Workers across the Centers for Disease Control and Prevention were summarily fired on Tuesday, triggering what will be an unprecedented and chaotic withdrawal of the agency from many areas of disease prevention on which it has long worked.
In all, the CDC is expected to lose roughly 2,400 employees, or about 18% of its staff, as part of the broader cuts playing out across the Department of Health and Human Services.
Scientists in divisions dedicated to tobacco control, injury prevention, workplace safety, birth defects, reproductive health, and substance abuse woke to news they had received dreaded “reduction-in-force” notices. It appears that in some cases, the terminations were effective immediately, though some of the fired staff were put on administrative leave that would see them paid into June. Some were barred from CDC offices on Tuesday, while others were allowed to report to work, one source told STAT.
The Trump administration has argued the CDC’s mission had become too broad, and that it should focus squarely on infectious disease concerns. And, indeed, the bulk of cuts hit agency units focused on health issues beyond that remit. But there were reports that some infectious disease divisions were also impacted, including those working on HIV prevention and tuberculosis containment.
Though HHS Secretary Robert F. Kennedy Jr. promised an era of “radical transparency,” his department on Tuesday released no details on which divisions and programs were being cut, with surviving employees and their bosses trying to piece together who still works at the CDC and who has been let go.
The agency’s workers and leadership — with the possible exception of acting director Susan Monarez, who has also been nominated to the position by President Trump, and people in her office — learned of the cuts when employees reported they had been fired or through the news media. Some supervisors emailed team members to ask them to report back if they’d been fired. Because HHS locked terminated employees out of their email accounts, bounce-back messages may have served as that notification.
Asked for comment, the HHS communications office pointed STAT toward statements it released last week, when plans for the cutbacks were announced. At the time, it argued that the reductions, in addition to saving money, would “streamline” the department by reducing redundancies across agencies and centralizing administrative positions and functions. It also said that the reorganization would enable the department to address chronic diseases — a Kennedy priority — while maintaining other essential programs.
In a video statement announcing the HHS staffing cuts last last week, Kennedy said he would create a new agency within HHS called the Administration for a Healthy America, or AHA. It was not clear Tuesday if any CDC staffers who work on chronic diseases will be offered opportunities to take jobs in AHA.
CDC chief of staff Matt Buzzelli acknowledged the turmoil the agency was experiencing in an all-hands note to staff.
“We understand that this news brings uncertainty and concern for you, your colleagues, and your families. Please know that we are fully committed to supporting you through this difficult period,” Buzzelli said, noting online resources such as a worksheet for calculating severance and a guide for staff being “separated.” He also pointed to the employee assistance program, which currently warns that due to increased demand, “the current wait time to receive an appointment is longer than usual.”
People within the CDC and outside it worried that the country’s capacity to respond to any sort of public health threat has been dangerously eroded.
“We are weaker,” said one CDC employee who did not receive a termination notice but asked not to be identified for fear of reprisals. The individual noted that the CDC is the country’s rapid response force, deployed when there are new disease threats or bioterror attacks. “If there was an outbreak, I would not know who is deployment-ready to get on a plane in the next 24 hours,” this person wrote. “I would not know who is still left to GET people deployment-ready if they are not already up-to-date.”
Critics have faulted the CDC for its handling of the Covid pandemic and argue that is precisely why its attention needs to be refocused on infectious disease threats. CDC officials have acknowledged missteps during their Covid response but said the agency has already taken steps aimed at reform.
Richard Besser, director and CEO of the Robert Wood Johnson Foundation, said the cuts would hurt, not help, any future response to health emergencies. Besser worked for years at the CDC, ending his career there in a stint as acting director at the start of the Obama administration — and the start of the H1N1 flu pandemic.
“I’m very concerned,’’ he said of the agency’s current capacity to respond if an emergency were to arise. “The reason I was made the acting director of CDC was that for the previous four years I had run emergency preparedness and response for the agency. And there was a recognition that in particular during a period of transition you want to make sure that there is leadership in place that knows how to respond to a public health crisis.
“I have great concerns about the agency’s ability to respond to a public health crisis in the midst of the agency being dismantled.”
