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With confirmation hearings soon to begin for Kennedy and other healthcare department heads with similar views about to begin, the threat of future pandemics in an administration with a disastrous track record is another reason to urge their defeat.
One barely noticed pledge by President-elect Donald Trump during the 2024 campaign appeared in a May Time magazine interview that offers an especially ominous warning about Trump 2.0. If he won a new term, Trump said, he would “probably” disband the Office of Pandemic Preparedness and Response policy established by Congress in 2022.
Fast forward to his new nominees, especially Secretary of Health and Human Services anti-vax conspiracy theorist Robert F. Kennedy Jr., who has said he would pause National Institute of Health infectious disease and drug development research for eight years. As the saying goes, we might have a problem.
With confirmation hearings soon to begin for Kennedy and other healthcare department heads with similar views about to begin, the threat of future pandemics in an administration with a disastrous track record is another reason to urge their defeat.
If the U.S. had the same death rate as Australia, The New York Times later reported, about 900,000 American lives would have been saved.
The 2022 law was prompted by the worst pandemic in a century, that has killed over 1.2 million Americans. The law’s roots were in a pandemic global health security office former President Barack Obama set in the National Security Council. It followed Obama’s experiences with the H1N1 swine flu pandemic in 2009 that killed up to 575,000 people globally, including more than 12,000 in the U.S., and the 2014 Ebola outbreak that claimed thousands of lives in West Africa and provoked a major scare in the U.S.
Trump eliminated the office in 2018, suggesting, The Associated Press reported, “that he did not see the threat of pandemics in the same way that many experts in the field did.” In March, 2020, former pandemic office director Beth Cameron wrote she was “mystified” by the unit’s shutdown “leaving the country less prepared for pandemics… all with the goal of avoiding a six-alarm blaze.” Trump officials insisted they were fully prepared. Facts on the ground tell a different story.
In December 2019 the first reports emerged of patients in China suffering symptoms of an unknown pneumonia-like illness, drawing reminders of the Severe Acute Respiratory Syndrome Coronavirus, SARS Cov-1. By early January 2020, the World Health Organization (WHO) began referring to the outbreak as a 2019 Novel Coronavirus, soon to be renamed Covid-19.
With infections spreading in Asia, the U.S. Centers for Disease Control and Prevention (CDC) in late January reported the first U.S. cases. The first U.S. deaths occurred in January 2020. By mid-March, when Cameron’s op-ed appeared, the WHO confirmed more than 118,000 Covid cases and 4,291 deaths.
Australia, which had a similar profile of libertarian individualism and a right-wing prime minister in 2020, created a bipartisan response with opposition Labor Party and state leaders, and medical officers out front. They quickly subsidized production and distribution of masks, prioritized testing and contact tracing, and understood some shutdowns were necessary. If the U.S. had the same death rate as Australia, TheNew York Times later reported, about 900,000 American lives would have been saved.
The first year of Covid-19 was critical to establishing the protocols and public health protections to confront the crisis and reduce the deaths and suffering. But, due to widespread government failures, infections spread like wildfires. Yet the Trump administration was glacially slow to react. In his first public statement January 22, 2020, Trump declared, “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.”
In multiple comments tracked by Rep. Lloyd Doggett (D-Texas), Trump downplayed the danger. February 2020: “Looks like by April… when it gets a little warmer, it miraculously goes away,” “CDC and my Administration are doing a GREAT job of handling Coronavirus,” “We’re going very substantially down, not up,” and, “One day, it’s like a miracle, it will disappear.”
Due to Trump’s malfeasance; promotion of misinformation, including false miracle cures; and actively discouraging government and community safety steps to slow the spread, Covid-19 exploded.
As Trump’s term ended on January 20, 2021, the U.S. recorded 25 million cases, and over 400,000 deaths.
Embracing the sluggish signals from Washington, hospitals stalled on adopting critical safety protocols and were ill-prepared for the flood of desperately ill patients that led to cascading deaths, with bodies piling up in makeshift morgues or refrigerated trucks outside hospital doors. It was made worse by inadequate isolation of infected patients and shortages of ventilators and proper protective equipment for overwhelmed nurses and other healthcare workers who paid a horrific price with thousands of deaths and many leaving due to unwillingness to work in unsafe conditions.
