Americans have plenty to worry about these days when it comes to infectious-disease outbreaks. This is the worst flu season in 15 years, there’s a serious measles outbreak roiling Texas, and the threat of bird flu isn’t going away. “The house is on fire,” Denis Nash, an epidemiologist at CUNY School of Public Health, told me. The more America is pummeled by disease, the greater the chance of widespread outbreaks and even another pandemic.

As of this week, the federal government may be less equipped to deal with these threats. Elon Musk’s efforts to shrink the federal workforce have hit public-health agencies, including the CDC, NIH, and FDA. The Trump administration has not released details on the layoffs, but the cuts appear to be more than trivial. The CDC lost an estimated 700 people, according to the Associated Press. Meanwhile, more than 1,000 NIH staffers reportedly lost their jobs.

Perhaps as notable as who was laid off is who wasn’t. The Trump administration initially seemed likely to target the CDC’s Epidemic Intelligence Service, a cohort of doctors, scientists, nurses, and even veterinarians who investigate and respond to disease outbreaks around the world. Throughout the program’s history, EIS officers have been the first line of defense against anthrax, Ebola, smallpox, polio, E. coli, and, yes, bird flu. Four recent CDC directors have been part of the program.

The layoffs were mostly based on workers’ probationary status. (Most federal employees are considered probationary in their first year or two on the job, and recently promoted staffers can also count as probationary.) EIS fellows typically serve two-year stints, which makes them probationary and thus natural targets for the most recent purge. EIS fellows told me they were bracing to be let go last Friday afternoon, but the pink slips never came. Exactly why remains unclear. In response to backlash about the planned firings, Musk posted on X on Monday that EIS is “not canceled” and that those suggesting otherwise should “stop saying bullshit.” A spokesperson for DOGE did not respond to multiple requests for comment.

This doesn’t mean EIS is safe. Both DOGE and Robert F. Kennedy Jr., Donald Trump’s newly confirmed health secretary, are just getting started. More layoffs could still be coming, and significant cuts to EIS would send a clear message that the administration does not believe that investigating infectious-disease outbreaks is a good use of tax dollars. In that way, the future of EIS is a barometer of how seriously the Trump administration takes the task of protecting public health.

Trump and his advisers have made it abundantly clear that, after the pandemic shutdowns in 2020, they want a more hands-off approach to dealing with outbreaks. Both Trump and Kennedy have repeatedly downplayed the destruction caused by COVID. But so far, the second Trump administration’s approach to public health has been confusing. Last year, Trump said he would close the White House’s pandemic office; now he is reportedly picking a highly qualified expert to lead it. The president hasn’t laid out a bird-flu plan, but amid soaring egg prices, the head of his National Economic Council recently said that the plan is coming. Kennedy has also previously said that he wants to give infectious-disease research a “break” and focus on chronic illness; in a written testimony during his confirmation hearings, he claimed that he wouldn’t actually do anything to reduce America’s capacity to respond to outbreaks.

The decision to spare EIS, at least for now, only adds to the confusion. (Nor is it the sole murky aspect of the layoffs: Several USDA workers responding to bird flu were also targeted, although the USDA told me that those cuts were made in error and that it is working to “rectify the situation.”) On paper, EIS might look like a relatively inconsequential training program that would be apt for DOGEing. In reality, the program is less like a cushy internship and more akin to public health’s version of the CIA.

Fellows are deployed around the world to investigate, and hopefully stop, some of the world’s most dangerous pathogens. The actual work of an EIS officer varies depending on where they’re deployed, though the program’s approach is often described as “shoe-leather epidemiology”—going door to door or village to village probing the cause of an illness in the way a New York City detective might investigate a stabbing on the subway. Fellows are highly credentialed experts, but the process provides hands-on training in how to conduct an outbreak investigation, according to Nash, the CUNY professor, who took part in the program. Nash entered EIS with a Ph.D. in epidemiology, but “none of our training could prepare us for the kinds of things we would learn through EIS,” he said.

In many cases, EIS officials are on the ground investigating before most people even know there’s a potential problem. An EIS officer investigated and recorded the United States’ first COVID case back in January 2020, when the virus was still known as 2019-nCoV. It would be another month before the CDC warned that the virus would cause widespread disruption to American life.

More recently, in October, EIS officers were on the ground in Washington when the state was hit with its first human cases of bird flu, Roberto Bonaccorso, a spokesperson with the Washington State Department of Health, wrote to me. “Every single outbreak in the United States and Washington State requires deployment of our current EIS officers,” Bonaccorso said.

EIS is hardly the only tool the federal government uses to protect the country against public-health threats. Managing an outbreak requires coordination across an alphabet soup of agencies and programs; an EIS fellow may have investigated the first COVID case, but that of course didn’t stop the pandemic from happening. Other vital parts of how America responds to infectious diseases were not spared by the DOGE layoffs. Two training programs with missions similar to that of EIS were affected by the cuts, according to a CDC employee whom I agreed not to identify by name because the staffer is not authorized to talk to the press.

The DOGE website boasts of saving nearly $4 million on the National Immunization Surveys, collectively one of the nation’s key tools for tracking how many Americans, particularly children, are fully vaccinated. What those cuts will ultimately mean for the future of the surveys is unknown. A spokesperson for the research group that runs the surveys, the National Opinion Research Center, declined to comment and directed all questions to the CDC.

And more cuts to the nation’s public-health infrastructure, including EIS, could be around the corner. RFK Jr. has already warned that certain FDA workers should pack their bags. Kennedy has repeatedly claimed that public-health officials inflate the risks of infectious disease threats to bolster their importance with the public; EIS fellows are the first responders who hit the ground often before public officials are even sounding the alarm bells.

Ironically, the work of the EIS is poised to become especially pressing during Trump’s second term. If measles, bird flu, or any other infectious disease begins spreading through America unabated after we have fired the public-health workforce, undermined vaccines, or halted key research, it will be the job of EIS fellows to figure out what went wrong.

The best way to dismantle the federal government, then repurpose it as a tool of personal power and ideological warfare, is to start with the soft targets. Entitlements and defense, which comprise more than half of federal spending and a large share of its fraud and waste, enjoy too much support for Elon Musk to roll them up easily. But nothing is less popular than sending taxpayers’ money to unknown people in poor, faraway countries that might be rife with corruption. Americans dislike foreign aid so much that they wrongly believe it consumes at least a quarter of the budget (in the previous fiscal year, aid constituted barely 1 percent). President John F. Kennedy understood the problem, and after creating the United States Agency for International Development, in 1961, he told his advisers: “We hope we can tie this whole concept of aid to the safety of the United States. That is the reason we give aid. The test is whether it will serve the United States. Aid is not a good word. Perhaps we can describe it better as ‘Mutual Assistance.’ ” At another meeting, Kennedy suggested “International Security.”

USAID continued for the next six decades because leaders of both parties believed that ending polio, preventing famine, stabilizing poor countries, strengthening democracies, and opening new markets served the United States. But on January 20, within hours of his inauguration, President Donald Trump signed an executive order that froze foreign aid. USAID was instructed to stop nearly all work. Its Washington headquarters was occupied and sensitive data were seized by whiz kids from Musk’s Department of Government Efficiency, or DOGE. One of their elder members, a 25-year-old software engineer and Matt Gaetz fan named Gavin Kliger, acquired an official email address to instruct the staff of USAID to stay home.

Contractors were fired and employees were placed on indefinite leave; those on overseas missions were given 30 days to return to the States with their families. Under orders to remain silent, they used pseudo­nyms on encrypted chats to inform the outside world of what was going on. When I spoke on Signal with government employees, they sounded as if they were in Moscow or Tehran. “It felt like it went very authoritarian very quickly,” one civil servant told me. “You have to watch everything you say and do in a way that is gross.”

The website usaid.gov vanished, then reappeared with a bare-bones announcement of the organization’s dismemberment, followed by the message “Thank you for your service.” A veteran USAID official called it “brutal—­from some 20-year-old idiot who doesn’t know anything. What the fuck do you know about my service?” A curtain fell over the public information that could have served to challenge the outpouring of lies and distortions from the White House and from Musk, who called USAID “a criminal organization” and “evil.” If you looked into the charges, nearly all turned out to be outright falsehoods, highly misleading, or isolated examples of the kind of stupid, wasteful programs that exist in any organization.

