The CDC Diaspora Fights Back

Atlanta, Georgia
THE SCIENTISTS GATHERING INSIDE a cavernous convention hall here this week weren’t chanting or carrying protest signs or wearing frog costumes. But over the course of four days, they engaged in what felt like their own brand of political resistance.

They were there for IDWeek, the annual gathering of professional societies that work on infectious diseases. And in many ways the meeting was like any other medical conference. Participants attended mostly narrow, technical lectures on topics like tuberculosis, HIV, and tropical diseases—one session had the title of “Big Beasts of Clinical Mycology”—with occasional breaks for networking at receptions and strolling among the vendors in the exhibit hall.

But the meeting at the Georgia World Congress Center, which goes four stories down into the side of the hill, so that riding the escalators down was a bit like entering a concrete bunker, was not your typical medical conference.

This was the first IDWeek gathering of Donald Trump’s second presidency, meaning it was the first since Robert F. Kennedy Jr.—Trump’s Health and Human Services Secretary—launched his assault on federal public health institutions. That includes the Centers for Disease Control and Prevention, whose Atlanta headquarters are just a few miles away and where there are still bullet dimples in the walls from the August assault by a gunman angry about COVID-19 vaccines.

The difference was impossible to miss, attendees told me, and it started with who was there—or, more accurately, who was not.

CDC staff traditionally attend IDWeek in large numbers, to present and to learn—and to make connections for future collaborations, including in a potential crisis. A year ago, when the Atlanta location for this year’s meeting was announced, everybody assumed CDC attendance would be higher than usual because it would be almost literally down the street.

But no CDC staff were present in their official capacity this week. The immediate reason was the federal shutdown, which includes government-wide rules forbidding conduct of most normal business. But several former officials who were at the meeting told me the agency’s new political leaders had made clear long before the shutdown that they would be dramatically limiting attendance and presentations.

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HHS officials did not confirm that, or (yet again) respond to my queries for this article. But scaling back CDC participation in the conference would be consistent with Kennedy’s contempt both for expertise and for experts—and with the way he has treated the CDC more generally, through a series of cuts, firings, and forced resignations that have effectively wiped out whole divisions.

One reason I came to Atlanta this week was to get a better sense of just how big a toll Kennedy’s actions had taken. The answers I got were not exactly encouraging. The attendees I met (along with some CDC veterans I reached separately) painted a picture of an agency that is struggling to carry out some basic operations, and in which scientists are subject to a level of political control that goes well beyond anything in CDC history.

In the aftermath of this devastation, however, something quite unique to the scientific community has arisen: a coordinated effort to step into the void the CDC is leaving, as a source of information the public can trust. Nobody thinks these efforts can come close to making up for what CDC is no longer doing. But there was a discernible sense that the effort itself has value—that by taking action the scientists were making clear not only their determination to call out the administration’s attacks, but to do something about it.

THE FIRST STEP in pushing back against the administration has been to catalogue the damage it has done. But that is proving a difficult task, because HHS has not published detailed lists of who’s gone and who’s left—or how many have departed. Making things even more difficult is the ambiguous status of many employees, since pending lawsuits have blocked some layoffs and a number of people are on forced administrative leave, being paid but not actually at work or doing their jobs.

And all of that is separate from the government shutdown, which has most of the agency’s workers on furlough.

The best estimates come from crowdsourcing efforts by former employees. Acting through existing or new groups, they’ve combined what they’re hearing from old colleagues along with information from unions. And based on that, it looks like the CDC has effectively lost between a fourth and a third of the roughly 12,000 people who were working there as of January, according to Barbara Marston, who retired from the CDC in 2022 and is coordinating a network of former staff.

These losses are scattered across the agency, IDWeek attendees told me—sometimes in ways that reflect obvious ideological motives, like the shuttering or hollowing out of offices that deal with equity or LGBTQ issues, but sometimes in ways that don’t appear to have any particular logic other than an imperative to cut staffing levels.

“I’d describe the CDC as Swiss cheese, with holes throughout it, or maybe Jenga, where you’ve built it up and then taken out a whole bunch of blocks,” Abigail Tighe, founding member of a group of former CDC employees called the National Public Health Coalition, told me. “We are not tipping over yet, but we are very close, in a couple of different ways.”

Another way to think about the cuts and their effects is to think about the types of personnel who have been lost. And one underappreciated category, attendees told me, were staff in departments like human resources or accounting whose positions might have looked ancillary or less essential to Trump administration budget cutters, but whose day-to-day work is essential for an agency that has to award and manage grants—or dispatch personnel to work with cities and states.

And then there are the changes at the very top.

JIM O’NEILL, THE ACTING CDC DIRECTOR who took over after Kennedy forced out Susan Monarez, is believed to be the first non-scientist to head up the agency, even on a temporary basis. But more disturbing to some of the attendees I met was the fact that the other senior members of the agency director’s office—typically about ten in all—appear to be mostly or all political appointees, rather than career officials, as in the past.

“When I was in the CDC Office of the Director, there was one political appointee—and that was the director,” Kathleen Ethier, a twenty-six-year CDC veteran who left in January, told me. “Now I think—I can’t verify the number—but I think it’s about ten. As best as I can tell, there is no one in a leadership position at CDC who is not a political appointe