Archives for category: Health

We know that Trump chose RFK Jr. to run the federal public health system as head of the Department of Health and Human Services. we know that Kennedy opposes vaccines. He has said that he would not ban vaccines outright but suggested that he might leave the decision about vaxxing to parents. We also know that senior Republican Mitch McConnell had polio as a child and does not like the idea of making the polio vaccine a matter of personal choice.

But we didn’t know much about what Trump believes or wants when it comes to vaccines.

Politico reports that he wants to keep vaccines, at least for adults. But he is doubtful about vaccine mandates for attending school. Public schools in every state require students to be vaccinated. If these mandates are reversed, we can expect to see a spread of the highly infectious diseases that were nearly eradicated.

Your child or grandchild might get measles or mumps or rubella or tetanus. These are deadly diseases.

This is a Politico report on a Trump press conference today:

Politico: •Vaccines: Trump said he’s a “big believer” in the polio vaccine, but he doesn’t like school mandates of vaccines (most states require vaccination from measles, mumps and rubella to attend public schools).

Here is the later, longer version.

If Kennedy, with Trump’s blessings, wipes out vaccination mandates for school attendance, deadly diseases will surge and children will die.

There’s online speculation that the Senate is warning to Robert F. Kennedy Jr., despite his reputation as an opponent of vaccines. RFK thinks he knows more than scientists and physicians, but he is a crank and a crackpot with no medical or scientific training.

He is well established in the world of phony cures for COVID.

If this kook is confirmed as Secretary of Health and Human Services, many people will die.

The New York Times reported that Robert F. Kennedy Jr.’s’s lawyer Aaron Siri has repeatedly sued to block vaccines and mandates. Siri is now advising Kennedy as he selects high-level personnel for the Department of Heslth and Human Services. Kennedy’s reliance on Siri demonstrates that his opposition to vaccines has not waned and will animate his actions should he be confirmed.

The story begins:

The lawyer helping Robert F. Kennedy Jr. pick federal health officials for the incoming Trump administration has petitioned the government to revoke its approval of the polio vaccine, which for decades has protected millions of people from a virus that can cause paralysis or death.

That campaign is just one front in the war that the lawyer, Aaron Siri, is waging against vaccines of all kinds.

Mr. Siri has also filed a petition seeking to pause the distribution of 13 other vaccines; challenged, and in some cases quashed, Covid vaccine mandates around the country; sued federal agencies for the disclosure of records related to vaccine approvals; and subjected prominent vaccine scientists to grueling videotaped depositions….

At the Trump transition headquarters in Florida, Mr. Siri has joined Mr. Kennedy in questioning and choosing candidates for top health positions, according to someone who observed the interactions but insisted on anonymity to disclose private conversations. They have asked candidates about their views of vaccines, the person said.

Are Kennedy and Siri determined to exclude those who understand the value of vaccines? No doubt.

“I love Aaron Siri,” Mr. Kennedy said in a clip played on a recent episode of a podcast hosted by Del Bigtree, who is Mr. Kennedy’s former campaign communications director and the founder of the Informed Consent Action Network, which describes itself as a “medical freedom” nonprofit. “There’s nobody who’s been a greater asset to the medical freedom movement than him.”

Like Mr. Kennedy, Mr. Siri insists he does not want to take vaccines away from anyone who wants them. “You want to get the vaccine — it’s America, a free country.” he told Arizona legislators last year after laying out his concerns about the vaccines for polio and other illnesses.

The Times notes that Siri has petitioned the Food and Drug Administration to withdraw approval of the polio vaccine as well as the vaccine for Hepatitis B.

Let me reiterate: Robert F. Kennedy Jr. is a dangerous crackpot. His beliefs kill.

In Houston, Lisa Gray of the Houston Chronicle interviewed Dr. Peter Hotez, a respected practitioner, about the Trump agenda for public health. This is part two of a two-part post.

Gray writes:

Recently, after outlining five terrifying infectious diseases and potential pandemics looming on the world horizon, vaccine researcher Peter Hotez said that he doesn’t believe that the incoming Trump administration is taking those threats seriously enough.

