Uganda confirms a new Ebola outbreak. The CDC cannot help; Details on CDC censorship emerge; The NSF bends to Trump's fiat, despite reversal.

Also: Senator Bill Cassidy has waited his whole life to be a hero. Now's his chance.

It’s day 11 of President Trump’s full-throttle attack on the US public health. Today, we’ll discuss how these policies are already affecting our safety and how censorship has taken hold at the CDC. Plus, a depressing update from the National Science Foundation. Finally, an update on the RFK Jr. hearings—including a glimmer of hope and a way you can help.

Today’s newsletter has a short exclusive video just for us from Dr. Craig Spencer and insight from legal expert Professor Lawrence Gostin.

Thanks for reading Inside Medicine and supporting this work! —Jeremy

Medical staff check their protective suits before entering the isolation unit at a hospital in Bundibugyo, western Uganda, on August 17, 2018. Getty Images / Sumy Sadurni

Ebola outbreak in Uganda. CDC cannot help the WHO or local officials control it. Expert insight from Dr. Craig Spencer, in an Inside Medicine video exclusive.

Last week President Trump not only announced that the US would withdraw from the WHO, but also directed an immediate stop-work order, and a halt to all foreign aid and related communications. This means that CDC and other US officials cannot help Uganda respond to an Ebola outbreak that was reported today. The WHO has committed $1 million in aid already.

To understand what this means, I asked Dr. Craig Spencer to explain it to Inside Medicine. Dr. Spencer survived Ebola 10 years ago, is now an Associate Professor at the Brown School of Public Health, and serves on the board of Doctors Without Borders.

Here’s a brief video recorded just for us, exclusive to Inside Medicine, late last night.

Thank you, Craig! (Follow him on Threads and Bluesky). Here’s the transcript:

"Hey Jeremy and hey Inside Medicine readers. My name is Craig Spencer and I'm here to give you a brief update of what is happening with Ebola in Uganda. You may have heard that there was a nurse who died at a large referral hospital in Kampala, the capital in Uganda today, and may be wondering what will happen next and how the US is contributing to the response. There have been nine outbreaks in Uganda since 2000, including most recently in 2022, when the United States was helpful in sending CDC staff support, funds, etc., as we normally do. What's going to happen here? Well, we just don't know. Normally, we'd have CDC staff packing their bags right now and in the next 24 hours, hopping on a plane, landing in Kampala and helping with the response. We would have CDC folks talking to the WHO, thinking about how we can contribute resources and work together to ending this outbreak quickly. We would also have global health leadership in the White House that would be thinking about and assessing the threat there as well as assessing the threat to Americans here and thinking about what we need to do to contribute. The reality is that right now, I suspect none of those things are happening. The CDC has been told it can't talk to the WHO. I doubt that there are CDC folks that are going to be sent to Kampala to help contain this outbreak. And there's not that global health leadership there to assess that threat on the ground in Kampala or even here in the US as there was just a few weeks ago. So what does that mean for us? Well, we have no eyes and ears on what is actually happening. We can read, just like everybody else, the statements that come out from the Ugandan government and Ministry of Health and from the WHO, but we all know that this is just the tip of the iceberg of what's actually really happening on the ground. My worry here is that this outbreak, a nurse in a hospital that was likely infected by a patient from who knows where that we don't know about yet, this could become a lot bigger. This could be really problematic, and we're not going to know about it. In previous outbreaks, we would be ready. We'd have the information, we'd have the people on the ground that could respond. We'd have those relationships that we built over a long period of time, those trusted relationships that are so important for information sharing and for preparedness. We don't have them now. And that concerns me. We have an Ebola outbreak in Uganda. We have a Marburg outbreak next door in Tanzania. We have MPOX in DR Congo and other places. And because of the restrictions that we've put in place in the past week, we're not really gonna be sure of the epidemiology of these outbreaks, how they're changing, how they're moving. And unfortunately, that makes people on the ground there less safe, and it also makes us here less safe."

CDC’s medical journals enter second week of government censorship. Details emerge.

An important but chilling story by KFF Health News reporter Amy Maxmen provides clearly-documented details about some of the studies that the Trump Administration temporarily censored by halting last week’s publication of its flagship scientific journal Morbidity and Mortality Weekly Report (MMWR). The absence of an MMWR last Thursday (and again yesterday) marked the first such gap in publication in approximately 60 years.

