Part 1: The Rise of Preventable Diseases
Editor’s Note: This is the first of a multipart series on the Trump administration’s broad attack on the health of Americans. Physician, author, and Indivisible Weston co-founder Kim Bergner starts with an overview of the issues and introduces the series.
by Kim Bergner, MD
Knowledge is power. That’s why authoritarian governments want to limit our knowledge and spin their own self-serving narratives. An informed and healthy society is a powerful society. By sowing distrust in science and experts, and by spreading misinformation, anti-science ideologues are weakening American society and putting us all at risk.
The assault on our people’s health has taken many forms and spans a dizzying array of laws, federal policies, funding, and regulatory agencies. This series will look at some of the major thrusts of that attack and identify steps Indivisibles can take to educate ourselves and arrest this slide. We start the series with issues that are at the foundation of our health: prevention of communicable disease, preventive health screening, and medical research.
Communicable disease outbreaks are on the rise.
As the school year progresses, families prepare for the winter holidays, and access to healthcare becomes more expensive, Americans face a growing health crisis. Among the most urgent concerns is erosion of community/”herd” immunity. Community immunity, a cornerstone of public health, is necessary to limit the spread of communicable diseases. Some individuals are too young to be fully vaccinated. Some are immunocompromised due to age, pregnancy, illness, or necessary medication. And some don’t develop adequate immunity even when vaccinated.
Scientific understanding of how disease spreads — and how to prevent it — is well-established.
The percentage of a population that must be immune to prevent spread depends on the disease. For measles, the herd immunity percentage is about 95%. The Center for American Progress notes that, “Researchers estimate that routine measles vaccinations have prevented nearly 508 million cases of illness, 32 million hospitalizations, and 1 million deaths among children born in the United States between 1994 and 2023. Vaccines also protect against leading causes of death among adults, such as influenza, COVID-19, and pneumonia, among others.”
These statistics highlight how we now underestimate the importance of public health and vaccines in our society. Those who lived before today’s standard childhood vaccines and public health system for delivering them remember the death and devastation that are now rarely seen in the U.S. In 1952, there were 21,000 cases of paralytic polio — it was every parent’s worst nightmare. Currently, due to the steep rise of vaccine skepticism fomented during the Trump administrations, the U.S. is on the verge of losing its measles elimination status. We are likely to see more children become severely ill or die from infections that we have not seen in decades.
The Commonwealth mandates immunization for school against nine infectious diseases. Each state is different, and Florida is moving to eliminate vaccine mandates. But infectious diseases do not observe geographic borders. In June, a person infected with measles flew on a JetBlue flight from Boston to Miami. Any of us — our grandparents, our infants, our loved ones and other household contacts — could have been on that flight.
The Trump Administration’s policy of spreading demonstrably false claims about the safety of vaccines has risen to the level of appointing anti-vaxx propagandist RFK Jr. as HHS Secretary. He fired the entire panel of 17 experts who served on the CDC’s Advisory Committee on Immunization Practices (ACIP) and replaced them with his own appointees, many of whom are not experts in relevant fields and are vaccine skeptics.
The fired ACIP vaccine experts wrote in a statement: “We are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses.”
RFK Jr. has eliminated previous recommendations for COVID vaccines for healthy children and pregnant women, disregarding data that would support recommending COVID vaccination for those populations. He has now ordered the mostly non-expert ACIP panel to revise the CDC’s current evidence-based vaccine schedule for children without providing any meaningful rationale.
Loss of insurance coverage for a wide range of health screenings also threatens protections against serious illness. RFK Jr. reportedly plans to remove members of an advisory panel on cancer screening and preventive health because they are too “woke”. The Affordable Care Act mandates insurers cover these tests, and dismissing this panel could lead to lack of basic insurance coverage for lifesaving screenings such as routine mammograms and colonoscopies.
[RFK Jr.] would be less hazardous if he decided to do cardiac surgery. Then he would kill people only one at a time rather than his current ability to kill by the thousands.
Former CDC Director William Foege
Catastrophic defunding of medical research will cost lives and harm our economy.
In addition to changing essential health policies, the Trump Administration is slashing billions of dollars for medical research, dashing hope for many life-altering or life-saving advances in care. Discontinuing clinical trials and pharmaceutical development will be catastrophic for many people with adult and childhood cancers, diabetes, long COVID, Alzheimer’s, Parkinson’s Disease, postpartum depression, and countless other diseases.
The Journal of the American Medical Association notes that:
- “Scientists researching new cancer cures are neither culture warriors nor campus protesters. But so far, the biggest financial blows against academia have been borne by biomedical research. The Trump administration has canceled grants, fired researchers, and proposed to Congress a 43% cut to next year’s National Institutes of Health budget, equivalent to $20 billion per year.
- “The government has threatened to stop funding virtually all biomedical research if certain universities do not accept demands for changes in curriculum, admissions, hiring, and other policies — none of which are related to lifesaving science. As a result, hiring freezes are common at medical centers, and clinical trials are or might be put on hold.
- “More than 99% of all new drugs approved from 2010 through 2019 had some research funded by NIH. The consequences of a 33% effective cut in biomedical research funding … will lead to 15.3% fewer new therapies … which would reduce life expectancy by 0.24 years per person. In a population of more than 340 million, this reflects 82 million fewer years of life.
- “Proposed reductions in biomedical funding also impact the economy. It’s estimated that a dollar of NIH spending produces $2.56 of economic activity. So a $20 billion reduction in biomedical research reduces US economic output by $51 billion.”
We will address additional aspects of the current health care crises in upcoming blog posts, including: impaired access to healthcare, attacks on women’s health, and increased exposure to environmental hazards.
The role for activists
We can all resist authoritarianism by rejecting propaganda, relying instead on evidence-based and science-backed sources. (1, 2 & 5 below), and supporting advocacy organizations that put patients over politics. (3 & 4). Specifically, you should:
- Determine whether your source of medical information comes from a medical professional or organization that uses evidence based science, not ideology. You can trust information from your physician and groups such as the American Academy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology, the Infectious Diseases Society of America, and the Center for Infectious Disease Research and Policy.
- Don’t take medical advice from social media influencers, groups of laypeople, or ideological political appointees.
- Understand the training, experience, dedication and disciplined critical thinking that distinguish medical experts.
- Support Doctors for America. You’ll receive alerts about policy changes and proposed legislative actions, and can participate in coordinated healthcare advocacy.)
- Support Healthcare for Action, a political PAC that informs the public and supports healthcare advocates running for political office.
- Understand the Trump Administration’s motivations for spreading health disinformation:
Reading
Podcasts
- How Science, Communication, and Preparedness Must Evolve
- The Republican War on Knowledge
- The Rise of Bad Medicine and Anti-Vaxxers: Combatting Trump’s Health Agenda
Kim Bergner, MD is a pediatrician and co-founder of Indivisible Weston.
