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Despite his assurances in January, Mr. Kennedy is not simply trying to ensure that the best science is used to guide the nation’s health policies or demanding greater transparency into health policy decision making or insisting that disenfranchised groups be heard out. He is trying to fully dismantle the nation’s vaccination apparatus, regardless of what science says or what most people want. And less than a year into his tenure as health secretary, he is succeeding brilliantly.

At least four of the C.D.C.’s top officials have resigned in protest of Dr. Monarez’s firing. More departures, voluntary or forced, are rumored to be afoot. In a resignation letter, one official noted that the data used to justify recent changes in immunization schedules was never shared with the agency, despite requests. This opacity is offensive and alarming, but again, in light of all we have seen these several months, it is hardly shocking at this point.

Neither are the departures; scientists and civil servants have been leaving the nation’s federal health institutions in droves all year, taking decades of knowledge and expertise with them. But the reverberations of such a serious and sustained exodus will be felt for a generation at least.

Meanwhile, as the institutions he was charged with leading crumble around him, Mr. Kennedy has been speculating about the link between antidepressants and school shooters and pontificating about what he sees as the obvious “mitochondrial challenges” plaguing so many American children. “You can tell from their faces, from their body movements and from their lack of social connection,” he said recently.

What is he talking about? How on earth did we get here, and where do we go next? Whatever the answers, it’s clear that the nation’s leading public health official does not have any real interest in — or possibly any real understanding of — public health.