Censorship at the CDC continues. But false rumors and exaggerations could make things worse.
Separating reality from fear is important. Things are already bad enough. We have to focus our attention and fight intelligently.
Before we start: I want to update you on censorship at the CDC today. But first, a quick NIH update. Expect this week to be busy on that front. After Friday’s announcement that the NIH plans to cap indirect research costs to institutions of higher education at 15%, medical and science academia collectively flipped out. I expect the universities to pound the Trump administration with legal action as soon as today. However, that's speculation and I have nothing solid to convey. While we wait, here’s—in my view—a small but perhaps crucial nugget to consider: a story of how the NIH’s sudden change was received by a major university in a Red State. The lede says it all. “It just got real in Alabama….The University of Alabama at Birmingham has received more than a billion dollars in NIH funding in recent years and relied heavily on those and other federal grants for its rise to prominence.” When Trump policies hurt his own base, it merits attention. Given the power dynamics, these are opportunities. Effective pushback is more likely to be successful coming from leaders from Red States.
Now, let’s get to the CDC and where things stand with censorship there.
But first…if you want to support work like this, please share and support Inside Medicine. Your support is making this all possible. Thank you!
CDC censorship: Two stories that aren’t as bad as billed and why it matters. (The truth is bad enough.)
Since January 20, we’ve witnessed censorship at the CDC like we never expected to endure or tolerate. We’ve seen massive data purges, clinical resources scrubbed, science impeded, and the agency’s dependable scientific journals ceasing publication for the first time in decades. The easing of some censorship feels like a consolation but the whole thing remains an outrageous attack on scientific freedom. While the CDC has always had baroque clearance procedures for everything it publishes—whether a press release, data brief, website, or its flagship journal Morbidity and Mortality Weekly Report (MMWR), never before has every single communication been subject to approval by a single political appointee, virtually forcing CDC scientists into such quiet submission, lest they lose their jobs. And yet, that is the case in the new Trump administration. It’s intolerable and draconian.
That said, it’s important that we get it right on what is happening. CDC officials are working tirelessly to make things as normal as possible. They’re neither surrendering nor obeying in advance. From what I can tell, they’re just trying to keep the place from imploding, and the way journalists and commentators cover the news matters.
Over the weekend, I learned about two stories whose implications initially looked far worse than they are. To be clear, both are bad situations, but they are not escalations.
Story #1. What happened to the H5N1 bird flu paper in the MMWR? It’s not as bad as reported.
On Friday, The New York Times reported that part of an unpublished MMWR paper on H5N1 bird flu describing viral transmission in cats appeared online briefly before being taken down. It had been previously reported in KFF Health News that the Trump administration’s blanket communications pause meant that H5N1/cat paper had not been published in a late-January MMWR as planned, because nothing was. This had made the H5N1/cat manuscript the first known victim of the Trump administration’s censorship of a new scientific paper coming from the CDC. So, when a new MMWR finally appeared last Thursday, February 6—after two eerie Thursdays without it, a break with decades of tradition—many of us were surprised by what we got: two papers about wildfires and nary an H5N1/cat paper. (Also, why was the new issue so short? If anything, many of us had expected a much longer-than-usual MMWR to make up for the two weeks of delayed content.)
To its credit, the Times made it clear that the partial and temporary appearance of the H5N1 paper was the result of a glitch, rather than some nefarious new escalation of censorship. The same is mostly true of a story published on CBS.com, albeit that article claimed the reason the H5N1 paper was not published last Thursday was Trump administration pressure. A source I spoke to at the CDC denied this convincingly, saying that both the paper’s delay and its brief and partial publication were procedural and scientific issues, not philosophical ones related to censorship. Apparently, it was determined that the H5N1/cat paper needed further revision before it could be published—not due to suppression or censorship, but, rather, fears stemming from the recognition that the MMWR has suddenly come under far more scrutiny than usual. That’s a reasonable concern. The wildfire papers published last week were hardly landmark papers, but they garnered metrics that were up to 100-times higher than many typical recent MMWR manuscripts (and 2-3 times higher than some 2024 “blockbuster” reports). The margin for error in the MMWR at the moment is zero.
While I did not learn whether the discussed H5N1/cat paper will appear in this coming week’s MMWR, it’s possible that it and/or another H5N1 paper might. “Everything needs to be air tight,” I was told.
But posts on Bluesky by a CBS reporter (who is generally excellent, I should add) seemed to frame things in ways that are far more scandalous than reality—if my sources are correct. Take a look:
Look, The MMWR couldn’t just scramble two papers on wildfires out of thin air. Rather, these were manuscripts in the queue that were deemed ready for primetime. The fact that President Trump’s acting CDC Director Susan Monarez has to rubber-stamp anything that goes into the MMWR is not news, at this point. The wildfire papers went up because the MMWR was cleared to resume publication and these two manuscripts were deemed ready by CDC officials other than Monarez. Meanwhile, the H5N1/cat paper was held because those same career officials were, as of a few days ago, still not yet entirely satisfied with revisions. (That paper did not appear in embargoed copies of last week’s MMWR sent to the media the day before publication, by the way.)
