Before becoming director of the National Institutes of Health (NIH) earlier this year, Stanford physician and economist Dr. Jay Bhattacharya was an outspoken critic of the country’s COVID-19 lockdowns under longtime NIH head Dr. Francis Collins.
A researcher focused on aging and chronic disease, Bhattacharya is known for coauthoring the Great Barrington Declaration in 2020, using scientific modeling to argue for focused protection of the vulnerable rather than sweeping restrictions. But few realized that Bhattacharya—a churchgoing Presbyterian—also drew from his faith to advocate for a more relational response, including preaching on the topic.
As Bhattacharya comes into his new role, fellow scientist and Christian Dr. S. Joshua Swamidass interviewed the NIH director about his convictions and his plans to lead the medical-research agency while controversy and questions swirl around the current administration’s approach to science and medicine.
Bhattacharya spoke to CT about his faith and the challenge of rebuilding trust in public health while addressing the crisis of chronic disease.
This interview has been edited for length and clarity.
You were raised Hindu and became a Christian in high school. Can you tell us more about how that happened and how your family responded? That’s not always an easy conversation.
Actually, it was the other way around. My family was Hindu, Brahmin Bengalis, but we came to the US when I was 4. When I was 13, my dad had a heart attack. There was a local church with someone who had a heart for immigrant communities—a woman named Maureen Bryan who reached out to my mom, offered to help. That was a big help when my dad was in the hospital. After he got out, my parents started going to church. They dragged me and my brother along. I was mystified—math and science felt closer to my faith than Hinduism did, and I didn’t understand Christianity. It didn’t make sense to me.
At some point, my parents and brother accepted Christ, but I couldn’t. I didn’t see how faith was compatible with science. Then, when I was 18, I had this experience—a sense that I had made an idol out of science. It was poisoning the way I thought and interacted with people. I was judging people based on how smart they were; how good they were at math, science, and other things.
It was this sense, and it came out of nowhere—actually, I know where it came from; it came from God—it was a great evil. It was really pride. And that is the day I accepted Christ.
I thought, What have I done? What is this faith I’ve stepped into? It was easy to talk to my parents about it—they were happy since they had accepted Christ earlier. I went to college, joined some Bible studies, trying to understand what the Christian faith was all about. Spent a lot of time in grad school in these Bible studies with some close friends of mine, where we had argued about every single page of the Bible together over the course of years.
I’ve been learning about, doing a lot of reading—basically now for most of my life—about what it means to be a Christian; the Bible, of course; but also how other people who’ve had that same struggle between faith and science, how they’ve thought about things.
In your thinking, who have been the most helpful people?
As for helpful people, ironically, Francis Collins was helpful. His book The Language of God and his example of balancing faith and science were important to me when I was younger. There are also countless quiet examples, people who have given up their lives in response to the call of faith. They’re not necessarily famous, but they’ve been significant.
John Lennox, the Oxford mathematician, also comes to mind. I’ve read a lot about Aquinas too. Modern interpretations of his work have helped me see that scientists often have a cramped metaphysics. There are other ways of thinking that are worth considering.
Some of the old too, like Aquinas and the more modern interpretations of Aquinas, have helped. There’s a metaphysics to thinking about science, and the metaphysics that scientists have is cramped. The idea that there are other metaphysics available that are worth thinking about. For example, can you use scientific evidence to prove that science itself is true? The answer is no, you cannot.
Ultimately, you must make decisions about what is the ground truth of reality, on which base—how do you decide what is the ground truth of reality? And if the idea is that the material world is all there is, I don’t know, it leaves me with all kinds of holes, fundamental things about how I ought to live my life.
The Christian story answers those holes. It tells me why that sacrifice of myself for others is good, good for not just for me but in line with how the universe is really structured—and also that it’s just a good thing. Why love is necessary? Why love is the center of the universe? That’s something that a worldview that says that the material world is all there is, well, it doesn’t help you answer any of those questions.
You alluded that “ironically” Collins’s work has been helpful to you, but you’ve also been a public critic of his. Can you explain briefly what your main disagreements with him have been and what you would have done differently in his position—the position you now hold?
The primary disagreement was how to manage the pandemic. In October 2020, I wrote the Great Barrington Declaration arguing we should account for the collateral harms of lockdown policy: the harm that the school closures were doing to children, the harm that the economic dislocation caused by the lockdowns were doing to the world’s poor. The UN estimated that about 100 million people would face starvation due to lockdown-induced economic dislocations caused by the lockdown in April 2020.
We recommended protecting elderly people who were really at high risk from the disease much better than we had been while not disrupting so much the lives of the less vulnerable populations. Because those disruptions were going to cause more harm to them than COVID. This, by the way, has come to be true.