That alarmed me. I’ve been interviewing Hotez since early 2020, right after COVID infections showed up in the United States. As he’s the dean of the National School of Tropical Medicine at Baylor College of Medicine, he follows emerging disease threats closely. And with his team at Texas Children’s Hospital Center for Vaccine Development, he develops low-cost vaccines for low-income nations. During the pandemic, he became one of the most recognized medical experts on COVID — and a local hero here in Houston. 

Videographer Sharon Steinmann and I spoke with Hotez in his office at Baylor. This Q&A has been edited for length and clarity.

Q: Why are you worried that the incoming Trump administration may not be ready for public-health threats on Day 1? Is that based on the people Donald Trump has named to health positions?

A: 
I’m concerned that the Trump administration is picking individuals based on their ideologies rather than either their subject-matter expertise or their ability to get things done in government.

Q: You’ve been acquainted for years with RFK Jr. — Robert F. Kennedy, Jr., who Trump has nominated to be secretary of the U.S. Department of Health and Human Services. How did you meet him?

A: 
I used to call him “Bobby.” I got to know him because in 2017 he indicated that he was going to head a vaccine commission for the new incoming Trump administration.

I was in my office, here where we’re speaking now, and my assistant said, “Hey, Dr. Hotez, I have Dr. Anthony Fauci and Dr. Francis Collins on the phone. Can you talk to them?”

Q: Whoa! Those are two big names in your field.

A: 
[Grins.] I said, “Yeah, I guess I’ll take the call.”

They said, “Peter, we’ve got a job for you. If anyone can explain to Kennedy why vaccines don’t cause autism, it’s you.”

They asked because I was a scientist and a pediatrician, and most importantly, I’d written a book, “Vaccines Did Not Cause Rachel’s Autism,” explaining how I can be sure that my daughter’s autism is not linked to vaccines. 

Tim Shriver, a terrific guy who heads the Special Olympics, brokered a meeting for us with RFK Jr. And for months after that, I had a number of long, long phone conversations with Bobby. Sometimes that would be while my wife Ann and I were out for a long walk through Montrose, and she’d listen in.

Q: How did that go? 

A: 
Our conversations weren’t very productive. It was an exercise in frustration, probably for both of us. He was pretty dug in. Either he didn’t understand the science or he didn’t have a lot of interest in it.

For instance, I would point out to Bobby that autism is a neurodevelopmental condition that starts early in pregnancy. We know this from multiple neurodevelopmental studies. So autism is well in motion before kids ever even see their first vaccine.

In addition to that, the Broad Institute, at Harvard and the Massachusetts Institute of Technology, had also identified at least a hundred autism genes. Many of them are a type of gene called the neuronal cytoskeleton gene, which is involved in neuronal connections. (My wife Ann and I actually did a whole-genome sequencing on Rachel. We found that Rachel’s autism gene is different from the ones published by the Broad Institute, but it’s similar — it’s a neuronal cytoskeleton gene.)

Sergiu Pasca and his associates at Stanford University Medical School have also looked at what they call brain organoids. They can put neurons together in a petri dish and basically assemble them as mini-brains. This has been done now with neurons that have autism genes, and so the aberrant neuronal patterns really tell the complete story now.

It was frustrating to me that Bobby didn’t pay attention to the science and instead spouted dogma.

A: I got to know her during the COVID pandemic. She was a Fox News talking head, and I was going on Fox News pretty regularly in the evenings until I wouldn’t go along with the hydroxychloroquinine nonsense.

At the time, we talking heads on the various news channels would talk to each other. That was helpful because we were learning from each other. We all brought different expertise to the table.

Dr. Nesheiwat had a lot of humility. She wanted to know my opinion on COVID vaccines, how they worked and what were the different technologies. She was inquisitive and delightful to talk with. So I’m excited about her role as surgeon general. That’s at least one silver lining.

Q: Are there other silver linings?

A: Yeah. The other person that I got to know during the pandemic was Mehmet Oz, Dr. Oz, because he had a show with wide reach. I would go on his show and talk about COVID vaccines.

I liked being on his show. He was respectful and thoughtful. He asked good questions and gave me an opportunity to talk to daytime audiences — people I wouldn’t ordinarily reach. I was grateful for that opportunity.

I think that both Dr. Nesheiwat and Dr. Oz are effective communicators. I think President-elect Trump wants to bring on good communicators.

Dr. Oz is heading a very bureaucratic organization, the Centers for Medicare and Medicaid Services. I don’t think that’s a perfect fit for him — he’d have been better off as something like surgeon general — but we’ll see.

