Public Health Scrambles To Figure Out Trump's Health Orders
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It's Tuesday, January 28th. I'm Jane Koston, and this is What A Day, the show that will keep calling the Gulf of Mexico, the Gulf of Mexico. Sorry, Google. This show is staying strong on critical issues like what gulfs are called.

On today's show, Florida Republican Governor Ron DeSantis doesn't take rejection from his own party very well. And the Tuskegee Airmen and World War II Women's Air Force service pilots will remain in the Air Force's basic military training. But let's start with the Trump administration's war on public health, at the same time as H5N1, bird flu, is running rampant on farms and in flocks across the country.

Late Sunday, the Trump administration ordered federal health workers to stop working with the World Health Organization effective immediately. It followed President Trump's executive order last week to pull the U.S. out of the WHO entirely, though many believed it would happen gradually. And that's not all. The Trump administration directed federal health agencies to stop almost all external communications, from updating websites to issuing scientific reports.

According to the administration, this is supposed to be a temporary measure ending on February 1st. But the chaos is real, with conferences canceled and studies postponed and research that could save lives left up in the air.

And we're awaiting Robert F. Kennedy Jr.'s confirmation hearings for a potential role as secretary of the Department of Health and Human Services later this week. All in all, not great. So for more on Trump's public health orders and how they're resonating among the workforce, I talked to Dr. Abdul Al-Sayed. He's an epidemiologist and health officer for Wayne County, Michigan. He's also the host of the podcast America Dissected. Abdul, welcome back to What A Day.

Thank you so much for having me. And as is a running gag now on this show, I'm only brought back when like really terrible shit is happening in the world. So like I've said, at some point, I'm welcoming the opportunity to talk about my beautiful skincare routine if you would like that. Look, I would love nothing more than to talk about retinols and moisturizer. But...

We're not here for that. Abdul. That's not the world we live in. Sadly. So what's the mood like within the public health community right now? I'm imagining it's not great. Think the funeral of your favorite great aunt, the one who knitted you sweaters that you actually liked and made the best food.

and made you feel comfortable and confident in the world? That one. That's kind of the mood. It's like, how are we going to be okay? But then also, we have to be okay. And I'm getting texts from all corners of the world, folks who are working in the federal bureaucracy, which from them, it's like, what the hell is going on? To folks working in other health departments, to folks out in the research community who are watching as their funding may be slipping away, funding they've worked for for their entire lives.

And, and it's very frustrating. And then the other part of our work is that, you know, in some respects, the show must go on, right? We don't get to put a pause on H5N1 because an individual who has no basis in basic science may be confirmed HHS secretary. So we've got to keep going. And, and so, yeah.

It's a really difficult moment, but then there's also just a lot of resolve that we're going to try and do all the things that we need to do to keep people safe because that's the work we signed up for. Let's get into talking about H5N1, which is bird flu, which if you haven't been able to get eggs at the grocery store, that's why. And I'm worried about that for a lot of reasons, but-

The Trump administration ordered federal health officials to stop working with the World Health Organization effective immediately. With bird flu, what kind of chaos does this create? Tremendous chaos. So let me just clarify where we are in this situation because I think for a lot of folks who haven't been watching this,

What this is, is a virus that has been spreading, frankly, around the world now in migratory waterfowl, mainly since the late 1990s. And had you asked folks before COVID what the next pandemic would have been, they would have told you it was going to be H5N1. And what happened in April of 2024 is that we found that it spilled over into cattle and that has been spilling into mammalian species for a very long time now.

And so what the challenge is, is that we're watching this thing spread from animals into humans. Now, the cases that we've seen by for the most part haven't been too serious. But ask yourself, who are the folks who are most likely to get this virus from livestock? They're workers who work with livestock. So a lot of those folks tend to be undocumented.

And one of the things that we've seen from immigration officials is that they're no longer keeping themselves from raiding what they used to call sensitive locations, places like churches or places like clinics. And so now if you're somebody who may work at a dairy farm and you've got conjunctivitis and you wonder, I wonder if this is H5N1, the probability that you're going to go to a clinic and risk potentially being raided is a lot lower. And so we're in the situation now where it feels like the perfect storm.

