As the federal government shutdown enters its 12th day on Sunday, the Trumpadministration has implemented a comprehensive purge of the federal public health workforce, laying off thousands of employees at the Department of Health and Human Services, including at the Centers for Disease Control and Prevention.

The cuts have dismantled critical programs in family planning, LGBTQ+ and adolescent health, and infectious disease surveillance, leaving experts warning that the United States is entering the viral respiratory infection season flying blind.

The Office of Management and Budget confirmed “substantial” reductions in force across multiple agencies.

OMB Director Russ Vought, who announced “The RIFs have begun” on X, formerly Twitter, said the cuts represent a shift from traditional furloughs to permanent terminations. In his post, Vought made clear the purge is broad: “These are RIFs, not furloughs.”

Reuters reports that between 1,100 and 1,200 HHS employees have already been fired, with more layoffs expected next week. At the CDC, entire divisions, including those overseeing epidemiology, global health, and the Morbidity and Mortality Weekly Report, the agency’s flagship public-health bulletin, were dissolved. One senior scientist told Time that the CDC “is not functional.”

Within HHS, the fallout has been particularly severe. A former senior Biden administration official told The Advocate that the Office of Population Affairs, which administered the nation’s Title X family-planning network, teen-pregnancy prevention, and LGBTQ+ health initiatives, was eliminated entirely. “This wasn’t a budget decision — it was ideological,” the former official said. “These are the programs that centered reproductive and queer health, and now they’re gone.”

Adrian Shanker, who served as deputy assistant secretary for health policy and senior adviser on LGBTQ+ health equity under the Biden administration, told The Advocate the cuts “are devastating” for both federal employees and the American public.

“This new reduction in force is devastating, certainly for the dedicated public health workers who have contributed countless years to advancing the health and well-being of the American people, and certainly don’t deserve to be political pawns in the Trump administration’s shutdown games,” Shanker said. He added that the Office of Population Affairs had provided funding for sex education programs benefiting LGBTQ+ youth and that its elimination “leaves us more vulnerable to health inequities and worsened health outcomes.”

He noted that this marks “the first time that the office itself is being cut” rather than its programs being politicized. In recent weeks, the administration has rolled back support for state grants that included transgender people. “It’s not a small cut — it’s actually the entire office,” Shanker said. “Without these people in place, it’s unlikely that a lot of these programs will be able to continue even after the government reopens.”

These layoffs come just weeks after the CDC’s collapse in leadership. In August, Dr. Demetre Daskalakis, then director of the National Center for Immunization and Respiratory Diseases, resigned in protest, telling The Advocate that “the CDC you knew is over.” His departure followed the firing of CDC Director Susan Monarez, who clashed with HHS Secretary Robert F. Kennedy Jr. over vaccine policy and scientific independence. Daskalakis said the “firewall between science and ideology” had already broken down, an assessment many public-health veterans now say was prophetic.

Other senior scientists, including Debra Houry and Daniel Jernigan, also resigned this summer, warned that the administration was undermining evidence-based policymaking.

“They have cut so deep into the muscle of CDC that it will not be able to deliver on routine or emergency situations. I fear it has been damaged beyond repair. We need to prepare for the next incarnation of public health,” Daskalakis told The Advocate on Saturday. 

The American Federation of Government Employees has filed lalwsuit to block the firings, arguing that mass layoffs during a shutdown violate civil-service protections. Democratic lawmakers have called the cuts an abuse of executive power.