Lisa Gray is the op-ed editor and a member of the Houston Chronicle editorial board. During the pandemic, she was the Chronicle’s lead COVID reporter.

Lisa Gray, an editor at the Houston Chronicle, interviewed Dr. Peter Hotez, a vaccine scientist and specialist in infectious diseases, about the major public health challenges facing the incoming Trump administration. Dr. Hotez shares the story of his effort to persuade Robert F. Kennedy Jr. of the importance of vaccines. This post is the first of two.

Gray wrote:

During the COVID pandemic, Americans came to rely on bow-tied vaccine scientist Peter Hotez for calm, scientific assessments of the virus and the vaccines being developed to fight it. With his team at Texas Children’s Hospital Center for Vaccine Development, Hotez develops low-cost vaccines for low-income nations. He’s also the dean of the National School of Tropical Medicine at Baylor College of Medicine — and is arguably Houston’s most beloved doctor.

He still monitors the public-health landscape closely. To find out what public-health threats await the Donald Trump administration, Houston Chronicle videographer Sharon Steinmann and I interviewed him at his office at Baylor.

Our conversation has been edited for length and clarity.

Q: What are the public health challenges that the Trump administration will face on Day 1? Are you monitoring any major health threats?

A: We’ve got some big-ticket concerns regarding infectious disease and pandemic threats. The new administration is not going to have the luxury of time to organize and think about it. They’re going to be confronted with this from the very beginning.

One of the big threats I’m following is H5N1, an avian influenza. The virus is widespread now in migratory birds that fly from the north to the south.

It’s spilling over into domestic birds and poultry. We’re now seeing a big increase in infections of domestic birds and poultry in California and elsewhere in the western part of the United States, as well as across the northern part of the country. 

An H5N1 strain has also crossed over from birds into cattle. It’s gotten into our herds, including in Texas, as well as in the Great Plains and other parts of the United States.

I’m concerned that, eventually, this virus could spill over to people as well. We’re starting to see human cases. In the last few weeks, we’ve had six human cases. I think eventually H5N1 could become a major human public-health threat.

It’s not there yet. We’re not seeing human-to-human transmission yet. But monitoring it and being prepared for it has got to be a big priority for the new incoming administration. 

Q: Oof. Is that all that’s on the horizon?

A: Guess what? That’s just the beginning.

The other thing that’s happening is, we still have COVID with us. Our COVID-19 numbers are low again, but I expect them to rise. You can protect yourself from that, of course, by keeping your immunizations up to date. If you got a dose of the vaccine in September, like I did, you’ll be due again around January.

But here’s the thing: COVID-19 isn’t the only COVID threat. There are other coronaviruses.

Remember that the name for the virus that causes COVID is the SARS-2 coronavirus. There was a SARS-1, the Severe Acute Respiratory Syndrome that came out of southern China in 2002. We had Middle East Respiratory Syndrome, also caused by a coronavirus, in 2012. And of course, we had SARS-2 cause COVID, the largest pandemic of them all, starting in 2019.

We should expect SARS-3 to come in the next few years.

Q: Why are we seeing these new coronaviruses in people?

A: Because these viruses are widespread in bats. Across China and East Asia, they’re jumping regularly to people. In some cases that’s through intermediate animal hosts. In some cases it’s directly from bats to people.

By some estimates, these new SARS coronaviruses are jumping from bats to people on the order of 66,000 times a year. Every now and then, one catches fire and ignites a pandemic.

So that needs to occupy the attention of the Trump administration. What kind of surveillance are we doing for SARS-3, which is brewing as we speak among bats in Asia?

Q: That’s a lot to take care of.

A: That’s not all we have to worry about. A third big-ticket item is the fact that we’ve seen a significant uptick in the number of virus infections transmitted by mosquitoes or other biting arthropods. We all know about the West Nile virus. Last year was a pretty bad year for infections in the United States, including Texas. But that’s just the beginning.

With these mosquito-transmitted viruses, which we call arboviruses, we know what to expect in the U.S. because we usually see it first in Brazil. In the Western Hemisphere, Brazil is the arbovirus epicenter.  And right now, dengueOropouche, Zika and even yellow fever are all expanding in Brazil. They’re even extending beyond the Amazon rainforest, where we typically see them, because of climate change and possibly because of deforestation. 

