To put it bluntly, the U.S. Centers for Disease Control and Prevention is in a complete freefall.<\/p>\n
Under the reign of Robert F. Kennedy Jr., the longtime crank turned U.S. Health and Human Services Secretary, thousands of people<\/a> have lost their jobs, the organization\u2019s policies<\/a> have been hijacked by allies of the anti-vaccination movement, and workers there have endured a deadly shooting committed by a man whose motives were likely influenced by misinformation<\/a>\u00a0<\/strong>about the covid-19 vaccines.<\/p>\n The most dramatic upheaval occurred<\/a> in late August, when former CDC director Susan Monarez was fired just four weeks into taking the role. Monarez has since publicly testified<\/a> that she was let go for refusing to sign off, without review, on the vaccine-related recommendations of RFK\u2019s handpicked advisors<\/a>, many of whom\u2014like Kennedy himself\u2014have a history<\/a> of spreading misinformation about vaccines.<\/p>\n Immediately after Monarez\u2019s reported firing, in a coordinated act of protest, three senior staff members at the CDC turned in their resignation notice: Debra Houry, CDC\u2019s former chief medical officer, Daniel Jernigan, former director of the National Center for Emerging and Zoonotic Infectious Diseases, and Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases (a fourth senior official, Jennifer Layden, former director of the CDC\u2019s Office of Public Health Data, Surveillance, and Technology, also resigned).<\/p>\n \u201cWe should practice detachment from the organizations and focus on the mission. And the mission is the health of the public.\u201d <\/p>\n Gizmodo reached out to Daskalakis to discuss the events within the CDC leading up to the resignation, the fallout since, and what the path forward might look like in a world where trust in the CDC has eroded. The following conversation has been lightly edited for clarity and grammar.<\/p>\n Ed Cara, Gizmodo: <\/strong>Can you take us through the first days and weeks of the second Trump administration for you and others at the CDC? What was the general mood?<\/p>\n Demetre Daskalakis:<\/strong> Soon after the election, when President Donald Trump announced that RFK Jr. was going to be his candidate for the Secretary of Health and Human Services\u2014that was obviously the beginning red flag.<\/p>\n Prior to the CDC, I had worked in New York City for many years in the Department of Health and Mental Hygiene. While there, I had been involved as the incident commander over the measles outbreak from 2018 to 2019. And that\u2019s the first time that I had any awareness of the sort of anti-vaccine strategies of RFK Jr. and the organizations he participated in.<\/p>\n So while we were running the measles response, one of his organizations, Children\u2019s Health Defense,\u00a0was working to undermine the work we were doing. It supported anti-vaccine messaging, and RFK Jr. would go on to sue the health department<\/a> while we were in the middle of our response, trying to destabilize what we were doing. At that point, I was like, \u201cThere\u2019s this kooky guy who\u2019s a Kennedy who is really trying to interfere with this important work to prevent kids from getting sick.\u201d So when they said his name as the candidate, I was like, \u201cOh boy.\u201d<\/p>\n Author\u2019s note: Kennedy founded Children\u2019s Health Defense and served as its chairman and chief litigation counsel before resigning ahead of his failed presidential run.<\/p>\n But then I did research on it, and not just me, all the doctors at CDC who were in leadership. We all read books, we looked at papers, to figure out what we were up for. And also to see where there were opportunities for us to integrate our sort of science and strategy in public health with what will be the vision of the new secretary. It\u2019s what you do as a civil servant: How do I work with the new leadership and still make sure that we\u2019re protecting the health of the country?<\/p>\n<\/p>\n Before he was appointed, though, there were the confirmation hearings. Ahead of those hearings, his cousin [Carolyn Kennedy] came out<\/a>, called him a predator and said that he was dangerous for American health. So that was something. And watching the hearings, I was not particularly impressed. He seemed not very well prepared, but that\u2019s probably less his problem and more his teams. But we made it through that and then he got confirmed.