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iomedical and public health researchers struggled Wednesday to fathom what the incoming Trump administration might mean for their fields, as they tried to separate their personal views about the election (many supported Hillary Clinton) from what’s known or expected about the president-elect’s plans.

“It’s so hard to know” what the Trump White House will do, said Dr. Eric Topol, director of the Scripps Translational Science Institute and professor of genomics at the Scripps Research Institute. One hopeful sign: Newt Gingrich, former speaker of the House of Representatives and a close Trump ally, last year called for a doubling of the National Institutes of Health budget and is a strong supporter of science research (he used to have a replica of a T. rex skull in his office).

“I have spoken to Newt in the past, around the time of his NIH op-ed, and I know he is passionate about that,” said Topol. “But will his views have influence? It’s unclear who Trump will turn to for top advisors in science and biomedical research.”

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Very few scientists publicly supported Trump, leading some long-term biomedical leaders to say their first order of business should be to open the lines of communication. “Some responsible scientist needs to educate [Trump’s transition team] about the importance of the scientific enterprise,” said Dr. Harold Varmus, a former director of the NIH and now at Weill Cornell Medicine. “I hope we’re going to be able to accommodate the new reality. But someone needs to give the transition team a tutorial.”

One concern: Trump told a radio host last year, “I can tell you, because I hear so much about the NIH, and it’s terrible.”

Nor is it clear how Trump’s anti-immigration stance would affect the willingness, or ability, of foreign science and medical students to study, train, and stay in the US.

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“It’s deeply troubling, obviously, though as with so many things about the president-elect there is a question about how much he means,” said Dr. Sandro Galea, dean of the School of Public Health at Boston University. If Trump builds a metaphorical version of the physical wall he promised to build on the US-Mexican border, perhaps by pushing through policies that restrict the flow of foreign students, Galea said, “then we’ll have a tougher time maintaining the high quality of our research” in biomedicine and public health.

On Tuesday night, environmental scientist Murray Rudd of Emory University tweeted to the journal Nature, “As a Canadian working at a US university, a move back to Canada will be something I’ll be looking into.” Chemist Maria Escribano, a postdoctoral researcher at Stanford University, who hails from Spain, tweeted, “this is terrifying for science, research, education, and the future of our planet. I guess it’s time for me to go back to Europe.”

The number of graduate students in science and engineering rose 5.5 percent from 2013 to 2014, the latest figures available, according to the National Science Foundation, from 570,300 to 601,883. Much of that increase reflected a years-long rise in the number of foreign graduate students on temporary visas, which grew 7.4 percent from 2012 to 2013 and 16 percent from 2013 to 2014. At many US biomedical labs, they constitute a majority of the bench talent.

“One of things [Trump] has to understand is that the vitality of our scientific enterprise depends on continued immigration,” said Varmus. Although Trump has said he’s not opposed to immigration of high-skilled workers, “people are not going to want to come to a country that looks with suspicion and resentment on people from abroad. There are other countries that do good science, and if we don’t send signals that we welcome [foreign science students and scientists], that’s bad news.”

As some scientists worried about what would happen to President Obama’s precision medicine initiative and cancer moonshot, among other high-profile science projects, Varmus was more sanguine. Trump “seemed sincere in offering an olive branch” to his opponents in his election night victory speech. “If he is, then this is a good place to begin, in biomedical research and preparing for the next outbreak” of an emerging infectious disease such as Zika.

Much of the concern over what the Trump administration will mean for science reflects what physicians and researchers see as the president-elect’s suspicion of, and even antipathy toward, empirical evidence that does not fit his ideology, such as Trump’s assertion that human-caused climate change is a hoax.

“I hope we’re going to be able to accommodate the new reality. But someone needs to give the transition team a tutorial.”

Dr. Harold Varmus, former director of the NIH

“Rational policy requires a respect for evidence,” said Dr. Allen Frances, a psychiatrist formerly at Duke University who led the 1994 effort to revise psychiatry’s diagnostic manual. “Humane policy requires a respect for those less privileged. Prudent policy requires a respect for risk — the dangers of unintended and unpredictable consequences. I fear that the Trump administration is not likely to have much respect or wisdom.”

For instance, Trump asserted, during a Republican presidential debate, that childhood vaccines given on the recommended schedule can cause autism, something that goes against scientific evidence. Although the executive branch can shape health care policy through appointments at the Centers for Disease Control and Prevention and elsewhere within the Department of Health and Human Services, “it strikes me as many steps far removed” from likely, Galea said, “and would be an unprecedented break” from decades of health care policies being driven by science.

“But he could use the bully pulpit to change hearts and minds about childhood vaccines,” Galea said, adding that as more parents opt out of vaccines for their children then outbreaks of preventable infectious diseases such as measles become more likely. “And that,” he said, “would be heartbreaking.”

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