The week of Jan. 20, 2025, made history in a way few Americans realize. For the first time in 128 years, the Morbidity and Mortality Weekly Report, originally called Public Health Reports, was not published due to a gag order placed on all federal agencies by the new president.

Public health agencies, hospitals, and physicians around the country look to the morbidity and mortality report for crucial information about the prevalence of infectious diseases and other threats to public health. Dr. Tina Tan, president of the Infectious Disease Society of America, called this first-of-a-kind decision “a disaster.”

Chaos and confusion have reigned in the National Institutes of Health as travel, communication, research grant reviews have been canceled, threatening funding, scientists’ careers, and ongoing research like the use of AI to fight rare diseases, and new treatments for cancer.

One of those meetings, which the White House called off, was one Dr. Tan and her colleagues were to have with the CDC about H5N1 (avian flu). The avian flu is ravaging the poultry and dairy industry, has infected 67 people and caused one death so far.

People who blamed our former president on the price of eggs picked the wrong culprit: It wasn’t Biden. It was the bird flu. So far human-to human transmission has not occurred, but the situation is changeable. Remember COVID?

The pandemic, which ravaged our country and the world only four years ago, was first recognized, named and publicized by the World Health Organization. In 1948, the U.S. was a founder of this international organization, which plays an essential role in protecting public health from dangerous infectious disease worldwide. WHO’s research, assistance with medical supply shortages (like masks), sharing of information, assistance with vaccines and treatment options, was crucial in U.S. efforts to lessen the effects of this deadly disease.

Yet for the first time in its 76-year history, the president of the United States pulled us out of this organization.

One of the public health threats that WHO monitors is the threat of climate change. We physicians are seeing rapidly rising rates of heat illness and death, especially in the very young, the elderly, and those suffering from cardiovascular, respiratory or kidney disease. We’re also seeing much more asthma and other pulmonary diseases, from heat, humidity and smoke from distant fires. And that’s not counting the thousands more killed directly by massive floods or firestorms fueled by climate catastrophes or the disastrous mental health effects of the loss of loved ones, homes and communities.

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Worldwide, heat waves kill close to a half-million people a year. Famine is growing because of worsening droughts and floods. Tropical diseases like dengue fever are devastating nations like Bangladesh. Here at home ticks are living through warmer winters, and Lyme disease now infects an estimated half-million Americans annually.

Climate change poses significant direct threats to our health and safety.

Yet this administration has pulled out of the U.N. climate talks — a worldwide effort to at last get a handle on how to keep Earth, which of course includes the United States, a livable place for us, our children, and our grandchildren. As a physician, I can’t think of a more important goal than that.

Inexplicably, the president has also canceled the Biden administration’s hard-won negotiations with pharmaceutical companies to rein in skyrocketing drug costs. Medicare recipients had begun to save a cumulative $1.5 billion annually for 10 commonly used medications for disorders ranging from diabetes to arthritis to cardiovascular disease. Direct savings to the federal government, which helps to finance the cost of medications for seniors, would have been $6 billion annually. Fifteen additional medicines were to be negotiated this year.

This would have simply put the U.S. in line with the rest of the developed world where governments routinely bargain with pharmaceutical companies, and with the rest of the businesses that contract with the federal government, where prices are not dictated but mutually agreed upon. The plan would have done little to cut into the profits of the companies that produce these 10 drugs. To take one example, at the negotiated rates, the cost for the diabetes medication Januvia (with a 79% price cut) would still be seven times its cost in Europe.

RFK Jr., confirmed on Thursday become the next secretary of Health and Human Services, is a famously vocal and sadly effective opponent of one of the greatest public health achievements of modern medicine: vaccines. He has written a best-selling book that cast doubt on HIV as the cause of AIDS, promoted paranoid conspiracy theories, and fueled death threats against a true American hero, Dr. Anthony Fauci. Prominent scientists and physicians have called RFK Jr’s claims “disgusting, hateful, and wrong,” and a perfection “of the art of the illusion of fact.”

Finally, Trump and his unelected, all-powerful head of the so-called Department of Government Efficiency have laid off thousands of workers from the U.S. Agency of International Development and curtailed its programs. USAID is the prime source of U.S. aid for health and food programs across the world that monitor and fight famine, and epidemic disease such as tuberculosis. We are a global community; infectious disease that spreads over the world will almost certainly spread to the U.S.

President Trump has boasted that he did more in two weeks than Joe Biden did in his entire four years. When it comes to the damage Trump has done to the American health care system, he is sadly correct.

Dr. David Gottsegen of Belchertown is a practicing physician at Holyoke Pediatric Associates and a new monthly columnist for the Gazette.