Several high-ranking public health officials have resigned since the Trump administration took office. Some left before inauguration, some left following disagreements with new leadership, and others left unexpectedly.
These mass layoffs are largely linked to the Department of Government Efficiency (DOGE), run by billionaire Elon Musk, which has been firing people to achieve its stated goal of lofty cost cutting.
In total, 24,000 federal employees have been let go, though a federal judge ruled on March 14 that they should be reinstated. NPR reported last month that this includes 1,300 staffers at the CDC and between 1,000 to 1,200 at NIH.
But employees in the affected federal agencies are concerned the cuts will not only hurt patients and public health, but also make the government less efficient.
“Of all the places to look for efficiency in a country that just came out of a pandemic, maybe CDC isn’t the place,” Itir Cole, a former US Digital Service (USDS) employee, told Healthcare Brew. USDS works with federal agencies as a consultancy on IT matters.
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Cole worked with USDS for two years, most recently as a CDC team lead, which meant she helped collect data and catch infectious diseases before they became a bigger problem.
For example, if a patient turned up in the emergency room with an unknown and unidentifiable condition, the clinicians would record questions about things like what foods they had eaten or if they had interacted with animals to track down the cause.
This is the same system experts used to catch Covid-19, she said.
Up until Inauguration Day on Jan. 20, everything was business as usual, Cole said, except for some additional transition planning.
Then in late January, she got the “fork in the road” email, which offered pay through September to federal employees who resign. She knew cuts were coming and decided to resign, writing about her decision in a LinkedIn post. She said she didn’t agree with Musk’s “method of trying to find efficiencies.”
Cole’s last day was Feb. 14, and on that same day, most of her team was let go, she said. To her knowledge, only one person is left.
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Arielle Kane worked for the Centers for Medicare and Medicaid Services (CMS) Innovation Center, which looks for new ways to pay for and deliver care that can cut costs and improve patient outcomes. Specifically, she was working on the Transforming Maternal Health (TMaH) model.
Launched on Jan. 1, her team was collaborating with 15 states and their Medicaid programs to implement new evidence-based strategies and improve maternal health outcomes. But on Feb. 15, after less than a year into her first role with the federal government, she was fired. Now the team is down to half its original size, she said.
“When you’re talking about dramatically changing things or firing people so abruptly that they don’t even get to say goodbye to their colleagues or pass along documents…it inhibits the work that is being done, but it also weakens the integrity of the federal government overall,” she said.
USDS, the CDC, and CMS did not respond to requests for comment.
Finding Creating inefficiencies
While DOGE states its goal is to make the government more efficient, Kane and Cole both said having fewer employees in these agencies will do the opposite.
“The job at that point becomes just responding to fires or responding to requests instead of having enough time and brain space to think about the future, plan, strategize, and innovate,” Cole said.
Cole’s team was working to modernize the data collection system, which she said was 20 years old and needed improvements to keep up with future public health issues, and create systems that are “resilient when a pandemic comes through.” Given the complexity of the program, she said she can’t see the system succeeding with so few people working on it.
“There are certain things that may not be a profitable business in the market, but it is a worthwhile thing the federal government should do to protect its people. This program, I would say, is one of those things,” Cole said.