I lived it. I was inside the Trump administration during the first term, working on national security and pandemic response as COVID-19 swept across the country. I saw firsthand how politics took precedence over public health, how expertise was sidelined, and how critical decisions were shaped by electoral considerations rather than the well-being of the American people. Now, in Trump’s second term, the same troubling patterns are emerging—only this time, they are deliberate, systematic, and more dangerous than before. During COVID-19, Trump routinely dismissed the guidance of the Centers for Disease Control and Prevention (CDC) and pressured health agencies to downplay the severity of the virus. I witnessed how the administration attempted to control messaging, sometimes rewriting guidance for political purposes. Public health officials, including Dr. Anthony Fauci, Dr. Deborah Birx, and Dr. Stephen Hahn, became targets of Trump’s attacks whenever their advice contradicted his political goals. Science was subjugated to ideology. Fast forward to 2025, and we are seeing a deliberate effort to reshape public health institutions. Robert F. Kennedy Jr., a vocal critic of vaccines, is now at the helm as Secretary of Health and Human Services. This is the same RFK Jr. who fueled vaccine misinformation during the pandemic, contributing to the rise of the anti-vaccine movement. His appointment was an overt signal that Trump’s second-term health policy will be dictated by conspiracy theorists rather than scientific consensus. This isn’t just an echo of the past—it’s an escalation. Where the first term sought to control and manipulate health agencies, this term seeks to dismantle and remake them in the image of a more extreme and controlled ideology. Slashing Healthcare Access: From COVID-19 to Medicaid Cuts During COVID-19, the Trump administration’s initial response was to deny the severity of the crisis. But behind closed doors, discussions about cutting Medicaid were still happening. I remember those conversations vividly. Even as millions of Americans faced financial ruin and job losses, there were internal talks about rolling back healthcare access. The administration didn’t aggressively pursue Medicaid cuts at the time because COVID-19 forced a different political calculus—people were relying on government-supported healthcare to survive a pandemic. But make no mistake: the desire to gut Medicaid was always there. Now, in 2025, that long-standing goal is coming to fruition. Trump’s administration is moving forward with proposed cuts of $800 billion from Medicaid over the next decade. This will disproportionately harm low-income families, seniors, and people with disabilities—many of whom relied on Medicaid for COVID-19 treatment just a few years ago. The flagrant negligence of how they will likely go about this cannot be overstated. It is not about fiscal responsibility, but about dismantling social safety nets for ideological reasons. The safety nets that people across the political ideological spectrum rely on for their own well-being. Yes, that’s why you’re seeing some nervous Republicans, especially at the state, level trying to figure out how they’re going to publicly navigate it. Politicizing Public Health, Then and Now While there are certainly lessons learned from what we as a country faced during the pandemic and the government’s response to it, one of the most damaging aspects of the Trump administration’s COVID-19 response was the way it politicized public health measures. Whether it was downplaying masks, pushing hydroxychloroquine despite scientific evidence, or undermining the credibility of the vaccine rollout, Trump’s actions created lasting distrust in medical institutions. This distrust laid the groundwork for today’s entrenched anti-vaccine movement, which has only grown more extreme. The difference is that in 2020, it was a fringe movement that gained traction with Trump’s tacit encouragement. In 2025, it is embedded within the federal government itself. As I mentioned earlier, RFK Jr. isn’t just a vaccine skeptic—he’s an activist against public health initiatives that have saved millions of lives. Under his leadership, we are already seeing a rollback of vaccine advocacy programs, a re-evaluation of school vaccination requirements, and new funding restrictions for global health initiatives, including those that combat measles and polio in developing nations. This is how public health collapses—not overnight, but through deliberate erosion, misinformation, and the elevation of conspiracy theories over evidence-based policy. From Global Neglect to Domestic Rollbacks Trump’s withdrawal from the World Health Organization (WHO) in 2020 was a disastrous decision that hampered global cooperation during the worst pandemic in a century. Even when he eventually reversed course, his administration’s hostility toward international health efforts remained evident. Now, in 2025, that hostility is even more pronounced. Trump