And unfortunately, what starts in Brazil doesn’t stay in Brazil. It will eventually make its way to the Gulf Coast of the United States, including Texas.  So for next summer, I’m worried about dengue. I’m worried about Chikungunya, and even the possibility of yellow fever. I wrote about the possibility of a yellow fever outbreak in the New England Journal of Medicine; it would be catastrophic. The virus affects pregnant women and could be transmitted to the fetus, causing horrible birth defects. And besides yellow fever, Oropouche virus [pronounced “o-ro-push”] is going to be yet another big-ticket item. It’s spreading fast in Brazil. 

Q: So we’ve got four big-ticket concerns.

A: Wait, wait: We’re not done yet. Anti-vaccine activism accelerated during COVID; we’ve spoken about it many times. Now it’s spilling over to childhood immunizations. We’re seeing unprecedented levels of vaccine hesitancy and of parents refusing to have their kids vaccinated. So guess what?

From 2023 to 2024, we had a nearly sixfold increase in pertussis, or whooping cough, cases. We went from four measles outbreaks in 2023 to 16 in 2024. We’ve even seen polio in the wastewater of New York state.

I’m expecting a big rise in illnesses that are preventable with childhood vaccines.

Q: And the Trump administration has to be ready for all five of these major threats?

A: All of that is going to come crashing down on them. It’s going to be important that they take all those threats seriously.

It’s not just public health that could be affected. We’ve learned that pandemics have all sorts of other aspects. There’s an economic impact. There’s the impact on our security. And if we have a serious epidemic here in the U.S., it could block our travel from the U.S. to other countries.

I don’t have the sense that these big-ticket infectious disease threats are being taken with the seriousness that they need to be.

Q: Is that based on the people Donald Trump has named to health positions?

A: I’m concerned that the Trump administration is picking individuals based on their ideologies rather than either their subject-matter expertise or their ability to get things done in government.

Lisa Gray is the op-ed editor and a member of the Houston Chronicle editorial board. During the pandemic, she was the Chronicle’s lead COVID reporter.

President-elect Trump appointed a man who has actively sabotaged global health to be in charge of our nation’s public health system. Robert F. Kennedy Jr. is a dangerous quack, whose conspiracy theories put millions of lives at risk.

Why did Trump choose a man to lead HHS whose ideology subverts public health? Well, he promised RFK Jr. the job in exchange for his endorsement. Why does Trump fill key positions at HHS with others whose views or experience are derided by mainstream scientists? Clearly, he is being advised by RFK Jr., so he can surround himself with like-minded people.

The effect of these appointments on the career scientists and physicians at HHS will be devastating. There is sure to be a brain drain. Trump could cripple our nation’s public health system for years to come.

The New York Times reported:

Robert F. Kennedy Jr., who is in line to lead the Department of Health and Human Services in the next Trump administration, is well-known for promoting conspiracy theories and vaccine skepticism in the United States.

But Mr. Kennedy, an environmental lawyer, has also spent years working abroad to undermine policies that have been pillars of global health policy for a half-century, records show.

He has done this by lending his celebrity, and the name of his nonprofit group, Children’s Health Defense, to a network of overseas chapters that sow distrust in vaccine safety and spread misinformation far and wide.

He, his organizations and their officials have interfered with vaccination efforts, undermined sex education campaigns meant to stem the spread of AIDS in Africa, and railed against global organizations like the World Health Organization that are in charge of health initiatives.

Along the way, Mr. Kennedy has partnered with, financed or promoted fringe figures — people who claim that 5G cellphone towers cause cancer, that homosexuality and contraceptive education are part of a global conspiracy to reduce African fertility and that the World Health Organization is trying to steal countries’ sovereignty.

One of his group’s advisers, in Uganda, suggested using “supernatural insight” and a man she calls Prophet Elvis to guide policymaking. “We do well to embrace ethereal means to get ahead as a nation,” she wrote on a Ugandan news site this year.

These people, more than leading scientists and experienced public health professionals, have existed in Mr. Kennedy’s orbit for years. The ideas spread by him and his associates abroad highlight the unorthodox, sometimes conspiratorial nature of the world occupied by a man who stands to lead America’s health department, its 80,000 employees and its $1.8 trillion budget.

Please open the link to continue reading.

