Photo: AP

A lengthy piece published by The Atlantic today explores what might happen when a White House that comports itself with “a casual disregard for evidence” and “reckless self-confidence” needs to deal with a viral pandemic like swine flu, Ebola, or Zika. Guess what: It’s not great!

Of course, President-elect Donald Trump does not have what one would consider any kind of record on public health, because he has never held public office, although that didn’t stop him from weighing in on Twitter during the largest Ebola outbreak in history.

Still, his tweets during this time give us some idea of how he might handle such a situation as president. From The Atlantic:

Trump’s Ebola tweets also revealed how he might deal with an outbreak as President. He repeatedly called for the U.S. to stop all flights from Ebola-infected countries, even though no such direct flights existed, and even though flight bans don’t work. Several countries enacted such bans during the SARS epidemic of 2003 and the swine flu pandemic of 2009, but to no avail. It’s impossible to fully seal a country; when air travel is blocked, people will move by land, sea, and alternative routes that are even harder to track. And back in the source nation, fearful patients go underground, making it even harder to stop the outbreak and paradoxically increasing the odds that it will spread.

And yet, Trump’s predilection for clamping down and closing borders extended even to his fellow citizens: He said that American health workers who became infected should be stopped from re-entering the country. “KEEP THEM OUT OF HERE!” he asserted. “People that go to far away places to help out are great-but must suffer the consequences!” As global-health researcher Jeremy Youde wrote, “This framework sees infected persons as an enemy to be contained and avoided rather than as people who need treatment.”

Meanwhile, as governor of Indiana, Mike Pence refused on moral grounds to set up needle exchange programs for intravenous drug users amid an outbreak of HIV last year—an outbreak that policies Pence had supported had made possible in the first place. The governor eventually changed his mind about needle exchanges, but only after praying on it. Even then, the bill that Pence signed only partially lifted the ban on needle exchanges, and offered barely any financial support to the poor, rural counties most affected by the outbreak.

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“As far as I can tell, Trump has zero experience on this,” Carnegie Mellon University’s Jack Chow, formerly of both the World Health Organization (WHO) and the State Department, told The Atlantic. “If I asked him, ‘What is your stance on global health?,’ I don’t know what he’d say. I don’t think anyone really does.”

On an unrelated note, you should get a flu shot.