Part the First: Make Polio Great Again! And measles, mumps, rubella, diphtheria, tetanus, bacterial meningitis, chickenpox/shingles, cervical cancer, hepatitis B! The title of Part the First comes from an old friend in both senses of the word. He is one of the very few Florida natives you would ever meet. But he is not a Florida Man. Only the prototypical Florida Man could come up with this: Florida will work to eliminate all childhood vaccine mandates in the state, officials say:
Florida will work to phase out all childhood vaccine mandates in the state, building on the effort by Republican Gov. Ron DeSantis (Florida Man by way of Yale and Harvard Law School) to curb vaccine requirements and other health mandates during the Covid-19 pandemic.
DeSantis also announced on Wednesday the creation of a state-level “Make America Healthy Again” commission modeled after similar initiatives pushed at the federal level by Health and Human Services Secretary Robert F. Kennedy Jr.
On the vaccines, state Surgeon General Dr. Joseph Ladapo (Florida Man by way of Wake Forest and Harvard Medical School) cast current requirements in schools and elsewhere as an “immoral” intrusion on people’s rights bordering on “slavery,” and hampers parents’ ability to make health decisions for their children.
“People have a right to make their own decisions, informed decisions,” said Ladapo, who has frequently clashed with the medical establishment, at a news conference in Valrico, Florida, in the Tampa area. “They (always they) don’t have the right to tell you what to put in your body. Take it away from them.”
Slavery? Public health measures that have been shown to work since the 18th-century (smallpox vaccination)? Okay, then. The soft eugenics of MAHA is about to harden and get out of hand, even if this will be slow in developing. Human papilloma virus is stealthy and spread by normal human behavior between normal human beings. HPV is the usual cause of cervical cancer – research for which Harald zur Hausen was awarded half of a Nobel Prize with the other half going to the discoverers of HIV. HPV cares not one whit how otherwise healthy its victims are, but its transmission is prevented by a vaccine.
Measles kills. Mumps can render one sterile or cause encephalitis leading to permanent brain damage or death. And chickenpox reappears in old age as shingles, which can be painful and debilitating, not to mention unsightly. Hepatitis B causes liver cancer; an argument can be made that this vaccine can be delivered later, but there is no evidence that early vaccination is harmful. And contrary to the testimony of the Surgeon General in Waiting in the Court of Joe Rogan, there is no evidence that multiple vaccines cause harm.
When the rest of the world issues health and safety advisories regarding travel to the Sunshine State, what will happen to their largest business? Anyway:
In Florida, vaccine mandates for child day care facilities and public schools include shots for measles, chickenpox, hepatitis B, Diphtheria-tetanus-acellular pertussis (DTaP), polio and other diseases, according to the state Health Department’s website.
Under DeSantis, Florida resisted imposing Covid vaccines on schoolchildren, requiring “passports” for places that draw crowds, school closures and mandates that workers get the shots to keep their jobs.
“I don’t think there’s another state that’s done as much as Florida. We want to stay ahead of the curve,” the governor said.
Maybe you are ahead of the curve at the moment, Governor! But give RFKJr time. The rest of the nation will catch up soon enough. And people, young and old, rich and poor, will get sick. Some will die. Unnecessarily.
Part the Second. Around the Bowl and Down the Hole Goes CDC. I know this will come as a shock, After ousting CDC’s director, RFK Jr. mirrors her ideas to reform the agency. Or, in other words, the Secretary of Health and Human Services fired Dr. Susan Monarez, his handpicked choice as Director of CDC, and then used her own plan to explain why she became persona non grata. The Secretary’s plea in Wall Street Journal plea is archived here. The table in STAT is more complete and thoroughly damning. Here is the summary:
- The CDC’s data systems and infrastructure need to be modernized, they both wrote, “to meet 21st-century threats” (Kennedy) and “keep pace with the demands of the 21st century” (Monarez).
- Monarez made the case that the agency should “invest in workforce excellence.” One of Kennedy’s priorities is to “invest in workforce” at the agency.
- Kennedy writes that CDC needs to “empower states and communities.” Monarez calls for local partnerships and health guidance tailored to “state, local, and community levels.”
- Kennedy underscores that “effectiveness—not politics—will be the watchword of our leadership,” — while Monarez urges “results-driven public health efforts” that include “a rigorous firewall against political and bureaucratic influence.”
There were a few differences in policy and approach between Dr. Monarez’s plan and the Secretary’s version. But RFKJr, (Harvard, LSE, University of Virginia), would get a flat “F” for the simple-minded plagiarism in this opinion piece.