A grant for hundreds of ethnic-minority students from Myanmar to attend universities throughout Southeast Asia became a propaganda tool in the hands of the wrecking crew because it went under the name “Diversity and Inclusion Scholar­ship Program”—as if the money were going to a “woke” bureaucracy, not to Rohingya refugees from the military regime’s genocide. The orthodoxy of a previous administration required the terminology; the orthodoxy of the new one has ended the students’ education and forced them to return to the country that oppressed them. One of Trump’s executive orders is called “Defending Women Against Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”; meanwhile, the administration suspended the online education of nearly 1,000 women in Afghanistan who had been studying undetected by the Taliban with funding from the State Department.

But hardly anyone in this country knows these things. Contesting Musk’s algorithmically boosted lies on X with the tools of a reporter is like fighting a wildfire with a garden hose.

With no workforce or funding, USAID’s efforts around the world—vaccine campaigns in Nepal, HIV-drug distribution in Nigeria, nutrition for starving children in Sudanese refugee camps—were forced to end. Secretary of State Marco Rubio (who championed USAID as a senator and now, as the agency’s acting head, is its executioner) issued a waiver for lifesaving programs. But it proved almost meaningless, because the people needed to run the programs were locked out of their computers, had no way to communicate, and feared punishment if they kept working.

The heedlessness of the aid wreckers recalls Nick Carraway’s description in The Great Gatsby of Tom and Daisy Buchanan: “They were careless people, Tom and Daisy—they smashed up things and creatures and then retreated back into their money or their vast carelessness, or whatever it was that kept them together, and let other people clean up the mess they had made.” An agency of 10,000 employees is shrinking to about 300 and, despite its statutory independence, being dissolved into the State Department. The veteran USAID official I spoke with foresaw a skeletal operation reduced to health and food assistance, with everything else—education, the environment, governance, economic development—gone. But even basic humanitarian programs will be nearly impossible to sustain with the numbers that the administration envisions—for example, 12 staff members for all of Africa.

“This is the infrastructure and architecture that has given us a doubling of the human lifespan,” Atul Gawande, the writer and surgeon who was the most recent, and perhaps last, head of the agency’s Bureau for Global Health, told me. “Taking it down kills people.”

Trump and Musk’s destruction of USAID was a trial blitzkrieg: Send tanks and bombers into defenseless Poland to see what works before turning on the Western powers. The assault provided a model for eviscerating the rest of the federal bureaucracy. It also demonstrated the radicalism of Trump’s view of America’s role in the world.

Every president from Franklin D. Roosevelt to Barack Obama understood that American power was enhanced, not threatened, by attaching it to alliances, institutions, and values that the American people support, such as freedom, pluralism, and humanitarianism. This was the common idea behind Harry Truman’s Marshall Plan for postwar Europe, Kennedy’s establishment of USAID, Jimmy Carter’s creation of the U.S. refugee program, and George W. Bush’s Emergency Plan for AIDS Relief. These weren’t simple acts of generosity. They were designed to prevent chaos and misery from overwhelming other countries and, eventually, harming our own. They expanded American influence by attraction rather than coercion, showing people around the world that the Leviathan could benefit them, too. Political scientists call this “soft power.”

Every president betrayed these ideas in one way or another, making U.S. foreign policy a fat target for criticism at home and abroad, by the left and the right. Kennedy used foreign aid to wage a bloody counterinsurgency in South Vietnam; Carter put human rights at the center of his policy and then toasted the repressive shah of Iran; Bush, claiming to be spreading democracy to the Middle East, seriously damaged America’s global legitimacy. USAID antagonized host governments and local populations with its arrogance and bloat. “We had a hand in our own destruction,” one longtime official told me. “We threw money in areas we didn’t need to.”

But the alternative to the hypocrisies of soft power and the postwar liberal order was never going to be a chastened, humbler American foreign policy—­neither the left’s fantasy of a plus-size Norway nor the right’s of a return to the isolationist 1920s. The U.S. is far too big, strong, and messianic for voluntary diminish­ment. The choice for this superpower is between enlightened self-­interest, with all its blind spots and failures, and raw coercion.

Trump is showing what raw coercion looks like. Rather than negotiate with Canada and Mexico, impose U.S. demands with tariffs; rather than strengthen NATO, undermine it and threaten a conflict with one of its smallest, most benign member countries; rather than review aid programs for their efficacy, shut them down, slander the people who make them work, and shrug at the humanitarian catastrophe that follows. The deeper reason for the extinction event at USAID is Trump’s contempt for anything that looks like cooperation between the strong and the weak. “America First” is more imperialist than isolationist, which is why William McKinley, not George Washington or John Quincy Adams, is Donald Trump’s new presidential hero. He’s using a techno-futurist billionaire to return America to the late 19th century, when the civil service was a patronage network and great-power doctrine held that “might makes right.” He’s ridding himself and the country of restraining codes—the rule of law at home, the rules-based order abroad—and replacing them with a simple test: “What’s in it for me?” He’s unilaterally disarming America of its soft power, making the United States no different from China, Russia, or Iran. This is why the gutting of USAID has received propaganda assistance and glowing reviews from Beijing, Moscow, and Tehran.

Transactional logic has an obvious appeal. Dispensing with the annoying niceties of multilateral partnerships and foreign aid brings a kind of clarity to international relations, showing where the real muscle is, like a strip-down before a wrestling match. Set loose, the U.S. might be strong enough to work its will on weaker friends and neighbors, or at least claim to do so. Trump’s threat of tariffs to intimidate Colombia into allowing deportation flights to land there was like the assault on USAID—an easy demonstration project. His domination of the propaganda sphere allows him to convince the public of victories even where, as with Canada, there was never much of a dispute to begin with. If NATO dissolved while the U.S. grabbed Greenland, many Americans would regard it as a net win: We’d save money and gain a strategic chunk of the North Atlantic while freeing ourselves of an obligation whose benefit to us wasn’t entirely clear.

It isn’t obvious why funding the education of oppressed Burmese students serves our national interest. It’s easier to see the advantages of strong-­arming weak countries into giving in to our demands. If this creates resentment, well, who said gratitude mattered between nations? Strength has its own attractive force. A sizable cohort of Americans have made their peace with Trump, not because he tempered his cruelty and checked his abuses but because he is at the height of his power and is using it without restraint. This is called power worship. The Russian invasion of Ukraine won Vladimir Putin a certain admiration in countries of the global South, as well as among MAGA Americans, while Joe Biden’s appeals to democratic values seemed pallid and hypocritical. The law of “might makes right” is the political norm in most countries. Trump needs no explaining in Nigeria or India.

Coercion also depends on the American people’s shortsightedness and incuriosity. Trump’s flood of executive orders and Musk’s assault on the federal government are intended to create such chaos that not even the insiders most affected understand what’s happening. An inattentive public might simply see a Washington melee—the disrupters against the bureaucrats. Short of going to war, if the U.S. starts behaving like the great powers of earlier centuries and the rival powers of our own, how many Americans will notice a difference in their own lives?

According to Rubio, the purpose of the aid pause is to weed out programs that don’t advance “core national interests.” Gawande compared the process to stopping a plane in midair and firing the crew in order to conduct a review of the airline industry. But the light of the bonfire burning in Washington makes it easier to see how soft power actually works—how most aid programs do serve the national interest. Shutting down African health programs makes monitoring the recent outbreak of Ebola in Uganda, and preventing its spread from that region to the rest of the world, nearly impossible. In many countries, the end of aid opens the door wider to predatory Chinese loans and propaganda. As one USAID official explained: “My job literally was countering China, providing develop­ment assistance in a much nicer, kinder, partnership way to local people who were being pressured and had their arms twisted.” When 70 Afghan students in central Asia, mostly women, had their scholarships to American universities suddenly suspended and in some cases their plane tickets canceled, the values of freedom and open inquiry lost a bit of their attractiveness. The American college administrator responsible for the students told me, “Young people who are sympathetic to the United States and share our best values are not only not being welcomed; they’re having the door slammed in their faces.”