<\/p>\n The next thing that I did was, when he gave his big talk<\/a> at HHS after he was sworn in, I made my whole team stop doing work so they could hear what he had to say. And honestly, it was good. He said gold standard science and radical transparency are things that he was going to uphold. And he made it seem like he was going to engage with the scientists and the experts across HHS to make sure that we\u2019re going down the right scientific path. So we took copious notes, and we felt like we could do it\u2014we\u2019re going to figure out how to work with this guy. We prepared all these transition documents, all these plans, all these things to be ready to talk to him.<\/p>\n Gizmodo:<\/strong> Then what happened?<\/p>\n Daskalakis:<\/strong> Then he landed and we never, ever heard from him. We reached out to try to brief him. He never said yes. We talked to his teams. They never said yes. And the communications we were getting were some combination of dismantling CDC and doing really unhinged policy things. Around February 14th, we had our first CDC massacre<\/a> where they fired a bunch of people who were newly hired staff. April 1st, we had our next CDC massacre<\/a> where they literally deleted thousands of positions from CDC. And then just now, we had our third CDC massacre<\/a>. We\u2019re now about a quarter down of the staff that we had in CDC.<\/p>\n \u201cThere\u2019s no need to destroy public health to rebuild it.\u201d <\/p>\n And then there\u2019s all the policy things.<\/p>\n He changed the covid-19 vaccine recommendations for kids and pregnant women via a tweet<\/a> [in late May]. We had heard nothing about it before that. He had never conferred with any scientists. When we asked him if we could get the documents underlying the data that support your decision, his staff said no. So CDC was directed to make changes and no one had ever seen the data underneath it. So we made it; we tried to mitigate that and made it a little bit not as bad.<\/p>\n He then fired all of the experts on the Advisory Committee for Immunization Practices (ACIP), which is the body responsible for guiding CDC on what they should do for vaccine policy. And he replaced them mostly with people who were, frankly, political appointees who were ideologically aligned to his desire to dismantle and destroy vaccines. They\u2019ve changed the way that the committee works. The entire agenda, the entire membership, all of the conversations are only driven by these people that he put in who are his ideological clones and the scientists are completely sidelined, only being able to provide data as requested rather than really engaging in the conversations.<\/p>\n And then, of course, Susan Monarez was fired. There was this brief shining moment when we had a scientific leader who was going to help be a diplomat to build the bridge between us and the secretary. And then he basically told her that he didn\u2019t want her science here; he just wanted her to sign off on these recommendations. And they fired her.<\/p>\n Gizmodo: <\/strong>So the Monarez firing was the breaking point that led you and your senior colleagues to resign in protest?<\/p>\n Daskalakis: <\/strong>That\u2019s what led all of us to get together, and for me to say that it was time to go, because I can\u2019t support something that\u2019s not going to use good science, something that will potentially end up making terrible decisions for the country that could impact the health of people.<\/p>\n But we had all been writing our resignation letters. I started my resignation letter when he fired ACIP because I was like, \u201cI just need to have all this documentation for the moment when I have to get out of here, because I can\u2019t do any good anymore.\u201d<\/p>\n RFK Jr. was dictating things in a way that wouldn\u2019t let science get done or be reviewed adequately. But then I was very excited when Susan came aboard, when she had this moment of like, let\u2019s try to work with this and make it better. She had a vision for how to do it. And he just threw it aside. She was like a trusted expert<\/a> two months before, and now she\u2019s absolutely a demon. So when we lost that scientific leadership, it was the end.<\/p>\n \u201cThese are a bunch of rookies that don\u2019t know even how to run a medium-sized organization, much less one that\u2019s complex like CDC.\u201d <\/p>\n Bottom line, their office of the director at CDC only had one person other than Susan who was a scientist, and that was Debra Houry. So when that conversation began and she said she was also going to leave, that was the end of that. It\u2019s like having a head and body but with no neck.<\/p>\n Gizmodo:\u00a0<\/strong>What do you say to the critiques made by RFK Jr. and his allies that all this chaos is needed? That the only way to \u201cMake America Healthy Again,\u201d as his saying goes, is to dismantle the status quo of the CDC and the country\u2019s public health systems in general?