Trump’s failures continued for months. At a White House press conference on April 3, Trump eroded a new tepid CDC guidance people consider wearing masks, as other countries were now requiring to reduce transmission of the virus, by adding he would not do so.
Trump’s position, New York University sociologist Eric Klinenberg recalled, “undermined it,” suggesting “to anyone in his world that wears a mask, it’s cowardly, weak, feminine, so no one’s going to wear masks. [It] becomes clear to everyone in the Republican establishment that bearing your face is the way to show solidarity and support to the president,” reinforcing a partisan political divide on not just masks but soon all public health measures.
In late April 2020, as the U.S. death toll passed 60,000, Trump said, “This is going away.” In May, amid 80,000 deaths, Trump said, “We have met the moment, and we have prevailed.” In June, with 110,000 dead Americans, Trump said, “It is dying out, it’s going to fade away.”
On August 31, with the death count passing 180,000, Trump said, “We’ve done a great job in Covid, but we don’t get the credit” blaming a “fake news media conspiracy.” For months, Trump demanded an end to steps some states were implementing to limit infections. As Trump’s term ended on January 20, 2021, the U.S. recorded 25 million cases, and over 400,000 deaths.
National Nurses United (NNU), one of the first to respond to prior pandemics during H1N1 in 2009 and Ebola in 2014, had gained valuable experience. By early January, 2020, “before most people in the U.S. had even heard of Covid-19,” as The New York Times noted, NNU began mobilizing and aggressively pushing employers, government elected officials, and health and regulatory agencies to implement decisive safety actions. In contrast to public agencies, NNU launched multiple public endeavors from rallies to marches, vigils, pickets, and other collective action, including strikes, to demand optimal protections for nurses, other healthcare workers, patients, and the broader public.
Employers took their lead from Trump and the federal agencies he influenced, including the CDC and Occupational Safety and Health Administration (OSHA) that continually eroded safety guidelines and workplace regulations. Hospitals, observed NNU executive director Bonnie Castillo, RN, “took a gamble relative to how much to have and how much to be prepared. And the CDC came out with guidelines shifting, commensurate to what the hospitals are complaining of. The lower standard is cheaper. So they just kept lowering and lowering, all the way down to bandannas. They’re looking at us like fodder.”
Trump’s mismanagement and indifference to who was most harmed proved catastrophic for communities of color, including a large percentage who were essential workers in transit, food processing, service industries, and healthcare.
Early in the pandemic, Trump sought to shift blame from his administration to China, repeatedly referring to Covid-19 as “the China virus,” though by April the U.S., with 4% of the world’s population, accounted for 17% of global Covid-19 deaths. Trump’s racist scapegoating ignited a sharp rise in anti-Asian hate speech and physical assaults.
His future HHS nominee Kennedy was among those adding fuel to the fire. At a 2023 New York press event Kennedy claimed “there is an argument that it is ethnically targeted. COVID-19 attacks certain races disproportionately… The people who are most immune are Ashkenazi Jews and Chinese.”
“We’re being treated like we don’t matter and we’re dispensable.”
Asian American and Pacific Islander (AAPI) healthcare workers subsequently reported a rise in racist incidents, both in hospital settings and in their daily lives. Twice as many verbal and physical assaults were directed at women. “We must unite to challenge anti-Asian violence, harassment, and racism,” said University of California San Diego RN Dahlia Tayag at a statewide California Nurses Association protest against ongoing anti-Asian hate crimes.
The disproportionate racial impact was evident in Covid=19’s devastating toll on Filipino healthcare workers. Kansas City RN Celia Yap Banago, one of many RNs who had pressed her hospital to fix inadequate protections, was one of the first RNs to die in April 2020. “We were being told we’re not allowed to wear masks because it’s going to scare our patients,” said Jenn Caldwell, RN.
By August 2023 when the government stopped reporting healthcare-worker Covid-19 data, 5,753 healthcare workers, including 501 RNs, had died of Covid-19. In a June interview, Zenei Triunfo-Cortez, RN, CNA/NNOC’s first Filipina president, noted that nurses call for help from Trump and Congress “fell on deaf ears… Our employers are banking on (CDC) guidelines, which have been watered down… We’re being treated like we don’t matter and we’re dispensable.”
