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    CDC employees on chaos of being fired, rehired and fired again: ‘stuck in limbo’

    As layoff notices swept through the US Centers for Disease Control and Prevention (CDC) on 10 October, Aryn Melton Backus thought she would be safe this time.Then she received the email: she was part of a major reduction in force (RIF) during the US government shutdown. It wasn’t the first time she’d been fired from the CDC by email, nor the second.Backus has been terminated and then reinstated three times this year.Her experience demonstrates the inefficiencies and tumult at US health agencies as leaders continue cutting into the workforce and ending programs vital for Americans’ health.The latest round of shutdown RIFs is illegal, according to the American Federation of Government Employees (AFGE), which is among the unions representing federal workers that are suing the government to stop the layoffs. A quarter of the CDC has now been cut by multiple rounds of layoffs.Some employees who had to work without pay through the shutdown received RIF notices; others who were furloughed learned they would never return to their jobs. Employees who were supposed to be protected from RIFs by an ongoing lawsuit received them anyway. The human resources department at CDC was brought back from unpaid furlough in order to process about 1,300 layoffs – and then their own, as the entire HR department was eliminated.Some of the gutted departments are required by law to continue their work, despite having no employees. The ethics office and the institutional review board (IRB) were also ended, which means the CDC will no longer have oversight on ethical violations and research protocols.The entire library staff at the CDC, an integral part of research and recommendations, was terminated. The Washington office, which developed policy briefings and provided information to Congress members, was eliminated as well.The National Center for Chronic Disease Prevention and Health Promotion, the national health and nutrition examination survey, and the staff focused on suicide prevention also suffered layoffs.The multiple cuts across the agency mean the CDC is not able to carry out much of its work, even as some employees remain, said Karen Remley, who previously ran the National Center on Birth Defects and Developmental Disabilities and was a state health official in Virginia.In April, for instance, the entire team behind the Pregnancy Risk Assessment Monitoring System (Prams) was cut, which means a critical tool for understanding maternal and child health is now missing.“You can’t take out Prams and keep the registry and have all that work happen,” Remley said. “This artificial separating and splitting really means the work on the local level stops.”Meanwhile, CDC employees have endured attacks and harassment.On 8 August, a gunman fired 500 rounds of ammunition at the CDC headquarters, killing David Rose, an officer, and traumatizing agency employees and their families.Health agency employees have been doxed, with their identities and personal information revealed. Matthew Buckham, Kennedy’s acting chief of staff, was co-founder of the group that maintains a “DEI Watch List” targeting HHS employees. The agency has also been roiled by high-profile departures.“At the highest level of leadership in the CDC, there are no public health or medical professionals left to help guide CDC recommendations,” said Abigail Tighe, a former CDC employee and founding member of the National Public Health Coalition, which held a recent press conference where Backus and other former CDC employees spoke.“Billions in contracts and direct funding to state and local public health agencies has been canceled or clawed back, and the American people are cued up to suffer. It is hard to succinctly put into words what the decimation of the CDC means for everyday Americans.”The first round of layoffs at CDC came on Valentine’s day. Probationary employees – who were in the first year or two of their jobs, either because they had been recently hired or had moved to new positions – along with established senior employees received notices.A judge ruled in September that the probationary terminations went too far and some of the employees were reinstated and placed on administrative leave.In the meantime, RIF notices went out on 1 April, eliminating entire offices such as the office on smoking and health, where Backus worked. She didn’t even receive the notice at first because her access to the CDC network, including email, had been cut off.The lawsuit specifically prevents employees like Backus from being reorganized into new offices or terminated from the agency, she said. That’s why she thought she would be safe this time – but she still received a third layoff notice. That notice was rescinded after less than 24 hours. About 700 employees were reinstated, while 600 remain terminated.“I still remain on administrative leave, unable to do my job,” Backus said. “My situation just highlights the chaos and confusion that federal employees have experienced over the past year. I’m stuck in limbo, following court cases, gathering information, and trying to figure out what my next steps should be.”Charlotte Kent, former editor-in-chief of the Morbidity and Mortality Weekly Report (MMWR), said: “We have so many people who, if they’ve been [un-RIFed], have been on administrative leave. We have the inefficiency of so many government resources, our taxpayer dollars, going to fight the illegal activities that have been done by the administration.”The MMWR was among the departments completely gutted and then reinstated – which was particularly surprising, because the highly regarded scientific journal was specifically included in the president’s budget request for the first time this year.“To have it cut at this point is just shocking,” Kent said.“It’s like being in a strange game where there’s no rules,” said one former CDC employee who was RIFed on 10 October and spoke anonymously to avoid reprisal from the Trump administration. “It’s honestly like Squid Games – we don’t know what’s going to happen next.”John Brooks, who retired last year from the CDC after 26 years and served as the chief medical officer for several emergency responses, said the RIFs demonstrated a “stunning level of incompetency”. Firing the CDC Washington staff means “Congress no longer has a means of direct access to the agency it funds when it needs information or briefings”.The Trump administration reportedly says about 700 of the terminations were a coding error.“It is clear to us that this was not a coding error,” said Tighe. “This RIF was carried out just as all the other ones have been, where they fire as many people as they think they can get away with, there’s public outcry, there’s outcry from congressional members and then they bring back the things that they think people cannot get over.”She called the firings “an intentional attack on the American people and the public’s health”.“Our country is on an uncertain and frankly frightening path,” Tighe said. “We would love to see Congress step in.” More

