You're doubtless familiar with the term armchair quarterback, and probably with its myriad modifications for disciplines outside of football, like armchair meteorologist to connote enthusiasm for forecasting despite an obvious lack of expertise, but I heard a different usage yesterday that sounded truly groundbreaking.

Armchair epidemiologist.

"During the pandemic, everybody was an armchair epidemiologist, right?" Dr. Tyler Evans was telling me on the phone from California. People were excited about the mRNA technology used to develop COVID-19 vaccines.

"Everybody was citing the evidence and the data and all that. A lot of my patients were like, 'Oh yeah well Pfizer's 96% effective, Moderna's 97%.' Everybody knew these numbers, so I'm surprised now that people are having amnesia."

RFK is not rooted in reality

In the wake of Robert F. Kennedy Jr.'s announcement that the government would cancel $500 million in funding for mRNA vaccines currently in development, I reached out to Dr. Evans after reading about his book, which seemed relevant.

"Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19," seems like a project requiring more qualifications in this theater than even Kennedy's, which do not include doctor or scientist but somehow do include bear corpse delivery driver.

In one iteration of his professional resume, Evans was the only doctor for 29,000 refugees in South Sudan in a career that has included field work during Ebola outbreaks in the Democratic Republic of the Congo and with Doctors Without Borders in Africa, Asia, and the Middle East. His stateside work has focused on homelessness, substance abuse, and facilitating health system access to marginalized communities.

As for his direct interpretation of Kennedy's mRNA opinions, Evans didn't qualify it.

"The reasons (for defunding) that RFK Jr. cites are just not rooted in reality," he said. "When he says, 'Oh, it's not as effective for upper respiratory infections,' that's fundamentally untrue. It's really unfortunate and it further destabilizes the faith and trust folks have in science, especially when there are a lot of tenuous feelings and emotions out there, it really just weaponizes that and feeds those fears further."

Elevated against all reason and sanity to the position of U.S. Secretary of Health and Human Services four months after Donald Trump said he'd allow the former heroin addict and conspiracy theorist to "go wild on health," Kennedy's first year on the job has lowlighted an administration dedicated to making America dumber, sicker, and more fearful every day.

When the Centers for Disease Control and Prevention were shot up in Atlanta last Friday, with a responding police officer killed and multiple buildings damaged, it didn't take long for CDC staffers to reach an uncomfortable conclusion.

Make America vulnerable again

"There's a lot of misinformation, a lot of really dangerous rhetoric that's currently being spread by the current administration, that makes us seem like villains, that makes us seem like our work is setting out to hurt people," CDC employee Elizabeth Soda told NBC. "So it's not at all surprising, right, that people are going to listen to our leaders."

These leaders? In July, the leader of the Congressionally mandated Office of Pandemic Preparedness and Response resigned, the last of seven staffers Trump inherited in January. Gerald Parker, announced in February as the office's new director, was never formally installed and the whole apparatus has been effectively abandoned.

"There is no senior official in the White House responsible for pandemic preparedness, biosecurity, or biodefense," former OPPR chief of staff Nikki Romanik wrote on thinkglobalhealth.org, "at a time when experts estimate a greater than one in four chance of another pandemic as deadly as COVID-19 within the next decade."

This is the exact strain of government incompetence/fecklessness that can make an entire population more susceptible to potentially catastrophic illness.

We've long associated such conditions with the Congo or sub-Saharan Africa, but in abandoning America's position as a global health leader, there's nowhere to go but in the direction of greater vulnerability. As one prominent researcher said of Kennedy's scuttling of the emerging mRNA technologies, it's stupid and potentially catastrophic.

"I say this all the time, you know, microbes don't know the difference between borders, between blue and red states, they just affect humans," said Evans. "The more that we're removing this infrastructure, the more we're hurting all Americans."

Politics can kill people

In his book, the doctor details the countless ways in which a country's politics drive its health outcomes, even to the point of pandemic.

"It's referred to as population stress," he said yesterday. "From an immunological standpoint, when we have stress on our systems, either emotionally or physically, it manifests in the same way, causing us to become immunocompromised. In populations that don't have access to basic necessities — food, shelter, basic security, education — when you have an outbreak, the smallest little outbreak can push on an already tenuous situation and it implodes very quickly.

"When Ebola hit in the Congo, there was a lack of trust with the government that then extended to health care workers. I worked out there and there were health care workers who ended up dead. There are common themes that are socially and politically seeded that literally lead to the same outcomes."

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