We are overdue for another update on what the health is going on in the US public health world right now. There’s a lot. What comes below almost reads like The Onion, except The Onion is usually funny and this is not—because this is real, and it’s real people’s lives and health at stake.
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RFK Jr., the Secretary of Health, shared pictures a few days ago of him and his grandchildren swimming. Aw, isn’t that nice? Fresh air and exercise—all things that someone who cares about Making America Healthy Again should be promoting. Except the photo was from them swimming in Rock Creek, a place where swimming is expressly prohibited because of widespread “fecal” contamination and high levels of bacteria, including E. coli. I have no words. A few people have asked me what I thought the point was. Was he just ignorant to the dangers? I really can’t imagine that was it. I haven’t been to Rock Creek but I have to imagine there are plenty of signs. Was he trying to demonstrate his apparent belief that if you eat healthy foods and reduce exposure to environmental toxins, then viruses and bacteria won’t make you sick? I don’t pretend to know what’s going on in his head, but it’s making my head hurt. The leader of a major health-focused entity (and HHS is, well, one of the major-ist) should be acting like a leader. A good role model, promoting behaviors that keep people healthy. A health leader does not swim in sewage-filled water, and get their grandkids to do it, too. Please don’t follow his lead. Please.
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The White House pulled their original pick for Surgeon General, and instead has put forward Casey Means, a wellness influencer. Let’s get a few things straight:
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She’s buddies with RFK Jr., which surprises no one.
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In April 2020, on a date by which almost 43,000 Americans had died of COVID, she published an op-ed that argued “Americans must build personal immunity defenses through radical changes in diet and exercise, or risk getting sick and dying. This means reducing or eliminating the seven deadly sins from our diet: processed foods, excess industrially-raised meats, refined sugar, dairy, refined grains, vegetable oils and excess sodium — a revolution in personal behavior and national policy.” This one makes my head hurt, too. Do any of you know someone who was a super health nut, marathon runner, eating all the best foods, and got COVID and was extremely ill for months, struggling to breathe and complete daily tasks? I do. Do any of you have a loved one who died of COVID through no fault of their own, after years of trying to stay healthy and strong? I do. These were the early days of COVID and it doesn’t matter how much we need to improve the average American diet: it is distasteful and unprofessional to try to capitalize on the spread of a deadly infectious disease to promote ideas that might benefit the wellness company you co-founded one year earlier (and therefore might benefit your own bank account).
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The op-ed refers to her as a “practicing physician,” but she has not had an active medical license since 2019 (before that op-ed was written), and dropped out of her surgical residency program. Yes, she has an MD from Stanford, where she focused on otolaryngology (ear, nose and throat surgery). She did not specialize in endocrinology, despite her self-professed expertise on metabolic health, which she describes in her book as “Good Energy,” as opposed to the 93% of US adults she says have “Bad Energy.” Stanford is an elite university, but an MD from Stanford doesn’t make her a reasonable candidate for Surgeon General. Do you know how many actual surgeons, or at least incredibly skilled medical doctors with active medical licenses there are in the United States? This is an absolute embarrassment.
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While the NIH is being decimated—with all international research being frozen and billions of other dollars for lifesaving research being summarily terminated or withheld—former Acting NIH Director (and current Principal Deputy Director) Matthew Memoli, and new Acting NIAID Director Jeffery Taubenberger have had a surprising windfall. These two are slashing and burning research that will save the lives of people who need it most, and meanwhile they have been awarded $500 million for their own project to develop universal Covid-19 and influenza vaccines. This sounds great, right? Except as one scientist said to Stat News: “There is incredible work going on. This is not it.” Sure, we all want research into next-generation COVID-19 vaccines. But something smells fishy about bypassing usual procedures for evaluating research projects—intended to ensure money is spent on those with greatest scientific merit—and instead directing money to a single vaccine project linked to two of the leaders overseeing NIH’s demise. This vaccine effort is one of 200 different COVID-vaccine projects within NIH (many of which just had their funding terminated with no notice), and uses technology that was largely abandoned in the 1970s—fifty years ago, for those of you who are trying to decide what counts as “next-generation.” This particular vaccine just underwent safety testing in a small study earlier this year (what scientists call a “Phase 1” study, which is the first major step of many steps required to bring a vaccine to market for humans). Now they’re getting $500 million for their own research, and no one else received money to keep working on theirs? Look: corruption by any other name is still corruption. This is not how good science unfolds.
