The Preventable Return of Deadly Diseases

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Hello, and welcome back to the David Fromm Show.

I'm David Fromm, a staff writer at The Atlantic.

My guest this week will be Kyle Harper, one of our leading historians, if not our very leading historian, of infectious disease.

I'll be talking to him about the rise of anti-vaccination sentiment in the United States and the new threat we face from diseases that a generation ago we thought had been overcome forever.

Americans dying of measles in the 2020s?

Really?

How did that happen?

That's going to be the topic of our conversation today.

At the end of the program, I'm going to do a discussion of a book by a German philosopher named Carl Schmidt.

The book is called The Concept of the Political.

This is the next in a series of finale book talks that I'll be appending to the end of the David Fromm program.

I hope you'll stay through the discussion to watch the book talk.

Before my talk with Kyle Harper, I want to say a few words about the president's non-enforcement of the legal ban on TikTok.

People who defend or rationalize the president often say, what are you talking about?

Nothing so very dramatic is happening.

Life in the United States still proceeds more or less the way it always did.

People go to work every day, they listen to music, they go watch sports.

What has really changed?

It's hard for people who make these rationalizations to see or pay enough attention to or care enough about the slow dissolution of the fabric of law in the society.

Donald Trump has never accepted that he is bound by law.

He doesn't believe he has any duty to enforce the law impartially in office.

He never has.

He never will.

January 6th, his attempt to overthrow the election of 2020, is the most dramatic and violent of these manifestations.

But since he has become president in 2025, we have seen again and again and again the president declare that he is not bound by clear law.

It began with his refusal to spend monies appropriated by Congress, the whole Doge program.

When Congress votes the money and the president signs the bill from Congress by which the money is voted, he doesn't keep the power to say, you know what, I've thought it over and that money bill, that money law that Congress voted, that I signed or that my predecessor signed, I'm not going to do it.

I decide I'm not going to be bound.

Those are laws.

They are acts acts of Congress and the president is bound to carry them out.

Once the money is voted, the president does not have the power to refuse to spend the money.

And there are a lot of Supreme Court decisions dating back half a century that make it clear.

The president does not have the power to refuse to spend money that Congress voted.

Some state governors do have that power under the Constitution of their states.

The president of the United States does not.

Well, okay, that's a question of not doing something.

But the president has also claimed the power to do things that defy the law.

He's claimed that he can arrest people without due process if he says they're not citizens or if he says they're not legally in the country.

Now, how do you know they're not legally in the country if you don't have a due process?

He says, well, it doesn't, in my case, I can arrest them because I think they're not here in the country legally.

I can deport them.

I can send them to a prison.

I can keep them there for life.

I can avert my eyes or even give kind of tacit permission to them to be abused or tortured.

And they have no right to be processed.

And I refuse to accept the authority of the courts.

He's retreated a little from some of those claims, but those claims are still there.

More remarkable still is the president's tariffs, where he's collecting tens of billions of dollars of revenue every month without a vote from Congress.

One of the foundational ideas of the American Constitution is that money cannot be spent unless Congress agrees to spend it.

That's the core issue of the American Revolution.

No taxation without representation, which means that before the government spends our money, there must be a vote by some legislative body agreeing that the money can be collected and then spent.

Trump has found a way to bypass Congress to raise tens of billions of dollars of money, which he's still collecting, vastly more than any of his so-called give backs to ordinary people, the no-tax on tips, collecting tens of billions of dollars a month without permission from Congress.

But he's argued in court that he has the power to remove agency heads, again, in violation of congressional statutes.

And now he's trying to apply that.

to the Federal Reserve, where the Supreme Court has expressly said the president does not have the power to fire governors unless there's a good, good, good reason they've done something wrong.

And he's now, it looks like, fabricated a completely fictitious case or mostly fictitious case against the Federal Reserve governor in order to say, you know what, I can fire any member of the Federal Reserve anytime I want.

This brings us to the TikTok ban.

Now, many people have different views about what we should do about TikTok.

The question is not whether it's wise or not to ban TikTok.

The point is, Congress has done so.

In March of 2024, the House of Representatives voted 352 to 65 to say to TikTok, either you find an American owner or you lose the right to be circulated in the United States, to be on American phones.

American owner or out.

That's it.

This builds on previous similar legislation that applied to television stations back in the founding days of TV.

It's not unprecedented.

It may be wise.

It may not be wise, but the House voted 352 to 65 in March, no TikTok unless it's American-owned.

The Senate the next month voted 79 to 18 to affirm the House vote, no TikTok in the United States unless American-owned.

That law was signed by President Biden.

TikTok, of course, contested it in the courts.

The measure went to the Supreme Court.

In January 2025, the Supreme Court said Congress had acted validly, that it can say to TikTok the same thing it said to TV stations back in the 50s and 60s, you must be American-owned or you can't circulate in the United States.

So that was the law.

That's law.

House, Senate, President, Supreme Court, law.

And the ban was to go into effect on January 19th of 2025, or by no later than January 19th of 2025, the day before Inauguration Day.

And TikTok, which refused to sell itself to an American owner for whatever reasons they have, they refused to do it,

complied with the law and went dark on January 18th.

Kicked off a lot of unhappiness.

A lot of people enjoy TikTok for better or worse.

And so Donald Trump took measure.

On Trump's first day in office, January 20th, 2025, he signed a letter that said, I am going to have not enforced the TikTok ban for 75 days.

