Welcome back to One Thing. I'm David Rind and this is Dr. Richard Besser.

You know, I used to say to people that I get my recommendations from CDC and here's what I think you should do. I'm not practicing pediatrics now, but I wouldn't say that.

What the shakeup at the CDC means for you right after this. Stick with us.

You know, we keep thinking, what could possibly be next? There's no way that the bottom could drop any lower. And then it does. It's exhausting and heartbreaking.

This is a CDC employee. She's asked us not to use her name since she's afraid of repercussions for speaking out. But she sent us these voice notes over the weekend because after more than a decade of working there, she says 2025 is pushing her and her colleagues to the limit. First came the DOGE mass firings and freezes on everything like travel and hiring and external communications. It's also meant extra approvals that are slowing down the work.

If it wasn't so frustrating, it would be comical how inefficient we have become.

Then the number of measles cases hit the highest levels since the disease was declared eliminated in 2000, a tragic milestone after the new Health and Human Services Secretary Robert F. Kennedy Jr. Highlighted unconventional treatments rather than highly effective vaccines. Then in early August, violence arrived at CDC's doorstep. A gunman approached the agency's headquarters in Atlanta and pumped nearly 500 shots into the building, spraying glass and sending employees scrambling under desks. No one inside was hurt, but a police officer was killed responding to the scene.

'A law enforcement official also tells CNN that 30 year old Patrick Joseph White, the suspect, believed that he was sick and blamed the COVID-19 vaccine.

Traumatized staffers are angry. The Trump White House has not paid more attention to the attack and employees are now being told to return to the office on September 15th.

I have never been this frightened to be a CDC employee, and I have done international deployments and I've worked abroad, but I never felt as scared as I feel now to do my job.

And then just last week, Dr. Susan Monarez, the head of this embattled agency, was shown the door after less than a month on the job.

After clashing with HHS secretary Robert Kennedy Jr. Over vaccine policy, the director of the CDC was fired by President Trump. This led to other top officials at the agency to resign in protest.

All of this has left demoralized staffers wondering whether the agency has been fully corrupted by politics and if it's even worth trying to fight the good fight from the inside.

But at what cost? How do we keep staying in this position? How much longer can I keep weathering this storm? I am a human being, but I'm not being treated like a human beings.

'So what is next for this agency? And where should everyday Americans turn for reliable medical advice? I wanna bring in Dr. Richard Besser. He was the acting director of the CDC in 2009 and led the agency during the swine flu epidemic. He's currently the president and CEO of the public health nonprofit, the Robert Wood Johnson Foundation. So Dr. Besser, as we talk here on Tuesday morning, it's been a little less than a week since the CDC director was fired and other top scientists resigned in protest. And then on Monday, you teamed up with eight other former permanent or acting CDC directors who served under both Republican and Democratic administrations going back to 1977 for an op-ed in the New York Times. It was titled, We Ran the CDC, Kennedy is Endangering Every American's Health. So I guess I'm wondering, why did you in this group feel like this moment warranted a piece like that?

Well, David, this is a moment unlike any other we've seen in public health. I worked at the CDC for 13 years, initially as a disease detective and then in various parts of the agency. I ran emergency preparedness and response for four years during the Bush administration. And then I was the acting director during the Obama administration. And it didn't matter what party was in power. The agency is an extremely technical agency that's there to protect the health of people here and people around the world. What we're seeing now is a wholesale different approach to public health and what we do. It's the first time I've seen. A secretary of health be in charge, who came in with a strong ideological approach to health that flies in the face of science. And then so with that, we felt we had to speak out, you know, we are individuals who cut across the political spectrum and have worked in every administration since the Carter administration. And we feel we need to raise our voice, in particular to ask Congress to do its job.

Was it the firing of the CDC director in the way that went down reportedly over disagreements over vaccine issues? Or are there other things that you see happening at the agency that have you concerned?

Well, the firing of Dr. Manara's was really the final push to get us to come together and say we need to do something. But it was far from the only action that the secretary has taken since he came on board. You know, the initially firing of thousands of federal employees who work on health, this gutted and undermined programs that focus on injury prevention. Cancer prevention, heart disease prevention, smoking prevention. You know, we have a secretary who claims to be very concerned about chronic diseases and he basically eliminated the part of CDC that tries to keep kids from starting smoking. Absolutely incredible. He has stopped the research on the most promising lines of vaccine development. He has eliminated the experts who provide the advice to CDC. On vaccines. These things put us all at great risk.