Centuries of structural racism accelerate the disproportionate impact of any crisis, including pandemics. As Trump was continuing to downplay the tsunami of infections and deaths, and discouraging safety procedures, the racial impact escalated. Black Chicagoans, 30% of city residents, comprised 72% of the Covid-19 deaths. Black Michigan residents, under 15% of the population, accounted for 40% of the deaths. Milwaukee African Americans, 26% of the population, totaled 70% of Covid-19 deaths. Similar rates were evident across the country, from states with large Black populations like North and South Carolina, to those with smaller percentages, such as Nevada and Connecticut.
Latinos were 80% of the first people admitted for care at San Francisco’s large public hospital and in Latino San Jose neighborhoods. Native Hawaiians and Pacific Islander infection and death rates were also higher in California. In March 2020, New Mexico Gov. Michelle Lujan Grisham cited “incredible spikes” in Navajo Nation. Two months later, Navajo Nation still had higher Covid-19 infection cases per capita than much more publicized, hard-hit New York City.
Columnist Jamelle Bouie linked the disparities to “longstanding structural inequities.” Systemic racism in healthcare had a long history, evident in less access to medical institutions and caregivers, provider treatment biases, lower rates of costly health coverage, housing segregation, and higher concentration in polluted neighborhoods. Hospitals in Black neighborhoods were far more likely to close than in mostly white areas, a National Institutes of Health study found.
“What it meant to be an essential worker was to be deemed expendable.”
Black and Latino workers were also far more likely to hold “essential” jobs. Many were concentrated in lower paid jobs often forced to keep working due to economic need or employer pressure, including in food services, grocery and drug stores, and poultry and other meat processing plants. The Guardianreported alarmingly high transit worker death rates among bus and subway drivers, mechanics, and maintenance workers in New York, Boston, Chicago, St. Louis, Detroit, Washington D.C., and other major cities.
In September 2020, the CDC drew condemnation for reportedly soft-pedaling safety precautions due to political interference at a South Dakota meatpacking plant. All these factors resulted in workers of color having less economic ability or opportunity to shelter or work from home, and less access to safety measures, from masks to social distancing on the job where they risked constant exposure.
It also reinforced a class chasm with “a lot of professional and more affluent people who could afford to make the kind of sacrifices this public emergency called for who were able to protect themselves, able to sustain a level of comfort that other people in America were not,” says sociologist Klinenberg.
“It wasn’t like when we called them essential, we said, because you’re essential we’re going to honor you, we’re giving you masks, you get the best access to healthcare in the world, and here’s a bonus from all of us and our forever gratitude. What it meant to be an essential worker was to be deemed expendable. And it wasn’t just you, you got exposed to the virus, then you were more likely to go back home to your family who also got exposed to the virus. So you’ve got these neighborhoods throughout the country where there’s a lot of working class people who are getting exposed and they have higher mortality,” he added.
“Covid was kind of a search light that showed us everyone, everywhere we had studiously looked away from,” writer and activist Naomi Klein observed. “Suddenly we’re forced to think about the way in which our culture produces disposable people, whether they are working in elder care facilities when there’s suddenly Covid outbreaks, or the poultry plants [that] were Covid hotspots. Places where you never see a camera because we’re not supposed to think about, [like] what’s going on in prisons.” Klein cited “the myth of neoliberalism, like we are just individual people and families, and we don’t owe anything to each other. Covid said that wasn’t the case because you can’t just treat individuals, you have to treat a body of enmeshed individuals.”
Workers and unions had to fight their employers and public agencies under Trump to protect their members and the public. Union pressure, Castillo told The New York Times, moved some hospitals to act. In the first six months alone, NNU “staged more than 350 socially distanced protests, including two vigils in front of the White House for the nurses who died from the virus.”
Though Trump’s first term ended with the rollout of a Covid-19 vaccine, lasting damage had been done with his encouragement of opposition to critical community protections from masking to social isolation to needed closures to reduce the spread of the virus, and his sympathy for an escalating anti-vax movement. NNU early in 2021 characterized the Trump administration’s response as “one of denial and abandonment.”
