US public health infrastructure is facing a significant challenge, with potential harmful consequences for infection prevention nationwide. It stems from a wave of unanticipated layoffs at federal departments focused on maintaining public health, which threaten to disrupt the effective functioning of the infrastructure.
Key organizations namely the Department of Health and Human Services (HHS) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) have been targeted, leaving thousands of public health professionals jobless and the future of infection prevention in turmoil. Carol McLay, serving as APIC president in 2025, raised concerns about the repercussions of both short- and long-term nature of these precipitous staffing cuts.
The public health investment has receded on the federal level, a trend that had been somewhat anticipated within the field. However, the magnitude and speed of these layoffs have incited an atmosphere of apprehension. Various public health departments and organizations, including those handling crucial issues such as hepatitis and HIV under the Centers for Disease Control and Prevention (CDC), are feeling the strain.
Restaffing, restructuring, and determining the future trajectory of these departments are going to take some time, opines McLay. All the more, as there has been limited guidance given to the affected departments, leaving them grappling with confusion and a lack of clear direction.
The issue is compounded with the existing pressure exerted by the COVID-19 pandemic on infection prevention teams. As a result of these layoffs, departments are being dismantled without proper communication or clarity. This decimation has significant implications, particularly for local and state health departments, which largely depend on federal grants for executing essential services like investigating outbreaks. With this infrastructure loss, crucial investigations related to outbreaks, such as foodborne illnesses might be delayed or missed completely leading to a surge in the healthcare-associated infections (HAIs).
Infectious preventionists (IPs), who play a crucial role in monitoring infection trends, and enforcing prevention protocols and staff education, are among the most harmed. This widening resource gap will likely increase patient risk and healthcare costs. It does not stop here, cuts to programs around tobacco cessation, obesity, and food security could exacerbate comorbidities as they are critical factors influencing infection susceptibility.
McLay warns of a looming threat to the profession’s future. With a significant portion of IPs due to retire within the next five years, APIC has been focusing on workforce development. However, the present uncertainty could deter potential professionals from viewing public health as a viable career path, which could lead to a dwindling enrolment in public health university programs, exacerbating the professional shortage.
Undeterred by the grim scenario, McLay encourages advocacy. She refers to APIC’s “Voice for Advocacy” initiative that aids professionals and members of the public to reach out to lawmakers. IPs must remain resilient, stay interconnected and continue fighting for the resources and recognition they deserve. As the health care system girds itself against the complete effect of these widespread layoffs, the infection prevention community must be prepared to manage the risk of not only pathogens but also the risk of being neglected.