Part the Third. This Malicious Mishegoss Continues. Melissa Fay Greene writes in STAT (no paywall), CDC’s Injury Center has been devastated by cuts. Here’s what we’ve lost: The Injury Center’s experts on gun violence, transportation safety, drowning — all RIF’d:
On Aug. 8, Centers for Disease Control and Prevention staff in Atlanta came under attack. A gunman fired hundreds of rounds at CDC’s campus, shattering 150 windows. While public health experts crouched under their desks and their expelled colleagues watched the TV news in despair, many felt it to be the obvious result of the slander, disinformation campaigns, and conspiracy theories wielded against them for months by President Trump, amplified by Health and Human Services Secretary Robert F. Kennedy Jr.
Now, they thought bitterly, American citizens are literally shooting at us.
Of course, in April, the entire Gun Violence Prevention team within CDC’s Injury Center had been RIF’d — as federal employees refer to those reduction in force layoffs — so no one conversant with the underlying causes of gun violence was available to comment.
The Injury Center may be among the least familiar of the CDC programs eviscerated by the White House, but acts of prevention rarely attract headlines. Many towns, for example, display white-painted “ghost bikes” at intersections where a cyclist was killed by a car. But no town displays a multi-colored bike with streamers to mark a crossing through which everyone glides safely home because Injury Center transportation experts got there ahead of them.
As Congress debates CDC funding levels for the upcoming fiscal year, I want to pay tribute to this place, which is being dismantled. “How can I relay the value of your work to folks who have never even heard of the Injury Center?” I recently asked a staffer.
He gestured at the people around us. None of them had drowned.
One of the excuses the Current Administration uses in its ongoing devastation of CDC is that, as we noted last week, “communicable disease” was removed from the name of an agency that grew naturally into the Centers for Disease Control and Prevention. Yes, CDC can be improved, especially at the executive level. Dr. Susan Monarez may have been the person to do just that, by staying in place and doing the work. Alas, we will never know.
As an aside, Melissa Fay Greene of Atlanta has written books that endure. Praying for Sheetrock (1991) is nearly perfect, coming from someone with some first-hand knowledge of the people, place, and time she described. The Temple Bombing is also worth the read, and a reminder of where we were then, in 1958, and where we are not now, in 2025. Same for Last Man Out (2002), which also describes were we were then, also in 1958, and are not now, despite having a lot of work left to do.
Part the Fourth: Institutions and a Lesson for Our Time from the Late Middle Ages. No institution of politics or society is immune to criticism. I have met no one who would really believe this, even if notional liberals and notional conservatives both have their protected favorites. But the spirit of the time is leading directly to the destruction of institutions that are essential for our cultural, social, political, intellectual, and individual health and survival. This is a two-way street, by the way. Both wings of the same bird of prey do it throughout the Neoliberal Dispensation in the Global North and a few other places.
I am currently reading The World at First Light: A New History of the Renaissance by Bernd Roeck (transl. Patrick Baker, 2025). At 949 pages and 49 chapters, I’ll complete the task in a month at 1-2 chapters per evening. I hope. We are still only just past Magna Carta (1215) in Chapter 12: “Vertical Power, Horizontal Power.” Both axes of power are essential in any society larger than a small group of hunter gatherers. Here is Professor Bernd on institutions:
Institutions – that dry term, which we have already encountered in the discussion of universities and in other contexts, denotes something very big and important. Institutions are what first allow the state to become perpetual; without them, it dies. If advisers appear as the mind and memory of the body politic, and the military its muscles, it is law and institutions that provide a skeleton for the state. They alone are capable of establishing justice over the long term. Only they can set limits to power and arbitrary will. They preserve knowledge of how to achieve success, as well as reminders of mistakes to be avoided in the future. No one knew this better than Cicero, who emphasized the Roman Republic’s special ability to gather experience and make decisions based on it. Before the advent of modernity, no section of the globe created institutions as robust and effective as those that developed in medieval Latin Europe. Moreover, these institutions were highly inclusive. The guaranteed protection under the law and the right to private property, provided education, and were relatively pluralistic (i.e., horizontally structured).
Indeed, Rome owed its success to its institutions. They then provided the states consolidating during the Middle Ages with models of compelling rationality.
This is not the place to quibble about details. But those who want to destroy our political, cultural, social, and educational institutions rather than improve them or refocus them along lines upon which reasonable people will agree? These unreasonable people are not to be respected:
“We want the bureaucrats to be traumatically affected,” Vought (Russell Vought, OMB Director) said in a video revealed by ProPublica and the research group Documented in October. “When they wake up in the morning, we want them to not want to go to work, because they are increasingly viewed as the villains. We want their funding to be shut down … We want to put them in trauma.”
