Public Health in the USA (Part 2): The COVID-19 pandemic, and Trump's long shadow over global health

In this series on "Public Health in the USA" the author explores recent developments in public health and politics that created ripple effects in the present and future of science and medicine in the USA and beyond.

Donald Trump and the COVID-19 pandemic

In 2020, at the end of his first presidential term, Donald Trump had to deal with the COVID-19 pandemic. The Trump administration tackled the COVID-19 pandemic with decisions and rhetoric that had a profound impact on the public's perception of the health risk and on the credibility of doctors and scientists. From the early stages of the pandemic, Trump repeatedly claimed that the virus would «disappear on its own», downplaying its severity even when epidemiological data indicated a dramatic situation.

In January 2020, when the Chinese healthcare system was already under pressure, Trump told CNBC's Joe Kernen from the World Economic Forum in Davos: «It's one person coming in from China. We have it under control. It's going to be just fine». President Trump not only downplayed the problem, but also insisted on calling SARS-CoV-2 the «Chinese virus», fuelling a geopolitical narrative rather than a health-related one.

There were numerous tensions between the White House and health agencies like the CDC and FDA, accused of hindering economic recovery and sometimes pressured to alter or delay communications for political reasons.

«I'm taking it, hydroxychloroquine. Right now, yeah. A couple of weeks ago, I started taking it. Because I think it's good. I've heard a lot of good stories» said President Trump in May 2020, promoting hydroxychloroquine as a treatment, even though it had not been scientifically validated. In addition to the episodes related to hydroxychloroquine, statements about disinfectants as possible treatments, without any solid evidence, were also emblematic.

President Trump's positions contributed to consolidating a deep mistrust of science and health institutions among a significant portion of the American public.

Rise of anti-vaccine and anti-mask movements in Europe

Trump's rhetoric during the COVID-19 pandemic gave strength and legitimacy to movements that already existed in Europe but were more marginal. Here are some of the most critical situations:

Several European studies published in 2024 and 2025 correlate political affiliation with a greater propensity to refuse vaccination.

Trump back in the White House: what is happening in the US today

Trump's second term has reignited the spotlight on possible developments in US health policy. Although the healthcare context today is radically different from that of 2020, some continuities with the health policy adopted during the COVID-19 pandemic are emerging.

Recently, the new Trump administration has strongly relaunched the “lab leak” theory, arguing for the need for more in-depth investigations into the origin of SARS-CoV-2. This position, while legitimate on a scientific level if conducted methodically, has once again taken on a markedly political tone, with the risk of fuelling international tensions and anti-Chinese sentiment. A recent article in The Guardian highlights how the debate on the lab leak has now become more of an identity and political issue than a strictly scientific debate.

The new Trump administration has again criticised the WHO. In 2020, Trump officially notified his intention to withdraw the US from the WHO (the withdrawal never took effect). Today, Trump accuses the WHO of inefficiency and complicity with China in the initial management of the pandemic, criticises the fact that the United States is one of the WHO's largest funders, arguing that American funds «do not serve to protect American interests», and considers the WHO a den of bureaucrats who want to take away the sovereignty of individual states in the field of health policy. Although unconfirmed, rumours are circulating about possible cuts in US funding to international bodies such as the WHO and the Global Fund.

The WHO is not the only health agency in Trump's sights. The president has reiterated his desire to downsize the so-called “public health deep state”. Accusations against agencies such as the FDA and CDC, which the president claims are guilty of imposing excessive rules and restrictions during the pandemic, are fuelling proposals for new reforms to reduce their power. This could have repercussions on the approval processes for drugs and vaccines, with potential consequences not only in the United States but also for global pharmaceutical companies.

The Trump administration's approach to vaccines is highly ambiguous and ambivalent. In 2020, Trump launched “Operation Warp Speed”, a public-private partnership to accelerate the development, production and distribution of COVID-19 vaccines. Recently, the Washington Post ran the headline “Celebrated then disparaged: mRNA's promise is tarnished under Trump”, highlighting the current administration's backtracking on funding for research into this technology, which has resulted, for example, in the cancellation of funds for new mRNA vaccines, such as the one against H5N1 avian flu.