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    Senate postpones hearing for Trump’s surgeon general pick after she goes into labor

    The Senate hearing for Donald Trump’s nominee for surgeon general, Casey Means, has been postponed after the nominee went into labor with her first child.Means had planned to make history as the first nominee to appear virtually before the Senate health, education, labor and pensions committee due to her pregnancy on Thursday. The hearing was originally scheduled for two days after her due date, a person familiar with the matter told CNN. It remains unclear when the hearing will be rescheduled.In a statement shared with the Guardian, Emily Hilliard, press secretary for the department of health and human services (HHS), said: “Everyone is happy for Dr Means and her family. This is one of the few times in life when it’s easy to ask to move a Senate hearing.”Trump nominated Means in May to serve as US surgeon general, the president’s second pick for the role often referred to as “the nation’s doctor”. Means, a wellness influencer and physician with an inactive medical license, follows the abrupt withdrawal of Trump’s first nominee, Dr Janette Nesheiwat, whose confirmation hearing was canceled amid rightwing criticism and questions about her credentials.Means, 38, is a Los Angeles-based medical entrepreneur who rose to prominence in conservative wellness circles for her critiques of mainstream medicine and her advocacy for improving the nation’s food supply.She is the author of the bestselling book Good Energy and a leading figure in the “Make America healthy again” (Maha) movement. Her selection underscores the growing influence of the health secretary, Robert F Kennedy Jr, within the Trump administration.In a social media post, Trump said that Means “has impeccable ‘Maha’ credentials”.“Her academic achievements, together with her life’s work, are absolutely outstanding,” Trump said. “Dr Casey Means has the potential to be one of the finest Surgeon Generals in United States History.”Asked about the nomination shortly after it was announced, Trump said: “I don’t know her. I listened to the recommendation of Bobby.”Means, through her book, blog and speaking appearances, has championed holistic health with a focus on whole and natural foods, exercise, and curbing pharmaceutical prescriptions for chronic ailments.The Stanford Medicine-trained doctor has also suggested that psychedelics such as psilocybin can be beneficial for mental health, decried broad pesticide use and warned against long-term use of hormonal birth control.Means and her brother, former lobbyist Calley Means, served as key advisers to Kennedy’s long-shot 2024 presidential bid and helped broker his endorsement of Trump last summer. The pair made appearances with some of Trump’s biggest supporters, winning praise from conservative pundit Tucker Carlson and podcaster Joe Rogan.Calley Means is now a White House adviser who appears frequently on television to promote restrictions on Snap benefits, removing fluoride from drinking water and other Maha agenda items. More

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    Share how the ongoing US government shutdown could affect your access to food or health insurance

    More than 40 million Americans will stop receiving food stamps on 1 November, as the US government shutdown enters its fifth week.The Department of Agriculture says the Supplemental Nutrition Assistance Program (Snap) will be suspended until Congress reopens the government. While the Trump administration argues the department does not have the legal authority to use a $5bn contingency fund to continue the aid, Democrats disagree, and two dozen states have sued the government to force the program to continue.Meanwhile, Democrats are also refusing to vote to end the shutdown because health insurance costs are set to go up dramatically as insurers prepare for a lapse in subsidies. Senate Democrats are demanding that any short-term government funding deal include an extension of the enhanced subsidies for Affordable Care Act plans, while Trump and the Republicans have said they will not negotiate until the government is back up and running. Extending the subsidies would require $350bn in federal spending over the coming decade.We’d like to hear from Americans who are about to lose Snap food assistance due to the shutdown, as well as from people whose healthcare may become unaffordable due to rising premiums. Have you received any notices or paperwork that your insurance will change soon? Tell us. More

