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U.S. Public Health Agencies Aren't ‘Following the Science’

By Marty Makary M.D., M.P.H. and Tracy Beth Høeg M.D., Ph.D.

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In one sentence

The authors’ central claim is that senior U.S. public-health agencies were not consistently letting evidence guide policy. Instead, politics, bureaucratic groupthink, and fear of professional consequences allegedly encouraged officials to defend or implement policies they privately regarded as poorly supported.

Overview

The essay opens with anonymous accounts from scientists and physicians working at the NIH, FDA, and CDC. These sources describe declining morale, fear of speaking candidly, and frustration with agency decisions during the COVID-19 response. The authors focus especially on vaccination policy for young children and on what they present as insufficient attention to immunity acquired through prior infection.

They argue that the agencies’ public insistence that they were “following the science” concealed uncertainty and disagreement inside the institutions. In their view, evidence was sometimes treated as a justification for predetermined policy rather than as a reason to revise policy. The essay concludes that agencies should tolerate internal dissent, acknowledge uncertainty, and communicate more honestly if they want to restore public trust.

Core ideas

Anonymous insiders as evidence of institutional dysfunction

The article relies on conversations with unnamed officials who describe censorship, retaliation, embarrassment, and low morale. Their testimony is used to argue that agency culture discouraged open scientific disagreement.

Policy decisions allegedly outran the evidence

The authors object to COVID-vaccine authorization and recommendations for infants and young children, particularly where they believe clinical evidence was limited or did not clearly establish meaningful benefit for children already infected.

Natural immunity was treated as politically inconvenient

The authors say public-health messaging insufficiently recognized immunity following infection. They present this as an example of agencies prioritizing a universal vaccination message over a more differentiated account of risk and protection.

‘Following the science’ can become a shield against scrutiny

The phrase is criticized when it implies that one policy is scientifically compelled. The authors’ preferred model is provisional: assess evidence, expose disagreement, account for tradeoffs, and change course when new data warrant it.

Trust depends on visible dissent and humility

The proposed remedy is not simply different policy, but better institutional behavior: encourage internal challenge, separate scientific findings from political judgments, admit uncertainty, and avoid presenting contested conclusions as settled fact.

Practical takeaways

Caveats and counterpoints

Questions worth revisiting

Return to this when…

Return to this essay when assessing claims that institutions are ‘following the science,’ especially during emergencies. Its most durable use is as a checklist for institutional transparency: inspect the evidence, identify dissent, separate facts from policy choices, and ask whether officials were willing to revise their position.

References

  1. reddit.com
  2. thefp.com
  3. childrenshealthdefense.org
  4. thefp.com
  5. thetrumpet.com
  6. downloads.regulations.gov
  7. bigfooty.com
  8. thenewamerican.com
  9. thefp.com
  10. riseupnh.org
  11. hbiostat.org
  12. thefp.com
  13. commonsense.news