The Worst Case Scenario
Engineering the Conditions for the Next Pandemic
Following up on our recent article about The Binary Fallacy, we promised to talk about a little something called... The Worst Case Scenario. A perfect storm of pestilence and ignorance-based policy making that could make COVID-19 look like a spring picnic. Today's article is how you make that a reality, and how best we can prevent it from happening.
A Quick Lay of the Land
The Medical Establishment under Trump and HHS Secretary RFK Jr. is not having a very good time. FDA Commissioner Marty Makary is making a fool of himself on national television, yet again falsely proclaiming SARS-CoV-2 to be a common cold. NIH Director Jay Bhattacharya has been completely humiliated by the agency he was tasked to lead in an article from Important Context. Vinay Prasad was publicly humiliated about his ignorance regarding transparency about published research from government scientists. From journalist Sarah Karlin-Smith:
"Prasad says he has never met RFK Jr. when asked why Secretary doesn't want research published in certain journals. He says one of Kennedy's issue is he wants govt papers publicly available - someone in audience yells out this has been policy for 20 years."
You almost have to feel bad for Prasad, who made bank off of being RFK Jr's biggest fanboy on social media. UCSF Administration chose to look the other way.
As it turns out, saying a bunch of thoughtless garbage about public health for five years is not an effective barometer for judging one's competence in running some of the nation's most critical public agencies. Yet, it's what Trump and his ilk wanted to hear, so these arrogantly boorish social media contrarians were rewarded with power. Now they're making a mess of things, including the integration of "Elsa," a "generative AI tool" - which, like every other "genAI" gimmick, doesn't actually work - into the organization that is tasked with safeguarding the food your children eat and medicine they take when they're ill. The FDA's Vinay Prasad was nowhere to be found demanding a randomized control trial of the effectiveness of this automated MadLibs software built atop a mountain of theft.
![Wikipedia: "The 1992–1993 Jack in the Box E. coli outbreak occurred when the Escherichia coli O157:H7 bacterium (originating from contaminated beef patties) killed 4 children and infected 732 people across four US states.[1][2] The outbreak involved 73 Jack in the Box restaurants in California, Idaho, Washington, and Nevada, and has been described as "far and away the most infamous food poison outbreak in contemporary history."[3][4] The majority of the affected were under 10 years old.[5][6] Four children died and 178 others were left with permanent injury including kidney and brain damage."](https://substackcdn.com/image/fetch/f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff7c8656e-f5e8-429e-b099-18df34de414c_913x357.png "Wikipedia: \"The 1992–1993 Jack in the Box E. coli outbreak occurred when the Escherichia coli O157:H7 bacterium (originating from contaminated beef patties) killed 4 children and infected 732 people across four US states.[1][2] The outbreak involved 73 Jack in the Box restaurants in California, Idaho, Washington, and Nevada, and has been described as \"far and away the most infamous food poison outbreak in contemporary history.\"[3][4] The majority of the affected were under 10 years old.[5][6] Four children died and 178 others were left with permanent injury including kidney and brain damage.\"")
While Trump and RFK Jr. won't be in power forever, the foundations for what one might term "The Worst Case Scenario" for public health in America will linger for the decades that follow if left unattended. Laying the groundwork for another infamous Jack-in-the-Box outbreak, in which kids died from eating contaminated cheeseburgers, because Marty Makary put a dysfunctional spambot in charge of an automated deregulatory agenda - is just the start of looming threats. Measles is on the path to becoming endemic in America, thanks to fearmongering about vaccines and the minimization of infectious diseases. A new COVID-19 variant is causing incredibly painful "razor blade throat." That's just the tip of the iceberg of challenges facing a Medical Establishment dedicated to the censorship of scientists above all else.
The Next Generation of Anti-Vaccine Quackery
With all of the chaos unfolding now, we're losing sight of a potential crisis I've been quietly worrying about for the past few years: the normalization of anti-vaccine views in American medical and scientific universities. Makary, Bhattacharya, and Prasad were all credentialed academics before joining the Trump Administration, and after years of well-documented misconduct, university administrators were too cowardly to enforce basic professional standards. Now the Trump Administration wants universities to make being "objectively incorrect" & "morally depraved" protected statuses to be platformed and defended from inquiry and criticism.
This has long been a conservative political project, and if you'd like a refresher I would recommend the podcast episode "The Coddling of the American Mind" from the excellent "If Books Could Kill" podcast.
Is there a young, impressionable med student at a university somewhere watching these men rise to power and is now thinking to themselves, if I want to advance my career, perhaps this is the sort of behavior I should be emulating? Are they looking at mass layoffs throughout federal public health agencies and thinking that being an abrasive loudmouth is the path to job security in American science? While Kevin Bass tried and failed to emulate these men in the hopes of becoming a well-paid anti-vaccine Z-list celebrity, there’s a clear incentive for other students to try walking this same road into rabid crankery.
We're already watching liberals like Former COVID Czar Ashish Jha, now dean of public health at Brown University, publicly come out against the pediatric COVID-19 vaccine, which could have prevented thousands of needless deaths. This is indefensible, unscientific cowardice. This pre-mature surrender to the demands of the Trump Administration and their war on lifesaving vaccines does nothing but forge a consensus that some lives aren't worth saving.
Surrendering to the demands of the anti-vaccine movement for one disease means surrendering across all other diseases - including future threats we have yet become aware of.
Organizing the Next Pandemic
Much of the reason behind conservatives, anti-vaxxers, and other useless contrarians insistence that SARS-CoV-2 was engineered in a lab is because the most likely origin for the pandemic was due to unsafe livestock handling practies in a Wuhan "wet market," in which animals urinate and defecate all over one another in close proximity, passing germs and viruses back and forth like a foosball table. This demands greater government regulation of the agricultural industry, something that "free market" libertarian thinking is very much against - even as it gets Americans killed with outbreaks such as listeria. While it may be years before H5N1 (bird flu) evolves into a human-to-human transmitted virus, obscene proposals such as a "Great Birdington Declaration," endorsing the consumption of unpasteurized milk, and importing infected ostriches would only advance this timeline.
Part of the core mission of public health is preventing disease outbreaks, and halting the engineering of conditions that could trigger the next pandemic or harm Americans' health in other ways. This is an inherently political project, as public health is forced to butt heads against wealthy interests who are happy to sacrifice the lives of working Americans in exchange for short-term revenue growth. This is precisely why you saw so much money being burned on astroturfing contrarian quacks like Jay Bhattacharya or Vinay Prasad - and now with the help of the Trump Administration, these same wealthy interests are being giving free reign to light the match on a new disaster.
Just what do you think happens when you have a whole generation of fresh-faced healthcare workers and scientists who have been taught that the anti-vaccine movement has some important things to say and are worth listening to, if and when they encounter a new pandemic emergency? If this happens under the second Trump Administration, will they be brave enough to stand against a federal government that actively encourages infections which inevitably lead to overwhelmed hospitals, death, and disability? Worse yet, if the Democrats retake the White House in 2028, are they going to be foolish enough to leave quacks like Prasad and Makary in power? There is a dangerous new standard being set for public health in America that must be confronted head-on and is a central priority for anyone in politics.
Setting Things Right
We could spend another thousand words detailing the numerous points of failure this regime of incompetency may cause, not just in the next five years, but decades going forward. Instead, here's some basic policy proposals that anyone serious about rebuilding public health in America can behind:
Medical institutions must root out and terminate associations with anti-vaccine quacks. It's sad that this must be demanded, but enough damage has been done. When a single virus kills and disables countless American children in just a few short years, no serious medical professional or academic should be telling parents not to vaccinate their children against it. This is the lowest bar to clear, and no real loss to medical profession for kicking the cranks to the curb - freeing up more resources for actual science.
A federal ban on "generative AI" slop in public health agencies. These products simply are not capable of what they've been sold as, and are used by anti-vaccine creeps who are not serious about real science. The public's health shouldn't be put at risk because of nonsense produced by a highly wasteful spambot that has essentially banned the entire study of epidemiology, according to Ellie Murray:
A pledge to rehire anyone who was terminated because of "DOGE" and a blanket restoration of previous grant funding. On top of this, stricter safeguards to prevent outside meddling from unqualified, wholly unscientific creeps are clearly required. The brain drain that is happening now will haunt America for years after Trump and his goons are gone otherwise, with devastating effects.
A nationwide infrastructure upgrade to prevent transmission of SARS-CoV-2 and other airborne viruses in schools, hospitals, and other public places. The Biden Administration's surrender to the anti-vaccine movement and construction of a "post-pandemic" fantasy to try and secure electoral success failed, and essential projects such as this fell by the wayside as a result. This is such a political no-brainer: jobs creation, public-private partnerships, and improved population health are all easy wins that will be much needed come January 2029. We shouldn't have to wait for the start of another pandemic to get this done. As a bonus, it pisses off all the worst people like Vinay Prasad and their "evidence-based medicine" worship of unchecked pestilence; and we need to make preventing disease outbreaks a top priority.
A full Congressional inquiry and criminal charges against everyone involved in this ridiculous crusade against public health. To understand the full scope of this devastation, the American people are going to have to get some real answers, as well as a bold committment to ensuring this never happens again - which likely involves sending some of these creeps to a federal pentitentiary for fraud, negligience, and heavens only know what other crimes. This is another easy political dunk: You have some real villains doing everything they can to compromise the health of working American families and their children; and are desperate for a champion willing to fight for them.
So much is at stake when it comes to the next five years, and it's time that the public start demanding politicians be brave enough to stand up and take a stand for public health. Surrendering to the depravity of the anti-vaccine movement will only cause more needless suffering and death in exchange for nothing but demands of further compromise. Cowardice now will only lead to future calamity.
