In the middle of a hepatitis outbreak, CDC shutters the one lab that could help

After people started testing positive for hepatitis C in a coastal Florida town in December, state officials collected blood from patients, wrapped their specimens in dry ice and mailed them straight to the Centers for Disease Control in Atlanta, Ga.

The hepatitis C virus, which is spread through contact with infected blood and can lead to deadly liver cancer, is notoriously hard to identify. But if anyone could understand what was happening in Florida, it would be the Division of Viral Hepatitis in the CDC’s headquarters.

Using samples from the laboratory’s collection of nearly 1 million frozen specimens, scientists helped make the initial discovery of the hepatitis C virus in the 1980s. In 2020, that research was awarded the Nobel Prize in Medicine.

But on April 1, the outbreak investigation was brought to a halt. All 27 of the lab’s scientists received an email from the U.S. Department of Health and Human Services informing them that they were losing their jobs. Like thousands of other employees who received similar emails that day, the scientists were told they would be placed on administrative leave until June 2, after which they would no longer work for the CDC.

“More people get sick, or you don’t recognize outbreaks at all, and they just continue to spread unchecked,” said the Director of Infectious Disease Programs at the Association of Public Health Laboratories, Kelly Wroblewski. “That’s the ultimate risk.”

“Commercial laboratories do not do this because it’s not profitable,” said the employee. “That’s why no one really does it except for us.”

Without the CDC’s scientists available to test the genetic material in patient samples, it will be harder for epidemiologists to confirm whether people with hepatitis C were infected in the same Florida doctor’s office or somewhere else where the virus could still be spreading, CDC scientists said.

“We won’t know whether there are other linked cases in this clinic,” said one of the lab’s scientists. “There could potentially be hundreds more people that have been infected with hepatitis C and not know it.”

Two days after the lab’s scientists received their reduction in force emails, HHS Secretary Robert F. Kennedy Jr. acknowledged that about a fifth of the cuts at HHS were made unintentionally and some people would be offered their jobs back.

“We’re reinstating them,” Kennedy told reporters on April 3. “We’re going to do 80 percent cuts, but 20 percent of those are going to have to be reinstalled, because we’ll make mistakes.”

On April 4, the Association of Public Health Laboratories sent a letter to Kennedy urging HHS to reinstate all personnel in the Division of Viral Hepatitis and at the Division of STD Prevention, another lab at the CDC that was also shuttered.

“The [Division of Viral Hepatitis] Laboratory Branch had the highest degree of viral hepatitis expertise of any public health laboratory in the world,” wrote Scott Becker, the association’s CEO. “Their loss eliminated critical national testing services that do not exist anywhere else within the HHS agencies.”

As of April 16, the association had not received a response from Kennedy, Becker said.

Hepatitis is an inflammation of the liver, most often caused by a virus. The disease sickens and kills thousands of Americans every year. In 2022, there were more than 85,000 estimated viral hepatitis infections in all 50 states and the District of Columbia, the latest surveillance data shows. More than 14,500 people are known to have died from the infections in 2022. That number does not include patients who might have died from related complications, like long-term liver disease, without knowing the cause could have been a hepatitis infection.

Viral hepatitis is often undiagnosed and underreported. For more than 30 years, the Division of Viral Hepatitis has been trying to change that, scientists said. Hepatitis samples in the lab’s collection in the CDC’s headquarters have been used by scientists to invent multiple vaccines and identify new viral strains. The lab’s scientists have linked thousands of infections to their sources, they said, which likely prevented dozens of outbreaks from affecting far more members of the public.

Because of the unique role that U.S. government labs like the Division of Viral Hepatitis play in disease detection and prevention, they rarely shut down. If a single scientist is expected to leave or retire, the lab creates an elaborate plan to transition their work to someone else who can continue it, said one of the scientists.

“Nothing has been shut down correctly,” said one of the lab’s workers. “These aren’t pieces of equipment you can just unplug.”

The lab’s computer genomic analysis program – called the Global Hepatitis Outbreak and Surveillance Technology, or GHOST – is also in limbo. That’s the program that allowed scientists to link the genetic information from patients in Florida to the doctor’s office where the infections spread. More than 20 other states access the CDC’s GHOST technology remotely by uploading their own samples directly to the program. But the system, which was built with help from a more than $6 million dollar allocation from Congress, is not fully remote. To function correctly, and to allow the program to keep improving itself with artificial intelligence, it requires frequent in-person maintenance by scientists working at high-end computer stations located at the CDC, said four CDC employees who work with the technology.

“If we don’t have the experts behind it, we’re not going to be able to use it,” said a health worker at the CDC involved with the Florida outbreak investigation. “Something will happen and it will glitch and it will go down. If this happens, it’s going to take decades to come back from that, and that’s devastating not just to us, but to the American people.”

Expensive equipment and irreplaceable specimens could be permanently lost if scientists cannot keep working in the lab, CDC employees said.

“You have to do certain things to make sure they’re set up for long-term pauses,” said a lab member. “That’s millions of dollars worth of equipment if they’re not shut down correctly.”

“We were there during the pandemic when everyone was afraid and we didn’t know anything about COVID,” said one lab scientist. “And now we’re thrown out, just like that.”

“Everyone is saying that this seems to be a mistake,” said one scientist. “If they knew the impact of these programs, they would never do this.”