has reinstated the Global Gag Rule, which blocks U.S. funding to foreign organizations that provide or even discuss abortion services. To be clear–this is not just about reproductive health—it affects entire healthcare systems in low-income countries, reducing access to HIV treatment, maternal healthcare, and vaccinations. Meanwhile, the administration is rolling back pandemic-era public health protections at home. At a recent cabinet meeting, Elon Musk defended this rapid dismantling of federal programs, saying, “We will make mistakes. We won’t be perfect. But when we make a mistake, we’ll fix it very quickly. So we restored the Ebola prevention immediately. And there was no interruption.” Oops! See, here’s the thing: There was and remains an interruption. Cutting USAID staff and programs means that the personnel deployed to fight ebola were dismantled. While Musk continuously frames these cuts as a necessary part of an agile government, the reality is that such abrupt policy shifts can create dangerous gaps in public health preparedness. Funding for pandemic preparedness has been slashed, and public health agencies are being restructured to align with Trump’s political agenda. This reckless dismantling of infrastructure leaves us vulnerable to future pandemics, which are not questions of if but when. The Economy Over Public Safety—Then and Now In 2020, the Trump administration prioritized economic reopening over pandemic containment. I watched as internal debates over lockdowns, safety measures, and financial recovery were often guided by political optics rather than public health data. Trump’s push to reopen states quickly, despite rising COVID-19 cases, contributed to avoidable deaths and long-term economic instability. Now, in 2025, we are seeing a similar pattern. The administration’s focus is on deregulating healthcare protections and reducing employer mandates for worker safety. Public health policies are being rewritten to accommodate corporate interests rather than protect public safety. This includes weakening workplace safety rules on airborne diseases and eliminating pandemic-related emergency response mechanisms. Measles Outbreak in Texas: A Direct Consequence Nowhere is the impact of these policies more evident than in the measles outbreak currently sweeping through Texas. Once considered eradicated in the U.S., measles has resurged due to plummeting vaccination rates—a direct consequence of the anti-vaccine rhetoric amplified by many. During COVID-19, the administration stoked distrust in public health measures, and in 2025, it has gone even further by dismantling vaccine advocacy programs and HHS Secretary RFK Jr. doing his best to downplay what’s currently happening in Texas. The Texas outbreak is a case study of what happens when public health is politicized: preventable diseases make a deadly return, hospitals become overwhelmed, and lives—especially those of children—are put at unnecessary risk. Just like in 2020, the consequences of these decisions are being felt in real-time, with the most vulnerable paying the price. A Warning from Experience I was there in 2020. I saw the damage firsthand. Before you send me angry messages about your feelings on what happened during the COVID-19 pandemic–whatever they may be–I want you to know that this entire moment of my career will haunt me for the rest of my life. And I am watching, with deep concern, as the same patterns unfold in 2025, but this time with more precision, intent, and fewer obstacles. The Trump administration is not merely repeating the mistakes of its first term; it is deliberately institutionalizing them to reshape public health policy for years to come. The warning signs are clear for those who lived through the COVID-19 era. The question is: will we recognize them in time to stop history from repeating itself? If you care about protecting public health, access to healthcare, and science-based policy, your voice does matter. Put the pressure on the leaders that represent you in Congress. If you work in healthcare, make your voice heard. YOU are the experts in the trenches living this day in and day out. We don’t need another pandemic to remind us how it became an effort of local communities, doctors, and trusted voices working together to protect the safety and well-being of Americans while the leadership in the Oval Office consistently failed us. We’ve seen this movie before. We know how it ends. But this time, we still have a chance to change the script. More soon, Olivia If you’d like to take a deeper dive into topics like this, consider becoming a premium member to join our exclusive troll-free chat where you can ask the questions I’ll answer in an exclusive weekly video series. And now I’m going to make a bold request. If you enjoy reading my work, would it be too much to ask you to share it on your favorite social network so we can keep growing this awesome community? Have an idea or feedback? Reply directly to this email. © 2025 Olivia Troye |