The good news for today is that it seems like the tide of public opinion on the action of this federal administration is starting to turn. People are starting to really recognize the negative impacts of these executive orders and DOGE actions, and realize that saying these things are being done in the name of “government efficiency” and “cutting government waste” just doesn’t add up, when you look closely and try to do the math. We need to keep speaking up and making our voices heard, asking our government representatives to explain how these actions really make positive change for Americans (at least the ones who aren’t extremely wealthy)!
In the meantime, a lot of damage continues to be done to public health, at a dizzying pace.
–Today, a school-aged child who had not been vaccinated against measles died in the outbreak in West Texas. As of yesterday 124 people were officially sick in this measles outbreak Texas, 18 of which have been hospitalized, and almost all of which are unvaccinated children under age 18. Measles is one of the most infectious diseases known to humans. It’s typically used as the example of the most easily transmitted disease in epidemiology classes: while it varies from situation to situation, measles is estimated to have a “reproductive number” of 12-18, which means every person who is infected with measles infects an average of 12-18 more people in a population with no immunity (i.e. if everyone is unvaccinated and hasn’t yet had measles). In comparison, COVID’s reproductive number back when we all had no immunity was estimated to be only around 3. Part of the problem is that a person with measles is highly contagious about four days before the telltale rash appears. Measles can cause pregnancy complications, and while it’s rare, can lead to swelling of the brain and death, like presumably happened to this child. (This also happened to Roald Dahl’s daughter in the 1960s, which he wrote about eloquently.) Unsurprisingly, given his take on vaccines and especially the childhood vaccine that could have prevented this outbreak (the MMR), RKF Jr. dismissed this as much of a concern today after it was announced the child had died, saying “We have measles outbreaks every year.” In the same cabinet meeting he also said that a second person had died, which Lubbock health department officials said later was incorrect. (Well at least the Secretary of HHS is well informed, keeping a close eye on the facts. /sarcasm)
–Medicare will no longer cover telehealth visits after March 31 of this year. You might remember that as part of the year-end spending bill in late 2024, Congress had proposed a bill that would have (among other things) extended telehealth coverage by Medicare for two more years, and these changes had pronounced bipartisan support. However, Elon Musk was a key player in striking down that bill even before Trump’s inauguration. The package that ultimately kept the government open extended coverage through March 31 and that’s it. Trump himself was the one who expanded Medicare coverage for telehealth in March 2020, to allow Americans over age 65 to seek healthcare more safely and easily during the early days of the COVID-19 pandemic. And sure, telehealth doesn’t work well for everyone. But for a LOT of people on Medicare, it has been a game-changer that has allowed them to see a doctor more readily when they’re not well; they don’t need to find a way to get to a clinic (and potentially be exposed to other sick people in the process) to seek care. Notably, people who are in urban areas and are on dialysis, are being seen for a potential/acute stroke, or need mental health or substance use health services can still use telehealth and Medicare will pay. But for people in rural areas (where transportation to get to a doctor can be much more arduous) they’ll have to get to a clinic starting April 1 in order for it to be covered.
–On Feb 19, an executive order ordered the termination of five Federal Advisory Committees; one of them was the Health Equity Advisory Committee for the Administrator of the Centers for Medicare and Medicaid Services, and another was the HHS Secretary’s Advisory Committee on Long COVID. The Advisory Committee on Long COVID included 14 members including patient advocates, doctors, researchers, and people living with Long COVID, with the charge to “bring perspectives from outside of the government to help inform actions of the Executive Branch on Long COVID and associated conditions, with a focus on health equity.” It took more than a year to establish the committee and swear in the new members, which happened in January 2025. They hadn’t even had a meeting yet before the committee was terminated. This action also follows removal of information on Long COVID from AskJan, a free service provided by the US Department of Labor’s Office of Disability Employment Policy that helps the public learn about federal guidance on workplace accommodations and employment while disabled (archived version here).
–The next day, the National Law Enforcement Accountability Database (NLEAD) was shut down. Ironically, this database was first proposed by Trump himself, in an executive order in 2020 in the wake of George Floyd’s murder. However, it wasn’t actually launched until Biden did so three years later. NLEAD tracked misconduct by federal police officers. In an email sent to the Washington Post, the White House stated, “President Trump believes in an appropriate balance of accountability without compromising law enforcement’s ability to do its job of fighting crime and keeping communities safe…But the Biden executive order creating this database was full of woke, anti-police concepts that make communities less safe like a call for ‘equitable’ policing and addressing ‘systemic racism in our criminal justice system.’” Unsurprisingly, many people suspect this is a lot less about ending something that Biden created (since it was Trump’s own suggestion) but rather an effort to hide data that showed that police brutality continues in the US at a distressing rate, especially for Black Americans.
We need data to know what’s happening on issues like Long COVID and police brutality, so we can make decisions as a society about whether we’re moving in the right direction and whether change is coming quickly enough. We need advisory committees so our policymakers can hear from experts who aren’t federal employees, and make the most informed and effective decisions possible. We need strategies that are going to increase people’s access to care—like telehealth, paid for by health insurance—and decrease people’s likelihood of dying of completely preventable diseases like measles. These are the ways to actually make America healthy again, as any public health professional will tell you.