If you follow #medtwitter, #epitwitter or #covid twitter even cursorily, you've probably noticed a serious freakout over political interference in an obscure journal you've likely never heard of before: MMWR - Morbidity and Mortality Weekly Report. Who cares? Why so much? 1/

MMWR is...not the world's most exciting journal. Imagine if your mom produced a medical journal. It would be a lot like MMWR. Reports about consumption rates of sugary drinks in high schoolers, etc. But it has a very special role in the medical ecosystem. 2/

For instance, on June 4, 1981, MMWR published the report, Pneumocystis Pneumonia -- Los Angeles. Yes, that's really its title. About as exciting as pencil shavings, right? 3/ https://www.cdc.gov/mmwr/preview/mmwrhtml/00043494.htm

The report described an extremely rare form of pneumonia in 5 gay men in LA. The cause was then unknown, but this was the first medical publication anywhere of people suffering from what came to be known, a year later, as the Acquired Immune Deficiency Syndrome - AIDS. 4/

You see, trying to figure out what a disease is, in real time, takes eyes and ears all over the world. Someone notices an odd pattern. What's going on here? When you're not sure, MMWR is where you can send up a red flare to let everyone know "Something's up." 5/

It's that ability to communicate extremely rapidly, yet as accurately and honestly as possible, that is critical to global disease surveillance, identification, and mitigation. THAT is the capability the Trump administration has been quietly seeking to strangle. 6/6