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On Christmas Eve of 2020, my father was admitted to the hospital with sudden weakness. My mother was not allowed to join him. She pleaded with the staff—my dad needed help making medical decisions, she said—but there were no exceptions at that grisly stage of the coronavirus pandemic. I contemplated making the trip from Maryland to New Jersey to see whether I, as a doctor, could garner special treatment until I realized that state and employer travel rules would mean waiting for a COVID test result and possibly facing quarantine on my return. In the end, my father spent his time in the hospital alone, suffering the double harm of illness and isolation.

These events still frustrate me years later; I have a hard time believing that restrictions on hospital visitation and interstate travel helped more people than they hurt. Many Americans remain angry about the pandemic for other reasons too: angry about losing a job, getting bullied into vaccination, or watching children fall behind in a virtual classroom. That legacy of bitterness and distrust is now a major political force. Robert F. Kennedy Jr. is on the precipice of leading our nation’s health-care system as secretary of Health and Human Services. The Johns Hopkins professor Marty Makary has been tapped to lead the Food and Drug Administration. And the Stanford professor Jay Bhattacharya is expected to be picked to run the National Institutes of Health. These men have each advocated for changes to the systems and structures of public health. But what unites them all—and what legitimizes them in the eyes of this next administration—is a lasting rage over COVID.

To understand this group’s ascent to power and what it could mean for America, one must consider their perception of the past five years. The world, as Kennedy, Makary, Bhattacharya, and their compatriots variously understand it, is dreadful: SARS-CoV-2 was likely created in a lab in Wuhan, China; U.S. officials tried to cover up that fact; and the government responded to the virus by ignoring scientific evidence, violating citizens’ civil rights, and suppressing dissent. In the face of this modern “dark age,” as Bhattacharya has called it, only a few brave dissidents were willing to flip on the light.

Makary, Trump’s pick for the FDA, presents as being in the truth-to-power mold. A surgeon, policy researcher, and—full disclosure—my academic colleague, he gained a loyal following during the pandemic as a public-health critic. Through media outlets such as Fox News and The Wall Street Journal, Makary advocated for a more reserved use of COVID vaccines: He suggested that adults who had recovered from a COVID infection, as well as children more generally, could forgo some doses; he is also skeptical of booster shots for everyone and vaccine mandates. Makary, too, thinks that public-health officials have been lying to the American people: “The greatest perpetrator of misinformation during the pandemic has been the United States government,” he told Congress last year, referring to public-health guidance that emphasized transmission of COVID on surfaces, downplayed natural immunity, encouraged boosters in young people, and promoted the efficacy of masking.

[Read: The sanewashing of RFK Jr.]

Bhattacharya, a doctor and health economist, rose to fame in October 2020 as a co-author of the Great Barrington Declaration, which advocated for a “focused protection” approach to the pandemic. The idea was to isolate vulnerable seniors while allowing low-risk individuals to return to their normal lives. Much of the public-health community aggressively criticized this strategy at the time, and—as would later be revealed—NIH Director Francis Collins privately called for a “quick and devastating” takedown of its premise. Twitter placed Bhattacharya on a “trends blacklist” that reduced the reach of his posts, according to internal documents released to the journalist Bari Weiss in 2022. Among conservatives and lockdown skeptics, Bhattacharya has come to be seen as a fearless truth teller who was silenced by the federal government and Big Tech. (In reality, and despite his frequent umbrage, Bhattacharya was not ignored. He met with the Trump administration and was in communication with Florida Governor Ron DeSantis.)

In response to their marginalization from polite scientific society—and long before they were in line for key government positions—Makary and Bhattacharya have each sought out a public reckoning. They both called for the medical establishment to issue an apology to the American people. Makary demanded “fresh leadership” at an FDA that had made serious blunders on COVID medications and vaccines, and Bhattacharya asked for the formation of a COVID commission as a necessary first step in “restoring the public’s trust in scientific experts.” They even worked together at the Norfolk Group, a cohort of like-minded scientists and doctors that laid out what they deemed to be the most vital questions that must be asked of the nation’s public-health leaders. The gist of some of these is: Why didn’t they listen to “focused protection” supporters such as Bhattacharya and Makary? The report wonders, for instance, why Deborah Birx, a member of the White House Coronavirus Task Force, avoided meeting with a cadre of anti-lockdown advocates that included Bhattacharya in the summer of 2020. (“They are a fringe group without grounding in epidemics, public health or on the ground common sense experience,” Birx wrote in an email to the vice president’s chief of staff at the time.)

