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Is Wildfire Smoke Causing Birds to Tend to Empty Nests?

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Monday, September 30, 2024

Hazy skies caused by smoke from Canadian wildfires blanketed Washington, D.C. on June 7, 2023. Win McNamee / Getty Images Early last summer, dull orange horizons replaced blue skies and hid city skylines in New York and Washington, D.C. Even the midday sun was dialed down to an ominously weak glow. People in the western half of North America have become all too familiar with the eerie scene that often accompanies a big wildfire. Thick smoke often blankets cities like Boise and Seattle. But the morning of June 7, 2023, was different. Smoke season had come east, heavier than many people there had ever seen before. But humans weren’t alone in dealing with that sudden smoke and its health effects. Wildlife across the Northeast, including millions of breeding birds, felt it, too. New research suggests the smoke may have more impact on birds than we ever realized, harming them both during their nesting season and throughout their lives. These studies are part of a new understanding of smoke, not just as a side effect of wildfire, but as a threat to wildlife and ecosystem health on its own. Just as that historic smoke was about to arrive in the White Mountains of New Hampshire last summer, two tiny songbirds were building their nest. A pair of black-throated blue warblers, striking birds with a blue back, a black mask and a bright white belly, had finished that season’s nest on June 4. The cup-like structure was constructed of bark, pine needles and other materials from around the forest. But just when the next cycle of life for these little birds was about to start, something unusual happened. The female of the pair started to sit in the nest vigilantly, as if incubating her eggs. But no eggs were there. She was incubating an empty nest, and nearby, someone was taking notes. A male black-throated blue warbler Gary Irwin via Wikipedia under CC By-SA 2.0 These warblers didn’t build their nest in just any woods, but in Hubbard Brook Experimental Forest, a 7,800-acre ecological research station that has hosted scientists and students of multiple fields for over 60 years. Hubbard Brook is well known in certain scientific circles and has produced a wealth of studies over the decades, but it is most famous as the site where acid rain was first discovered and studied in the 1960s. The only reason this nest was being monitored at all was because the male of the pair had previously been captured and marked with colored leg bands. A student named August Davidson-Onsgard noticed a nest being built in that banded bird’s territory and started watching it. Davidson-Onsgard happened to work for an ecologist and self-described naturalist with just the right experience and interest in the details of bird ecology to recognize how unusual, and potentially important, this observation could be. Ecologist Sara Kaiser is a research associate at the Smithsonian’s National Zoo and Conservation Biology Institute (NZCBI), and she directs the Cornell Lab of Ornithology’s field study program at Hubbard. When Davidson-Onsgard mentioned the empty nest incubator to Kaiser on her next visit to the site, it immediately got her attention. For a breeding bird, incubating a nest is always a gamble. Female black-throated blue warblers sit on their eggs for about 12 days straight, only leaving briefly to feed. During that time, they are more vulnerable to predators looking to make a meal of the bird, her eggs or both. Without the payoff of eggs and future offspring to keep her at the nest, the bird should not, theoretically, make the investment to stick to the nest so closely. “I said, you know, I haven’t really heard of anything like this before,” says Kaiser. She encouraged her student to follow up and search the scientific literature for examples of birds sitting on empty nests as if they had eggs. They found over 200 records of birds of 11 species, all in Europe, showing this strange behavior, and in over 80 percent of these accounts, the authors had noted environmental pollution as a possible cause. Researchers can’t say for sure if smoke is directly causing nesting birds like the warblers to fail in such a particular way, but the new observation as well as the literature review suggest a potential link. Kaiser and colleagues at Cornell and NZCBI recently published their findings in the Wilson Journal of Ornithology, with Davidson-Onsgard as the lead author. The study is the first systematic review of this particular kind of nest failure. We are