Title: The Latest on The Firings at the CDC

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Brian Lehrer: Brian Lehrer on WNYC. Now we turn to our Health & Climate segment of the week, which we do on Tuesdays on the show to not those not let those issues get lost in the flurry of news that is always attacking us these days or engulfing us at least. Today, the ongoing turmoil at the Centers for Disease Control and the implications for keeping track of what's sickening Americans and what's killing us, the agency terminated around 1,300 employees on Friday, not just furloughed in the shutdown, but laid them off, but then quickly worked to rescind about half of those notices the next day.

That's according to the union that represents federal employees. What happened here? The New York Times reports those rehired were "mistakenly fired in what appeared to be a substantial procedural lapse." At least more DOGE-like sloppiness, we can say. The remaining 600 still laid off were in offices, including the National Center for Injury Prevention and Control, the National Center for Health Statistics, and the CDC's Washington office, which is the channel for communications with Congress, all of that, as described by Axios.

Health and Human Services communications Director Andrew Nixon said the government axed "non-essential employees." Now, on Friday evening, President Trump, speaking to reporters in the White House with Health Secretary Robert F. Kennedy, Jr., behind him, suggested the layoffs would target "Democrat-oriented agencies in response to Democrats not voting to approve a stopgap measure to fund the government." Listen.

Reporter: How many layoffs have you authorized for this first round, and from which agencies?

President Trump: It will be Democrat-oriented because we figure they started this thing, so they should be Democrat-oriented.

Brian Lehrer: While several other agencies were impacted by the layoffs, the CDC was hit particularly hard. I guess they consider it Democrat to count how many people are getting sick or dying, and from what. This is the latest of several incidents impacting the agency, including back in April, and we talked about it at the time when the CDC lost about a third of its staff, though again, many were rehired later.

There was the firing of the CDC's director in less than a month after her hiring. There was the shooting at the CDC's Atlanta headquarters back in August. It itself was a target of political violence. Apoorva Mandavilli is back with us, science and global health reporter at The New York Times. Apoorva, we always appreciate when you come on with us with your knowledge and wisdom. Welcome back to WNYC.

Apoorva Mandavilli: Thank you, Brian.

Brian Lehrer: Listeners, you can participate, too. Anybody have ties to HHS generally or the CDC? Anybody laid off in the last few days? Anybody laid off and rehired in the last few days? Anybody work on any of these data reports which track health and disease outbreaks and causes of death in the United States? Who wants to contribute to this segment with a story or with a question? 212-433-WNYC, 212-433-9692. Fill us in a little more on what I gave in the intro to what happened between Friday and Saturday. How did they go from laying off 1,300 people to recalling 700 of them in a day?

Apoorva Mandavilli: Yes, it's not really clear exactly the level of confusion and when they might have realized that they had made a mistake. The procedural lapse that you mentioned that we wrote about, the level of confusion just in talking to them on Saturday was really significant. Early on Saturday, I heard that the top two people of the measles response team had been laid off, but I can tell you that when I went back to the HHS with that, it seemed like that was a surprise to them.

They kept telling me that nobody in the measles office was touched. I had to explain to them that there is no such thing as a measles office. When there is a measles outbreak, the CDC pulls people from all different parts of the agency, all different parts, because you need people with different kinds of expertise. I don't think that the HHS realized that there is no such thing as an ongoing measles office.

You only put that team together with all these different people from different parts of the agency when there's an outbreak, and when the outbreak goes away, those people go back. I'm not sure they actually intended to get rid of any of those people, but once they discovered that, they had to bring a certain number of people back. The way that the layoffs work, if you bring back one person from a unit that was laid off, you have to bring everybody back. You can't just bring that one person back. I found out that approximately double the number of people who were actually supposed to be laid off that day got notices. They were scrambling to rescind the rest of them.

Brian Lehrer: You know what really made me jump out of my chair when I read it on Saturday, which is what made me want to focus on this as our Tuesday health section topic for today, it was reading that the entire staff of the Morbidity and Mortality Weekly Report had been laid off. Now, this is this is not The New York Times, this is not something that is read en masse by people around the country.

Maybe I reacted because, as some of the listeners know, once upon a time in my secret life, I went to grad school in public health, and it seems like some of those employees have been rehired, but STAT News reports. I'm just going to use their description of it on the Morbidity and Mortality Weekly Report, not your beach reading, but that it has been on pause since the government shutdown began on October 1st.