Going forward, with Trump nominating people with similar views opposing the importance of a robust approach to public health, including full preparedness and action on sure-to-come future epidemics, there is ample cause for concern. A new avian flu’s first U.S. death has already occurred. Measles, polio, and other illnesses could mushroom, especially with health officials hostile to vaccines in charge of health agencies with vaccination rates already declining.
With confirmation hearings approaching, The New York Times this week reported the alarming vaccination drop “creating new pockets of students no longer protected by herd immunity [with]… now an estimated 280,000 kindergartners without documented vaccination against measles, an increase of some 100,000 children from before the pandemic.” Resurgence of polio, once virtually eradicated, is also a threat.
Rising temperatures from climate change mean that bacteria not only grow faster but are also associated with increased antibiotic resistance, facilitating the rise of new deadly pandemics. Factor in expected cuts in federal agencies and reduced enforcement of workplace and community protections by an administration more friendly to corporate demands for cuts in regulations.
Over the coming days and years, our vigilance and mass action will be critical to protecting public health.
Defense against dangerous epidemic outbreaks requires constant vigilance. With Robert F. Kennedy Jr. and Donald Trump headed to Washington, D.C., we are entering very troubling territory.
Elvis Presley hardly seems a likely candidate for the pantheon of public health heroes. But in October 1956 the ascending rock idol lent his considerable stardom to helping save lives.
His little remembered role is a cautionary tale as incoming President Trump advances a series of farright and unqualified appointees to major public agencies. The most dangerous is likely to be conspiracy theorist Robert Kennedy Jr. as Secretary of Health and Human Services, augmented by like-minded, perilous public health heads of the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), National Institutes of Health (NIH), Federal Drug Administration (FDA), and his choice for Surgeon General.
For a century, polio epidemics made it one of the world’s most terrifying diseases. A 1916 outbreak in New York City killed over 2,000 people; another in the U.S. in 1952 claimed over 3,000. Children were especially targeted, over 60,000 infected yearly, facing lifelong severe spinal injuries requiring braces, crutches, and wheelchairs, and the dreaded iron lung, an artificial respirator, or premature death.
Wealth and status proved no barrier, as evidenced by President Franklin Roosevelt who was diagnosed at age 39 in 1921 with polio and endured it the rest of his life. What was a safeguard was the first vaccine, developed by virologist/medical researcher Jonas Salk. The announcement on April 12, 1955 by University of Michigan School of Public Health scientist Thomas Francis, Jr., who declared it “safe, effective, and potent,” was greeted as a national celebration, spread rapidly over radio, television, and wire services.
Parents lined up to vaccinate their young children, plenty did not. Teen immunization levels stagnated at just 0.6 percent. Enter Elvis. He agreed to go on the popular Ed Sullivan TV show, not to sing, but to get publicly vaccinated, viewed by millions. Vaccination rates among American youth soared to 80 percent in just six months. Overall annual cases of polio plummeted within a year from 58,000 to 5,600. By 1961, only 161 cases remained. After an oral vaccine followed, polio disappeared in the U.S. completely.
Yet polio never vanished globally, especially in underdeveloped nations, as in Africa, and in war zones, including in Gaza today—driven by Israel’s decimation of public health protections during its catastrophic and ongoing assault. In 2022, the first U.S. case in decades was reported by the New York State Department of Health.
Defense against dangerous epidemic outbreaks requires constant vigilance, and public support for full embrace of public health safety measures, including vaccinations. The experience of Trump’s first tenure is far from reassuring, especially his abominable failure in the face of Covid-19, the worst global pandemic in a century which ultimately cost the lives of over 1.2 million Americans.
Initial skepticism over the polio vaccine has a long antecedent in the U.S., described early in the Covid pandemic by what Los Angeles Times writer Carolina Miranda aptly termed “toxic individualism” and rugged individualism. It is traceable to a virulent brew of misguided notions of individual liberty that undermine and sabotage the public good, or a commons of national and community interest. Much of its roots are linked to structural racism, as in the resistance to Civil Rights Movement measures, and continuing today in white opposition to reforms such as expansion of health care and other public programs, immigration rights, and other societal benefits.
