For John Besser, recent cuts to federal health agencies feel somewhat personal.
“I've spent my entire working career building systems to make people safer and healthier,” Besser said. “And to see it, what seems like, randomly slashed, it hurts me personally.”
In the early 2000s, Besser came to the Atlanta-based Centers for Disease Control and Prevention from a local public health department in Minnesota to work in a laboratory that monitors and prevents food-borne illness.
“We viewed CDC as the mothership; whatever kind of strange health crisis that came up, there's somebody here who was an expert in that,” Besser said. “I felt so lucky to be here.”
Besser was one of over 100 demonstrators to gather at the Centers for Disease Control and Prevention headquarters in North Decatur on Tuesday. Retired workers from federal agencies and state public health, among others, cheered in support of current CDC employees as they left work to go home.
“Some of our friends on the inside, we heard that some people were crying when they saw people, in those buildings,” Besser said, pointing to the massive collection of office buildings off Clifton Road. “They were very moved.”
Because in recent days, more than 1,000 employees at the CDC and more at other agencies under the Department of Health and Human Services have been let go, including the Food and Drug Administration and the National Institutes of Health.
Other health agencies have taken a hit, too. The Centers for Medicare and Medicaid expects to see a $10 million reduction in funding — nearly 90% — for health insurance navigators. Millions for public health programs and research have also been slashed.
The layoffs come after President Trump’s administration offered buyouts to federal workers, a move that was at first blocked by a U.S. district judge, but allowed to move forward late last week. Tens of thousands have taken those severance agreements.
At this point, it's reported that close to 5,000 employees across health agencies have been terminated.
“I heard Gov. Kemp say we can lose some folks,” said one attendee, Barbara Stahnke. "I'm not saying that we don't need to tighten up or anything like that; maybe we do. But the way this is happening, it's not right.”
Stahnke, who's retired from the state Department of Public Health, said that the cuts to CDC staff will leave frontline workers without critical guidance. Local public health departments — of which there is one in every county in Georgia — use guidance from federal health agencies to respond to disease outbreaks and manage all sorts of illness.
“It takes a lot to get from federal, to state, to local, to the people and communities,” Stahnke said. “You got to have somebody giving the local health department good information.”
Employees terminated from federal health agencies reportedly included doctors, infectious disease specialists, outreach specialists in specific communities and scientists, to list a few. Most had been working under a probationary period or were no more than two years into their public service. In termination letters, they were told that they were “not fit for continued employment.”
“I think that the apparent rationale for who has been dismissed is an administrative one, and not about the quality of the work that's being done or how critical these functions are to our national health,” said Patrick Sullivan of Emory University.
Sullivan, an epidemiology professor, teaches officers in the CDC’s Epidemic Intelligence Service, a two-year fellowship program. He also graduated from the program years back.
On Friday, first-year EIS officers received termination letters just like other federal employees. But by Tuesday, it was being reported that officers had actually not been fired, but that cuts had been made to a laboratory fellowship program.
Speaking with GPB on Monday, Sullivan said that layoffs to the EIS force should be carried out.
“The consequences of that are going to be more costly than the salaries would have been,” he said.
Similar consequences could be felt from cuts that could disrupt the pipeline of workers into public health.
Standing outside the CDC headquarters on Tuesday, second-year public health masters students Julia Greenfield, Haley Cionfolo and Avery Morse said they’ve experienced the effects of recent mandates.
As students of Emory University, they recognize the deep ties their school has with the CDC, and what’s at stake. Professionals at the federal agency often hold adjunct teaching roles at the school and students are encouraged to take advantage of fellowship and research opportunities offered by the CDC.
A communications freeze put on federal health agencies by the Trump administration has left professors scrambling to teach courses that have historically relied on CDC expertise. That includes a course Greenfield is taking on the epidemiology of tuberculosis. She said presenters from the CDC have not been allowed in.
“These professionals are not able to come next door and teach the course,” Greenfield said. “They're some of the most important people in public health and global health. So we need them. We need to talk to them. We need to learn from them.”
Tuberculosis is one of the deadliest infectious diseases in the world. Having access to people with knowledge about such diseases, and experience in responding to them, was a driver in the students' decision to apply to Emory.
Though Greenfield and her colleagues, who all graduate in a mere three months, agree that the federal cuts are discouraging, they said they will still pursue careers in public health.
“Public health has always been a scrappy field,” Morse said. “I'm happy to be out here and fighting.”
Currently, across the country infections of influenza are rising, paired with a resurgence of measles. There’s also reported cases of deadly tuberculosis infections. Meanwhile there’s growing concern that highly pathogenic avian influenza, while still less present in humans than in animals, could be the next big zoonotic (animal-to-human transfer) disease.
Some staff cut from health agencies, and possibly others who have taken buyout offers, were working directly on these outbreaks.
“Our country is less safe today than it was on Friday,” said Jodie Guest, senior vice chair of Emory’s Department of Epidemiology.
Georgia has some of the highest rates of HIV and sexually transmitted diseases in the country. The leading cause of death in the state is heart disease, followed by cancer. The state ranks near the bottom for health care access overall, a problem especially in rural communities.
Meanwhile, rates of multi-morbidities, or the condition of having more than one chronic disease at the same time, is going up nationwide but notably fast in the Southeast.
Without staff that can do surveillance on diseases and physicians who can provide targeted preventative care, outcomes likely won’t improve.
Biplap Datta is a lead author of Augusta University’s annual Healthy Georgia report and said that it’s concerning to see rates of preventable diseases going up.
“This is the fourth year we published this report and I'm seeing these rates persisting,” Datta said of conditions like hypertension and diabetes. There’s also been no improvement in closing disparities between urban and rural residents.
And it’s possible rates are higher than reported, simply because fewer people are going to the doctor and being diagnosed.
While barriers to transportation and insurance coverage leading to access issues certainly come into play, Datta said trust in the public health system plays a huge factor. Providers are still trying to gain back trust after the COVID-19 pandemic disrupted regular appointments and fractured the country into those who supported health-related mandates, and those who did not.
“At this point, I think that's the public health challenge and we should focus more on that,” Datta said. “Like how to bring that trust and increase that utilization of health care among patients.”
Recently confirmed Secretary of the Department of Health and Human Services, Robert F. Kennedy Jr., promised "radical transparency" from the agency during his testimony to the Senate.
HHS receives trillions of dollars for health care spending. Kennedy has so far promised to address chronic diseases in adults and children, but has also cast doubt on the efficacy of vaccines.
Datta said in his opinion, it will take consistent messaging for any sort of measurable change at the level of individuals in their communities.
“I don't know whether they will do that or not,” Datta said. “But like, if that can be done, then I think we can regain some of the trust back.”