To be clear, as of right now, there is no evidence that the disease is spreading between humans. But how worried should we be? So the situation right now as we stand is that we're not in a scenario that could potentially end up in a pandemic. But so long as this continues to spread between animals, right, we are creating the situation wherein a certain virus particle could evolve the ability to

That makes it able to spread between people. And if that were to happen, that's going to be that break glass situation. So I can't give you a particular probability that's based in any evidence, but I would tell you that this is the global health situation that folks are most worried about. And if you were going to watch one virus that would potentially go pandemic, it would be this one.

Which makes the fact that federal health agencies are also still prohibited from making any external communications deemed non-emergency seem very bad. What kinds of impediments does that lack of communications create for ongoing research or for telling people what the hell is going on in public health? Huge impediments. So I'll tell you, you know, when you talk to most people in public health,

The equivalent of our weather forecast is this publication called the Morbidity and Mortality Weekly Report, MMWR. And MMWR has been published on Thursday nights, Friday mornings. That's usually when you see it in your inbox.

every week since 1960, for the first time, those of us in public health basically went without our weather report in a moment when the free exchange of basic scientific information has is really important. And so the fact that we're flying blind and more importantly, the fact that folks in, uh,

The federal health agencies are now under a scenario where they've been warned about what to say, given that there has been a gag order that's violated all of the past precedent. I worry that we are going to be missing a very, very important picture, even if things get worse.

Because the impact of this gag order isn't just to shut down information flow right now. It's to tell folks that any information moving forward is going to be that which comports to political leadership. And if you remember back to the last pandemic, there was a very, very clear effort to mix the information to make sure that it was manipulated into what put the administration into the best political light. And when you're trying to take on a pandemic, that ain't it.

What has all of this chaos meant for city and state public health workers like you?

Yeah. We're spending a lot of our time now sitting down with our lawyers to ask, all right, what is it that is at risk? Where is our funding coming from? We don't know what is potentially going to get cut. We don't know what this anti-DEI effort will mean for investments in funding for folks in lower income, predominantly black and brown communities, like the one that I serve. And so we're sitting here tracing funds. And so there's just

a profound lack of clarity. And the fact that all of this is happening at the same time feels like it's part of the goal here. Finally, I'll tell you, I spent most much of last week thinking about the fact that we had H5N1, uh, the, the, the bird flu, uh, in a backyard flock in my County. And so, uh, we're thinking about, okay, so, uh,

How do we interact with the federal government on this? Because usually you would send your collected samples to the CDC. Are they there to receive it? And in the moment when you're not getting clear information back, it just makes any of these responses that much more difficult. And then multiply that by 3,000 local health departments just like mine, and you start to realize how complex and how dangerous this moment is.

I want to go back to the World Health Organization because, as we mentioned earlier, Trump has moved to pull the U.S. out of the WHO, and he wants federal health workers to immediately stop working with the agency. Can you explain why pulling out of the World Health Organization is such a big deal and the potential downsides for the U.S.? Yeah, so the reason that this is so dangerous for us right now and is dangerous for the world, frankly, is because we don't know where the next very serious pathogen is going to emerge.

And if we're serious about protecting our own people, we want to be sourcing and driving our best public health minds to those locations to protect folks there so that we protect it from spreading anywhere, including to our own shores. Think Ebola, for example.

One of the most important things we did during the Ebola epidemic was send our best public health minds over to West Africa to contain the virus there, to protect people there, yes, but also to protect it from coming here. And for the most part, it worked. We had a couple of cases among folks here, but we were able to contain it.

And so that's the approach that we would want to take. And considering the fact that we account for upwards of one sixth of the WHO's entire budget, the fact that we pulled out doesn't just keep us from being able to protect folks here by protecting folks abroad. It also undercuts the entire World Health Organization's ability to protect everybody globally. But like there's an underlying thread here to all of this that we really need to call out.

which is you can't really control science. And so you got to ask what's so threatening about the free flow of scientific information. It's that it's one of those things that politicians simply can't control, but this is an effort to do exactly that. And usually when you try and, you know,

manipulate or massage scientific messaging, it usually backfires in your face, which is exactly what we saw during the COVID-19 pandemic. And I worry that we have fundamentally failed to take that lesson. And we're putting ourselves in a position where we're all that much less secure for it. Abdul, as always, thank you so much for joining me.