'Well, so you call on Congress to do more, but I also noticed that you wrote that Americans, quote, deserve a Health and Human Services Secretary who stands up for health, supports science, and has their back. But you did not explicitly call on RFK Junior to resign, as Senator Bernie Sanders has done, for example. Why not? I think-

he should resign. I think he should be removed. You know, we had nine individuals on this and so it's pretty hard to read that paragraph and say we deserve better without saying give us better and given that you can't have two people in the job, he's got to go.

The other top officials who did resign in protest, did you agree with their decision to step away? Cause those are like three less voices who can push back against Kennedy from the inside, right?

You know, those are incredibly hard decisions. I think what became ultimately impossible for some of those leaders was the feeling that if they were in that role, in charge of immunizations, in charge infectious diseases, they might be seen as agreeing with the recommendations that the secretary was making because they would be going out with the name CDC on them.

And just by being there, it would kind of be lumped in by association.

Yeah, because when you're there, you don't have the freedom to speak.

We want to stay, we believe in the mission, but when you can't make things work, sometimes leaving is the statement to make.

So you're hearing those leaders speak out now about what it was like, what their experience was, and they're gonna speak out very loudly.

Secretary Kennedy is actually scheduled to testify before Senate finance on September 4th. That was before all of this happened. What do you want Senate Republicans to ask him?

I would love for those folks to be asking him what is his priority.

They're speaking out loudly about whether pregnant women should get the COVID vaccine, whether children should get their COVID vaccine. Things they couldn't do in their roles at CDC.

'That another important thing to ask the secretary is, has he been ever briefed by a CDC expert on anything, specifically measles, COVID-19 flu? I think that people should ask him that in that hearing.

What would the answer to that be?

The answer is no.

My fear, though, you know, we've got incredibly courageous people at CDC who are who are in their jobs. It's really hard to do that without cover from above. And with all those leaders leaving, it's going to be very hard for those folks.

I mean, yeah, can you game that out? Like, what do these next couple of weeks look like? There's a big ACIP, this advisory council on vaccine meeting coming up. What is that going to be looking like for the people who are still there?

Yeah, I mean, Senator Cassidy has called on them to postpone that meeting. The way the system works, the Food and Drug Administration, their role is to decide whether or not a vaccine is safe and effective and to approve it. And then it comes to the CDC and the CDC's job is to make recommendations. Well, okay, it's safe and affective, but who should get it? And that's done with outside advisory committee of experts. The secretary came in and fired them all, got rid of the whole group. And it's not like they're doing it for the money. This is these are groups of experts who are there serving their country.

You know, the CDC is an agency that is very troubled.

The secretary has said that more leaders at CDC have to go.

It's going to require getting rid of some people over the long term in order for us to change the institutional culture.

You know, these are civil servants. They're not political appointees. You know I've heard some people say, well, you know, didn't these people all come in with the last administration? It's like that's not how it works at CDC. This is a group of technical experts.

'We'll be right back. I do want to ask about some of this confusion around vaccines, specifically the COVID vaccine. And I'm sure just a lot of parents will hear about the chaos at the top levels and just wonder what they should do on a day-to-day basis for their kids. So as a pediatrician, what advice would you give parents who are concerned about vaccines and vaccine eligibility as the school year kicks into gear?

It is so confusing with all the noise that's out there. You know, I used to say to people that I get my recommendations from CDC and here's what I think you should do. I'm not practicing pediatrics now, but I wouldn't say that anymore. What I'd say to parents and adults, talk to your own doctor, someone you trust, someone who knows you and let them sort through this noise. Because you're gonna hear things from the department and from CDC that probably aren't the best advice. The big challenge that I see though, is that insurance will only cover vaccines if they're recommended by CDC. And we are gonna see a situation where if you're lower income, you don't have the choice that you might want.

Something else that RFK Jr. Has promised to do is to reveal the causes of autism sometime later this month. What are your thoughts about that promise?