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    Americans brace for food stamps to run out: ‘The greatest hunger catastrophe since the Great Depression’

    Two decades ago, Sara Carlson, then a mother of three, was newly single because of a traumatic event, and the US’s food stamp program, now called the Supplemental Nutrition Assistance Program (Snap), helped her feed her children with free food supplies.“I wouldn’t have been able to afford to live,” said Carlson, 45, who lives in Rochester, Minnesota, and now works as an operations manager for a wealth-management firm and serves on the board of Channel One Regional Food Bank, which works to increase food access.While the food stamps helped her, the government cut her off after a couple years because she started making too much money, which meant she again had to worry about having enough food.Now, nearly 42 million people around the country could face the same fate if the federal government shutdown continues and funding for Snap is cut off on 1 November.While Republicans have sought to blame Democrats for the potential loss in benefits that people who make little money rely on, those who work in the food-insecurity space say that is misleading because Donald Trump’s One Big Beautiful Bill Act already eliminated almost $187bn in funding for Snap through 2024, according to a congressional budget office estimate.Should funding run out at the end of the month, “we will have the greatest hunger catastrophe in America since the Great Depression, and I don’t say that as hyperbole”, said Joel Berg, CEO of Hunger Free America.Snap supports working families with low-paying jobs, low-income people aged 60 years and older and people with disabilities living on a fixed income, according to the Center on Budget and Policy Priorities.Snap participants generally must be at or below 130% of the federal poverty line. The average participant receives about $187 a month, the center reports.The Department of Agriculture recently sent a letter to regional Snap directors warning them that funding for Snap will run out at the end of the month and directing them to hold payments “until further notice”.More than 200 Democratic representatives have urged the USDA to use contingency funds to continue paying for Snap benefits.“There are clear steps the administration can and must take immediately to ensure that millions of families across the country can put food on their table in November,” a letter from the lawmakers to the USDA states. “SNAP benefits reach those in need this November would be a gross dereliction of your responsibilities to the American people. We appreciate your consideration of these requests.”Democrats have refused to pass a funding resolution to reopen the government because they want the legislation to include provisions to maintain healthcare subsidies under the Affordable Care Act, which the Trump administration cut and are set to expire at the end of the year.A USDA spokesperson blamed Democrats for the upcoming loss in Snap benefits.“We are approaching an inflection point for Senate Democrats,” the spokesperson told Fox News. “Continue to hold out for healthcare for illegals or reopen the government so mothers babies, and the most vulnerable among us can receive timely Wic [special supplemental nutrition program for women, infants, and children] and Snap allotments”.That claim is inaccurate: undocumented immigrants are not eligible for Affordable Care Act subsidies.While his organization is focused on food insecurity, Berg supports the Democrats in fighting for healthcare subsidies because “this has grave repercussions for the people we represent”, he said.“The population getting the healthcare subsidies may have a marginally higher income than people getting Snap, but there is certainly a lot of overlap,” Berg said.Brittany, a 38-year-old mother of three, lives in Greenup, Kentucky, and works 35 to 40 hours each week as a home health nurse.She also has received Snap benefits for a few years.“It’s not like I receive benefits and not work,” said Brittany, pushing back against the misconception that people who receive food stamps just sit on the couch.They allow her to get “most of the necessities throughout the month and then I just pay cash for the rest of them”, said Brittany, who did not want her last name used.If the Snap funding is cut off, she said, she would have to work on the weekends to make up the difference, which would mean she would have “hardly any time with my children”.Still, she supports Trump and blames Democrats for the shutdown because “they are not agreeing on anything that the Republicans offer”. More

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    Wes Streeting blasts doctors’ strike as ‘slap in the face’ for NHS

