Trump’s New Surgeon General Pick Took Social Darwinist View Of Pandemic
Wellness influencer Casey Means wrote that Americans needed to get healthy or risk death from COVID, calling the crisis “a Darwinian moment for America.”
This piece has been updated from its original email version.
Donald Trump’s new surgeon general pick called the COVID-19 pandemic “a Darwinian moment for America” in the spring of 2020, echoing long-discredited pseudoscience.
Stanford-educated physician-turned-wellness influencer Casey Means, whose nomination for the surgeon post was announced on Wednesday, made the statement in an op-ed for The Hill titled, “Healthy Food: The Unexpected Medicine for COVID-19 and National Security.” The piece was published on April 21, 2020, at the height of the pandemic’s deadly first wave. In it, Means, who a year prior had co-founded a wellness company, argued that the nation could not “continue to shut down our economy and parts of our military, and overwhelm our health care system.” Instead, she proposed a strategy of promoting “healthy living” through personal behavior changes and cuts to agricultural subsidies for “dairy, sugar, wheat, corn and soybeans.”
“Americans must build personal immunity defenses through radical changes in diet and exercise, or risk getting sick and dying,” wrote Means. “This means reducing or eliminating the seven deadly sins from our diet: processed foods, excess industrially-raised meats, refined sugar, dairy, refined grains, vegetable oils and excess sodium — a revolution in personal behavior and national policy.”
Social epidemiologist Justin Feldman of Harvard’s FXB Center for Health & Human Rights told Important Context that Means was “saying the quiet part out loud,” and exposing the so-called “Make American Health Again” movement.
“MAHA has always been about social Darwinism, about blaming people for their own health problems and letting vulnerable people die instead of offering them protection,” Feldman said. “As the Trump administration destroys lifesaving public health protections and defunds essential research on cancer and other diseases, MAHA serves as a smokescreen. It promotes a vision of health that is based on lies and excludes most of us.”
Social Darwinism is a pseudoscientific ideology that misapplies British naturalist Charles Darwin’s biological concept of evolution by natural selection to human beings and societies. It emerged in the late 19th Century to rationalize inequities—particularly class and racial hierarchies. In the early 20th Century, it served as a justification for eugenics.
Feldman noted that individual diet and exercise habits are not as simple as questions of personal choice and responsibility. Rather, he explained, they are impacted by societal and environmental factors.
“People would exercise more if they lived in places where they could safely walk, roll a wheelchair, or ride a bike, or take public transit to do their errands,” Feldman said. “People would eat better if they had more time to prepare home-cooked meals and if profit-seeking food manufacturers didn’t engineer foods to be addictive. While [Health and Human Services Secretary Robert Kennedy] Jr. and his MAHA allies pay lip service to harmful corporate practices and environmental causes of disease, they are silent about what really matters, including the Trump administration’s weakening of corporate regulations and the harm it is trying to do to public transit.”
While the overwhelming majority of those hospitalized or killed by COVID have had comorbidities, epidemiologist and Accountability Journalism Institute board member and scientific advisor Robert Morris said the focus on that fact “is a red herring.”
“For any and all diseases, those most likely to die are those whose health is already compromised,” Morris said.
Additionally, many of the health problems associated with increased vulnerability to the disease have causes beyond lifestyle choices. Hypertension, for example, which impacts half of all U.S. adults, has genetic components as well.
“Hypertension is well documented as having multiple complicated genetic causes based in single nucleotide polymorphisms,” said AJI scientific advisor Frank Han, MD, a pediatrician and pediatric cardiologist. “In my world a structural heart problem like aortic coarctation cannot be cured by even the best kale in the world, that problem needs a surgeon or interventional cardiologist.”
At the time Means’ piece was published, COVID was killing thousands of Americans per week. In April 2020, the Centers for Disease Control and Prevention reported well over 50,000 deaths. To date, more than 1.2 million Americans have lost their lives to the disease and millions more have suffered long COVID.
Means is not the only Trump public health pick to have advocated for reopening and letting nature take its course with the pandemic. National Institutes of Health Director Jay Bhattacharya, for example, was a fierce proponent of pursuing herd immunity through infection, allowing the virus to spread through the young and healthy population while somehow squirreling away the vulnerable. He articulated the idea in the October 2020 Great Barrington Declaration. His ally Marty Makary, a surgeon who is now Food and Drug Administration commissioner, also emphasized “natural” immunity to COVID.
"Casey Means' viewpoints fits well among the eugenics beliefs espoused by the current Trump administration, which we've seen through Trump's supposed statement saying disabled people should just die and Robert F. Kennedy Jr.'s hatred of autistic people,” Mother Jones disability reporter Julia Métraux told Important Context.
As surgeon general, Means would be the nation’s top medical doctor and health educator, responsible for communicating the latest science to the general public. She would oversee the U.S. Public Health Service Commissioned Corps—a body of more than 6,000 uniformed officers, made up of public health professionals.
Questions about Means’ qualifications have swirled since her nomination was announced along with the withdrawal of the previous nominee, Fox News medical contributor Janette Nesheiwat, who has been dogged by claims she misrepresented her credentials. But while Nesheiwat is a board-certified physician, Means is not. She dropped out of her surgical residency program in otolaryngology (ear, nose, throat) and has no active medical license.
Instead, she is prolific voice in the wellness industry. Means co-founded a company called Levels, which offers a personal nutrition app and continuous glucose monitoring for metabolic optimization. She is the author of a bestselling book on metabolic health and does speaking engagements. Her profile on All American Speakers Bureau, which bills her as a “physician, bestselling author & tech entrepreneur,” lists her speaking fees as $30,000 to $50,000 for in-person events and $10,000 to $20,000 for virtual.
Means close association with anti-vax HHS Secretary Kennedy has raised eyebrows. She and her brother, Calley, founder of another wellness company called TrueMed, rose to prominence in Kennedy’s MAHA movement. Casey was reportedly on the list of potential surgeon general nominees back in November and there was even speculation at the time that Calley, who worked on Kennedy independent presidential campaign, might join the new secretary as chief of staff.
Like the secretary, the Means siblings have, between the two of them, been vocal critics of the Food and Drug Administration and standard medical practices. They have promoted raw milk, cast doubt on fluoridated drinking water, and attacked the childhood vaccination schedule, taking particular aim at the hepatitis B vaccine, which is recommended for infants.
In a post on X last August, boosting a video of her brother talking about the vaccine, Casey Means wrote that the shot conferred “no benefit” to children or population as a whole, falsely claiming that the disease was only transmitted through intravenous needles and sexual contact.
NIH Director Bhattacharya made similar remarks on a podcast in September, suggesting he was open to alternative vaccine schedules, which are popular with anti-vaxxers. In our coverage of Bhattacharya’s remarks, Important Context spoke with pediatrician and renowned virology and immunology expert Dr. Paul Offit, who warned that hepatitis B can spread through casual contact—with deadly consequences.
“If you were infected with hepatitis B in the first few months of life, you have a 90 percent chance of going on to develop cirrhosis or liver cancer,” Offit said. “That's why it needs to be given early.”
Should Means be confirmed by the Senate, she will be the latest vaccine skeptic to join the Trump administration in a critical public health role. Others include Bhattacharya at NIH, Makary at the FDA, Makary’s special assistant, Tracy Beth Høeg, and Vinay Prasad, the new head of the FDA’s Center for Biologics Evaluation and Research.