Trump cuts target next generation of scientists and public health leaders

Washington: The notices came all weekend, landing in the inboxes of federal scientists, doctors and public health professionals: Your work is no longer needed.

At the National Institutes of Health, the nation's premier biomedical research agency, an estimated 1,200 employees -- including promising young investigators slated for larger roles -- have been dismissed.

At the Centers for Disease Control and Prevention, two prestigious training programs were gutted: one that embeds recent public health graduates in local health departments and another to cultivate the next generation of doctoral laboratory scientists. But the agency's Epidemic Intelligence Service -- the "disease detectives" who track outbreaks around the world -- has apparently been spared, perhaps because of an uproar among alumni after a majority of its members were told Friday that they would be let go.

President Donald Trump's plan to shrink the size of the federal workforce dealt blows to thousands of civil servants in the past few days. But the cuts to the Department of Health and Human Services -- coming on the heels of the coronavirus pandemic, the worst public health crisis in a century -- have been especially jarring. Experts say the firings threaten to leave the country exposed to further shortages of health workers, putting Americans at risk if another crisis erupts.

Public health officials, for instance, have been tracking a lethal strain of bird flu that they say remains a low risk to Americans. In recent weeks, however, it claimed its first victim in the United States -- a patient in Louisiana who had been exposed to a backyard flock.

"It's not canceled," Elon Musk, the billionaire in charge of the downsizing, wrote on social media in response to the blowback about the purported dismantling of the Epidemic Intelligence Service.

The firings have also excised the next generation of leaders at the CDC, the NIH, the Food and Drug Administration and other agencies that the department oversees.

"It seems like a very destructive strategy to fire the new talent at an agency, and the talent that's being promoted," said Dr. David Fleming, the chair of an advisory committee to the CDC director. He added, "A lot of energy and time has been spent in recruiting those folks, and that's now tossed out the window."

The form-letter emails told recipients they were "not fit for continued employment" because their "ability, knowledge and skills do not fit the agency's needs" and their "performance has not been adequate."

On Monday, eight officials who led health agencies under President Joe Biden -- including the heads of the CDC, the NIH and the FDA -- issued a joint statement denouncing the cuts. It listed a string of initiatives, from combating the opioid epidemic to bringing primary care to rural communities, that are "vital to the economic security of our nation" and are carried out by public servants.

"These individuals are not numbers on a spreadsheet," they wrote, adding, "We owe them a debt of gratitude, not a pink slip."

The dismissals have also rattled graduate students eyeing careers in public health and the biomedical sciences.

"I just lectured to 42 graduate students this morning whose whole future at this point is not clear," said Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "Will they have jobs? Will there be public health employment in the future?"

A spokesperson for the Health and Human Services Department said it was following administration guidance and "taking action to support the president's broader efforts to restructure and streamline the federal government."

"This is to ensure that HHS better serves the American people at the highest and most efficient standard," the spokesperson, Andrew Nixon, said in an email Friday.

As with the rest of the government, the cuts are aimed at probationary employees with less than a year on the job. But the cuts come as Robert F. Kennedy Jr., a prominent vaccine skeptic and newly confirmed health secretary, is starting in his job. Officials at the NIH are especially concerned that he might target more senior employees by asking for their resignations.

Kennedy has repeatedly said he intends to clean house at various federal agencies. He warned that he would cut 600 jobs at the health institutes. In October, after merging his presidential campaign with that of Trump, he instructed FDA officials to "preserve your records" and "pack your bags."

About 700 staff members were cut at the FDA, including lawyers, doctors and doctorate-level reviewers in the medical device, tobacco, food and drug divisions.

The cuts over the weekend have touched all manner of health workers. They are not only scientists and disease hunters but also administrators who oversee grant proposals, analysts figuring out new ways to cut health care costs, and computer specialists who try to improve the government's antiquated systems for tracking health information.

Arielle Kane was hired in May to work on a new project that aimed to improve maternal health outcomes in Medicaid. She was assured by a manager Friday that her job at the Centers for Medicare and Medicaid Services was safe. On Saturday afternoon, she received an email that she had been fired for poor performance.

"I was just so excited to be working on maternal health and on Medicaid," Kane said. "It feels extra enraging to have finally gotten the job I wanted, to have just had a good performance review and then be so unceremoniously fired for poor performance."

The Laboratory Leadership Service, a prestigious training fellowship at the CDC, was hit hard, according to three people familiar with the program. Of its 24 fellows, four were protected because they are in the Commissioned Corps of the U.S. Public Health Service, a uniformed branch whose members work across government. The other 20 were let go.

The program, begun in 2015 in response to quality and safety concerns in laboratories, is a sister program to the more prominent Epidemic Intelligence Service, or EIS. It was developed to strengthen ties between epidemiologists and laboratory scientists. Applicants must hold a doctorate in microbiology, organic chemistry or another laboratory-related discipline.

Some of the fellows are assigned to state and local public health laboratories. Others work at the CDC in Atlanta. During outbreaks like the coronavirus pandemic, they are sent into the field with EIS officers.

"EIS has such a strong culture and alumni; the response will be, 'Thank God EIS was spared,'" said Dr. Michael Iademarco, who helped create the Laboratory Leadership Service when he was at the CDC. "And my response will be, 'Yeah, but we just killed the promising half of field investigation, because nobody knows about it.'"

The agency has also lost its presidential management fellows, who were assigned to the CDC under a decades-old government initiative that describes itself as "the premier leadership development program for advanced degree holders across all academic disciplines."

Veterans of the health agencies said they were troubled by the seemingly random nature of the cuts.

"If there's a need to reduce the budget, that happens at all levels of government, but there should be a thoughtful approach," said Dr. Joshua M. Sharfstein, a former deputy commissioner of the FDA. He added, "For some of these roles, there is very specialized knowledge."

Fleming, a former deputy CDC director, said many health professionals can earn more in the private sector but choose to join the government because they are drawn to public service. The terminations would make it harder to attract new talent, he said.

"We're cutting off our hand to spite our face," he said.