The deadline was January 19th.

They now have 75 more days either to find an American owner or else I will make them go dark at the end of the 75 days.

It's not clear exactly where he got the authority to do this 75-day measure, but new president, different policies, maybe he wants to appeal the laws, repeal the laws to different Congress.

And people sort of shrugged and said, okay, 75 days more for TikTok.

Those 75 days were to expire in April.

On April 4th, Donald Trump extended for another 75 days.

That period expired in June.

On June 19th, he extended the non-enforcement of the ban for 90 days more.

Time's up on September 19th, and it looks like another extension is coming.

Pretty obviously, what Donald Trump has decided is I'm going to sign a series of pieces of paper that are forever or for a long time going to not enforce a law that was passed by the House, passed by the Senate, signed by President Biden, and upheld by the Supreme Court, and which I have made no effort to repeal.

It's just, I'm just going to say there's a law in the books.

It governs this incredibly powerful corporation.

I'm just not going to enforce it.

Now, It's pretty obvious why he's not going to enforce it.

Trump himself said at a press conference in December that he had a warm spot in my heart for TikTok TikTok because, as he observed about his election, TikTok had something to do with it.

And indeed it did.

The algorithm seems to be radicalizing young people in an anti-institutional direction, not always exactly right-wing, but in a way that makes them distrustful of institutions,

contemptuous of law, contemptuous of process, hostile to each other.

That's exactly the environment in which Donald Trump thrives.

TikTok is good for him, and so he's not going to enforce the law.

But, you know, the enforcement of law is not an option for the president.

He doesn't have some right to say, you know what, I've been thinking it over and I don't like this law.

It's inconvenient to me.

It interferes with other things I want to do.

But it's part of a pattern of the slow dissolution of the legal system of the United States.

You know, when people think about the end of democracy, the end of a free society, they often think back to other periods in history where it happened very dramatically.

The Soviet, Russia in 1917,

there's a revolution, they stormed the palace,

It happens like that in the blink of an eye.

But you can also lose legal institutions gradually, slowly, bit by bit.

Maybe starting with policies that are controversial and arguably not wise, like banning TikTok or forcing it to sell.

Maybe that's not a good idea, but it's the law.

You get into the habit of saying, the president, you know, We never thought he could

fire the head of the Federal Trade Commission or the head of the Federal Communication Commission or the commissioners.

Now he's asserting that right.

Now he's asserting a right to control the Federal Reserve any way he wants wants to.

Now he's asserting the right to detain people, illegal people, illegal people, not you, not anyone you know, not yet, illegal people, or people he says are illegal, detain them, arrest them, send them to a dungeon in a foreign country forever.

Maybe he can do that.

And of course, that he can now bypass the whole system that Americans have to protect their rights to be taxed by consent and create systems of revenue that ignore Congress.

It's coming together in a coalition of powers that will add up something that is not like a legal state.

It's not dramatic.

There's no storming of the Winter Palace.

It's just the slow end of everything you thought you had.

And now, my discussion with Kyle Harper.

But first, a quick break.

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Kyle Harper is a professor of history and of classics at the University of Oklahoma.

He is the author of four books, including, most recently, The Fate of Rome and Plagues Upon the Earth.

Both of these two books integrate climate science and epidemiology into the human political and economic story.

I truly cannot recommend these books enough.

I've read each of them twice with growing benefit each time, and I am thrilled to welcome Kyle Harper to the David Frum Show.

Kyle, thank you for joining us.

Hi, David.

Thanks for having me.

I want to start with a point that is often made in kind of the online discussion about vaccines and other benefits of public health, where people say, well, you know, the human species has been around for a long time and vaccines are pretty new.

We got on fine before there were vaccines, so I don't have to give them to my child.

So before we had vaccines, before we started pasteurizing milk before drinking it, before we

had the array of public health benefits we have in the 20th century, how did we do?

Well, I would ask that interlocutor to define what you mean by getting on fine, because it's no kind of life that I would choose to experience.

And I think as a historian, what's so striking is just how easily we forget.

and one of the one of the great values of history is to to sort of aid our memory a little bit when we lose sight of of what it is that we've accomplished as a species and how far we've come so it's really only in the late 19th century say around the 1880s 90s early 1900s that for the very first time and only in the most scientifically developed societies like the U.S.

and Britain, that non-infectious causes of disease passed infectious causes of disease.

And so, infectious disease is just any kind of disease that's caused by something invading your body, viruses, bacteria usually.

And

for most of the time, through 99.9% of our history as a species, most people died of infectious causes.

So, the world was very different, and it shaped really not just how we died, but everything about the way we live.

Yeah, one of the things I learned from the fate of Rome is that the Romans were very short, not because they were malnourished, as modern people might expect, but because if you're exposed to infectious disease as a child, it saps the energy your body has to produce growth.

And so you emerge shrunken and stunted and malformed just in order to pay the tax to shake off the disease, even if you have abundant food.

Right.

It's just one of those kind of humanly striking indices indices of how different the past was.

Humans all over the world have gotten taller over the last several generations.

And it's partly nutrition.

It's definitely food and protein during the period of growth.

But absolutely, it's the fact that we don't have to pay the really extremely high metabolic cost that our immune system requires to constantly fight off infection.

So the sort of traces of this change are evident to anybody who works on archaeology and has dug up skeletons and is struck by just how much smaller people were in the past.

