A week ago, on Aug. 8, a gunman attacked the CDC headquarters in Atlanta, firing nearly 500 rounds, breaking about 150 windows, and killing a police officer.

The shooter had reportedly become fixated on his belief that the Covid-19 vaccine had made him and others sick, and wanted to make “the public aware of his discontent,” according to the Georgia Bureau of Investigation. Were it not for the blast-reinforced glass, campus security, and a considerable amount of luck, Aug. 8 would almost certainly have been the deadliest attack against health workers in world history.

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The vast majority of Americans who were frustrated with the Covid-19 response, or have been influenced by vaccine misinformation, do not commit acts of violence. Like so many mass shooters before him, the CDC shooter was also struggling with mental illness and enabled by easy access to guns. It would be easy, then, to think of the shooting as a tragic episode: a byproduct of a long-standing, right-leaning disinformation ecosystem, one that serves financial and ideological objectives that are perhaps contemptible, but not explicitly violent.

The truth is both more complex and more alarming.

The anti-vaccine movement that existed before Covid-19 is not the anti-public health movement that exists today. In 2020, the right-wing media and financing machine went searching for spokespeople to push back against business closures and vaccine mandates. What they found, and unleashed into American politics, was a cohort of pseudo-intellectuals who were not only comfortable spreading misinformation, but in many cases, actively incited violence against the doctors, scientists, public servants, and journalists who opposed them.

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Unlike average Americans who mistrust vaccines or medical institutions, the ersatz “experts” who found their voice in the Covid-19 pandemic cannot truly be said to believe anything — their ideology is driven by vested financial interests and culture war grievances. Now, thanks to Health and Human Services Secretary Robert F. Kennedy, Jr., they run the American public health apparatus.

In 2023, Kennedy said, “There’s no vaccine that is safe and effective”; in 2024, during his presidential campaign, he called the CDC a “cesspool of corruption.” Three days before the shooting, Kennedy announced plans to start developing a new (scientifically impossible) kind of vaccine that could target every virus in existence, which he touted as “much safer” than mRNA vaccines.

After the shooting, he shared photos of a recent fishing trip half an hour before issuing a statement on the shooting; by Tuesday, he had resumed his criticism of how public health agencies led the Covid-19 response.

Kennedy’s appointees have gone even further. In 2022, the National Institutes of Health’s now-Director Jay Bhattacharya appeared on a panel that inaccurately claimed Covid-19 vaccines had killed 20 times as many people as they had saved. The day after the shooting, Bhattacharya went on Steve Bannon’s podcast to criticize mRNA vaccines. A few days later, he doubled down in a Washington Post op-ed.

Just last year, Vinay Prasad, now a Food and Drug Administration official, said of the public health professionals who guided the Covid-19 response, “I don’t believe in forgiveness, because in my opinion, these pieces of shit are still lying.” Prasad left the agency on July 30, but was reappointed to his position on Monday, not even 72 hours after the CDC attack.

In the wake of the shooting, news outlets have drawn the obvious connection between the anti-vaccine messages broadcast by Kennedy, Bhattacharya, Prasad, and the right-wing political machine that installed them. The few public health experts who have been brave enough to speak up have tried to counter chaos with civility, calling repeatedly for the administration to drop its dangerous rhetoric.

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But it is a mistake to believe that our opponents can be pressured into civility, just as it is a mistake to understand the shooting as a random byproduct of fringe but non-violent beliefs. What happened on Aug. 8 is part of the same trend as Jan. 6 and other recent attempted and successful acts of stochastic terrorism: an intentional campaign of political violence on all fronts, actively driven to target public health by the people who now ostensibly lead its institutions.

Like Trump, Kennedy and his numerous hand-picked appointees have spent years calling for the punishment of their political opponents. Like Trump, they do not need to call for violence explicitly — others in their immediate circles have done the dirty work of using imagery like guillotines to articulate their preferred solution. We cannot be so gullible as to take their winking condemnations of the shooting at face value, while they simultaneously send unanimous and unequivocal signals that double down on anti-vaccine and anti-public servant messaging.

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How should public health institutions move forward after our own Jan. 6? Nearly five years later, it should be clear that America’s failure to treat Donald Trump as the organizer of a violent coup — as any functional democracy would have — has paved the way for an administration that has managed to build concentration camps and (potentially irreversibly) destroy the constitutional order in just a few months. A weak response to the Aug. 8 attack on the CDC will have the same effect: If violent rhetoric is denounced but never deplatformed, it will only become bolder — and more violent. In RFK Jr.’s America, it will never be safe to practice public health or medicine.

The window for action — or at least, to agree on a narrative — is closing. Congressional Democrats must demand resignations, and use hearings and investigations to achieve that outcome, however long it takes. This is a fight we can win: politicians with far more support have been driven from office with far less culpability for an attempted mass slaughter than Kennedy, Bhattacharya, and Prasad. In the first Trump administration, scandals and embarrassment successfully pushed many appointees out of office, and Prasad himself was ousted merely weeks ago due to internal tensions within the administration.

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Public health professionals must demand this — and the public must demand this of us. Many of us feel torn between our mission and the feeling that we have lost our mandate. As a result, we have failed to present a unified front against Kennedy’s nomination, and since he entered office, we have sought compromise with his movement, in the hopes of rebuilding trust.

But we cannot legitimize political violence, even if its proponents are popular. Trust goes both ways — we cannot engage with the grassroots MAHA movement if its self-selected leader is an active threat to our safety. The public must demand more than thoughts and prayers, not just from Kennedy and his cohort, but from the loudest voices in public health: together, we can mount a meaningful opposition against violence, starting at the source.

Colin J. Carlson, Ph.D., is an infectious disease epidemiologist at Yale University and currently studies how scientific evidence was used in the Covid-19 pandemic. Sean Kennedy, M.P.H., is a public health communicator and worked at the CDC for more than six years.