The MAGA GOP Against Anthony Fauci, MD...

 

The Lie	The Facts
Lie 1: "Fauci lied about masks." The Claim: repeatedly asserts Fauci intentionally lied to the public to manipulate them or that his changing guidance proved he was deceptive.	In March 2020 (the early weeks of the pandemic), public health officials—including Fauci—advised the general public against buying N95 surgical masks to prevent a severe shortage for front-line healthcare workers, given the initial belief that COVID-19 spread primarily through large droplets and surfaces. As airborne transmission and asymptomatic spread became clear in April 2020, guidance shifted to universal cloth mask-wearing. Scientific adaptation to new data was re-framed by critics as a malicious "lie."
Lie 2: "Fauci created/funded COVID-19 in Wuhan." The Claim:  Repeated claims state that Fauci personally authorized "gain-of-function" research at the Wuhan Institute of Virology that directly created the SARS-CoV-2 virus.	While the National Institutes of Health (NIH) did fund grants to EcoHealth Alliance for bat coronavirus research in China, independent scientific panels, the NIH, and intelligence reviews clarified that the specific bat coronaviruses studied under those sub-grants were genetically distinct from SARS-CoV-2 and could not have evolved into the pandemic virus. The political rhetoric, however, repeats the "Fauci created the virus" line to frame a public servant as a criminal perpetrator.  Some circles suggest there was homicidal intent.
Lie 3: "Fauci personally forced lockdowns and school closures." The Claim: characterizes lockdowns, school closures, and business restrictions as unilateral mandates handed down personally by "Dictator Fauci."	Under the U.S. federal system, public health mandates (closing schools, restricting indoor dining, stay-at-home orders) were legally enacted by state governors and local public health departments—not federal advisory scientists. Fauci served as an advisor whose task force issued recommendations, but he lacked any statutory executive power to pass laws or order closures. See Supplementary 7 (below).
Lie 4:  "Fauci lied when he said vaccines stop 100% of transmission." The Claim: Asserts that public health officials promised the original COVID-19 vaccines would permanently block all infection and transmission, calling subsequent variant breakthrough cases "proof of a lie."	Clinical trials in late 2020 measured efficacy against symptomatic disease (which was ~95% for original strains). While early real-world data showed significant reduction in transmission against original variants, the emergence of mutated variants (like Delta and Omicron) eroded protection against infection while maintaining strong protection against severe illness and death. The shift in viral evolution was reframed as a deliberate institutional falsehood.
Lie 5: “Fauci made millions of dollars directly off the COVID-19 pandemic.” The Claim:  made millions through secret royalty checks paid by pharmaceutical companies for COVID-19 vaccines. The claim frames him not as an independent public health scientist, but as a compromised figure using federal authority to enrich himself and corporate allies.  In this hearing there was a comments that he was “enriching himself through the use of federal employees.”  There has also been a longstanding complain that Dr. Fauci is the “highest paid federal employee and he makes more than the President.”  That is true but it is full disclosure and according to federal regulations.	-Dr. Fauci holds no patents and receives no royalties related to any COVID-19 vaccines or treatments (including the Pfizer, Moderna, or Johnson & Johnson vaccines). -FOIA disclosures obtained by watchdog groups showed that the NIH and its scientists received third-party royalties for older, pre-pandemic medical innovations (such as early HIV/AIDS research from decades prior). However, sensationalist headlines falsely claimed that these past, unrelated payments were "COVID-19 vaccine profits." -Dr. Fauci has repeatedly stated—dating back to interviews with the Associated Press and BMJ in 2004/2005—that he attempted to refuse statutory royalty payments from earlier research (such as an interleukin-2 treatment developed for HIV/AIDS) because he felt it posed a potential conflict of interest.  Because federal law required the agency to issue the funds, Fauci pledged to donate 100% of his royalty payments to charity. -Federal Salary: As the former Director of the National Institute of Allergy and Infectious Diseases (NIAID) and Chief Medical Advisor, Dr. Fauci was one of the highest-paid federal civil servants, earning a fixed annual government salary (~$480,000 before his retirement in late 2022). This salary was set by federal civil service pay scales, completely independent of vaccine sales or corporate profits. - Public Filings: Under the Ethics in Government Act, Fauci’s financial disclosures—including his investments, stock holdings, and outside income—are subject to strict federal conflict-of-interest audits and are a matter of public record. His filings show no stock holdings in individual pharmaceutical companies; his personal investments are held in broad mutual funds, municipal bonds, and standard retirement accounts.  income—are subject to strict federal conflict-of-interest audits and are a matter of public record. His filings show no stock holdings in individual pharmaceutical companies; his personal investments are held in broad mutual funds, municipal bonds, and standard retirement accounts. -In February 2021, Tel Aviv University awarded Dr. Fauci the Dan David Prize for lifetime achievement in public health and his leadership during the HIV/AIDS and COVID-19 crises.  After tax withholdings and administrative fees, the direct deposit received by Fauci totaled $899,960.  The National Institutes of Health (NIH) ethics office has long-standing regulations (5 C.F.R. § 2635.204(g)) that allow federal researchers and doctors to accept bona fide, prestigious awards for scientific achievement from non-profit or educational institutions, provided the award is approved by an agency ethics officer.  Before accepting the Dan David Prize (and other academic honors throughout his 50-year career), Fauci submitted the award for official NIH ethics review, which formally authorized him to accept the cash prize.

I saw the various clips but don’t have to watch the entire debacle.  It was the usual exercise in rhetoric as I watched the US slide farther and farther from reality.  After all this was a debate about the COVID pandemic that officially ran from March 11, 2020 to May 5, 2023.  It has been over for more than 3 years.  The argument can easily be made there are more pressing public health and safety problems at this point ( foodborne illness outbreaks, vaccine preventable disease outbreaks (measles, pertussis), toxicology emergencies (lead poisoning), wildfires, that are direct  products of the policies of this administration and currently endanger thousands of Americans. 

