Cough Syrup for a Coronavirus

Covid numbers are up. Don't cound on Trump or RFK Jr. to tell the truth about the growing numbers or do the right thing when it comes to vaccination.

This week a friend told me he had a cold. We spent a couple of minutes agreeing that summer colds are the worst kind, which is one of those things people say to each other every July and probably isn’t true.

Then he mentioned the aches. And the sore throat. That is not a cold, I told him. It sounded more like the flu or COVID.

It was COVID. Day two, which meant he had two days left to do something about it. Paxlovid only helps if you start it inside five days of symptoms. Go to urgent care, I told him. Ask for it by name.

The nurse practitioner declined. Her explanation, as my friend relayed it me, was that COVID is basically a cold now.

She reccomended a prescription cough suppressant and a course of steroids.

Nobody gives narcotics and steroids for a cold. Whatever she believed about the virus, her own prescription pad disagreed with her. I was a frontline worker in 2020 and so I got the vaccine first. I was fine. In 2024, after the vaccine efficacy had dropped, I did get COVID and ended up in the ER. It is a real disease.

COVID was the third epidemic I’ve worked on, after AIDS and opioids, and I had stopped doubting what politics and bad science do to healthcare. Often clinicians take in what’s around them and don’t notice they’ve done it. This NP was being reckless. Somewhere upstream of that exam room, a coronavirus got quietly demoted to a rhinovirus, and she took the demotion at face value. As they say, shit flows downstream.

Upstream is Robert F. Kennedy Jr., who has run the Department of Health and Human Services since February of last year.

The trouble with Kennedy is not that he is wrong, though he is, reliably and across an impressive range of subjects. Institutions absorb wrong all the time. That’s most of what peer review is for. The trouble is that he misrepresents what the evidence says, and it gets translated into exam rooms like the one my friend sat in last week.

Consider the Tylenol business. On September 22, 2025, Kennedy stood in the Roosevelt Room next to the President and announced a link between acetaminophen in pregnancy and autism. FDA was told to issue a physician notice and start a safety label change. HHS launched a public campaign. The American College of Obstetricians and Gynecologists said flatly that no clear evidence supported a direct relationship. The Autism Science Foundation called the association limited and inconsistent and the announcement premature. The best study anyone has run on this, a sibling-control design published in JAMA, found nothing: no autism link, no ADHD link, no intellectual disability link. Autism diagnoses have risen for twenty years. Acetaminophen use has been flat the whole time.

Five weeks later Kennedy allowed that the causative association was not sufficient to say Tylenol definitely causes autism. Very suggestive, he said. By then the label change was moving and the attorney general of Texas had sued Kenvue and Johnson & Johnson, citing the administration’s own announcement as his evidence.

In between, at an October Cabinet meeting, he offered a supporting argument: two studies showing circumcised boys have double the autism rate, which he figured was highly likely to be the Tylenol. FactCheck.org went and read them. Neither one linked acetaminophen to anything.

Then there is the testosterone, which I keep coming back to because it is such a small, clean example of the whole problem. Kennedy has said he’s on an anti-aging protocol from his doctor that includes testosterone replacement. In the next sentence, same interview, he said he doesn’t take any anabolic steroids.

Testosterone is an anabolic steroid. Not adjacent to one. It is the parent compound, the molecule every synthetic variant is built to imitate, which is why the Anabolic Steroid Control Act of 1990 names it directly. This is not an obscure catch. It is week one of pharmacology. He is 72, he has never disclosed a dose, and he is the ranking health official of the United States.

The vaccine apparatus took the worst of it. In June 2025 he fired all seventeen sitting members of the Advisory Committee on Immunization Practices, a body that had done this work for sixty years, and seated thirteen of his own. They moved COVID vaccination for adults and children from a universal recommendation to shared clinical decision-making, which sounds collaborative but is more of a barrier.

This would matter less if we could still see COVID clearly. We can’t.

COVID is rising right now concentrated for the moment in the South. Test positivity ran 4.8 percent as of July 12, up about a point on the week. Emergency department visits are climbing in every age group. CDC’s own modeling had COVID infections growing in 18 states as of July 15, flat in 28, falling in three. The dominant variant is NB.1.8.1, at something like 43 percent of sequenced cases.

Something like 43 percent. The agency now rates the precision of its own variant estimates as low, because there is not enough sequencing being done.

So we know cases are up. That is the one thing the system still does well.

COVID mortality data runs behind. The NCHS figures for the week ending June 27 simply weren’t there. The two systems tracking the virus in the country’s sewage have stopped agreeing with each other: CDC’s National Wastewater Surveillance System reads national levels as low, WastewaterSCAN, the independent municipal network, reads them as high. Two categories apart.

The retrospective numbers are no better. CDC’s own accounting of the last respiratory season put COVID hospitalizations somewhere between 290,000 and 450,000 and COVID deaths between 34,000 and 53,000. That second range is nineteen thousand people wide, published well after the fact, about a season already finished.

This is not a budgeting accident. An administration with no COVID policy worth the name does better in the dark, and Kennedy has not suppressed the data so much as let it go thin, which accomplishes the same thing and is much harder to point at. If nobody can say how many Americans this virus put in a hospital bed last month, nobody can price what the vaccine retreat cost. The blur is RFK Jr.’s actual work.

What the blur is covering is a disease that killed somewhere in the neighborhood of forty thousand Americans last season and is currently climbing again in eighteen states.

So here we are in Trump’s America healthcare disaster. Fewer Americans vaccinated against COVID, guidance on it being settled in court instead of in medical committees, sequencing too thin to say with confidence which version is circulating, wastewater numbers that contradict each other, a severity picture that arrives months late in ranges wide enough to hide a small city, and a nurse practitioner in a strip mall handing cough syrup to a man with COVID who qualified for an antiviral. Any one of those is a bad week. Together they describe a country that has lost a good deal of its ability to see this virus coming and much of its willingness to treat it once it has.

Kennedy told a Senate committee last year that he doesn’t think people should take medical advice from him. It remains the most accurate statement he has made in office. Trump has kept him anyway, and that is not a personnel decision gone wrong. It is a moral one.

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