Well, it is working and the lack of imagination and humanity here is striking. These “bureaucrats” are the scientists who make sure our food is safe and that the chemical plant on the waterfront is not dumping its waste into the tidal creek. They are the scientists who hunt down the causes of emerging diseases. They are the meteorologists at the National Hurricane Center who have gotten so very good at predicting the paths of cyclones. They are the men and women who sign up Vought’s parents for Social Security and Medicare. They are the people of the IRS who sent me a substantial tax refund because I overpaid, something pleasant I did not ask for nor expect. They are also the professors who teach engineers how to build bridges that will bear the load and teach medical students the basics of health and disease. And yes, they are the professors who teach us there is No Politics But Class Politics. The key here is that all of this is debatable by reasonable men and women of good will.
To paraphrase Justice Oliver Wendell Holmes, the institutions funded by our taxes are the cost of civilization. Perhaps we will remember this ancient wisdom before it is too late? Probably not. The urge to burn it all down, instead of rewiring the building and replacing the roof, is strong.
Part the Fifth. Where Did We Come From? Fair warning, a bit of science geekdom follows. The “we” here are not dangerous, flailing politicians, professional and amateur, but animals – us. This is one of the outstanding questions of biology and several laboratories are making progress, as reviewed in this short, non-technical article in Nature, How did life get multicellular? Five simple organisms could have the answer (the embedded video is here). Why, you might ask, is this part of today’s Coffee Break? Well, because this work was some of the last I did in the lab, and I still have not given up on it, completely. Plus, it is interesting.
Beginning in the early 2000s, researchers interested in this remarkable event made a series of unexpected discoveries. The prevailing view held that a flood of genes had to evolve to enable the key properties of multicellularity: the ability of cells to stick together, communication using molecular signals and the coordinated regulation of gene expression that causes each cell to specialize and take its position in the organism. But studies found that some unicellular organisms express a slew of proteins that control key properties of multicellularity in animals. The molecular toolkit required for multicellularity seems to have existed well before the first animals came to be.
While old-fashioned experimental biology will eventually tell the tale, the revolution in genomics provided the foundation for a deep study of animal multicellularity. About twenty years ago, the Broad Institute of Harvard and MIT funded a project called the Origins of Multicellularity Genome Database in which it sequenced the genomes of several organisms shown in the video. The project showed that the first protein in this molecular toolkit extends back nearly 1.8 billion years all the way to the “missing link” between the lineage that led to animals and the lineage that led to all other extant organisms (plants and most “protists”). Timetree of Life is fun: Humans and the pathogenic bacterium Haemophilus influenzae had a last common ancestor ~4 billion years ago – very deep time for a planet only 4.5 billion years old.
That “first” protein was the primary focus of my independent scientific research, and our laboratory was productive. But my NSF reviewers were singularly unimpressed, as every grant revision got a progressively worse review as it was passed around from one irrelevant review panel to another. As I have mentioned before, a reviewer threw a regular fit because I referred to a seminal, but largely ignored, paper on how to study biology at different integrative levels, written by a well-known cell biologist before there was a discipline called Cell Biology. Why was he (it had to be a “he”) so exercised? The paper was published in 1945 and therefore irrelevant. I have no doubt my reviewer had never heard of Alex B. Novikoff. Stuff happens.
But from a wider perspective, why should we care? There is no doubt the current berserkers besieging NIH and NSF do not care. Nevertheless, unconventional model organisms will lead to breakthroughs that are relevant to human health. Colonial hydroids have stem cells and they are easier to study at the fundamental level than human stem cells (according to Timetree, the last common ancestor of Hydractinia and humans was ~715 million years ago). The ctenophore at 0:14 in the Nature video could be a representative of the first multicellular animal, based on molecular phylogenomics (the use of DNA sequence data to construct evolutionary histories).
Perhaps more importantly, a hallmark of the cancer cell is that it loses control and stops behaving as it should in a multicellular organism. Among other derangements, it can dedifferentiate into a malignant, single amoeboid cell that can go virtually anywhere and seed new tumors. Could understanding how animals came to be multicellular provide a new perspective on the cancer cell? Who knows? But who knew before Leland Hartwell and Paul Nurse figured it out that yeast cells would provide the keys to how and when our cells decide to divide? Research on the control of cell division using cultured mammalian cells was going nowhere fast and that is where it would have remained because of the lack of genetic tools.
Like art, history, philosophy, building and manufacturing, and every other human endeavor, science is cool. You never know what you might find. But unless the current trajectory is seriously reversed, a lot of this coolness, none of which is an “Administration priority,” will remain forever unknown. The opportunity costs are unknowable but large.