Politico posted an article today claiming that Robert F. Kennedy Jr. was gaining approval by focusing on his criticism of Big Pharma and Big Ag.

The article claims that RFK is a normal politician! He wants people to eat healthy foods!He is against ultra processed foods, even if you saw the photo of him eating a Big Mac on Trump’s plane.

Despite initial resistance, Bobby is winning people over:

Less than a month later, however, some of Kennedy’s other views — especially on food — are surprisingly taking root on Capitol Hill. There’s still considerable resistance to Kennedy — and no certainty that he gets confirmed by the Senate. But his attacks on Big Ag and Big Pharma are resonating and RFK is finding allies among some populists who share the goal of taking on big corporate interests.

Ignore the fact that he is opposed to vaccines. Ignore the fact that dozens of children died in Samoa after he brought news that (in his view) measles vaccines cause measles.

Ignore the fact that he recently claimed that heroin improved his school performance.

Shame on Politico.

Robert F. Kennedy Jr. should not run our nation’s healthcare system. Maybe a food safety program. But NOT the Department of Health and Human Services!

He is an extremist who opposes science.

Billionaire Michael Bloomberg has devoted a significant part of his wealth to medical research and public health. So it should not be surprising that he denounced CDC red

as the selection of Robert F. Kennedy Jr. as Secretary of the Department of Health and Human Services. HHS oversees all of the federal agencies concerned with medical research and public health.

Michael R. Bloomberg, the former New York City mayor, launched a lengthy broadside on Tuesday against Robert F. Kennedy Jr., using his opening remarks at a public health conference to warn that installing Mr. Kennedy as health secretary would be “beyond dangerous,” and tantamount to “medical malpractice on a mass scale.”

Mr. Bloomberg, speaking at the two-day Bloomberg American Health Summit in Washington, called on Senate Republicans to persuade President-elect Donald J. Trump to “rethink” his choice of Mr. Kennedy for health secretary. If Mr. Trump cannot be persuaded, he said, the Senate has “a duty to our whole country, but especially to our children,” to vote against confirming him.

Mr. Bloomberg also assailed Mr. Kennedy for discouraging measles vaccination during an outbreak in the island nation of Samoa, where 83 people died.

“Parents who have been swayed by vaccine skepticism love their children and want to protect them, and we need leaders who will help them do that,” he said, “not conspiracy theorists who will scare them into decisions that will put their children at risk of disease….”

Among other things, Mr. Bloomberg chided Mr. Kennedy for “nutty conspiracy theories,” including making the “outrageous false claim” that the Covid-19 shot was the “deadliest vaccine ever made.” He said Mr. Trump deserved credit for Operation Warp Speed, the fast-track initiative that produced coronavirus vaccines in record time, noting that studies have shown that the vaccines have saved an estimated 20 million lives around the world.

Robert F. Kennedy Jr. is a nonconformist. Also an oddball and a crackpot. He has fought against vaccines for years. Donald Trump chose him to oversee the federal department of Health and Human Services. There he will have the power to stop research on vaccines, to ban vaccines–to use his power to kills hundreds of thousands of people, mainly children and the elderly.

He was a heroin addict for many years. Watch the video from a few months ago where he explained how heroin improved his academic performance.

The Senate should not put this man in charge of the nation’s health.

Timothy Snyder is an expert on European history and on tyranny (the title of one of his books is On Tyranny). He writes here about the creeping authoritarianism of the coming Trump regime.

Snyder writes:

We should be wary of shock, which excuses inaction. Who could have known? What could I have done? If there is a plan, shock is part of the plan. We have to get through the surprise and the shock to see the design and the risk. We don’t have much time. Nor is outrage the point.

Of course we are outraged. But our own reactions can distract is from the larger pattern.
The newspapers address the surprise and the shock by investigating each proposed appointment individually. And we need this. With detail comes leverage and power. But clarity must also come, and quickly. Each appointment is part of a larger picture. Taken together, Trump’s candidates constitute an attempt to wreck the American government.

In historical context we can see this. There is a history of the modern democratic state. There is also a history of engineered regime change and deliberate state destruction. In both histories, five key zones are health, law, administration, defense, and intelligence. These people, with power over these areas of life, can make America impossible to sustain.

