dismantling

It’s not my habit to preface my columns with “trigger alerts,” so this is a first:

If talking about circumcision makes you cringe, feel free to move along.

If, on the other hand, you wish to understand what Robert F. Kennedy Jr. was talking about during a White House meeting Oct. 9 when he tried to connect circumcision with autism, follow along with me.

The offhand reference to circumcision’s possible role in autism by Kennedy, Trump’s secretary of Health and Human Services, is part and parcel of Kennedy’s documented assault on science-based medicine.

His campaign encompasses attacks on COVID-19 vaccines, which have been shown over the years to have saved millions of people from death, hospitalization or long-term disability; his firing members of professional advisory boards at his agency and replacing them with anti-vaccine activists; his promotion of unproven “cures” for vaccine-preventable diseases; and his inaction in the face of a nationwide surge in cases of measles, a disease that was declared eliminated in the U.S. in 2000.

Let’s pause for a few words about the broader consequences of the erosion of our public health infrastructure. It not only exposes Americans to more disease and more serious disease, but has profound economic effects.

That’s true worldwide, but especially in the U.S., which spends much more per capita on healthcare than other developed countries, for lower results. Undermining the existing system for partisan ends won’t make the picture look any lovelier.

“The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations,” according to a 2021 paper from the Department of Health and Human Services, the agency that Kennedy now leads.

“U.S. employers depend on a healthy workforce to maximize productivity and minimize healthcare costs,” the paper stated. “Population health also affects the consumer market, whereby the demand for nonessential products and services suffers when families are struggling with illnesses and much of their disposable income is required for medical expenses.”

The chaos imposed on our public health system under the Trump administration only intensifies the damage.

On Friday, hundreds of employees at Kennedy’s agency, including the Centers for Disease Control and Prevention, abruptly received layoff notices. Some were hastily informed that their firings were erroneous, but the experience rattled the CDC, an agency tasked with overseeing the national response to seasonal respiratory illnesses at a time when those illnesses typically spike.

“The damage is beyond repair,” Demetre Daskalakis, who resigned as director of the National Center for Immunization and Respiratory Diseases, a unit of the National Institutes of Health, over conflicts with Kennedy, told CNN. “Crippling CDC, even as a ploy to create political pressure to end the government shutdown, means America is even less prepared for outbreaks and infectious disease security threats.”

That brings us back to Kennedy’s preoccupation with autism. He has claimed that the autism rate is on the rise due to “environmental toxins” such as childhood vaccinations and the use of Tylenol — or acetaminophen, its generic name — by mothers during pregnancy.

As I’ve reported, however, the roots of the increase in reported autism rates in recent decades are well understood: They have much to do with a broader definition of autism, which is widely described today as “autism spectrum disorder,” and with improved access to screening and diagnostic services by formerly overlooked groups such as Blacks, Hispanics and other nonwhite cohorts.

Kennedy’s comment about circumcision came during a White House Cabinet meeting. At first, he and Trump traded misconceptions they had previously aired about Tylenol use by pregnant women — Trump asserting that “obviously,” the rise in autism rates is “artificially induced” and adding, “I would say don’t take Tylenol if you’re pregnant, and … when the baby is born don’t give it Tylenol.”

That advice dismayed physicians, who say that fevers during pregnancy are a greater risk for the unborn and that acetaminophen is safer than alternative fever-reducing medicines.

Kennedy then injected circumcision into the discussion. “There’s two studies that show children who were circumcised early have double the rate of autism,” he said. “It’s highly likely because they were given Tylenol.”

Unsurprisingly, Kennedy’s remark got extensive play in the news media, prompting him to try walking it back via a tweet on X. Rather than accept responsibility for his confusing words, he responded with Bondi-esque truculence, writing: “As usual, the mainstream media attacks me for something I didn’t say in order to distract from the truth of what I did say.”

He even took arms against the Murdoch-owned New York Post, which posted its story with the headline, “RFK Jr. says Tylenol after circumcisions linked to autism,” and proceeded to debunk the claim.

In trying to clarify his point, however, Kennedy dug himself a deeper hole. According to his tweet, the two studies he was referring to at the cabinet meeting were a Danish study from 2015 and a non-peer-reviewed preprint posted online in August, which refers to the Danish paper. Kennedy mischaracterizes both.

