Trump's orders sow chaos in global public health

A recent flurry of executive orders and surprise actions by the Trump administration have roiled the international public health community, leaving healthcare workers scrambling and aid programs in peril. 

On January 20, President Donald Trump issued an executive order pausing U.S. foreign development assistance for 90 days to assess “programmatic efficiencies and consistency.” The ripple effects spread immediately. On January 24, the State Department put out a stop-work order halting foreign aid work. And on January 27, the Trump administration placed dozens of officials at the U.S. Agency for International Development on leave. 

All members of the Environmental Protection Agency’s boards of outside advisers on science and clean air were dismissed in a letter emailed late Tuesday, an unusual step the Trump administration said was aimed at depoliticizing the panels.

Panel members expressed disappointment and confusion at the assertion in the letter signed by James Payne, a career EPA attorney Trump installed as acting administrator. Critics charged the Trump administration with politicizing the process by eliminating the current independent advisers and clearing the way for them to be replaced with hand-picked appointees.

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Storms Are Getting Bigger With Climate Change. A New Flood Study Offers One Region Ideas to Prepare In southeastern Pennsylvania, Hurricane Ida in 2021 was a preview of a flood-prone future. A report recommends construction projects and other fixes to save lives and property. Derek Harrison Inside Climate News

The outlook for more climate-related flooding in a southeastern Pennsylvania watershed has prompted a new call for measures to contain heavy rains, allow raging waters to pass downstream and help the public anticipate bigger and more frequent storms.

VA study shows COVID more severe than RSV, flu Primary outcomes included rates of 30-day hospitalization, intensive care unit admission, and death, as well as the secondary outcome of long-term death extending through 180 days. CIDRAP

A large study of Veterans Affairs (VA) patients in JAMA Internal Medicine shows that, during the 2022 to 2023 season, having COVID-19 was associated with more severe disease outcomes than flu or respiratory syncytial virus (RSV) infection. Differences became less pronounced, however, during the 2023 to 2024 season. 

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Will bird flu spark a human pandemic? Scientists say the risk is rising Nature - H5N1 is adapting to new mammalian hosts, raising the possibility of the virus spreading between humans. Kozlov, Max nature

Although many of the infections have been mild, emerging data indicate that variants of the avian influenza virus H5N1 that are spreading in North America can cause severe disease and death, especially when passed directly to humans from birds. The virus is also adapting to new hosts — cows and other mammals — raising the risk that it could spark a human pandemic.

Americans' support for school vaccine mandates remains strong, but opt-out options gain traction With President Donald Trump having threatened school vaccine mandates for children during his campaign, a new survey finds that nearly three-quarters of U.S. adults support requiring that children be ... Annenberg Public Policy Center of the University of Pennsylvania Medical Xpress

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Flu vaccines have prevented millions of deaths, research shows The 1918 Spanish flu pandemic was caused by a particularly virulent strain of influenza virus. It infected 500 million people, caused around 50 million deaths, and its impact was so severe that global ... Medical Xpress

...In terms of its effectiveness in preventing deaths, our analysis of the data shows that influenza vaccination is able to reduce infection-associated mortality by half overall, including H3N2 infections.

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White House blames "outage" for locking out Medicaid, Head Start, health centers from funding site The online system for federal health funding warned of delays due to executive orders after the Trump administration announced a freeze. CBS News

Multiple state Medicaid programs reported late Tuesday they have been able to resume accessing their payment systems after the nationwide lockout. 

Despite concerns about the future of research at the National Institutes of Health, current clinical trials can continue as scheduled, the agency’s acting director told staff scientists in an email Monday.

The clarification followed what staffers called “chaos” Wednesday when the Trump administration “paused” all communications from federal health agencies and suspended all government travel. The directive left NIH staff members with unanswered questions about their work and even whether they’d be able to continue caring for their patients.

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State Department Reverses Near-Full Stop of Foreign Aid Marco Rubio’s memo now exempts ‘core life saving programs’ but withholds assistance for diversity and abortions. Michael R. Gordon and Alexander Ward WSJ

The Trump administration pulled back from its order to pause nearly all foreign aid, and will now exempt “core life saving programs” that involve medicine, medical services, food and shelter, according to a Tuesday memo from Secretary of State Marco Rubio.