in an age of megafires. Fire has always been an important part of the ecology of the West, but climate change and a century of forest mismanagement have amplified the scale and severity of wildfires beyond anything in modern history. A 2020 study showed that the average acreage burned in a wildfire almost tripled between 1950 and 2019. Through mid-September this year, over seven million acres have burned in the United States. Three times in the last decade, that number has topped seven million acres per year. In 2023, Canada’s fire season made even those numbers seem small. Forty-five million acres burned in Canada last year, an area larger than the entire state of Florida turned to smoke in one season. Wildfire smoke contains chemicals like carbon monoxide, sulfur dioxide and even lead. It also carries particles that scientists call PM2.5, meaning they are less than 2.5 microns, or 1/400th of a millimeter, in size—which makes them deadly. Because they’re so tiny, these particles can fit into the smallest crevices of the lung. A global study published in the Lancet found that four million people died as a result of PM2.5 pollution in 2019, more than twice the death toll of Covid-19 in 2020. According to Kaiser, the effects on birds could be even more severe. “It’s because of their respiratory system,” says Kaiser. “They’re moving a lot of air, much more volume of air than other animals. They have very efficient lungs, and so any air that has this particulate matter could be problematic for these birds.” In clean air, bird lungs have evolved to be incredibly efficient, but in smoky conditions, that same adaptation works against them. Nesting isn’t the only time that birds are susceptible to wildfire smoke. Until recently, smoke season rarely overlapped with the breeding season of most North American birds. But as fire seasons become longer and more severe, the chances increase of big smoke events like the one in 2023 that catch birds right as they are nesting. On the other side of the country from the woods of New Hampshire, another research team recently showed another set of effects from PM2.5 pollution and wildfire smoke on birds across the summer and fall, not just when they’re on the nest. Olivia Sanderfoot is an ecologist at the La Kretz Center for California Conservation Science at the University of California, Los Angeles. In a recent paper in Ornithology, Sanderfoot and colleagues found that birds in the San Francisco Bay Area lost body mass, a key measure of health that harms their ability to migrate, when they were exposed to wildfire smoke during the Bay Area’s July to November fire season. Scientists had theorized about that kind of effect but had not been able to establish and measure it before. “Knowing how big of a deal wildfire smoke is for people, it just made sense to me that birds would be similarly impacted,” says Sanderfoot, “because they are so highly sensitive to air pollution, and because, unlike people, they can’t take refuge indoors when the air is hazardous.” Like the New Hampshire warbler study, the San Francisco paper was led by a student, Anna Nihei, then an undergraduate majoring in computational and systems biology at the University of California, Los Angeles. Sanderfoot also helps oversee Project Phoenix, a community science effort that lets anyone in a study area in California, Oregon and Washington help monitor birds during wildfire season. She sees the warbler observations around the smoke event in 2023 as a meaningful development in understanding the effect of smoke on birds, and says the study is really important and powerful. “I think that considering smoke to be a disturbance in and of itself, outside the concept of fire, is a brand-new way of thinking about air pollution impacts on wildlife,” says Sanderfoot. Researchers are only now starting to understand some of the long-term effects of wildfire smoke on humans, and they still have a long way to go to measure its effect on birds and other wildlife as well. But evidence is mounting that smoke is another climate-related stressor, like heat and drought, that can have serious repercussions for birds, off and on the nest. As Sanderfoot explains, the warbler nesting observations around the smoke event in 2023 are a meaningful development in understanding the effect of smoke on birds. “It is not the norm that when we see these intense smoke events, the timing overlaps with the breeding season,” she says. “I have had conversations with many colleagues in which we have anticipated that should these two things align, the impact on bird populations would be big.” Get the latest Science stories in your inbox.