So let's start with the history of vaccination.

So smallpox vaccination, if I recall right, comes along first, actually comes along quite a while ago.

Then come tuberculosis and then the post-war miracle drugs against measles and polio and other infections.

Do I have that right?

Or just would you recapitulate

how we developed this technology?

And I would even back up a little bit briefly.

I can talk more about it if you want, but smallpox is a really important disease.

It's almost unimaginably nasty.

It's a viral disease.

It hasn't been around forever.

It sort of responds to population growth and trade and urbanism in modern times and becomes one of the worst diseases in human history.

And it becomes just utterly ubiquitous.

And in a way that's hard for us to imagine.

Life was just a struggle against smallpox and it was painful and horrifying and emotionally traumatic.

For a different project, I've been reading some texts from the 17th century from Britain, you know, from England in the time of the Civil War and so on.

And this is in the middle of the scientific revolution.

This is kind of the front edge of human social development.

And they're just totally helpless against smallpox.

I was just reading the diary of a woman last week named Alice Thornton.

We happened to have her diary from the mid-17th century.

She lost six of her nine kids.

And this is somebody literate from sort of the upper classes.

But smallpox is just a pervasive part of life.

And probably the average family would have buried a child just to this one disease.

Almost everybody got it.

So

it was a real problem.

And by the early 18th century, a technique called variolation is spreading.

It's a horrible.

intervention.

It's actually infecting people with smallpox.

And it is very dangerous, but smallpox is such a killer that this technique was better than the alternative, but it was still very dangerous because you were intentionally inoculating people with the virus.

But in the late 18th century, late 1700s, there's no vaccines,

but people start in the kind of age of the enlightenment.

Knowledge is circulating, people are observing, people are trying to figure out how to improve human health.

And people observe that women in particular who worked in the dairy industry seem to be less vulnerable to smallpox mortality.

And it's an English physician named Edward Jenner who kind of puts all this together and starts to run experiments and realizes that you can intentionally

expose people to what we call cowpox, which is caused by a very closely related virus.

He didn't know this.

They didn't have germ theory.

He doesn't actually know the microbiology of what's going on.

But he observes that if you inoculate people with the cowpox material, that it defends them from smallpox.

This is the 1790s.

It spreads rapidly.

It's salvation.

I would argue it's the most important medical discovery of all time.

And we call it vaccination because the Latin word for cow is vaca.

To vaccinate somebody means to cow them.

And even without understanding all of the mechanisms, this miracle intervention

saves countless human lives.

It mostly spares children from the doom of early death.

It starts to spread like wildfire.

And over the course of the 1800s,

in societies like Western Europe and the U.S., smallpox is really goes from being the number one killer to being quite marginal.

And for those who think there's something un-American about requiring people to be vaccinated, we should note that George Washington vaccinated the Continental Army under command and duress.

You had no choice about it.

If you were one of the soldiers who fought the American Revolution, you were vaccinated by order of General Washington.

Yeah, I mean, that's inoculation.

I mean, yeah, virulation, actually.

And then smallpox is even better.

I mean, you should, you know, read what Thomas Jefferson, the great kind of, you know, libertarian hero, says about gender and vaccination.

He recognized that this is the most liberating advance in human societies.

And so

people who had experience with the horrors of this disease knew what a miraculous discovery it was.

So the terrible plagues that are part of life in London and Venice and cities like that into the 1600s begin to abate in the 1700s.

But people still die of all kinds of things that today would easily be preventable.

Tell us more about how we have overcome those terrible killers.

Right.

So the sort of most explosive epidemic disease is actually the plague, the bubonic plague, which is just a kind of horror of a disease

that is hard for us to even sort of understand.

But smallpox, typhus.

And one by one, we sort of figure out how to blunt the worst ravages of those disease.

And over the course of the 19th century, people like Louis Pasteur and Robert Cook figure out that there are these little things called microbes that are behind the causes of these killers, like tuberculosis, which is one of the worst killers, typhoid fever, as well as a huge range of kind of bacterial diarrheal diseases.

Now, it should be said, the present Secretary of Health and Human Services doesn't believe in microbes or doesn't believe they cause diseases, which is a level of dumbassery that would get you flunked out of, what, grade six intro to, I mean, it's just, it's just unbelievable.

I don't know what he thinks they are caused by.

Bad attitude, maybe.

But this is one of the great breakthroughs: is that understanding that there existed this microscopic world and that it could be intensely dangerous to human beings.

But once you knew what it was, you could begin to look for ways to, as you say, first blunt, then cure, and then prevent, maybe prevent before cure, the impact of these microbes.

Exactly.

And so it's vaccination, it's public health, it's water treatment.

It's almost unfathomable what a difference it makes when we realize that people need clean water as a as a resource and you have to keep it separate from your sewage.

And then antibiotics and oral rehydration therapy, one discovery after the next.

Many of the most important vaccines are quite new, meaning post-World War II.

So walk us through a little bit the spread of these miraculous techniques after 1945.

Right.

I mean, I sometimes use the analogy that

human health is like a medieval castle castle where you've got different layers of defense you've got a moat out there you've got a drawbridge you've got guys shooting from the from the ramparts and it's not there's never one layer you want you have to have in fact you have to have a multi-layered uh defense system in order to to protect human health from microbial invaders And when you think of that sort of array of defense weaponry that we have, vaccines are the linchpin.