Most Americans don’t want to believe that their government is taking life­saving medicine away from sick people in Africa, or betraying Afghans who sacrificed for this country. They might disapprove of foreign aid, but they want starving children to be fed. This native generosity explains why Trump and Musk have gone to such lengths to clog the internet with falsehoods and hide the consequences of their cruelty. The only obstacle to ending American soft power isn’t Congress, the bureaucracy, or the courts, but public opinion.

One of the country’s most popular programs is the resettlement of refugees. For decades, ordinary American citizens have welcomed the world’s most persecuted and desperate people—European Jews after World War II, Vietnamese after the fall of Saigon, Afghans after the fall of Kabul. Refugees are in a separate category from most immigrants: After years of waiting and vetting by U.S. and international agencies, they come here legally, with local sponsors. But Trump and his adviser Stephen Miller see them as no different from migrants crossing the southern border. The flurry of executive orders and memos has halted the processing of all refugees and ended funding for resettlement. The story has received little attention.

Here’s what the program’s shutdown means: I spoke with an Afghan special-forces captain who served alongside Americans—­when Kabul was about to fall in 2021, he prevented armed Taliban at the airport from seizing U.S. weaponry, but he was left behind during the evacuation. Arrested by the new regime, the captain was imprisoned for seven months and suffered regular and severe torture, including the amputation of a testicle. He managed to escape with his family to Pakistan in 2023 and was near the end of being processed as a refugee when Trump took office. He had heard Trump criticize the Biden administration for leaving military equipment behind in Afghanistan. Because he had worked to prevent that from happening, he told me, “that gave me a hope that the new administration would value my work and look at me as a valuable person, a person who is aligned with all the administration is hoping to achieve, and that would give a chance for my kids and family to be moved out safely.” Biden’s ineptitude stranded the captain once; Trump’s coldheartedness is doing it again.

A sense of loyalty and compassion isn’t extraneous to American identity; it is at the core of national pride, and its betrayal exacts a cost that can’t be easily measured. The Biden administration created a program called Welcome Corps that allows ordinary Americans to act as resettlement agencies. (My wife and I participated in it.) In Pennsylvania, a retiree named Chuck Pugh formed a sponsor group to bring an Afghan family here, and the final medical exam was completed just before Inauguration Day. When resettlement was abruptly ended, Pugh found himself wondering, Who are we? I know what I want to think, but I’m just not sure. The sponsor group includes Pugh’s sister, Virginia Mirra. She and her husband are devout Christians and ardent Trump supporters. When I asked her early this month how she felt about the suspension of the refugee program, she sounded surprised, and disappointed—she hadn’t heard the news. “I feel sad about that,” she said. “It does bother me. It’s starting to sink in. With these people in danger, I would wonder if there would be an exception made for them. How would we go about that?” Her husband frequently sends American-flag lapel pins to Trump, and I suggested that he write the president about the Afghan family. “I will talk to my husband tonight,” Mirra said. “And I will continue to pray that the Lord will protect them and bring them to this country by some means. I do believe in miracles.”

This article appears in the April 2025 print edition with the headline “The Era of Might Makes Right.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

Like many Americans lately, I am seized with curiosity about who is actually running the government of the United States. For that reason, I watched Sean Hannity’s Fox News interview tonight with President Donald Trump and Elon Musk.

But I am still not sure who’s in charge. If there is a headline from the interview, it is that the president of the United States feels that he requires the services of a multi-billionaire to enforce his executive orders. Trump complained that he would write these “beautiful” executive orders, that would then languish in administrative limbo. Musk, for his part, explained how the president is the embodiment of the nation and that resisting his orders is the same as thwarting the will of the people. Hannity, of course, enthusiastically supported all of this whining about how hard it is to govern a superpower.

In other words, it was an hour of conversation among three men who have no idea how American democracy works.

The goal of the interview, I assume, was to calm some of the waters around Trump’s relationship with Musk, and especially to present Musk as just another patriotic American who is only trying to help out his government in a time of crisis. Hannity deplored how shamefully the richest man in the world is being treated despite trying to create technologies to “help the blind to see.” Trump and Musk bemoaned how the world is trying to drive them apart, but affirmed that they like each other very much. “I wanted to find somebody smarter than him,” Trump said in one of his classic insult-praise combination punches, “but I couldn’t do it.”

[Jonathan Lemire: Elon Musk is president]

They may have even been telling the truth: Trump loves people who publicly love him back, and Musk seems to be grateful to be in a place—in this case, the White House—where people aren’t judging him for supporting Trump, a new social opprobrium that clearly stings him. “The eye-daggers level is insane,” he said, after recounting that people at a dinner party reacted to Trump’s name as if they’d been hit with “a dart in the jugular that contained, like, methamphetamine and rabies.” (This, from a man whose social media feed is a daily exercise in trolling.)

The interview was arduous both for the viewer and for Hannity, because everyone who interviews Trump must always contend with the president’s apparent inability to hold a single thought for very long. Hannity, as usual, tried to throw softballs; Trump, as usual, missed every pitch. Hannity at one point noted that Trump has “become a student of history” and then asked how the Framers of the Constitution would view his efforts to rein in the bureaucracy. Trump verbally wandered about before returning to his talking points about Musk, who he said is “amazing” and “cares.” So say James Madison and the other Founders, apparently.

And so it went, with Trump digressing into various riffs drawn from his rally speeches, ranging from immigration to the money he saved on contracts for Air Force One to hurricane damage in North Carolina. (He was trying to praise Musk for providing Starlink access to stricken areas, but it was evident that Trump has no idea what Starlink is or does.)

A few other news flashes from the interview: The president of the United States thinks that the government should not pay its bills in full. It should lowball its contractors and force them to accept half payment, he said. Former President Joe Biden was going to leave two American astronauts marooned in space for “political reasons” according to Musk. Also, Biden wrecked America in every possible way, but they’re fixing it. Musk said he has never seen Trump do anything “mean” or “wrong,” while Trump claimed that he’s always respected Musk. Musk added that he’s never asked Trump for anything, ever, and that if a conflict should arise in his DOGE efforts, he’ll recognize it and recuse himself.  (Earlier today, when asked why DOGE and SpaceX employees are working at the FAA and DoD, agencies where Musk has contracts or regulatory relationships, Trump said: “Well, I mean, I’m just hearing about it.”) Finally, Trump and Musk expect to find a trillion dollars of fraud and waste in the government.

Musk did generally behave himself, instead of stealing the show as he did a few days ago in the Oval Office. When prompted by Trump, he said he very much liked “Bobby”—Robert F. Kennedy, Jr. —who he said was demonstrating the scientific method by questioning science.  And in an interesting moment of inadvertent candor, Musk also defended some of the people working for DOGE, noting that they were taking much lower pay to help the government rather than the salaries they could command in private industry—much like the people he’s working to get fired.

[Tom Nichols: Trump and Musk are destroying the basics of a healthy democracy]

Hannity at one point brushed away Musk’s status as an unelected functionary by noting that no one votes for the Cabinet, either, which returns us to the problem that this conversation took place among people who do not understand the basic structure of their own government. (Cabinet officials, unlike Musk, are confirmed by the Senate and impeachable; the days when Republicans objected to Hillary Clinton’s task force on health care because she was unelected and unaccountable are now only of blessed memory.)

After an hour of this rambling and sometimes weird conversation, all I could think of was George W. Bush’s reported reaction to Trump’s first inaugural address: “That was some weird shit.”

This low-key fandango was probably good enough for MAGA fan-servicing purposes, but seems unlikely to reassure the millions of Americans doubtful that the president and the plutocrat know what they’re doing. The president seems only dimly aware of the details of Musk’s adventures, but he’s certain a smart guy like Musk is furthering his agenda—whatever it is. Musk, who answers to no one, is full of fervor to kill off government agencies he does not understand, because unelected rich men firing probationary federal employees is apparently how true Jeffersonian democracy is restored to an ailing America.

