SCOTT DETROW, HOST:
When he ran for another term, President Trump was pretty clear with voters. If he returned to the White House, he would give Robert F. Kennedy Jr. a lot of power.
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PRESIDENT DONALD TRUMP: I'm going to let him go wild on health. I'm going to let him go wild on the food. I'm going to let him go wild on medicines.
DETROW: Trump followed through. He picked Kennedy, who promotes vaccine disinformation, to lead the Department of Health and Human Services. And Kennedy has moved quickly to enact his Make America Healthy Again agenda and to dismantle the expertise of the federal government's health agencies. It's resulted in billions of dollars cut from research, the firing of independent vaccine boards and, most recently, firing of Center for Disease Control and Prevention director, Susan Monarez. The move stems from Monarez's refusal to support Secretary Kennedy's request to fire other agency officials and to make changes to vaccine policy. Last week's events have sent shock waves through the public health sector. Joining us to talk about all of this is Dr. Craig Spencer. He's an emergency medicine physician and teaches public health policy at Brown University. Thanks for joining us.
CRAIG SPENCER: Thanks for having me.
DETROW: Let's start with this. What was your reaction to the news at the CDC this week?
SPENCER: Well, what we've heard over the last seven days has been chaos and confusion and uncertainty, but it really just heightens what we've been hearing over, really, the last six to seven months since this administration has come in. If you recall, just within days of the second Trump inauguration, the CDC was pulling down webpages, and it was replacing you know, long-trusted epidemiology with ideology. And so this is a continuous drip, drip, drip of what I see as really unfortunate and bad news, destabilizing not just for the CDC but for the health of the country.
And the red flags that were raised by the folks who quit the CDC over the past couple of days - some of the most dedicated and incredible professionals, some of whom I know and know the quality of their work - the flags that they raised, the things that they've been saying in interviews since then, should make us all concerned whether you're committed to MAHA, the Make America Healthy Again movement, whether you're MAGA, neither, both, don't care about political labels because this is going to have acute and long-term impacts on the health of all Americans.
DETROW: Give me one or two specifics that you're most worried about.
SPENCER: Well, the thing that I've been most worried about as someone that's worked a lot internationally in humanitarian crises responding to disease outbreaks is that over the past six months, we've torn apart the disease surveillance systems that the U.S. has helped set up for decades in places all around the world, to make sure that when the first cases of Ebola or Marburg or another concerning disease emerges, it's able to be quickly identified, responded to with the support of the local government, the local country. That has selfish implications as well because that means that we're able to prevent it before it spreads here.
DETROW: We have seen across a lot of different areas of federal government the suppression of research programs that go against the Trump administration's political agenda in the world of climate change, right?
SPENCER: Yeah.
DETROW: We have seen the firing of the head of the Bureau of Labor Statistics after an economic report that the president didn't like. Now we have seen the firing of the head of the CDC and many other top officials. Given all of that, I am wondering whether it comes to recommendations for shots this fall, whether it comes to other information, do you at this point, going forward, trust what the CDC recommends on these key issues?
SPENCER: Honestly, it's really, really hard. And it pains me to say this 'cause the CDC has been the preeminent agency to give us this information. But even hearing people like Demetre who - you know, Dr. Demetre who left the CDC a couple of days ago, who resigned - he's even saying that he doesn't think that you can trust the information or the recommendations coming out from the CDC. You had Bill Cassidy, who was really that swing vote to put RFK Jr. at the head of HHS, who said that if the ACIP, this Advisory Council on Immunization, goes ahead in a couple of weeks, that we shouldn't be able to - we're not going to be able to trust the recommendations that come from that. You have multiple states coming out trying to think about what the most recent guidance on COVID vaccines from the FDA and the increasing restrictions on availability for those for different populations, what that means for Americans.
And so right now, whether you're Democrats, Republicans, left, right, whatever it is, we have an agency where it's really hard to trust the recommendations that are coming out. We're hearing that senior staff are not able to brief RFK Jr. and that gold standard science, which he keeps preaching about, is actually just my way or the highway.
DETROW: Yeah.
SPENCER: And that is remarkably concerning as we go into another potentially bad RSV, COVID and flu season.
DETROW: I also want to get your response in the context of public health policy to the argument that we hear coming from that. This was the argument with Monarez's firing and other things. I'm the president of the United States. I ran on this policy. I was put into the White House. So if you disagree with me, I'm going to fire you.
SPENCER: I mean, this is incredibly concerning, right? There needs to be disagreements. We've heard from a lot of the folks that have senior leadership positions right now in this administration - Jay Bhattacharya at NIH, Marty Makary at the FDA, RFK Jr. himself, who said in his confirmation hearings, I want to hear different viewpoints. Like, that is what he projected his leadership to be. But that's not what's happening. We're seeing decisions that are being made unilaterally. And the result is that just because these guys had contrarian ideas during the pandemic doesn't mean that their dictates are exactly what we need right now. We get good policy by sitting down in a group, by talking about data, by thinking about areas where the data doesn't exist, where we can fill in expertise so that we can make policy recommendations. That does not appear to be what's happening right now, at least according to the people who walked off their job at the CDC this week.
DETROW: I want to bring this all back to the ground floor. You're an emergency medicine physician. This world that we are talking about, where you just can't quite trust what the CDC is saying, what does that look like in an emergency room come January, come February, at the peak of infectious disease season?
SPENCER: This looks really concerning, quite frankly. It looks like confusion for my patients that don't know what shots they should be getting, whether they can get them, whether they need a prescription. We're seeing right now that in over a dozen states, the COVID vaccine can only be obtained if you have a prescription from a physician. But as we've already said, a lot of folks don't even have physicians where they can get one. So does that mean they're going to come to me in the emergency room to get a prescription for a COVID vaccine, where they may be exposed to things like COVID?
I think it looks like more confusion around what vaccines kids may potentially be able to get. And there is, I think, in the short and the long term, the very worrying possibility that RFK Jr. is not necessarily going to take away all vaccines, but like they've done for COVID, make it a lot harder to get, make it more confusing to get, make it so that you have to jump through a lot more hoops to get COVID vaccines or to get routine vaccines. And that is what it looks like in the emergency rooms across the U.S., this country - more confusion, more chaos, more uncertainty and I think, unfortunately, a lot more sickness.
DETROW: Dr. Craig Spencer, thank you for talking us through all this.
SPENCER: Thank you.
DETROW: Secretary Kennedy is scheduled to be on Capitol Hill later this week facing questions from lawmakers for the first time since he fired the director of the CDC. Transcript provided by NPR, Copyright NPR.
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