“Ongoing Assault”: How HHS Layoffs Have Eviscerated Infection Prevention Support Across the Nation

CDC and HHS cuts

(Adobe Stock unknown)

April 1, 2025, will be remembered not for its policy reform or bureaucratic shift—but for the unraveling of a fragile public health safety net that has taken decades to build. Thousands of health professionals across the Department of Health and Human Services (HHS) and the CDC were terminated with no warning, no plan, and no guidance. And for infection preventionists (IPs), the consequences couldn’t be more devastating—or more personal.

An IP who chooses to be anonymous wrote to Infection Control Today^® (ICT^®) this morning, “Due to federal funding cuts, [my facility] is laying off 200 people today. I am at this point safe (I think), but will be taking on more work from my coworkers who aren’t so lucky. This is also just a start to the funding cuts and layoffs. I am not sure how this is all going to play out, but it isn’t looking great.”

From immunization clinics to antimicrobial resistance tracking, the cuts reach into every core of infection control. And while the news media talks in terms of policy, funding, and structure, those on the ground know the truth: infection prevention programs across the country have lost critical resources, key expertise, and, in many cases, hope.

Among those terminated were epidemiologists, lab specialists, and public health nurses—people who work side by side with infection prevention teams to detect, prevent, and respond to threats. These roles aren’t just administrative—they’re essential.

For IPs, this isn’t just a policy shift—it’s a matter of life and death.

“This is an ongoing assault on public health, and it has to end. We are crippling the very system that's in place to protect us, and then when we cry out later, when the system is absent, when we need it, that's the situation that we are creating with these cuts,” said Sharon Gilmartin, MPH, executive director of Safe States Alliance and a new campaign to protect the CDC Injury Prevention Center called the Keep America Safe Coalition.

Gilmartin continued, “Ironically, you may have seen the email that terminated employees included the sign offline leadership at HHS appreciates your service. This is something HHS declared that their mission is to make America healthy again. How can we do that when the people who have spent decades of their lives combating the most pervasive health issues in the nation are being kicked out with no notice projects tackling the very issues that our administration claims to prioritize are now left without anyone to work on them. For infection preventionists who have long relied on CDC technical support, guidelines, and grant-funded programming, the losses are already being felt.”

Among the casualties are programs dedicated to antimicrobial resistance, tuberculosis, sexually transmitted infections, hospital-acquired infection surveillance, and environmental health. At the CDC, the Division of Healthcare Quality Promotion (DHQP)—a cornerstone for IP professionals—has reportedly lost significant staff. While some offices may remain in name, insiders say they are now shells of their former selves.

Programs to educate the public and train health care workers are also vanishing. Data modernization initiatives, wastewater surveillance systems, and even core infection control training programs for nursing homes have been shuttered or paused indefinitely.

Without these systems in place, IPs will be operating without the infrastructure that enables early detection and effective response.

“I just had to tell our Commissioners Court that we are having to cancel 50 plus different immunization clinics, outreach events in the community that we've been planning, including several that have just come up from some of the schools that have low vaccination rates,” said Phil Huang, MD, MPH, director of Dallas County Health and Human Services. “This announcement today, [makes me] really concerned about the added impact of the lack of support being available to us from the CDC; the technical expertise is really what we rely on the ground.”

At the center of the storm is a stunning lack of communication from leadership. HHS has not issued guidance on how remaining departments are expected to continue infection prevention initiatives. Congress, which had already allocated funding for these programs, has received no clear answers on where those appropriated dollars are now going.

“CDC keeps us healthy,” said Susan Polan, PhD, associate executive director of the American Public Health Association. “The risks that are happening today, dismantle the CDC and remove the programs, research and data structure, leaving us ultimately with poor health outcomes, increased strain on all health systems, and unnecessary suffering and death.”

Polan noted that the CDC’s Office of Smoking and Health, Climate and Health Program, and several divisions related to HIV, tuberculosis, and antimicrobial stewardship were either eliminated or deeply gutted.

The loss of technical experts will be felt most acutely by infection preventionists during outbreaks. When measles cases began climbing in Texas, Dallas County reached out to schools with low immunization rates to schedule rapid-response vaccine clinics. Those clinics were among the first programs canceled.

IPs are also losing key partners in surveillance. Many local health departments rely on CDC support for case definition updates, outbreak alerting, and data analysis. These tools are critical in helping hospitals adjust protocols during upticks in HAIs, C difficile infections, or drug-resistant organisms.

The layoffs also cripple the development and dissemination of infection control guidelines. During COVID-19, infection preventionists leaned heavily on CDC updates for evolving personal protective equipment protocols, isolation guidance, and environmental cleaning standards. Those departments, IPs say, are no longer staffed adequately to fulfill that mission.

The concern isn’t just about short-term disruption. Infection preventionists are worried about long-term damage to the field, particularly as public trust and workforce morale hang in the balance.

Even the ability to respond to natural disasters may now be compromised. Historically, the CDC’s emergency response capabilities have depended not just on the Office of Readiness and Response but on the subject matter experts pulled in from multiple departments. If a hurricane hits or a bioterrorism event occurs, who will support local IPs on the ground?

Moving forward, some in the public health community are exploring legal action or rapid-response coalitions to fill the gaps—but everyone agrees these efforts can’t replace the scale of the federal system.

For infection prevention professionals, the road ahead is murky. The absence of guidance, training, and surveillance leaves many feeling vulnerable—not just professionally, but personally.

And as more information trickles out, IPs are left with more questions than answers. What happens to NHSN reporting? Will CDC infection control guidelines be updated in real time? Who will help hospitals meet regulatory requirements? How can IPs educate their staff without federally funded training tools?

No one seems to know.

What is known, however, is that IPs have been placed in an impossible position: tasked with protecting patients during a time of rising threats, with fewer tools, less support, and growing burnout.

Yet, as they always have, IPs will persist. They will rewrite protocols, retrain staff, and continue tracking infections late into the night. They will educate administrators, chase down exposures, and keep fighting the invisible battles that few people ever see.

But they shouldn’t have to do it alone.

The question now isn’t whether IPs will rise to the occasion—they always have. The question is whether the nation will rise with them.

Because in infection prevention, when support disappears, infections don’t.