Anti-vaccine activist and Fox hero Robert F. Kennedy Jr. will lead the Department of Health and Human Services. He will potentially oversee former Fox contributor Dr. Marty Makary at the Food and Drug Administration, Fox medical contributor Dr. Janette Nesheiwat as U.S. surgeon general, and frequent Fox guests Dr. Jay Bhattacharya at the National Institutes of Health and Dr. Mehmet Oz at the Centers for Medicare & Medicaid Services.

These picks, to an extent, show Trump aligning his health policy hires with his own Fox-molded views.

As president during the pandemic, he clashed with his official advisers when they contradicted what he was hearing from Fox personalities. The result was often chaos in decision-making, implementation, and public messaging.

Makary, Bhattacharya, Oz, and Nesheiwat received regular Fox airtime because on issues like the use of untested drugs such as hydroxychloroquine or nonpharmaceutical interventions like office and school closures, they tended to hew close to the Fox line — which also became the Trump line. If another pandemic hits, it is possible that they will be able to mitigate Trump’s worst impulses; they have real medical credentials, and Trump is likely to have greater confidence in them due to their shared past views.

But while Trump’s promotion of COVID-19 vaccines through Operation Warp Speed was an unalloyed triumph in his first term, Kennedy is a crank who was openly hostile to the drugs. And other members of the second-term team regularly went on Fox to warn about the purported health impacts of the vaccines and criticize mandates to ensure their use. That does not bode well for the prospect of a successful response should another pandemic hit during the next four years.

RFK Jr. at HHS is a Fox-fueled disaster for health policy

Fox hosts and other right-wing media figures like Tucker Carlson spent 18 months irresponsibly championing Kennedy as part of a strategy to return Trump to the White House. The network regularly promoted him as a Democratic candidate, then showered him with praise and vouched for his health views after Carlson ensured that he endorsed Trump.

The result is that Kennedy — who has pushed debunked claims about childhood vaccination causing autism, questioned the well-established science over whether HIV actually causes AIDS, and promoted kooky conspiracy theories about 5G cellular towers and chemtrails — is Trump’s nominee to lead the Department of Health and Human Services.

Kennedy was among the biggest U.S. sources of anti-vaccine misinformation during the coronavirus pandemic, terming the COVID-19 vaccine “the deadliest vaccine ever made.” Other noted anti-vaccine figures and fringe crackpots claim to be advising him on the transition.

He also suggested that the pandemic may have been “planned,” that public health efforts taken in response constituted “a pharmaceutical-driven, biosecurity agenda that will enslave the entire human race and plunge us into a dystopian nightmare,” and that the virus itself had been “ethnically targeted” to afflict “Caucasians and Black people” while sparing “Ashkenazi Jews and Chinese."

Trump picked other people he saw on Fox to run health agencies

Several other Trump picks for top health posts were heavily featured during the Fox’s coronavirus coverage.

Oz, the television personality and grifter Trump selected to lead the Centers for Medicare & Medicaid Services, became a Fox regular in 2020. He made scores of network appearances at the start of the pandemic, particularly championing hydroxychloroquine, the antimalarial drug that right-wing media figures promoted as a treatment for or preventative to COVID.

Oz’s commentary attracted the attention of Trump, who reportedly urged aides to consult with the TV doctor about the outbreak. Oz subsequently ran for the U.S. Senate with the support of Fox star and Trump adviser Sean Hannity, but he came up short in the 2022 midterms.

Makary, Nesheiwat, and Bhattacharya also seemingly became Fox regulars because of their willingness to contradict COVID-19 guidance from federal public health agencies on its airwaves.

FDA selection Makary — who argued in a February 2021 Wall Street Journal op-ed that the U.S. would reach “herd Immunity by April” — used his Fox platform in the months leading up to the emergence of the deadly delta variant to criticize public health officials for warning of new strains of the virus. He also criticized vaccine mandates, particularly for children, citing the vaccine’s purported health risks.

Reported NIH pick Bhattacharya — a signatory of the 2020 Great Barrington Declaration, which called for building up herd immunity through “natural infection” — likewise used his time in Fox’s spotlight to criticize vaccine mandates. He agreed with Fox host Laura Ingraham during an August 2021 segment that the FDA approved COVID-19 vaccines “too fast,” saying, “The FDA approval does not change the fact that we don't have long-term safety data with the vaccine."

And Nesheiwat, the Fox medical contributor Trump selected as surgeon general, promoted the use of supplemental zinc as a COVID-19 treatment and repeatedly highlighted the purported health risks of vaccination for children and young men.

Their commentary was part of a massive and effective effort by Fox to undermine the COVID-19 vaccination program. Now, if confirmed, they will be running major federal health bureaucracies.

The last pandemic — and the next one

Trump regularly leaned on Fox’s programming and personalities for advice, and the network shaped both his worldview and his administration’s actions. No event demonstrated the extent of the network’s influence more than his response to the coronavirus pandemic.

Trump didn’t treat COVID’s initial spread as an emergency because Fox was telling him that the media and Democrats were deliberately exaggerating the danger it posed.

He propped up hydroxychloroquine because the network told him it could be a miracle cure, refused to wear masks or socially distance because its hosts said those interventions didn’t work, and then urged the swift reopening of the economy they demanded.

He cut off support to the World Health Organization because one of Fox's stars suggested it and selected a White House adviser from the network’s green room to implement a “herd immunity” strategy.

The result was mass death.

The saving grace of the Trump pandemic response was Operation Warp Speed, an innovative program that sped the development of safe, effective vaccines against the virus. But Trump was out of office by the time the vaccines were deployed, and Fox responded with a yearslong campaign against the drugs. Fox regulars like Makary, Nesheiwat, and Bhattacharya pitched in by criticizing the safety of the vaccines or mandates for their use.

The four doctors Trump picked from Fox’s airwaves do have real medical credentials, and their selections have received some praise from public health experts.

Dr. Peter Hotez, a vaccine scientist, said Nesheiwat is “a good appointment,” describing her as “very smart, thoughtful, interested in learning.”

Dr. Ashish Jha, who served in President Joe Biden’s White House, called the appointments of Makary, Oz, and Bhattacharya “pretty reasonable,” adding: “I have plenty of policy disagreements with them. They are smart and experienced. We will need them to do well.”

Indeed, they may take office as H5N1 bird flu spreads in American livestock and from livestock to people. If that virus makes the jump to human-to-human transmission, the U.S. health bureaucracy will be forced to grapple with another deadly pandemic.

Focusing specifically on Bhattacharya, Slow Boring’s Matt Yglesias offered the best-case scenario for how Trump’s health appointees could impact a pandemic response:

Bhattacharya’s criticisms of nonpharmaceutical intervetions during 2020 went further than I would have, and I don’t agree with him per se. That said, he is well-credentialed and smart and also aligned with Trump on the substantive question.

Four years ago, Trump had a lot of people in place who he didn’t have confidence in and didn’t listen to, and then he had a lot of unqualified people articulating his views.

Bhattacharya can do what an executive branch official is supposed to do and channel Trump-style views in a professional way.

What’s more, precisely because his anti-NPI credentials are unimpeachable, if a much deadlier virus comes around that shifts Trump’s sense of the cost-benefit balance, he would be the right person to deliver that message.

But as he further notes, “the most effective weapon against Covid was pharmaceutical interventions” — and in Kennedy, Trump has selected “an anti-vaccine crank” as Bhattacharya’s boss.

That means things could get bad fast.