It can be argued that the public health implications of the second Trump administration pale in comparison to broader implications for freedom of speech, rule of law, and respect for human rights. But the impacts on public health offer a specific illustration of the ways in which this administration is threatening very basic aspects of our society fundamental to everyone’s health and well-being.

Much could be inferred based on the experience of Trump’s first presidency, the ideology reflected in Trump’s campaign (and in Project 2025), and early indications of who his nominees for top government health-related positions might be. But the first few weeks after Trump’s inauguration, marked by multiple presidential executive orders and the actions of the so-called Department of Government Efficiency (DOGE), added a sinister dimension and have created much confusion, chaos, and fear in the public health community about how bad things really could be.