It says other components of the report, which include supplemental and longer form reports, have also been slowed. I know some of the history here. This was in The Times on this, the publication, its history includes a June 1981 report. Why am I citing 1981? That was when five previously healthy gay men were treated for an unusual pneumonia. It was the first hint of what came to be known as the AIDS epidemic. The Morbidity and Mortality Weekly Report pegged it and put it on a lot of doctors' and public health officials' radar screen. Can you talk a little bit about the place of that particular data collection and dissemination publication, and what might be lost if it is lost?

Apoorva Mandavilli: Yes, it's hugely important. As you noted, it's not beach reading, but it is essential reading for people in public health. You mentioned the first HIV report, but on an ongoing basis, MMWR is where you would expect to see HIV statistics for the country reported in an easy way for the whole public health community in the country to digest. You and I have talked a lot about bird flu.

The case reports for some of the people infected with bird flu have appeared there. During the MPOX outbreak, when the CDC decided on who should get the vaccine and who shouldn't, or who it's not really recommended for, those appeared in the MMWR. One of the last reports before the shutdown was about this new, amazing preventive drug called lenacapavir that people only need to take once every six months.

The guidelines for how US Doctors should prescribe that and how they should think about using it, that all appeared in the MMWR. It is just a hugely important publication, and probably most Americans would recognize this, which is that every time there were new COVID vaccine guidelines, they would show up in there, too. Anything that the vaccine committee decides comes out in the MMWR.

That's how the states know to interpret those guidelines, because they come out in great detail. Then the states and medical organizations can look at those guidelines and go, "Okay, this is how we're going to apply those." Not having that communication from the CDC is massively confusing to state and other public health officials.

Brian Lehrer: Do you see this, as a health reporter for The Times, as part of a concerted effort to-- What's the right term? Just not report or cover up, if we want to be even less generous, what's really going on with health, and then also separately with climate in the country? I know they're talking about ceasing the carbon emissions or greenhouse gas emissions reporting program that's been in effect for a long time.

They don't even want the major fuel installations and things like that to have to report their emissions. That's on the climate side. I think they shut down a number of other health data initiatives. I know I talked to the New York City health commissioner on the show about how they don't seem to want to track health disparities anymore, right? As part of the war on DEI, they don't want to look numerically at how particular diseases or conditions are affecting, let's say, poorer people of color as opposed to more affluent white people. What's the bigger picture, as you've been reporting on it or as you see it, of what they're trying to not let the public know or not even report about data, and why?

Apoorva Mandavilli: To begin with, we don't even know how many people are gone from the CDC. That sort of begins to tell you how little information we have. When we see, "Oh, so many people got laid off or so many people got those layoffs rescinded," we're just guessing at the numbers. A lot of it is self-assembled by the staff with the union. We don't have any clue what's going on there.

Some of the teams lost, as you pointed out, our teams that collect data. Not having people collecting data is a real problem because then you don't know what's going on. They also got rid of this entire system that was supposed to modernize how states collect infectious disease data and report it to the CDC. It was supposed to be something that really brought the CDC into the 21st century, and a flaw that they recognized during COVID, we really, really needed to modernize our data systems.

That was well underway. It's not clear what's going to happen with that now. Even globally, there are these massive surveys that happen in countries across the world that the US Government was helping to pay for, and that tells those governments what to prioritize in their own countries, and those surveys are now defunded by the government. They did manage to get some money elsewhere, but it's just been a very consistent pattern of not just getting rid of public health programs, but then also getting rid of the reporting on those public health programs.

Brian Lehrer: With Apoorva Mandavilli, who reports on science and global health for The New York Times, as we talk about these mass layoffs, not just furloughs during the government shutdown, but layoffs that they're pinning on the government shutdown at the Centers for Disease Control, and the implications for public health reporting, and then eventually potentially for public health itself in the United States.

212-433-WNYC, 212-433-9692, with your comments, questions, or stories. Here's a text that came in at that number. This says, "I think you're misinterpreting Trump's use of the term 'Democrat layoffs.' What he really means," according to this listener, "is the people being laid off are mostly Democrats, union members, and people of color. That's what a lot of these DOGE cuts and other firings by Trump are really designed for: cutting people of color and union members out of the federal workforce. Eventually, he wants to replace them with right-wing whites." Now, that might be overstating it or oversimplifying it, but I wonder if you have any evidence that to any degree what that listener accuses them of is accurate.