    Wes Streeting has hit out at the doctors’ union after it announced a fresh round of strikes, warning it is a “slap in the face” for NHS staff and will play directly into the hands of Nigel Farage.The health secretary accused the British Medical Association (BMA) of trying to “wreck” the NHS recovery with a “rush to industrial action” after it announced resident doctors in England would strike on five consecutive days next month in an ongoing row over jobs and pay.The association claims doctors are left unemployed and struggling to find jobs, while shifts in But Mr Streeting, writing exclusively in The Independent, said the strike “flies in the face of the wishes of their patients who have consistently opposed these disruptive walkouts”. Resident doctors have been in a pay dispute since March 2023, and next month’s industrial action will be the 13th strike since it began. They were awarded a 28.9 per cent pay rise over the last three years, but the BMA says wages are still around 20 per cent lower in real terms than in 2008.Junior doctors protested outside Downing Street over the summer in their ongoing dispute over pay More

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    Doctors in England to strike for five days in November over pay and jobs row

    Doctors are set to go on strike for five days in row over jobs and pay, the British Medical Association (BMA) has announced.Resident doctors in England will strike on five consecutive days from 7am on November 14 to 7am on November 19.The BMA claims doctors are going unemployed and “struggling to find jobs” – while “shifts in hospitals go unfilled” and patients stay on waiting lists. Resident doctors, previously named junior doctors, make up around half of all doctors in the NHS and the BMA is arguing better pay will stop them leaving.”This is not where we wanted to be,” Dr Jack Fletcher, chair of the BMA’s resident doctors committee (RDC), said announcing the strikes.Junior doctors protested outside Downing Street over the summer in their ongoing dispute over pay (Jordan Pettitt/PA) More

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    US anti-vax stance to blame for continent-wide surge in measles, say experts

    Governments across Latin America are stepping up efforts to vaccinate their populations against measles, as outbreaks in North America drive a 34-fold increase in the number of cases reported in the region this year.Measles cases have surged worldwide to a 25-year high, due to low vaccine coverage and the spread of misinformation about vaccine safety. However, there is added concern in parts of Latin America over unequal access to healthcare and the worrying situation in the US, which is facing its worst measles outbreak in decades following a reversal of vaccine policy led by Donald Trump’s health secretary, Robert F Kennedy Jr.“The US’s political position in relation to health and vaccination is an outrage,” said Rosana Richtmann, an infectious disease doctor and coordinator of the Brazilian Society of Infectious Disease’s immunisation committee. “It’s a problem for us.”View image in fullscreenMeasles was successfully eliminated from the Americas in 2016, and then again in 2024, but the continent is now at risk of losing its measles-free status. There have been 11,668 cases reported across 10 countries in North and Latin America, according to the latest data from the Pan-American Health Organization (Paho).More than half of these cases are in the US and Canada, with three deaths in the US and two in Canada so far.Mexico is the hardest-hit country in Latin America, with more than 4,800 cases and 22 deaths, followed by Bolivia with 354 cases. Other countries, including Brazil, Belize and Paraguay, are dealing with a few dozen infections linked to imported cases.Concern over high numbers of cases in North America has led the Brazilian health ministry to focus more on the highly contagious disease with a nationwide vaccination campaign launched for children and teenagers in October. Adults who did not have the measles, mumps and rubella (MMR) vaccine as children are also being offered the jab.View image in fullscreenBrazil also has protocols in place to respond swiftly to individual cases. When a nine-year-old tested positive for measles on 7 October in Várzea Grande, health authorities were swift to act. Nurses kitted out in protective gear visited the child’s school and worked quickly to implement “ring vaccination”, inoculating everyone who had been in contact with her.The city’s health teams have also been going from door to door to identify unvaccinated people and holding vaccination drives in a shopping centre and the international airport.Richtmann said the biggest fear was imported cases. “We are much more worried about Brazilians travelling to Europe, to the US or Canada [catching measles and bringing it back], than about those who live here,” she said.Amira Roess, a professor of global health and epidemiology at Virginia’s George Mason University, agreed that the outbreaks in the US posed a threat to neighbouring countries.“Now suddenly, you’re more likely to run into someone who has some kind of infectious disease [in the US]. You visit the US, you go home with souvenirs – and you might also go home with measles,” she said.Mexico’s first measles case in February was imported from Texas by an unvaccinated Mennonite boy. Bolivia’s first cases also spread through pockets of unvaccinated people living in Mennonite settlements.Mennonites are Anabaptist Christian communities of European descent who reject many aspects of modern life, including vaccines.Daniel Salas, executive manager of Paho’s special programme for comprehensive immunisation, said: “Having close-knit communities that are often reluctant to receive vaccinations and having large flows [of people] from country to country through the region are aggravating factors.”View image in fullscreenHealth authorities should identify communities resistant to vaccination and target their efforts there, Salas said.There is no cure for measles, which can lead to serious complications and even death, but it is easily preventable with two doses of the MMR vaccine, which provides 97% protection.MMR vaccination rates in Latin America fell during the Covid pandemic and the years leading up to it but have recovered since 2022, reaching 86% last year, according to the World Bank. However, this remains below the 95% threshold needed for herd immunity, with a lag in uptake of second doses and significant disparities between countries and within them.View image in fullscreenLack of information and access to heathcare has contributed to lower vaccination rates, but doctors also blame the influence of the growing anti-vaxxer movement in the US.“A lot of South American countries look to the US,” said Carlos Paz, head of infectious diseases at the Mario Ortiz Suárez paediatric hospital in Santa Cruz, Bolivia, where 80% of the country’s cases have been reported.“The population sees what a US minister says about vaccines, and some people start to say, ‘well, we shouldn’t get vaccinated here either’,” he said.While the US health secretary did endorse the MMR vaccine after an outbreak in Texas in April, Kennedy has also spread misleading information about it and misinformation about measles treatment.This month the US Centers for Disease Control and Prevention, now led by a biotech investor, suggested the MMR vaccine should be given as three separate jabs, even though the safety and efficacy of combined shots have been demonstrated by decades of research and going against the CDC’s own longstanding advice.Bolivia declared a national health emergency in June, extended school holidays to avoid contact between children, and launched a widespread vaccination drive, relying partly on donations from Brazil, India and Chile. But coverage in October had still only reached 45%, while the government still has 1.6m doses available.“We’ve been campaigning to increase the vaccination rate. Each doctor, each paediatrician, is a soldier advocating for vaccination,” said Paz. More

