Crisis within CDC is spilling into real world, experts say

STAT News – Thursday, August 28, 2025
By Elizabeth Cooney

The implosion of leadership at the Centers for Disease Control and Prevention threatens the agency, its mission, and the trust people place in public health, medical experts told STAT Thursday, a day after Director Susan Monarez refused to dismiss top scientists only to be ousted herself.

The crisis in the agency, which has been battered by personnel and policy changes ordered by health secretary Robert F. Kennedy Jr., is spilling into real-world harms, the experts said. They are seeing uncertainty from the public about vaccine recommendations and availability, in light of new Covid-19 vaccine policies announced by Kennedy, as well as deeper concerns about emergency preparedness for the inevitable next challenge to the nation’s health.

“I’m worried that CDC will not be there with the full capacity that’s necessary to help us with the next big threat,” Georges Benjamin, a physician and executive director of the American Public Health Association, told STAT. “But I’m also worried about the current threats that we have today.”

White House spokesperson Karoline Leavitt said Thursday that a statement from Monarez’s lawyers “made it clear she was not aligned with the president’s mission to make American health again,” so Kennedy asked for her resignation.

“The president and Secretary Kennedy are committed to restoring trust and transparency and credibility to the CDC by ensuring their leadership and their decisions are more public-facing, more accountable, strengthening our public health system and restoring it to its core mission of protecting Americans from communicable diseases, investing in innovation to prevent, detect, and respond to future threats,” Leavitt said.

Budget cuts ordered by President Trump have steadily hammered at jobs and programs, in some cases erasing entire sectors of the agency’s public health activity. That list includes air quality as well as individual diseases like HIV, viral hepatitis, sexually transmitted infections, and tuberculosis. There has been an erosion of the study of gun violence.

Food safety was hit, too, when the FoodNet program to track foodborne infections reduced the pathogens it monitors from eight to two, as of July 1. The effort is a collaboration between CDC, the Food and Drug Administration, the Department of Agriculture, and 10 states. Surveillance will continue for salmonella and Shiga toxin-producing E. coli, but has ended for six others: campylobacter, cyclospora, listeria, shigella, vibrio, and Yersinia. Those six pathogens are often found in chicken or other foods, causing illness and death each year.

Surveillance has suffered for diseases that are communicable and illnesses that aren’t, Wendy Armstrong, vice president of the Infectious Diseases Society of America, told STAT.

“It’s beyond measles,” she said in an interview. “It’s all kinds of diseases, some of which are vaccine-preventable, and some of which may not be, but it’s how we understand what’s happening so that we can keep our patients safe and make diagnoses quickly.”

Armstrong, an infectious disease physician at University of Colorado Medicine, recently confronted one such loss in her practice in Colorado. Her patient had signs of what could be a cancer or could be an unusual infection — diagnoses that would require completely different treatment. Ordinarily, she would confirm an infection after sending a sample to the CDC for testing its lab would perform — the only one in the U.S. capable of doing so.

The CDC no longer has the capacity to do that, she was told, not disclosing the nature of the test to protect her patient’s privacy.

“That directly impacted my patient,” she said. “It had a real-world, absolutely direct impact on a patient that I was evaluating and has led to a much, much more complicated situation.”

With the dismissal of Monarez on Wednesday and the resignations of other leaders, the agency’s future is even more uncertain.
Scores of CDC employees gathered outside the main campus in Atlanta on Thursday afternoon for a “Clap Out” in appreciation of departing leaders, including Deb Houry.Courtesy

“The entire group of people who resigned yesterday are an important part of the brain trust that works to improve and protect the health of people here and around the world,” Richard Besser told reporters Thursday. President and CEO of the Robert Wood Johnson Foundation and also a pediatrician, he worked at the CDC for more than a decade. “With their loss, we are in much worse shape than we were a day ago.”

The list of leadership vacancies is long and growing, two weeks after gunshots claimed the life of one police officer and left the Atlanta campus pockmarked by bullet holes. The high-ranking scientists who resigned Wednesday include Daniel Jernigan, director of the National Center for Emerging and Zoonotic Infectious Diseases; Chief Medical Officer Deb Houry; Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases; and Jennifer Layden, who oversaw the agency’s data and surveillance efforts.

Their colleagues gathered to say farewell on Thursday afternoon, in a “clap out” with signs thanking them for “standing up to protect American health and CDC workforce.”

