Americans have plenty to worry about these days when it comes to infectious-disease outbreaks. This is the worst flu season in 15 years, there’s a serious measles outbreak roiling Texas, and the threat of bird flu isn’t going away. “The house is on fire,” Denis Nash, an epidemiologist at CUNY School of Public Health, told me. The more America is pummeled by disease, the greater the chance of widespread outbreaks and even another pandemic.
As of this week, the federal government may be less equipped to deal with these threats. Elon Musk’s efforts to shrink the federal workforce have hit public-health agencies, including the CDC, NIH, and FDA. The Trump administration has not released details on the layoffs, but the cuts appear to be more than trivial. The CDC lost an estimated 700 people, according to the Associated Press. Meanwhile, more than 1,000 NIH staffers reportedly lost their jobs.
Perhaps as notable as who was laid off is who wasn’t. The Trump administration initially seemed likely to target the CDC’s Epidemic Intelligence Service, a cohort of doctors, scientists, nurses, and even veterinarians who investigate and respond to disease outbreaks around the world. Throughout the program’s history, EIS officers have been the first line of defense against anthrax, Ebola, smallpox, polio, E. coli, and, yes, bird flu. Four recent CDC directors have been part of the program.
The layoffs were mostly based on workers’ probationary status. (Most federal employees are considered probationary in their first year or two on the job, and recently promoted staffers can also count as probationary.) EIS fellows typically serve two-year stints, which makes them probationary and thus natural targets for the most recent purge. EIS fellows told me they were bracing to be let go last Friday afternoon, but the pink slips never came. Exactly why remains unclear. In response to backlash about the planned firings, Musk posted on X on Monday that EIS is “not canceled” and that those suggesting otherwise should “stop saying bullshit.” A spokesperson for DOGE did not respond to multiple requests for comment.
This doesn’t mean EIS is safe. Both DOGE and Robert F. Kennedy Jr., Donald Trump’s newly confirmed health secretary, are just getting started. More layoffs could still be coming, and significant cuts to EIS would send a clear message that the administration does not believe that investigating infectious-disease outbreaks is a good use of tax dollars. In that way, the future of EIS is a barometer of how seriously the Trump administration takes the task of protecting public health.
Trump and his advisers have made it abundantly clear that, after the pandemic shutdowns in 2020, they want a more hands-off approach to dealing with outbreaks. Both Trump and Kennedy have repeatedly downplayed the destruction caused by COVID. But so far, the second Trump administration’s approach to public health has been confusing. Last year, Trump said he would close the White House’s pandemic office; now he is reportedly picking a highly qualified expert to lead it. The president hasn’t laid out a bird-flu plan, but amid soaring egg prices, the head of his National Economic Council recently said that the plan is coming. Kennedy has also previously said that he wants to give infectious-disease research a “break” and focus on chronic illness; in a written testimony during his confirmation hearings, he claimed that he wouldn’t actually do anything to reduce America’s capacity to respond to outbreaks.
The decision to spare EIS, at least for now, only adds to the confusion. (Nor is it the sole murky aspect of the layoffs: Several USDA workers responding to bird flu were also targeted, although the USDA told me those cuts were made in error and it is working to “rectify the situation.”) On paper, EIS might look like a relatively inconsequential training program that would be apt for DOGEing. In reality, the program is less like a cushy internship and more akin to public health’s version of the CIA.
Fellows are deployed around the world to investigate, and hopefully stop, some of the world’s most dangerous pathogens. The actual work of an EIS officer varies depending on where they’re deployed, though the program’s approach is often described as “shoe-leather epidemiology”—going door to door or village to village probing the cause of an illness in the way a New York City detective might investigate a stabbing on the subway. Fellows are highly credentialed experts, but the process provides hands-on training in how to conduct an outbreak investigation, according to Nash, the CUNY professor, who took part in the program. Nash entered EIS with a Ph.D. in epidemiology, but “none of our training could prepare us for the kinds of things we would learn through EIS,” he said.
In many cases, EIS officials are on the ground investigating before most people even know there’s a potential problem. An EIS officer investigated and recorded the United States’ first COVID case back in January 2020, when the virus was still known as 2019-nCoV. It would be another month before the CDC warned that the virus would cause widespread disruption to American life.
More recently, in October, EIS officers were on the ground in Washington when the state was hit with its first human cases of bird flu, Roberto Bonaccorso, a spokesperson with the Washington State Department of Health, wrote to me. “Every single outbreak in the United States and Washington State requires deployment of our current EIS officers,” Bonaccorso said.
EIS is hardly the only tool the federal government uses to protect the country against public-health threats. Managing an outbreak requires coordination across an alphabet soup of agencies and programs; an EIS fellow may have investigated the first COVID case, but of course that did not stop the pandemic from happening. Other vital parts of how America responds to infectious diseases were not spared by the DOGE layoffs. Two training programs with missions similar to that of EIS were affected by the cuts, according to a CDC employee whom I agreed not to identify by name because the staffer is not authorized to talk to the press.
The DOGE website boasts of saving nearly $4 million on the National Immunization Surveys, collectively one of the nation’s key tools for tracking how many Americans, particularly children, are fully vaccinated. What those cuts ultimately will mean for the future of the surveys is unknown. A spokesperson for the research group that runs the surveys, the National Opinion Research Center, declined to comment and directed all questions to CDC.
And more cuts to the nation’s public-health infrastructure, including EIS, could be around the corner. RFK Jr. has already warned that certain FDA workers should pack their bags. Kennedy has repeatedly claimed that public-health officials inflate the risks of infectious disease threats to bolster their importance with the public; EIS fellows are the first responders that hit the ground often before public officials are even sounding the alarm bells.
Ironically, the work of the EIS is poised to become especially pressing during Trump’s second term. If measles, bird flu, or any other infectious disease begins spreading through America unabated after we have fired the public-health workforce, undermined vaccines, or halted key research, it will be the job of EIS fellows to figure out what went wrong.
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