A troubling pick to lead the Department of Health and Human Services

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In Minnesota, Brainerd is best known as lake country’s unofficial capital and home to an acclaimed motorsports race track.

But in medical circles, this Crow Wing County community has a much less pleasant connotation. The reason: In the early 1980s, 122 residents were sickened with a “previously undescribed chronic diarrhea syndrome” that lasted “at least a year” for 75% of those affected. A 1986 medical journal article makes clear this is something you do not want to get, with the condition characterized by “acute onset, marked urgency, a lack of systemic symptoms and a failure of response to antimicrobial agents.”

Brainerd isn’t the only place where people have become ill with this explosive illness. But because the city was the first place an outbreak was reported, the condition is now infamously known as “Brainerd Diarrhea.”

I hesitated to bring up this bit of state history because of the yuck factor. But it’s relevant at this moment because another important detail about Brainerd Diarrhea illustrates why Robert F. Kennedy, Jr., is such a shocking pick to lead the U.S. Department of Health and Human Services (HHS) during President-elect Donald Trump’s second term.

That detail: Brainerd Diarrhea is associated with drinking “raw milk,” which hasn’t been pasteurized to kill potential disease-causing pathogens.

Some believe raw milk can cure many diseases despite warnings from experts about its dangers. Unfortunately, Kennedy is a prominent raw milk advocate, and he’s now just a U.S. Senate confirmation away from leading HHS, which is effectively the world’s largest public health organization.

Drinking raw milk can expose people to Campylobacter, Cryptosporidium, E. coli, Listeria, Brucella, and salmonella. Between 1998 and 2018, 202 outbreaks and 2,645 illnesses were linked to unpasteurized milk, including 228 hospitalizations and three deaths, according to a 2022 analysis. The U.S. Food and Drug Administration also notes the lack of scientific evidence for supposed benefits.

And yet none of this seems to matter to Kennedy. He recently tweeted that public health’s “aggressive suppression” of raw milk, psychedelics, peptides, hyperbaric therapies and ivermectin will end under him. Ivermectin has been touted as a COVID cure-all, despite studies showing it is ineffective.

If Kennedy ignores the science on raw milk and ivermectin, it raises disturbing and dangerous questions about other key health decisions and whether he’ll continue to ignore data in favor of his personal biases. This is especially problematic when it comes to immunizations. Kennedy, politely known as a vaccine skeptic, would have sweeping influence over access and policies. That’s a concern when the federal Vaccines for Children program purchases about half of the nation’s childhood immunizations to help low-income families.

Seventy-seven Nobel laureates are among those sounding the alarm. In a recent letter to the Senate, signatories objected to Kennedy’s confirmation, citing his contrarian views on vaccines and AIDS treatments.

As home to world-class medical centers and medical device companies, Minnesotans should be at the forefront of opposing Kennedy’s confirmation. It’s frustrating that Mayo Clinic, a global health care leader whose opposition would attract notice, has declined to publicly comment on Kennedy. The Minnesota Hospital Association provided a feeble statement. Like other organizations, they’ve likely performed a political calculus and are wary of challenging the incoming administration.

But Minnesota infectious disease expert Mike Osterholm has shown commendable courage. He co-authored a New York Times commentary, calling the nomination “outrageous.” I followed up with him recently. Key exchanges:

Q. Why are you speaking out so forcefully?

A. “I’ve seen a lot of public health in my 50 years in this business. Some of that has been really hard-fought gains in reducing childhood illness in ways that most people take for granted ... when I started at the Minnesota Department of Health, Haemophilus influenzae B or HiB, affected about 1 out of every 250 kids before they reached the age of five. It was the number one cause of hearing loss in addition to other neurologic issues. It was a tragedy. Today, nationwide, we see usually less than 10 cases a year and it’s because of a vaccine. We have made such advances in reducing serious illness, hospitalizations and deaths, particularly in kids. It’s the loss of that gain that to me would be the greatest travesty of all.”

Q. Kennedy has recently said he’s “all for the polio vaccine” after years of disputing its effectiveness and linking it to cancer. Is the change of heart credible?

A. “I can’t tell you who he is. It’s like nailing Jell-O to the wall. He changes his statements all the time.”

Q. What’s the problem with making vaccine safety data transparent, as Kennedy has vowed?

A. “That safety data has been available to everybody since the beginning of vaccines. All the data for approval at the FDA. All the data for the (Advisory Committee on Immunization Practices). All the data ongoing on a collection basis. It’s public. What is he going to do differently? But you know, by saying that, he gives people the sense that we’re hiding something.”

Q. Kennedy has said he’d take an eight-year break on infectious disease research. Your thoughts?

A. Osterholm noted that measles causes 100,000-plus deaths a year globally. A “break” would weaken our defenses against this pathogen and others. “Trying to restrict infectious disease research right now would be like saying we’re only going to invest in safety for highways that run north and south, but forgetting all the ones that run east and west.”

As we wrapped up, Osterholm noted that he has grandchildren and wants to ensure a public health system robust enough to protect them and generations to come. HHS needs a leader who not only continues to build that system, but bolsters confidence in medicine’s growing arsenal against disease.

“These viruses are making a comeback. It’s not because we don’t have the tools. It’s because we’ve scared people into not using them,” said the courageous grandfather and needed profile in courage.