEI have also received: “Research programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”
Beyer, in a column for STAT News, easily debunked that claim, writing, “Categories such as language, gender, and race aren’t arbitrary; they correlate strongly with exposure to harm and access to opportunity. For example, my patients who do not speak English face inherent barriers to accessing health care and frequently live in neighborhoods with fewer resources. Ignoring socially potent categories under the guise of ‘color-blind’ science will only augment disparities. How can we fix what we cannot study?”
But making sure such disparities don’t get fixed seems to be precisely the point.
Much the same happened to Dr. Brittany Charlton, who got a similar “antithetical to scientific inquiry” letter instantly terminating all her research grants, which focused on LGBTQ health. Charleton, an epidemiologist, is an associate professor and founding director of the LGBTQ Health Center of Excellence, which is based at Harvard Pilgrim Health Care Institute in partnership with Harvard T.H. Chan School of Public Health.
In a blistering op-ed for The Hill, Charlton, who is one of the plaintiffs in a lawsuit challenging the terminations, wrote:
“Let me set the record straight: I’m not promoting radical ideology, woke ideology, gender ideology or any kind of ideology at all. I’m a scientist. I work to keep people healthy.
“And I’m outraged that the federal government has abruptly — and, I believe, illegally — terminated contracts to support work that I and hundreds of my fellow researchers have been pursuing to better understand and combat cancer, heart disease, maternal mortality, depression, Alzheimer’s disease and countless other threats to health and well-being.”
Charlton and others point out that understanding whether and how different groups are impacted differently by particular illnesses helps scientists get a fuller picture of the disease in question, which ultimately helps everyone. It’s not some mindless pursuit of “amorphous” DEI, it’s an attempt to fully understand what’s going on with diseases that impact millions or even billions of people.
Nevertheless, a crackdown on DEI has been used to justify axing numerous studies seeking to shed light on Alzheimer’s disease and many other serious conditions. (Full disclosure: Charlton is a member of Defend Public Health, the national network of researchers and healthcare providers for whom I’m providing volunteer communications support).
But a lot of scientists in similar situations have been reluctant to speak openly. One researcher I’m acquainted with, who also lost a grant but didn’t feel able to go on the record right now, described the situation as “precarious” and expressed a deep desire to get their funding reinstated and to keep their work alive. They added that the terminations felt sudden and inexplicable—that “it now feels like we are under heightened scrutiny, where any misstep, however minor, could further jeopardize our ability to do the work. Yet the opacity of the process makes it nearly impossible to know what would even be considered a misstep.”
The “antithetical to scientific inquiry” study this researcher was doing aimed to answer this question: Does safer, more private shelter—non-congregate shelter models like hotels and tiny home—reduce psychiatric emergencies for unhoused people, as compared to shelters where they are housed together? The research team hoped to provide actionable evidence to guide local and national housing policy at a time when homelessness and mental health crises are rising.
“We centered voices of people with lived experience of homelessness, who were compensated, trained, and employed as part of the research team—not studied as subjects, but included as collaborators,” the researcher explained, adding that they “did not rely on ‘DEI terminology’ (whatever that’s supposed to mean) or race-based selection criteria. We were focused on health systems and shelter structure, not identity categories.”
Other suddenly axed funding included grants for training students to be the next generation of researchers, studies of COVID-19 immunity and research into preventing intimate partner violence, among others. Trump has also frozen funding awards from the National Science Foundation, an independent federal agency, and has begun cancelling existing grants over the same supposed DEI issues.
Remaining NIH grantees are now being sent a notice informing them that “by accepting the grant award, recipients are certifying that: (i) They do not, and will not during the term of this financial assistance award, operate any programs that advance or promote DEI, DEIA, or discriminatory equity ideology in violation of Federal anti-discrimination laws.” While most would argue vehemently that their diversity, equity and inclusion activities or research into marginalized communities don’t violate any antidiscrimination laws, it would likely mean a lengthy court fight to retain their funds if HHS tags what they’re doing as “DEI.”
But the cancelled research funding represents just one piece of the administration’s assault on health research. Advisory group meetings were postponed and NIH study sections, which review funding applications, have been abruptly cancelled. Sudden staff cutbacks have created confusion and disarray. As virologist James Alwine, another Defend Public Health member, put it in a recent piece forThe Progressive, “The world’s most successful health science and public health apparatus is being shredded, putting all of us at great risk of chronic and infectious disease.”