In addition, the elimination of Medicaid and SNAP benefits endanger millions more.  Medicaid is the nation's largest payer of mental health and substance use disorder care, and the primary funding vehicle for addressing Social Determinants of Health (SDOH) (housing, food security, and transportation).  Medicaid is also the single largest payer of maternity care in the US covering 40% of all births. In the midst of those problems the HHS Secretary has decided that he knows something about mental health and has decided he knows more about what medications and treatments people with those disorders need to take.  So why is the pandemic being relitigated while this administration is ironically making American unhealthy again?

The most straightforward answer is because they can.  Trump and his allies have tapped in to strong anti-science, anti-knowledge, and anti-expert biases in the US and used them to their advantage.  They routinely scapegoat and vilify anyone who they consider to be an enemy or outsider and that is a very low bar.  To end up in the enemy camp – all you have to do is disagree with them.  Disagreement is easy when they have produced so many ideological decisions that have no rational basis.  The list of those irrational decisions can fill volumes at this point.  I will focus on the dynamics of the Fauci hearing.   

This hearing was clearly a set up by Paul, and Fauci made that point in his opening statement – specifically that Paul had an unhealthy obsession with him and had threatened to jail him. This is apparently because of Paul’s conspiracy theory that the COVID virus (SARS-CoV-2) was a virus modified in a Chinese lab and accidentally released.  He claims that Fauci knew something about this despite Fauci’s diary entry of 2021 documenting that the latest genetic information made manufacture in a lab an impossibility. The remainder of the hearing was essentially Fauci taking the Fifth Amendment against self-incrimination.  Anyone who knows how the government works would be foolish to start any discussion in such a biased proceeding. That is especially true in the case of Fauci who has a pardon from former President Biden. In this setting it is easy to suggest perjury incidents and file those charges in the absence of any real evidence for the original charge.

At least some of the impetus for these hearings was the personal diary of Dr. Fauci.  Paul apparently was given this access by HHS Secretary Kennedy who discovered it on their servers.  At this point I do not know if it was Dr. Fauci’s naiveté about recording personal notes on a government server or something else.  I do know that it is common sense that diaries are not written for public disclosure.  To publish this as Paul has done shows that it is all part of a general smear campaign and an attempt to suggest that the things nobody says out loud are really “lies”. 

Like almost all of the current governments tactics this all comes down to rhetoric at several levels.  The first is just the usual scapegoating and rage-bating.  Fauci is an intellectual, an elite, etc.  He is not like the rest of us but he likes to tell us all what to do.  This is our chance to rise up and throw him in jail.  Of course, the rage baiting caused more problems than that for Dr. Fauci and his family.  He has been threatened with harm and many of those threats were considered serious.  He had a government security detail from 2022 until it was terminated by Trump on January 24, 2025. It has not prevented further public threats in some cases by public figures who have no idea who Dr. Fauci is or what he has accomplished.  They are generally focused on one of the lies in the above table.

I thought about adding a section here on the academic references to the various rhetorical devices used by autocrats and fascists.  But I will keep it simple.  Trump and his administration use them all to distort reality, provoke anger in his base, and further divide the country.  One of his advisors was very clear about it and called it “flooding the zone.”  There is plenty written about that process in academic references, but you can see how it works in real time just by watching the news every day. Trump promotes the lie that the 2020 election was “stolen” and none of his cabinet nominees will answer that question in Congressional hearings.  Suddenly we have unconstitutional interference with local elections and pending federal legislation that will eliminate tens of thousands of eligible voters.

The pattern is clear.  Initiate a divisive issue, never admit it is false or involves any wrongdoing, and keep repeating it.  Ignore the fallout even if that includes casualties on the streets of Minnesota or in an unnecessary war.  Blame everyone else and never acknowledge mistakes even when they are obvious to everyone else. Academic references about logical fallacies are unnecessary in these scenarios. This is where the lies about Anthony Fauci come from.  When he was coming up with solutions to the horror of the pandemic, Trump and his cohort were suggesting bleach, ivermectin, and hydroxychloroquine – all completely ineffective and in some cases dangerous.  In fact with the “pile on” effect from this hearing one of those cabinet members took to social media to claim he had stockpiles of hydroxychloroquine that would have saved thousands of people.  That is another completely inaccurate claim.     

 In the final analysis. It all comes down to whether or not you are a rational person.  You may feel encapsulated by a Democrat or Republican label.  That clearly does not insulate you from unnecessary wars, the erosion of civil rights, the dismantling of the public health infrastructure, a deteriorating climate and environment, a worsening health care system, diversion of most economic resources to the wealthy, enabling convicted criminals and fraudsters to commit further crimes and trying to reimburse them for jail time, and using government resources to attack innocent American citizens.  It does not insulate you from the fact that we have an administration that has appointed people to serve in the cabinet who have no qualifications.  None of this passes muster as politics as usual much less rational decision-making.

So – be a rational person.  Respond to facts and not rhetoric. Notice when there is an appeal to your emotion rather than your decision-making. Recognize the obvious fallacies when you see them – like the frequent name-calling and witch hunts. 

Get the USA back on track again…

 

George Dawson, MD, DFAPA 

 

 

Supplementary 1:  The American Public Health Association (APHA) has come out on social media in support of Dr. Fauci.  Several medical organizations have done this in the past related to COVID and HIV controversies. It is time that every physician organization does the same thing and does it now.  I have been an elected official in physician organizations and there is always a “big-tent” concern.  In this case that would mean supporting Dr. Fauci would alienate any dues paying Republicans. As I hope to have pointed out in the above post – this is larger than political labels.  In the above table you can choose to be in column 1 or column 2.  Column 2 is the rational choice.  