That history provides context for the eruption of the anti-vax, anti-public health measures that exacerbated and prolonged Covid suffering and death and seeded the ground for opposition to other essential vaccines. It’s true, as medical ethicist Arthur Caplan writes, that much of “the damage to getting Americans to vaccinate has already been done… There are almost no serious state mandates for childhood vaccines. Parents who want to opt out are easily doing so, as can be seen by the resurgence in measles and whooping cough. Nearly 40% of teenagers are not up to date on the HPV vaccine even as Australia and Scotland are on the verge of eliminating cervical cancer thanks to serious immunization campaigns.”
Further, he adds “Democrats avoided vaccination as an issue this election year because they knew that, post Covid, vaccination has become something of a political third rail. Could Kennedy and [CMS nominee Dr. Mehmet] Oz make things worse—absolutely. But are matters already bad—sadly, yes.”
The Kennedy-Trump threat
Yet Kennedy and his coterie of other department heads can make matters much worse. With the imprimatur of a President-elect already lionized by an often-fawning base will likely discourage more resistance to vaccines that can turn schools into major disease vectors and hasten the spread of new epidemics sure to come.
Even in the wake of Covid, Kennedy, with his power as HHS Secretary has said he would pause NIH’s drug development and infectious disease research and shift its focus to chronic diseases that do need attention but not at the expense of combating global epidemics.
Kennedy has also indicated a desire to shutter “entire” FDA departments, which oversee safety and effectiveness of prescription drugs and vaccines. And he has threatened to purge FDA staff for “aggressive suppression” of unsafe products and therapies, such as raw milk, and discredited COVID treatments, including hydroxychloroquine.
There’s his lurid, scientifically refuted linkage of vaccines to autism and other conspiracies, such as his claim that Covid was bioengineered to exempt Chinese people, already targeted by Trump rhetoric that fueled hate crimes, and Ashkenazi Jews of Eastern Europe origin, reinforcing right-wing antisemitic bigotry.
And that’s not including his attack on fluoride in drinking waterwhich promotes oral health, as cited in a letter by 77Nobel Prize winners opposing Kennedy, or his speculated doubt that HIV causes AIDS and the effectiveness of AZT therapy.
Anti-vax consequences
Still, it is his fanaticism on vaccines that prompts the most alarm.
During the COVID-19 epidemic, Children’s Health Defense, a group Kennedy founded and led, petitioned the FDA to halt the use of all COVID vaccines. In a 2023 podcast, Kennedy proclaimed there is “no vaccine that is safe and effective,” and disputed CDC’s guidelines about if and when kids should get vaccinated.
The implications are alone enough for a mass movement to escalate pressure to block confirmation of Kennedy, and Trump’s nominees to lead the CDC, CMS, FDA, NIH and Surgeon General who mostly share his chilling views on vaccine safety. Multiple studies document what is at stake.
The World Health Organization estimates vaccines have protected 150 million lives over the past 50 years, and that 100 million were infants. About 4 million deaths worldwide are prevented by childhood vaccination every year. More than 50 million deaths can be prevented through immunization between 2021 and 2030. By 2030, it is estimated that measles vaccination alone can save nearly 19 million lives.
In November 2013, University of Pittsburgh researchers issued a similar study. It documented that about 103 million cases of disease had been prevented by vaccination since 1924. The disease with the most cases prevented was diphtheria, 40 million cases. Second was measles, 35 million cases.
Globally, reported Scientific American, measles vaccines, preserved 94 million lives over the past 50 years. It cited a 2024 Lancet study published in October that vaccines against 14 common pathogens protected 154 million people over the past five decades—that's a rate of six lives every minute. They have cut infant mortality by 40 percent globally and by more than 50 percent in Africa. Throughout history vaccines secured more lives than almost any other intervention.
Lancet found that each life defended through immunization contributed to 66 years of full health, without long-term linked to disease.Vaccines impact nearly every measurement of health equity, from improving access to care, to reducing disability and long-term morbidity, to preventing loss of labor and the death of caretakers.
Writing in Forbes, hardly a left-wing Trump critic, earlier this year, ER doctor/health researcher Arthur Kellerman also cited the Pittsburgh study, as well as Johns Hopkins data of nearly 88 million cases of illness. In 1900, he wrote, 30 percent of deaths in the U.S. occurred in children under 5 years of age. In 1999, they accounted for only 1.4 percent. "Vaccines," he concluded, "played a vital role in this progress.”