Apoorva Mandavilli: Well, we have seen some signs of things like that, right? They've gotten rid of diversity initiatives that pretty much every agency-- and there have been some efforts to look at the race of people who were let go. It does seem like people of color are disproportionately affected. It's not clear whether that's really an accident. It's not as extreme to be able to say with firm conviction that is exactly what's going on, but certainly that the statistics point in that direction.

We also know that some of the things that they've gone after are things that they do believe are Democrat-led initiatives. For example, one of the things that was cut on Friday was the office of the director of the Global Health Center. We know they don't really like global health and global health aid. That's been very low on their priority. That was returned the next day because the leader of the measles team actually works in that office of the director, so they needed her back, but it does seem like they have gone after some initiatives that they believe were put in place by previous Democratic administrations.

When I asked them, actually, on Saturday, about this confusion on why some people were laid off and then their layoffs were rescinded, I was also told that that coding error, that that was because the Biden administration had put those codes in place to confuse them. When I pointed out that, no, that's actually how the CDC system has always worked, then they said, "Well, the Biden administration had four years to fix it, and they didn't fix it." I do think there is an element of wanting to blame the previous Democratic administrations for the problems they're dealing with.

Brian Lehrer: Listener writes, "Vital to understand about the firings at the Center for Injury Prevention. This includes research, programming, and policy development around gun violence, sexual violence, and intimate partner violence, all highly politicized public health arenas." This Listener writes, "Painted as too woke and encroaching on people's personal liberties." Does that sound right to you if you've reported on this? [silence] Have you done anything on the Center for Injury Prevention? Did we lose Apoorva Mandavilli?

Apoorva Mandavilli: I'm sorry. Can you hear me?

Brian Lehrer: I'm sorry. You're back now. Yep. I'm not sure what happened. Go ahead.

Apoorva Mandavilli: That's not part of my domain, but I will say I've been following it just in this sort of layoff, not laid off, all of that structure. One of the things that is lost is the Office of Science within that center. That goes back to what we were talking about, about not wanting to know what is actually the correct way to do things, and also what is the correct way to report on those things.

One of the other things that's lost within that Injury Prevention Center is also the Office of Violence Prevention Policy Office. There are definitely some things lost that are involved in, for example, collecting data on gun violence and all of those things. It's not sure that they're coming back.

Brian Lehrer: Listener writes, "Do individual states have their own version of CDC for their population?" That's an interesting question, because if the states keep track of public health trends, disease outbreaks, and so forth, then maybe it's redundant that the federal government do it, but I don't know.

Apoorva Mandavilli: They don't. States definitely don't have their own CDC, and they don't even have the money to have big operations. When they are hit with a new disease, like for example, when MPOX was spreading, they get on the phone with the CDC. It's impossible for every state to have experts in every disease. They rely heavily on the CDC's expertise.

They call people, even for something like food safety, they'll call the CDC and ask, "What should we do with this kind of food-borne illness outbreak? What precautions should we take?" To lose that expertise is a huge hit. Then the other thing that I think has gotten lost a little bit in the conversations about this is that about 80% of the CDC's budget goes to states and jurisdictions. It doesn't stay at the CDC. When you're cutting the CDC's budget, you are essentially cutting state health departments' budgets. Some states have already had to lay off lots and lots of people because they can't even support their own public health teams. They're being cut off multiple levels here.

Brian Lehrer: Listener writes, "How are they allowed to fire union workers?"

Apoorva Mandavilli: It's a good question.

Brian Lehrer: Good question, right? Because there are contracts, collective bargaining agreements, presumably.

Apoorva Mandavilli: It's an excellent question. I think the union that represents a lot of CDC employees is on the case, but we'll have to see what they end up being able to accomplish.

Brian Lehrer: Again, this may be beyond the scope of your reporting, but are there criteria that the government has to meet for laying off workers? When we're talking about layoffs, that's not firing people for poor job performance. Layoffs are usually, I think, in most organizations, firing people for economic reasons, but the government shutdown is temporary. Eventually, it's going to end.

Usually, the government gets fully funded at that point in whatever the agreement is from the beginning of the fiscal year, October 1, which is when the shutdown starts. People get back pay. In this case, Trump says, "Oh, this time maybe people won't get back pay." They're doing this, which is different, laying off people, not just furloughing them until the shutdown ends. Does there have to be a rationale under these collective bargaining agreements, which this wouldn't seem to meet, assuming that the government is retroactively fully funded once they come to an agreement?