The foundation of the modern democratic state is a healthy, long-lived population. We lived longer in the twentieth century because of hygiene and vaccinations, pioneered by scientists and physicians and then institutionalized by governments. We treat one another better when we know we have longer lives to lose. Health is not only the central human good; it enables the peaceful interactions we associate with the rule of law and democracy. Robert F. Kennedy, Jr., the proposed secretary of the Department of Health and Human Services, would undo all of this. On his watch, were his ideas implemented, millions of us would die. Knowing that our lives will be shorter, we become nasty and brutish.

A modern democratic state depends upon the rule of law. Before anything else is possible, we have to endorse the principle that we are all governed by law, and that our institutions are grounded in law. This enables a functional government of a specific sort, in which leaders can be regularly replaced by elections. It allows us to live as free individuals, within a set of rules that we can alter together. The rule of law depends on people who believe in the spirit of law. Matt Gaetz, Trump’s first proposed attorney general, is the opposite of such a person. It is not just that he flouts law himself, spectacularly and disgustingly. It is that he embodies lawlessness, and can be counted upon to abuse law to pursue Trump’s political opponents. The end of the rule of law is an essential component of a regime change. He has been replaced by Pam Bondi, who will evade the sex-crime allegations that seem to have brought Gaetz down. But Bondi is someone who dropped an investigation against Trump when he made an illegal donation to one of her foundations. She also led “lock her up” chants against Hillary Clinton, who had committed no crime. And she participated in a central injustice of contemporary American history, Donald Trump’s Big Lie that he won the election of 2020. She can be expected to lead prosecutions based upon alternative reality.

In a class by himself is Kash Patel, whom Trump would like to see as director of the FBI. This, of course, requires Trump to fire Christopher Wray, whom he himself appointed, and who has three years left to serve. Firing Wray for no reason would be unprecedented and would itself have been an outrage in a more sane time. Giving Patel authority over the national police force is nothing less than a promise of authoritarian rule.

Patel is a narcissitic zealot with zero qualification for such a post, as even hard-right Trump insiders such as Bill Barr have said (“over my dead body” were his words when Trump proposed Patel for a lesser position of authority in 2020). Patel got Trump’s attention for his efforts to denounce the entirely correct proposition that Trump was supported by Russia in 2016. Patel was then one of the most active and outspoken participants in Trump’s coup attempt of 2020-2021. Patel has since become a pitchman for a clothing line as well as pills that, he claims, will detox your body from the harmful effects of vaccinations. Patel said both that he would shut down the FBI and that he would use it to prosecute journalists and people who deny the untrue conspiracy theories in which he believes, and to prosecute people who say true things, such as that Russia supports Donald Trump when he runs for office. Russian trolls have been, understandably, very excited in their support of Patel.

A pattern is emerging: the federal government is to be used only as an instrument of revenge, which means that the law will be subverted as such. Laws that were passed to improve the lives of citizens, meanwhile, will simply not be implemented.

The United States of America exists not only because laws are passed, but because we can expect that these laws will be implemented by civil servants. We might find bureaucracy annoying; its absence, though, is deadly. We cannot take the pollution out of the air ourselves, or build the highways ourselves, or write our Social Security checks ourselves. Without a civil service, the law becomes mere paper, and all that works is the personal connection to the government, which the oligarchs will have, and which the rest of us will not. This is the engineered helplessness promised by Elon Musk and Vivek Ramaswamy, who are to head a black hole named after a cryptocurrency. There are already oversight instruments in government. DOGE is something entirely different: an agency of destruction, run by people who believe that government should exist for the wealthy or not at all.

The understandable jokes are that DOGE just adds unelected bureaucrats when it is supposed to replace them, and that DOGE is itself a model of inefficiency, since it has two incompetent directors. But the humor distracts from the basic truth: DOGE is there to make the government fail, and then to divide the profitable bits among regime-proximate oligarchs.

DOGE = Den of Oligarchs Gets Everything.