How long this chaos can go on is anyone’s guess. At some point, Musk might cross one of Trump’s other officials, or he might bring enough bad press that Trump himself could end up throwing Musk off the ship of state, as he has done to so many other of his loyal subordinates. But no matter how it ends, Trump will still be president, and Musk will still be rich. The rest of us, unfortunately, will be living with the damage done.

In pre-COVID times, I published a book about how to use data in early-childhood parenting, and one of the book’s long chapters was on vaccines and evidence for their safety. When the book was published, I wondered whether I would get questions on this topic. Breastfeeding, sleep training, and day care all came up regularly. But I remember being asked about vaccines only once. People seemed to have read the chapter, accepted it, and moved on.

Today, the world of vaccine questions has totally changed—in my view, for the much worse. I’m not just referring to the spectacle of Robert F. Kennedy Jr.’s likely ascension to the top of the government’s health-care bureaucracy or of Republican senators questioning vaccine safety publicly. Something is also happening among parents. I’ve continued to write about parenting, and to talk with parents about vaccines. And those conversations over the past few years—and especially the past year—have completely changed.

The first change is obvious: The parents and public personalities who strongly oppose vaccines have gotten louder. They have developed larger platforms, and faced less stigma for making hard-line anti-vaccination statements. Skepticism has gone more mainstream.

[Read: To understand anti-vaxxers, consider Aristotle]

The second change is less obvious, but more important: There has been huge growth in the number of parents who belong to what I think of as “the middle group”—parents who are not fundamentally opposed to vaccines but do have more questions, more concerns, and (often) more skepticism than parents had in the past. This group wants to do their own research, or at least hear about the details of research from people and institutions they trust—which does not include the government or the American Academy of Pediatrics.

With more parents in this questioning group, the market for vaccine misinformation is bigger than ever. Deeply flawed studies that would, in the past, have gotten no airtime are now being widely circulated, cited, and believed.

One recent example: Anthony Mawson, a well-known anti-vaccination advocate, released a new study online. The study, which was posted on a website that focuses on research critical of vaccines, has deep methodological flaws. The authors claim to have compared unvaccinated and vaccinated children in Florida, and to show higher autism rates among the vaccinated children. But the data on who is and isn’t vaccinated seem suspect: Far too many children were labeled as unvaccinated relative to the population being studied, suggesting that the researchers somehow miscategorized a large number of vaccinated children. (This is just one of several problems.)

In the past, such a study would never have been given any attention outside of the fringe communities that already bought into the view it supported. In the current climate, it was everywhere on Instagram (posted by accounts with huge followings) and in Facebook groups, and was even cited at the confirmation hearing for Kennedy, who suggested that this study was a reason for continued skepticism about vaccines.

“Is this true?” filled my inbox. “Can you reassure me?” “I’m about to vaccinate my child but now I’m not sure!” This is where we are, and where we are headed.

How did this happen? Although no trend ever has a single, simple explanation, my one-word answer is: COVID. More specifically, the ways that COVID shifted Americans’ conception of which authorities are trustworthy. It’s a cliché that trust, once lost, is difficult to regain. Less well understood is that, once gained, trust can be exploited.

The shift in trust began with shutdowns. Some people may still believe that the early-era COVID restrictions were a good idea, but many people do not, and did not at the time. Parents were angry about school closures; businesses were angry about lost customers. Many of these restrictions had a political bent—Republicans were less in favor of restrictions than Democrats. People started to lose trust in some institutions—such as the government and mainstream public-health groups—and transferred some of that trust to others, especially influencers.

[Read: What an undervaccinated America would look like]

Then vaccines arrived. I want to be clear: Operation Warp Speed was, as a scientific matter, an unbelievable success. It saved millions and millions of lives. If it had moved slower, more people would have died. However, it also made people nervous, as new technologies often do. That anxiety was an opening for people who oppose vaccines, many of whom had also opposed lockdowns. Some of them were able to use the trust they had recently gained to generate vaccine resistance.

Activists twisted facts (for example, that the vaccine was developed quickly) to imply falsehoods (for example, that it was not subject to large trials). They jumped on every misstep, such as initial overstatements about the vaccines’ effect on transmission, to sow concern and confusion.

This might have stayed in the domain of COVID except that these activists now had people’s trust, and their concerns about vaccines did not end with the new COVID shots. If you trust me rather than the public-health authorities on this one vaccine, why not on the others?

I think some loss of trust would have taken place to some extent no matter what, but in the years during and since the pandemic, public-health advice has inadvertently made the problem worse.

In particular, public-health advice continues to recommend that everyone—including healthy adults and children—get a COVID-19 booster every year. These vaccines have been shown to be safe and, certainly, I think getting an annual COVID shot is a reasonable choice. However, the universal recommendation is out of step with many of our peer countries’ guidelines, and public-health authorities in the U.S. have failed to explain why the recommendations differ.

The push for mass COVID boosters has provided a continued opening for those who oppose vaccines to sow further doubt. There has been an effective weaponization of these booster recommendations to feed the narrative that governmental authorities are blindly promoting vaccines. People’s discomfort with these recommendations, to the extent that it exists, provides another opportunity to generate mistrust in the rest of the vaccine schedule.

[Billy Ball: My 6-year-old son died. Then the anti-vaxxers found out.]

The result of the combination of public-health overreach and motivated anti-vaccination forces is a reality with lower vaccination rates for childhood illnesses. They have already started to slide, and I worry this will go further. The world without childhood vaccines isn’t one I want to live in. As measles and pertussis vaccination rates go down, kids will get those diseases. And some of those kids will die. The same is true for other vaccine-preventable illnesses.

How can trust be regained, or at least vaccination rates increased? One real, but unfortunate, avenue is disease. I’ve found in my research that when there are outbreaks of vaccine-preventable diseases, people are more likely to vaccinate. If measles or polio vaccination rates fall to a point that those diseases begin to appear frequently in the population, vaccination rates will go up.

A more hopeful possibility lies in the role of pediatricians. People trust their pediatricians, and that group has an opportunity to help parents really understand their vaccine choices. The data do support trust in vaccines, and if that message can be delivered by someone whom parents trust, it can make a difference.

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America’s health secretaries, almost as a rule, have résumés manicured to a point of frictionlessness. Once in a while one will attract scandal in their tenure; see Tom Price’s reported fondness for chartered jets. But anyone who has garnered enough cachet to be nominated to head the Department of Health and Human Services tends to arrive in front of the Senate with such impeccable credentials that finding anything that might disqualify them from the position is difficult.

Donald Trump’s selection of Robert F. Kennedy Jr., who was confirmed today as America’s newest health secretary, was specifically intended to break that mold. Kennedy positioned himself as a truth teller determined to uproot the “corporate capture” and “tyrannical insensate bureaucracies” that had taken hold of the nation’s public-health agencies. Even so, it’s remarkable just how unimaginable his confirmation would have been in any political moment other than today’s, when an online reactionary has been given a high-level position in the Justice Department and a teenager known as “Big Balls” is advising the State Department. Kennedy holds broadly appealing views on combatting corruption and helping Americans overcome chronic disease. But he is also, to an almost cartoonish degree, not impeccably credentialed. He has trafficked in innumerable unproven and dangerous conspiracy theories about vaccines, AIDS, anthrax, President John F. Kennedy’s assassination, COVID-19, sunlight, gender dysphoria, and 5G. He has potential financial conflicts of interest. He has spoken about a worm eating part of his brain and about dumping a dead bear in Central Park. He has been accused of sexual assault. (In his confirmation hearing, Kennedy denied the allegation and said it was “debunked.”)

In the end, none of it mattered. While Senate Democrats unanimously opposed Kennedy’s confirmation, he sailed through the Senate’s vote this morning after losing just one Republican vote, Senator Mitch McConnell of Kentucky, a polio survivor who appears to have taken issue with Kennedy’s anti-vaccine activism. Kennedy did, however, earn the support of Senator Bill Cassidy, a physician who until last week seemed to be the Republican lawmaker most concerned about the potential damage of elevating an anti-vaccine conspiracy theorist to the nation’s highest perch in public health. Kennedy’s confirmation is a victory for Trump, and a clear message that Senate Republicans are willing to embrace pseudoscience in their unwavering deference to him. Americans’ health is in Kennedy’s hands.

