Mike the Mad Biologist

Over at The Handbasket, Marisa Kabas has a terrifying excerpt about Trump administration officials’ ignorance of basic biology from Nicholas Enrich’s new book, Into the Wood Chipper: A Whistleblower’s Account of How the Trump Administration Shredded USAID (boldface mine):

The first question came from Adam Korzeniewski, a veteran of the first Trump administration where he served short stints with the departments of Treasury and Commerce. Adam, the White House liaison to USAID, wanted to know more about the risks associated with interruptions to TB clinical trials, which I had mentioned in my overview…

“Some of the studies are testing new treatment regimens for drug- resistant tuberculosis,” I explained, hoping I could convey the very real danger in terms that would register with this audience. “Thousands of enrolled patients are at risk now that their lifesaving treatment is stopped. But that’s not the only danger. We only have limited options to treat drug- resistant TB. We’re using our antibiotics of last resort in these trials. Interrupting treatment midstream risks the development of new, even more drug-resistant strains that could be untreatable. For an airborne infectious disease, that is a serious national security risk.”

Adam thought for a moment and then responded, noting that the political appointees at USAID were “not health people.” It would be hard, he surmised, for nonexperts to understand this issue. And so he suggested that we draft a simple, “Barney-style” set of slides to help the political leadership grasp the dangers, referring to the purple dinosaur of children’s television. He recommended that we use the term “Super TB” instead of “drug- resistant TB” to describe the mutations that can develop when treatment is interrupted, because it might be more likely to “catch their attention.”

Adam then made clear that he did not count himself among those political appointees who were not health experts. Though he had no relevant training or experience, he reassured me that he understood the severity of infectious diseases, noting that he had recently read a book about smallpox. Apparently he had watched movies as well.

“One thing I thought of while you were talking,” he added, gesticulating wildly with his hands to conjure the image in his mind. “If you can make one of those maps like they have in Outbreak, where it shows the red growing over time as the disease spreads? You know, like the zombie apocalypse? That would be great, very effective.”

Here’s the thing about the concept of drug-resistant tuberculosis: it is described in the fucking name. It is tuberculosis that is resistant to some or all of the drugs (antibiotics) we use to treat the infection. If you do not understand this descriptive phrase, you do not belong anywhere near public health. And this is not some kind of academic elitism: not understanding this is like being a basketball player who cannot hit freethrows ever–if you cannot do that, you do not make the team. This level of ignorance is just stunning.

While I am not naive about other Republican administrations, at least they understood the basic concepts (as ideologues, they just often did not care about the policy implications).

Anyway, the only reason I might not buy this book is because it might give me an aneurysm.