Massive censorship escalation at CDC. Trump Administration now choosing the public health data you can see.

Shuttering of public health data has become a hobby of this President.

Day 12 of President Trump’s attack on the public health infrastructure of the United States was focused on data. All day, various observers reported that numerous CDC websites containing everything from epidemiological data to guidelines for the treatment of deadly diseases had been taken offline. Here’s a rundown of what happened, and why it matters.

A brief word of caution: today’s Inside Medicine has a little more snark than is my custom. But it’s been a long week, and I simply need to express myself. And since most of the federal government is under a gag order right now, I feel justified in expressing a little outrage on their behalf.

Thanks for reading Inside Medicine and supporting this work!

Stay woke, or whatever.

—Jeremy

Trump goes all-in on censoring public health—including the public health part.

President Trump’s screed about gender and DEI has forced the CDC to purge a wide array of public health resources. The scope of this purge is particularly chilling, going well beyond any interpretation limited to the President’s stated rationale of “defending women.”

To understand how far Trump went in his first-rate foray into third-world censorship, let’s look at a simple example: contraception. It’s difficult to understand why the administration would take down websites that clinicians use to select birth control after a recent pregnancy. But, indeed, that’s what it did on Friday.

So what? Choosing postpartum contraception sounds easy enough, right? Well, guess what? It’s not. There are many options, including some absolutely unacceptable ones for patients with heart disease, sickle cell anemia, lupus, and an array of other conditions including organ donor recipients. The list goes on. In fact, even choosing to breastfeed means that certain contraceptive options are perfectly acceptable while others are exceedingly risky. It’s too much information for any expert to keep straight which is why the CDC developed easy-to-use charts for clinicians to use. At the moment, though, your government has decided to take those charts offline, scrubbed (dead link as of 1/31/25 at 10pm) from the internet on Friday. Here’s the chart, archived and published on Substack by Jessica Valenti:

Cdc Birth Control Chart (archived)

618KB ∙ PDF file

Download

Download

Fortunately, Valenti’s Substack has links to a number of archived CDC sites containing useful treatment guidelines, updated information on populations who benefit from pre-exposure prophylaxis to prevent HIV/AIDS, and other data and helpful tools that your government shielded your precious lil eyes from seeing last night. Other axed sites include those with information on preventing HIV and one listing foods to avoid during pregnancy. The name of the latter resource: “Safer Food Choices for Pregnant People.” Oh, no! Someone said people instead of women. Someone better send in the National Guard before anybody flushes the wrong toilet.

Why did they do this? Indeed, likely because the website (or an adjacent one) referred to “pregnant people” instead of “pregnant women,” which, according to their own reckoning, thou shalt not do—The horror! (Have you noticed how thin-skinned and petty Trump World is?) The moral panic around this would be remotely credible if President Trump didn’t show a genuine predilection for people who are actually dangerous to women.

They’re offended by demographics. Also, data resources related to race or ethnicity are seemingly verboten. While some of these resources are not relevant to clinical practice today (but again, some are), it’s chilling that the administration censored webpages like the Youth Risk Behavior Surveillance System and the Social Vulnerability Index While these are useful research tools, the latter would be important if another pandemic were to occur, because it would help officials and other public health experts know where to send resources.

Per an HHS website (where the link to the data itself is broken), “Social vulnerability refers to the resilience of communities when confronted by external stresses on human health, stresses such as natural or human-caused disasters, or disease outbreaks. Reducing social vulnerability can decrease both human suffering and economic loss. ATSDR's Social Vulnerability Index uses U.S. census variables at tract level to help local officials identify communities that may need support in preparing for hazards, or recovering from disaster.”

….A disaster like a fire or an extreme weather event influenced by climate change—another forbidden topic that fell victim to the purge, by the way.

A page titled "Efforts to Address Racism as a Fundamental Driver of Health Disparities” was also blocked, which I found disturbing considering the documented disparities that have occurred this century (and worsened by the Covid-19 pandemic) that my colleagues and I reported (as did others)—which reflect biological differences stemming from societal factors (as opposed to genetics). One way to ignore a problem is to try to pretend it doesn’t exist. (A bunch of federal agencies banned any mention of Black History Month, which starts today. How fitting.) Censorship, apparently, is the mechanism of choice in this administration.

The power grab gets worse. Even if you believe President Trump’s election was a mandate to rethink or tone down DEI and LGBTQ+ issues in the public discourse (which I think is a stretch), there’s absolutely no reason for your government to shut down CDC.Data.Gov, as it did on Friday evening. That repository contains much of the information that powers the Inside Medicine Respiratory Virus Dashboard (plus information we present on hospital capacity in each state). But they did it anyway. Fortunately, we updated most of the dashboard before those jerks scrapped the source data, although some data are missing and other data were updated after we did our first pass but are now offline so we can’t get them. This is critical information.

They even removed the CDC’s vaccine recommendations, en masse. Think about what this means.

Perhaps all of this will be temporary. Perhaps you think I am overreacting. Maybe I am. But it should bother us that a few ideologues in the White House seemingly hold all the power here. They can probably extend their regime of censorship as long as they’d like, or at least curate public health content to match their personal beliefs.