I mean, they're just the single most important tool that we have, and particularly for diseases that are in other ways hard to stop through just cleaning the water or good hygiene or treating through therapeutics like antibiotics.

Vaccines are sort of like the best bullet that we've got to really target some of the worst diseases.

So we've developed an array of vaccines that we tend to reserve reserve for the infectious diseases that are otherwise very, very difficult to stop.

So in addition to smallpox, which was sort of the original, we developed vaccines against tuberculosis, diphtheria, and then particularly measles, which is a pretty nasty disease.

We can talk about that if you want.

The history of measles, understanding it's really important to understanding why the development of its vaccine in the 1950s was such a huge deal.

And we need vaccines as well because

of evolution.

I mean, microbes don't stand still.

They adapt.

They're organisms.

They're trying to spread their genes.

They're trying to take advantage of hosts in order to replicate themselves.

And they evolve.

They adapt.

They change.

And so diseases that either didn't exist or were pretty marginal, like polio, all of a sudden can become dire threats.

And that's what happens in the 20th century.

Polio had existed before.

Its history is not very well understood, but it's certainly sort of at the time when we're starting to get a hold of a lot of other infectious diseases, polio becomes a scourge.

It's a horrific disease.

And it's, of course, it's tragic because it tends to affect children, often causing lifelong paralysis and death.

And so we have to invent a vaccine against polio.

And, you know, Jonas Salk and other scientists develop a vaccine.

And he's a hero.

There are literally parades

because parents who'd lived through the excruciating fear and experience of polio as a disease knew that

this was liberating.

And so he was hailed as a modern hero for developing this bullet that could help take out this otherwise very difficult to control infection.

Well, just to show that there are continuities in history and that the people of the recent past were no less susceptible to dumbassery than present people.

It needs to be said that there were anti-vaxxers against the polio vaccine at the time that it was new.

And one of them was the kind of semi-washed up radioact

broadcaster named Walter Winchell, who'd been a big liberal voice in the 1930s, became progressively more conservative in the 1950s, who's close to Joe McCarthy.

But by the middle 50s, Winchell's career is in trouble.

He had a face.

He was the original face for radio.

And as TV comes along, Winchell's career gets under pressure.

And he tries to revive himself by spreading with a tiny smidgen of truth, because the first versions of the polio vaccine could be dangerous.

He said there was an early experiment with some precursors to the polio vaccine.

People were injured by those precursors.

And then when the John Assault vaccine comes along, Winchell, either out of ignorance or malice, conflates the two and goes on this rampage.

And that famous image of Ed Sullivan hosting Elvis Presley as Elvis Presley took the polio vaccine live on national television, the most famous man in America, on the biggest show in America.

That was in part a response to Walter Winchell, who, and we have our own counterparts.

Again, Winchell was coping with a career on the downslope, and maybe that's what drove him to this malicious and ignorant act, but we have similar people today.

So one of the things you know from history is there are

human history does have parallels and patterns.

Yeah, it does.

And we don't have a monopoly on

dumbassery, but I think the way in which the lack of trust in a polarized society has allowed this issue to become politicized is

very dangerous.

Anti-vax sentiment has been there from the beginning

and there was a lot of hard work to build trust.

Exactly.

I mean, the Elvis is such a great example.

What is that about?

It's about building trust and

reminding people that there's a lot of very serious, thoughtful expertise that goes into trying to develop

safe medical interventions, and that we're in it together.

That's why there has to be trust is because we breathe the same air, we share the same space, and the decisions that we make don't just affect our own health.

I was thinking about you and your work and especially work on Rome.

The day before I record this interview with you, I was at a farmer's market with my wife and we're wandering around in early September in Washington, D.C., a semi-tropical city.

And I was saying, you know,

I was quoting to her your observation that the ancient city of Rome produced 100,000 pounds of human feces every day.

And here we are in this market and there are no flies.

And there are no flies because all the meat products are carefully wrapped.

The fish products are carefully wrapped.

People who touch meat and fish touch them through

the wrapping around the product and also the plastic gloves on their hands.

And while there are fruits and vegetables out in the plain air, again, they are under regimes that keep them protected and there are no flies.

And we'll all, of course, when we get at home, wash it again anyway.

But this is a series of layered defenses, the product of human practices and human insight and human wisdom.

And maybe the people who have the meat and or the fish and plastic don't exactly understand how microbes work, but they do know you shouldn't have meat or plastic out in the open air, meat or fish out in the open air.

Exactly.

I mean, that's a great example of how the scientific understanding then works its way into our daily lives and to habits that we don't even necessarily think about.

But that was a process.

I mean, that took time.

And it didn't just happen spontaneously.

It happened because reformers promoted knowledge.

The fly is a great example.

People came to realize that flies are vectors of disease.

And there were massive campaigns, including by the Boy Scouts, to educate people and to try and control diseases.

There's a technological element of it.

You know, the windows in my house have window screens that were the product of engineers who figured out how to let air flow out, but not little bugs.

And there's a government role.

And

our food safety cultures are the product of science and society, but also of smart

public regulation that makes sure that we don't have to worry about dying of shigellosis

on a daily basis.

You said something I want to pick up on because I think it might have gone by some listeners and viewers too fast.

And it's an unusual concept, so I want to strike it.

You referred to these diseases being old or new.

