Who can ever forget when, in April 2020, President Donald Trump stood at the White House podium and outlined a possible new avenue for treating COVID-19: America’s scientists should study disinfecting the human body by injecting bleach.
For over half a century, medical guidance from the United States has shaped public health decisions worldwide. At that moment in 2020, it seemed almost incomprehensible that an American president could be dispensing advice so evidently lethal and nonsensical that even a middle schooler would know not to follow it. One indelible image from that day was the anguished expression of Trump’s pandemic response coordinator, Dr. Deborah Birx, who looked as if her soul was leaving her body.
Apparently, this was just a warm-up act. In his second administration, the president’s alliance with Robert F. Kennedy Jr. has plunged the American public health apparatus into its vibes-based era, in which evidence-based medicine needn’t factor into decisions of enormous significance.
On Monday, Trump joined with RFK Jr. and the directors of other top health agencies to reveal what they claimed was a remarkable discovery that could give American parents renewed hope: Over the course of just five months, they said they’d discovered one of the causes of autism, acetaminophen taken during pregnancy, and a promising treatment for the disorder, leucovorin, a form of vitamin B9.
“Don’t take Tylenol,” President Trump advised pregnant women over and over, referring to the brand name for acetaminophen. “Don’t take it.”
In a wild, rambling disquisition on the horrors of Tylenol as well as vaccines, he cautioned, “They pump so much stuff into those beautiful little babies, it’s a disgrace.” A spool of dubious statements then ensued, including: “There are certain groups of people that don’t take vaccines and don’t take any pills, that have no autism,” Trump said, making an untrue claim about the Amish population. That was bookended with: “Cuba, they don’t have Tylenol because they don’t have the money for Tylenol, and they have virtually no autism.”
In his turn at the microphone, Kennedy then opined on how America’s health agencies had been able to so rapidly deliver this so-called breakthrough. For 20 years, he contended, the National Institutes of Health had been focused “almost solely on politically driven and entirely fruitless research about the genetic drivers of autism.” He added, “We are now replacing the institutional culture of politicized science and corruption with evidence-based medicine.”
Autism scientists and other public health experts were quick to denounce the press conference, pointing out that HHS had provided little evidence to support its sweeping claims.
The Coalition of Autism Scientists, comprising top research scientists in the field, quickly released a statement, saying the press conference “alarms us…. The data cited do not support the claim that Tylenol causes autism and leucovorin is a cure, and only stoke fear and falsely suggest hope when there is no simple answer.”
What now passes for medical guidance from the US government has become so chaotic, confusing, and riddled with untruths that even the HHS’s own advisers are losing the plot.
At last week’s hotly awaited meeting of the Advisory Committee on Immunization Practices (ACIP), which makes recommendations to HHS on which vaccines America’s children should take and insurance companies should cover, one of its newly appointed members, Dr. Cody Meissner, arguably the most qualified to be there, admitted that he was “still confused.” The committee was weighing whether the MMRV shot that bundles measles, mumps, rubella, and varicella vaccines into one injection should be covered by the government’s Vaccines for Children Program, which provides vaccines at no cost to eligible children. Meissner concluded, “I’m going to abstain because I’m not quite sure what I’m voting for here.”
Just seven months into Secretary Kennedy’s tenure as the nation’s health secretary, the machinery of our public health infrastructure, with its advisory committees and carefully scrutinized research grants, has become so degraded that it’s becoming challenging for even a well-informed citizen to know what basic healthcare steps to take. When and how should they vaccinate their children? Should they get a COVID-19 booster, and will insurance cover it? Should they “tough it out” if pregnant with a fever and not take Tylenol, as Trump suggested?
Remarkably, even Senator Bill Cassidy (R-La.), who cast the deciding vote to confirm Kennedy as health secretary, said at a hearing last Wednesday that the recommendations of the newly constituted ACIP committee, now stacked with vaccine skeptics, could no longer be trusted and lacked legitimacy.
Secretary Kennedy swept into office with a pledge to use radical transparency and gold-standard science to overhaul America’s broken medical system, throwing aside precedent in favor of unbiased, clear-eyed decisions, free from conflicts of interest.
But a very different portrait of what drives his decision-making came into view last Wednesday, when Dr. Susan Monarez testified before the Senate Health Committee that she was fired as director of the Centers for Disease Control and Prevention, 29 days after being confirmed, because she refused to preemptively approve every vaccine recommendation from the ACIP committee, regardless of scientific evidence. (Kennedy refuted the claim, telling the Senate that he fired her because she was “untrustworthy.”)
Cassidy asked Monarez, “Did [Kennedy] cite any data or science as relates to the potential ACIP recommendations to persuade you to support them?”
To which Monarez replied, “He responded that there was no science or evidence associated with the childhood vaccine schedule.”
In this era of vibes-based medicine, government recommendations can be built on the thinnest reeds of evidence and do not need to rest on boring stuff like lengthy research studies and grueling searches for proof. At the autism press conference, Dr. Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services, characterized it as an “aggressive approach…demanded by the president and by the secretary.”
But as the Coalition of Autism Scientists said in their statement, given that acetaminophen use during pregnancy has not increased over the last two decades alongside rising autism case rates, “It’s clearly not the cause of the increased diagnoses of autism.” It further pointed out, “Fevers during pregnancy are known to increase risk for autism, and that’s why mothers take acetaminophen in the first place.”
At the press conference, President Trump noticeably struggled to pronounce the word acetaminophen, which led several commentators on X afterward to question whether he should be dispensing medical advice about something he can’t even correctly say.
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