In sum, the tenor of the situation at MMWR apparently is less of an escalation of Trump administration overreach and something more like this: After two shocking weeks devoid of new MMWR’s, the journal returned last week (albeit somewhat shorter than usual) and is currently slated to be published again this week. But heightened scrutiny has delayed some papers, including the H5N1/cat manuscript that had initially been intended as a January release.
Story #2. 48% of articles published in CDC’s journal Preventing Chronic Disease since 2015 currently are not on its website.
A Bluesky post by Dr. Erika Trapl broke a little bit of news about the CDC’s journal Preventing Chronic Disease. Dr. Trapl had noticed that two out of six papers she had authored in the journal over the years were no longer online. Her team looked into it and found that among 1,470 articles published in the journal since 2015, only 763 (52%) were still accessible on the CDC’s website.
Had these pieces been retracted without the authors being told? Nobody knew. And were there any suspicious patterns or commonalities among the 707 articles that had been taken offline? Dr. Trapl’s team looked into it and didn’t find any suspicious themes. Her two papers that are offline aren’t particularly different from the four that remain available, she said. (It’s worth noting that Dr. Trapl’s team studies health outcomes in low-income Black communities, a topic that could be misunderstood by the Trump administration as woke, or something.) In looking through the spreadsheet that Dr. Trapl provided me, I reached the same conclusion. Some papers mentioning health disparities and equities remain online and some are offline. There doesn’t seem to have been a targeted kneecapping of papers that President Trump and his Project 2025 pals would not like.
Meanwhile, all of the journal’s papers are still available via a separate NIH website (The National Library of Medicine) that posts PDFs from a number of public journals, including Preventing Chronic Disease. But was that because Trump operatives aren’t sophisticated enough to know about the redundancy? Or, was it because the sudden disappearance of 707 manuscripts was simply a procedural snafu—an artifact of the fact that the CDC had been forced to take down thousands of webpages recently, in an audacious flex of censorship by the Trump administration?
“I don’t know what this means, and it’s weird,” Dr. Trapl told Inside Medicine, “I’m not trying to say it’s the end of the world, but where does this fit in with everything that’s going on over there?”
With her permission to pursue the lead, I asked CDC officials about this over the weekend. An answer from someone with adequate knowledge of the situation to speak confidently was reassuring. “I think this is random,” the official told me. In fact, historical manuscripts were never supposed to have been affected by the blackout, and there has not been any new escalation in the already bold censorship policy. CDC technicians, I was told, are in the process of putting things back online, and it’s taking time. When I directly asked whether anyone had been instructed to remove Preventing Chronic Disease manuscripts, either on specific topics or generally, the answer was no. However, that same source pointed out that many clinical websites remain offline because CDC officials are still “waiting on guidance” from the Trump administration.
In short, this story could have shaped up to be another massive escalation in Trump era science censorship. Thankfully, the facts indicate that it appears not to be.
And so, the bizarro data thaw at the CDC continues…
Hints and allegations. Be careful, folks!
Last week, I heard three rumors that, as far as I know, all turned out to be false. But each of them seemed within the realm of possibility in “all of this.” I’m repeating them below as cautionary tales. As the Trump administration does increasingly unbelievable things, it’s understandably easy to believe that anything horrible is possible. But we don’t want to spread unconfirmed rumors, especially when there are people just waiting to discredit any of us for making mistakes. So, please be careful with what you post online. (That said, if you hear something and want me to help vet it, I’m certainly here for that.)
Here are three rumors I heard at various times this past week that, to the best of my knowledge, are untrue:
Unconfirmed/untrue rumor #1: DOGE was physically at the CDC in Atlanta last week. From what I’ve gathered, that’s untrue. However, what is true is that DOGE’s presence was felt at the CDC through its offsite actions last week; That is, DOGE agents made trouble at the CDC despite not actually being in the building itself, I’m now told. Apparently DOGE likes remote work after all!
Unconfirmed/untrue rumor #2: CDC employees have been barred from teaching at Emory University in Atlanta. Again, not true. For context, many CDC scientists serve as faculty at Emory. If this policy were to be true, it would be a sad development.
Unconfirmed/untrue rumor #3: All over social media yesterday, there were reports that Elon Musk has spent $40 million of his own money to buy Super Bowl ads that would spread falsehoods about supposed USAID fraud. I heard this rumor from smart people and saw numerous online posts repeating it (from normally reliable non-credulous folks). All to say, in this upside-down world we’re navigating, we have to be even more careful than usual.
Bottom line: Things are bad enough already. We don’t want to be distracted and fight the wrong battles.
It’s going to be a big week. Let’s be ready and, as a community, let’s stay alert.
That’s what we know for now. If you have information about any of the unfolding stories we are following, please email me or find me on Signal.
Thanks for reading, sharing, speaking out, and supporting Inside Medicine! Please ask your questions in the comments and if you can’t upgrade due to financial considerations, just email me.
Thank you for this update. Silencing scientists and filtering public health data through a political appointee is the kind of thing we expect from authoritarian regimes, not the U.S. Even if every CDC delay isn’t direct censorship, the chilling effect is undeniable—scientists are being forced into submission under Trump’s watch, and public health is taking a backseat to political control. In times like these, we need to stay sharp, stick to facts, and avoid false rumors that only serve to undermine real concerns.
Thank you SO much for your consistent efforts at truth-telling! I agree wholeheartedly that we need to stay focused, not distracted, and fight the real fights.