You pay a lot of tribute to your great predecessor in this field, William McNeill, who wrote a book 50 years ago called Plagues and Peoples.

And one of the unexamined assumptions of that book is the diseases we have today are the diseases we've always had.

And if you pull up a caveman grave, you don't find them sick of these diseases, he would say, is because, well, the populations were so small, the densities were so light that they couldn't communicate the disease one to another, but the disease was there lurking, just waiting for cities.

And with the benefit of more modern investigative techniques, half a century later, you point out that some diseases are old, some are new, and they're constantly changing.

So the smallpox, as we know it, was not the smallpox that would have hit previous generations of human beings.

Yeah, exactly.

You're right.

It's worth worth slowing down over this, that

our disease pool, so the hundreds of bacteria and viruses that are adapted to try and take advantage of human hosts, are a product of our own history.

And if you went back 10,000 years ago, sort of at the transition from hunting, gathering to farming, there's a very different disease pool.

Now, there's always been infectious diseases.

Humans...

have infectious diseases just like other animals.

Chimps, our closest primate relatives, they they have infectious diseases.

But actually, if you start, it's a this is kind of a revealing comparison.

The human disease pool is much worse than the other great apes.

And the reason why is because of our history, how we live.

We domesticate animals, we build trade networks, we build cities, and the microorganisms that cause disease take advantage of that.

And because particularly because of sort of advances in our ability to sequence DNA, we've come to start to get a much richer picture of the evolutionary history of our pathogens.

And one of the headlines is just that a lot of the big diseases of human history were not there in the Pleistocene and the Ice Age when we were hunter-gatherers.

They evolve, they adapt, and they constantly adapt.

And so, you know, we control one disease, but then another is going to pop up.

But I also would emphasize, too, that, you know, we can, if we can never completely win this war we can control the situation if we use all of the tools at our disposal and that's why the average human life expectancy has more than tripled in the last 200 years it's an amazing it's the greatest accomplishment in the history of our species it's a technical social medical

miracle of enlightenment, of science, of wise policy.

We have tripled the average human life expectancy because we've controlled infectious diseases, but we can never declare victory because they'll keep evolving.

And one of the most important drivers of that tripling of the average human life expectancy is the sharp decline in child mortality.

When people say, we did fine before, I don't think they just

how heartrending the life of the typical human being was before the modern era.

Everyone buried children.

You described the story of the Roman Emperor

Marcus Aurelius.

He and his wife had 14 children, two outlived their parents, you say.

I mean, sometimes modern modern people say, well, maybe the ancients didn't love their children as much and didn't get as upset.

They were just used to this constant heartbreaking.

They had to adapt to it.

But liberating human beings from that horror where so many children died before the age of one, so many more die before the age of five, the chance of reaching age 18 was already put you on the lucky half of

human life.

Yeah, that's right.

And, you know, you made this point that sometimes historians have said that people in the past had different attitudes towards towards their children.

And I'm sure there, of course, there were differences.

But whenever we have sources, you know, they loved their kids like we love ours.

I was just reading some of the letters of John Evelyn, who's a really interesting English scientist, the late 17th, early 18th century.

This isn't that long ago.

And, you know, he talks about

losing his kids and to what we know is now infectious disease.

And he says, here ends my joy, right?

These people were broken by this heartache and trauma.

They had to go go on,

but that didn't make it less horrible at a human level.

And the burden of infectious diseases falls disproportionately on children.

Their bodies are developing immunity.

They're developing hygiene practices.

As a father of four, I can tell you, that's a process.

And

their bodies have to learn to fight off infections, but they're vulnerable.

And in the past, childhood was simply a gauntlet, and a much smaller portion of children came through it.

Let's talk specifically about measles because for some reason, and I can't follow the trail of crazy that produced this outcome, but the measles vaccine is the one that seems to have most attracted hostility from the crackpot element of society.

Tell us a little bit about what measles used to be and the story of how it was overcome.

And if you want to speculate, maybe as a historian, you don't, but if you do, why this vaccine is the one that the crackpots hate so much?

Yeah.

So

measles is a remarkable infectious disease.

It's viral.

It's caused by RNA virus that

is the most contagious disease we know of, which is quite remarkable.

It's a respiratory disease.

So if a person infected with measles walks into a room of unvaccinated people and coughs, there's a higher risk that those people will get infected than any other disease we know.

It's really, really contagious.

It's kind of an old disease.

It depends on your perspective.

It's only two, three thousand years old.

It evolves to adapt to humans when we build big cities.

Because it's so contagious, it has to have big populations.

It's a pretty severe disease that can be extremely severe if your immunity is weakened.

And this is also like really characteristic of the disease.

And I think it's critical to your question about why does this draw crackpots.

Measles is so contagious, it became basically ubiquitous.

And it's a disease that, if you're healthy if you're an affluent kid

with good food and and care

you're you're usually almost always going to be okay if you get measles if you're nourished if you're not co-infected with a bunch of other things the mortality rate from measles is pretty low that doesn't mean it's it's not zero but if your immunity is compromised, if you have other infections, if you're poor and hungry, if you're in any other way compromised, measles measles can be really dangerous.

And

so we wanted a vaccine against measles.

We worked hard to develop one.

In the 50s, I guess 53, a measles vaccine is brought out.

And it becomes part of the compulsory vaccination schedule because it's a relatively severe disease in all people and very dangerous for the vulnerable.