You preached a sermon in 2022 at your church in Northern California about how Christians should respond to one another during the pandemic.
The ideology of the lockdowns was that we are all merely biohazards and we should treat each other as such. That is fundamentally at odds with how Christians view our fellow human beings. For Christians, we view each other as the focus of the love of God, each of us made in the image of God—that we’re not mere biohazards. We may be biohazards, but not mere biohazards, and we should treat each other in self-sacrificial ways, even our enemies. We should forgive.
In your sermon, you contrasted Jesus’ response to lepers with Elisha’s response.
He [Elisha] is visited by the Syrian general Naaman, who has leprosy or some disease like leprosy. Elisha won’t physically see him. Instead, Elisha sends out a messenger: “Go jump in the Jordan. Jump in the Jordan. You’ll be cleansed.” Naaman responded, “Wait, what is this? Why can’t I go jump into [the] Syrian river? Syrian rivers are better than rivers in Israel. What is this guy telling me?” One of his slaves, this girl who’s a Jew, tells him, “Well, look, you came all this way to get his advice. You may as well just do it.” So he says, “Okay, I’ll do it.” He jumps in the river, then he’s healed. And he’s really grateful.
There’s lots to that story, but the element of the story I picked up was that Elisha, the prophet, does not actually physically touch Naaman when he cures him.
It is in contrast with Matthew. In Matthew, Jesus encounters a leper, and he physically touches him. If you believe Jesus is God, well, he didn’t need to [touch the leper]. He’s more powerful than Elisha. He didn’t need to physically touch him. In fact, we see Jesus healing at a distance in other stories in the Bible. So why did he physically touch him?
One lesson I draw is that he meant to send a message that there is no one unclean in the kingdom of heaven. There’s no one unclean. We may be biological hazards, but we don’t treat each other as mere biological hazards. It’s not that we don’t take precautions, but at the fundamental core of what we do is we treat each other as human beings, not as mere biohazards.
Many evangelical Christians have a great deal of respect for Collins. What would you want them to understand about your disagreements with him?
I still have a deep respect for him. After I wrote the Great Barrington Declaration with Martin Kulldorff and Sunetra Gupta, he wrote an email to Tony Fauci four days later calling for a “devastating takedown” of the premises of the declaration. They called me, Martin, and Sunetra “fringe epidemiologists,” essentially trying to marginalize us. That was an irresponsible use of his power. He’s since apologized to me for the use of the word fringe epidemiologists.
Now that I’ve been in his office a couple of months, I understand. He must have been under tremendous pressure, and he had his view about how the pandemic ought to be managed. I believe that view was very shortsighted—focused on infection control—but he forgot that most people on Earth do not have the capacity to lock themselves away. The poor do not have that capacity. The kind of policies he was pushing could only be followed by the laptop class. The world’s poor do not have that capacity.
There was a seroprevalence study in July 2020 in Mumbai, where 70 percent of people living in the slums had already had COVID and recovered, while in the richer parts of Mumbai, it was 20 percent. That class divide shows up in the data everywhere in 2020 and beyond. The world’s poor were asked to lock down, but they still got infected and still suffered from the harms of the lockdowns.
It is fair to say that trust in public health and scientists, more broadly, has eroded substantially. This has been a big part of the loss of trust, hasn’t it? How can that trust be rebuilt?
Trust in public health is at an all-time low, at least in my adult life, maybe in a century. In previous decades, we saw so many successes in public health—addressing the polio epidemic, advances in sanitation and nutrition worldwide, increases in life expectancy—huge successes. But during the pandemic, the public health establishment embraced ideas that were not actually supported by scientific evidence and ignored basic facts about the consequences of the policies they recommended. So yes, it’s true: The public has lost trust in public health.
First, we have to acknowledge that the public has good reasons for that loss of trust. Pretending that the public somehow got things wrong and that the public health establishment got it right and the only problem was that the public didn’t obey blindly—that attitude guarantees the trust will never come back. We in public health have to acknowledge the errors we made.
Second, we have to get back to fundamental scientific ideas and processes that underlie public health. The kinds of ideas I have for what I’d like to accomplish as NIH director are designed around that. For example, I want to make sure we fund research that actually addresses the problems people face. The pandemic is a great opportunity for that. We have a chronic-disease crisis that is catastrophic.
You often emphasize clinical research and its impact on medical practice, and that’s a big part of NIH’s mission. But what about research that advances our understanding of the world but has long-term and uncertain impacts on patient care? Does that kind of science still have a future at NIH?