Contrary to Kennedy’s implication, the Danish study did not address the use of acetaminophen (called “paracetamol” in the paper) in connection with circumcision. The reason, its authors wrote, was that “we had no data available on analgesics or possible local anesthetics used during ritual circumcisions in our cohort, so we were unable to address the paracetamol hypothesis directly.”

They did note, however, that the acetaminophen theory had only “limited empirical support.” In other words, evidence was lacking. Anyway, the Danish study was criticized — in the same journal that had published it — for its reliance on a very small sample of children.

As for the preprint, contrary to Kennedy’s description, it did not identify the Danish paper as offering “the most compelling ‘standalone’ evidence” for an autism-acetaminophen link. That language referred to three studies, one of which was the Danish paper. Of the other papers, one was based on later interviews with parents. The other was a study of the effects of acetaminophen on 10-day-old mice, not human children.

I asked Kennedy’s agency to clarify his claim and to explain the discrepancies between his words and the papers themselves, but received no reply.

To summarize, Robert F. Kennedy Jr., the nation’s top federal healthcare official, conjured up a connection between circumcision and autism via a relationship between circumcision and Tylenol that is unsupported by the research he cited. Indeed, the Danish paper describes the idea that boys undergoing circumcision invariably are given acetaminophen for pain as “a questionable assumption.”

In searching for empirical support for the acetaminophen theory, moreover, the Danish paper cited a 2010 paper funded by NIH that cautioned: “No evidence is presented here that acetaminophen in any way causes autism. … This hypothesis is largely based on multiple lines of often weak evidence.” Anyway, the paper was focused on a possible link between acetaminophen use and asthma, not autism.

Sadly, this sort of mischaracterization of research described as “a rigorous scientific framework” (RFK Jr.’s words) isn’t surprising coming from today’s Department of Health and Human Services. This is the agency, it may be recalled, that in May issued an “assessment” of the health of America’s children that cited at least seven sources that did not exist.

Nothing can stop unwary parents from relying on the judgment of Donald Trump or Robert F. Kennedy Jr. to make healthcare decisions for their infants and children. But they should be warned: They do so at their own and their offsprings’ risk.

When it comes to vaccines, virtually nothing that comes out of Robert F. Kennedy Jr.’s mouth is true.

The man in charge of the nation’s health and well being is impervious to science, expertise and knowledge. His brand of arrogance is not just dangerous, it is lethal. Undermining trust in vaccines, he will have the blood of children around the world on his hands.

Scratch that.

He already does, as he presides over the second largest measles outbreak in this country since the disease was declared “eliminated” a quarter century ago.

“Vaccines have become a divisive issue in American politics,” Kennedy wrote the other day in a Wall Street Journal essay, “but there is one thing all parties can agree on: The U.S. faces a crisis of public trust.”

The lack of self-awareness would be funny if it weren’t so tragic.

Over the past two decades or so, Kennedy has done more than almost any other American to destroy the public’s trust in vaccines and science. And now he’s bemoaning the very thing he has helped cause.

Earlier this month, Kennedy fired the 17 medical and public health experts of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices — qualified doctors and public health experts — and replaced them with a group of (mostly) anti-vaxxers in order to pursue his relentless, ascientific crusade.

On Thursday, at its first meeting, his newly reconstituted council voted to ban the preservative thimerosal from the few remaining vaccines that contain it, despite many studies showing that thimerosal is safe. On that point, even the Food and Drug Administration website is blunt: “A robust body of peer-reviewed scientific studies conducted in the U.S. and other countries support the safety of thimerosal-containing vaccines.”

“If you searched the world wide, you could not find a less suitable person to be leading healthcare efforts in the United States or the world,” psychiatrist Allen Frances told NPR on Thursday. Frances, who chaired the task force that changed how the Diagnostic and Statistical Manual of Mental Disorders, or DSM, defines autism, published an essay in the New York Times on Monday explaining why the incidence of autism has increased but is neither an epidemic nor related to vaccines.

“The rapid rise in autism cases is not because of vaccines or environmental toxins,” Frances wrote, “but is rather the result of changes in the way that autism is defined and assessed — changes that I helped put into place.”