New studies suggest smoke from western megafires may be damaging bird health and leading to strange behavior

Wildfire Smoke Over Washington
Hazy skies caused by smoke from Canadian wildfires blanketed Washington, D.C. on June 7, 2023. Win McNamee / Getty Images

Early last summer, dull orange horizons replaced blue skies and hid city skylines in New York and Washington, D.C. Even the midday sun was dialed down to an ominously weak glow. People in the western half of North America have become all too familiar with the eerie scene that often accompanies a big wildfire. Thick smoke often blankets cities like Boise and Seattle. But the morning of June 7, 2023, was different. Smoke season had come east, heavier than many people there had ever seen before.

But humans weren’t alone in dealing with that sudden smoke and its health effects. Wildlife across the Northeast, including millions of breeding birds, felt it, too. New research suggests the smoke may have more impact on birds than we ever realized, harming them both during their nesting season and throughout their lives. These studies are part of a new understanding of smoke, not just as a side effect of wildfire, but as a threat to wildlife and ecosystem health on its own.

Just as that historic smoke was about to arrive in the White Mountains of New Hampshire last summer, two tiny songbirds were building their nest. A pair of black-throated blue warblers, striking birds with a blue back, a black mask and a bright white belly, had finished that season’s nest on June 4. The cup-like structure was constructed of bark, pine needles and other materials from around the forest. But just when the next cycle of life for these little birds was about to start, something unusual happened. The female of the pair started to sit in the nest vigilantly, as if incubating her eggs. But no eggs were there. She was incubating an empty nest, and nearby, someone was taking notes.

Black-Throated Blue Warbler
A male black-throated blue warbler Gary Irwin via Wikipedia under CC By-SA 2.0

These warblers didn’t build their nest in just any woods, but in Hubbard Brook Experimental Forest, a 7,800-acre ecological research station that has hosted scientists and students of multiple fields for over 60 years. Hubbard Brook is well known in certain scientific circles and has produced a wealth of studies over the decades, but it is most famous as the site where acid rain was first discovered and studied in the 1960s. The only reason this nest was being monitored at all was because the male of the pair had previously been captured and marked with colored leg bands. A student named August Davidson-Onsgard noticed a nest being built in that banded bird’s territory and started watching it. Davidson-Onsgard happened to work for an ecologist and self-described naturalist with just the right experience and interest in the details of bird ecology to recognize how unusual, and potentially important, this observation could be.

Ecologist Sara Kaiser is a research associate at the Smithsonian’s National Zoo and Conservation Biology Institute (NZCBI), and she directs the Cornell Lab of Ornithology’s field study program at Hubbard. When Davidson-Onsgard mentioned the empty nest incubator to Kaiser on her next visit to the site, it immediately got her attention.

For a breeding bird, incubating a nest is always a gamble. Female black-throated blue warblers sit on their eggs for about 12 days straight, only leaving briefly to feed. During that time, they are more vulnerable to predators looking to make a meal of the bird, her eggs or both. Without the payoff of eggs and future offspring to keep her at the nest, the bird should not, theoretically, make the investment to stick to the nest so closely.

“I said, you know, I haven’t really heard of anything like this before,” says Kaiser. She encouraged her student to follow up and search the scientific literature for examples of birds sitting on empty nests as if they had eggs. They found over 200 records of birds of 11 species, all in Europe, showing this strange behavior, and in over 80 percent of these accounts, the authors had noted environmental pollution as a possible cause.

Researchers can’t say for sure if smoke is directly causing nesting birds like the warblers to fail in such a particular way, but the new observation as well as the literature review suggest a potential link. Kaiser and colleagues at Cornell and NZCBI recently published their findings in the Wilson Journal of Ornithology, with Davidson-Onsgard as the lead author. The study is the first systematic review of this particular kind of nest failure.


We are in an age of megafires. Fire has always been an important part of the ecology of the West, but climate change and a century of forest mismanagement have amplified the scale and severity of wildfires beyond anything in modern history. A 2020 study showed that the average acreage burned in a wildfire almost tripled between 1950 and 2019. Through mid-September this year, over seven million acres have burned in the United States. Three times in the last decade, that number has topped seven million acres per year. In 2023, Canada’s fire season made even those numbers seem small. Forty-five million acres burned in Canada last year, an area larger than the entire state of Florida turned to smoke in one season.

Wildfire smoke contains chemicals like carbon monoxide, sulfur dioxide and even lead. It also carries particles that scientists call PM2.5, meaning they are less than 2.5 microns, or 1/400th of a millimeter, in size—which makes them deadly. Because they’re so tiny, these particles can fit into the smallest crevices of the lung. A global study published in the Lancet found that four million people died as a result of PM2.5 pollution in 2019, more than twice the death toll of Covid-19 in 2020.

According to Kaiser, the effects on birds could be even more severe.

“It’s because of their respiratory system,” says Kaiser. “They’re moving a lot of air, much more volume of air than other animals. They have very efficient lungs, and so any air that has this particulate matter could be problematic for these birds.”

In clean air, bird lungs have evolved to be incredibly efficient, but in smoky conditions, that same adaptation works against them.

Nesting isn’t the only time that birds are susceptible to wildfire smoke. Until recently, smoke season rarely overlapped with the breeding season of most North American birds. But as fire seasons become longer and more severe, the chances increase of big smoke events like the one in 2023 that catch birds right as they are nesting.