In a modern democratic state, the armed forces are meant to preserve a healthy, long-lived people from external threats. This principal has been much abused in American practice. But never before Donald Trump have we had a president who has presented the purpose of the armed forces as the oppression of Americans. Trump says that Russia and China are less of a threat than “internal enemies.” In American tradition, members of the armed forces swear an oath to the Constitution. Trump has indicated that he would prefer “Hitler’s generals,” which means a personal oath to himself. Pete Hegseth, Trump’s proposed secretary of defense, defends war criminals and displays tattoos associated with white nationalism and Christian nationalism. He is a fundraiser and television personality, with a complicated sexual past and zero experience running an organization. Like Trump, he has no coherent account of how foreign powers might threaten America; if anything, he praises them for sharing his misogyny. His own obsessions with gender lead him to believe that American high officers should be politically purged — a proposition that America’s actual enemies would of course welcome. Hegseth makes perfect sense as the person who would direct American armed forces against American citizens.

In a world of hostile powers, an intelligence service is indispensable. Intelligence can be abused, and certainly has been abused. Yet it is necessary to consider military threats: consider the Biden administration’s correct call the Russia was about to invade Ukraine. It is also necessary to counter the attempts by foreign intelligence agencies, which are constant, to harm American society. This often involves disinformation. Tulsi Gabbard, insofar as she is known at all, is known as a spreader of Syrian and Russian disinformation. She visited Syria, where her remarks could only be understood as an endorsement of the atrocities of Assad. She suggested to burn victims that they had not suffered because of Assad and his ally Russia, which was in fact the case. Gabbard has no relevant experience. Were she to become director of national intelligence, as Trump proposes, we would lose the trust of our allies, and lose contact with much of what is happening in the world — just for starters. We would be vulnerable to all of those who wish to cause us harm. Unsurprisingly, Gabbard is regarded in Russia as “girlfriend,” “superwoman” and a “Putin’s agent.”

In the Soviet theory of regime change, one crucial aspect was control of the power ministries: those associated with defense, the police, and intelligence. Patel, Gabbard, and Hegseth are such shocking suggestions as custodians of American power and law that it is easy to overlook Kristi Noem as Trump’s proposed director of Homeland Security. Noem is regarded positively in Trump’s circles because of a publicity stunt in which she, as governor of South Dakota, effectively privatized her states’s National Guard by accepting a big private donation to send a few of its members to the border with Mexico. The border is, of course, a serious matter, Noem’s combination of spectacle, privatization, and incompetence is more than concerning.

Imagine that you are a foreign leader who wishes to destroy the United States. How could you do so? The easiest way would be to get Americans to do the work themselves, to somehow induce Americans to undo their own health, law, administration, defense, and intelligence. From this perspective, Trump’s proposed appointments — Kennedy, Jr.; Bondi; Musk; Ramaswamy; Hegseth; Gabbard; Noem — are perfect instruments. They combine narcissism, incompetence, corruption, sexual incontinence, personal vulnerability, dangerous convictions, and foreign influence as no group before them has done. These proposed appointments look like a decapitation strike: destroying the American government from the top, leaving the body politic to rot, and the rest of us to suffer.

I do not defend the status quo. I have no doubt whatsoever that the Department of Defense and the Food and Drug Administration require reform. But such a reform, of these or other agencies, would have to be guided by people with knowledge and experience, who cared about their country, and who had a vision of improvement. That is simply not what is happening here. We are confronted instead with a group of people who, were they to hold the positions they have been assigned, could bring an end to the United States of America.

It is a mistake to think of these people as flawed. It is not they will do a bad job in their assigned posts. It is that they will do a good job using those assigned posts to destroy our country.

However and by whomever this was organized, the intention of these appointments is clear: to create American horror. Elected officials should see this for what it is. Senators, regardless of party, should understand that the United States Senate will not outlast the United States, insist on voting, and vote accordingly. The Supreme Court of the United States will likely be called upon. Although it is a faint hope, one must venture it anyway: that its justices will understand that the Constitution was not in fact written as the cover story for state destruction. The Supreme Court will also not outlast the United States.

And citizens, regardless of how they voted, need now to check their attitudes. This is no longer a post-electoral moment. It is a pre-catastrophic moment. Trump voters are caught in the notion that Trump must be doing the right thing if Harris voters are upset. But Harris voters are upset now because they love their country. And Harris voters will have to get past the idea that Trump voters should reap what they have sown. Yes, some of them did vote to burn it all down. But if it all burns down, we burn too. It is not easy to speak right now; but if some Republicans wish to, please listen

Both inside and outside Congress, there will have to be simple defiance, joined with a rhetoric of a better America. And, at moments at least, there will also have to be alliances among Americans who, though they differ on other matters, would like to see their country endure.