Last week, a measles outbreak claimed the life of a person in New Mexico. Late last month an unvaccinated child died in Texas in a separate measles outbreak. The deaths come as the U.S. public health programs and agencies are rocked by the appointment of Robert F. Kennedy Jr., a well-known vaccine skeptic, as the new secretary of health and human services.
It also comes at the five-year anniversary of the beginning of the COVID pandemic. Dr. Mike Osterholm, one of the country’s top health experts, spoke to The Advocate recently about the anniversary and his concerns about U.S. public health.
During the height of the pandemic, then-President Joe Biden appointed Osterholm to his COVID advisory committee because of his expertise in pandemic preparedness, disease outbreak investigations, and public health practice. Osterholm is Regents Professor, McKnight Presidential Endowed Chair in Public Health and the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, where he's taught for almost 50 years.
Osterholm has been vocal about the potential negative impacts of Kennedy’s appointment on both national and global health.
“One of the immediate actions taken under Secretary Kennedy's leadership was the suspension of critical vaccine advisory meetings,” Osterholm said. “The Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention, which is responsible for recommending vaccine protocols, and a similar committee advising the Food and Drug Administration on flu vaccines, have both had their sessions canceled.”
Osterholm expressed deep concern over these cancellations. "I don't see any reason why we would need to have a total pause in the sharing of information," he pointed out. “Such disruptions could jeopardize the ability of agencies like the CDC and FDA to respond to emerging public health crises.”
He also pointed to the CDC's delayed response to the measles outbreak in Texas, attributing it to the necessity of clearing communications through the Department of Health and Human Services. “Effective public health relies heavily on good communication; without it, challenges become more pronounced, as evidenced during the COVID-19 pandemic,” he explained. “Effective communication enhances the likelihood of successfully addressing public health emergencies and bringing them to a resolution.”
The importance of maintaining robust communication as well as vaccination programs is being underscored by the measles outbreaks. In Texas, that outbreak has resulted in over 130 cases. The death in the state is the first U.S. measles fatality in about a decade.
During a recent Cabinet meeting, Kennedy downplayed the severity of the outbreak, suggesting that measles occurrences are routine and misstating hospitalization protocols.
“What he said was not true,” Osterholm said. “He had a number of misstatements...He also said that the children that were hospitalized were being quarantined. Quarantine is something we use to basically take people who might be infectious and capable of transmitting and in a sense isolating them from doing that. That is not true. These children are all hospitalized because they're severely ill.”
In the last week, Kennedy, who first seemed to tout fish oil instead of vaccines, has taken to Fox News to recommend the measles vaccine.
On top of all this, Osterholm characterized the administration's approach to governing as being led by a "wildly swinging machete" rather than a "finely precisioned surgical tool," suggesting that necessary changes should be implemented thoughtfully and strategically. “While it's essential to assess workforce productivity and make necessary adjustments, such actions should be executed with precision, akin to using a surgical instrument, rather than through broad and hasty measures, because some of our finest doctors and researchers as well as grants might be part of that machete cut.”
He further criticized the abrupt withdrawal of support for numerous global health programs aimed at combating diseases and promoting healthy lives for children. “I compare it to suddenly denying a patient a lifesaving drug without warning because these moves by the administration will have immediate and severe consequences,” he said.
He predicted that these decisions could lead to a crisis, especially with anticipated major cuts to federal health agencies like the CDC, FDA, and National Institutes of Health.
Addressing the potential cuts in funding for programs targeting diseases like AIDS and malaria, Osterholm asserted that these diseases "don't know borders, but they love chaos." He explained that reduced attention and resources can enhance the transmission of these diseases, leading to a "double whammy" where the elimination of international borders for transmission is compounded by increased spread due to diverted focus.
“The damage inflicted by such neglect may be immediate but will have long-term implications, making recovery challenging,” he noted.
Regarding the bird flu problem, Osterholm emphasized that it requires a long-term solution, particularly the development of reliable, durable, and safe vaccines. He criticized the current minimal investment in vaccine research and development for both flu and coronaviruses. “It’s a major mistake that will incur a significant price in the future,” he said. “Having more effective vaccines readily available and ensuring public willingness to receive them are crucial steps in mitigating the impact of future pandemics.”
The convergence of leadership that undermines vaccine efficacy, coupled with policies that disrupt both domestic and global health initiatives, presents a precarious future for public health, setting up a perfect storm, he said.
"Everything that I could define as a disrupter is what's happening in terms of public health in this country,” he cautioned. “The proof is in the pudding of what's happening right now. When people used to ask me how concerned I was about public health, I always said I sleep with one eye open, and lately I feel like I've been sleeping with three eyes open."