I really appreciate you having me, Ethan. You know, next time, maybe we can talk retinol. Perfect. That was my conversation with Dr. Abdul Al-Sayed, health officer for Wayne County, Michigan, and host of the podcast, America Dissected. We'll link to his show in our show notes. We'll get to more of the news in a moment, but if you like the show, make sure to subscribe, leave a five-star review on Apple Podcasts, watch us on YouTube, and share with your friends. More to come after some ads.

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Meta's open-source AI, available to all, not just the few. Here's Brandon Mitchell, CEO of RightSea. We use Lama, Meta's free open-source AI model, to build an AI tool that helps people get their dream job. Learn more at ai.meta.com slash open. Here's what else we're following today. Headlines. To ensure that we have the most lethal fighting force in the world, we will get transgender ideology the hell out of our military. It's going to be great. Gross. Gross.

President Trump said he would sign another round of executive orders on Monday taking aim at U.S. military policy. One bans transgender people from serving in the armed forces. Trump imposed a similar measure during his first presidency that included exceptions for trans people who were already in the military. Former President Biden repealed it in 2021.

It's unclear if the new ban will make any exceptions. Monday's order argues that trans people who get gender-affirming surgeries are physically and mentally unfit to serve. But you know who Trump says is fit to serve? Anti-vaxxers who disobeyed orders. Another order reinstates service members who were discharged for refusing to take the COVID-19 vaccine. The third would eliminate DEI initiatives in the military.

Our newly sworn in Secretary of Defense Pete Hegseth praised the executive orders on Monday, his first day on the job. As the Secretary of Defense, it's an honor to salute smartly as I did as a junior officer and now as the Secretary of Defense to ensure these orders are complied with rapidly and quickly.

On Monday, the Justice Department fired more than a dozen prosecutors who worked on criminal investigations into President Trump. The employees were part of special counsel Jack Smith's team and worked on the now-dismissed indictments against Trump over his handling of classified documents and his efforts to overturn the 2020 election ahead of the January 6th attack on the Capitol. A DOJ official told NBC News, quote, "...the acting attorney general does not trust these officials to assist in faithfully implementing the president's agenda."

This action is consistent with the mission of ending the weaponization of government. Interesting. And acting D.C. U.S. Attorney Edward Martin reportedly plans to investigate some of the DOJ lawyers who brought charges against Capitol insurrectionists. Which is wild, considering Trump already pardoned January 6th defendants. What more do these people want? Oh wait, so-called Proud Boys chairman and pardon recipient Enrique Tarrio has already told us.

What I mean by retaliation, and I want to be, again, unequivocally clear, is not anything to do with violence. I want investigations. Martin is investigating the cases in which defendants were charged with obstruction of an official proceeding. Those charges were tossed because of a Supreme Court ruling last year. According to an internal memo sent out Monday, prosecutors were asked to hand over all related documents. Some prosecutors told CNN that the memo raises questions that Trump's DOJ is beginning to, quote, "...investigate the investigators."

They also bizarrely strip immigration enforcement power from the governor and give it to the commissioner of agriculture. But agriculture has not exactly been known for immigration enforcement. So it's almost like the fox guarding the hen house. It was bizarre. What's that? That's the sound of Florida Republican Governor Ron DeSantis whining. Bizarre.

That's because Republican lawmakers in Florida's legislature defied DeSantis on Monday by refusing to hold a special session he called regarding immigration. DeSantis had called the session in preparation for President Trump's executive orders on border policy. House Speaker Daniel Perez said on the chamber floor, quote, I believe special sessions should be used sparingly and should not be stunts used to generate headlines. Instead, the lawmakers called their own special session and overrode one of DeSantis' budget vetoes.

It was the first time in 15 years the legislature overturned a Florida governor's veto. But don't get too excited. The lawmakers also came up with a separate immigration measure and named it the Tackling and Reforming Unlawful Migration Policy, or TRUMP Act.