At the same time as they’re throttling new research, RFK Jr. and the White House seem hell-bent on turning HHS into a leading source of health disinformation.
HHS has long maintained two important websites offering COVID-19 information: covid.gov, which provided a wide variety of information and resources, and covidtests.gov, which had specific details about COVID testing, including the availability of free home tests paid for by the US government. Both pages are now dead, and instead redirect visitors to a new White House page titled, “Lab Leak: The True Origins of COVID-19.”
The new page, featuring a prominent photo of a stern-faced Donald Trump striding purposefully toward the camera, is essentially a collection of COVID truther conspiracy theories, starting with claims that SARS-CoV-2 was genetically engineered in a Wuhan lab by Chinese scientists—claims that were thoroughly debunked some time ago. The page then goes on to wild attacks on the Biden administration and former NIH infectious diseases chief Dr. Anthony Fauci. It’s filled with right-wing talking points, including denunciations of so-called “lockdowns” and outright disinformation about masks, claiming, “There was no conclusive evidence that masks effectively protected Americans from COVID-19.”
That’s nonsense. Research shows beyond doubt that masks greatly reduce the amount of virus that infected individuals release into the air, with N95 respirators being nearly perfect at keeping the virus contained. An authoritative review of the research published last year states it plainly:
“First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens.”
Meanwhile, Kennedy remains obsessed with autism and attempting to link it to vaccines. On April 16, he announced a new quest to find “the cause” of what he termed an autism “epidemic,” promising “to identify precisely what the environmental toxins are that are causing” this supposed epidemic by September. He dismissed the idea that autism’s roots are genetic rather than environmental, saying of environmental toxins, “that’s where we’re going to find the answer.” The fact that he previously hired a notorious and discredited antivaxxer to “study” links between vaccines and autism suggests where this is likely headed.
Such behavior is classic RFK Jr.: starting with a conclusion and then looking for evidence to back it up, rather than conducting an open-minded inquiry like actual scientists. And he punctuated his diatribe with remarks about autistic children that spurred anger and revulsion among the autistic community as well as experts. “These are kids who will never pay taxes,” Kennedy said. “They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.”
That’s utterly false. Autism has long been understood as a spectrum, with a wide variety of manifestations. While the severe impairment Kennedy describes does happen, it’s far from universal. Many autistic people do not need the intense support Kennedy claims that they all need, and more than a few are quite able to live independently.
Scientific American promptly debunked Kennedy’s bizarre claims of a toxic “epidemic,” explaining, “In fact, researchers say, autism is between 60 and 90 percent heritable. And in up to 40 percent of cases, doctors can find a specific set of genetic mutations to explain the condition. While there are environmental risk factors for autism, such as air pollution, rising rates are mostly attributable to broadened diagnostic categories and more comprehensive screening.”
Grace Danqing Yang, an autistic college student and president of Students For Science, dismissed Kennedy’s quest for a cause of the supposed “epidemic” as “an already-answered question.” And she offered a scathing response to Kennedy’s dismissive perceptions of autism:
“I can’t say that it was easy growing up as an autistic child, but I wouldn’t trade it for the world. Do not weave my disability into your narrative of tragedy. My brain being wired differently gives me perspectives on issues that others do not. It hinders me in some ways, but people like me bring diverse perspectives to the table that are often needed. For example, my autistic “obsession” led to my winning a research prize on a topic I care about, and even a poetry prize. My autism drives the slam poetry I scream into a microphone; it oozes into the poems I publish in lit mags. My autism led me to an obsession with science, an obsession that landed me one of my first jobs in the very research labs that you want to gut. My extension, my autism led me to make enough money for me to file my taxes for the first time, at 20 years old. Do not make me a tragedy; My autism is as fundamental to me as my bones and my autism is beautiful.”
Not content to merely promote disinformation, the administration may now be looking to try to coerce medical journals to join its campaign. MedPage Today reported recently that Edward R. Martin Jr., the Trump-appointed US Attorney for the District of Columbia, has written to editors of at least three medical journals claiming that journals have become “partisans in various scientific debates” and asking how they handle “competing viewpoints.”
To say that a federal prosecutor seeking to intervene in the editorial processes of privately-owned publications raises serious First Amendment issues would seem to be an understatement. Such an action would have been unthinkable under any previous administration, Republican or Democrat, but in Trumpworld, the unthinkable is now standard operating procedure.