Supplementary 2:  If you want to see how some of these lies played out in real time - I have a post here that recorded some of what football star Aaron Rodgers  had to say about Dr. Fauci back in 2024.  Mercifully the video has been taken down but the lies and distortions are still all there.  He goes even further suggesting that both the HIV and COVID pandemics were created to respond to only specific drugs and enrich Dr. Fauci and Pharma.  I am not saying that Rodgers is lying but he certainly is repeating them almost exactly as outlined in the above table.  The information to refute his assertions was widely available at the time and in the case of HIV for decades earlier. 

Supplementary 3:  Commentators on this issue always soft pedal any direct confrontation of the lie.  For exam on Lie #2 - Fauci funded the creation of the pathological COVID virus (already walked back by Sen. Paul to GOF and not the pandemic virus) it is common to hear:  "Well I don't agree with that but I do disagree with the way the pandemic was handled."  First off what part do you disagree with?  Fauci's job was keeping up with the research and trying to change guidance on the fly while hospitals were overwhelmed and tens of thousands of people were dying. Anyone in that situation is going to make what they consider to be the most conservative recommendation to save the most people.  Secondly, by making that hedging statement you are endorsing Lie #3.  Fauci did not personally close down anything.  That was all local officials.  

Supplementary 4:  I have a great interest in airborne viruses.  Because of that interest I documented the transition in thinking about COVID transmission from droplet nuclei to airborne on this blog.  The date was April 8, 2020.  This confirms row 1 in the table. 

Supplementary 5:  Highly recommend the nonpartisan Annenberg Foundation's FactCheck.org to fact check anything this party or administration has to say about Dr. Fauci or the COVID pandemic.

Supplementary 6:  Since I posted this around noon on August 1, 2026 I have heard the following in the media:

"Fauci is responsible for 8 or 9 millions deaths."

"Fauci is worse than Joseph Mengele."

And from a national comedian: "Of course Fauci lied about gain of function."

No he did not.  All of these statements confirm what is said in the body of my post and will probably be repeated every day if you are paying attention.  To be a rational person you have to be intentional.  All of these inaccurate statements cannot be brushed off or in the case of comedians - laughed at.  Pick a column and stay there.

8/2/2026:  Day 2 of the Fauci hysteria.  Many people have taken to social media to reinforce the message of the MAGA Republicans today portraying Fauci as a megalomaniac and blaming him for everything from vaccination side effects to their kid having to wear a dirty mask to school for 8 days in a row.  One of the worst examples I have seen was an excerpt posted about a meeting with a CIA official that supposedly informed him of a lab leak and suggesting he covered this up.  It is clear from the diary entry that he considered both the information and informant unreliable and actually suspicious.  This same author likened the situation to finding out Dick Cheney wrote in his diary that he knew there were no weapons of mass destruction in Iraq.  The huge problem with that comparison is not only what was recorded at the time (unreliable source) - but that genetic analysis of the virus showed it was not produced in a lab.  The real comparison here is from law enforcement and that is:  1:  eyewitnesses are unreliable and this informant would not even qualify as an eyewitness.  According to rules of evidence this is hearsay.  2:  In court - hearsay is not evidence, but genetic analysis is.  

And then there was this interview of RFK, Jr by CCN's Dana Bash.  It was full of misinformation including some of the misrepresentations in the table above.  Ashish Jha, MD provides a bit of commentary at the end and has the stunning disclosure that he now believes the pandemic virus was a lab leak.  I have searched everywhere for what he is basing that opinion on and so far have found nothing.  No matter what side of the issue you are on - all of this agitation does absolutely nothing to address either future outbreaks or the outbreaks that are occurring right now.  

 Supplementary 7:  A reminder of what actually happened and what the timeline was (see Lie #3).  States clearly ended emergency declarations before the dates declared by Trump HHS Secretary Azar,  Trump himself, and Biden ending it early.  Dr. Fauci was not in that loop.  Red states did it before Blue states and there was a mortality gap due to COVID with red states having a higher mortality. 

Feature	Federal Emergency Declarations	State Emergency Declarations
Primary Purpose	Funding, regulatory flexibility, and administrative waivers.	Direct police power over public movement, business operations, and health rules.
Scope	Unlocked federal funds (FEMA, CARES Act), allowed FDA Emergency Use Authorizations (EUAs), expanded telehealth, and provided extra Medicaid matching funds.	Enforced stay-at-home orders, indoor mask mandates, business closures/capacity limits, and school rules.
Jurisdiction	Did not have the legal power to issue nationwide lockdowns, close private businesses, or mandate masks for the general public.	Had direct legal authority under state constitutions to issue and enforce mandates.
The Two Federal Declarations The federal government established blanket, nationwide emergency statuses covering all 50 states: Public Health Emergency (PHE): Declared by HHS Secretary Alex Azar on January 31, 2020 under Section 319 of the Public Health Service Act. It officially ended on May 11, 2023 (6 days after the World Health Organization declared an end to the pandemic on May 5, 2023). National Emergency: Declared by President Donald Trump on March 13, 2020 (retroactive to March 1) under the National Emergencies Act and Stafford Act. President Biden signed a bipartisan congressional resolution ending it slightly early on April 10, 2023. State Actions: Florida:  April 30, 2020 (Stay-at-Home Order Ends): DeSantis issued a 30-day "Safer at Home" order on April 1, 2020. He allowed it to expire on April 30, 2020, initiating Phase 1 of state reopening on May 4.  September 25, 2020 (Lifting Business Limits & Banning Mask Fines): DeSantis moved Florida directly into Phase 3 reopening. This order: Removed all state-level capacity limits on restaurants, bars, and businesses.  Prohibited local municipalities from enforcing mask rules or public health orders with fines or penalties, effectively gutting local mask mandates.  May 3, 2021 (Invalidating All Local Mandates): DeSantis signed Senate Bill 2006 and issued an immediate executive order that canceled all remaining emergency orders and mask mandates passed by cities or counties statewide.  June 26, 2021 (State of Emergency Expires): DeSantis allowed Florida's official statewide COVID-19 State of Emergency to lapse without renewal.  July 30, 2021 (School Mask Mandates Prohibited): As schools prepared to reopen for the fall, DeSantis issued an executive order banning local school boards from requiring students to wear masks.  States That Ended Emergency Declarations Before Florida Michigan (October 12, 2020): The Michigan Supreme Court ruled in October 2020 that Governor Gretchen Whitmer lacked the legal authority to maintain executive emergency powers without legislative approval, effectively striking down the state of emergency early. Wisconsin (March 31, 2021): The Wisconsin Supreme Court struck down Governor Tony Evers’ emergency declaration, ruling he violated state law by repeatedly extending 60-day emergency orders without legislative consent. Alaska (April 30, 2021): Governor Mike Dunleavy allowed the legislature's extended public health emergency declaration to lapse on April 30, shifting the state into an administrative recovery phase. North Dakota (April 30, 2021): Governor Doug Burgum officially rescinded North Dakota’s executive order declaring a state of emergency at the end of April. Oklahoma (May 4, 2021): Governor Kevin Stitt issued an executive order terminating Oklahoma’s state of emergency in early May, citing falling cases and wide vaccine availability.

