With respiratory-disease season in full swing and a bird flu outbreak rapidly evolving, the new Trump Administration has ordered federal health agencies to secure White House approval before communicating with the public.
“As the new Administration considers its plan for managing the federal policy and public communications processes, it is important that the President’s appointees and designees have the opportunity to review and approve any regulations, guidance documents, and other public documents and communications (including social media),” through Feb. 1, reads a Jan. 21 memo sent by Department of Health and Human Services officials and reviewed by TIME.
The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH) are all housed within HHS. These agencies regularly publish reports, research, and guidance that shape public response to both chronic and acute health threats, ranging from tobacco to infectious and food-borne disease.
“CDC is the health warning system of the United States,” says Katelyn Jetelina, an epidemiologist who has been a communications adviser to the CDC but was not speaking on behalf of the agency. Any policy that slows that warning system, she says, could make CDC’s job “incredibly chaotic.”
Behind the scenes, staff at federal health agencies are scrambling to understand what the directive means for their work, says a person with firsthand knowledge of the discussions, who asked not to be identified due to the political sensitivity of the situation. “They’re gaining clarity in real time,” they say.
The directive does not constitute a full freeze on public communication, suggests the Jan. 21 memo, but rather requires pre-publication review of documents, press releases, website updates, social media posts, and other public communications. Such a policy is not totally unprecedented. In 2017, the first Trump Administration issued a similar communications pause for agencies including the Environmental Protection Agency, the Department of Agriculture, and the Department of the Interior. And both the Trump and Biden White Houses vetted communications related to COVID-19 at various points in the pandemic.
Mitch Zeller, who was director of the FDA’s Center for Tobacco Products from 2013 to 2022, says it is “not unusual” for an incoming administration to issue a temporary pause on publications. “They want to get up to speed on stuff that would otherwise be coming out before they’ve all even gotten their IDs laminated,” Zeller says.
It is less standard—and more concerning—for the White House to request review of scientific documents, he says. During his tenure with the FDA, White House communications staff were “almost never involved” in agency announcements unless it was an “extremely high-profile, once-in-a-decade kind of announcement,” Zeller says.
HHS has its own “challenging” system for getting materials approved, Zeller says. Adding an extra layer of review, he says, could create a “bottleneck” in agencies’ communications, which are potentially time-sensitive. Already, the policy has reportedly delayed CDC reports on bird flu, according to the Washington Post. (The memo reviewed by TIME notes that agency personnel can notify HHS executives if they believe a document or communication should be exempt from the policy for reasons including “affect[ing] critical health, safety, environmental, financial, or national security functions of the Department.”)
Further, “I don’t trust the incoming administration on issues like this,” says Zeller, who worked at the FDA during the first Trump Administration. “They have come in with an anti-regulatory, anti-science agenda.”
Robert F. Kennedy Jr., the vaccine skeptic who Trump has tapped to lead HHS, has repeatedly said he will spearhead dramatic changes within federal health agencies if he is confirmed. (Kennedy’s confirmation hearing is unlikely to happen before February, Bloomberg reports.) These changes potentially include clearing out “entire departments” at the FDA, limiting the CDC’s ability to create and disseminate vaccination guidance, and redirecting NIH research funding to topics related to preventive, alternative, and holistic health.
A day before the communications memo was circulated, Trump also signed an executive order withdrawing the U.S. from the World Health Organization, a move that experts say makes the U.S. more susceptible to public-health threats. The White House office that handles pandemic preparedness is also expected to dramatically shrink under the Trump Administration.
Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, views the communications directive, however short-lived, as another “assault on American health.”
“The White House has no expertise in science and health and medicine,” Gostin says. “Why would I want to know what they think more than I would want to know what a top public-health scientist thinks?”
HHS representatives did not respond to TIME’s requests for comment before press time. However, according to the memo, “The President’s appointees intend to review documents and communications expeditiously and return to a more regular process as soon as possible.”
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