Trust, inside and outside the agency

More difficult to quantify than headcount is the deficit in trust, said both CDC staffers granted anonymity to discuss the problem and outside experts in public health.

Trust is easy to lose and hard to regain, Benjamin of the public health association said. He’s less sure of food safety in a restaurant than before, given the gaps in CDC’s monitoring abilities. Then there’s continued fallout from pandemic policies.

“The problem now is they’ve not only lost the trust of the American people, but they’re also losing the trust of the professionals they rely on working with,” he said about the agency.

The next threat could be an emerging disease or a bioterror attack, Benjamin said, something a political appointee might not be fit to fight.

“What they want is an anti-vaccine, anti-science infectious disease agency,” he said about the current administration. (In April the public health group he leads called for Kennedy’s resignation.) “And the problem is the bugs don’t know that.”

When it comes to trust, Armstrong made a distinction between the people who work at CDC and the official messaging, including from the new members of the Advisory Committee on Immunization Practices.

“The folks who are long-term CDC employees are wonderful and thorough and expert and do an amazing service for people every day. There are fewer and fewer of those people,” she said. “The statements coming out of the CDC and things like the ACIP, for example, are not trustworthy at this point.”

Besser cited Daskalakis’ resignation letter, in which the former official said Kennedy wasn’t turning to the expertise of CDC to manage the recent measles outbreak.

“When we hear from the head of the Respiratory Diseases Center that he and his people have not been part of the secretary’s deliberations around how to manage the measles pandemic, and that they have not even seen the so-called evidence that the secretary says he has used to make new recommendations around COVID vaccination, that is chilling.”

The amount of misinformation in the air around Covid vaccination is also shocking, Besser said.

“The idea that we would accept the deaths of 200 children a year from Covid, when it is highly preventable with vaccination, just blows my mind,” he said. “Why did the prevention system not work? If it’s not working because it is being undermined by our secretary of health, then why is this person our secretary of health? We deserve better as a nation.”

Inside the agency, staffers say CDC is losing decades of knowledge that cannot easily be replaced. “Above all, I want CDC to return to being led by science and expertise, not politics,” one person said on condition of anonymity. “That’s the only way the public will trust us — and the only way we can do our jobs.”

“The villainization that has happened is heartbreaking,” a second CDC person told STAT. “We’re humans. We’re driven by a mission to protect public health. Some of us have spent multiple decades of our lives, all of our training, all of our work, to protect the health of the public. This is unlike anything I’ve ever seen. I feel so othered and it’s so awful.”

The second person called Wednesday a watershed day. “Public health people tend to be permanently optimistic, permanently resilient. But I’ve never heard as many colleagues saying things like ‘CDC is dead’ as I have today, not even in the darkest days of Covid. I don’t think there’s anyone left at CDC right now who believes there’s any ability to do public health under this administration.”

What’s next for CDC?

Besser called it the wild, wild west.

“You have a secretary of health who through his remarks has done so much to undercut the nation’s trust in our public health system,” he said. “He has been part of the effort to demonize public health leaders, and we saw the outcome of that when a gunman went to Atlanta and shot up the buildings in which I worked for more than a decade.”

Besser also predicted a further loss of talent from the CDC, and a political appointee “in line with the secretary’s radical beliefs” rather than a public health leader to fill the director’s role after Monarez’s firing by President Trump. And he’s not looking to Congress with any hope, “dumbfounded” by the lack of action by elected officials.

“We know there will be future pandemics. We have come through a pandemic and are now still seeing the impacts of Covid as a day-to-day disease, but we will see future pandemics and our ability to respond to the next pandemic has been so devastated that I worry greatly about what will happen,” Besser said. “It will take the White House saying that this is unacceptable for there to be any change.”

‘CDC was a gem to the world’

The CDC’s first days were in July 1946, when its mission to prevent the spread of malaria explained its home in Atlanta, then considered deep in the South’s malaria zone. Disease surveillance was central to its purpose, while the “prevention” in its name has grown to include a multitude of diseases, studying their origin, treatment, prevention, and prevalence. The agency’s knowledge, standards, and investigations are shared around the world and in all U.S. states and territories.

Armstrong said she and her colleagues have been talking about the CDC’s value in the past tense.

“The CDC was a gem to the world,” she said. “That standing is gone. So much expertise is gone. People who wanted to go into public health don’t see a future. The debate that we’re all having is, will the CDC ever recover, not how long it will take. I don’t know that it can ever recover to what it was.”

Access this article at its original source.