Dr. David Fleming spent last week learning of the scope of the cuts at the Centers for Disease Control and Prevention, not through meetings with department officials or emails, but by text messages and news stories. As far as he knows, he said, there is still no official public list of the cuts.

“This is unprecedented, both in the scale and scope of destruction of CDC, and unprecedented in the secret manner in which it’s been being carried out,” said Fleming, a public health professional in the state of Washington and chairman of the Advisory Committee to the Director of the CDC.

Just 10 weeks in, the administration of President Donald Trump has just cut broad swathes from federal health agencies, including the Atlanta-based CDC. Including hundreds of CDC workers who were laid off in February, the cuts last week were meant to eliminate 2,400 jobs from the agency’s workforce of perhaps 12,000. That’s part of 20,000 jobs expected to be eliminated from the Department of Health and Human Services overall.

Fired employees paint a picture of a long list of decimated departments, including areas where Georgia has experienced significant health challenges — such as tobacco prevention, maternal health and HIV and asthma prevention. The cuts snared both support workers and researchers who work directly on science, workers inside the agency told The Atlanta Journal-Constitution.

But perhaps less noticed, the way the cuts were done will impact the public far beyond what the 20% reduction would suggest, public health experts told the AJC in interviews.

Many see indiscriminate cutting that has hamstrung remaining workers. It’s an outsize hit to CDC leadership positions, they said. And one significant part of the devastating impact they see comes from wiping out the embedded communications workforce that would typically help shape and communicate the researchers’ reports to the public and health professionals that would put them into action. Instead, Health and Human Services Secretary Robert F. Kennedy Jr. plans to cut down and centralize communications closer to him.

In all these cuts Kennedy, Trump and efficiency adviser Elon Musk have said they want to attack waste, fraud and abuse in the federal government, and restore trust and transparency.

“Over time, bureaucracies like HHS become wasteful and inefficient even when most of their staff are dedicated and competent civil servants,” Kennedy said. “This overhaul will be a win-win for taxpayers and for those that HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

Accurate information, and knowing how to get it and to which communities among the general public, is critical, Fleming said. The whole point is to get that information to doctors and the people so they can make healthy decisions; otherwise the research is useless.

Fleming, CDC workers and other public health communications expert said that mission is now in danger.

“It’s like with the game of Jenga,” Fleming said. “You don’t have to pull out 75% of the pieces for the tower to fall.”

A communications gap

Trump, in nominating Kennedy Jr., said he would restore the health branches as “beacons of transparency.” As for Kennedy, he promised “radical transparency” when he testified before Congress, saying, “Public health agencies should be transparent, and if we want Americans to restore trust in the public health agencies, we need transparency.”

Both in the run-up to his confirmation and afterward, HHS decisions in the opposite direction have caused an uproar.

HHS suspended, for the first time in decades, publication of the CDC’s weekly science report. HHS placed a ban on CDC workers freely communicating with outsiders, including longtime partners in global health organizations. Kennedy moved to eliminate the public comment process from much of the agency’s rulemaking.

Recently, the investigative news outlet ProPublica reported that CDC staff were ordered not to release an assessment of the measles outbreak that stressed the need for vaccines.

The Trump administration laid out the layoff goals and some high-level bullet points on the restructuring the week before it happened. But the layoff form was not detailed, and even after it was issued the layoffs were delayed amid reports that leaders were making changes to the plan after receiving pushback.

When the layoff notices arrived, some employees received incorrect information, such as the wrong total years of service. But those trying to seek corrections found HR had been gutted and they had lost access to their own email.

‘Effective communication is health care’

Among those laid off, according to the circulating lists and employees who spoke with the AJC, were the entire office that fulfills legal open records requests from the public, called Freedom of Information Act requests, and large numbers of communications workers across the agency’s scientific offices who work to get information out to the public in a clear and understandable way.

“Is that crazy?” Fleming said. “Is that crazy that that’s the level of secrecy? That, rather than being open about what is happening we’re having to figure it out in a piecemeal fashion by reports of people whose careers have been terminated.”

Fleming emphasized he did not learn of the cuts from unauthorized employees inside the CDC.

In a written statement to the AJC, HHS said it would still provide information to the public under the new central organization.

“The FOIA (Freedom of Information Act) offices throughout the Department were previously siloed and did not communicate with one another,” HHS wrote. “Under Secretary Kennedy’s vision for a more efficient HHS, these offices will be streamlined, and the work will continue.”

Others have raised concerns about the changes.

“Just talking to the people who’ve been involved in some of these programs, they have not been talked to at all” as the leadership analyzed what to cut, said Jennifer Nuzzo a professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health. “And they haven’t known. And the fact that people showed up Tuesday not knowing that they had been fired until their badges didn’t work: I mean, that clearly is an indication that this was capricious and chaotic,” Nuzzo said. “It absolutely matters. It’s no way to run a business. It’s no way to govern.”

“I’ve been working in this field for 40 years,” said Matt Seeger, a professor of communications in the public health sector at Wayne State University. “I’ve never seen a systematic effort to reduce the capacity of a public health organization to communicate to the public — it’s just anathema. … I think that’s what we are seeing now.”

The attempt to centralize communications will harm people’s ability to make healthy decisions for themselves and their families, he said. “Effective communication is health care.”

He and other communications workers said the wholesale consolidation of CDC communications workers away from the scientists and into management offices was a mistake. The subject matter is complicated, and communicators train for long periods of time to do such work, they maintained.

Another employee who said he was laid off and spoke to the AJC disagreed somewhat, saying there could be room for efficiency. However, the employee, Isaac Michael, now acting as a private citizen, was circulating a letter trying to get Kennedy to save the unique and valuable 40-year-old dataset he said he worked on with maternal health data, called PRAMS.

Meanwhile, within the CDC’s remaining ranks, workers are taking stock of the shaky new reality at staff meetings. One director broke down as he thanked the departed employees for their service and hinted at the impact to come from their absence, according to a recording viewed by the AJC.

“You have saved millions of lives. You have made America safer, stronger and more prosperous,” said the leader, Hank Tomlinson, as center workers rose from their seats to applaud. “You have prevented the development of resistance for global HIV and global TB that keeps Americans with those infections and diseases safe. You have stabilized families, communities, economies and countries. You have prevented failed states. … Thank you, and I am so sorry that this has happened.”

An ‘unfolding disaster’

Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at the University of Pennsylvania, cited the CDC’s recent response to the mpox outbreak as an example of how things should work but likely won’t after the cuts.

“When it happened, we had the expertise, and the federal government’s communication about that was very clear, very effective,” she said. “It got to the people who needed to know, and we quelled the problem.

“We’re not going to be able to do that if those with that kind of expertise aren’t there the next time an unanticipated health challenge emerges,” she said. “And people as a result are going to die.”

Fleming and his colleagues on the advisory committee made much the same case in writing a letter to the CDC director about the cuts, which they called an “unfolding disaster.”

“These sweeping reductions inflict such extensive harm that it is impossible to fully capture their impact in brief,” the letter stated. “Loss of funding and dissolution of programs combined with loss of key CDC staff and leadership will profoundly erode the effectiveness of all the public health efforts and expertise that today keeps Americans safe and healthy.

“Logic and law dictate you suspend these actions until you engage Congress, which has legally authorized the programs you are proposing to eliminate.”

They haven’t received a response.

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