A new report from the NYT tells a chilling story of how the Centers for Disease Control has been hollowed out over the last 18 months under Trump and RFK Jr. We have been covering this story as it has been developing, but it is useful to take a look at where we are and the totality of the destruction that has occurred.
The CDC has been arguably the premiere organization in the world to track illness, gather data, develop recommendations, and promote public health. They are critical to detecting and responding to public health emergencies. They have been relied upon by state and local governments, as well as people around the world, for their guidance and help. Over the last few decades the CDC has been one of my go-to places for definitive health information.
In under two years, this organization has been utterly devastated.
This starts with the fact that the CDC has lost 30% of it’s staff over this short period of time. RFK defenders claim that the agency was bloated and wasteful, but this is just a baseless rationalization. The CDC’s workforce has been relatively flat in recent decades, with a small bump during COVID. After the recent cuts the CDC now has almost 10% fewer employees than it did in 2012. Historically, the CDC has always been stretched thin. It’s budget has also been relatively flat, which means functionally decreased due to inflation.
By all accounts, the CDC was a lean and underfunded organization, doing heroic work that was relied upon by health professionals around the world. Now, former and current CDC employees tell a story of utter collapse. There are simply too few people to do the necessary work of the agency. Anyone who has worked for a large organization likely has a good sense of how difficult it is to deal with even a small reduction in staff. Those remaining have to cover more tasks, everything becomes less efficient as you spend more and more time just doing damage control. There is a critical point below which the entire enterprise is overwhelmed with dysfunction. The CDC appears to be well below that threshold.
Further, these cuts have not been random but appear to have disproportionately affected scientists and those in leadership positions. They didn’t just prune the janitorial staff – they gutted the people making the organization function. Of the 20 director positions at the CDC, all but one are now staffed by temporary appointees. Some entire programs have been shuttered, like smoking prevention and elder safety.
Worse still – the number of political appointees has dramatically increased. Instead of 2-3 political appointees overseeing the organization while scientists and experts get the work done, the agency is now run by political appointees. According to reports, those workers remaining spend a lot of their time chasing down every crackpot theory RFK Jr wants to follow, rather than doing good science. They spend their time trying to prove already debunked theories, like that maternal vaccines cause autism.
The CDC has been unable to fulfill basic functions, like putting out vaccine recommendations for the coming flu season. They are delayed in responding to requests for help from state and local health departments, and some requests go unfulfilled.
Meanwhile, the US is seeing a dramatic increase in measles. We have more cases this year so far than any in the last 35 years. The US is at risk of losing its elimination status (and we may already have done so – but the CDC is failing to track the data that would tell us).
The current Ebola outbreak has seen 8,067 confirmed cases and 3,901 deaths, the second largest outbreak in history, and it is not done yet. In the 2016 outbreak the CDC send 2,000 workers to help contain the deadly disease. Now the CDC has sent only 100 workers. The CDC is focused on preventing cases from reaching the US, not on containing the outbreak itself.
The response to these two outbreaks, measles and Ebola, by the CDC under RFK has been anemic and ineffective. We should hope that these are the worst disease outbreaks we face under his regime. Imagine if we face another epidemic or pandemic during this epic dysfunction.
This is what happens when you put an incompetent, unqualified, conspiracy mongering pseudoscientist in charge of America’s public health. This is what happens when you prioritize ideology and a political agenda ahead of good science and the public health. I can only hope that the public learns a lesson from all this, without having to pay too high a price.
The CDC Has Been Hollowed Out