The Centers for Disease Control and Prevention (CDC) is in the middle of modernizing a data system responsible for tracking diseases across the nation, but recent layoffs and contract uncertainty have put the future of the critical system in jeopardy.
The National Electronic Disease Surveillance System Base System, or NBS, is a CDC-designed product that is given to states for free to support their reportable disease detection and investigation work. In simple terms, the system helps states track how many cases of measles, Salmonella, or E. coli they have.
The free system is used by 23 state, Tribal, local, and territorial health departments to store all of their case investigation information and then pass that data on to the CDC.
The CDC has been working to modernize and redesign the system – which is over 20 years old – to better serve the public health experts that use it. However, recent layoffs under the Trump administration may put an end to that modernization effort.
According to multiple reputable sources, the team of Federal employees working on the NBS used to be about 20, but it was recently cut down to only a handful. This came amid mass layoffs of probationary employees – who are typically recent hires – across the CDC.
Sources told MeriTalk that some of the staff on the NBS team have been reinstated, but some critical staff are still missing.
“It’s probably just enough people to keep the lights on. It’s not enough to continue the modernization effort,” said Itir Cole, a former employee at what used to be the U.S. Digital Service (USDS).
Until recently, Cole was the portfolio lead at the CDC. Her team at USDS worked with CDC employees on the NBS, creating a partnership with expertise in public health and technology.
President Donald Trump remade the USDS into the Department of Government Efficiency (DOGE) on his first day in office. Cole resigned in February because she disagreed with the approach and didn’t want to work for DOGE or its leader Elon Musk.
A CDC spokesperson told MeriTalk that it now works with staff from DOGE to support NBS users.
However, a reputable source told MeriTalk that there is only a single USDS/DOGE employee left who is involved in the NBS project.
“I don’t see how the modernization effort can continue with this few people,” Cole said.
“If you reduce the size of the team – and you’re down to four people trying to do all of it – some [problems are] going to fall off your plate, no matter how many hours a week you work,” she added. “There aren’t enough hours, and there wouldn’t be enough expertise.”
Another reputable source who requested to speak on background told MeriTalk that the NBS team was “not operating with redundant staff or extra staff. So, now everything is slower.”
“When jurisdictions need things or they’re going to be scheduled for upgrades, or whatever it might be, they may not be able to get to theirs as quickly as they could,” they said.
The NBS modernization effort is supported in part by a contract. Cole explained that if the CDC ended up giving the contract to “a very capable vendor” who would have to own all of the planning and strategy work, “maybe then [it could continue], but I just see it being really challenging.”
According to multiple sources, the NBS contract was paused in late January – resulting in a stressful time for states that use the system.
One source told MeriTalk that some jurisdictions were scheduled for an upgrade and did not know if they would be able to receive it. Without the upgrade, the system would “go dark,” they said, explaining that the outdated system could not operate without it.
“The contract was able to be renewed, but it wasn’t until jurisdictions actually complained about it,” the source told MeriTalk. “That wasn’t a CDC choice. This is something [that is] so core to your job function. It’s like if the phone didn’t work for 911 anymore. There’s no other way to do your business. You can’t get 911 calls if the phone doesn’t work.”
Luckily, the systems did not go offline during the contract pause. However, the recent layoffs have already led to technical issues with the system.
For example, the source explained that there is no one to support the NBS’s tech “help desk” for jurisdictions anymore. Certain states have reported technical issues such as the system matching people to the wrong information, but the source said there’s no one there to support these help desk requests.
“This is unacceptable. We cannot not know when and where diseases and conditions are occurring,” the source said.
“Without states having access to NBS, they are flying blind, and that means more people are going to get sick. Kids are going to get sick in schools, adults aren’t going to be able to go to work, and people will die,” they added. “You would never tell a hospital that they had to operate without patient medical records.”
The source explained that many people don’t realize that state and territorial health departments rely heavily on Federal funding for both epidemiology activities and personnel.
According to the 2024 Council of State and Territorial Epidemiologists (CSTE) Epidemiology Capacity Assessment report, on average, Federal funds constituted 83 percent of funding for all epidemiologic activities in state programs.
The CDC recently announced it was pulling back over $11 billion in funds allocated to state and community health departments, as well as non-government organizations and international recipients.
While these funds came in response to the COVID-19 pandemic, many states are concerned that the loss of Federal funding will impact their ability to track other emerging diseases or modernize disease data systems.
“When that CDC funding goes away, so does all of the work in health departments,” one source said. “You might say, ‘Well, what’s their backup plan?’ There is no backup plan … the work will not continue.”