“Medicine is a social science, and politics is nothing but medicine on a grand scale.”—Dr. Rudolph Virchow, known as “the father of modern pathology” and the central figure in the emergence of public health in Germany.

“I see the disinfectant which knocks it out in a minute … is there a way we can do something like that, by injection inside for almost a cleaning? … Supposing we hit the body with a tremendous, whether it’s ultraviolet or just very powerful light … supposing it brought the light inside the body, which you can either do through the skin or some other way.” —Donald Trump, April 2020

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Five years after the start of the COVID-19 pandemic in January 2020, Donald Trump will return to the White House on Monday. More so than any other figure, Trump is identified with the disastrous official response to the pandemic, initiating a war on science and public health epitomized in the murderous “herd immunity” strategy of deliberate mass infection and death.

Over the course of 2020, Trump set into motion a basic pattern of lies, denial and anti-science disinformation. In his return to power, Trump II will likely be accompanied by the notorious purveyor of pseudoscience and anti-vaccine disinformation, Robert F. Kennedy Jr., slated to head the Department of Health and Human Services (HHS).

Gregg Gonsalves, an epidemiologist at the Yale School of Public Health, recently compared Kennedy heading the HHS to “putting a flat earther in charge of NASA.” A letter to the US Senate signed by more than 15,000 physicians warned:

The health and well-being of 336 million Americans depend on leadership at HHS that prioritizes science, evidence-based medicine, and strengthening the integrity of our public health system. RFK Jr. is not only unqualified to lead this essential agency—he is actively dangerous.

On Friday, the New York Times reported that Kennedy filed a petition with the Food and Drug Administration (FDA) to revoke its authorization of all anti-COVID-19 vaccines in May 2021, as thousands of Americans were still dying from the disease each week.

Trump’s other public health appointees—Great Barrington Declaration co-author Jay Bhattacharya to head the National Institutes of Health (NIH), Dr. Mehmet Oz to head the Department of Medicare and Medicaid, anti-abortion fanatic Dave Weldon to head the Centers for Disease Control and Prevention (CDC), Fox News television doctor Janette Nesheiwat as Surgeon General, and Marty Makary to head the Food and Drug Administration (FDA)—amount to a rogue’s gallery of some of the leading anti-science advocates throughout the pandemic. They have all denigrated or cast doubt on the COVID-19 vaccines and vociferously opposed virtually every public health measure that saved lives. Their aim is to put the final nail in the coffin of public health in the US, which will have vast global ramifications.

Under the banner “Make America Healthy Again,” Trump, Kennedy and this gang of quacks will do everything in their power to facilitate the spread of disease, including previously eliminated pathogens like measles and new existential threats like H5N1 “bird flu.”

Biden, having won the 2020 election in large part due to his pledges to “follow the science,” steadily eviscerated every limited public health measure in place during his tenure in office. Over the past four years, Biden and the Democratic Party have implemented a bipartisan “forever COVID” policy of perpetual mass infection, debilitation and death, in the process overseeing the excess deaths of nearly 1 million Americans.

The cumulative toll of five years of the COVID-19 pandemic

Contrary to the lies of capitalist politicians and the corporate media, the pandemic is by no means over. In fact, Trump returns to power amid the 10th wave of mass infection in the United States, with wastewater data showing that over 1 million Americans are being infected with COVID-19 every day and rising. This coincides with a surge in seasonal flu, respiratory syncytial virus (RSV) and norovirus, dubbed a “quad-demic” by health officials, with similar conditions in the UK and across Europe.

The corporate media in the US has provided scant coverage of this crisis, with virtually no mention of the central role played by COVID-19 or the horrific conditions that now exist in hospital systems across the country.

In just the last three months of 2024, the Centers for Disease Control and Prevention (CDC) estimates that there were 9.3 million cases of flu, leading to 140,000 hospitalizations and 13,000 deaths, along with 1.2 million cases of RSV, causing 60,000 hospitalizations and 3,100 deaths.

Due to inadequate testing, large numbers of COVID-19 hospitalizations and deaths go uncounted, but the CDC data show that at least 130,000 Americans were hospitalized and over 15,000 killed by COVID-19 in the same time period. While official figures show that over 50,000 Americans died of COVID-19 in 2024, excess death estimates by The Economist were roughly 120,000. In total, the US has now suffered over 1.5 million excess deaths, while the global figure is approaching 30 million.

