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In this episode, we speak with epidemiologist Caitlin Rivers about her book Crisis Averted. From the successful eradication of smallpox to navigating the COVID-19 pandemic, Rivers delves into public health challenges, funding gaps, and the “panic and neglect” cycle that threatens our preparedness for future outbreaks.
Host’s Note
We are less than a week away from the most consequential election in US history. A lot is at stake, including the fate of basic freedoms and democratic rights. But one huge matter life and death matter has gone largely ignored: the fate of our public health system.
Everything from access to clean water, life-saving vaccines, reproductive and maternal health, and so much more, is on the ballot — but few voters know that. That’s because public health — the infrastructure that keeps us safe and healthy — is the invisible half of our health care system. We only think about it when we are in danger, like during a pandemic, not when we are well.
The choices made for President and Congress in this election will determine whether we can meet challenges by strengthening our public health system — or whether we will fail because that public health system has been utterly dismantled.
The American Public Health Association has published a terrifying description of what would happen if Donald Trump is able to put Project 2025 into action — It was created by the most extreme members of his previous administration and widely considered to be the plans for his next, whatever he may deny. The report says, “while Project 2025 is aimed at the executive branch and intended as guidance for the next administration, many members of the U.S. House and Senate and those in state government support many of the policies proposed in Project 2025,” and are looking for ways to enact them.
Here’s just some of what the APHA warns about Project 2025:
- It would politicize the Centers for Disease Control, replacing scientific experts with political loyalists to Donald Trump and MAGA ideology. Project 2025 would cripple the use of data collection on disease outbreaks and prohibit it from issuing health guidance on vaccines and masks.
- Project 2025 would nationalize strict anti-abortion measures, including requiring states to report abortion data — meaning states would have to monitor women’s pregnancies. It also would limit or ban access to reproductive health care drugs like Mifepristone.
- Project 2025 would limit access to Medicaid: adding work requirements and capping benefits, which would disproportionately affect those with chronic conditions or disabilities, affecting the poor and disproportionately people of color.
- It would entirely privatize Medicare, skyrocketing costs — and profits to insurance companies — while limited access to seniors and people with disabilities
- Project 2025 would cripple our response to the climate crisis, ending government research on climate, stripping away environmental protections and encouraging the use of oil and fracked gas, putting the dangerous impacts of climate change on human health on steroids.
- And it would also privatize the weather service, so that Americans would have to pay to know if a hurricane or tornado was coming their way.
But we don’t have to speculate about the future impact of another Trump administration. Donald Trump already has a track record on public health, with his epic failures in responding to the Covid pandemic. He claimed the virus would go away “like magic.” He told Americans to drink bleach or take horse tranquilizers to cure it. He set governors of different states against each other competing for masks and medical supplies in a kind of Pandemic Hunger Games. He favored Red states over Blue states in providing funds.
If re-elected, Trump promises to put a purveyor of anti-vaccine lies—RFK Jr— in charge of the Health and Human Services and let him “go wild.” These are the stakes. Vote accordingly.
Episode Topics Covered
- Personal story and the challenges of twin-to-twin transfusion syndrome
- The eradication of smallpox and lessons learned
- Underfunding of public health and its consequences
- The “panic and neglect” cycle in public health
- New threats: Mpox and H5N1
- Public trust, transparency, and public health communication
- The balance between public health mandates and individual autonomy
- Advocacy for the creation of the CDC’s Center for Forecasting and Outbreak Analytics
Writers Voice— in depth conversation with writers of all genres, on the air since 2004.
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Key words: public health, pandemic preparedness, Caitlin Rivers, Crisis Averted, infectious disease, smallpox eradication, public health funding, CDC, public trust in health, Mpox, H5N1, health policy, epidemiology
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