Remember, if they merely wanted these websites to be updated to reflect their preferred language on a variety of health topics, they could do that on a reasonable timetable, without shutting down websites and depriving clinicians and the public access to information they need in the clinic right this minute (like vaccine recommendations). The Wall Street Journal found that over 1,000 CDC, NIH, or HHS websites had been blocked. So, part of what concerns me is the wide berth they took here. Speaking of “they,” they probably banned that word too. Good thing I’m not a federal employee. Here's hoping the blackout will be temporary, as some of the shuttered websites promise. But do you trust these people to keep their word?

NIH update. New programs must adhere to Trump bans.

Like the National Science Foundation (NSF), the NIH is bending to Trump-era bans, in an effort to mitigate what it sees as a worse fate: a complete gutting. However, the NIH is taking a somewhat different approach, Science reported yesterday.

Like the NSF, the NIH has "also canceled DEI contracts, which pay for a specific deliverable, but staff are not taking any action on grants already awarded [italics added].”

In an attempt to adapt to Trump’s policies, “NIH staff are pulling down program descriptions and revising requests for applications for programs that violate the orders, which have primarily focused on DEI.”

Reading this, I am torn. It bothers me to see the NIH bending to the will of the new administration. On the other hand, I want grants to be distributed and for scientists to continue to make some kind of contributions, and to survive. It’s an awful situation.

A Profile in Courage: USAID leader Nicholas Gottlieb refuses to fire staff—so he was fired.

The Trump administration placed dozens of top leaders at USAID (the United States Agency for International Development) on administrative leave last week. This was done for no reason other than to gut the place—a cruel and immoral attempt to end the era of US dominance in assisting poor nations of the world combat famine and disease. (The nerve!)

Yesterday, an independent journalist named Marisa Kabas posted two emails on Bluesky (and reported in the media) demonstrating an act of courage by a civil servant named Nicholas Gottlieb, who attempted to use his authority to resist these draconian moves. Gottlieb’s emails to USAID staffers who had been placed on leave were a one-two punch of morality and courage. In the first, he announced that he had personally canceled their administrative leave status, as upon review, he could find no reason for the action. He anticipated that this action would be met with his own firing (Email #1). As you can see (Email #2), he was correct.

Email #1:

All: Attached, please find a memorandum documenting the cancellation of your administrative leave status under my authority. Before you get your hopes up, your systems accesses remain severed; you may receive another email within the day reinstating your leave status. However, that notice will not come from me.

I have reviewed the materials that served as the purported basis for your placement in this status. Most of you had no role whatsoever in those materials. For the small number of you actually involved, the materials show no evidence that you engaged in misconduct.

As a result, I no longer have authority to maintain you in this status. Someone else may claim to have that authority and I wish them the best in making a colorable argument to that end. I may not maintain my own accesses for much longer, so if you would like to stay in touch, I can be reached at

I wish you all the best - you do not deserve this.

Email #2:

Today, representatives of the Agency's front office and DOGE instructed me to violate the due process of our employees by issuing immediate termination notices to a group of employees without due process. I refused and have provided Acting Administrator Gray with written notification of my refusal. I have recommended in that written notification that his office cease and desist from further illegal activity.

It is and has always been my office's commitment to the workforce that we ensure all employees receive their due process in any of our actions. I will not be party to a violation of that commitment. I was notified moments ago that I will be placed on administrative leave, effective immediately. It has been an honor working with all of you at this Agency, which I treasure.

Please be kind and considerate of my staff at who will be very short-staffed and pressed over the coming months. Until you hear otherwise, Kirsten Gunsclus will be acting in my absence. If you would like to stay in touch, I can be reached at [redacted]. Wish you all the best.

Sincerely,

Nicholas Gottlieb

Director, Employee and Labor Relations. US AGENCY FOR INTERNATIONAL DEVELOPMENT.

History is watching. This reminds me of one of the most important written lines I’ve read in the last decade. In September 2020, former CDC Director Dr. Bill Foege sent then-CDC Director Dr. Robert Redfield a letter in the midst of Covid-19.

What a profound and simple message. It’s easy to judge others in positions of leadership. Dr. Foege knew that because he had lived it. Likewise, I wonder how many of us—myself included—would have the courage that Nicholas Gottlieb demonstrated this week. I don’t know anything else about Nicholas Gottlieb, but today he is an inspiration to us all.

A word on pronouns.

Somehow, between slamming Diet Cokes and blaming DEI for the first commercial airline disaster in the US in 16 years, President Trump found time to issue a policy requiring federal employees to remove their preferred gender pronouns from their email signatures.

Here’s the thing. I’ve never listed my pronouns in an email signature. For me, listing my pronouns just never felt authentic for me personally (though I’ve bowed to peer pressure and put them on name tags at events where everyone else was doing it, and I somehow survived). But, I’m glad that other people do it—and I probably would list my pronouns in my email signature if it would help normalize the practice. Fortunately, there’s already critical mass, so I quietly opted out of the trend, hoping either nobody would notice or care.

One thing that’s been great about the trend of listing pronouns is that, in medicine and science, you work and communicate with people from countries whose names may be less familiar. If your name is Jim and Sally, I’ve got a good beat on your gender. But if your name is Mahari, Tenzing, or Valery, I simply might not know if we are only connected by email. In some cultures, names are used by both men and women. So, just from the standpoint of clarity when communicating electronically with people whose names aren’t Bob, I’ve personally benefited from the practice. So, thanks for nothing, Trump. Any advice on this email I just got from someone called Nikita?

That’s all for today. I promise less snark (but just as much coverage) in the next installment. Please contribute your comments and questions in Comments section and…