 

References:

1:  Rasmussen A.  RFK Jr is Asking to Be Proven Wrong Again So Here Are 40 Examples From Just One CNN Interview.  August 4, 2026:  https://rasmussenretorts.substack.com/p/rfk-jr-is-asking-to-be-proven-wrong

If you read one reference this is the one I recommend.  Dr. Rasmussen is a working academic virologist who knows more about these issues than anyone in the Trump administration or their affiliated media networks.  

2:  Robertson L.  The Wuhan Lab and the Gain-of-Function Disagreement.   FactCheck.org.  Posted on May 21, 2021 | Updated on July 1, 2021  https://www.factcheck.org/2021/05/the-wuhan-lab-and-the-gain-of-function-disagreement/

3:  Robertson J, MacDonald J.  Fauci and Paul, Round 2.   FactCheck.org Posted on August 11, 2023 | Updated on August 23, 2024  Posted on July 22, 2021 | Updated on August 19, 2021 https://www.factcheck.org/2021/07/scicheck-fauci-and-paul-round-2/

“There’s no evidence that Fauci lied to Congress, as Paul asserted in the July 20 hearing, given that the NIH unequivocally backs up Fauci’s statement that the grant-backed research “was judged by qualified staff up and down the chain as not being gain-of-function.”

In a May 19 statement, NIH Director Dr. Francis S. Collins said that “neither NIH nor NIAID have ever approved any grant that would have supported ‘gain-of-function’ research on coronaviruses that would have increased their transmissibility or lethality for humans.”  “

4:  Jaramillio C, and Yandell K.  RFK Jr.’s COVID-19 Deceptions.  FactCheck.org Posted on August 11, 2023 | Updated on August 23, 2024  https://www.factcheck.org/2023/08/scicheck-rfk-jr-s-covid-19-deceptions/

5:  Kaiser J.  Under fire from Republican senators, Fauci takes the Fifth at COVID-19 hearing.  Science July 29, 2026:  https://www.science.org/content/article/under-fire-republican-senators-fauci-takes-fifth-covid-19-hearing

6:  American Society of Microbiology Letter in Support of Dr. Fauci.  July 28, 2026:  https://asm.org/articles/policy/2026/july/asm-letter-to-senate-committee-in-support-of-fauci

 

How To Stop Burning Witches...

 

I was hoping for a timely post for Halloween but just missed the deadline. Witches are considered an icon of the season, although I have not seen a lot of those costumes recently. I came across an important book that analyzed the witchmongering movement in 15^th to 18^th century.   Witchmongering was term was coined by Reginald Scott in 1584 in his book The Discoverie of Witchcraft.  He used it to describe people promoting the ideas and superstitions about witchcraft – specifically those who profited from spreading these ideas.  His book discusses the idea that witches have connections to the devil and Scott’s position was that this was all imaginary.  He studied magic and concluded that the belief in witchcraft was rooted in illusions, imposters, or inaccurate conclusions due to mental disorders.  He sought to prevent marginalized individuals from being attacked as witches.

Despite Scott’s rational approach, witchmongering was actively debated for at least another century.  Thomas Ady wrote A Candle in the Dark in 1656 and took a similar position.  Popular opinion about the existence of witches and their presence began to wane around 1700, but witchcraft laws and executions persisted much longer. In Great Britain the Witchcraft Act was repealed in 1736.  By the late 18^th century most witchcraft prosecutions and punishments were banned in Europe. The last witchcraft trial in the US was in 1878.  There is a detailed history of both witch hunts and executions of witches resulting in the deaths of tens of thousands of women.  Even though most people do not know the details of this dark practice – the concept witch hunt is used rhetorically these days to indicate an unfair investigation.  

There are various ways to analyze the history of witchmongering. Social scientists have looked at anthropological and sociopolitical analyses. Rhetoric seems like a powerful approach to me because humans seem to use the same patterns over time to make irrational decisions.  Rhetoric is a component of cultural inheritance.  In the case of witches – anxiety provoking events like crop failures, illnesses, economic and political instability, religious and sexist biases could lead to accusations of witchcraft.  But once the precedent was set behaviors, social factors, and personality factors could also be included as well as accusations of supernatural phenomenon like sorcery and causing people to disappear.  There is no doubt that some had mental illnesses but that is not currently considered to be a major factor in the women who were persecuted.

