"Most of the top leaders who run key centers have resigned en masse," Jha wrote. "Total implosion. All because of @SecKennedy leadership."
The chaos began Wednesday when Health and Human Services Secretary Robert F. Kennedy fired Susan Monarez, the CDC director appointed less than a month ago. President Trump confirmed her firing Thursday morning, and in the wake of Wednesday's news four top CDC officials resigned in protest. They include the agency's leaders on vaccination and respiratory illnesses and emerging infectious diseases.
Kennedy, in statements Thursday, said the agency needs new direction, citing his disagreement with policies related to abortion, water fluoridation, and vaccination.
"So we need to look at the priorities of the agency," he said, "if there's really a deeply, deeply embedded, I would say, malaise at the agency, and we need strong leadership that will go in there, and that will be able to execute on President Trump's broad ambitions."
Fluoridation and vaccination are considered by most experts to be among the greatest accomplishments in public health's history, and the exodus from the CDC seems to have accelerated the dissolution of the nation's health system, a process that's been underway since Trump took office.
"It's not hyperbole to say that public health is physically under attack in this country,' said Dr. Nahid Bhadelia, founding director of Boston University's Center on Emerging Infectious Diseases.
Bhadelia said the rapidly growing list of assaults on public health, even before the latest mass exodus of top officials at the CDC, is making it hard, even for health experts, to trust information coming from the federal government.
"All the things that are coming out about our federal agencies, there is a shadow of doubt now about whether they're going to be based on science," she said.
The CDC officials who departed were stuck in a lose, lose scenario, said Paul Offit, a Philadelphia-based expert who advises the Food and Drug Administration on vaccination and was a co-inventor of a rotavirus vaccine. Kennedy's decision making so far has made clear he isn't paying attention to the CDC's expertise.
"You can stay and watch people ignore you, or you can leave," Offit said.
When Trump appointed Kennedy to lead the nation's health agencies, there was considerable angst about how much his history as a vaccine denier would influence his decision making. His recent moves provide the answer, Offit said. The secretary, he said, is a science denier and an anti-vaccine activist who is actively seeking to misinform people about vaccines. He suspects Kennedy welcomes the departure of CDC experts who would fight against his agenda.
"What he's trying to do is disarm the CDC," Offit said.
In an interview on Fox News' Fox and Friends Wednesday, Kennedy said he was not surprised by the resignations and that it "may be that some people should not be working there anymore."
Monarez's firing and the subsequent resignations came as the federal government issued guidelines for COVID vaccines that departed in significant ways from established science. Kennedy announced in May that the government would no longer recommend the shots for young children and pregnant women. He didn't appear to consult with the CDC before making that announcement, and the decision contradicted evidence that children younger than 2 years old are at higher risk of serious illness, and that infants can inherit valuable immunity against the virus if their mothers are vaccinated while pregnant.
The FDA on Wednesday rescinded emergency use authorizations for COVID booster shots, and approved them only for seniors and people with conditions that make them more susceptible to serious illness if infected. Healthy adults who have either been vaccinated or recovered from COVID are at low risk of serious consequences from a COVID infection, but a booster can meaningfully reduce the risk of illness over a short period of time and the risk a person could pass the virus on to someone more vulnerable. Making it harder for people to get doses undermines people's ability to make choices about their own health, experts said.
"He seems hell bent on making sure people don't have the choice to get vaccinated," said Jennifer Nuzzo director of the Pandemic Center at the Brown University School of Public Health.
Amid the seeming dismantling of the nation's public health system, some scientists are assembling networks of groups, trying to stitch together alternative ways to gather and share reliable information. Nuzzo's center issues a weekly newsletter that tracks infectious diseases, including H5N1, measles, mpox, screwworm, and cholera, around the world.
Subscriptions, including many for local and state public health officials, have skyrocketed during the Trump administration. In partnership with the World Health Organization, Bhadelia, of Boston University, launched a global biothreats surveillance and response system a few months ago, called BEACON, that's followed by 40 local public health departments and 29 Ministries of Health and National Public Health Institutes, she said. The surveillance system has already tracked 400 outbreaks and published more than 700 reports in 120 countries.
State health departments, meanwhile, are seeking ways to compensate for the credibility and expertise fast seeping away from the CDC. Last week, public health leaders from Massachusetts, Rhode Island, Maine, Vermont, Connecticut, New York, New Jersey, and Pennsylvania met, and discussed ways they could coordinate vaccination policy, disease tracking, and emergency response in light of the Trump administration's assault on federal agencies.
Bhadelia said while public health coalitions establishing alternatives are vital, what's needed is a concerted effort to stop the dismantling of public health in the U.S.
"We can stop the bleeding," she said. "But we can't stitch the wound up without real help."
Nuzzo, of Brown, also applauded the effort, but said regional health coalitions simply cannot do some things as effectively as a federal health system. She is particularly worried about a biological weapons attack on the United States, which the country now is woefully unprepared to either prevent or manage.