On the other side of the country from the woods of New Hampshire, another research team recently showed another set of effects from PM2.5 pollution and wildfire smoke on birds across the summer and fall, not just when they’re on the nest.

Olivia Sanderfoot is an ecologist at the La Kretz Center for California Conservation Science at the University of California, Los Angeles. In a recent paper in Ornithology, Sanderfoot and colleagues found that birds in the San Francisco Bay Area lost body mass, a key measure of health that harms their ability to migrate, when they were exposed to wildfire smoke during the Bay Area’s July to November fire season. Scientists had theorized about that kind of effect but had not been able to establish and measure it before.

“Knowing how big of a deal wildfire smoke is for people, it just made sense to me that birds would be similarly impacted,” says Sanderfoot, “because they are so highly sensitive to air pollution, and because, unlike people, they can’t take refuge indoors when the air is hazardous.”

Like the New Hampshire warbler study, the San Francisco paper was led by a student, Anna Nihei, then an undergraduate majoring in computational and systems biology at the University of California, Los Angeles.

Sanderfoot also helps oversee Project Phoenix, a community science effort that lets anyone in a study area in California, Oregon and Washington help monitor birds during wildfire season. She sees the warbler observations around the smoke event in 2023 as a meaningful development in understanding the effect of smoke on birds, and says the study is really important and powerful.

“I think that considering smoke to be a disturbance in and of itself, outside the concept of fire, is a brand-new way of thinking about air pollution impacts on wildlife,” says Sanderfoot.

Researchers are only now starting to understand some of the long-term effects of wildfire smoke on humans, and they still have a long way to go to measure its effect on birds and other wildlife as well. But evidence is mounting that smoke is another climate-related stressor, like heat and drought, that can have serious repercussions for birds, off and on the nest.

As Sanderfoot explains, the warbler nesting observations around the smoke event in 2023 are a meaningful development in understanding the effect of smoke on birds. “It is not the norm that when we see these intense smoke events, the timing overlaps with the breeding season,” she says. “I have had conversations with many colleagues in which we have anticipated that should these two things align, the impact on bird populations would be big.”

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New Flu Variant Could Bring Another Severe U.S. Season

By I. Edwards HealthDay ReporterTHURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough...

THURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough winter in the United States, experts warn.The strain, called subclade K, has caused a rise in flu cases in the United Kingdom, Canada and Japan. And now signs suggest it is beginning to take hold across the United States as flu activity rises.According to the latest U.S. Centers for Disease Control and Prevention (CDC) FluView report, reported flu activity in the United States remains low but is climbing quickly.Last year’s flu season was the worst the United States had seen in nearly 15 years and led to at least 280 child deaths, according to the CDC.Most cases this year are from the H3N2 virus and about half of those belong to the subclade K variant, the same strain that fueled a difficult flu season in the Southern Hemisphere.Because it wasn’t circulating widely when strains were selected for the vaccine update, this year’s flu shot targets close strains of the virus."It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case," Richard Webby, a researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee, told CNN.Early findings from the UK Health Security Agency suggest the variant carries seven genetic changes on a major part of the virus, making it a bit harder for the body's immune system to recognize.Even so, they found that the flu shot has reduced the risk of hospitalization or emergency care by about 75% in children and 30% to 40% in adults so far this season.What worries experts even more is that fewer Americans appear to be getting the flu shot.Data from IQVIA shows that pharmacies gave 26.5 million flu vaccinations from August through October, down from 28.7 million during the same period last year."I’m not surprised," Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University in Providence, Rhode Island, said.She said recent debates about vaccine safety have "left people confused but possibly at the worst have left people worried about getting vaccinated."Australia’s flu shot rates also fell this year and the country went on to record more than 443,000 cases."What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming," Dr. Earl Rubin, division director of infectious disease at Montreal Children’s Hospital, told CNN.Several early indicators already show flu levels rising in the U.S.The WastewaterSCAN network found type A flu in 40% of samples in November, up from 18% in October, according to Marlene Wolfe, an assistant professor in the department of environmental health at Emory University in Atlanta.Only four U.S. monitoring sites in Maine, Vermont, Iowa and Hawaii have officially crossed the threshold for declaring flu activity high, but experts say the trend is clear.While it’s not yet clear whether subclade K could cause more severe illness, a rise in infections alone could cause hospitalizations to skyrocket, Rubin noted."It’s not too late. Go and get your flu shot," Dr. Adam Lauring, chief of the division of infectious diseases at the University of Michigan Medical School, in Ann Arbor, said.These results are preliminary and have not yet been peer-reviewed.The Texas Department of State Health Services (DSHS) has more on the flu vaccine.SOURCE: CNN, Nov. 18, 2025Copyright © 2025 HealthDay. All rights reserved.

