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October 16th, 2025
Another Bad Week for the CDC, and a Personal Note
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, several of those “reductions in force” (RIFs) are reversed. The whiplash reinforces a dispiriting pattern: act first, think later. Call it the chaos formula: “flood the zone” and let the fallout be someone else’s problem, the media (both mainstream and social) scrambling to keep up.
A quick word on the euphemism “RIF.” These are not abstractions. These are human beings who chose public service and were told they were fired for no cause. Imagine opening that email after years of outbreak response. The last time I commented on the chaos at CDC, one of the readers articulated a view that I 100% share:
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 – they cared so much for people they would never meet. My heart aches for this loss, and our patients will be worse for it.
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: Certain quarters harbor such hostility toward government actions — and especially public health policies — that they now dismantle the CDC just because they can.
In support of my theory, however, a physician I know — one of our former trainees here in Boston — shared a strongly worded critique that began, “With all due respect…” (Never a comforting way to begin.) He viewed the CDC’s pandemic response as a “Chernobyl-level catastrophe,” 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.
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.
Here’s my view: Two things can be true at once. Some policies were eventually proven to be flawed and dismantling the country’s premier disease-control agency is a terrible form of self-harm. Regarding the former: 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?
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?
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.
And what then? Rebuild, slowly, during the next public health emergency? Sounds like a recipe for disaster.
Personal note. In other sad news, our dog Louie died this week. We’re heartbroken and grateful for the kind messages so many of you sent. Here’s more information about what happened, plus a remarkable video.
14 Responses to “Another Bad Week for the CDC, and a Personal Note”
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Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
Learn more about HIV and ID Observations.
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Totally agree Paul – I have worked with CDC since I started as state epidemiologist in Massachusetts Department of Public Health in 1985 and then when I moved to NIH in 1989 and for all the years since. These are highly dedicated, smart, caring people who do their best under difficult circumstances – and personally I think COVID was handled as best as it could at the time, with modification as we learned more. It was not a “catastrophe”, it was dealing with a pandemic that was killing hundreds and thousands of people. Do we forget storing dead people in cold trucks in NYC? Dismantling of CDC is what is the catastrophe. So sorry to hear about Louie; we have an elderly 19 year old cat with thyroid disease and asthma (!) who has been with us since a kitten, and expect sometime soon we may have similar issue.
I’m so sorry to learn of Louie dying. I am so sorry about what is happening at CDC. I ask if there are physicians who do fully support this current Presidential administration. Why? We cannot simply dismiss these matters as “politics.” The decimation in terms of health care in our country is not just politics. It is far too harmful to the lives of far too many citizens. I would hope that all who call themselves caring physicians are horrified.
The dismantling and undercutting of the American Public Health system will not only affect the lives and safety of Americans but threatens global health and stability. Decades of progress on stabilizing the HIV/AIDS pandemic will be undermined and result in a new surge of preventable cases along with morbidity and morality that we have not witnessed in years given the developing world losing wide access for ARVs and PrEP. Americans and the global community need to step up and maintain critical public health initiatives like maternal/child vaccinations and HIV/AIDS care to prevent unnecessary loss of life and illness!
My sincere condolences to you and your family Paul on the loss of Louis ️
Re Covid; In April of 2020, NYS department of health did pop up testing for COVID Ab across NYS. At that time, the seroprevalence was 25% in Elmhurst Queens—the NYC area with earliest cases. NYC ILI data showed a bump in school age children in February 2020—likely the invisible first wave of benign COVID. The vaccine efficacy of the ChAdOx vaccine against infection was extremely low ( 38% I think but don’t quote me!) The insistence on following the science oversimplified the rationale for vaccination. The unwillingness to acknowledge the role of asymptomatic covid could have helped defuse the all or none vaccine mandates. Asymptomatic infection fueled the epidemic as well as immunity. There could have been gentler vaccine mandates. We were asked to follow the science but actually we were being asked to follow the scientists. While I agree that the baby is being thrown out with the bath water, I am not shocked or surprised at the lack of ability for the public to understand the importance of public health. Too long health had been conflated with health care without understanding that what really matters are structural factors. Hopefully some of the egregious waste and cost will get the ax too. Without promoting medical literacy, we are doomed. But this too shall pass. Bless the memory of Louie.
