Respect for smarts and science even as Trump nominates a dangerous quack to lead public health policy

I have a much smarter brother named Joe. He’s a scientist. In fact, he’s an expert on toxicology and risk assessment who has lectured about public health policy around the world. He wrote a book, called “Calculated Risks: The Toxicity and Human Health Risks of Chemicals in our Environment,” that has been widely used as a text. 

I’ve asked Joe a lot of questions over the years, sometimes as a journalist, but more often out of curiosity or personal concern. (“Joe, is Equal safe? What about Splenda?”) There are definite benefits to having a toxicologist in the family.

Recently, I asked about the U.S. Surgeon General’s warning that consumption of alcohol poses a risk of cancer. I got the kind of informed and measured response I’ve grown used to: “I have not reviewed the recent literature on alcohol and cancer(s), and can’t really say much about the risks of  low levels of intake,” he wrote in an email, careful, as always, to qualify his level of knowledge. “I can say that epidemiology studies that are being used to make claims about cancer risk are studies that rely on self-reporting of [consumption], and it’s fairly well-established that individuals tend to under-report their intakes. And it’s obvious why that is: We probably all do that with things that everyone knows are bad for us. … Unless recent studies have found a way to deal with the bias that underreporting introduces — underreporting intake will tend to inflate the health risk — I suspect that some of the low intake risk has been inflated in the risk assessment.

“High levels of alcohol intake can increase risk of several cancers, but I suspect the risk findings for low levels of intake  — let’s say one drink per day, maybe even two — are probably quite uncertain. Also, ethanol does not have the gene-damaging effects that are a property of most of the very dangerous chemical carcinogens.

“One thing seems pretty clear: Health benefits from alcohol consumption are, if they exist at all, pretty small. I have not, and will not, give up a drink a day. (By the way, the amount of alcohol in a standard cocktail, glass of wine and glass of beer is about 14 milliliters, the same for each source.)

“Maybe the Surgeon General’s report should emphasize truly dangerous levels of intake and try to scare people off those.”

Joe finished with a throw to a colleague, Harvey Clewell, a research scientist with similar expertise. He concurred with my brother’s perspective. “Regarding the epidemiological studies,” Clewell wrote, “uncertainty in exposure estimates is a major problem, because it tends to mask the true dose-response for effects in a population, resulting in a dose-response that appears more linear than it really is. This is true whether the relationship is between ethanol and cancer or salt intake and blood pressure. I generally recommend moderation rather than abstinence.”

I present all this for two reasons — to give you some informed views on what the Surgeon General had to say about alcohol, but, more importantly, to highlight the value of scientific knowledge to a civilized and healthy society.

The latter might seem obvious, but it needs to be said because, as we saw during the pandemic, there is abundant ignorance throughout the land, with many Americans, including elected leaders, scorn for science and the “inconvenient truths” about health risks.

The next presidency will attempt to infest the federal government with Trump stooges, right-wing extremists and quacks. Leading the pack on the quack side is Robert F. Kennedy Jr., a dangerous anti-vaxxer who Trump has nominated to be health secretary. That nomination is an insult to every man and woman who has served this nation in some form of public health. It celebrates fringe thinking and conspiracy theories over reputable science and sound policy. 

I don’t think that’s what Trump supporters voted for, but that’s what they’re going to get unless the Senate rejects RFK Jr. 

If not, there’s no telling what we could be in for.

Junior has at his side, helping with the selection of staff, an adviser who wants the Food and Drug Administration to withdraw or suspend approval of the polio vaccine. This adviser, attorney Aaron Siri, works full time at challenging government approval of vaccines that have saved countless lives.

Junior, while trying to soften his image by denying that he’s an anti-vaxxer, has a long record showing he’s exactly that. For one thing, he spread the thoroughly debunked claim that vaccines were to blame for autism. He also made misleading claims about a vaccine that can prevent certain types of cancer. And, as the Daily Beast reported this week, he’s profited handsomely from his crusade.

Trump and his handlers are in many ways trying to subvert our democracy, concentrate power in the Oval Office and perhaps establish an autocracy. That’s not Trump Derangement Syndrome speaking; that’s real concern based on an abundance of evidence and declarations of intent. The MAGA headed to Washington pose serious threats to individual rights and civil order. Trump appears determined to tear down or neutralize parts of the government that regulate industry or provide a check on executive power. 

That’s bad, but messing with public health policy and established science — from denigrating life-saving vaccinations to dismissing climate warnings — is even worse. The actions or inactions of people engaged in public health during the next four years could pose serious risks to Americans. At some point — I don’t know when or how it will be — this country needs to push the Big Reset Button to reject quackery and ignorance, fear-mongering and corruption while renewing respect for higher education and science, embracing empathy and voting for people with integrity.