So what happens next? Spokespeople for Kennedy did not respond to my request to talk with him about his agenda. Nevertheless, Kennedy’s first weeks in office will likely be hectic ones, adding to the chaos of Trump’s nonstop executive orders and Elon Musk’s crackdowns on numerous federal agencies. As HHS head, Kennedy will oversee 13 different agencies, including the CDC, FDA, and National Institutes of Health. Prior to being appointed, Kennedy said he believed that 600 employees would need to be fired at the NIH and replaced with employees more aligned with Trump’s views. (The NIH employs roughly 20,000 people, so such a cut at least would be minor compared with the Department of Government Efficiency’s more sweeping moves.) He has also implied that everyone at the FDA’s food center could be handed pink slips. More generally, he has said he will “remove the financial conflicts of interest in our agencies,” but he hasn’t spelled out exactly who he believes is so conflicted that they should be out of a job.

At NIH in particular, any sudden moves by Kennedy would compound changes already unfolding under the auspices of DOGE. Musk’s crew has attempted to dramatically cut the amount of administrative funding typically doled out by the agency to universities in support of scientific research. Planned meetings about those funds were also abruptly canceled last month. (The funding cuts have been temporarily halted by a federal judge, and funding meetings appear to have resumed.) It’s easy to assume that Kennedy would support these efforts, given his aspirations to fire federal bureaucrats. But the DOGE effort may in fact undermine his larger goals, setting up some potential tension between Kennedy and Musk. Research funding is essential to Kennedy’s pursuit of unraveling the causes of America’s chronic-disease crisis; he has suggested devoting more of the NIH’s resources to investigating “preventive, alternative, and holistic approaches to health.”

On the policy front, in both the immediate and long term, chronic diseases will likely occupy Kennedy’s attention the most. He has called that issue an existential threat to the United States, and it is the clearest part of Kennedy’s agenda that has bipartisan support. However, exactly what he can do on this issue is uncertain. Many of the policies he’s advocated for, such as removing junk food from school lunches, actually fall to a different agency: the U.S. Department of Agriculture. The only food-related policy he’s regularly touted that he has the power to enact is banning certain chemical additives in the food supply. Even so, banning a food additive is typically a laboriously slow legal process.

His public statements provide other, vaguer hints about issues that he will likely contend with during his term. On abortion, he has said that he will direct the FDA and NIH to closely scrutinize the safety of the abortion pill mifepristone. (Trump has previously suggested that his administration would protect access to abortion pills, though the president’s position is murky at best.) On the price of drugs, Kennedy has said that he wants to crack down on the middlemen who negotiate them for insurance companies. But by and large Kennedy has said little about how he will tackle the complex regulatory issues that are traditionally the focus of the health secretary. He might simply not have that much to say. Kennedy has implied that he cares far less about those topics than about diet and chronic disease. During his confirmation hearing, he told senators that focusing on issues such as insurance payments without lowering the rate of chronic illness would be akin to “moving deck chairs around on the Titanic."

The biggest and most consequential question mark is how Kennedy will approach vaccines. If he were to chip away at Americans’ access to shots, or even simply at Americans’ readiness to receive them, he could degrade the nation’s protections against an array of diseases and, ultimately, be the cause of people’s deaths. Kennedy’s anti-vaccine advocacy was the subject of some of the most intense scrutiny during his confirmation hearings. “If you come out unequivocally, ‘Vaccines are safe; it does not cause autism,’ that would have an incredible impact. That’s your power. So what’s it going to be?” Cassidy asked. Kennedy pledged that he would not deprioritize or delay approval of new vaccines, and not muck up the government’s vaccine-approval standards. Throughout the process, he attempted to distance himself from his past vaccine positions, which include an assertion that the federal officials supporting the U.S. childhood-vaccine program were akin to leaders in the Catholic Church covering up pedophilia among priests. But his answers to senators’ questions about his past remarks and whether vaccines cause autism were consistently evasive. And some of his plans play into the anti-vaccine camp’s hands. He has promised, for example, to push for government-funded studies to be released with their full raw data—a move that likely would please transparency advocates, though also would act as an olive branch to anti-vaccine activists who have had to sue federal agencies in recent years for certain vaccine data.

Last week, after Cassidy cast a decisive committee vote that allowed Kennedy’s nomination to advance to full Senate consideration, he said in a speech on the Senate floor that he had pressure-tested Kennedy enough to feel confident that he could rebuild trust in public health. (Cassidy did not mention that advancing Kennedy was also in his political interest. A spokesperson for Cassidy declined my requests for an interview.) Kennedy holds an almost biblical status among his supporters, and a significant portion of those people distrust federal health agencies. Cassidy’s professed belief in Kennedy’s leadership offers a soothing vision: Imagine Americans whose views on the public-health establishment have been deeply eroded over time, all with their faith restored in one of the world’s most rigorous scientific institutions thanks to a radical outsider.

But consider the logic here. By voting to confirm Kennedy, the U.S. Senate is wagering the future of our public-health system on a prayer that a conspiracy theorist can build back up the agencies that he and his supporters have spent years breaking down. A more realistic outcome may be that Kennedy leaves public health more broken than ever before. Although many Americans are skeptical of the government’s scientific institutions, polls show that relatively few have the sort of deep-seated contempt for public-health agencies that Kennedy has espoused. By pandering to that fraction of voters, Kennedy risks alienating the much larger portion of Americans who might not agree with everything the CDC has done in recent years, but also don’t think that the agency’s vaccine program is comparable to a Nazi death camp, as Kennedy has claimed.

If Kennedy did go so far as to disavow any connection between autism and vaccines, that itself might lead to trouble. Jennifer Reich, a professor at the University of Colorado at Denver who has studied vaccine skepticism, told me that the autism issue is just one part of a larger, much more diffuse set of concerns shared by parents who question vaccinating their children. For RFK to disavow all of his vaccine antagonism, he would essentially have to abandon his prima facie skepticism toward science more generally. Such an apology would likely do more to turn some of his most ardent supporters against him than change their views, argues Alison Buttenheim, an expert on vaccine skepticism at the University of Pennsylvania. “People will do amazing leaps and cartwheels to not have their beliefs and their behaviors in conflict,” she told me.

If Kennedy genuinely wants to restore faith in public health, he’ll have to win over his fellow conspiracists while maintaining the trust of the many people who already thought the agencies were doing a fine job before he arrived. Perhaps he’ll try. But proclaiming, as he did in October, that the “FDA’s war on public health is about to end” is not a great way to start.

Twice during his Senate confirmation hearings at the end of last month, Robert F. Kennedy Jr., America’s new health secretary, brought up a peer-reviewed study by a certain “Mawson” that had come out just the week before. “That article is by Mawson,” he said to Senator Bill Cassidy, then spelled out the author’s name for emphasis: “M-A-W-S-O-N.” And to Bernie Sanders: “Look at the Mawson study, Senator … Mawson. Just look at that study.”

“Mawson” is Anthony Mawson, an epidemiologist and a former academic who has published several papers alleging a connection between childhood vaccines and autism. (Any such connection has been thoroughly debunked.) His latest on the subject, and the one to which Kennedy was referring, appeared in a journal that is not indexed by the National Library of Medicine or by any other organization that might provide it with some scientific credibility. One leading member of the journal’s editorial board, a stubborn advocate for using hydroxychloroquine and ivermectin to treat COVID-19, has lost five papers to retraction. Another member is Didier Raoult (whose name the journal has misspelled), a presence on the Retraction Watch leaderboard, which is derived from the work of a nonprofit we cofounded, with 31 retractions. A third, and the journal’s editor in chief, is James Lyons-Weiler, who has one retraction of his own and has called himself, in a since-deleted post on X, a friend and “close adviser to Bobby Kennedy.” (Mawson told us he chose this journal because several mainstream ones had rejected his manuscript without review. Lyons-Weiler did not respond to a request for comment.)