Thousands of US Hazardous Sites Are at Risk of Flooding Because of Sea Level Rise, Study Finds

A new study finds that thousands of hazardous sites across the U.S. are at risk of flooding due to sea level rise that could pose public health threats to neighboring communities

If heat-trapping pollution from burning coal, oil and gas continues unchecked, thousands of hazardous sites across the United States risk being flooded from sea level rise by the turn of the century, posing serious health risks to nearby communities, according to a new study.Researchers identified 5,500 sites that store, emit or handle sewage, trash, oil, gas and other hazards that could face coastal flooding by 2100, with much of the risk already locked in due to past emissions. But more than half the sites are projected to face flood risk much sooner — as soon as 2050. Low-income, communities of color and other marginalized groups are the most at risk.With even moderate reductions to planet-warming emissions, researchers also determined that roughly 300 fewer sites would be at risk by the end of the century. “Our goal with this analysis was to try to get ahead of the problem by looking far out into the future," said Lara J. Cushing, associate professor in the Department of Environmental Health Sciences at the University of California, Los Angeles who co-authored the paper published in the science journal Nature Communications.“We do have time to respond and try to mitigate the risks and also increase resilience," she added, speaking at a media briefing Wednesday ahead of the study's release. The study was funded by the Environmental Protection Agency and builds on previous research from California. Climate change is driving and accelerating sea level rise. Glaciers and ice sheets are melting, and the sea's waters are expanding as they warm. In many places along the coastal U.S., sea level rise is accelerating faster than the global average because of things like erosion and land sinking from groundwater pumping, according to the National Oceanic and Atmospheric Administration. Thomas Chandler, managing director at the National Center for Disaster Preparedness at Columbia University who was not involved in the research, said it’s “a really important study” that the public, policy makers and government agencies “need to make note of.” Derek Van Berkel, an associate professor in the school for environment and sustainability at University of Michigan who was also not involved in the study, wasn't surprised to learn about the disproportionate risks. What was “alarming” was considering the magnitude of “feedback effects” from flooding, he said. How researchers approached the data The study's researchers started by identifying and classifying tens of thousands of hazardous sites near the coasts of Puerto Rico and the 23 states with coastline. Next, they wanted to know each site's projected future flood risk. They did this by calculating how likely each year coastal flooding could inundate a site using historical sea level measurements and projected sea level rise in 2050 and 2100 under low and high emissions scenarios. Lastly, they identified and classified communities as being at-risk if homes are located within 1 kilometer (0.62 miles) of a hazardous site with a high threat of future flooding, and compared those communities' characteristics with other coastal neighborhoods with no at-risk sites nearby. But researchers did not include all types of hazardous facilities, such as oil and gas pipelines, nor did they account for groundwater upwelling or more intense and frequent storms in the future, which could lead to underestimates. On the other end, the flood-risk model they used could have overestimated the number of threatened sites. “It is important to note that previous disasters, such as hurricanes Katrina, Rita and Harvey, did result in a lot of toxic contamination from oil and gas pipelines,” Chandler said. The 5,500 at-risk sites includes 44% that are fossil fuel ports and terminals, 30% power plants, 24% refineries and 22% coastal sewage treatment facilities. Most of the sites — nearly 80% — are in Louisiana, Florida, New Jersey, Texas, California, New York and Massachusetts. Potential health impacts from exposure to hazards People exposed to flood waters near industrial animal farms or sewage treatment plants could be exposed to bacteria like E. coli, said Sacoby Wilson, professor of global, environmental and occupational health at the University of Maryland during the briefing. Symptoms can include bloody or watery diarrhea, severe stomach cramps or vomiting and fever. Those living near industrial sites like refineries could be exposed to heavy metals and chemicals that can cause rashes, burning of the eyes, nose and throat, headaches or fatigue, added Wilson, who was not involved in the study. “For folks who are vulnerable, maybe have an underlying health condition, those health conditions could be exacerbated during those flood events.” Longer term, some of these exposures could contribute to cancer, liver, kidney or other organ damage, or have reproductive effects, he said. For Chandler, the Columbia University director, the study highlights the need to heavily invest in hazard mitigation. “It's really important for federal, state and local governments in the United States to address these factors through multi-stakeholder resilience planning and encouraging local governments to integrate climate risk assessments into their mitigation strategies.”The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment.Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – Nov. 2025

