"I would describe this year as hand-to-hand combat. Really, every day," he said at an academic conference at Stanford in April. It's a sentiment the FDA commissioner has expressed often.

What's been getting Califf's goat? Misinformation, which gets part of the blame for Americans' stagnating life expectancy. To Califf, the country that invents many of the most advanced drugs and devices is terrible at using those technologies well. And one reason for that is Americans' misinformed choices, he has suggested. Many don't use statins, vaccines, or COVID-19 therapies. Many choose to smoke cigarettes and eat the wrong food.

Califf and the FDA are fighting misinformation head-on. "The misinformation machine is really causing a lot of death," he said, in an apparent ad-lib, this spring in a speech at Tufts University. The pandemic, he told KFF Health News, helped "crystallize" his need to tackle misinformation. It was a "blatant case," in which multiple studies gave evidence about very effective therapeutics against COVID. "And a lot of people chose not to do it." There were "large-scale purveyors of misinformation," he said, poisoning the well.