I think it's absurd, you know, there is so much research going on to try and look at the various causes of autism, how best to support people, this idea that he's going to find some magical cause of autism. He has come in with preconceived ideas that autism is all about exposure to, we'll hear what in a couple weeks, but this is not how science is conducted.

You're saying it's worthy of further research and looking into, but you're saying RFK Junior is coming in with some ideas that are already just kind of not supported by any science.

Yeah, the he is trying to relitigate questions that have already been answered. He is very focused on the already disproven idea that autism is is from vaccine exposure. And so I would expect he's going to conclude that in a couple of weeks. But that question has been asked repeatedly, answered repeatedly.

I wanna go back to something you said. So you said, if you were still practicing physician, you would not be looking to CDC for guidance.

'That's right. It's unfortunate, but you can only look to an agency like CDC for guidance if they're allowed to follow their basic principles, which is let the science drive the policy. At the last meeting, the secretary, he put on to the agenda a question about thimerosal and flu vaccines. Thimerosol is a preservative that's been used for a long time. It's been shown to be safe and effective at preventing bacteria germs from growing in vaccine bottles. He put on a leader of an anti-vaccine group onto the agenda to present the science around thimerosal and flu vaccines and they voted to no longer allow those to be given. No one at CDC reviewed that presentation. No-one at CDC was allowed to present the wide evidence around thimerasal and its use so that there could be a balanced discussion. Yeah, in that kind of a setting, I cannot trust the recommendations from the CDC, and I'm glad to see some other medical organizations stepping up.

'So by extension, the average American, in your view, should not be listening to what is coming out of CDC at this point and think that it is gold standard science, something they can trust. That's right. I mean, that's a pretty staggering statement, right? And it just reminds me, like during the pandemic, many people were very skeptical of the CDC when it came to masking or social distancing guidance and eventually vaccines, a lot of misinformation and Conspiracy theories sprouted up around that. They continued to spread to this day. And the whole mantra of, you know, do your own research kind of became a punchline for people who were firmly pro-science and looking to the CDC for help. So I imagine some of those same people today might actually be turning away from the federal government when they look at what RFK Jr. Is doing and all the knock-on effects at CDC. And they're more or less doing their own research. What does that say about the future of public health? If this mistrust of public health spans the full political spectrum.

Yeah, you're lifting up really important questions, David. Mistrust is really at crisis levels. And a lot of it did come out of COVID and the politicization of the response. I led CDC briefly. I was six months, but it was at the start of the H1N1 swine flu pandemic. And, you know, what I would always say at every press conference is here's what we know, here's we don't know, and here's what we're doing to find out the answer to those questions. We're gonna make our best recommendations now, but as we learn more, our recommendations are gonna change. And that's a good thing. It means we're learning. You need to get everyone on board with that kind of a mantra. And with COVID, every time CDC learned more and changed recommendations. There were politicians who said, look at CDC, they don't know what they're talking about. Because the story wasn't straight. Yeah, the CDC had the microphone taken away from them very early in COVID. And clearly, there were things CDC did that caused big issues. But if you're able to explain those and there's transparency and honesty, you can bring people along with you. But if you have politicians who are looking to gain political capital off of the mistakes that public health makes, then you're in a situation where you are today where how you feel about public health aligns very much with your politics. And that's really bad.

Well, Dr. Richard Besser, thank you so much for the time. I appreciate.

Thank you David.

'On Monday, President Trump appeared to question the COVID-19 vaccines that were developed during his first term under Operation Warp Speed. On True Social, he called on drug companies to prove publicly that the shots are effective and questioned whether some data was being held back. He claimed the CDC was being, quote, ripped apart over the debate. Top experts, of course, noted that companies already share troves of data with the public and government health agencies as the shots are developed and used. And the data continues to show the vaccines are safe and effective at preventing severe disease. Meanwhile, we reached out to HHS for comment. They pointed us to an op-ed in the Wall Street Journal written by Secretary Kennedy, where he defended his moves at the CDC, saying the agency has strayed from its central mission and a series of reforms will help restore public trust. That's it for us today. Just a reminder, our voicemail box is open. If you work at the CVC or any other agency and have something to share, We'd love to hear from you. Our number is 202-240-2895. That's 202 240 2895. We'll put the number in our show notes as well. We're back on Sunday. I will talk to you then. Thanks for listening.