But Kennedy is not one to let the facts stand in the way of his cockamamie theories. Manufacturers long ago removed thimerosal from childhood vaccines because of unfounded fears it contained mercury that could accumulate in the brain and unfounded fears about a relationship between mercury and autism.

That did not stop one of Kennedy’s new council members, Lyn Redwood, who once led Children’s Health Defense, the anti-vaccine group founded by Kennedy, from declaring a victory for children.

“Removing a known neurotoxin from being injected into our most vulnerable population is a good place to start with making America healthy again,” Redwood told the committee.

Autism rates, by the way, have continued to climb despite the thimerosal ban. But fear not, gullible Americans, Kennedy has promised to pinpoint a cause for the complex condition by September!

Like his boss, Kennedy just makes stuff up.

On Wednesday, he halted a $1-billion American commitment to Gavi, an organization that provides vaccines to millions of children around the world, wrongly accusing the group of failing to investigate adverse reactions to the diptheria vaccine.

“This is utterly disastrous for children around the world and for public health,” Atul Gawande, a surgeon who worked in the Biden administration, told the New York Times.

Unilaterally, and contrary to the evidence, Kennedy decided to abandon the CDC recommendation that healthy pregnant women receive COVID vaccines. But an unvaccinated pregnant woman’s COVID infection can lead to serious health problems for her newborn. In fact, a study last year found that babies born to such mothers had “unusually high rates” of respiratory distress at or just after birth. According to the CDC, nearly 90% of babies who were hospitalized for COVID-19 had unvaccinated mothers. Also, vaccinated moms can pass protective antibodies to their fetuses, who will not be able to get a COVID shot until they are 6 months old.

What else? Oh yes: Kennedy once told podcaster Joe Rogan that the 1918 Spanish flu epidemic was “vaccine-induced flu” even though no flu vaccine existed at the time.

He also told Rogan that a 2003 study by physician scientist Michael Pichichero, an expert on the use of thimerosal in vaccines, involved feeding babies 6 months old and younger mercury-contaminated tuna sandwiches, and that 64 days later, the mercury was still in their system. “Who would do that?” Kennedy demanded.

Well, no one.

In the study, 40 babies were injected with vaccines containing thimerosal, while a control group of 21 babies got shots that did not contain the preservative. None was fed tuna. Ethylmercury, the form of mercury in thimerosal, the researchers concluded, “seems to be eliminated from blood rapidly via the stools.” (BTW, the mercury found in fish is methylmercury, a different chemical, which can damage the brain and nervous system. In a 2012 deposition for his divorce, which was revealed last year, Kennedy said he suffered memory loss and brain fog from mercury poisoning caused by eating too much tuna fish. He also revealed he has a dead worm in his brain.)

Kennedy’s tuna sandwich anecdote on Rogan’s podcast was “a ChatGPT-level of hallucination,” said Morgan McSweeney, a.k.a. “Dr. Noc,” a scientist with a doctorate in pharmaceutical sciences, focusing on immunology and antibodies. McSweeney debunks the idiotic medical claims of non-scientists like Kennedy in his popular social media videos.

Speaking of AI hallucinations, on Tuesday, at a congressional committee hearing, Kennedy was questioned about inaccuracies, misinformation and made up research and citations for nonexistent studies in the first report from his Make America Healthy Again Commission.

The report focused on how American children are being harmed by their poor diets, exposure to environmental toxins and, predictably, over-vaccination. It was immediately savaged by experts. “This is not an evidence-based report, and for all practical purposes, it should be junked at this point,” Georges C. Benjamin, executive director of the American Public Health Assn. told the Washington Post.

If Kennedy was sincere about improving the health of American children he would focus on combating real scourges like gun violence, drug overdoses, depression, poverty and lack of access to preventive healthcare. He would be fighting the proposed cuts to Medicaid tooth and nail.

Do you suppose he even knows that over the past 50 years, the lives of an estimated 154 million children have been saved by vaccines?

Or that he cares?

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@rabcarian

Reporting from Washington — President Trump stepped up his attack on federal environmental protections Tuesday, issuing an order directing his administration to begin the long process of rolling back sweeping clean water rules that were enacted by his predecessor.

The order directing the Environmental Protection Agency to set about dismantling the Waters of the United States rule takes aim at one of President Obama’s signature environmental legacies, a far-reaching anti-pollution effort that expanded the authority of regulators over the nation’s waterways and wetlands.