Included in the censored studies are manuscripts that “reveal whether veterinarians who treat cattle have been unknowingly infected by the bird flu virus. Another report documents cases in which people carrying the virus might have infected their pet cats.” These have the potential to be highly important reports. Keeping them from the public eye is unethical, to say nothing of the nauseating policy that the Trump Administration has pursued: a gag order on public health publications “until it has been reviewed and approved by a presidential appointee.” I can’t believe I just wrote that sentence from the United States of America.

All three of the CDC’s scientific journals remain offline. Here’s their status:

Morbidity and Mortality Weekly Report: Weekly. Last update 1/16/2025. It’s telling that one of the MMWR’s last publications before President Trump began censoring it was entitled “Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2025.”

Preventing Chronic Disease: Weekly. Last update, 1/16/2025. Given HHS Secretary Nominee RFK Jr.’s stated interest in this area, it feels ironic that the CDC’s journal on the topic—in continuous circulation since 2004—has now been silenced.

Emerging Infectious Diseases: Monthly. Last update: 1/3/2025. (Note: This was prior to Trump’s inauguration. The next issue of this journal isn’t due out until February.)

NSF begins to comply with Trump fiat on funded projects, despite reversal of freeze. Expert insight from Professor Lawrence Gostin.

The National Science Foundation, which provides approximately 40,000 individual grants to researchers in the United States, told its grantees to identify any funded projects that fall under President Trump’s now-revoked freeze on research that promotes “‘woke gender ideology;’ diversity, equity, and inclusion; foreign aid; the green new deal; and support for nongovernmental organizations that undermine the national interest.”

Why the NSF has taken this move, as reported by Science, is unclear, given that the memo that directed this policy was rescinded. However, it is possible that the policy preceded Trump’s rescinding of the memo that set this whole crisis off. Science also reported that NSF “officials have temporarily blocked institutions and scientific organizations from getting access to money they have been promised while vetting projects. The agency has provided no indication of how long that review will take. That has left investigators wondering how to meet payrolls and buy and maintain essential equipment and supplies.”

STAT reported that this already had real effects on scientists because the NSF’s payment portal was down. That outage was, according to an NSF email viewed by STAT “to ensure only eligible activities are funded.”

Again, this appears to be occurring despite the actual absence of the previously announced federal grant freeze (initially stopped due to a judge’s stay and then because the Trump Administration rescinded its own memo that had announced it).

I asked Professor Lawrence Gostin of Georgetown University what he made of this. Here was his response for us via email:

“Dear Jeremy, I wish NSF and others would stop all the timid subservient nonsense. There’s fear and confusion. Here’s what I know: Trump rescinded the freeze after the national injunction. But he maintained the block on programs he doesn’t like such as anything to do with DEI and much more. He’s placed a chill on funders to halt anything that he may object to. It really is disruptive even outrageous. But everyone is running scared. They shouldn’t. Does that help?”

Yes, Larry, it does. Thank you so much! (Follow Larry on Twitter/X)

RFK Jr. nomination fate hangs in balance. Here’s what is at stake and who to call.

RFK Jr. faced another Senate confirmation hearing yesterday. Here’s coverage from MedPage Today and NPR, highlighting a barrage of questions that focused on Kennedy’s widely documented anti-vaccine activities.

The stakes are high. In a piece featuring input from several key experts, MedPage Today’s Shannon Firth and Joyce Frieden describe what RFK Jr. could (and could not) do as HHS Secretary, including guiding vaccine policy and setting NIH research priorities.

The stakes could not be higher, virologist Dr. Angela Rasmussen wrote in Foreign Policy yesterday. As Rasmussen argues, if an H5N1 bird flu pandemic were to erupt on RFK’s watch, a vaccine would be our best hope at getting out of it alive. RFK’s stances make it uncertain (at best) whether one of President Trump’s bright spots during the early Covid-19 pandemic—Operation Warp Speed, which brought us safe and effective vaccines in record time—would be repeated.

All of this rests in the hands of a few Senators. One key vote that could make or break this nomination is Republican Senator Bill Cassidy of Louisiana (a physician) who said he is “struggling” with this decision. If Cassidy stands up for public health, RFK’s nomination may be sunk. I suspect Senator Cassidy has waited his whole life to be hailed as a hero. Here’s his chance.

Let’s help him get there. Senator Cassidy’s contact information page was “under maintenance” on Thursday evening when I tried to access it. (I hope this is because internet traffic broke the site, not because he's hiding or has been otherwise cut off.)

A screenshot of Senator Cassidy’s contact information page I took Thursday evening.

However, his main page still lists his office number in Louisiana which is (318)-448-7176 and Congress.gov listed his D.C. office phone number as (202) 224-5824.

That’s all for today. I need to sleep before my second morning ER shift in a row! Please contribute your comments and questions in Comments section and…