Outbreak of Layoffs Spares EIS

As the Department of Government Efficiency (DOGE)’s restructuring extends through healthcare agencies, implications for infectious disease management remain unclear, but it appears that the Centers for Disease Control and Prevention (CDC)’s “disease detectives” will continue their key roles in protecting public health, according to the CDC’s website.

“EIS [Epidemiology Intelligence Service] officers step up at a moment’s notice to investigate public health threats in the United States and around the world,” according to the website, which retains information about applying for the 2-year EIS fellowship.

At one point, the Associated Press and other news outlets reported information via anonymous sources that the CDC’s EIS would be targeted, and its newly minted graduates terminated as part of the larger CDC layoffs. However, the website of Chemical & Engineering News cited an email communication from the CDC saying that the EIS officers would remain in place.

The EIS officers’ roles include traveling throughout the United States and globally to gather and analyze first-hand scientific data on disease epidemiology that inform public health policy.

EIS’s Unique and Essential Role

“The CDC’s Epidemic Intelligence Service is a world-renowned program for disease investigation and, more importantly, serves as the nation’s premier pathway for training future disease detectives and public health leaders,” said James Lawler, MD, associate director for International Programs and Innovation at the Global Center for Health Security and professor in the Infectious Diseases Division at the University of Nebraska Medical Center, Omaha, Nebraska, in an interview. The EIS serves one of the core functions of the federal government: Protecting the health and safety of Americans, and its work is something that the CDC does right, Lawler said.

To appreciate the impact of the EIS, look no further than the past few issues of the CDC’s Morbidity and Mortality Weekly Report, Lawler told Medscape Medical News. EIS officers tracked down a hepatitis A outbreak in Los Angeles, identified dangerous mercury exposures to recycling center workers in Ohio, investigated an outbreak of fungal pneumonia in a paper mill in Michigan, supported treatment of infants with respiratory syncytial virus infections in New York, and traced the origins of a cluster of Rocky Mountain spotted fever outbreak in California, he said. These are only recent examples, but the EIS works every day, in every state, tracking down outbreaks of foodborne illness, environmental toxin exposures, drug overdoses, and many other health threats, he emphasized.

“The current measles outbreak in Texas and New Mexico, and the tuberculosis epidemic happening in Kansas? You can bet that EIS officers are on the ground, practicing ‘shoe-leather epidemiology,’” said Lawler. In many cases, the efforts of the members of the EIS go unpublished and unnoticed because they stop problems before they become major public health issues, he noted. “That is the beauty and curse of public health; when we do our job well, nothing happens,” he said.

Other staff cuts at federal healthcare agencies may negatively affect infectious disease management, Lawler told Medscape Medical News. “Our federal health agencies protect us against much more than infectious diseases, but we are in a dangerous time for infectious diseases,” he said. The increasingly complex landscape of infectious disease threats includes the lingering impact of the COVID-19 pandemic, as well as the rise of H5N1 avian influenza, MPOX, measles, and tuberculosis, all recently making news in the United States, Lawler said. “Outbreaks are happening with increased frequency, and this is not the time to lower our defenses,” he added.

Reform Efforts Should Be Informed Efforts

Lawler has been a vocal critic of the CDC and said he believes that the agency has made mistakes in handling recent health emergencies and has some fundamental problems. “Much can and should be reformed,” he told Medscape Medical News. “However, that is not what DOGE is doing right now,” he said. Lawler described the current DOGE activity as “reckless and destructive,” with the potential for long-lasting harm to systems that protect the lives and welfare of Americans. “Firing personnel across the board without consideration of their function or performance is hardly precision reform,” he said.

Lawler had no financial conflicts to disclose.