Scientific studies indicate that over 20 million Americans and roughly 500 million people globally are now suffering from Long COVID, an often debilitating affliction that can impact virtually every organ in the body. Multiple rigorous studies have established that reinfections with COVID-19 compound one’s risk of developing Long COVID. On average, every American has been infected with COVID at least three to four times since the beginning of the pandemic.

A recent study on cognitive impairments associated with neurological Long COVID found that these patients exhibited higher rates of fatigue, depression and anxiety and did worse on cognitive tests. They had impairments in their mental flexibility, verbal short-term memory, working memory and processing speed. These findings are proven every day in the real-life experiences of millions of workers and professionals, for whom the chronic disabling disease has caused significant daily disruptions to every aspect of their lives.

Furthermore, recent studies have found an association between common non-COVID infections and non-communicable diseases later in life, including stomach cancer and cirrhosis. Multiple infections earlier in life have shown deleterious impacts on overall health, underscoring the importance of infection prevention and indicating the vast potential health ramifications of the “forever COVID” policy.

Growing danger of an H5N1 “bird flu” pandemic

Beyond the acute and long-term physical damage caused by the pandemic, its social, political and even psychological consequences have been far-reaching. Above all, the capitalist response to the pandemic has exposed the ruling class’s visceral hatred for public health and determination to lower life expectancy in the working class.

This has found concentrated expression in the Biden administration’s non-response to the escalating threat of an H5N1 “bird flu” pandemic, which has been greeted with a collective shrug. The announcement last month of the first human death from bird flu in the US is a stark reminder of how unprepared the world remains for another pandemic. Historically, bird flu has had a documented case fatality rate of roughly 50 percent.

The man who has overseen the response to the bird flu outbreak in the US, USDA head Tom Vilsack, is intimately connected to the agribusiness, meat and dairy industries and has directly profited from these connections throughout his political career. Under Vilsack’s direction, the Biden administration has done nothing to stop the spread of bird flu among cattle over the past year, which so far has likely infected hundreds of farmworkers.

Regardless of whether the next pandemic is bird flu, mpox or some other disease, the response will once again amount to extreme nationalism and the promotion of a eugenicist and fascistic “herd immunity” policy.

There have already been articles published by the same purveyors of disinformation during the COVID-19 pandemic, including the Brownstone Institute and the War Room podcast hosted by Steve Bannon, falsely claiming that bird flu is a hoax or another lab leak engineered by Anthony Fauci, a conspiracy theory which Bannon pioneered in January 2020 with the Wuhan Lab Lie.

The danger of a bird flu pandemic will only worsen under Trump and Kennedy, as the latter has actively promoted the consumption of unpasteurized raw milk, well known to increase the risk of bird flu infections among humans.

Socialist public health vs. capitalist barbarism

The bipartisan assault on public health has had disastrous and far-reaching consequences. In a recent widely-read interview with the World Socialist Web Site, noted COVID researcher Dr. Arijit Chakravarty summarized the historic assault on public health, which has taken place during the COVID-19 pandemic, stating:

This is what failure looks like. We are looking at it. No one ever said when the concept of public health emerged in the 19th century, “We really need an organization that is committed to serving as the doula for every newly emergent pathogen that pops out of the wild.” The idea that emergent pathogens need to be shepherded into endemicity, this has never been in any public health mission statement…

There really is no historical precedent for this. No society in the world ever said, “Oh, you’re infected? Let’s let it spread.” This whole concept of pox parties being a thing is ludicrous. But that’s exactly where we are today. Quarantines used to happen in the 14th century with plague. This uncritical acceptance of infectious disease as a sort of lord and savior is brand new.

Indeed, the open repudiation of the most basic principles of public health over the past five years is, except under police state and fascist regimes, unprecedented in modern history. Alongside the ongoing genocide in Gaza, the normalization of the use of nuclear weapons in the US-NATO war against Russia, and the global rise of fascist politicians, the attacks on science and public health during an active pandemic epitomize the modern descent into capitalist barbarism.

The intersection of the emergence of public health as a discipline and the development of Marxism was not incidental. Only three years after Friedrich Engels published his seminal 1845 work, The Condition of the Working Class in England, in 1848 the distinguished German physician and progressive liberal Rudolf Virchow (1821-1902) was commissioned by the central government in Berlin to investigate a typhus epidemic that had erupted in the depressed and impoverished Eastern province of Silesia in what was then Prussia.

Virchow’s report was an indictment of the abject poverty and squalid living conditions that affected the Silesian peasants. Noting that the epidemic was concentrated among the poorest and malnourished who became more vulnerable to the disease, Virchow stressed that the typhus epidemic was more a social problem than a medical issue, and that it could only be prevented through the ending of “social inequality.” He advocated for “full and unlimited democracy” and “education, freedom and prosperity” for all.