And measles vaccination becomes almost universal.

Now,

measles is also, it's interesting too.

It's an RNA virus that doesn't, it can't mutate quite as much as other viruses because it's so well adapted to what it does.

And so it's very stable.

And the vaccine is very effective.

It's one of the reasons why like you can usually get a measles vaccination as a kid and it's going to last for decades and decades.

Once you build antibodies to it, you're pretty safe.

So we were winning against measles big time.

In fact, smallpox is the only human pathogen that we've driven completely to extinction.

It's gone.

There's no naturally occurring smallpox anymore.

Measles was sort of on that path.

We'd completely eradicated it from the United States.

And then anti-vax sentiment started to kind of latch on to this particular vaccine.

There's debunked...

non-science that sometimes is invoked.

But I think it has to do a lot with the fact that measles sort of the biology of it sort of makes it extremely differential in its effects.

If a healthy kid gets measles, they're probably going to survive.

Not always, but 98, 90% of the time.

But it's a vaccine that you get because of its protection of society.

It's so contagious that if you get measles, you're going to spread it.

And no vaccine is 100%.

I want to emphasize that, you know, no vaccine is ever 100%.

The immune system is too complicated.

The measles vaccine is extremely effective.

And it's a vaccine that you get not only to protect yourself, but to protect the herd.

And in a polarized society where we have deeply individualistic values, the idea that you would receive this medical intervention because it protects the broader society.

has become an argument that doesn't seem to have the purchase that it used to.

It should.

We had measles gone from the U.S.

We could get rid of measles globally if we had the political willpower.

We were on the path to send it the way of smallpox, but now it's back.

And so it's like a it's like a virus that exploits the pathologies of our society almost.

You talk about how the pathologies of our society, which include social and political pathologies, make us vulnerable.

And one of them is that

Modern Americans seem to value protection for themselves, particularly, their children particularly.

But when you say, look, you're actually doing this to protect others, they say, well, then

why would I bother?

And we saw that, I think, very much during the COVID-19 debate, where COVID did not present that much of a threat to healthy middle-aged adults.

It presented a very large threat to older people.

And the question was, how much should healthy middle-aged adults circumscribe themselves for the benefit of older people?

And there was a considerable voice in our society that said, zero, nothing.

Yeah, that's right.

And I mean, I like to point out that the COVID-19 COVID-19 pandemic was not very dangerous to healthy kids.

And the biology behind that shaped the entire perception and social response, right?

I mean, I think there will be another pandemic.

If a pandemic affects children, heaven forbid, the whole attitude of our society will be shaped by that.

And our response to COVID very much was shaped by the fact that it affected different groups.

And look, I think we need to have, we need to have candid conversations about this too, right?

I don't think the response to COVID was in any sense

an A, but it did.

It affected kids in school.

It affected parents with hourly wage jobs, different from people with salaries, big companies, different from little companies.

These are hard questions.

They're hard on a good day.

They're hard when you have an honest approach to the science and the political trade-offs.

And they're just impossible when you're pretending bunk science is real and when you don't have trust in a society.

Well, I was

struck again, to cite your Roman book, by,

again, the eternal human ability to focus on what we care about in the face of things that we don't understand.

And as the Roman world became more and more swept by pandemics after about the year 200,

that the Romans argued, well, was this happening because they were neglecting the old gods?

Or was this happening because they weren't switching fast enough to a new god?

And from a modern point of view, it says, you know, Jupiter is Jesus.

It's not going to make a lot of difference in the face of smallpox or bubonic plague.

But they believed it did.

And they had these intense arguments about who is to blame, the adherents of the old religions or the promoters of the new religion.

Yeah, I mean,

the very first scene in Western literature is in Homer's Iliad, and the God Apollo has sent a plague.

I mean, these are very deep

human ways of responding to disease.

It's, you know, particularly in a world where you don't have germ theory and you don't know about microbes, you look to blame something or someone,

and it sort of speaks to a deep human tendency to moralize diseases

that we need to try and understand with the cool enlightenment reason.

Well, let's finish by talking about how we understand and how we respond.

That modern societies have built these institutions of public health and scientific research that have become increasingly internationalized.

And the scientists form a kind of global fraternity, and they often share information.

As repressive as China has become, Chinese scientists shared information as they discovered it about the shape and form of the COVID-19 virus with their Western counterparts.

And there are these large systems of infrastructure.

I think a lot of us tend to think those institutions are always there, have to be there, can't be damaged by human choice.

But we have seen in just the past few months an unprecedented degree of damage done to these institutions.

Without going into politics, can you talk about modern medical research as a human social achievement, how it was built, how it could be vulnerable?

Yeah, I mean, it is an institution.

It's an institution in the sense that it was built.

by lots of people, lots of hard work over many, many years.

It has purely sort of philosophical dimensions.

I mean, I mentioned Jenner and in my book on infectious diseases, I talk about Jenner a lot because his career sort of embodies the best of the 18th century Enlightenment and its empiricist foundations, right?

He doesn't say, trust me, this works.

He sets up experiments.

And if you read his book on vaccination that sort of announces it to the world, it's just a series of case studies.

And science is a human enterprise.

It's not perfect.

It's why we set up institutions to reinforce our best tendencies to check one another and the the kind of empiricist spirit of don't trust me let's verify this very carefully is sort of at the the root of it and we try and then put together systems of institutions that that draw out our best, that mobilize our greatest weapon is our ability to innovate, to come up with solutions, and to work together.