Perhaps a scientist or politician—and certainly a citizen-activist who hopes to be the nation’s leading health-policy official—should be wary of citing anything from this researcher or this journal to support a claim. The fact that one can do so anyway in a setting of the highest stakes, while stating truthfully that the work originated in a peer-reviewed, academic publication, reveals an awkward fact: The scientific literature is an essential ocean of knowledge, in which floats an alarming amount of junk. Think of the Great Pacific Garbage Patch, but the trash cannot be identified without special knowledge and equipment. And although this problem is long-standing, until the past decade or so, no one with both the necessary expertise and the power to intervene has been inclined to help. With the Trump administration taking control of the CDC and other posts on the nation’s science bulwark, the consequences are getting worse. As RFK Jr. made plain during his confirmation hearing, the advocates or foes of virtually any claim can point to published work and say, “See? Science!”

This state of affairs is not terribly surprising when one considers how many studies labeled as “peer reviewed” appear every year: at least 3 million. The system of scientific publishing is, as others have noted, under severe strain. Junk papers proliferate at vanity journals and legitimate ones alike, due in part to the “publish or perish” ethos that pervades the research enterprise, and in part to the catastrophic business model that has captured much of scientific publishing since the early 2000s.

That model—based on a well-meaning attempt to free scientific findings from subscription paywalls—relies on what are known as article-processing charges: fees researchers pay to publishers. The charges aren’t inconsequential, sometimes running into the low five figures. And the more papers that journals publish, the more money they bring in. Researchers are solicited to feed the beast with an ever-increasing number of manuscripts, while publishers have reason to create new journals that may end up serving as a destination for lower-quality work. The result: Far too many papers appear each year in too many journals without adequate peer review or even editing.

[Read: The real cost of knowledge]

The mess that this creates, in the form of unreliable research, can to some extent be cleaned up after publication. Indeed, the retraction rate in science—meaning the frequency with which a journal says, for one reason or another, “Don’t rely on this paper”—has been growing rapidly. It’s going up even faster than the rate of publication, having increased roughly tenfold over the past decade. That may sound like editors are weeding out the literature more aggressively as it expands. And the news is in some ways good—but even now, far more papers should be retracted than are retracted. No one likes to admit an error—not scientists, not publishers, not universities, not funders.

Profit motive can sometimes trump quality control even at the world’s largest publishers, which earn billions annually. It also fuels a ravenous pack of “paper mills” that publish scientific work with barely any standards whatsoever, including those that might be used to screen out AI-generated scientific slop.

An empiricist might say that the sum total of these articles simply adds to human knowledge. If only. Many, or even most, published papers serve no purpose whatsoever. They simply appear and … that’s it. No one ever cites them in subsequent work; they leave virtually no trace of their existence.

Until, of course, someone convinces a gullible public—or a U.S. senator—that all research currency, new and old, is created equal. Want to make the case that childhood vaccines cause autism? Find a paper in a journal that says as much and, more important, ignore the countless other articles discrediting the same idea. Consumers are already all too familiar with this strategy: News outlets use the same tactic when they tell you that chocolate, coffee, and red wine are good for you one week—but will kill you the next.

Scientists are not immune from picking and choosing, either. They may, for example, assert that there is no evidence for a claim even though such evidence exists—a practice that has been termed “dismissive citation.” Or they may cite retracted papers, either because they didn’t bother checking on those papers’ status or because that status was unclear. (Our team built and shared the Retraction Watch Database—recently acquired by another nonprofit—to help address the latter problem.)

The pharmaceutical industry can also play the science-publication system to its advantage. Today, reviewers at the FDA rely on raw data for their drug approvals, not the questionable thumbs-up of journals’ peer review. But if the agency, flawed as it may be, has its power or its workforce curbed, the scientific literature (with even greater flaws) is not prepared to fill the gap.

Kennedy has endorsed at least one idea that could help to solve these many problems. At his confirmation hearing, he suggested that scientific papers should be published alongside their peer reviews. (By convention, these appraisals are kept both anonymous and secret.) A few publishers have already taken this step, and although only time will tell if it succeeds, the practice does appear to blunt the argument that too much scientific work is hashed out behind closed doors. If such a policy were applied across the literature, we might all be better off.

Regardless, publishers must be more honest about their limitations, and the fact that many of their papers are unreliable. If they did their part to clean up the literature by retracting more unworthy papers, even better. Opening up science at various stages to more aggressive scrutiny—“red teaming,” if you will—would also help. Any such reforms will be slow-moving, though, and America is foundering right now in a whirlpool of contested facts. The scientific literature is not equipped to bail us out.

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The single greatest success of Donald Trump’s second term so far might be his Cabinet. Today, senators confirmed Robert F. Kennedy Jr. to lead the Department of Health and Human Services, one day after confirming Tulsi Gabbard as director of national intelligence. The nomination of Kash Patel to lead the FBI is headed to a floor vote, and Linda McMahon—chosen to lead and apparently dismantle the Department of Education—is testifying to senators today.

Many parts of Trump’s agenda are deceptively fragile, as the journalist Ezra Klein recently argued. Courts have stepped in to block some of his executive orders and impede Elon Musk’s demolition of broad swaths of the federal government as we know it. Republicans in Congress still don’t seem to have a plan for moving the president’s legislative agenda forward. But despite clear concern from a variety of Republican senators about Trump’s Cabinet picks, it now seems possible that Trump will get every one confirmed except for Matt Gaetz—an indication of how completely Senate Republicans have surrendered their role as an independent check on the president.

The initial rollout of nominees was inauspicious. Gaetz, whom Trump reportedly chose spontaneously during a two-hour flight, lasted just eight days before withdrawing his nomination, after it became evident that Republicans would not confirm him. The rest of the slate was weak enough that at least one more casualty was likely, though I warned in November that a uniformly bad group might perversely make it harder for Republicans to take down any individual. How could they say no to one and justify saying yes to any of the others?

Pete Hegseth had no clear qualifications to run the Defense Department, serial infidelities, and allegations of a sexual assault and alcohol abuse. (He has denied both allegations, and settled with the sexual-assault accuser out of court. Prosecutors have said that they did not have sufficient evidence to pursue charges.) Gabbard not only lacked any intelligence experience but also brought a history of views antithetical to many Republican senators, an affinity for deposed Syrian dictator Bashar al-Assad and Russian President Vladimir Putin, and evidence of dishonesty. Patel was, in the view of many of his former colleagues in the first Trump administration, simply dangerous. Kennedy was, um, Robert F. Kennedy Jr.

Now all seem likely to take up their posts. Sure, it’s taken a while. Democrats have done what they can to slow down many of these nominations, and they voted unanimously against Hegseth, Kennedy, and Gabbard (a former Democratic House member!). Republicans objected when the administration tried to drive nominees through without FBI background checks, and damaging information about each of these nominees has continued to emerge; earlier this week, Democratic Senator Dick Durbin accused Patel of orchestrating a political purge at the FBI, despite promises not to do so. Yet none of that has mattered to the results.

Getting this done has required the White House to do some deft maneuvering. Trump allies publicly bullied Joni Ernst, an Iowa Republican who is a veteran and an outspoken advocate for victims of sexual assault, into backing Hegseth. According to The Wall Street Journal, they privately bullied the Republican Thom Tillis, a North Carolinian who has sometimes bucked Trump and faces a tough reelection campaign next year, after he indicated that he’d vote against Hegseth; he ultimately voted in favor. They horse-traded with Bill Cassidy, a Louisiana medical doctor who sounded very skeptical of Kennedy during hearings, giving him undisclosed reassurances in exchange for his support. As Politico reported, Trump dispatched J. D. Vance to absorb the grievances of Todd Young, an Indiana senator, about Gabbard; the vice president called off attacks from Trump allies and won Young’s vote.

One lone Republican voted against all three: Kentucky’s Mitch McConnell, the man responsible for keeping GOP senators lined up behind Trump during his first four years in office. The rest have various justifications for voting more or less in lockstep. They say they were reassured by what they heard in meetings—as though they’ve never seen a nominee fib, and as though that outweighed long histories. They say that presidents deserve to have the advisers they want. Behind closed doors, they might lay out a different calculation: Voting no on Cabinet members is a good way to tick Trump off while gaining little more than symbolism; better for them to keep their powder dry for real policy issues where they disagree with him.