Ady describes a common scenario in his era. The poor and disabled went door to door in those days asking for relief. Many were elderly, malnourished, and disabled. If they were denied assistance by the landowner and his crops or cattle failed or one of his family fell ill – that person could be blamed for witchcraft as a source for these problems.  They could be subjected to false tests or torture and sentenced to death as a witch.  

Once these negative qualities were specified as evidence, the sequence of events proceeded in the same manner that can easily be observed in modern American politics.  If enough people are anxious about some matter, it is easy enough to incite them.  Just claim that you are the only person who can solve that problem and find a group that is the modern equivalent of witches to blame.  In recent months we have seen documented and undocumented immigrants, women, non-white minorities, university professors, public health officials, public sector employees, the disabled, the economically disadvantaged, the food insecure, members of the previous administration, and just about anyone who is a critic of the current administration. Scapegoating a small segment of the LGBTQ community may have been the deciding factor in that last Presidential election and it continues to be an issue.

Ady’s book is a tour de force against witchcraft.  He begins his three part treatise by directly confronting popular notions of witchcraft with the Biblical moral code of the day.  He lists 16 – “where is it written” or “it is written” clauses in his introductory “A Dilemma that Cannot bee answered By Witchmongers.”  In the subsequent text he elaborates on how references to witches have been misinterpreted to fuel witch misinformation.  An excerpt of the Dilemma is reproduced below.  Note that the original spellings are preserved:

 

 

At the end of this this volume he gives two excellent counterfactuals to falsify witch mongering. It is clear from these examples that any misfortune can be erroneously ascribed to witches and therefore witch mongering and everything that involves adds no explanatory power.  That is made much worse by the fact that this non-explanation resulted in the deaths of thousands.    

 

 Moral reasoning and rationalism was used to discredit witch mongering but they were not the sole factors.  Johann Weyer (1515-1588) was a Dutch physician who argued that witches were mentally ill suffering from melancholia.  He thought that any confessions of witchcraft were based on delusional thinking.  He published numerous works on witchcraft and magic. 

Medicine, science, and rational thought were not enough to immediately correct the practice of persecuting women as witches.  Pseudoscience and various “tests” were used to prove that a woman was a witch.  Many of these tests defy reason like the pseudoscience of the current era.  For example, one test of a witch was to bind them, throw them into a body of water and see if they float.  Certain marks on the skin were taken to be the marks of a witch.  That included puncture marks inflicted with needles by others – if the puncture wound did not bleed it was considered evidence of a witch. Ady provided counterarguments about why these were inadequate tests.  Needless to say there were no control groups. 

Despite Weyer’s direct observations there are competing theories that social and cultural factors were important.  It is likely that both played a part, with psychiatric etiologies as suggested by Weyer playing the minor part.  If you are identified as a physician who works with a particular problem – it is likely that selection bias is operating in the clinical population that you see and treat.  Cultural symbols are often incorporated into psychotic symptoms.  In 40 years of practice – I saw a handful of people who believed they were Christ-like and many more who believed they were the Antichrist. During the time of Satanic Ritualistic Abuse (SRA) I saw many people who were not delusional but believed that they had witnessed homicidal rituals by satanists.  Those are all modern examples of observations that were not accurate and could be scientifically disproven.

If we agree that witch accusations and persecutions were psychiatric, social, and cultural in origins are there some common factors that might account for these patterns?  Anti-intellectualism is a complex societal problem that has been examined by Hofstader, Pigliucci, and others (3-5).  Hofstader traced some of it back to right wing politics and religion in the 1950s where it still resides today.  Hofstader described 3 forms (antirationalism, anti-elitism, unreflective instrumentalism) to which Rigney added unreflective hedonism and Pigliucci added academic post modernism as a fifth (4).  Pigliucci also added a qualifier that post modernism may be an intellectual anti-science field.   

The refutation of witchmongering is an important lesson for people in modern times. Reasoning and moral reasoning based on Christian principles and local laws eventually carried the day – but it took a long time. Science through early observations of mental illness were a small part of the story.  The most significant aspects of this historical period is focused on cultural inheritance and rhetoric.  Neither of those dimensions is necessarily predicated on the truth.  The commonest ignored pattern is the use of a scapegoat to avoid the reality of the situation or in the worst case divert attention to an emotional topic that is really all part of the scapegoating.

We typically see these issues categorized as hot button issues or culture wars.  They are responsible for large scale irrational decision making about guns, abortion, welfare, religion in schools, banned books, restricted access to voting, racism, misogyny, the medically uninsured, and corporate welfare.  They are currently responsible for the dismantling of basic research, health care, food subsidies, public health, foreign aid, the Department of Justice, the Department of Defense, and the layoffs and firings of 200,000 federal employees.  There is an estimated large death and morbidity toll associated with those decisions.

While we are no longer naming witches and prosecuting them – a lot of the thinking behind that process has been passed along as cultural inheritance and the associated rhetoric.  A significant number of Americans react to it in expected ways.  Recognizing the pattern of scapegoating and the associated emotions is a critical first step.  The second is to figure out what science is and what it is not.  Science is definitely not doing your own research unless you have been trained in the scientific method or (ideally) are a scientist.  The ultimate ability is to be able to use reason, moral reason, and science to make the best possible decisions.

That is the best way to avoid more witchmongering.      

 

George Dawson, MD, DFAPA   

 

 

 

Graphic Attribution:

“The Witches' Ride' William Holbrook Beard (1870), Public domain, via Wikimedia Commons

 

References:

1;  The National Archives - UK.  Early Modern witch trials.  https://www.nationalarchives.gov.uk/education/resources/early-modern-witch-trials/

2:  Schoeneman TJ. Criticisms of the psychopathological interpretation of witch hunts: a review. Am J Psychiatry. 1982 Aug;139(8):1028-32. doi: 10.1176/ajp.139.8.1028. PMID: 7046480.

