CDC Firings Fray Lifelines to Local Health Departments

The U.S. public health system has long been under strain, stymied by declines in funding as well as employees. And so state and local public health departments around the nation — tasked with monitoring and responding to disease outbreaks that threaten to sicken the masses — have relied on workers from the Centers for Disease Control and Prevention to help.

In February, the Trump administration abruptly fired many of them, a move that local and state officials said would undermine the nation’s continual effort to control the spread of infectious disease.

A few examples: Terminated CDC employees had helped prevent and respond to outbreaks such as dengue fever and the flu. They worked with local officials to quickly test for viruses — including Oropouche, an illness that doesn’t have a vaccine or effective treatment — and ensure that testing in public health labs complies with federal regulations. Others monitored potential cases of tuberculosis or provided health education to adolescents to prevent sexually transmitted infections.

The Trump administration’s Department of Government Efficiency, spearheaded by billionaire Elon Musk, is trying to slash the workforce across the Department of Health and Human Services and other federal agencies. The swift staff reductions targeted probationary employees, many hired within the past two years, who lack civil service protections against firings.

My colleague Noam N. Levey reported this week on layoffs at a division of the Centers for Medicare & Medicaid Services — the Center for Consumer Information and Insurance Oversight — that could hinder enforcement of a law to prevent surprise medical bills that Trump himself signed in his first term.

One of the CDC trainees let go was Gaël Cruanes, who had been working at New York City’s Department of Health and Mental Hygiene to detect cases of tuberculosis. Cruanes, who called the firings “unconscionable,” contacted newly arrived immigrants and refugees potentially at risk of spreading TB in hopes of getting them into the city’s clinics for screening. “It’s purely for the safety of the public at the end of the day,” Cruanes said.

The firings were communicated in mid-February in notices with identical language alleging workers had displayed poor performance and that their skills weren’t a match for the department’s current needs. Several people interviewed by KFF Health News disputed that characterization.

After our reporting was published, fired CDC workers in the training programs were notified March 4 that their terminations were rescinded and that they should start work again March 5, according to emails viewed by KFF Health News. “We apologize for any disruption that this may have caused,” said the emails, which were unsigned and sent from an internal CDC email address. The CDC didn’t respond to requests for comment.

The reversal came less than a week after a federal judge ruled the Trump administration’s widespread firings of probationary employees were likely illegal. But there’s still uncertainty. Although some workers were rehired, federal agencies are still drawing up plans for large-scale layoffs, a move that could encompass a much broader swath of workers.

We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.