These rationalizations might have made sense for a distasteful nominee here and there, but what Trump has put forward is likely the least qualified Cabinet in American history. In 2019, the Senate deep-sixed John Ratcliffe’s nomination as DNI (though it did confirm him a year later); this time around, when nominated for director of the CIA, he was seen as one of the more sober and qualified picks. Putting people like Trump’s nominees in charge of important parts of the federal government poses real dangers to the nation. Tom Nichols has explained how Hegseth exemplifies this: He seems more interested in bestowing trollish names on bases and giving contradictory messages about Ukraine than the tough work of running the Pentagon. That’s bad news in the immediate term and worse news when a crisis hits.

The idea of waiting to push back on Trump later might be more convincing if no one had ever seen him in action, as I discussed yesterday. Successfully ramming through this slate of nominees will only encourage the president. If Republican members wanted to, they could exert unusual leverage over the White House because of the narrow 53–47 margin in the chamber; Kyrsten Sinema and Joe Manchin showed during the Biden presidency how a tiny fraction of the Democratic caucus could bend leadership to its will. But if Trump managed to get senators to vote for Gabbard and Kennedy, two fringe nominees with some far-left views, why should he expect them to restrain him on anything else?

The real reason for these votes is presumably fear. Republicans have seen Trump’s taste for retribution, and they fear his supporters in primaries. The irony is that in bowing to Trump, senators may actually be defying voters’ preferences. A CBS News poll published Monday found that six in 10 GOP voters would prefer to see congressional Republicans stand up to Trump when they disagree with him. By knocking down some of the worst nominees, senators might have made the Cabinet better and served the country well. But if that wasn’t enough to persuade them, perhaps the chance for political gain could.

Related:

Kash Patel will do anything for Trump. The perverse logic of Trump’s nomination circus (From November)

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The “Gulf of America” is an admission of defeat, David Frum writes. RFK Jr. won. Now what? Who’s running the Defense Department? Anne Applebaum: There’s a term for what Trump and Musk are doing.

Today’s News

Trump signed a proclamation that outlines a plan to implement reciprocal tariffs for any country that imposes tariffs on the United States. A federal judge extended the pause on the Trump administration’s efforts to dismantle USAID for at least another week. Roughly 77,000 federal employees accepted the Trump administration’s buyout offer by last night’s deadline after a federal judge lifted the freeze on the program yesterday.

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The House Where 28,000 Records Burned

By Nancy Walecki

Before it burned, Charlie Springer’s house contained 18,000 vinyl LPs, 12,000 CDs, 10,000 45s, 4,000 cassettes, 600 78s, 150 8-tracks, hundreds of signed musical posters, and about 100 gold records. The albums alone occupied an entire wall of shelves in the family room, and another in the garage. On his desk were a set of drumsticks from Nirvana and an old RCA microphone that Prince had given to him at a recording session for Prince. A neon Beach Boys sign—as far as he knows, one of only eight remaining in the world—hung above the dining table.

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Kennedy will now oversee the US health industry including food safety, pharmaceuticals and vaccinations.

The lawsuit filed last week to halt the Trump administration’s dismantling of the U.S. Agency for International Development stands on a bedrock constitutional principle: “Congress, not the President or the U.S. Constitution, creates and organizes the offices and departments” of the government—as a 2017 Heritage Foundation report accurately stated.

Good-faith arguments exist both for and against America having an independent USAID, or—to name another Donald Trump target—a stand-alone federal Department of Education. Over the decades, Congress has changed its mind about both. Constitutionally, however, that’s the point: The decision is up to Congress. Unilateral moves to dismantle USAID, to mothball the Consumer Financial Protection Bureau, or, if Trump’s advisers have their way, to disassemble the Education Department are beyond the president’s constitutional authority.

Since the Kennedy administration, foreign-assistance functions have been lodged in different agency homes. With authority granted him by the Foreign Assistance Act of 1961, President John F. Kennedy established USAID as a division of the State Department. Using powers delegated to him by statutes enacted in 1979, President Jimmy Carter moved USAID’s functions to the United States International Development Cooperation Agency. In 1998, Congress gave President Bill Clinton authority to either return USAID to the State Department or allow it to become an independent establishment within the executive branch; Clinton did the latter. Although presidential judgment thus informed the shape of USAID at every stage of its evolution, everything that presidents pre-Trump did with regard to the structure of USAID or the allocation of its functions was done pursuant to laws that Congress had enacted. No president asserted authority independent of Congress to create, reshape, or eliminate USAID.

This history reflects the Framers’ decision to give Congress, not the president, the authority to generate the executive-organization chart. The Constitution’s executive-branch charter, Article II, envisions what we now call the federal bureaucracy. The president is given explicit authority to “require the opinion, in writing, of the principal officer in each of the executive departments, upon any subject relating to the duties of their respective offices.” But Article II says nothing else about those “departments.” Instead, Article I of the Constitution, the charter for the legislative branch, assigns to Congress the responsibility to “make all laws which shall be necessary and proper for carrying into execution … all … powers vested by this Constitution in the government of the United States, or in any department or officer thereof.” The president’s job is to faithfully execute the law, but law—including law that establishes and structures executive offices and agencies—gets made by Congress.

[Read: The other fear of the founders]

Since the very first Congress, the legislative branch has jealously guarded its power over organization. When the first House bill creating the Department of Foreign Affairs was introduced in the Senate, Senator William Maclay of Pennsylvania suggested that the organization of the executive branch might be left to the president, as the holder of executive power. His scheme would have given to the president the power of a British monarch to create offices. The Senate rejected his position, and the First Congress enacted a round of statutes organizing the new departments—Foreign Affairs, War, and Treasury. The statutory duties of the secretaries heading Foreign Affairs and War were largely to carry out presidential instructions; Congress recognized that Article II envisioned significant discretionary roles in foreign and military affairs for the president. The Treasury, however, was organized in detail. Not only did Congress assign the Treasury Secretary a significant number of specific legal duties, but it also created additional offices within the department—all requiring Senate advice and consent. These additional offices, as explained by the administrative-law scholar Jerry L. Mashaw, “were meant to provide checks on the Secretary and each other in the crucial matter of safeguarding the integrity of the fiscal and monetary affairs of the nation.” Congress went on to create a variety of other agencies, including the Mint, the Post Office, a Customs Service, and a national bank, tailoring the structure of each according to its sense of how best to fit structure to mission. No one doubted that this was Congress’s prerogative to decide.

Supreme Court jurisprudence recognized Congress’s role. In Myers v. United States, the 1926 Supreme Court decision most protective of broad presidential power over administration, Chief Justice (and former president) William Howard Taft acknowledged: “To Congress under its legislative power is given the establishment of offices, the determination of their functions and jurisdiction, the prescribing of reasonable and relevant qualifications and rules of eligibility of appointees, and the fixing of the term for which they are to be appointed.” This proposition has never been open to serious question.

Congress has recognized, of course, that presidents may have valuable ideas regarding administrative organization. Beginning in 1939, Congress enacted a series of so-called Reorganization Acts, which gave presidents significant (but not unlimited) discretion to create, abolish, or restructure administrative agencies, subject to an important caveat. Presidential reorganization plans were subject to a “legislative veto”—that is, a resolution disapproving the plan enacted by both Houses of Congress, which could keep it from going into effect. This would be a concurrent resolution of the House and the Senate that the president could not veto and did not have to sign in order to make it binding. Through the threat of legislative vetoes, Congress kept control over what got created, abolished, or restructured.

In 1983, however, the Supreme Court held that legislative vetoes were an unconstitutional form of legislation. As a result, Congress took away presidential authority to implement reorganizations unilaterally. If presidential reorganization plans could not easily be blocked, Congress would no longer authorize them. Since 1984, presidents have been allowed only to propose reorganizations, which Congress could enact or reject through the ordinary legislative process. (A suggestion in 2023 by Vivek Ramaswamy that a 1977 Reorganization Act continues to empower presidents to abolish agencies despite the statutory changes Congress enacted in 1984 is an appallingly fanciful statutory interpretation.)