And science is a human institution.

And

in particular, the medical science in America is a crowning glory of this country.

It was created deliberately and particularly by massive amounts of investment in the 1980s and 1990s that were scaled up in order to try and conquer the things that make us sick and that shorten our lives and have done immeasurable good, not just for America, but ideas spread and they've done tremendous good globally.

I think when historians look back, they'll say this is one of the things we did really well, that we did right, we invested.

We research diseases that hurt people here.

We research diseases that hurt people globally, like tuberculosis, partly because we care about humanity, partly because we know that our health is all intertwined, that if tuberculosis lurks in other populations, it's going to evolve, it's going to adapt, and that can come back and hurt Americans.

But now the scientific enterprise, the institutions of science within universities and beyond have been swept up in the polarization of our society.

And

that's not just...

tragedy.

It's going to have real world impacts.

And I think we all have to try and step back and say we need to recognize recognize the importance of these institutions that are not in any way meant to be

belong to one side or another in our political wars.

They need to be neutral ground.

And it's very hard.

The problem politically is that it's very hard to pay, to know where the price is paid, but it will be paid, right?

I mean, the COVID pandemic was brought to bay by mRNA vaccines.

Those depended on huge investments in basic science upstream 10, 20 years in advance.

And so it'll be very difficult politically in 10 years, 20 years to say that this is happening and it didn't have to happen because we didn't have to undermine the NIH and the CDC and so on.

But

we need to have long-term thinking.

We need to recognize the importance of these institutions, their neutrality, and really take pride in what they've accomplished and what they still are going to accomplish if we believe in them.

Because the next pandemic is coming, as you say, and when it comes, it will be more or less catastrophic according to how well prepared we were, both scientifically and also socially.

And

this is a year in which we don't look very well prepared in either dimension.

And let's hope we do better in the years ahead.

Yeah, exactly.

It's a sad fact we're less prepared today than we were for COVID-19.

We don't know when the next pandemic will threaten us, but we know that it will come someday.

Kyle Harper, thank you so much for joining me today.

Thanks, David.

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Thanks so much to Kyle Harper for joining me today on the David Frum program.

Remember, if there are young people in your life, please be sure that they are properly vaccinated.

And take care of yourself too.

It's supposed to be a tough flu season this year.

Make sure you have your flu shot in your COVID booster as well to protect you and those you care about.

As promised, I'm going to end this segment with a discussion of a book.

Last week I talked about Mary Shelley Frankenstein.

This week I'm going to talk about a work of political philosophy.

I'm driven to this work by the recent tragic events in the country, the assassination of Charlie Kirk and the really dangerous reaction we have seen in many, many quarters to that terrible crime.

I'm going to quote something.

You've probably heard it before, but Robert Kennedy's words the night that he heard that Martin Luther King had been assassinated.

This may be one of of the greatest improvised speeches in American history.

Robert Kennedy was in Indianapolis.

He himself had only a couple of months left to live.

He didn't know that, of course.

He was going to be assassinated in June of 1968 when Martin Luther King was assassinated in April.

Kennedy was talking to a group of his supporters who were mostly, if not overwhelmingly, African-American.

The mood was one of tremendous anger because it was already clear that King had been assassinated by a white racist for white supremacist reasons.

I want to quote the key passage from Robert Kennedy's speech.

For those of you who are black and are tempted to be filled with hatred and distrust at the injustice of such an act against all white people, I can only say that I feel in my own heart the same kind of feeling.

I had a member of my family killed, but he was killed by a white man.

But we have to make an effort in the United States.

We have to make an effort to understand, to go beyond these rather difficult times.

My favorite poet was Aeschylus.

He wrote, in our sleep, pain, which cannot forget, falls drop by drop upon the heart until, in our own despair, against our will,

comes wisdom through the awful grace of God.

And Robert Kennedy continued, what we need in the United States is not division.

What we need in the United States is not hatred.

What we need in the United States is not violence or lawlessness, but love and wisdom and compassion toward one another and a feeling of justice.

toward those who still suffer within our country.

Now, that's not the tone we hear from the present leadership of the United States, not remotely.

What we see is an incitement of the hatred and division that Robert Kennedy warned about.

And that's the inspiration, that presence of that mood of division is what inspires my book, Choice This Week.

The book I'm going to talk about is a book by a German philosopher named Carl Schmidt, and the book is called The Concept of the Political.

Now, Schmidt wrote many books.

quite rapidly over his enormously long life.

He lived to be age 96.

He was born in the Kaisers, Germany.

He lived to see Helmut Kohl be Chancellor of Germany.

But the concept of the political is his most important book.

And I read it in a reading binge this spring.

I read a lot of Carl Schmidt this spring because Schmidt is an increasingly important person in the MAGA world.

And unlike a lot of influences, which are kind of indirect and people don't know who the influence is, people in the MAGA world are quite conscious of the influence of Schmidt upon them.

So let's talk about him and understand what is going on here and how this book, written almost a century ago, matters so much to our time.

Now, Schmidt benefited.

Schmidt was born, as I said, in the Kaiser's Germany.

He served in the First World War in a non-combat role.

So when the war ended, he didn't understand why Germany had lost, and he had felt the bitterness and betrayal that so many Germans did.

And his politics turned increasingly on a dark path.