RFK Jr.’s Miasma Theory of Health Is Spreading

The agency is picking up Robert F. Kennedy Jr.’s argument that a healthy immune system can keep even pandemic germs at bay.

Last week, the two top officials at the National Institutes of Health—the world’s largest public funder of biomedical research—debuted a new plan to help Americans weather the next pandemic: getting everyone to eat better and exercise.The standard pandemic-preparedness playbook “has failed catastrophically,” NIH Director Jay Bhattacharya and NIH Principal Deputy Director Matthew J. Memoli wrote in City Journal, a magazine and website published by the Manhattan Institute for Policy Research, a conservative think tank. The pair argue that finding and studying pathogens that could cause outbreaks, then stockpiling vaccines against them, is a waste of money. Instead, they say, the United States should encourage people to improve their baseline health—“whether simply by stopping smoking, controlling hypertension or diabetes, or getting up and walking more.”On its own, Bhattacharya and Memoli’s apparently serious suggestion that just being in better shape will carry the U.S. through an infectious crisis is reckless, experts told me—especially if it’s executed at the expense of other public-health responses. In an email, Andrew Nixon, the director of communications at the Department of Health and Human Services—which oversees the NIH—wrote that the agency “supports a comprehensive approach to pandemic preparedness that recognizes the importance of both biomedical tools and the factors individuals can control.” But more broadly, Bhattacharya and Memoli’s proposal reflects the spread of a dangerous philosophy that Robert F. Kennedy Jr., the secretary of HHS, has been pushing for years: a dismissal of germ theory, or the notion that infectious microbes are responsible for many of the diseases that plague humankind.In his 2021 book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, Kennedy, a longtime anti-vaccine activist, argues that modern scientists have blamed too much of infectious disease on pathogens, which he suggests are rarely problematic, unless the immune system has been compromised by poor nutrition, toxins, and other environmental stressors. He credits sanitation and nutrition for driving declines in infectious-disease deaths during the 20th century; vaccination, he has baselessly claimed, was largely ineffective and unnecessary. In his view, germs don’t pose a substantial threat to people who have done the work of “fortifying the immune system”—essentially, those who have taken their health into their own hands.In terms of general health, most Americans would benefit from improvements in diet and exercise. A strong emphasis on both has been core to the Make America Healthy Again movement, and in one important aspect, Kennedy and his allies are correct: The immune system, like other bodily systems, is sensitive to nutritional status, and when people are dealing with chronic health issues, they often fare less well against infectious threats, Melinda Beck, a nutrition and infectious-disease researcher who recently retired from the University of North Carolina, told me. Conditions such as obesity and diabetes, for instance, raise the risk of severe COVID and flu; malnutrition exacerbates the course of diseases such as tuberculosis and measles.But applied to widespread infectious outbreaks, the MAHA prescription is still deeply flawed. Being generally healthy doesn’t guarantee survival, or even better outcomes against infectious diseases—especially when an entire population encounters a pathogen against which it has no immunity. Although some evidence suggests that the 1918 flu pandemic strongly affected certain groups of people who were less healthy at baseline—including undernourished World War I soldiers—“relatively healthy people, as far as we could understand, were the main victims,” Naomi Rogers, a historian of medicine at Yale, told me. Smallpox, too, infected and killed indiscriminately. HIV has devastated many communities of young, healthy people.In his book, Kennedy relies heavily on the term miasma theory as a shorthand for preventing disease “through nutrition and by reducing exposures to environmental toxins and stresses.” He’s employing that phrase incorrectly: Historically, at least, miasma theory referred to the notion that epidemics are caused by bad air—such as toxic emanations from corpses and trash—and was the predominant way of describing disease transmission until scientists found definitive proof of infectious microbes in the late 19th century. But his choice of words is also revealing. In pitting his ideas against germ theory, he plays on a centuries-old tension between lifestyle and microbes as roots of illness.In its early days, germ theory struggled to gain traction even among physicians, many of whom dismissed the idea as simplistic, Nancy Tomes, a historian at Stony Brook University, told me. After the idea became foundational to medicine, scientists still