{"id":11675,"date":"2025-10-16T18:31:38","date_gmt":"2025-10-16T22:31:38","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=11675"},"modified":"2025-10-17T05:18:44","modified_gmt":"2025-10-17T09:18:44","slug":"another-bad-week-for-the-cdc-and-a-personal-note","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/another-bad-week-for-the-cdc-and-a-personal-note\/2025\/10\/16\/","title":{"rendered":"Another Bad Week for the CDC, and a Personal Note"},"content":{"rendered":"

\"\"On Friday night, news broke that more than a thousand CDC staff received layoff notices<\/a> — including people who track measles outbreaks, analyze data to craft policy, monitor employee safety, and, remarkably, recent Epidemic Intelligence Service (EIS) fellows (the early-career epidemiologists who often show up first when something alarming appears).<\/p>\n

Now, nearly a week later, several of those \u201creductions in force\u201d (RIFs) are reversed. The whiplash reinforces a dispiriting pattern: act first, think later. Call it the chaos formula:\u00a0 “flood the zone” and let the fallout be someone else\u2019s problem, the media (both mainstream and social) scrambling to keep up.<\/p>\n

A quick word on the euphemism \u201cRIF.\u201d These are not abstractions. These are human beings who chose public service and were told they were fired for no cause.<\/em> Imagine opening that email after years of outbreak response. The last time I commented on the chaos at CDC<\/a>, one of the readers articulated a view that I 100% share:<\/p>\n

My interactions with the rank and file members of the CDC when I have reached out during Ebola, mpox, and individual patients with rare parasitic infectious diseases showed their wide-open hearts and their knowledge \u2013 they cared so much for people they would never meet. My heart aches for this loss, and our patients will be worse for it.<\/p><\/blockquote>\n

In that post, I further argued that anger over COVID-19 policies fueled these attacks on the CDC. Some of this site’s loyal readers disagreed, saying this would have happened anyway. Their view:\u00a0 Certain quarters harbor such hostility toward government actions — and especially public health policies — that they now dismantle the CDC just because they can.<\/p>\n

In support of my theory, however, a physician I know — one of our former trainees here in Boston — shared a strongly worded critique<\/a> that began, \u201cWith all due respect\u2026\u201d (Never a comforting way to begin.) He viewed the CDC\u2019s pandemic response as a \u201cChernobyl-level catastrophe,\u201d citing examples such as school closures, toddler masking, the six-foot rule, and universal booster mandates. His plea was for the agency to acknowledge its mistakes and rebuild trust.<\/p>\n

Not long after, I received a note from a government official who, while less fiery in tone, made a similar point. He wrote that we in the infectious diseases and public health communities underestimated how angry many Americans felt about being told to follow rules that, to them, never made sense — especially after the first year of the pandemic. He, too, cited the same examples, with a particular emphasis on school closures and rules about childhood masking, both acting as flash points that eroded public confidence and frustrated even medically sophisticated people.<\/p>\n

Here’s my view: Two things can be true at once. Some policies were eventually proven to be flawed and<\/em> dismantling the country\u2019s premier disease-control agency is a terrible form of self-harm. Regarding the former:\u00a0 In the context of the tremendous unknowns of dealing with a pathogen never before encountered on this planet, could we expect perfection on policies and guidance from any individual or any group?<\/p>\n

And were the missteps so grave that we should now systematically gut the institution that in recent history led the responses to Zika, Ebola, and the 2009 H1N1 pandemic? I don’t remember anyone complaining then. If avian influenza accelerates, who coordinates a national response? Do we really want measles to become re-established as a childhood illness in this country without anyone keeping track of outbreaks and trying to intervene? It looks like dengue and Chagas disease are about to take hold here — is anyone watching that? What’s going to happen the next time we need to consult someone with a rare parasitic disease?<\/p>\n

We can debate pandemic guidance (please do, for transparency’s sake), past and future. But if we keep cutting the CDC off at the knees, someday there may be nothing left to reform, the damage will be irremediable.<\/p>\n

And what then? Rebuild, slowly, during the next public health emergency? Sounds like a recipe for disaster.<\/p>\n

Personal note.<\/strong> In other sad news, our dog Louie died this week. We\u2019re heartbroken and grateful for the kind messages so many of you sent. Here’s more information about what happened<\/a>, plus a remarkable video.<\/p>\n","protected":false},"excerpt":{"rendered":"

On Friday night, news broke that more than a thousand CDC staff received layoff notices — including people who track measles outbreaks, analyze data to craft policy, monitor employee safety, and, remarkably, recent Epidemic Intelligence Service (EIS) fellows (the early-career epidemiologists who often show up first when something alarming appears). Now, nearly a week later, […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,9],"tags":[],"class_list":["post-11675","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-policy"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/11675","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=11675"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/11675\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=11675"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=11675"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=11675"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}