Editorial: Trumping Science with Snake Oil

With the second coming of Donald Trump to the White House, public health experts in the United States are expressing concern – make that alarm – about the potential for damage to the US health infrastructure over the next 4 years.

Trump 1.0 showed a clear disdain for science through his administration’s disparagement of COVID precautions, public demonization of infectious disease experts such as Dr. Anthony Fauci, and the touting of ‘alternative’ medicine, with ideas both bizarre and dangerous. Trump, possessor of a bachelor of science degree in economics, has claimed that “I alone can fix the system”. In his view that applies to health care, climate science, energy policy, or any other discipline where he has neither training nor experience.

Skepticism and Bleach

Trump has also voiced skepticism about the value of vaccines against COVID, and vaccines in general. Never mind that in the first year COVID -19 vaccines were available, unvaccinated persons were nearly five times more like to be infected, nearly 30 times more likely to be hospitalized, and nearly two-and-a-half times more likely to die from COVID-19 than vaccinated persons, data from the CDC and other sources shows

And never mind that in more than 225 years of immunizations billions of lives have been spared from death or debilitating illness from smallpox, polio, tetanus, diphtheria, typhus, measles, mumps, rubella, and many others.

But Trump is nothing if not a consummate salesman, and at the height of the COVID pandemic, while scientists at the CDC, FDA, and pharmaceutical companies were diligently and feverishly working on vaccines that could spare lives and bring the country out of quarantine, the president was busy flogging snake oil. In press conferences he touted supposed ‘treatments’ with either no or minimal evidence to back them up, such as the anti-parasitic drug ivermectin, the anti-malarial hydroxychloroquine, and, most disturbingly, intravenous bleach injections.

Back to the Future

Trump 2.0 promises to be even worse. Witness his proposed elevation of anti-vaxxer Robert F. Kennedy Jr. to a position of prominence over public health matters. Scientific consensus has long since debunked the idea that childhood vaccines cause autism, but why let science stand in the way of ambition? RFK Jr is a co-founder of Children’s Health Defense, a group that touts spurious medical theories and rejects scientific consensus, claiming that unvaccinated children are “healthier” than vaccinated children, citing as a source RFK’s co-author on a book claiming to help individuals make “informed choices for themselves and their families.”

“Robert F. Kennedy Jr. is a science denialist. He makes up his own scientific truths and ignores the actual truths,” said vaccine researcher and pediatrician Paul A Offit, MD, from Children’s Hospital of Philadelphia. Offit should know: he’s the co-creator of a vaccine against potentially lethal childhood rotavirus infections, and has called Kennedy out on his tweet proposing to remove fluoride from public water supplies nationwide.

“Fluoride has been well tested. It clearly and definitively decreases cavities, and is not associated with any clear evidence of the chronic diseases mentioned in that tweet,” Offit said.

‘Concepts of a Plan’

Throughout his first term and his campaign for a second, Trump has vowed that he would repeal the Affordable Care Act (also known as “Obamacare”) and “replace it with something great.”

At the only debate between Trump and Vice-President Kamala Harris, Trump ranted about the Affordable Care Act, calling it “lousy healthcare,” but when asked by the moderator whether he had an actual plan, he replied: “I have concepts of a plan.” No doubt that when it is finally brought into fruition it will be as dazzlingly successful as his other concepts, including Trump Steaks, Trump Shuttle, Trump University, the Trump Taj Mahal casino, and dozens of other bankrupt or failed business ventures.

Now, backed by a Republican-led Congress, Trump may finally get his wish to tear apart a program that, according to the US Department of Health and Human Services, covers more than 45 million Americans, many for the first time.

The naked hostility Republicans have shown to the ACA flies in the face of scientific truths. As reported by Medical News Insider and others, there is a robust body of evidence showing that access to affordable medical care translates into tangible and lasting health benefits. A 2023 study presented at a major gastroenterology conference showed that colorectal cancer screening rates are higher in states with expanded Medicare coverage than in those where conservative legislatures refused to offer expanded coverage. Another demonstrated that children and young adults with Hodgkin or non-Hodgkin lymphoma who had continuous Medicaid coverage were more likely to be diagnosed at an earlier disease stage than those only newly enrolled or who had interrupted coverage.

Do Not Go Gentle Into That Bad Night

In his defense of the British soldiers involved in the Boston Massacre John Adams said that “Facts are stubborn things.” Adams, a man of undisputed integrity, could not have foreseen that one of his successors as President of the United States would, two centuries later, base his entire career and persona on “alternative facts.”

Nonetheless, facts are the best tool that we as journalists have to help us combat the darkness, the ignorance, and the downright cruelty that is represented by Donald John Trump and his sycophants. We will continue to report the facts about the science, practice, and politics of medicine, while, in the words of a journalist from another era, attempting to comfort the afflicted and afflict the comfortable.

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Neil Osterweil is an award-winning medical journalist with more than 40 years of experience reporting on medicine and health care.