By Meg Tirrell, CNN

(CNN) — A Nobel Prize-winning scientist is still waiting on a crucial research grant from the United States government that was supposed to start weeks ago.

A fired public health worker at the US Centers for Disease Control and Prevention worries that she and her family will lose their housing as her pay runs out in mid-March.

And federal agencies overseeing the nation’s attempts to control bird flu are rapidly trying to rescind terminations of employees who are central to that effort.

The first month of the Trump administration has brought chaos to federal health agencies through mass firings, funding interruptions and communications freezes as the country battles not just the threat of bird flu but a historic measles outbreak centered in West Texas and the worst year for the seasonal flu in more than a decade.

“If these actions continue, they could have deadly consequences,” said Dr. Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health.

Firings since February 14 have exceeded 700 each at the CDC and the US Food and Drug Administration, and 1,100 at the National Institutes of Health, although final tallies still weren’t clear, sources told CNN, requesting anonymity because they weren’t authorized to share the information.

“On the inside, it’s absolute chaos,” said one epidemiologist still employed at the CDC. “There’s just been no communication to help us understand what’s happening, which is part of the trauma of it all.”

‘Haphazard inhumanity’

The cuts targeted probationary employees – those who recently took their current roles – but otherwise had little rhyme or reason, sources said. They included medical device reviewers and food safety experts at the FDA, lab fellows focused on infectious diseases at the CDC and specialists working to improve maternal health at the Centers for Medicare and Medicaid Services.

The way the firings were done was “a sign of haphazard inhumanity,” said Dr. Robert Califf, the just-departed commissioner of the FDA, showing “a lack of concern for the well-being of fellow people.”

CNN spoke with several people fired from health agency jobs they loved – and needed. One CDC employee, who asked to speak anonymously because she hopes to get her job back, said she’s considering moving her family in with another family member so she doesn’t run through her savings.

“I’m devastated,” she said. “All the vital work that many of us know that we’ve been doing for years” is now being “mocked, devalued and criticized.”

Another federal health worker who lost his job at the FDA told CNN that he felt “abandoned.” He too spoke anonymously, hoping he might get to go back to work.

“I’m just ready to go back and support my team,” he said. “In spite of everything, I am just waiting on word to go back to work so I can serve the American people. That’s why I’m in public service; that’s why all of us are.”

Both employees were in their probationary periods because they’d taken new roles within the previous two years. But their termination letters also cited poor performance, they said – after they’d received performance reviews with the highest marks.

One said he received a termination letter Saturday evening and then, just a few hours later, saw his performance review, in which his supervisor had scored him 4.4 out of 5.

“How could someone lie on an HR document like this?” he said.

Many of the cuts affected people who specifically chose government work, often at the expense of higher-paying jobs elsewhere. One fired employee, a PhD scientist who reviewed medical devices for the FDA, joined the agency after several years working for companies in the industry because he “believed in providing public service,” he said.

“Medical devices, if not proven to be safe and effective, can hurt people,” he told CNN. “FDA is responsible for making sure that doesn’t happen.”

He also spoke under the condition of anonymity because of the possibility of getting reinstated. Saturday, word came to several fired FDA employees that those decisions were being reversed, two sources told CNN. It wasn’t clear for what reason.

Ryan Sloane said he spent years trying to get his dream job doing communications for the CDC, only to be fired during his probationary period in a way he believes is illegal.

“We don’t care about politics,” he told CNN. “We don’t care about red or blue. Everyone that works in this building is dedicated to keeping people safe, regardless of who is in the Oval Office.”

Arielle Kane, who worked on improving maternal health outcomes at the Center for Medicare and Medicaid Innovation, also saw her work as bipartisan.

“Who doesn’t want to help moms and babies?” she asked.

Kane said she comes from a family of public servants; her dad was a teacher, and her sister works for the federal government. She started her job in May and was fired during her probationary period.

Not just ‘bureaucrats’

The terminations have caused unease about health agencies’ ability to fulfill their missions, stretching to the industries they regulate. On Tuesday, AdvaMed, the trade association representing medical technology companies, sent a letter to the US Department of Health and Human Services warning that the FDA job cuts “could have a very negative impact on patient care.”

The cuts extend to local public health efforts as well, said Chrissie Juliano, executive director of the Big Cities Health Coalition.

“This is not cutting ‘bureaucrats;’ this is cutting boots on the ground in communities across the country,” Juliano wrote in an email. “Losses to an already strained public health workforce put communities at risk.”

And some leaders have quit rather than go along with the firings. Jim Jones, who served as the FDA’s deputy commissioner for human foods, told CNN that he resigned after 89 people on his team were fired, about 4% of staff – people who’d been recently hired because, in many cases, they have specialized training to help with many of the same goals laid out by new HHS Secretary Robert F. Kennedy Jr.’s Make America Healthy Again platform.

“I happen to agree with the priorities” Kennedy has laid out, Jones said, “but won’t have any staff to do it.”

At the CDC, Dr. Nirav Shah, acting principal deputy director, told staff that his last day would be February 28, a source told CNN. And at the NIH, longtime Deputy Director Dr. Lawrence Tabak and Dr. Michael Lauer, deputy director for extramural research, announced their retirements from federal service.

Sources within the NIH told CNN that they didn’t believe Tabak, whose resignation was announced first, would have retired voluntarily and worried that other leaders would be forced out.

Training programs slashed

The cuts also hit future public health leaders, especially those doing prestigious training programs within the CDC. The Epidemic Intelligence Service or EIS, the agency’s so-called disease detectives deployed since the 1950s to aid with public health emergencies from smallpox to HIV/AIDS to anthrax, were expected to see their entire first-year class let go but were spared after outcry from the public health community. Two other similar programs were struck, though, sources said: the Public Health Associate Program for Recent Graduates and the Laboratory Leadership Service.

“When I heard that EIS was being cut, I joined in the outcry around that and did not realize the risk that was being put in place for those other important training programs,” said Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC.

The Laboratory Leadership Service program “are the labs that identify new infectious diseases and keep track of them,” he told CNN. “They’re the laboratories that do testing on infectious agents to look for antibiotic resistance. They track changes in viruses like the bird flu to see if they’re undergoing the kinds of changes that might make them more likely to spread and cause a pandemic.

“To cut those training programs,” Besser said, “is incredibly short-sighted.”

In some cases, agencies including the CDC have realized that themselves and sought to rescind terminations of workers who had protections or who did roles nobody else could do, a source told CNN. A spokesperson for the US Department of Agriculture said the agency was working to reverse firings of several employees important for the nation’s bird flu response.

The CDC epidemiologist said colleagues who were fired were locked out of network access so quickly that they couldn’t pass along information to help those still at the agency pick up their work. And she said some co-workers who weren’t in probationary periods and who hadn’t been terminated were locked out of their systems in error – but the IT department couldn’t immediately fix the problem because it had been hit by firings as well.

She emphasized that some who lost their jobs were veterans of the agency who’d just taken on new roles and were therefore still considered to be in probationary periods – and that newer employees weren’t fired because their work “is not essential, or their knowledge is not essential; it’s just because they’re the easiest ones to fire.”

Asked about the firings, an HHS spokesman said that the agency “is following the administration’s guidance and taking action to support the president’s broader efforts to restructure and streamline the federal government. This is to ensure that HHS better serves the American people at the highest and most efficient standard.”

Research funds on hold

It’s not just firings that have contributed to chaos emanating from health agencies; a communications pause put into place in the earliest days of the Trump administration still has ripple effects, including putting on hold crucial Federal Advisory Committee Act meetings, which are central to awarding new research funds at the NIH.

An advisory board meeting for the National Cancer Institute scheduled for February 13, for example, was canceled – probably meaning the delay of an estimated $200 million in NIH funding that supports cancer research at universities, medical centers, nonprofits and small biotechnology companies, said Dr. Ned Sharpless, former director of the institute.

Similar meetings have been canceled across the NIH’s 27 institutes and centers, sources told CNN.

Even some grants that have been approved are still on pause; a Nobel laureate told CNN that he’d hired a new staff member in anticipation of approved research funding, which was supposed to start at the beginning of the month and support work developing potential treatments for a major public health scourge.

“I will have to let them go if it does not kick in soon,” he said, requesting anonymity because he wasn’t authorized to announce the grant before the US government did.

Researchers warn that more job cuts could be coming to academic science, as well. The Trump administration is trying to implement a major change to the rate at which the NIH funds so-called indirect costs of research, those that don’t fall under specific research grants but are nonetheless crucial to enabling research to be done.

The academic and medical communities supported by the NIH argue that the policy change would upend the nation’s position as a global scientific leader; a temporary restraining order is in place while a judge considers lawsuits fighting the rate cut.

“Our public health system is under attack unlike any time in the past 100 years,” said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “And the deadly infectious agents of the world welcome our chaos.”

RFK Jr. at the helm

To a large extent, many of the most impactful moves at health agencies were put in motion before Kennedy, an anti-vaccine advocate, was sworn in as HHS secretary February 13. But public health experts worry that there could be more turmoil to come under his leadership.

Kennedy told HHS staffers on Wednesday that that he plans to investigate factors contributing to a rise in chronic disease rates, including some that were “formally taboo or insufficiently scrutinized.”

First on his list was the childhood vaccine schedule, which Besser, who practiced pediatrics for 30 years, called “irresponsible.”

“There was nothing I did as a general pediatrician that had more proven value than making sure that my patients were vaccinated fully and on time,” Besser said.

Already, since Kennedy took the helm at HHS, the agency has postponed a key meeting of vaccine advisers to the CDC, sparking concerns that he may try to interfere with the established process for making vaccine recommendations in the US. An HHS spokesperson said the delay was to allow public comment in advance of the meeting but didn’t say when it would be held.

The meeting, scheduled for February 26 to 28, had been set to discuss vaccines including those for flu, amid a season that’s the most intense the US has seen in at least 15 years.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, warned that controlling infectious disease outbreaks could get more difficult under Kennedy, exacerbated by the disruptions to the health agencies he oversees.

“In addition to being a rabid anti-vaccine activist, he’s expressed the idea that infectious disease work needs a pause” and conveyed doubt about germ theory, Adalja said in an email. “How can someone who has those beliefs be in a position to competently lead a response to communicable health threats?”

CNN’s Brenda Goodman, Kit Maher, Nick Valencia and Deidre McPhillips contributed to this report.

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