Feb. 20, 2025, 4:42 p.m.
Experts warn the U.S. is now more vulnerable to public health threats as the Trump administration slashes positions within the Centers for Disease Control and Prevention.
Over the weekend, several reports revealed the administration was moving to fire thousands of probationary employees, including at the Health and Human Services Department.
“HHS is following the Administration’s guidance and taking action to support the President’s broader efforts to restructure and streamline the federal government,” HHS spokesperson Andrew Nixon said in an emailed statement. “This is to ensure that HHS better serves the American people at the highest and most efficient standard.”
HHS did not provide National Journal an exact number of individuals who have been laid off but pointed to a Wednesday report from Fox News citing a senior Trump administration official saying 6,000 employees have left the department since Jan. 20. The official said the recent cuts “did not compromise health and safety of Americans.”
But public health experts warn the staffing cuts undermine the country’s efforts to track and respond to infectious disease outbreaks such as the avian flu and Ebola.
Even before the layoffs, Georges Benjamin, executive director of the American Public Health Association, said there was already long-term underinvestment in the U.S. public health system.
“I think it leaves us in shambles. They’re very close to critically breaking the whole thing,” he said. “That’s really a problem. The federal-state-local relationship is so fragile, and now we’re losing in many ways the core infrastructure for the nation’s public health system. It’s going to take years to recover from this.”
A letter sent earlier this week by the Advisory Committee to the Director of the CDC and obtained by National Journal explained that CDC employees conduct “vital epidemiologic and laboratory analysis” on current and emerging diseases. The committee members called the firings “especially reckless” at this time when there is an Ebola virus outbreak in Uganda, a surge in cases of seasonal influenza in the U.S., a new strain of Mpox, and an outbreak of the bird flu that has seen transmission occur between cattle and humans.
David Fleming, chair of the committee and clinical professor at the School of Public Health at the University of Washington, said the cuts do not create efficiency.
“More dangerously, though, they really do potentially put our country and folks that we all live with in danger from public health threats and emergencies that we know are on their way here,” he said.
Among those on the chopping block reportedly were members of CDC’s Epidemic Intelligence Service, which trains disease detectives. The move received criticism from the Association for Professionals in Infection Control and Epidemiology, and from Rep. Rosa DeLauro.
The EIS is a two-year fellowship during which officials participate in field investigations as they receive epidemiological training. APIC sounded the alarm that the layoffs included “all 50 first-year EIS officers, and potentially some second-year officers.”
But it appears this decision was reversed, with the CDC confirming to National Journal Wednesday that all officers of the EIS remain in their positions.
Other teams do not appear to be so lucky.
Members of CDC’s Laboratory Leadership Service were affected by staffing reductions, and as of Thursday, only the fellows who are part of the Commissioned Corps of the U.S. Public Health Service remain in their positions. The fellowship program provides training on lab quality and safety, and the fellows can provide services to the CDC, state, or local health departments. They often collaborate with EIS on outbreak responses.
Public health experts told National Journal that the CDC’s Public Health Associate Program for Recent Graduates was also affected by the layoffs. Associates in the program are assigned to state, tribal, and local health agencies and focus on a variety of activities such as public health science and law, program management, and health equity. After graduating from the program, PHAP associates are qualified to move to full-time positions at CDC and HHS.
Adriane Casalotti, chief of public and government affairs at the National Association of County and City Health Officials, said she heard from departments who lost workers that were providing services under the PHAP program.
“Our understanding is that many, if not all of them, have lost their positions, and that is something that we’ve already heard directly from some health departments about losing that staff person,” she said.
Casalotti said the impacts of losing PHAP staff on local health departments will vary, but that for smaller agencies, “it’s a significant portion of their workforce power that was eliminated when the PHAP position was canceled.”
The impacts of laying off individuals at the CDC will undermine many efforts, said Joshua Barocas, an infectious-disease physician in Denver and a member of the Infectious Diseases Society of America. Even if HHS Secretary Robert F. Kennedy Jr.’s focus is on chronic diseases, those staff members will need to be reassigned during emergencies to respond to the unforeseen crises, said Barocas.
“Where are we going to pull people?” he said. “It’s going to be from the priority areas of this administration: chronic diseases, childhood birth defects, et cetera. We now can’t respond to the ongoing epidemics that are non-infectious—that already exist—adequately, and we can’t respond to emerging ones, either.”
Barocas additionally said the CDC serves as a hub for clinicians “who are trying to treat the patient in front of them.”
“CDC acts as an information hub and also a treatment hub if I need specific treatments,” he said. “Now, if they’re understaffed, how do I call for the rancher in Colorado that develops dengue, malaria, whatever it is. … How do I call? How do I get the treatment for them? I can’t because they’re understaffed and stretched thin.”
Kathy Ward, president-elect of the Association for Professionals in Infection Control and Epidemiology, said CDC can provide guidance in areas such as health care-associated infections. “I’ve relied on the CDC since I became an infection preventionist,” she said.
CDC keeps “the pulse of the nation on what’s going on for emerging threats,” Ward said. APIC had called for members of EIS to be reinstated when it appeared they were laid off earlier this week. Ward still worries about whether new EIS fellows will be brought in.
“If there are no new EIS officers coming in, what happens when there’s no more in the pipeline?” she said.
HHS is not the only department facing job cuts that could have public health impacts. Employees helping with the response to avian influenza at the Agriculture Department were given termination notices, which the department said Wednesday it was working to reverse.
The USDA is “working to swiftly rectify the situation and rescind those letters,” a spokesperson said in an emailed statement. “USDA’s Food Safety and Inspection Service frontline positions are considered public safety positions, and we are continuing to hire the workforce necessary to ensure the safety and adequate supply of food to fulfill our statutory mission.”
