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As the government shutdown has dragged on for 20 days, President Donald Trump and Office of Management and Budget Director Russell Vought have fine-tuned a regimen of pain designed to break the parts of the federal government they see as aligned with Democratic priorities.
In particular, they have attempted to implement draconian public health cuts, some of which have been stayed by the courts, and others of which are being put into effect. The chaos around these cuts, and the lack of clarity as to which layoffs are being implemented and which are being reversed, has added further stress to an already devastated public health system.
In the second week of October, 1,300 Centers for Disease Control and Prevention (CDC) employees were notified of their terminations through “reduction in force” memos. The new assault on an already beleaguered institution means that the CDC has lost roughly one-quarter of its workforce in the past eight months. Those recently targeted, at least initially, include teams dedicated to fighting the growing measles outbreak, pandemic-preparedness experts, Ebola specialists, and others.
At the same time, the White House has managed to find money to keep the military and Immigration and Customs Enforcement going despite the government shutdown — and the Pentagon has juggled funds to keep paychecks flowing to soldiers. As a result, this is a government shutdown like no other — one that is seeing the beefing up of the GOP-coddled government sectors involved in deportations and militarism while eviscerating agencies and departments involved in providing health services to the U.S. population.
The CDC has lost roughly one-quarter of its workforce in the past eight months.
Some of the public health cuts — which initially resulted in the layoffs of the leaders of the measles team, and more than 130 staff members at the National Center for Immunization and Respiratory Diseases — were so manifestly off-the-wall that, within days, they were reversed. But about 600 other firings stuck, according to the National Public Health Coalition, a newly created nonprofit group that has grown out of another organization, Fired But Fighting, the membership of which consists largely of CDC workers who have lost their jobs over the past year.
Those fired over the past couple weeks include staff at the Administration for Strategic Preparedness and Response, the nation’s front-line biodefense experts, who were let go as a part of mass layoffs, as well as several specialists who track cyberattacks on hospitals and attempt to stop them. They also included a raft of “disease detectives” at the Epidemic Intelligence Service.
Other victims of the Trump administration’s onslaught against its own public health agencies include large numbers of people responsible for interpreting, and disseminating, critical public health data. One hundred staff at the National Center for Health Statistics, which tracks health data nationally, were fired, as were staff at the Nutrition Examination Survey, and a number of people who work on the Morbidity and Mortality Weekly Report — although it seems that the MMWR workers were rehired shortly after being let go. CDC staff who brief Congress were let go, as were staff at the center’s library.
This is a government shutdown like no other — one that is seeing the beefing up of the GOP-coddled government sectors involved in deportations and militarism while eviscerating agencies involved in providing health services.
Other critical public health functions have also been put at risk by the cuts. Experts on neurodegenerative prion diseases (which include the so-called Mad Cow Disease that, when it jumped into humans and killed people, caused mayhem in the food industry in Great Britain a generation ago) were dismissed. And at the Substance Abuse and Mental Health Services Administration (SAMHSA), staff responsible for distributing grants to states were terminated. Mental health advocates worry that the broader impact of this will cascade downwards through state and local services for mental health care over the coming months.
A few days later, the Office of Population Affairs, long in the sights of the religious fundamentalists now determining GOP priorities, was gutted by the administration, putting at risk STI resting and the contraception services provided to millions of low-income people around the United States. Staff at OPA were abruptly locked out of their government emails and computers, and they were informed that they were being dismissed as part of the reduction-in-force strategy.
At the same time as it has used the government shutdown as an excuse to decimate contraceptive services, the Trump administration has ramped up its efforts to make fertility treatments more accessible and affordable. This recalibration appears to be part of its strategy of boosting the U.S. birth rate while, simultaneously, making it ever harder for people to retain control over whether or not to conceive children and whether or not to bring pregnancies to term.
The accelerating federal efforts to use the shutdown to further corrode vital public health institutions has been noted, with alarm, at the state level. This past week, 15 Democratic governors banded together to create a Governors Public Health Alliance, intended to provide accurate information on vaccines and on disease surveillance, to coordinate purchases of vaccines, and to liaise with global public health bodies.
In response to the federal war on public health, large states such as California, New York, and Illinois are now flexing their muscles in an effort to fill the information and medical vacuums being left by the feds’ abandonment of the public health field. In the long run, these states may be able to recreate some of the institutions and knowledge-systems attacked by Trump, Vought, and Robert F. Kennedy Jr.
In the near term, however, due to the deliberate and opportunistic actions of the Trump administration, the United States is being left extraordinarily vulnerable to a range of potential health crises.
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