Yeah, definitely. Basic research is fundamental to the next generation of advances. It’s an essential part of the NIH portfolio. I have no intention of changing that. In fact, I want to make sure we do that—especially the kind that translates into advances in health. There are parts of the NIH portfolio—though we can debate the exact amount—that were focused on ideological goals. For example, the elimination of racism.
The NIH has the capacity to do research that makes people healthier and helps people live longer. But it doesn’t have the capacity to address historic wrongs or solve divisions caused by unethical or evil behavior that has lasted centuries. That’s not within our capacity. We can’t achieve cosmic social justice using the tools of the NIH. We should focus on the things we can actually accomplish.
You’ve described this as a “tough period” for the NIH, with canceled grants and looming budget cuts. What’s your assessment of all these shifts, and do you think we’ll be able to continue to invest in science at the same level?
The president wrote a letter to his science adviser, Michael Kratsios, committing the United States to being the world leader in biomedicine in the 21st century. That’s my task, right? Because the NIH is the primary agency of the federal government that will make that happen. The NIH funds biomedical research at levels that are like an order of magnitude greater than the rest of the world combined. And that will remain true even under the worst projections about the budget.
The budget is a negotiation between the administration and Congress. The key thing for me is to make sure that whatever the budget ends up being, we spend the money in a way that maintains American leadership in biomedicine in the 21st century. As best as I can tell, there’s widespread support for the actual scientific mission of the NIH both inside the administration, in Congress, and elsewhere.
In May, you gave a talk at the NIH where several NIH scientists walked out. Can you explain what happened?
I gave a town hall to introduce my vision for changes to the NIH—like reproducibility; a focus on chronic disease; support for high-risk, high-reward research; support for early-career investigators; things like that. One of the items I talked about is making sure that the NIH does not support work that puts the world in danger—that has the possibility of causing a pandemic, for instance.
While I was making that point, I think a few researchers—maybe part of the postdoc union—got up and walked out in a silent protest. I got an email from them later, complaining that they had not gotten to meet with me and ask questions. There was some irony in that, because during the town hall, I took lots of questions from the audience. We got about 1,200 questions NIH-wide before the town hall, and I answered some of those during the event, just like you’re asking me questions now. Then I opened the floor for more questions from the audience. If that postdoc group had stayed, they could have asked their questions. I very, very strongly believe in free speech, in academic freedom, and in engagement with folks.
Robert F. Kennedy Jr. has a big initiative that’s supposed to be testing a hypothesis about vaccines, and we’re supposed to find out the root causes of autism by September, I think. Is this under the NIH?
It’s my job, yeah.
I really worry about that. As a medical doctor who has studied some of this too, we do know a lot of the contributing factors and even causes of autism.
If you know the answer, tell me, because I also read this literature, and I’m frankly mystified about the cause of the rise in autism. What I’ve seen in my career is that a lot of scientists are afraid to address the question because they’re afraid they’ll get called anti-vax. Now, I don’t believe that it’s likely that vaccines are the cause of the rise in autism, as a matter of science. I’d like to have an assessment of the various hypotheses and how promising they actually are.
The thing that I’ve launched is an NIH-focused project to elucidate the etiology of autism. By September, we’ll have a dozen or more research groups funded. We cut a lot of red tape to make this happen pretty fast. We’ll have a scientific competition to identify those groups, just like the NIH always does. We’ll have basic science as well as more applied epidemiological approaches.
We’ve created this large data platform, which doesn’t exist now, so that you can deploy datasets that include genetic information, longitudinal health care data—including electronic-health-record data—environmental-exposure data, information about parents, tracking that allows scientists, in ways that protect confidentiality, to track the experience of autistic kids. We’re going to work with groups that represent autistic families or autistic kids to advise us on how to do this. That’s the standard way the NIH deals with problems like this.
Christians are a diverse group. Some of them are excited about the next four years. There are also a lot of Christians who are uncertain about the next four years and what it will mean for science, public health, and religious freedom. For those who are really skeptical, what would your final message to them be right now?
I mean, we’re called to be the salt of the earth, the light of the world, right? As Christians, that doesn’t have a political slant. It may have political implications, but there’s no political slant. Christians have many different kinds of political opinions. What I’d ask is that we treat each other with good faith—that we actually listen to each other, try to understand from each other, learn from each other. I think that will eventually pay off much better than assumptions of bad faith and evil intent when there are none.
Dr. S. Joshua Swamidass is a physician, scientist, and professor at Washington University in St. Louis, where he works at the intersection of artificial intelligence, medicine, and chemistry. He is the author of The Genealogical Adam and Eve.
