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Termination letters landed in the mailboxes of hundreds of employees at the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health over the weekend, as the Trump administration moved ahead with firings announced verbally Friday.

That's according to more than half a dozen current staffers who requested anonymity because they are not authorized to speak publicly and feared repercussions.

The number of employees who lost their jobs at the NIH and CDC was 

. At CDC, current staff members say they haven't been told why and still fear that more cuts could be coming.

Among staff who were caught up in the first wave of layoffs: Ph.D.-trained scientists tasked with helping local and state officials respond to outbreaks; employees who ensure that medical devices for patients with cancer and diabetes are safe; and a public health worker stationed at an international airport who enforces regulations to prevent animals carrying rabies and other infectious diseases from entering the U.S.

Altogether, about 750 CDC employees received termination letters over the weekend, according to a current CDC staffer who was on a call with agency leadership and another who reviewed an internal memo.

On Friday, CDC leadership told staff that 10% of the agency's workforce — about 1,300 employees — would be notified they'd be losing their jobs.

"I'm going to work tomorrow and I don't know who's employed," said one of the CDC staffers, who had yet to receive any official notification about exactly which employees in their division had lost their jobs.

At the National Institutes of Health, between 1,000 and 1,200 employees received notification Saturday night that they were being cut, two staffers with knowledge of the situation told NPR. This is a few hundred fewer than was 

Officials were able to save some jobs because certain positions were deemed essential, such as people who work at the NIH's clinical center, one person said. 

Cuts at the FDA hit people who do research and approvals on the medical device side of the agency, according to fired FDA employees who were fearful of the consequences of speaking out. 

Staffers who work on drug approvals were temporarily spared, a current FDA employee told NPR.

HHS, CDC, FDA and NIH did not respond to NPR's request for comment.

NPR reviewed termination letters sent to staff at the CDC, NIH and FDA.

All of them used similar language and cited inadequate performance as the reason for their firing — yet the employees NPR spoke with had records of stellar work.

"Unfortunately, the Agency finds you are not fit for continued employment because your ability, knowledge and skills do not fit the Agency's current needs, and your performance has not been adequate to justify further employment at the Agency," the letters from the Office of the Secretary of the Department of Health and Human Services states.

The letters set a termination date effective March 14, 2025.

At all three agencies, most who lost their jobs were staff in their 

 — a prolonged trial of one to two years for new employees or those who have moved to new positions within the agency — who have fewer worker protections.

Dr. Steve Monroe, a former senior CDC official, called the decision "extremely shortsighted," because it swept up people "regardless of whether they were filling an important role in the organization or how well they were performing."

Some employees were left on edge and confused about their job status and what to expect in the coming days.

For example, some who had been explicitly told they'd be terminated have yet to receive a letter, including fellows in the CDC's high-profile 

, a premier training program for what are called "disease detectives," staff who are dispatched to respond to outbreaks.

A current CDC staffer said they would love to know that cohort had been spared at the last minute, but they weren't necessarily "optimistic," given the mass firings over the weekend.

The job cuts dealt blows to some essential functions of the federal health agencies.

NPR heard from several FDA staff, who spoke anonymously because they fear retribution for speaking up, who worked on reviews for devices that do things like detect cancer and help people with diabetes. They say they have kept devices that don't work or are dangerous off the market and fear that downsizing their ranks could be dangerous to consumers.

At NIH, offices involved in reviewing and administering grants to researchers outside the agency, such as at universities and medical centers, were hit hard, one staffer with knowledge of the situation said. The NIH spends most of the agency's $48 billion annual budget on this kind of "extramural" research to find new cures for cancer, heart disease and other diseases.

"Our nation cannot afford to hollow out our research and public health assets," Mary Woolley, president and CEO of Research!America, an advocacy group, said in a statement. "Patients are waiting; lives are at stake."

At CDC, fellows who respond to disease outbreaks from at least two celebrated CDC training programs were cut. Twenty fellows in the 

 received termination letters on Saturday. They "help develop the tests for new and emerging diseases," one fellow explains. Those in the program have doctoral degrees and are often co-deployed with fellows in the Epidemic Intelligence Service for outbreak responses.

Every person in the lab fellowship cohort had received a letter and a performance review a few weeks ago attesting to the high quality of their work, the fellow said: "We included that letter in the response email to show good standing and more than adequate performance."

Monroe, the former CDC official, worries these cuts could "hobble" the nation's ability to respond to outbreaks. "Losing them today means that there's less capacity to assist states tomorrow if there's a need for an outbreak investigation," he says. 

In the longer term, the cuts may result in fewer people getting trained or choosing to work in public health. "A year from now, there won't be the people that have a year and a half of experience because we cut them loose," he says.

The ranks of the Public Health Associate Program were also decimated by the layoffs. The fellowship embeds recent college- and masters-level graduates in state and local health departments and serves as a pathway for careers in public health, says a current CDC staffer familiar with the program.

A CDC employee who was charged with preventing the introduction of zoonotic diseases (those that jump from animals to humans) had assumed they'd be safe from layoffs because their work involved national security and border control. They'd recently received a CDC award of excellence.

It's also not clear how the firings will save the government money, says 

, a law professor at Ohio State University who served as deputy general counsel to HHS, covering the FDA, until January.

For instance, FDA user fees, paid by drug and device-makers, began in the 1990s to speed up things like drug and device approvals. In exchange for the fees, the agency commits to hiring more staff and reviewing applications for new products more quickly.

"When we think about all of the layoffs across HHS, none of them are going to save the taxpayer money in the long run," she says. "It is especially clear that laying off FDA staff who are funded by user fees will not save the taxpayers any money. The taxpayers are not paying for these employees."

In response to a request for comment on the cuts when word of them came out Friday: Andrew Nixon, director of communications at HHS, wrote in an email to NPR: "HHS is following the Administration's guidance and taking action to support the President's broader efforts to restructure and streamline the federal government. This is to ensure that HHS better serves the American people at the highest and most efficient standard."

Have information you want to share about the ongoing changes across the federal government? Reach out to these authors via encrypted communications: Will Stone @wstonereports.95, Pien Huang @pienhuang.88, Rob Stein @robstein.22 and Sydney Lupkin @sydneylupkin.36.

Rob Stein and Sydney Lupkin contributed to this report. 

Will Stone

Author

Pien Huang

As the dust settles from the first wave of firings at health agencies, here's how many people got cut and the impact of the roles that were lost. 

Health agencies lose staff members in key areas as Trump firings set in

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