had to work to convince some members of the public that microbes could fell healthy people, too. In the early days of polio vaccination, when the virus still ran rampant in the U.S., some vaccine-skeptical Americans insisted that children were falling seriously ill primarily because their parents weren’t managing their kids’ nutrition well and “had disrupted the child’s internal health,” Rogers told me.Over time, as pharmaceutical companies made global businesses out of selling antibiotics, vaccines, and antivirals, the products became a symbol, for some people, of how germ theory had taken over medicine. Accepting vaccines came to represent trust in scientific expertise, Rogers said; misgivings about the industry, in contrast, might translate into rejecting those offerings. In that skeptical slice of the American public and amid the rise of alternative-wellness practitioners, Kennedy has found purchase for his ideas about nutrition as a cure-all.Since taking over as health secretary, he has on occasion made that distrust in germ theory national policy. In his book, he wrote that “when a starving African child succumbs to measles, the miasmist attributes the death to malnutrition; germ theory proponents (a.k.a. virologists) blame the virus.” Earlier this year, when measles raged through undervaccinated regions of West Texas, the secretary acted out his own miasmist theory of the outbreak, urging Americans to rely on vitamin-A supplementation as a first-line defense, even though deficiency of that vitamin is rare here.But germ theory is key to understanding why outbreaks become pandemics—not because people’s general health is wanting, but because a pathogen is so unfamiliar to so many people’s immune systems at once that it is able to spread unchecked. Pandemics then end because enough people acquire sufficient immunity to that pathogen. Vaccination, when available, remains the safest way to gain that immunity—and, unlike lifestyle choices, it can represent a near-universal strategy to shore up defenses against disease. Not all of the risk factors that worsen disease severity are tunable by simply eating better or working out more. For COVID and many other respiratory diseases, for instance, old age and pregnancy remain some of the biggest risk factors. Genetic predispositions to certain medical conditions, or structural barriers to changing health habits—not just lack of willpower—can make people vulnerable to disease, too.In their article, Bhattacharya and Memoli purport to be arguing against specific strategies of pandemic preparedness, most prominently the controversial type of gain-of-function research that can involve altering the disease-causing traits of pathogens, and has been restricted by the Trump administration. But the pair also mischaracterize the country’s current approach to pandemics, which, in addition to calling for virus research and vaccine development, prioritizes measures such as surveillance, international partnerships, and improved health-care capacity, Nahid Bhadelia, the director of the Center on Emerging Infectious Diseases at Boston University, told me. And Bhattacharya and Memoli’s alternative approach cuts against the most basic logic of public health—that the clearest way to help keep a whole population healthy is to offer protections that work on a societal level and that will reach as many people as possible. Fixating on personal nutrition and exercise regimens as pandemic preparedness would leave many people entirely unprotected. At the same time, “we’re basically setting up society to blame someone” in the event that they fall ill, Jennifer Nuzzo, the director of the pandemic center at the Brown University School of Public Health, told me.Kennedy’s book bemoans that the “warring philosophies” of miasma and germ theory have become a zero-sum game. And yet, at HHS, he and his officials are presenting outbreak preparedness—and the rest of public health—as exactly that: The country should worry about environment or pathogens; it should be either pushing people to eat better or stockpiling vaccines. Over email, Nixon told me that “encouraging healthier habits is one way to strengthen resilience alongside vaccines, treatments, and diagnostics developed through NIH-funded research.” But this year, under pressure from the Trump administration, the NIH has cut funding to hundreds of vaccine- and infectious-disease focused research projects; elsewhere at HHS, officials canceled nearly half a billion dollars’ worth of contracts geared toward developing mRNA vaccines.The reality is that both environment and pathogens often influence the outcome of disease, and both should be addressed. Today’s public-health establishment might not subscribe to the 19th-century version of miasma theory, but the idea that environmental and social factors shape people’s health is still core to the field. “They’re saying you can only do one thing at a time,” Bhadelia told me. “I don’t think we have to.”

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