I’m not you can overstate how much trust was lost by CDC’s ridiculous COVID policies. Yes, it was a new pathogen, but it was also clear who was dying very early on, and that should have been focused on, instead of masking kids and taking them out of school for 2 years. People lost their businesses and livelihoods because of the CDC’s overreactions.
Additionally, it was CLEAR that young boys were being harmed by the COVID vaccines and nothing was done about the myocarditis issues – just the ACIP rubber stamping things (and basically admitting to that during the meetings.) Many people then lost trust in the ACIP.
The overall problem is that politics got involved: look at what school districts opened early and which didn’t…it’s literally a map of blue for the districts that keep shut and virtual way too long.
Things like the Democrat governors making their own public health department collaboration is another huge mistake. THAT will be a disaster the next time we see a new pathogen. Maybe you can write your next article about that.
So very sorry to hear about Louie, Paul. It sounds like you had a great 2 weeks with him, and made some more beautiful memories. We had something similar happen to a Rat Terrier with a brain tumor. Corticosteroids gave him a brief period of being his old self, playing (hard) with our Pitbull girl, and generally being a hyperactive terrier. When he was gone, as painful as his death was, we had those memories. I hope that as time goes on, you will smile or laugh when you think of him, more often than you feel sad.
I appreciate Dr. Sax broaching this subject. IMO much of the ID/public health community remains in profound denial over the depth of the covid failure and the profundity of public anger, dismay, and disappointment. The only way forward is acknowledgement of the errors and apology. It is unfortunate that Dr. Cohen did not take the opportunity to do this, to dismiss the CDC leaders responsible, and undertake major agency reform during her term. I made some suggestions here: https://www.sensible-med.com/p/to-improve-public-trust-the-cdc-should
It appears that major reform will now come from outside.
I would encourage ID/public health leaders to read the following:
An Abundance of Caution
https://www.amazon.com/Abundance-Caution-American-Schools-Decisions/dp/0262549158
In Covid’s Wake
https://press.princeton.edu/books/hardcover/9780691267135/in-covids-wake
And watch “15 Days”
https://www.15daysfilm.com/
An additional point that must be considered is the political monoculture that has developed in the US ID/public health community. An article in 2020 revealed that 99.9% of political donations from CDC employees went to one political party.
https://www.washingtonexaminer.com/news/450573/filings-show-all-but-five-political-donations-from-cdc-employees-since-2015-have-gone-to-democrats/
Of course, CDC employees are free to give to whatever causes they would like. However, when a field systematically excludes the viewpoints of half of the country, it is not going to make policy that can sustain broad public support. Broadening the worldview and perspectives of the ID/public health community should be an urgent priority.
Certainly, the CDC made some painful errors during the pandemic, including testing, confusion over masking, keeping schools closed too long, overselling the efficacy of the vaccines, and struggling to find a balance between communicating uncertainty and getting the message across clearly. On the other hand, assessing their performance with the benefit of hindsight is not entirely reasonable.
Conservative commentators uniformly blame the CDC for the population’s loss of faith in public health. But is this really true? What about the role of decades of anti-vaccine activism, social media influencers who make money selling bogus “alternative” remedies, and efforts by the Republican Party since the Reagan era to convince people that the government is the cause of all their problems? And sadly, the entire concept of “public good” has become increasingly irrelevant as our society adopts the zero-sum game as a replacement for collective benefit. The CDC did not cause all these problems.
In any case, burning down the CDC is not the right response to the problem.