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    Proposed UK cuts to global aid fund could lead to 300,000 preventable deaths, say charities

    The UK is expected to slash its contribution to a leading aid fund combating preventable diseases, with charities warning this could lead to more than 300,000 otherwise preventable deaths.If confirmed, the anticipated 20% cut in the UK contribution to the Global Fund to Fight Aids, Tuberculosis and Malaria, would be announced on the sidelines of next month’s G20 summit in South Africa, which Keir Starmer is due to attend.Aid groups said such a reduction, on top of a 30% cut to the UK contribution at the previous funding round for the group three years ago, would further risk years of progress in combating the disease after Donald Trump slashed US aid.No decision has been publicly announced before the Global Fund’s “replenishment” summit, covering 2027-29, and one government official said this did not recognise the extent of the cut predicted.However, aid groups say a proposed reduction in UK funding from £1bn to £800m is being widely discussed by senior government officials.If confirmed, it would follow a 25% reduction in UK money towards another aid organisation seen as being highly efficient in saving lives, the Global Alliance for Vaccines and Immunisation (Gavi). The eventual £1.25bn commitment over five years to Gavi was nonetheless higher than many aid agencies had feared.The Switzerland-based Global Fund is credited with helping to save tens of million of lives in combating the three diseases. One aid agency estimated a £200m cut could lead to up to 340,000 avoidable deaths and nearly 5.9 million avoidable infections over the three-year funding period.Gareth Jenkins, an executive director at Malaria No More UK, said: “The world stands on the brink of a malaria resurgence, which will be so much more likely triggered if the UK makes a cut to its contribution to the Global Fund.“In this scenario many more children will lose their lives, health systems will be overwhelmed and economies dragged down – with huge knock-on effects for UK trade and health security.”Mike Podmore, the chief executive of StopAids, said the cut “would send a terrible message”, particularly as the UK is officially co-hosting next month’s funding event.Podmore said: “Not only did the UK already make a 30% cut three years ago, but to date no host has ever reduced their commitment from their previous pledge. This would represent a serious lack of leadership and undermine the UK’s reputation and soft power.”Adrian Lovett, the UK head of the development campaign One, said the cut would “put at risk decades of progress in the fight against Aids, TB and malaria – and as diseases do not stop at borders, it would jeopardise our own health security here at home too”.Monica Harding, the Liberal Democrats’ international development spokesperson, said cutting funding as co-host would be “an indictment of our global leadership in diplomacy and development”.She said: “Stepping back now and reducing our contribution to the fund at a time when the United States is abandoning vaccination programmes wholesale would be devastating to some of the world’s most vulnerable people. It would risk undoing much of the progress we have made in the global fight against disease.”A Foreign Office spokesperson said: “The UK has not yet decided what its pledge to the Global Fund will be. We will announce this in due course.” More