At first, much the same. But inevitably dangerous diseases would resurge in a country that isn’t prepared for them. Becoming a public-health expert means learning how to envision humanity’s worst-case scenarios for infectious disease. For decades, though, no one in the U.S. has had to consider the full danger of some of history’s most devastating pathogens. Widespread vaccination has eliminated several diseases—among them, measles, polio, and rubella—from the country, and helped keep more than a dozen others under control. But in the past few years, as childhood-vaccination rates have dipped nationwide, some of infectious disease’s ugliest hypotheticals have started to seem once again plausible.
The new Trump administration has only made the outlook more tenuous. Should Robert F. Kennedy Jr., one of the nation’s most prominent anti-vaccine activists, be confirmed as the next secretary of Health and Human Services, for instance, his actions could make a future in which diseases resurge in America that much more likely. His new position would grant him substantial power over the FDA and the CDC, and he is reportedly weighing plans—including one to axe a key vaccine advisory committee—that could prompt health-care providers to offer fewer shots to kids, and inspire states to repeal mandates for immunizations in schools. (Kennedy’s press team did not respond to a request for comment.)