The contentious rule had been fought for years by farmers, ranchers, real estate developers and others, who complained it invited heavy-handed bureaucrats to burden their businesses with onerous restrictions and fines for minor violations.

Obama’s EPA argued that such claims were exaggerated and misrepresented the realities of the enforcement process of a rule that promised to create substantially cleaner waterways, and with them healthier habitats for threatened species of wildlife.

The directive to undo the clean water initiative is expected to be closely followed by another aimed at unraveling the Obama administration’s ambitious plan to fight climate change by curbing power plant emissions.

“It is such a horrible, horrible rule,” Trump said as he signed the directive Tuesday aimed at the water rules. “It has such a nice name, but everything about it is bad.” He declared the rule, championed by environmental groups to give the EPA broad authority over nearly two-thirds of the waterways in the nation, “one of the worst examples of federal regulation” and “a massive power grab.”

While the executive orders are a clear sign of the new administration’s distaste for some of the highest profile federal environmental rules, they also reflect the challenge it faces in erasing them. Both the climate and the clean water rules were enacted only after a long and tedious process of public hearings, scientific analysis and bureaucratic review. That entire process must be revisited before they can be weakened. It could take years.

And environmental groups will be mobilized to fight every step of the way. “These wetland protections help ensure that over 100 million Americans have access to clean and safe drinking water,” California billionaire climate activist Tom Steyer said in a statement. “Access to safe drinking water is a human right, and Trump’s order is a direct violation of this right.”

The executive orders are compounded by the administration’s release of a budget blueprint that includes deep cuts at the EPA. Even if the process of changing the environmental rules is slow, the Trump administration will aim to hasten their demise by hollowing out the agencies charged with enforcing them.

At the same time, it is working with Congress to immediately kill some environmental protections under an obscure authority that applies to regulations enacted within the final months of the previous administration. A rule intended to limit water pollution from coal mining has already been killed by Congress, which is now weighing whether to jettison rules that force gas drilling operations on federal land to capture more of the toxic methane they emit.

Trump vowed Tuesday that he would continue to undermine the Obama-era environmental protections wherever he sees the opportunity, arguing they have cost jobs. “So many jobs we have delayed for so many years,” Trump said. “It is unfair to everybody.”

Many industries take issue with that interpretation. Tuesday’s order, for example, was met with a swift rebuke from sport fishing and hunting groups. They said the clean water rule has been a boon to the economy, sustaining hundreds of thousands of jobs in their industry.

“Sports men and women will do everything within their power to compel the administration to change course and to use the Clean Water Act to improve, not worsen, the nation’s waterways,” a statement from a half-dozen of the organizations said.

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June 6 (UPI) — Federal officials on Friday filed an application with the U.S. Supreme Court, asking it to remove a lower court judge’s ruling currently prohibiting further dismantling of the Department of Education.

President Donald Trump and Education Secretary Linda McMahon are listed as the applicants on court documents.

The Trump administration is attempting to remove a temporary order instituted last month by U.S. District Court Judge Myong Joun in Massachusetts that forces the federal government to re-hire almost 1,400 fired employees and prohibits further layoffs.

Solicitor General D. John Sauer also asked the Supreme Court to stay Joun’s order while it considers the application, which would allow the administration to move forward with its plans to further dismantle the department.

Joun last month ruled the department, which was created in 1979, “must be able to carry out its functions and its obligations under the [Department of Education Organization Act] and other relevant statutes as mandated by Congress.”

A spokesperson for the Department of Education said at the time the federal government would immediately challenge the order “on an emergency basis.”

“The Constitution vests the Executive Branch, not district courts, with the authority to make judgments about how many employees are needed to carry out an agency’s statutory functions, and whom they should be,” Sauer, who filed the application on behalf of Trump and McMahon, wrote.

“For the second time in three months, the same district court has thwarted the Executive Branch’s authority to manage the Department of Education despite lacking jurisdiction to second-guess the Executive’s internal management decisions. This Court curtailed that overreach when the district court attempted to prevent the Department from terminating discretionary grants.”

In mid-March, McMahon confirmed nearly half of her department’s staff would be placed on leave as part of Trump’s plan to eliminate the agency, part of a larger push to cut federal spending.