Apoorva Mandavilli: Well, they can, in theory, lay people off because they say that they are reorganizing an organization. In the case of the CDC and the HHS overall, for example, they've said repeatedly that what they're trying to do is reduce duplication. I will say that that's not entirely without merit, that point. There is some duplication across federal agencies, and I think they're trying to get rid of some of it.

Some of it is not just duplication, but they do have to get rid of entire units because of the way that those layoffs need to be. They can't just fire the people they don't like. That has been, I think, limiting for them because they don't understand the things that they lose. Then there's a huge outcry, and then those people get brought back. Several of the HR departments were gone on Friday, and so were several departments of communication.

One of the things they've said is, from now on, all communications across the HHS will be centralized, so we don't need all these other communications offices at these different departments, but again, it takes expertise to communicate things about specific diseases. It's not something you can really centralize. Yes, you can reorganize. You can lay people off, but where does that actually leave you when you need to get things done?

Brian Lehrer: Did the staff numbers at the CDC expand under President Biden, or let's say during the pandemic, as a result of the pandemic? Because I've seen some justification for trimming the staff of the Centers for Disease Control based on recent expansion that they now don't need anymore. Did it expand a lot?

Apoorva Mandavilli: It did expand significantly. There were a lot of people hired because they needed the manpower. They needed people to deal with the pandemic. They were putting out very detailed reports of infections. We were all looking at it all the time, right? Somebody needed to do that work and all the work related to the vaccines. There were a lot of people hired. That's also true at state and local public health levels.

They also got more funding, but what has happened this year is that either the funding has been pulled really abruptly, not giving those state and local departments time to think about how else they can accommodate those people, or who exactly they need to lay off. Give them some time to basically prepare for that loss. They were all preparing for this to happen sometime next year.

That happened very abruptly. Then, at the CDC, in theory, yes, you can say we've hired a lot of people, and we need to get rid of people that were hired that we no longer need, but that's not how these layoffs have happened. Those layoffs have happened all across the CDC, not just necessarily in the units that did grow.

Brian Lehrer: I want to acknowledge before we end that a listener texted, "Please mention that a police officer died in the CDC shooting." That was when somebody was shooting at CDC headquarters in Georgia earlier this year. Listener writes, "This anti-public health rhetoric has had deadly consequences and will have more." I think, obviously, we think any act of political violence is horrendous, no matter who it's aimed at, but that death didn't get a lot of press at the time.

Just this detail from the BBC, just so we honor at least one person who died not of a disease, but of political violence aimed at the Centers for Disease Control, the BBC version said a man who fired hundreds of rounds of ammunition at the US Centers for Disease Control and Prevention headquarters last week at that time had expressed distrust of the COVID-19 vaccine. Investigators say Police Officer David Rose, 33, who graduated from the police academy in March, died in hospital after he was wounded.

Where does this all land? Last question. I guess it's impossible to really say, but what do you see as the next turns of the screw on defunding the Centers for Disease Control and the data that it collects about public health, and who has any power to fight whatever they want to do that may be seen as excessive?

Apoorva Mandavilli: I'll answer that question, but before we do, I just do want to take a minute to say that it's really tragic that that police officer died, but also, I was in touch with my CDC sources that Friday evening and all that weekend, and they were terrified and traumatized. It's really quite surprising to me that essentially what's the terrorist attack on a federal building has gotten so little attention.

I know that there are many, many people I've talked to who didn't even know this had happened, and that's shocking. I was getting texts from CDC employees who were in lockdown that night until midnight in many cases, sending pictures of their offices that were riddled with bullet holes. Some of them actually had to run back into the building while there were bullets whizzing over their shoulders. It was terrifying for them. I'm not sure that they've gotten, really, the level of empathy that they deserve for having gone through something like that.

Brian Lehrer: Yes.

Apoorva Mandavilli: As far as what's their future, I can tell you that some of those same employees are feeling like the CDC is not going to survive. I actually wrote a story in August when many things have happened, even since then. People said that at the time that the CDC seems like it's on its death knell, and anything can really finish it off at this point. More things have happened. Really, the people that I talk to on a regular basis, the public health experts, feel that the CDC that they knew is already gone to a large extent, and if it can be built back at some point, it's going to take a very long time.

Brian Lehrer: Apoorva Mandavilli, science and global health reporter at The New York Times, we always appreciate when you come on with us. Thank you so much.

Apoorva Mandavilli: Always a pleasure, Brian.

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