Tag: epidemic

Can Kennedy’s HHS Restructuring End Chronic Disease?

In this post I look at Secretary of Health Robert Kennedy Jr’s plans to cut 10,000 jobs and close five regional offices in the Department of Health and Human Services (HHS) to tackle the “chronic disease epidemic”. The restructuring intends to reduce HHS’s budget by $1.8 billion while facing significant criticism from Democrats about the potential public health impact.

Secretary of Health Robert Kennedy Jr. and President Trump have established a goal of eliminating the “chronic disease epidemic.” To do so, the Secretary has ordered a massive reduction in the budget and workforce of HHS, the Department of Health and Human Services.

What is Chronic Disease?

Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.

Centers for Disease Control and Prevention

What is an Epidemic?

In the 21st century, epidemics of infectious diseases have threatened humans. Severe acute respiratory syndrome (SARS), avian influenza, and HIV/AIDS have supported the reality of this threat. 

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.

Late in the 20th century, epidemic was applied to noninfectious diseases, such as cancer epidemics or epidemics of obesity. Using epidemic for noninfectious causes refers to a disease that affects many people, with a recent and substantial increase in cases.

For nonmedical events, journalists use the term epidemic for anything that adversely affects large numbers of persons or objects and propagates like a disease, such as crack cocaine, computer viruses, or severe weather.

Reference: Martin P, Martin-Granel E. 2,500-year Evolution of the Term Epidemic. Emerging Infectious Diseases. 2006;12(6):976-980. doi:10.3201/eid1206.051263.

Here is the Secretary’s plan for HHS to address the “epidemic” he believes exists.

U.S. Department of Health and Human Services to slash 10,000 jobs, close 5 regional offices

By Jennifer Shutt, States Newsroom, March 27, 2025 | 12:26 pm ET

WASHINGTON — The Trump administration announced a sweeping plan Thursday to restructure the Department of Health and Human Services by cutting an additional 10,000 workers and closing down half of its 10 regional offices.

The overhaul will affect many of the agencies that make up HHS, including the Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, and the Centers for Medicare and Medicaid Services.

HHS overall will be downsized from a full-time workforce of 82,000 to 62,000, including those who took early retirement or a buyout offer.

HHS Secretary Robert F. Kennedy, Jr. released a written statement along with the announcement, saying the changes would benefit Americans.

“We aren’t just reducing bureaucratic sprawl.

We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”  

The U.S. Senate voted to confirm Kennedy as the nation’s top public health official in mid-February.

James H. Shannon Building (Building One), NIH campus, Bethesda, MD
James H. Shannon Building (Building One), NIH campus, Bethesda, MD

Congressional reaction

Democrats immediately reacted with deep concern.

Senate Appropriations Committee ranking member Patty Murray, D-Wash., said that she was “stunned at the lack of thought about what they are doing to the American public and their health.”

Murray said the committee, which controls about one-third of all federal spending, “absolutely” has an oversight role to play in tracking HHS actions.

Wisconsin Sen. Tammy Baldwin, the top Democrat on the Appropriations subcommittee that funds HHS, said she believes HHS has overstepped its authority and expects the panel will look into its actions.

“These individuals who are going to be terminated under this plan play vital roles in the health of Wisconsinites and people nationally,” Baldwin said. “And I believe that they do not have the authority, the Trump administration does not have the authority to do this wholesale reorganization without working with Congress.”

Maryland Democratic Sen. Angela Alsobrooks, whose constituents in suburban Washington likely hold many of the jobs in question, wrote in a statement the HHS’ restructuring plans are “dangerous and deadly.”

“I warned America that confirming RFK Jr. would be a mistake,” Alsobrooks wrote. “His blatant distrust of science and disregard for research and advancement makes him completely unqualified.”

Cuts across department

The announcement says reorganizing HHS will cut its $1.7 trillion annual budget by about $1.8 billion, in part, by lowering overall staff levels.

Staffing cuts will be spread out over HHS and several of the agencies it oversees. The restructuring plans to eliminate

  • 3,500 full-time workers at the FDA,
  • 2,400 employees at the CDC,
  • 1,200 staff at the NIH and
  • 300 workers at the Centers for Medicare and Medicaid Services.
President Donald Trump visited NIH on March 3, 2020 and toured the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center (VRC) to learn about research on a vaccine for the novel coronavirus SARS-CoV-2. public domain photo from flickr

“The consolidation and cuts are designed not only to save money, but to make the organization more efficient and more responsive to Americans’ needs, and to implement the Make America Healthy Again goal of ending the chronic disease epidemic,” according to a fact sheet.

Senate Health, Education, Labor and Pensions, or HELP, Committee Chairman Bill Cassidy, R-La., wrote in a statement that he looks “forward to hearing how this reorganization furthers these goals.”

“I am interested in HHS working better, such as lifesaving drug approval more rapidly, and Medicare service improved,” Cassidy wrote.

Regional offices, divisions affected

HHS did not immediately respond to a request from States Newsroom about which five of its 10 regional offices would shutter or when those closures would take effect.

Its website shows the offices are located in Boston; New York City; Philadelphia; Atlanta; Chicago; Dallas; Kansas City, Missouri; Denver; San Francisco; and Seattle.

HHS plans to reduce its divisions from 28 to 15 while also establishing the Administration for a Healthy America, or AHA.

That new entity will combine the Office of the Assistant Secretary for Health, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Agency for Toxic Substances and Disease Registry and National Institute for Occupational Safety and Health.

That change will “improve coordination of health resources for low-income Americans and will focus on areas including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce development.

Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs,” according to the announcement.

