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Covid-19 is still shaping the debate on health—and killing people. One thousand one hundred and eleven deaths worldwide from covid-19 were reported to the World Health Organization in the 28 days to 24 August 2025.1 Covid-19 is now rarely mentioned as a cause of death, and reduced routine testing will inevitably mean that WHO’s total is an underestimate. Notably, 74% of those deaths were in the US, where Robert F Kennedy Jr, the health secretary, is accused of taking an antivaccination approach to health policy (doi:10.1136/bmj.r1882).2 Covid vaccine provision is now restricted to specific vulnerable groups, and $500m (£370m; €428m) of funding for development of further mRNA vaccines—in the country that delivered Operation Warp Speed during Donald Trump’s first term—was recently cut.3