3:  Hofstadter, R. Anti-intellectualism in American life. Vol. 713. Vintage, 1966.

4:  Rigney D.  Rethinking Hofstadter: three kinds of anti-intellectualism. Sociological Inquiry.  1999.  61(4): 434-451.

5:  Pigliucci M.  Denying evolution – Creationism, science and the nature of science.  Sinauer Associates, Sunderland MA, 2002.   

6:  Ady T.  A Candle in the Dark or A Treatise Concerning the Nature of Witches and Witchcraft: Being Advice to Judges, Sheriffes, Justices of the Peace, and Grand Jury-men, what to do, before they pass Sentence on such as are arraigned for their Lives as Witches.  1656.  Theophania Publishing.  

Existential Threats....

 

Mapping Existential Threats in the Medical Literature

 

I heard President Trump and several right-wing politicians complaining about the term “existential threat” in the press the other day.  Some of the clips were a few months old but the overall message was first – “I didn’t know what it means”, second – the people using the term (in this case former President Biden discussing climate change) don’t know what it means, and third you are an elitist if you use the term because the average family in American does not use the term and you should learn to talk like them.  Like most statements uttered by the current President and his unquestioning party I found it rhetorical, not useful, and decided to see what the medical literature said.  This is what I found.

On PubMed, there are 248 references to the term dating back to 1979.  As seen in the table most of the scenarios listed like climate change, COVID and other pandemics (in this case HIV), diseases, antibiotic resistance, artificial intelligence, and other threats to life are the commonest threats listed in medical literature.  By definition, an existential threat puts the future of some group (humanity, specified individuals) or person at risk.  The worst-case scenario is an extinction event like the Cretaceous-Paleogene (K-Pg extinction) event that occurred 66 million years ago.  That was caused by an asteroid strike and it led to the extinction of non-avian dinosaurs and 75% of all plant and animal species. 

The tables contain existential threats to humanity, many subgroups including physicians and the afflicted, school and businesses, other animals, and plants, as well as ecosystems.  It also includes the psychological component where the perceived threat is experienced as a threat to existence, but more at a symbolic level.  Yalom’s text (1) on existential psychotherapy breaks those threats down to death anxiety, freedom, isolation, and meaninglessness.  Other psychoanalytical writers point out that existential crises are more likely to occur at various points in human development.  In psychiatric practice it is common to see people experiencing crises in these areas across all settings.  Existential crises can exist at the level of group or individual psychology depending on the nature and scope of the threat. Some scientists hypothesize that we are currently in the midst an extinction event.  They describe this as the sixth mass extinction event and verify it by estimating the number of vertebrate species that have gone extinct and compare it to previous mass extinctions (3).  Human culture is a critical factor in this extinction and the conclusion are a massive effort is needed to head off this event and much of that effort needs to be directed at reducing overconsumption, transitioning to environmentally friendly technologies, and an equitable path to those transitions (2).  These authors point out obstacles to these changes including most people being unaware of the changes required to prevent ecosystem damage by human culture, the scope of the problem, and the necessary solution of scaling back human impact – both the scale and processes.

The political use of the term “existential threat” has been applied to the Trump administration and this is probably why Trump himself is trying to spin the term in his favor. He is focused on blaming the opposition party, but at this point it goes far beyond the Democrats.  The non-partisan Bulletin of the Atomic Scientists has posted that the well know extreme budget cuts of the administration pose an existential threat to the next generation of scientists. Various publications around the world have written about Trump as an existential threat to democracy, the American economy, former American allies, Social Security, freedom, black Americans, American colleges and universities, public health, science, and critical international food and medical aid.  In many of these areas the facts are clear.  I can think of no better example than USAID and the PEPFAR program.  Just defunding those programs could lead to as many as 14 million deaths if none of these changes are reversed by the courts.  

Paranoid people do not do well with existential threats.  They lack the ability to assign probabilities. They cannot see a car on the street and just see it as another car.  They get the idea that all cars or all red cars are threats to them. The defined threat may be elaborated as surveillance by Homeland Security to being attacked by microwaves being transmitted from these cars.  In some cases, everything is seen as a threat.  The anxiety is real but the threat assessment is wrong.

If you do not know what an existential crisis is – you should.  Most students in the US start reading existential themed literature in middle school and early high school.  The average person needs to know at what level the threat exists (personal, group, civilization-wide) and what can be done about it.  That means that it makes sense to break down the specific threat, adequately assess it, and not leave it hanging there as ill-defined.  For example, nuclear war, a massive asteroid collision, and climate change threaten all human, animal, and plant life on the planet.  Not being able to get a job in an area where you were trained in college or losing your first significant relationship can be existential crises at an individual level.  That can be life changing at a personal level and the good news is most people find their way back on track with the help of family, friends, and the occasional therapist. 

The outcomes of existential threats can lead to unexpected action.  When I was in college, one of my jobs was working in the local public library.  It was a multi-county library and the main part of my work consisted of mailing out books and films to all the co-operating libraries. One day the chief librarian came in and told me it was now my job to dismantle the fall-out shelter in the basement.  The year was 1972 just 10 years after the Cuban Missile Crisis. The library had two Fallout Shelter signs like the one at the top of this post.  I went down into the basement and found about 100 steel drums.  They were all about 30-gallon capacity. According to the instructions on the side they were supposed to be used for water storage.  When empty they were supposed to be used as latrines.  None of them contained water.  I guess the planners thought there would be time after a nuclear attack to fill them all. When I asked my boss what I was supposed to do with the drums he said:” I don’t care just get them out of here.”  I took them back to my neighborhood and handed them out to anyone who wanted them.  Apart from the steel drums there was no food or medical supplies.  Just a very large room full of steel drums.