HHS will roll the Administration for Strategic Preparedness and Response into the CDC.

The department plans to create a new assistant secretary for enforcement, who will be responsible for work within the Departmental Appeals Board, Office of Medicare Hearings and Appeals and Office for Civil Rights.

House speaker says HHS is ‘bloated’

U.S. House Speaker Mike Johnson, R-La., posted on social media that he fully backed the changes in store for HHS.

​​”HHS is one of the most bureaucratic and bloated government agencies,” Johnson wrote. “@SecKennedy is bringing new, much-needed ideas to the department by returning HHS to its core mission while maintaining the critical programs it provides Americans.”

Advocates shared Democrats’ concern about the staff cutbacks.

Stella Dantas, president of the American College of Obstetricians and Gynecologists, released a statement saying the organization was “alarmed by the sudden termination of thousands of dedicated HHS employees, whose absence compounds the loss of thousands of fellow employees who have already been forced to leave U.S. health agencies.”

“Thanks to collaboration with HHS, ACOG has been able to contribute to advances in the provision of maternal health care, broadened coverage of critical preventive care, increased adoption of vaccines, raised awareness of fetal alcohol syndrome, strengthened STI prevention efforts, and more,” Dantas wrote. “This attack on public health—and HHS’ ability to advance it—will hurt people across the United States every single day.”

Originally Published on News From The States

All States Newsroom content is free to republish, as per our policy. 

https://www.newsfromthestates.com/article/us-department-health-and-human-services-slash-10000-jobs-close-5-regional-offices

Is there an “epidemic of chronic disease”?

When I practiced medicine, I and other professionals treated “chronic disease” daily. The number of people who live with a specific chronic disease varies, but the number and percentage of the population who have a chronic disease doesn’t seem to change much.

While we will always work to eliminate chronic disease, that will likely be impossible, at least soon. But improved treatments and lifestyle changes do help people with chronic diseases live longer, and healthier.

Key prevention points from the CDC

  • Most chronic diseases are caused by a short list of risk factors: tobacco use, poor nutrition, physical inactivity, and excessive alcohol use.
    • By avoiding these risks and getting good preventive care, you can improve your chance of staying well, feeling good, and living longer.
examples of ways to reduce the risk of a chronic disease, breast cancer.
Cover Image

The cover image is from the CDC website. It represents hypertension, high blood pressure, one of the most prevalent chronic medical conditions.

Exploring the HEART of Health

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Dr. Aletha

Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond-a book review

Author Sonia Shah’s book “Pandemic” explores infection spread and urges awareness of infectious diseases, emphasizing the importance of vaccinations amidst rising global health threats. This post reviews this informative book.

Influenza has arrived in the United States with some areas already experiencing epidemics. We pretty much expect this to happen in the winter despite wide availability of influenza vaccine.

But other diseases that haven’t been seen much in the past 20 years are making a comeback all over the world. The number of measles cases continues to climb, with 5 countries accounting for half of the world’s victims- Congo, Liberia, Madagascar, Somalia and Ukraine.

In 2019 the United States almost lost its measles elimination status because of a nearly year-long measles outbreak in New York, with the greatest number of measles cases since 1992. The New York State Department of Health declared the outbreak over in October, and the Centers for Disease Control and Prevention announced it would maintain the country’s elimination status.

And in a part of the world that conjures up images of a tropical island with sunny skies and pristine beaches, Samoan children are dying of measles due to increasingly low vaccination levels, currently only 31%. Over 5,100 measles cases have been reported since the outbreak, with 74 recorded in a recent 24-hour period alone, according to Samoa’s government. 

The low vaccination rate this year was caused in part by distrust of vaccinations that spread last year after two infants died after a vaccine error- nurses incorrectly mixed vaccines with another medicine. The accident compounded the worldwide spread of misinformation about vaccines. 

The anti-vaccination movement made the list of the World Health Organization’s top threats to global health in 2019. 

CBS NEWS

I don’t know if anyone has suggested it , but it seems we may be entering a pandemic of measles. Here is a review of a book explaining what that means.

Pandemic by Sonia Shah

Sonia Shah , a science journalist, has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

Tracking contagions from cholera, to Ebola, and beyond

And she answers the “why” in the introduction-

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

Let me back up and define some terms.

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

Epidemic– the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less.

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

map of the world
In a pandemic, an infectious disease may spread all around the world.

Why infectious disease still matters

With healthcare focus on chronic diseases like heart disease, diabetes, cancer, and dementia, even physicians can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

Cholera is rare in the United States now, but in the past it has been deadly here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors recognized this, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope
photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark

how disease spreads

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles.

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

Pandemic includes extensive footnotes and a glossary of terms used in the book.

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

Here are other resources about how infections spread and how they can be stopped

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”

created by Mark Honigsbaum and animated by Patrick Blower 

 

When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed

by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

 At this link read how Dr. Gretchen LaSalle

blows the whistle on anti-vax false claims

an excerpt-

“Vaccines are recommended for personal health and required for the greater good. To protect those who can’t be vaccinated and to preserve the health of our communities, many vaccines are required for school entry. If you choose to participate in the community (ie, attend school), you have a duty not to harm those you come into contact with. And if you can’t make that decision for yourself, sometimes the states have to step in and make that decision for you. But still, you always have the choice to keep your kids out of school. The consequence for you is that you are now in charge of educating your own children. The consequence for your child is that their health is at risk and they are deprived of socialization and interaction with their peers. But, hey. You always have a choice! “

exploring the HEART of preventing disease

I’d love for you to follow this blog. I share information and inspiration to help you turn health challenges into health opportunities.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha