First, Do No Harm. Or Don't.
Are there really Alternative Medical Facts?
I’m wary of reading too many political posts lately, mostly because it’s not great for mental health, but for lots of reasons, really. So I wasn’t going to write a political post. I was going to write a post about medicine and health. But unfortunately, the two have become inextricably linked, and this is what’s on my mind, the thing I can’t stop thinking about. Or rather, person: specifically, RFK Jr.
I don’t want to write about any of Trump’s other cabinet picks, or about Trump himself—there are a slew of people out there writing about all of them, and those people are much more qualified than I am to do so. Health and healthcare are what I know, and also what I feel passionate about. The actions of Health and Human Services) HHS, which is the umbrella over government health agencies, including the CDC, the NIH, and Medicare, have direct consequences on patients and healthcare workers alike. Trump, of course, has nominated RFK Jr. to head up HHS.
Before he ran for president on the independent ticket, RFK Jr. occupied only the tiniest little bit of my brain. Other than being a part of the Kennedy clan, I knew him as an ‘antivaxxer’, more accurately an anti-vaccine activist who promoted the belief that the measles, mumps, rubella (MMR) vaccine caused autism, and someone who echoed those who believed that hydroxychloroquine and ivermectin treated Covid, though both had been shown ineffective in scientific studies. I also knew he wrote a book in 2021, railing against Anthony Fauci and Bill Gates. It said, among other things, that Fauci and Gates conspired to suppress the knowledge that hydroxychloroquine and ivermectin were effective against Covid, and they conspired to prolong the pandemic in the service of a ‘vaccine cartel’ which just wanted to profit from producing dangerous vaccines. Essentially, what I knew about RFK Jr. was that he was a conspiracy theorist.
I didn’t take his presidential candidacy seriously. In fact, I ignored it completely, and he went away from the ballot as I’d hoped he would. But that was part of a game of whack-a-mole. Here he is again, and now is in a position where, if confirmed, he’ll have real power.
I have no problem saying that many mistakes occurred in the handling of the pandemic by the CDC, the WHO, Fauci… Mistakes that were inevitable in the management of a completely unknown viral entity in a country that was woefully unprepared. Alarms raised by experts, repeatedly over decades, that a pandemic was soon inevitable, had been ignored. Paucity of protective equipment, inaccuracies about modes of transmission, and an underestimated risk/benefit ratio for shut-downs and masking ensued.
But good things also happened. Talented and experienced researchers produced tests and vaccines in record time, and clinicians quickly learned best practices for care of Covid patients.
Unfortunately, both measures that proved right and measures that proved wrong became fodder for conspiracy theories and disinformation, creating even more barriers in preventing and treating Covid than already existed. Distrust in the medical establishment skyrocketed as the pandemic dragged on. Fear of Covid vaccines and anger over mandatory vaccination for Covid for some workers sparked anger and resentment. This generalized to other vaccines that had longstanding records of safety and efficacy.
We already had an epidemic of vaccine refusal on our hands after the pandemic, and cases of measles and whooping cough have crept up. This newly energized spate of distrust, anger and fear has complicated an already-struggling US healthcare system.
Enter a new Trump administration and his cabinet picks.
Every healthcare worker I’ve spoken to is terrified by the prospect of RFK as head of HHS. Here are some of the reasons why:
He wants to pull funding from infectious diseases research, though infectious diseases are one of the biggest threats to health, not just in the US, but in the entire world. We just emerged from one horrific pandemic. What makes anyone think that there won’t be another? Climate change pretty much guarantees some novel pathogens are going to come along.
We have capability to produce vaccines and medications to prevent and treat new diseases as well as diseases that already exist. Look at M-Pox (previously monkey-pox), a disease which induced fear that it would be the next epidemic or even pandemic. It is no coincidence that we tamped it back down. It was an alert public health system, research and data following trends, and doctors, nurses and, especially, patients receiving information in a timely fashion that allowed that to happen.
RFK Jr. claims he is not an antivaxxer and won’t ‘take vaccines away’ from those who they are ‘working for.’ He says he just wants more research into the safety of vaccines. Maybe we could use more data on newer vaccines, but some, like polio vaccine, have been around a very long time and their safety and efficacy profiles are thoroughly proven. RFK Jr. does not appear to believe this.
He says he’s not against vaccines, but he also says they are dangerous and they don’t prevent diseases. This vaccine skepticism, his statements that measles, mumps, rubella (MMR) vaccine causes autism, and the fact that he produced a documentary entitled Vaxed III: Authorization to Kill look like anti-vaccine to me. His statements will make it even more difficult for physicians and nurses to convince parents to vaccinate kids, so that measles, pertussis and, terrifyingly, polio are not circulating in schools and other group settings.
The relationship between MMR vaccine and autism, and the idea that other childhood vaccines are unsafe has been thoroughly debunked.
We know that in adults, too, vaccines against flu, Covid, shingles and a variety of other illnesses save lives. Since Covid, we have struggled to convince many of our adult patients to receive routine vaccines.
Historically, lower flu vaccination rates result in more hospitalizations and deaths during the flu season.
He wants to promote natural products, such as raw milk, which he personally believes are healthier than alternatives (in the case of milk, pasteurized milk), and wants to remove CDC regulation on such products. I can’t force a person who believes something not to believe it. Let him continue to drink raw milk. But the dangers of unpasteurized milk include E. coli infections, bird flu, and other bacterial and viral diseases. There was a reason pasteurization was developed!
I had E. coli gastroenteritis once and I spent 5 days in the hospital on IV fluids watching the lining of my GI tract shed. I wouldn’t wish the misery of that on anyone, but certainly would not risk it with a child. Regulation is not perfect but can prevent people from making mistakes they will regret.
He has, over the years, put forth a slew of theories and beliefs that are unproven at best and frankly wrong and HARMFUL at worst. One of them is that HIV is not the cause of AIDS (A COMPLETE FALSEHOOD) He alluded to the gay life style and drug use as causes.
He also claimed that the Covid virus was genetically engineered to target Black and white people, but not Jewish or Chinese people (WTF?), and that there is a link between antidepressants and school shootings (NO SUCH LINK has been found). There are more, but I’ll spare you.
For the record, I don’t think he’s wrong about everything.
I think he’s right that we need to be looking into the root causes of all the chronic disease in this country—Obesity, Diabetes, Heart disease. I agree that we need to do serious work to revamp the American diet. But in that same vein, his anti-drug stance on medications like Ozempic and Wegovy, which are saving lives, is ill-conceived. Yes, the drugs are expensive. Yet diet and exercise aren't working, so until we find something else that does, discouraging the use of these medications is irresponsible.
I agree with him that direct-too-consumer advertising of pharmaceuticals ought to be limited or abolished, as many of the drugs advertised are extremely expensive and their actions against the diseases they target too complicated for the majority of patients to understand. I have to wonder why there are only two countries in the world that allow these ads: the US and New Zealand. All other countries seem to know something we don’t.
I agree that we need to look into the many toxic exposures we all likely have and don’t even know about. Yet banning pesticides that are allowing farmers to produce crops will surely thwart the effort to get fruits and vegetables onto plates unless another solution is found. .
HERE’s the obvious thing: RFK Jr. is not trained in medicine or any kind of science. Just because he’s right about some things doesn’t mean he is qualified to head HHS. Truly, all the stuff he’s wrong about, but irresponsibly throws around, should disqualify him.
If you were talking to someone from another country, someone who didn’t know anything about our politics, wouldn’t you be horrified to have to tell them the the person at the top of the country’s health agenda is a lawyer (not a doctor or scientist) who states that part of his brain was eaten by a worm? That he is a vocal vaccine skeptic? Oh and by the way, he has dumped a dead bear in Central Park, faking a bicycle accident. Ten years later, he decapitated a dead whale and took the head home with him. Yes, he has also been accused of sexual assault (but he says that’s not true...wait, how do you know if someone who doesn't believe established truth is lying when he says something’s not true?) CAN’T WE DO BETTER THAN THIS????
As I said at the beginning of this post, I’m no expert on politics or government. But it seems so obvious that any sane group of senators, even though the same party as Trump, would block this nomination. At any other juncture, they would have. But it seems likely they won’t do it now.
We learn in medicine: FIRST DO NO HARM. But remember, RFK Jr. has no medical training. There’s going to be harm. The only question is, how much?
Spot on!