President Trump is, by his own account, the world’s greatest dealmaker, a political genius, a natural on television and an expert on, well, everything.
“@sherlock1313: .@realDonaldTrump Is there nothing that u don’t pretend to be an expert at?” No, absolutely nothing!
— Donald J. Trump (@realDonaldTrump) May 8, 2013
On Friday, during the question-and-insult part of the White House coronavirus task force briefing, he gave the nation a lesson in microbiology. His topic was how smart germs are:
“This is a very brilliant enemy. You know, it’s a brilliant enemy. They develop drugs like the antibiotics. You see it. Antibiotics used to solve every problem. Now one of the biggest problems the world has is the germ has gotten so brilliant that the antibiotic can’t keep up with it. And they’re constantly trying to come up with a new — people go to a hospital and they catch — they go for a heart operation — that’s no problem, but they end up dying from — from problems. You know the problems I’m talking about. There’s a whole genius to it.”
Trump frequently has displayed difficulty with the concept of impersonal social, economic and natural forces; his default mode is to anthropomorphize every obstacle into a “vicious enemy” or, more recently in reference to the coronavirus, a “monster.” This manner of speaking raises questions about how well he understands medical science, even if, as he frequently reminds the nation, his uncle was a professor at MIT. COVID-19 is caused by a virus, a blob of RNA that by some definitions is not even alive; antibiotics as a rule are effective against bacteria, living cells that have nothing in common with viruses. (Trump has touted an antibiotic, azithromycin, as a treatment for COVID-19 in combination with his favorite drug, hydroxychloroquine, but the evidence for it is slight.)
Trump also seems extremely — some might say unduly — impressed by the fact that the virus is invisible, which he brings up with virtually every mention of it. That is indeed true of viruses and bacteria, but medical science has adapted to the fact with the invention of the microscope and the electron microscope.
What Trump evidently meant by “the problems I’m talking about” was “antibiotic-resistant infections,” which are in fact a big problem, and not only in hospitals. Medical researchers agree, although they would take issue with his emphasis on intelligence as the mechanism for it. As he said on Friday, “We’re fighting — not only is it hidden, but it’s very smart. OK? It’s invisible and it’s hidden, but it’s — it’s very smart.”
This obviously is not meant literally, in the way that Trump describes himself as very smart — a genius, in fact. He is referring to the process of natural selection, by which organisms, even those without a brain, change in response to their environment — by, for example, developing resistance to antibiotics. Another word for this is “evolution,” which is, of course, anathema to Trump’s most ardent evangelical supporters, and a principle his own vice president declined to endorse when he was asked about it by Chris Matthews in 2009:
Pence: Do I believe in evolution? I embrace the view that God created the heavens and the earth, the seas and all that’s in them.
Matthews: Right. But do you believe in evolution as the way he did it?
Pence: The means, Chris, that he used to do that, I can’t say. But I do believe in that fundamental truth.
For Trump to acknowledge, even in his garbled form, the reality of antibiotic resistance is a significant step forward in his approach to science, which has been characterized by bizarre assertions about windmills that cause cancer and climate-change denial. Unfortunately, the problem he identified is caused in part by overuse of human antibiotics for livestock, a practice the World Health Organization, currently out of favor with Trump, issued guidelines to curtail in 2018. The Trump administration opposed it.
The other factor that promotes drug resistance is indiscriminate use of unneeded antibiotics, including azithromycin, which is already losing effectiveness against some infections. Trump has touted his unproven hydroxychloroquine-azithromycin regimen for COVID-19 patients with the slogan “What do you have to lose?” Perhaps one of his medical experts can suggest an answer.
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