Measles, a highly contagious childhood disease that can lead to pneumonia and fatal brain swelling, declined rapidly after the first measles vaccine was introduced in 1963. But, the CDC cites 16 measles outbreaks in 2024. Kennedy’s alleged role in promoting vaccine misinformation during a deadly measles outbreak in American Samoa in 2019, which he denies, has also been widely reported. Unvaccinated families, writes Kellerman, “tend to cluster in communities defined by faith, culture or political ideology. When a highly contagious disease gets into such a community, an outbreak can occur. We’ve already seen localized outbreaks of measles, rubella, mumps, and pertussis.”
In 2022, Kennedy’s attorney and close advisor Aaron Siri petitioned the FDA to revoke approval of the polio vaccine for further study despite its long history of success.
Republican Senate Majority Leader Mitch McConnell, who endured polio as a child, has denounced the push “to undermine public confidence in proven cures” like the polio vaccine. Only a “miraculous combination of modern medicine and a mother’s love” saved him from paralysis he said in a statement. “The polio vaccine has saved millions of lives and held out the promise of eradicating a terrible disease. Efforts to undermine public confidence in proven cures are not just uninformed—they’re dangerous,” McConnell said.
Yet McConnell, and similar Republican critics have yet to publicly oppose Kennedy and his similar malefactors of health (to borrow FDR’s “malefactors of wealth” frame).
We can no longer count on Elvis to protect our children, families and communities. It is up to the rest of us.
"He will set American health, innovation, and science back for a generation," said one virologist of Dr. Jay Bhattacharya.
Dr. Jay Bhattacharya, a physician and Stanford University professor who shot to prominence during the pandemic due to his heterodox views around Covid lockdowns, is President-elect Donald Trump's pick to lead the National Institutes of Health.
In announcing his selection, Trump wrote that Bhattacharya and Robert F. Kennedy Jr., who has been tapped to lead the Department of Health and Human Services, will work together to "Make America Healthy Again."
However, Bhattacharya's nomination was met by alarm from some health professionals who warned that the views he expressed during the pandemic make him a poor choice to run the globe's premier medical research agency.
"Despite his mild manners, Bhattacharya is a self-interested extremist who gives cover to anti-vaxxers and promotes policies that will kill people. He will set American health, innovation, and science back for a generation. He's not here to reform NIH. He's here to destroy it," wrote the virologist Dr. Angela Rasmussen on X.
Biomedical scientist and public health communicator Dr. Lucky Tran wrote: "Please google Great Barrington Declaration. If it had been implemented, millions more people would have died at the start of the pandemic. Now, one of its architects will lead the NIH (if confirmed), the largest funder of biomedical research in the world," wrote biomedical scientist and public health communicator Dr. Lucky Tran.
Another doctor, Alastair McAlpine, echoed these sentiments, writing that Bhattacharya is a "terrible" choice for head of NIH.
Bhattacharya is known for co-authoring the Great Barrington Declaration, a treatise published in October 2020 that advocated for a "focused protection" approach to the pandemic.
"The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk," Bhattacharya and his co-authors wrote.
The document was named after the Massachusetts town where the three authored and signed the proposal. That work took place on the campus of a libertarian think tank, the American Institute for Economic Research.
The proposal caught the attention of Trump's White House in 2020. Trump, for his part, minimized the threat of the virus, chafed against lockdowns during the pandemic.
Public health groups criticized Bhattacharya and his co-authors, arguing that the proposal would threaten vulnerable individuals, according to reporting a the time. Then-NIH director Dr. Francis Collins, also denounced the approach in an October 2020 interview with The Washington Post: "This is a fringe component of epidemiology. This is not mainstream science. It's dangerous. It fits into the political views of certain parts of our confused political establishment."
"What I worry about with this is it's being presented as if it’s a major alternative view that's held by large numbers of experts in the scientific community. That is not true," he said.
Now, four years later, Bhattacharya has been tapped to fill Collins' former seat.
Bhattacharya has also expressed an interest in shaking up NIH itself. "I would restructure the NIH to allow there to be many more centers of power, so that you couldn't have a small number of scientific bureaucrats, dominating a field for a very long time," Bhattacharya said in a January 2024 interview with the Post.