<\/p>\n Daskalakis:<\/strong> I call bullshit on it. It\u2019s garbage.<\/p>\n There\u2019s no need to destroy public health to rebuild it. There is a rational way to do it. The CDC, especially since covid, has changed a lot. Could it change more? Yes, but do you do it by destroying CDC? That\u2019s like flying a plane holding hundreds of people, thinking that the engine\u2019s not so great, and trying to rebuild the engine while it\u2019s flying. Even worse, it\u2019s like blowing up a plane while it\u2019s flying and hoping all the parts will land somewhere safe and the people will be fine. It\u2019s beyond irrational.<\/p>\n Tearing the CDC apart while saying that you\u2019re going to make it better also means that we\u2019re completely not prepared in the event that something disastrous happens. And frankly, we\u2019re not really prepared for the routine work either, because it\u2019s like an interconnected organism. We had already made proposals on how to make the CDC more efficient and how to do it quickly. But they wouldn\u2019t take them. Instead, they\u2019re taking this tech bro strategy of, \u201cLet\u2019s break it and then see how it goes.\u201d And you don\u2019t want your public health done that way.<\/p>\n Gizmodo: <\/strong>How has the CDC been doing since your resignation, in your opinion?<\/p>\n Daskalakis: <\/strong>It\u2019s just getting worse, and they still don\u2019t have any scientific leadership. The guy who they claim is the acting director of CDC, Jim O\u2019Neill, has never<\/a> met<\/a> with the senior leadership at CDC\u2014it\u2019s now been about five weeks since he was appointed. And yet he feels comfortable, as a non-scientist, tweeting out things about separating<\/a> the measles, mumps, rubella (MMR) vaccine and congratulating themselves<\/a> for taking down websites that are important for people\u2019s health because they have the word \u201cequity\u201d or talk about gender.<\/p>\n And this latest reduction in force, it\u2019s disastrous, even if some of those firings have been reversed. Right now, the CDC doesn\u2019t have an ethics office<\/a>; they don\u2019t have an institutional review board;<\/a> and they don\u2019t have the organization that looks after the advisory committees.<\/p>\n Author\u2019s note: Some of the employees fired in this latest round were responsible for overseeing conflicts of interests in these committees, while the Trump administration has previously terminated<\/a> several advisory committees.<\/p>\n It\u2019s supposed to be radical transparency, but they can\u2019t communicate because they got rid of all their communicators. They can\u2019t run a advisory committee because they got rid of the advisory committee groups. And they can\u2019t review science to be able to go forward.<\/p>\n Gizmodo:\u00a0<\/strong>What about those still left behind at the CDC? How have they been faring through all this?<\/p>\n Daskalakis: <\/strong>The staff is horribly traumatized. Two months ago, that place was shot with 500 bullets. My office has a giant hole in the window because of a bullet. And RFK Jr. came down, said thoughts and prayers, and then immediately went to an interview and said not to trust experts.<\/p>\n Author\u2019s note: During an August 11 interview three days after the shooting, RFK stated<\/a>, \u201cTrusting the experts is not a feature of either science or democracy.\u201d<\/p>\n No one seems to cares. When an ICE facility got shot up last month, the president ten minutes later had a statement<\/a> about it. He has never said one word<\/a> about the shooting at CDC; not one word about the police officer who died to protect us. So they do not value the workers, they do not value the work. For them, dismantling the CDC is no big deal and, frankly, it\u2019s because they don\u2019t understand the value that public health gives to the country and the world. Because these are a bunch of rookies that don\u2019t know even how to run a medium-sized organization, much less one that\u2019s complex like CDC.<\/p>\n Gizmodo:<\/strong> Circling back a bit, it seems like breaking up the MMR vaccine\u2014something that both acting CDC director O\u2019Neill and President Trump have called for\u2014would be the most dramatic change in vaccine policy seen yet. Just how realistic are the odds of that happening?<\/p>\n Daskalakis:<\/strong> A year ago, I would have said it\u2019s totally not possible. First of all, there\u2019s no separate measles vaccine that\u2019s produced and available in the U.S., and there\u2019s no such thing as a separate mumps and rubella vaccine, either.<\/p>\n<\/p>\n