It took me a long time to figure out what happened to the fallout shelters and how they went from a national priority to complete disrepair and abandonment in a decade.  The only explanation is that the planners knew there would be no survivors. A few groups here and there would survive the blast and radiation but nobody would survive the nuclear winter.  Even a limited nuclear exchange kicks enough dust up into the atmosphere that makes food production impossible. That marks the end of humanity – the ultimate existential crisis.

Shouldn’t the man with the power to end civilization quickly or slowly know something about this?  Shouldn’t everyone know the real existential threats we are facing?  Shouldn't we all be facing these threats realistically instead of denying they exist or pretending that we can survive them?

 

George Dawson, MD, DFAPA

 

References:

1:  Yalom ID.  Existential Psychotherapy.  Basic Books.  New York, 1980.

2:  Dirzo R, Ceballos G, Ehrlich PR. Circling the drain: the extinction crisis and the future of humanity. Philos Trans R Soc Lond B Biol Sci. 2022 Aug 15;377(1857):20210378. doi: 10.1098/rstb.2021.0378. Epub 2022 Jun 27. PMID: 35757873; PMCID: PMC9237743.

3: G. Ceballos, P. R. Ehrlich, A. D. Barnosky, A. García, R. M. Pringle, T. M. Palmer.  Accelerated modern human–induced species losses: Entering the sixth mass extinction. Sci. Adv. 1, e1400253 (2015).

Supplementary:

I thought I would list a few references to existential crisis as they occur:

Ford L.  Seymour Hersh Issues Grave Warning in Venice: “Trump Wants to Be Commander of America — He Wants to Not Have Another Election”  The Hollywood Reporter.  August 29, 2025.

https://www.yahoo.com/news/articles/seymour-hersh-issues-grave-warning-111210675.html

“There’s still integrity in America right now but as somebody said recently, we’re in existential crisis right now. And the president is a man who wants to be here for life. He wants to be commander of America. My belief is that’s his absolute sole mission. He wants to not have another election, because under the Constitution he cannot…. That’s what he’s going to be doing for the next three years.”

Science and Politics…..With A Lesson from Psychiatry

 

I started reading this week’s edition of Science and was surprised to find several editorials about the relationship between science and politics. In addition to the editorials, news items like “Will Trump upend public health?” and “Trump picks lawyer for EPA.” Were no less alarming.

Marcia McNutt, President of the National Academy of Sciences wrote the first essay (3).  She correctly discusses science as a rational neutral process that by its very nature is apolitical.  She describes the peril of citizens ignoring scientific reality by quoting a 26% increased mortality rate in areas of the US where political leaders dismissed the importance of the COVID-19 vaccine.  She makes the point that science must define the body of information that policy should be based on - but it should not actually dictate policy.  She advocates for a role of listening to the affected people and fighting the disinformation that affects them.  Unfortunately, the process of active listening will not do anything toward fighting misinformation – especially when things get to the wide dissemination and meme stage. 

H. Holden Thorp, Editor-in-Chief of Science journals wrote the second essay (4) and it was more specific to the current political situation.  After commenting on the win for Trump he provides the following qualifier:

“Although his success stems partly from a willingness to tap into xenophobia, racism, transphobia, nationalism, and disregard for the truth, his message resonates with a large part of the American populace who feel alienated from America’s governmental, social, and economic institutions.”

The first clause in this sentence is accurate – but there are problems with the second.  Are xenophobia, racism, transphobia, nationalism, and dishonesty really symptoms of an underlying problem or do they represent the real problem of an opportunistic politician successfully scapegoating a portion of the population to gain the support of the electorate with these biases?  That has immediate relevance for the author’s proposed solutions of decreasing scientific misconduct to enhance public trust.  He points out that an animated defense on X/Twitter by scientists was not successful (how could it be based on the platform’s structure, biases and conflicts of interest?). He ends by correctly predicting that the attacks on science and scientists will go on unabated into the future and would like to see a response by the scientific community that makes them less successful.

The essay by Jaffrey Mervis (2) highlights concerns that research advocates have for the Trump agenda that is described at one point as defunding research to reduce taxes.  Any analysis of the tax plan shows that the savings are disproportionately awarded to the top 1% of wage earners.  A research physicist points out that there is no good news for science in the Trump agenda and that also translates to no good news to the tech industry that depends on government funded research for innovation.  Three areas from the Biden administration that may suffer are the Chips and Science Act, climate change, and research collaboration with China. 

The essay by Jocelyn Kaiser (1) focuses on the possible impact on the National Institutes of Health (NIH).  In this essay there is clear focus on Robert F. Kennedy, Jr. as a danger to the NIH and health related basic science research.  That danger on the one hand describes him with the euphemism “vaccine skeptic” and on the other quotes former NIH Director Harold Varmus as saying: ”enormous risks especially if [Trump] placed someone as unhinged as [Kennedy] into a position of responsibility.”  There is a lot of room between skeptic and unhinged.  Trying to present an even-handed description in this case is a clear error when responding to RFK’s rhetoric. It is not a stretch to say that his rhetoric may replace science as the guiding principle behind the NIH.  That is a problem regarding the role of science advising policy makers and a boundary problem on the part of rhetoricians.  Simply put – if you are an administrator with no science background and you are making science up – stay in your lane.

Another clear example of potential problems with a Republican Congress is still based on the COVID-19 pandemic and insistence that the bat coronavirus research was the source of the pandemic virus.  This has reached meme status in the MAGA community fueled by rhetoric from both Trump and members of Congress who have directly attacked NIH scientists.  In some cases those verbal attacks have resulted in threats of violence to those same scientists. All of that happening even though the origins of SARS-CoV-2 are not settled science - but most recent reports suggest origins in the wild like practically all pandemic viruses. Some politicians want to reform the NIH and that is typically a code word for changing an institution to something more like the one they want.  In the case of the Trump administration that can include banning fetal tissue research and I would expect other issues related to women’s reproductive health that the religious right objects to.

