Autism spectrum disorder is not epidemic, and is not monocausal, the way a viral or bacterial infection is monocausal.

But imagine it were both. Let’s imagine autism didn’t exist until 2025, then emerged out of nowhere when diagnosticians began detecting it in children at the rate they do in the real world or higher.

What would Donald Trump do about a situation like that?

Everyone who lived through the year 2020 should know the answer.

His first instinct would be to downplay and deny the reality. He would discourage screening. He would try to restrict pregnant women from entering the country, and expel immigrant mothers whose children were on the autism spectrum. When that didn’t work, he’d hype false cures and false preventives. He’d be concerned primarily with avoiding both responsibility (for new public-health challenges that might require meaningful sacrifice) and culpability (insofar as the public might want to know what he knew and when he knew it).

The ad-hoc process of deflection and avoidance would cause immediate harm; it would also invite a cascade of cult-like behavior from loyalists who wanted to provide him an alibi, which would in turn set actual scientific progress back years.

That’s the COVID story.

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If we’re unlucky enough to experience another pandemic before Trump leaves office, I suspect his response will be, if anything, worse. But he’s choosing to engage in a similar kind of deadly sophistry now, as if autism were much like COVID, for similarly self-interested reasons.

Trump dabbled in anti-vaccine quackery before COVID, and then with more insidious motives after Joe Biden became president. But his real, full-bore assault on medical science for personal gain began when he nominated Robert F. Kennedy, Jr. to be U.S. health secretary, and reached its apogee on Monday, when he advised new parents to reject the immunization schedule, and told expecting mothers to stop taking Tylenol, which he blamed baselessly for causing autism.

Well-meaning people were aghast, and at pains to correct the record, so that unsuspecting women would not harm themselves or their pregnancies. But beyond the important work of refuting nonsense, we need to drive home the less cut-and-dry fact that Trump isn’t simply ignorant or eccentric or buffoonish. He isn’t someone who “questions the experts” in a putatively independent-minded way. On the contrary, he’s chosen to put infants and mothers at risk for the most selfish of reasons. It’s not just that he says things that are irresponsible or refuted by science. As during COVID, he’s saying things he knows to be false, or at least with cavalier disregard for the well-being of others, to shore up his political standing.

Tthe people who put their trust in him should detest him for it.

POISON IVER

It’s hard to explain how and why MAGA coopted the anti-vaccine movement, and vice versa, but the lines between the two weren’t fully erased until Trump lost in 2020. ...