Former CDC director Tom Frieden called the cuts “a recipe for disaster” and noted the costs of other kinds of work the agency does.
Frieden, the president and CEO of Resolve to Save Lives, a nonprofit that focuses on preventing cardiovascular deaths and averting disease outbreaks, called cutting the agency’s tobacco control efforts, for example, “a gift to Big Tobacco.”
He also expressed particular worry about the elimination of the CDC’s global health center, which he said investigates hundreds of disease outbreaks abroad every year. “It’s less expensive, safer, and more effective to stop health threats when and where they emerge than fight them in our country. Cuts to CDC’s global work will cost lives, damage America’s reputation, and weaken our economy,” he said in a statement.
There were reports that many workers focused on HIV prevention were fired as well on Tuesday — a puzzling target given Trump’s first term initiative to try to end transmission of HIV in the United States.
“In a matter of just a couple days, we are losing our nation’s ability to prevent HIV,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement. “The expertise of the staff, along with their decades of leadership, has now been destroyed and cannot be replaced. We will feel the impacts of these decisions for years to come and it will certainly, sadly, translate into an increase in new HIV infections and higher medical costs.”
One CDC employee told STAT that their “entire” branch of HIV prevention had been eliminated. Another, in CDC’s oral health division, said “virtually” every employee had been eliminated. The oral health department promoted fluoride in water, which Trump and Kennedy have planned to ban nationally. Already one state, Utah, has banned fluoride in drinking water.
That employee said they grew up wanting to work for the CDC, after reading Richard Preston’s “The Demon in the Freezer,” which in part narrates the agency’s work with the smallpox virus.
“This level of cut will seriously hinder CDC’s ability to do the work that it does to improve the health of Americans, and that includes its ability to provide expertise and resources to the states directly,” the former employee said, speaking on condition of anonymity over concerns about other family members’ employment. “As a result, I believe Americans will die younger and sicker.”
Outside the CDC, 81 people working for HHS’s emergency response unit, the Administration for Strategic Preparedness and Response, were told Tuesday that their jobs were eliminated. That includes roughly a dozen people who work the strategic national stockpile, the federal supply of emergency equipment, treatments, and vaccines, which states repeatedly tapped during the Covid-19 pandemic and the current outbreak of H5N1 among dairy cows and workers.
In the cuts announced by Kennedy last week, he said ASPR would be folded into the CDC.
One source told STAT that the people let go at the Strategic National Stockpile were responsible for helping train and prepare state and local officials to use stockpiled materials. The SNS had been under the control of the CDC until 2018, when responsibility for it shifted to ASPR. It is also reverting to management by the CDC.
The decision would also break away ASPR’s division responsible for rapidly developing new vaccines and treatments, STAT reported last week. Employees of the Biomedical Advanced Research and Development Authority, BARDA, were under the impression that their jobs would be safe from the layoff plans, but roughly 30 people were eliminated Tuesday, according to two sources familiar with the matter.
Rank-and-file staff were not the only CDC employees to lose their positions. A number of high-level leaders received notice that they were no longer employed by the CDC, but should report instead to the Indian Health Service. Among those were Jonathan Mermin, long-time director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, and Dylan George, director for the Center for Forecasting and Outbreak Analytics, set up during the Covid-19 pandemic to modernize CDC’s disease forecasting capacity.
Katie Bollbach, executive director of PIH-US, the domestic arm of the non-profit Partners in Health, expressed grave concern about the implications of all of these cuts.
“The bread and butter of public health work has been under-resourced and undervalued for so long,” Bollbach said in an interview. “This kind of disruption and chaos and just assault on the basic tenets of public health is not just dangerous, it’s demoralizing. Our biggest concern is the immediate harm, yes, but the ability to bounce back from something like this is not guaranteed. … I think we’re talking about some generational harm here.”
Susan Polan, associate executive director of the American Public Health Association, warned the country will come to rue these actions.
“This is an ongoing assault on public health and it has to end,” Polan said. “We are crippling the very system that’s in place to protect us and then, when we cry out later when the system is absent when we need it, that’s the situation we are creating with these cuts.”