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If you care about veterans, you might care that there has been a decision to indefinitely freeze new hires, fire probationary employees, and prevent renewals of time-limited appointments of clinician-scientists at the Veterans Administration. You may not realize that the VA is responsible for a huge amount of cutting-edge research in the United States, even since General Omar Bradley established a partnership between the VA and medical schools throughout the country in 1946. VA researchers publish more than 10,000 articles each year in medical journals, and millions of veterans have volunteered to participate in groundbreaking critical trials that will affect not just the health of veterans, but all of us. But now, as VA researchers just published in JAMA Internal Medicine, “Some 10 000 veterans are enrolled in treatment studies that are reported to be at risk of disruption or termination, which could deprive them of access to cutting-edge treatments and waste the effort and expense already invested in these studies by veterans and investigators.” Sound familiar? It’s not just the NIH playbook, it cuts much deeper than that.
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If you care about food safety, it might matter to you that RFK Jr. has laid off more than 3,500 people at FDA, which regulates nearly 80% of the U.S. food supply. But RFK Jr. talks so much about making our food healthier, surely those firings wouldn’t have affected the teams responsible for food safety…right? Wrong. And it’s not just the FDA. I can’t say it any better than Peter Lurie, the former Associate Commissioner for Public Health Strategy and Analysis at the FDA, who recently wrote in an op-ed: “The U.S. Department of Agriculture (USDA) terminated two food safety committees, one studying risk from Cronobacter in infant formula, and another that was seeking to improve food inspections using emerging technologies. Of even greater concern, the USDA also withdrew a Biden-era plan to require poultry companies to limit salmonella contamination in their products. According to USDA, that program would have prevented up to 4,300 salmonella illnesses per year. And the Justice Department plans to shutter a unit responsible for criminal and civil enforcement of food safety laws.” Remember this next time you hear RFK Jr. talk about how Americans need to eat higher quality food. (Or even worse, exploits indigenous people in the U.S. to promote his viewpoints—like he did in his House Appropriates Committee hearing testimony today— while making deep cuts throughout HHS that will absolutely harm indigenous people.)
OK, there’s a lot more that could be added to this list, but the last few updates have just contained information about the maddening and distressing things happening in public health, without enough opportunities for action. There ARE things you can do! Spread the word to those who want to know how they can help.
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Especially if you’re a public health professional, go to
https://www.defendpublichealth.org/ and join one of the current campaigns the group is supporting, take a training on how to write an op-ed, or better yet, join one of the committees (you might see me on a Thursday meeting of the Infectious Diseases, Pandemics, & Vaccines Committee if you attend!). Defend Public Health is an “all-volunteer network of public health researchers, healthcare workers, advocates, and allies fighting to protect the health of all from the Trump administration’s cruel attacks on proven, science-based public health policies.” Join us—there’s lots to do!
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Choose one of these five ways to advocate for public health, which Alison Brill highlighted in a recent Medical Care Blog entry. Whether you consider yourself a data lover, an activist for civic engagement, a public health champion, a community-builder, or a healer who wants to provide care and mutual aid for others, there is something on this list for you.
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Subscribe to Chop Wood, Carry Water, a weekday newsletter that “gives you easy, effective, political actions to take to stave off despair, effect positive change and elect more true public servants.” If you subscribe, Jessica Craven will send you (in her words) “short, encouraging email in your inbox each weekday (except Wednesday) telling you how you can make a difference by taking 5-7 minutes worth of EASY actions.” (There are bonus hopeful newsletters on Sundays, hence the Wednesday break.) This will help you feel like you’re making a difference—because you will be, even when the problems feel insurmountable.
There are lots more actions you can take, too. What are some of your favorite resources for taking action? Add a comment and let us know!