The final essay by Rachel Vogel (5) is focused primarily on the implications of Trump’s threat to leave the World Health Organization (WHO). The author reminds us that Trump started this process in July 2020 based on the false claim that “WHO had helped China cover up the spread of the virus in the early days of the pandemic.”  The Biden administration came in and stopped that process.  WHO member states are bracing for a second withdrawal or a reduction in funding to key programs that many think would be catastrophic.  Cuts could also be made to the US Agency for International Development (USAID) that administers many of these programs and other agencies funded to research and treat tuberculosis, malaria, and AIDS.  Political and religious ideology may also be a factor.  A program for AIDS relief started by George W. Bush is a possible target for indirect support of abortions and the use of language that right wing religious groups consider offensive including “transgender people” and “sex workers”.  It is likely that a “gag rule” on the dissemination of abortion information will be reinstated and the penalty will be withdrawal of funding.  Like aspects of the other essays, the author is hopeful that there will be ways to compensate for the Trump worst case scenario. Reform of the NIH has been talked about in the past.  Europe and other countries could compensate for the lack of US support.  Competitive funding sources like the BRICS group (Brazil, Russia, India, China, and South Africa) could also come to the forefront.  The amount of funding available from BRICS and what those countries would require in return is speculation at this point.    

The 5 essays highlight real problems and given Trump’s current nominations for the Director of HHS and NIH probably minimize them.  Suggested solutions to the problem seem to be the time-honored stay out of politics, present the data, and take the high road.  This is really an inadequate plan.  How do I know this?  The valuable lesson is that this is what psychiatry has done for decades.  Ever since Thomas Szasz began his repetitive rhetoric that there was no such thing as mental illness, or that psychiatric diagnoses were like drapetomania (later modified to drapetomania was somehow a psychiatric diagnosis) we have had to tolerate nonsensical criticism while major physician and psychiatric groups were silent.  The many leaders in the field who did respond and had excellent responses were eventually ignored as the neo-Szaszians continue to repeat this nonsense decades later.  An experiment by Rosenhan that was exposed as fraudulent continues to serve as an anchor point for antipsychiatrists – even though what happened clearly did not impact the field (deinstitutionalization had already started and the neo-Kraepelinians were already at work on reliable and valid diagnostic criteria).  The result of this rhetoric is significant hangover on the field. It is difficult to make a direct connection but common sense dictates that psychiatric resources probably takes a hit from all the repetitive negative rhetoric. That is the risk to all of medicine, public health, and scientific research with the current MAGA rhetoric.

Science typically considers itself above rhetoric and politics at least until the competition for grant funding heats up.  The editorials all fail to comment on this.  Instead, they suggest that leading by example, being available for consultation, and generally taking the higher ground will somehow correct corrosive politics.  That is both a naïve and losing strategy.  We currently have a party that has lied and misinformed the public repeatedly and at record levels.  It is supported by a large mainstream media organization with the same goals providing a constant diet of misinformation. It is funded by billionaires. The effects of all those dynamics are easily observed in attitudes toward real science and scientists.  Experts on autocracy and authoritarianism point out that the effect of constant lies on any group of citizens is that eventually they don’t believe anything – even if it happens to be the truth.  A standard authoritarian tactic is to attack expertise and pretend that it does not exist.   

At no recent point in history have legitimate scientists, physicians, and public health officials been threatened with violence by people who have no clear idea of what they do.  In many cases these professionals have been responsible for saving thousands of lives. That situation should be intolerable to any scientist or modern citizen who can evaluate the effects of science.  Furthermore, it should not be supported at any level by the government, but it currently is.  The same party that that supports lies also supports threats and violence at various levels up to an including an attempt to overthrow the US government. With the current election there is the expectation that attempt will be whitewashed as a protest further eroding the rule of law.

The curious aspect of this process is that it is right out there in the open. The repetitive lies are picked up by social media.  Proxies of that ideology begin to amplify them to the point that they become memes rapidly assimilated by true believers in the same ideology.  At that point they become part of that culture and resistant to change from rational arguments and additional information. There is no evidence that I am aware of that change is possible at that point and the most recent Presidential election is solid evidence.     

There is a semi rational basis to politics at best.  The current election illustrates this at many levels.  Major questions of character, intellect, and policy were ignored. The fact checking mode of the fourth estate was minimized.  Some media outlets were mere propaganda arms and provided no information for voters to make an informed decision. 

The only rational course is to continuously counter the repetitive propaganda being put out in social media.  There is no comprehensive strategy for doing this but it must be done.  It will take more than a few editors from Science journals.  A starting point may be a coalition of editors of science and medical journals with their own website dedicated to refuting misinformation and posting the real science. The time has come to stand up for what is science and what is not and protect people under attack for doing the right thing.

 

George Dawson, MD, DFAPA

 

References:

 

1:  Kaiser J. Trump won. Is NIH in for a major shake-up? Science. 2024 Nov 15;386(6723):713-714. doi: 10.1126/science.adu5821. Epub 2024 Nov 14. PMID: 39541475.

2:  Mervis J. Research advocates see 'no good news for science'. Science. 2024 Nov 15;386(6723):712-713. doi: 10.1126/science.adu5820. Epub 2024 Nov 14. PMID: 39541473.

3:  McNutt M. Science is neither red nor blue. Science. 2024 Nov 15;386(6723):707. doi: 10.1126/science.adu4907. Epub 2024 Nov 14. PMID: 39541446.

4:  Thorp HH. Time to take stock. Science. 2024 Nov 15;386(6723):709. doi: 10.1126/science.adu4331. Epub 2024 Nov 7. PMID: 39508752.

5:  Vogel G. 'America first' could affect health worldwide. Science. 2024 Nov 15;386(6723):715. doi: 10.1126/science.adu5822. Epub 2024 Nov 14. PMID: 39541476.