In the 1930s, he would end up a supporter of Hitler and a court philosopher in the 1990s.

But he lived long enough, as I said, he lived to be 96, to see his ideas taken up by post-liberals of the left and right.

He became quite popular in the 1960s with a a certain kind of leftist because Schmidt's first idea was to reject what he called liberalism, what you would call democracy.

And he argued, the problem with liberalism is it's all negotiation.

I'm going to quote him a little bit.

It's a cautious half measure in the hope that the decisive bloody battle can be transformed into a parliamentary debate and permit the decision to be suspended forever in an everlasting discussion.

Now, it's true.

People who are liberals and Democrats prefer everlasting discussion to bloody battles.

Schmidt thought that was all wrong.

Schmidt's most famous thought, and it's contained in this book, The Concept of the Political, compiled from lectures he delivered in the dying days of the Weimar Republic, was this.

There's a fundamental question about the study of politics, which is, what is politics?

What's it for?

What's it supposed to do?

And there's an answer, an ancient answer, that goes all the way back to Aristotle.

Politics is the study of how human beings live together in communities.

And the work of politics is to find the best way to live in a community.

Now, some people might say the best way is to live in accordance with the will of God.

Other people might say the best way is to live in equality.

Other people might say the best way is to maximize liberty.

But that's what politics, according to Aristotle, is, the study of how we live together in communities.

Carl Schmidt said, that is all wrong.

That's all wrong.

Aristotle's wrong.

Politics is not the study of community.

Politics is the study of enmity, the study of hatred.

That is the essence of the political.

As he says in his book, the specific political decision, sorry, the specific political distinction to which political actions and motives can be reduced is that between friend and enemy.

Now, he's not talking here about friend and enemy as in foreign friends and foreign enemies.

Germany decides, will it fight France, will it fight Poland, both, neither.

You know, the idea that war and peace are prerogatives of the sovereign, that's an ancient idea.

No, he was saying something much more powerful, much more potent, much more dangerous, much more dark.

which is the essence of politics within a society is deciding who in that society is friend and who is foe, who is inside, who is outside, who is enemy, who is to be hated and who is to be prized.

Not just across borders.

This is not the power to make war.

This applies within the national community, the power to decide that some people are enemies of the community, to be treated as enemies, to be potentially murdered.

That is the essence of the Schmidt idea.

And that was the teaching that the Nazis...

They didn't need him to give it to them, but the kind of rationalization and justification that he gave to Nazi power that made him the person whom the Nazis looked to to write a constitution if they'd ever gotten around to finishing the constitution they copied.

Politics is the art of inciting hatred by some in the community against others in the community.

And you can see that that concept of the political is one that the president and the people around him are acting on.

That is their politics.

And one of the things that is really striking about Trump is how completely random and even nihilistic it is.

Trump can be on any side of any question, trade.

He could change his mind tomorrow.

It's quite arbitrary that he's

for Israel and against Ukraine.

Could do it the other way around, and his people would follow him.

He's been on every side of the abortion issue.

He's been on every side of the gay rights issue.

I will live, I think, to see him flip-flop even on immigration.

He's backing away now from this imprisonment of 300 Korean engineers, and he's now sort of semi-apologizing for it or coming as close as he ever does.

Trump can be anywhere.

The one thing that he is consistent about.

is his method of politics, and that is the division of the society, the creation of enemies, and the use of those enemies to rally people to be his supporters.

And this is an idea that maybe has been,

look, it's every divisive person's pattern of

behavior in any kind of social situation.

But to turn this into a theory of politics and a basis of our politics, to use it as a way to justify the kind of politics that we've seen, that is Carl Schmidt's distinctive contribution.

When you see people on the MAGA right citing Schmidt, because he's German, because his language can often be quite dense,

because he wrote books full of very obstrue words, that the malignity of what he's saying is easy to overlook for those who don't actually read the books.

And it's kind of surprising when you read the books and encounter the malignity to realize there are people who read these same books as I read this spring and reacted not with horror, but with wide open discovery.

This is how to do it.

What we've seen in recent days in the United States is a kind of imperviousness to information on the part of those who wish to be aggrieved.

And that is what we are seeing now.

The playing of the victim to justify aggression, the invention of enemies in order to live in a perpetual state of enmity, and the invocation of threats to justify the overturning of the system of liberal democracy that protects us all.

When you hear the president speak, when you hear the people around him speak, you're hearing the words of Carl Schmidt.

They're not very nice words.

They're not words that it is a pleasure to read, but they're words we need to know and to understand and to reckon with, because some of the most powerful thoughts of our species are some of the worst thoughts of our species.

Thanks for joining me today on the David Frum program.

Thanks to Kyle Harper again for talking to me about the history of infectious disease.

Thanks to all of you for watching.

I hope you will like and support the program and any platform you can use it, whether you watch or whether you listen.

And as always, the best way to support the work of the show is by subscribing to The Atlantic and to read my work there and all of my colleagues.

I hope you'll please consider doing that.

See you next week.

Thanks for watching.

This episode of The David Frum Show was produced by Nathaniel Frum Frum and edited by Andrea Valdez.

It was engineered by Dave Grime.

Our theme is by Andrew M.

Edwards.

Claudine Abaid is the executive producer of Atlantic Audio, and Andrea Valdez is our managing editor.

I'm David Frum.

Thank you for listening.