This sense of outrage over COVID will be standard in the next administration. Trump’s pick for surgeon general, the doctor and Fox News personality Janette Nesheiwat, has called the prolonged isolation brought about by shutdowns “cruel and inhumane,” and said that the collateral damage caused by the government’s actions was “worse than the pandemic” for most Americans. His nominee for secretary of Defense, Pete Hegseth, pushed for herd immunity in May 2020 and encouraged anti-lockdown protests.

[Read: Donald Trump’s most dangerous Cabinet pick]

Bhattacharya, at least, has denied having any interest in revenge. Last year he helped write an op-ed that cautioned against initiating a “Nuremberg 2.0” and instead presented scientists like himself and Makary as “apostles of evidence-based science” who are simply “calling for restoring evidence-based medicine to a pride of place in public health.”

Taken on its own, I’m sympathetic to that goal. I consider myself a fellow member of the “evidence-based medicine” movement that values high-quality data over blind loyalty to authority. I’m also of a similar mind as Makary about the FDA’s long-standing dysfunction. The COVID skeptics are correct that, in some domains, the pandemic produced too little knowledge and too much bluster. We still don’t know how well various social-distancing measures worked, what the best vaccination policy might be, or what the true origins of the virus were. I remember following the debates about these issues on Twitter, which functioned as a town square for doctors, scientists, and public-health leaders during the pandemic years. Mainstream experts tended to defend unproved public-health measures with self-righteousness and absolutism: You were either in favor of saving lives or you were one of the skeptics who was trying to kill Grandma. Nuanced conversations were rare. Accusations of “misinformation” were plentiful.

[Read: COVID science is moving backwards]

Robert F. Kennedy Jr. was indeed spreading misinformation with a fire hose. (For example, he has falsely said that the COVID shots are the “deadliest vaccine ever made.”) Bhattacharya and Makary have been far more grounded in reality, but they did make their own share of mistakes during the pandemic—and they haven’t spent much time rehashing them. So allow me to reflect on their behalf: In March 2020, Bhattacharya argued that COVID’s mortality rate was likely to be much lower than anyone was saying at the time, even to the point of being one-tenth that of the flu. “If we’re right about the limited scale of the epidemic,” he wrote, “then measures focused on older populations and hospitals are sensible.” Bhattacharya continued to be wrong in important ways. A pivotal assumption of the Great Barrington Declaration was that as more healthy people got sick and then recovered, the residual risk of new infections would fall low enough that vulnerable people could safely leave isolation. This process would likely take three to six months, his group explained. SARS-CoV-2, however, is still circulating at high levels nearly five years later. At least 1.2 million Americans have died from COVID. Had effective vaccines not arrived shortly after the 2020 declaration, senior citizens might be in hiding to this day.

As for Makary, his most infamous take involved a February 2021 prediction that the United States would reach herd immunity within two months. “Scientists shouldn’t try to manipulate the public by hiding the truth,” he wrote in The Wall Street Journal. The Delta and Omicron waves followed, killing hundreds of thousands more Americans.

When I reached out to Bhattacharya, he said his early guess about COVID’s mortality rate was meant only to help describe a “range of possible outcomes,” and that to characterize it otherwise would be false. (Makary did not respond to my questions for this story.)

The incoming administration’s COVID skeptics have also expressed sympathy for still-unproved theories about the pandemic’s origin. If you want to become an evidence apostle, believing that SARS-CoV-2 came from an NIH-funded lab leak seems to be part of the deal. Kennedy wrote multiple books purporting to link Anthony Fauci, in particular, to the creation of the virus. Similarly, Makary appears in a new documentary called Thank You Dr. Fauci, which describes “a bio-arms race with China and what could be the largest coverup in modern history.” (Fauci has denied these claims on multiple occasions, including in congressional testimony. He called the idea that he participated in a cover-up of COVID’s origins “absolutely false and simply preposterous.”)

A certain amount of sycophancy toward the more bizarre elements of the coalition is also common. Makary and Bhattacharya have both praised Kennedy in extravagant terms despite his repeated falsehoods: “He wrote a 500-page book on Dr. Fauci and the medical industrial complex. A hundred percent of it was true,” Makary said of a volume that devotes multiple chapters to casting doubt on HIV as the cause of AIDS. Earlier this month, Bhattacharya called Kennedy a “disruptor” whose views on vaccines and AIDS are merely “eccentric.” (Bhattacharya has also suggested that the vaccine skeptic and conspiracy theorist Robert Malone would be an “amazing leader” for the country’s health agencies.)

Anger about the government’s response to the pandemic swept the COVID contrarians into power. Resentment was their entrée into Washington. Now they’ll have a chance to fix some genuine, systemic problems with the nation’s public-health establishment. They’ll also have the ability to settle scores.