In an article about Virchow’s work published in the Global Health Journal in 2021, coinciding with the deadliest year of the COVID-19 pandemic, Klause W. Lange wrote:

In the German revolution of 1848, Virchow became an activist committed to revolutionary social change. During the year of the revolution, he remained politically very active, was amongst those manning the barricades in Berlin and founded the weekly newspaper “Die Medicinische Reform” (Medical Reform), written for a mass readership. Virchow’s medical studies of social etiology, combined with his political radicalism, led him to characterize himself as a socialist with the primary objective of improving the welfare of the working class.

One of Virchow’s fundamental theories that proved prophetic and correct was his postulate that the impact of social circumstances and inequality contribute to the dissemination of illness and the emergence of epidemics, and that the equitable distribution of society’s resources would ameliorate these epidemics. As Virchow said then, medicine extends beyond just the treatment of disease and must encompass measures that address the health and well-being of the entire population.

Virchow’s four principles for reforming medicine included:

1. People’s health is a matter of social concern.
2. Economic and social conditions have major effects on health and disease, which must be scientifically studied.
3. Promoting health and combatting disease must include both social and medical measures.
4. Medical statistics provide the standard of measurement.

Virchow also advocated for the prohibition of child labor and protection of pregnant women from occupational exposures to toxic substances.

Much of Virchow’s revolutionary perspectives towards public health found fertile ground in the aftermath of the October 1917 Russian Revolution led by Vladimir Lenin and Leon Trotsky, which completed the overthrow of the Tsarist autocracy. By bringing an end to World War I and directing resources to the revolutionary democratic and socialist transformation of the country, and thereby addressing the high rates of infant and maternal mortality, the Bolshevik regime rapidly increased life expectancy for the entire population.

The social gains that have been made over the past century, including numerous mass vaccination campaigns, vast improvements in sanitation and food industries, safe drinking water, and the science of health, have led to a doubling of life expectancy across the globe.

However, in the aftermath of the dissolution of the Soviet Union and especially in the last two decades, these hard-won social gains began to be clawed back by the corporate and financial aristocracy, with life expectancy for working people steadily declining in comparison to the more affluent layers of society. The COVID-19 pandemic has starkly exacerbated and entrenched these inequities.

The appointment of RFK Jr. and the second Trump administration will quickly accelerate these decades-long processes. Only the working class has the means and objective interests in reversing these trajectories through socialist revolution on an international scale. The attack on public health is foremost an attack on the working class.

In Volume I of Capital, Karl Marx wrote:

Hence Capital is reckless of the health or length of life of the labourer, unless under compulsion from society. To the out-cry as to the physical and mental degradation, the premature death, the torture of over-work, it answers: Ought these to trouble us since they increase our profits? But looking at things as a whole, all this does not, indeed, depend on the good or ill will of the individual capitalist. Free competition brings out the inherent laws of capitalist production, in the shape of external coercive laws having power over every individual capitalist.

The same class forces and profit imperatives described by Marx over 150 years ago have only strengthened in the 21st century, as capitalism descends into modern barbarism.

The naked rule of the oligarchy, embodied in Trump, RFK Jr., their close ally Elon Musk and the entire incoming administration, must and will be opposed by the development of a powerful socialist movement in the American and international working class.

Throughout the pandemic, the World Socialist Web Site and the International Committee of the Fourth International alone have advanced a revolutionary strategy to stop the spread of COVID-19 and to protect the health and lives of the working class and the entire population. In opposition to the bourgeois propaganda and efforts to normalize the pandemic, which has produced a crippling fatalism among many anti-COVID advocates, the WSWS has relentlessly gathered and published information through the Global Workers’ Inquest into the COVID-19 Pandemic, as part of our broader efforts to educate the working class and build a socialist leadership.

The only viable policy toward COVID-19 is one of global elimination, which requires the universal deployment of all available public health measures and the renovation of all indoor public spaces with HEPA filters and Far-UVC technology. Not only would these measures stop the COVID-19 pandemic, but they would also lay the foundations for eliminating the flu, RSV and other pathogens that needlessly plague humanity, while creating the necessary public health infrastructure to prevent future pandemics.

The WSWS and ICFI renew our call for an alliance between principled scientists and the working class, the two interdependent forces whose combined strength is the only means to stop the capitalist war on public health and science, and rebuild global society on the basis of scientific economic planning.