CDC staff down 30% as concurrent outbreaks strain response, former officials say

80% of senior CDC leadership posts remain unfilled, staff down 30%

“Are we ready for the next big pandemic? My answer is no,” Dan Jernigan, former director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, told The Guardian.

Debra Houry, the former chief medical officer of the CDC, echoed the assessment. “Unfortunately, we’re really moving in the wrong direction,” she said.

The warnings come as the agency confronts a confluence of health threats — hantavirus, screwworm, Ebola, cyclospora, measles, whooping cough, and bird flu — that former officials said are exposing widening gaps in the nation’s ability to prevent, identify, and halt infectious disease outbreaks.

Houry said that 80% of senior leadership positions at the CDC still lack permanent appointees, and that between 25 and 30% of the agency’s entire staff have left — a combination of layoffs, early retirements, and attrition without replacement.

“Those are boots on the ground,” Houry said. “When you have Ebola, hantavirus, measles, and throw cyclospora in there — staffers were already spread thin, and now they’re spread even more thin.”

One of the most acute losses came after the Trump administration cut the US Agency for International Development (USAID), Jernigan said. The CDC lost roughly $40 million in funding for programs combating malaria and neglected tropical diseases. Of the 73 employees in those divisions, 35 were laid off. The program recovered $4 million but faces an uncertain future, even as global malaria deaths rise.

Those laid-off employees were some of the premier experts in the US on all parasites, not just malaria, Jernigan said.

“The laboratory methods you use and the expertise and the microscopy and all of that stuff is the same,” he said. “So the expertise in parasitic diseases has dropped.”

The CDC’s cyclospora laboratory, he noted, has fallen from 11 people to three. Similar losses have occurred with experts on mpox and Ebola.

Houry said the cuts extend beyond parasites. “We lost a lot of our lab scientists, and some of our specialized experts on things like rabies — those you can’t replace overnight.”

Jernigan said ideological approaches are making the confusion worse. “When confronted with complex situations where decisions need to be made quickly, their gut response might be one driven by ideology rather than by what the data is actually showing,” he said. “Without that clarity and hierarchy within a big response, you’re going to end up with uncoordinated activities and interventions.”

He pointed to conflicting messages during the hantavirus outbreak aboard the MV Hondius cruise ship. Officials initially said passengers could quarantine at home, then required some to stay in a biocontainment facility. Even when a CDC medical officer said home quarantine would be sufficient, Health and Human Services Secretary Robert F. Kennedy Jr. overruled the decision, Jernigan said.

Houry said similar confusion surrounds Ebola guidance for travelers from the Democratic Republic of Congo, where conflicting quarantine rules have left states uncertain which to follow. “It’s difficult for states to implement this guidance that isn’t based on science and often not on logic, coupled with the staffing and budget cuts,” she said, calling this a “precarious” time for public health.

The combined effect, Houry said, is that the US is “moving in the wrong direction” on public health preparedness at a moment when outbreaks are intensifying. The US has already surpassed last year’s measles case tally, and the CDC is tracking a fast-growing cyclospora outbreak that has infected thousands.

“During the Covid pandemic, that’s where we saw we didn’t have enough staff to go around the nation to respond to outbreaks, and public health was already significantly understaffed in state and local health departments,” Houry said. “It was a time to try to get right-sized, not oversized. And unfortunately, reverting back to more of the 2019 size leaves us woefully underprepared to respond to outbreaks, as we’re seeing.”

More than half of US states have passed laws limiting public health actions during emergencies, Jernigan added, and the CDC has lost millions in funding for mRNA vaccine research that would be “significant” for the next pandemic.

In the absence of clear federal leadership, regional alliances such as the Northeast Public Health Collaborative and the West Coast Health Alliance have formed to coordinate vaccination and crisis management. The Association of State and Territorial Health Officials now runs regular coordination calls for state health officials.

“Now you’re starting to see more regional alliances forming to better track things,” Houry said. “Like with measles — we very much see that it doesn’t stay within a city or state. So as a result of this moment, we’re seeing others step in to fill the gap.”