Another paradoxical situation? On the one hand, Trump's nominee for CDC director has stated that vaccines “save lives” and denied any link between vaccines and autism. On the other hand, US Health Secretary Robert F. Kennedy Jr. recently reformed the CDC's Advisory Committee on Immunisation Practices (ACIP) and has already obtained the first vote to break with established vaccination practices: the recommendation against the use of influenza vaccines containing thimerosal, a mercury-based preservative used for decades in multi-dose vials.

This decision affects only a small proportion of vaccines distributed in the country (less than 5%, according to the FDA), as thimerosal has already been largely eliminated from paediatric vaccines since 2001. The decision represents a political signal towards theories not supported by established scientific evidence.

The concrete implications for Europe

European institutions have learned an important lesson from the American experience: health communication must avoid contradictions and tones that are either overly reassuring or alarmist. The ECDC Report of May 2023, “Lessons from the COVID-19 pandemic”, identifies risk communication as one of the key areas for improvement. However, this greater caution has often made institutional communications slower and more bureaucratic, exposing them to criticism for lack of transparency.

The global spread of fake health news, amplified by prominent political figures such as Trump, has led the EU to strengthen its regulatory arsenal. The Digital Services Act (DSA), which came into force in 2024, aims precisely to curb the circulation of false or dangerous health content on digital platforms. The phenomenon is not marginal: recent studies (Nature, 2024) show that a significant part of the anti-vaccination content disseminated in Europe originates in the United States or echoes rhetoric developed overseas.

Another European response was to strengthen health autonomy through HERA, ensuring secure supplies and rapid response to future crises.

A lack of trust in science can have a devastating effect

Trump's handling of health policy during the pandemic has had a profound impact on the relationship between politics, science and public opinion, creating a rift that has never been fully repaired.

Concrete evidence of the consequences of this mistrust can be seen in the return of measles, both in the United States and in Europe. In the US, the CDC reported over 1.500 confirmed cases in 2025, a figure not seen in decades, often located in communities where conspiracy rhetoric has eroded confidence even in routine paediatric vaccines. The phenomenon is also causing concern in Europe: according to the ECDC, in 2024, vaccination coverage for measles-mumps-rubella fell below 90% in several regions, including parts of Germany, France and Italy, compared to the 95% recommended to ensure herd immunity.

Organisations such as the WHO and the ECDC, while not directly mentioning Trump, have repeatedly warned against the politicisation of public health and the destructive effect of misinformation on confidence in vaccines.

Mindful of what has happened, Europe is trying to protect itself by strengthening its health autonomy, investing in the fight against misinformation and focusing on clearer and more transparent institutional communication. But the challenge remains: public health knows no borders, and the political choices of a single country can have consequences far beyond its own territory. The measles epidemic is a concrete warning of how mistrust of science can quickly translate into new health emergencies.

Centers for Disease Control and Prevention (CDC). (2020). Measles - United States, January-December 2019. Morbidity and Mortality Weekly Report, 69(5), 153–157.
Centers for Disease Control and Prevention (CDC). (2020). COVID-19 pandemic planning scenarios.
European Centre for Disease Prevention and Control (ECDC). (2023). Lessons from the COVID-19 pandemic.
European Commission. (2022). Digital Services Act: Commission welcomes political agreement on rules ensuring a safe and accountable online environment.
Nature Medicine. (2022). Vaccine misinformation and its global impact. Nature Medicine, 28(8), 1537.
Science. (2021). Pandemic misinformation and its consequences. Science, 374(6571), 298–299.
The Guardian. (2020, April 24). Trump suggests injecting disinfectant as treatment for coronavirus. The Guardian.
Washington Post. (2020, May 19). Trump says he’s taking hydroxychloroquine to protect against coronavirus. The Washington Post.