When the Government Attacks Free Expression, the Pen Is a Mighty Sword

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To the Editor—We wholeheartedly agree with Cherabie [1] that in these perilous times, words are not enough: infectious diseases professionals must be prepared to organize and act to defend science, patients, and public health. We hoped that our call to resistance [2] would spur urgent discourse in the face of the Trump administration's draconian attacks on principles, institutions, and people that we hold dear, and we are grateful to Cherabie for proposing actions, which we endorse completely. We continue to emphasize the importance of standing up and speaking out against harmful actions of powerful people and institutions, particularly as the Trump administration wages war on free expression. The attacks surround us [3]. Noncitizen residents and visa holders are being stripped of their legal protections and dignity, detained in deplorable conditions, and/or deported for peacefully protesting government policies [4]. Social media accounts of foreign students and visa applicants are being scoured by the Department of Homeland Security for dissenting views to justify rejections [5], and academics have been reportedly denied entry for unflattering comments about the Trump administration uncovered on their personal electronic devices [6]. Universities are being threatened and billions of dollars in federal grant funding withheld in efforts to control what is taught and by whom [7]. Even the First Amendment rights of medical journals are under direct threat, with several publications, including the New England Journal of Medicine and Chest, receiving letters from a federal prosecutor inquiring about bias in editorial processes in a thinly veiled attempt at intimidation against free discourse [8]. In this context, we believe speech is an essential action in and of itself, and its power is evident in the zeal with which the administration is trying to snuff out its free expression. As infectious diseases professionals, we must all continue to speak out and act up to hold our governments to account, advocating for restored protection of free speech, reinstatement of investments in science and healthcare, and a return to just and evidence-based policies, while staunchly defending marginalized members of our communities. We remember the words of Jonathan Mann, who, in reflecting on our profession's role during the human immunodeficiency virus (HIV) epidemic, said: “Our responsibility is historic, for when the history of AIDS and the global response is written, our most precious contribution may well be that in a time of plague, we did not flee, we did not hide, we did not separate ourselves” [9]. We did not then, and we cannot now, flee, hide, or separate. We will one day be judged by whether and how we stand up to these grave threats. We must not falter. Financial support: No financial support was received for this manuscript.

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