DeSantis took to Twitter to complain that some of his, quote, very, very strong proposals were sidestepped. Most of the stuff that's really, really going to be meaningful was not in the proposal put forward by leaders of the Florida legislature, the Republican leaders.

You have to have a requirement that state and local entities actively cooperate with immigration enforcement federally. Otherwise, none of this stuff is going to amount to much. Complaining on the Internet about stuff that only you really care about? Ron DeSantis is just like me. Perez and other lawmakers said they didn't support some measures DeSantis called for, including criminal penalties against law enforcement officers who don't help with deportation efforts.

The lawmakers are expected to pass and send DeSantis the Trump Act today. The U.S. Air Force said on Sunday it will continue to teach about its first black pilots and its basic training, despite an executive order regarding diversity, equity and inclusion. The clarification came after President Trump issued an order last week to cut DEI programs across the government.

In response, DEI courses for the Air Force's basic military training were removed, including videos of the Tuskegee Airmen and World War II Women's Air Force service pilots. To refresh your memories, WASPs ferried warplanes for the military, and the Tuskegee Airmen were the first Black military pilots.

The airmen served in a segregated unit and had one of the lowest bomber loss rates in the war. On Sunday, the Air Force said the DEI courses had been removed for editing. The Air Force said, quote, the revised training, which focuses on the documented historic legacy and decorated valor with which these units and airmen fought for our nation in World War II and beyond, will continue. Remember, sometimes complaining works. And that's the news.

One more thing. DeepSeek. In just a few days, it has become the subject of endless conversations online. The stock market seems to hate it. App Store users seem to love it. One tech investor even called DeepSeek AI Sputnik moment, a reference to the Soviet Union launching the first artificial satellite in 1957.

It's a big deal. It's only been around for a bit, but DeepSeek has already vaulted to the top of the app store on Apple as the most downloaded app. And Trump? He thinks DeepSeek is good, though it's not quite clear if he knows what DeepSeek is. I view that as a positive, as an asset. So I really think if it's fact and if it's true, and nobody really knows if it is, but I view that as a positive. But honestly, neither do I.

I'm what some might call an AI skeptic, but it's more that I'm AI confused.

I used Claude AI to help figure out how to set up my living room, but I also don't want AI to, you know, empower the worst people alive before killing us all. That is to say, I'm not exactly sure what to think about DeepSeek. So I called up Stacey Vanik-Smith, senior story editor at Bloomberg and a noted friend of the pod, to answer my very, very basic questions. Stacey, welcome back to What A Day. Thanks, Jane. It's good to be here. Stacey, let's just cut to the chase.

What the hell is DeepSeek and why is it in the news right now? DeepSeek is basically a Chinese company. They produce something that is very close to chat GPT. And in fact, that is the problem. That is why they are all over the news. Because they have found a way to produce AI, to produce chat GPT, that is...

a lot cheaper than ChatGPT. In fact, like a fraction, a fraction of the cost. So Stacey, why is DeepSeek important to anyone other than stock bros and people who are excited about AI? So basically it opens up this whole world. The thing about ChatGPT is it's expensive. If you want the deep reasoning model of ChatGPT, it's 200 bucks a month.

And it uses just an enormous amount of energy. It's a ton of power. They've been building and investing in huge server farms to be able to support this AI. And apparently DeepSeek can do all the same things and operate very, very similarly to ChatGPT using just a fraction of this. And their model is totally freaky.

So the reason this is dragging the market down is because for people like you and me, we can just have access to really top quality AI for free. And this is completely disrupting the entire market. It means NVIDIA is not going to be able to sell as many chips anymore.

It means that construction companies aren't going to be building as many server farms. It has just huge implications. That's why the market's crashing. But it does open up this whole new world of cheaper AI that all kinds of companies are going to be able to develop. Stacey, as always, thank you for being here. I feel more knowledgeable now. Thank you, Jane. It's always so much fun to talk with you. That was my conversation with Stacey Vanek-Smith, Senior Story Editor at Bloomberg. ♪

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