How DOGE is driving America’s public-health guardians mad
ON A NARROW road on the main campus of the Centres for Disease Control and Prevention (CDC) lies Building 21, the crescent-shaped headquarters of America’s premier public-health agency. In a room lined with television screens researchers monitor the measles outbreak that killed a second American in the southern plains last week and the bird-flu epidemic now ravaging flocks in every state. The agency’s leadership occupies the 12th floor. Military-grade security ensures that only authorised visitors and the CDC’s local workforce of roughly 5,000 civil servants have access.
By mid-February, three weeks after Donald Trump became president, odd strangers had been cleared to enter CDC sites. A boss four levels from the top came back from a meeting to find two men in Tesla shirts leaving her office. When she asked what they were doing one said, “we came to update your computer.” She thanked them and told them, “it’s been giving me issues for so long,” even though it had not. She now keeps a paperclip in a particular position on her desk so she can see if anything has been moved.
Daily life under the influence of the Department of Government Efficiency (DOGE) has fostered mistrust and left even the CDC’s well-educated, methodical scientists feeling paranoid. Bosses have moved work chats to Signal, an encrypted messaging app. Participants who once chatted about meeting times now discuss how to handle threats of mass firings or interpret court decisions. In one recent chat a woman urged her colleagues to “be like a cockroach—resilient and undeterred”. Another invoked the bulldog’s example: “keep smiling even when you can’t breathe.” The atmosphere offers a disquieting case study of DOGE’s impact on the expertise housed in America’s civil service.
Sections of the MAGA right regard the CDC as “perhaps the most incompetent and arrogant agency in the federal government”, as Roger Severino, head of domestic policy at the Heritage Foundation, a think-tank, wrote in Project 2025, a blueprint for Mr Trump’s second term. They blamed it (fairly) for botching the rollout of diagnostic covid-19 tests. Later it became a bogeyman on the right for imposing masking and social-distance rules during the pandemic. An irony is that the CDC has an America-first mission. Its researchers monitor outbreaks of disease abroad to prevent them from reaching American shores. They also manage a stockpile of emergency medications and vaccines.
Over the past six weeks, according to interviews with more than a dozen insiders and nearly 100 internal emails obtained by The Economist, leaders and workers alike have been subjected to a flood of missives about firings and new rules—coded in legalese and often softened or reversed within days. The emails have confounded bosses and made it hard to lead. As if to troll the workforce, DOGE’s most consequential fiats have all landed at night and on weekends.
The CDC’s first intimation of what lay ahead came on inauguration day, January 20th, when Mr Trump issued sweeping executive orders to eliminate diversity, equity and inclusion and “gender-ideology extremism” from government activity. Follow-on emails offered few specifics yet demanded extensive reviews of all CDC programmes and communications. Researchers frantically pulled back submitted journal papers and stopped collecting data on trangender people, and in some cases racial minorities. Supervisors told scientists to replace any mention of “gender” with “sex”.
But it was not just wokeness that took a beating. The acting head of the Department of Health and Human Services (HHS), which houses the CDC, immediately banned CDC staff from communicating with the public without explicit approval from “a Presidential appointee”. “We stopped talking to anyone,” says an epidemiologist with two decades of experience. State and local health departments looking to retrieve already-authorised CDC grant funds found that the online payment system suddenly didn’t work. On January 23rd the Morbidity and Mortality Weekly Report, the agency’s flagship publication, did not come out for the first time in 60 years (it was paused for two weeks and then returned).
The next day the Trump administration named Susan Monarez, a CDC outsider, as acting director (the agency normally promotes from within). Rumours spread that DOGE people were inside the agency. Staff began to feel they were being watched and managers advised them to shut down their computers and put their phones on airplane mode when they weren’t working. “There was a fear that they were scanning for who was talking about Trump,” says a mid-level worker.
For CDC scientists, the now-famous “Fork in the Road” email of January 28th—offering pay until September if employees responded with the word “resign”—was the first sign that jobs were seriously at risk. Because there was stigma attached to taking the deal, agency leaders still don’t know how many did. Top managers soon got a directive from the Office of Personnel Management (OPM), DOGE’s enforcer, to rank their newer underlings as “mission critical”, working on “strategic priorities” or neither. When one of the CDC’s ten centres responded that all their staff were “mission critical”, higher-ups told them that wasn’t good enough, and set percentages for them to meet for each category. Anxiety made people frantic. One boss recently came back from a day off to find that his staff had tweaked big surveys of Americans without his direction, after reading about new executive orders online. “People are scared for their livelihood so they start trying to do what they think is expected of them,” he says, “but it’s only causing more chaos.”
Partly this is because unrelenting written instructions from Washington ask the CDC’s leaders to make daunting judgment calls without providing much guidance about the new administration’s requirements. One email allowed scientists to resume communicating with the public but only “regarding urgent public-health needs when the health and safety of US citizens is immediately threatened”. The order provided no examples of approved messages or additional guidance about how urgent or threatening a situation needs to be to justify a statement. It seemed possible that getting this wrong could mean losing one’s job.
On February 14th, Valentine’s Day, staff were told that probationary workers—those who had been in their current roles for only a few years—would be fired. Those fearing for their jobs included recently-promoted senior scientists, some of whom had been at the agency for decades. The following evening roughly 750 people got termination emails from the OPM. “Your ability, knowledge and skills do not fit the Agency’s current needs, and your performance has not been adequate,” the email said, without evidence. “I was shaking,” recalls one recipient.
Then came the OPM’s “What did you do last week?” email, demanding that every federal worker submit five bullet-points in response. On February 24th bosses at HHS told employees there was “no expectation” they should respond. Yet the OPM’s requests for bullet-point work reports continued. On March 3rd HHS reversed its directive, now requiring workers to answer. But it is also acting as some sort of buffer between the OPM and the CDC. The department told CDC workers to avoid references to specific “drugs, devices, biologics, therapeutics” and to assume their emails will be read by “malign foreign actors”. As a small act of resistance scientists are encrypting their messages, sending them as a screenshot or adding non-English characters (replacing every “e” with a cyrillic “e”, for example) to make it harder for DOGE-controlled AI bots to read them.
Since mid-February some sanity has been restored, partly by court order. On February 28th a federal judge ruled that “no statute, anywhere, ever” granted the OPM the authority to order probationary firings, and 180 workers have been called back (insiders don’t know how they were chosen). A revolt against DOGE by some of Mr Trump’s cabinet secretaries led to a heated cabinet meeting on March 6th where Mr Trump reportedly shifted authority over staff cuts to cabinet departments, with DOGE in an advisory role. Yet Elon Musk, DOGE’s boss, remains in Mr Trump’s favour.
CDC staff are now mostly allowed to talk to external partners and grantees have access to money again, though no new contracts can be signed. But scientists and managers are bracing for more cuts. The OPM has demanded that the agency offer lists of workers for two new phases of layoffs, starting on March 15th. Leaders do not know how to prepare. “What if 20% of our staff is fired, 40%, 60%, how do we go on?” asks a branch chief. If entire divisions disappear, large swaths of work simply won’t get done. That could have deadly consequences. “Public health is the mom of science,” says a laboratory scientist. “She does everything and no one notices until she stops doing it. ■