[Read: The Constitutional crisis is here]

In light of this legal background, the question is why Trump thinks a president can legally disassemble agencies on his own—assuming, that is, that he cares if it is legal. The likely answer would involve an especially ambitious version of an Article II interpretation called the “unitary executive theory.” The baseline premise of the unitary executive theory is that Article II guarantees presidents complete removal authority over every subordinate member of the executive branch. Bolder versions contend that he or she can also directly command how every function of the executive branch be performed—or even perform them personally.

The Supreme Court has never fully embraced the unitary executive theory. However, a broad reading of the Myers decision mentioned earlier—a reading the Court unanimously rejected seven years later—would invalidate any attempt by Congress to create independent administrators protected from presidential at-will removal. The Roberts Court has gone nearly all in on the broad reading of Myers, treating Humphrey’s Executor v. U.S., the 1935 opinion upholding the Federal Trade Commission, as a mere exception to Myers. (In the intervening decades, the Supreme Court had repeatedly reaffirmed Humphrey’s Executor as the controlling authority, most famously in its 1988 decision upholding the constitutionality of post-Watergate independent counsels.) As a result, the constitutionality of agency structures such as the Federal Trade Commission and the National Labor Relations Board now hangs by a thread; the Court could conceivably uphold the firing of the NLRB member Gwynne Wilcox.

Of course, even a presidential power to fire an individual agency head would not necessarily translate into authority to shut down entire government departments. However, in its 2024 opinion granting former presidents all-but-blanket immunity from prosecution for crimes committed while in office, the Court seemed to signal something far more ominous. The majority described the president’s authority to supervise the executive branch as a power that Congress may not touch—a conclusion that flies in the face of constitutional text. As explained by the Harvard law professor Jack Goldsmith, who had headed the Justice Department’s Office of Legal Counsel during part of George W. Bush’s second administration: “The ruling about the exclusivity of presidential enforcement discretion, especially vis-à-vis Congress, is entirely novel … And it has potentially massive implications, depending on its scope.” What the opinion now apparently implies to Trump is that the president, constitutionally speaking, is the entirety of the executive branch, and he can configure it however he wants.

That said, Trump’s record of legal success in the Supreme Court is a mixed one. But he presumably thinks it a good bet either that the legal challenges to his scorched-earth tactics will be too slow to stop him or that, if they reach the Supreme Court, that body’s right-wing supermajority will continue to improvise on behalf of de facto executive supremacy. Eyeing the latter possibility, the newly confirmed Office of Management and Budget Director Russell Vought has affirmed the administration’s position that Congress lacks authority to force the spending of appropriated funds—a position the Supreme Court has never endorsed, and which is constitutionally unfounded. But a majority that would proceed as vigorously and creatively as it did to protect Trump from prosecution might be willing to improvise some more.

[Read: Trump signals he might ignore the courts]

A government agency’s structure and location are not just abstract; they matter to the work the agency does on the ground. When Congress extracted a Department of Education from what was formerly the Department of Health, Education, and Welfare, it was to give federal support for education greater emphasis. When Congress moved the Coast Guard from Transportation to Homeland Security, it was presumably to prioritize the Coast Guard’s role in security rather than safety. The reason proposals to merge the Bureau of Land Management and the U.S. Forest Service have always failed is that the organizational DNA of the Interior Department, which houses BLM, favors conservation, whereas the reflexive policy mood of the Agriculture Department, which owns the Forest Service, is pro-development.

Perhaps the most worrying development is that the administration’s commitment to obeying court orders may not prove any more reliable than its dedication to following statutes. On Sunday, with a soupçon of Trumpian deniability in his precise wording, Vice President J. D. Vance posted on X: “Judges aren’t allowed to control the executive’s legitimate power.” Taken literally, Vance’s statement is accurate; what it fails to acknowledge is that the judicial power includes authority to state just how far the executive’s legitimate power extends. In rejecting President Richard Nixon’s claim of entitlement to withhold the Watergate tapes, the Court held in a unanimous opinion: “Many decisions of this Court … have unequivocally reaffirmed the [1803] holding of Marbury v. Madison that ‘[i]t is emphatically the province and duty of the judicial department to say what the law is.’” Should Trump ignore any court order to halt his demolition of the executive branch, he will have dismantled not just an agency, but the Constitution itself.

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When it comes to tariffs for Canada and Mexico, America is ending the week pretty much as it started. Over the course of just a few days, Donald Trump—following up on a November promise—announced 25 percent tariffs on the country’s North American neighbors, caused a panic in the stock market, eked out minor concessions from foreign leaders, and called the whole thing off (for 30 days, at least). But the residue of this week’s blink-and-you-missed-it trade war will stick.

The consensus among economists is that the now-paused tariffs on Canada and Mexico would have caused significant, perhaps even immediate, cost hikes and inflation for Americans. Tariffs on Mexico could have raised produce prices within days, because about a third of America’s fresh fruits and vegetables are imported from Mexico, Ernie Tedeschi, the director of economics at Yale’s Budget Lab, told me in an email. But “uncertainty about tariffs poses a strong risk of fueling inflation, even if tariffs don’t end up going into effect,” he argued. Tedeschi noted that “one of the cornerstone findings of economics over the past 50 years is the importance of expectations” when it comes to inflation. Consumers, nervous about inflation, may change their behavior—shifting their spending, trying to find higher-paying jobs, or asking for more raises—which can ultimately push up prices in what Tedeschi calls a “self-fulfilling prophecy.”

The drama of recent days may also make foreign companies balk at the idea of entering the American market. During Trump’s first term, domestic industrial production decreased after tariffs were imposed. Although Felix Tintelnot, an economics professor at Duke, was not as confident as Tedeschi is about the possibility of unimposed tariffs driving inflation, he suggested that the threats could have ripple effects on American business: “Uncertainty by itself is discouraging to investments that incur big onetime costs,” he told me. In sectors such as the auto industry, whose continental supply chains rely on border crossing, companies might avoid new domestic projects until all threats of a trade war are gone (which, given the persistence of Trump’s threats, may be never). That lack of investment could affect quality and availability, translating to higher costs down the line for American buyers. Some carmakers and manufacturers are already rethinking their operations, just in case.

And the 10 percent tariffs on China (although far smaller than the 60 percent Trump threatened during his campaign) are not nothing, either. These will hit an estimated $450 billion of imports—for context, last year, the United States imported about $4 trillion in foreign goods—and China has already hit back with new tariffs of its own. Yale’s Budget Lab found that the current China tariffs will raise overall average prices by 0.1 to 0.2 percent. Tariffs, Tedeschi added, are regressive, meaning they hurt lower-earning households more than high-income ones.

Even the most attentive companies and shoppers might have trouble anticipating how Trump will handle future tariffs. Last month, he threatened and then dropped a tariff on Colombia; this week, he hinted at a similar threat against the European Union. There is a case to be made that Trump was never serious about tariffs at all—they were merely a way for him to appear tough on trade and flex his power on the international stage. And although many of the concessions that Mexico and Canada offered were either symbolic or had been in the works before the tariff threats, Trump managed to appear like the winner to some of his supporters.

Still, the longest-lasting damage of the week in trade wars may be the solidification of America’s reputation as a fickle ally. As my colleague David Frum wrote on Wednesday, the whole episode leaves the world with the lesson that “countries such as Canada, Mexico, and Denmark that commit to the United States risk their security and dignity in the age of Trump.”

Related:

The tariffs were never real. How Trump lost his trade war

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Evening Read

Illustration by Akshita Chandra / The Atlantic. Sources: Getty; Wikimedia Commons.

The Rise of the Selfish Plutocrats

By Brian Klaas

The role of the ultra-wealthy has morphed from one of shared social responsibility and patronage to the freewheeling celebration of selfish opulence. Rather than investing in their society—say, by giving alms to the poor, or funding Caravaggios and cathedrals—many of today’s plutocrats use their wealth to escape to private islands, private Beyoncé concerts, and, above all, extremely private superyachts. One top Miami-based “yacht consultant” has dubbed itself Medici Yachts. The namesake recalls public patronage and social responsibility, but the consultant’s motto is more fitting for an era of indulgent billionaires: “Let us manage your boat. For you is only to smile and make memories.”

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