Very well said, Jonathan. The conservative opinion above demonstrates how politics and social media dysinformation has poisoned public health and healthcare in general.
With regards to the opinions Dr. Sax is referring to it is notable that to my knowledge no estimate of morbidity and mortality rates are ever mentioned had the CDC made the recommendations they favor.
Nor have I ever heard nor read any of the major acolytes of not masking in schools, not giving COVID-19 booster vaccinations etc, including Dr. Joseph Ladapo Surgeon General of Florida, Dr. Jay Bhattacharya NIH Chief or any of the signatories of the Great Barrington Declaration.
Dr. Bhattacharya likes to use the experience of Sweden’s public health interventions but never mentions that the other Scandinavian countries, which combined have a similar number of inhabitants to Sweden had fewer COVID-19 related deaths doing things more in line with what the CDC recommended..
Lastly these folks never seem to express any concerns for the health and welfare of the many older folks who are many of the school bus drivers and other school employees. Also never mentioned are immunosuppressed children nor how they would be protected.
What about “those people” ??
It is interesting that you can tell the political leaning of the commentators by their comments. Science has nothing to do with political parties. If you follow the science, it doesn’t matter whether you’re republican or a democrat: facts are facts and data is data. Many of the mistakes made by the CDC and our health leaders were indeed due to the fact that this was a new and different virus that we have ever seen before. Our health leaders was felt that the steps taken were necessary to protect the public. We were all taught from day one that respiratory viruses were not airborne. There is a long story and interesting story behind that ( see: William F Wells) which is worth knowing, but now we know the truth, and we’ve learned from the epidemic. I looked at some of the alternative ideas, such as not vaccinating kids and letting them get covid because they do not get sick as well the Barrington document. The Barrington document was literally undoable and allowing children to get it, would have increased their risk, especially in young children of severe disease and of giving it to their older family members. The public just wanted to go about life without change. Granted the response had flaws, but nobody is perfect and it became a political rallying. point We had a vaccine in under a year that kept people from going to the hospital and becoming ill, even though it didn’t prevent illness, just like the flu vaccine has been doing for years. Measles now endemic in the US. How about polio, rubella, mumps, diptheria, where will it stop??. Now, we will not have any vaccines because somehow the powers that be have decided it is safer to go back to the 19th century. Blame who you will but this political response is ignorant and even more ill advised than the response to covid. This is all political bullcrap and will do nothing make America Healthy Again. We asked for it and we will get it! Makes me ill!!
Indeed, when you mix politics with public health or medicine, you get politics and disease.
There was a scientifically correct way to deal with COVID.
And then, there was a societally-appropriate way to deal with it.
The latter should have included listening to the complaints of people who were affected by the measures taken to prevent spread of the virus.
The Govt (and CDC) were deaf to the latter; and chose the first path all the way to the bitter end. The same people whose lives may have been saved by these measures were, by then, hopping mad.. and here we are.
I also believe that the same can be said about the free, very generous, handouts given to people during COVID. The same people who took the money in 2021 suffered from inflation (caused by the same handouts), and voted accordingly.
Consequences, and consequences… of the second and third orders…
The CDC, as a federal agency, never had the jurisdiction to close public (or private) schools. The decision to close schools was made at the local or State level throughout the pandemic. In fact, that is why there are so many publications that compared rates of infection in students who had on-site instruction versus remote instruction. [For example, Cooper DM, Zulu MZ, Jankeel A, Ibraim IC, Ardo J, Kasper K, Stephens D, Meyer A, Stehli A, Condon C, Londoño ME, Schreiber CM, Lopez NV, Camplain RL, Weiss M, Golden C, Radom-Aizik S, Boden-Albala B, Chau C, Messaoudi I, Ulloa ER. SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools. Pediatr Res. 2021 Nov;90(5):1073-1080. doi: 10.1038/s41390-021-01660-x. Epub 2021 Jul 24. PMID: 34304252; PMCID: PMC8308070.]