‘Suppressing essential health information’: Some officials frustrated by Trump administration’s limits on health agencies

(CNN) — Canceled meetings, blocked webpages and limited updates on life-threatening diseases spreading across the country. These are some of the real-world implications caused by the vague and sweeping mandates President Donald Trump’s administration has imposed on federal health agencies in recent weeks amid an intense flu season and new H5N1 bird flu infections.

“President Trump is suppressing essential health information that public health agencies and providers across the country rely on to do our jobs,” said Dr. Robbie Goldstein, commissioner of the Massachusetts Department of Public Health. “He is putting the health and well-being of Americans at risk.”

When Trump entered office last month, his administration almost immediately directed federal health agencies to pause external communications. Even though an initial phase of the pause has been lifted, emails obtained by CNN show staffers at the US Centers for Disease Control and Prevention have been ordered to seek multiple layers of approval before releasing mass communications or committing to public speaking events.

Such limits have had ripple effects, records show. And more changes could be coming as thousands of federal probationary health workers across agencies were targeted to be pushed out Friday in what employees at the CDC called “The Valentine’s Day Massacre.”

In Texas, the state health department last week canceled an immunization conference scheduled for May because of “uncertainty about the ability of CDC personnel to participate.” The scuttling of the conference comes as some Texas counties are facing an outbreak of measles that includes unvaccinated people.

Separately, CDC representatives did not show up to a meeting in Fort Lauderdale, Florida, concerning the control of diseases caused by food and waterborne illnesses late last month.

“While local and state partners were able to connect, we were prevented from addressing the issue at hand, goals of national surveillance,” said one health official who requested anonymity out of fear of reprisals. “Without consensus on national goals, jurisdictions cannot best design and implement surveillance strategies.”

In Vermont, workers in the state’s health department, such as those who monitor infectious diseases, have noticed that information from the CDC is not flowing through the channels they have typically relied on, according to a department spokesperson who added this “could impact our ability to assess and respond to emerging issues” such as H5N1 bird flu and a new strain of mpox.

Three studies on bird flu, meanwhile, were delayed after the Trump administration issued the communication pause last month. One of those studies was released Thursday and showed the bird flu may be spreading more widely than testing is currently capturing.

“There are all these diseases out there in various states of outbreak or becoming endemic in some cases that we really need data, information, guidance, advisories floating frequently from our health agencies so that the people on the ground are equipped to keep the community safe and healthy,” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials. “We are hoping that the cadence improves.”

A CDC staffer, who spoke on the condition of anonymity for fear of reprisal, said a pause on external communication effectively remains in place because CDC staffers’ requests to attend meetings or events with outside health professionals are regularly denied.

A message from the US Department of Health and Human Services forwarded to CDC staffers on February 6 states, “The next planned phase of the external communications pause has begun, and we will be unpausing certain communications.” The email further specifies that requests to attend events and speaking engagements had to gain approval from local divisions as well as an HHS public affairs office, which also needed to be made aware of certain public communications not subject to the pause.

Neither HHS nor the CDC responded to requests for comment.

“Why would you remove guidelines?”

The changes at the CDC – which include an order to stop communicating with the World Health Organization – come amid a broader trend of the Trump administration asserting control and upending parts of the federal government, though some of those efforts have been opposed by courts.

A federal judge on Tuesday, for example, ordered the administration to restore certain public health webpages and datasets that federal health agencies had pulled down from the internet. Separately, the administration’s efforts to cut back on funding by the National Institutes of Health for research programs has been blocked nationwide by a federal court in Massachusetts.

But some clinicians expressed concerns over the last week about the unavailability of some essential health information, including guidelines for PrEP medication, which protects people from HIV.

Emily McGahey, clinical director of the Midwife Center in Pittsburgh, which provides reproductive care to families, said she was unable to access the PrEP guidelines or the CDC’s treatment guide app for sexually transmitted infections on Wednesday.

“This is how we access the most up-to-date treatment regimens for our clients,” she said. “Why would you remove guidelines that help keep people healthy?”

Doctors are often able to treat common conditions without having to refer to CDC guidelines, but when a patient’s history is more complex, those evidenced-based guidelines can prove helpful.

“There are many things we know how to treat, like chlamydia. We know how to treat that. But if somebody has a sensitivity to a medication or they can’t take the regular medication, you need to go [to the CDC guidelines] to find out what the best treatment is for them,” said Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists.

Both the PrEP guidelines and the STI app came back online late last week.

In addition to a lack of availability of CDC data, Dantas also said ACOG meetings with CDC representatives had been affected since Trump took office last month.

More restrictions

Researchers at the Department of Veterans Affairs have also been told to seek approval for any public-facing events in the coming months where VA employees would speak on behalf of the department, including presentation of their research results, according to emails sent to VA staff and reviewed by CNN. The guidance marks a significant change in policy, which previously mainly centered on preventing the inadvertent disclosure of veterans’ identifying information.

Public discussion of research at the VA – the largest integrated health care system in the country – is “hugely important,” said one researcher at the department who spoke on the condition of anonymity for fear of retribution.

The researcher said the department has unique insight into health outcomes of policies and can track things like the effects of vaccinations in veterans or whether receiving vaccinations is associated with certain diagnoses. Several seminars, which included non-VA members, have been restricted to VA employees in recent weeks, according to emails shared with CNN.

“VA research is funded by federal dollars and therefore belongs to the public,” the researcher said.

A VA spokesperson said in a statement, “As is typical and appropriate for any incoming administration, VA’s new leadership is reviewing VA employees’ public speaking engagements to ensure they are in line with our efforts to refocus the department on its core mission: providing the best possible care and benefits to Veterans, their families, caregivers and survivors.”

While incoming administrations often enact temporary pauses or processes for reviewing information, the Trump administration’s limits in recent weeks appeared to be unusual in more broadly limiting communications and meetings, two sources familiar with the matter told CNN.

Some local health agencies said their working relationship with the federal government has remained strong.

A spokesperson for the Los Angeles County Department of Public Health said that despite “some confusion and rapidly changing information” amid the change of presidential administrations, executive orders and court orders, the department has continued to have access to federal partners, especially on fire response and recovery activities.

In Nevada, where a dairy worker recently tested positive for avian flu, the CDC is actively meeting with health officials and supporting efforts to keep the virus at bay, said Nevada Department of Agriculture Director J.J. Goicoechea, who noted the CDC has reached out to his office for meetings about the state’s response.

“I don’t think there’s anything falling through the cracks on the public health side,” he said.

Others describe the current interplay with the federal government with more nuance.

A spokesperson for the Washington State Department of Health said federal partners have participated in urgent public health briefings but added that some routine meetings with those partners have remained on hold.

Dr. Manisha Juthani, the commissioner of the Connecticut Department of Public Health, said her colleagues have received timely federal information when they have submitted specific requests, though she said she has noticed a decrease in the US government proactively sharing information about health trends and updates at the national or international level.

“We have eyes on what is happening in our state, and at the very local level they’ve got eyes on what is happening in their jurisdiction, but pathogens don’t live by borders,” she said, stressing the importance of open communication. “This ecosystem of public health is very interconnected and nobody can function independently.”

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