The Trump administration’s new approach to communicating health and medical data has left a hazy picture of the country’s fight against bird flu and has complicated the relationship between the federal health bureaucracy and state agencies.
While some state health officials told NOTUS they’ve continued to get what they need from the Centers for Disease Control and Prevention, other officials and outside experts say they’re worried about what they’re not being told and how that could be hampering the urgent push against H5N1.
But at least some of the dysfunction of the federal health agencies has trickled down to the states that have had human infections, say some pandemic experts and health officials — making responding to the ongoing H5N1 outbreak that much harder.
Washington state epidemiologist Scott Lindquist said it’s been difficult for state health officials to understand the scope of the outbreak. “Normally, we would be having pretty regular updates, but I’ve seen one health alert come out last week,” he said on Feb. 13.
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Alabama medical officer Burnestine Taylor said that they have had “absolutely no communications” from the federal health agencies recently.
“We’re basically just kind of continuing with the groundwork that was laid before the halt in communication,” Taylor said. “We’re carrying on and doing what we had planned to do, but we no longer have direct communication with them.”
But other states said that their work coordinating public health operations with the CDC hasn’t been interrupted in any meaningful way.
“We appear to be working very seamlessly, particularly even through this new administration change,” said Jae Williams, a spokesperson for the Florida Department of Health. “They’re still getting things situated up in D.C., but it hasn’t slowed down our operations at all.”
H5N1, also known as avian influenza or bird flu, has been circulating in U.S. poultry and cattle since early last year. Upwards of 60 human infections occurred in the U.S. and Canada last fall. Cases occurred mostly in workers on dairy farms — though several people were infected who had no known contact with livestock or birds. One person with underlying health conditions died in Louisiana late last year.
The scope of the outbreak in humans has continued to expand in 2025: Ohio announced its first human H5N1 case last week, joining Washington, Oregon, California, Nevada, Colorado, Texas, Louisiana, Iowa, Missouri, Wisconsin and Michigan as states that have seen infections in humans. While state agriculture departments and the U.S. Department of Agriculture have taken the lead in responding to the H5N1 outbreak in animals, the CDC has played a critical role in tracking human cases and issuing guidance to researchers and epidemiologists tracking the outbreak.
All that came to a thudding halt after Trump issued an executive order freezing communication from the federal health agencies. While some communication appears to have been restored, scientists say what they’ve heard from the CDC still seems to be limited.
“It’s really alarming, the lack of communication about H5N1,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “I have to assume that we haven’t heard big developments because big developments haven’t happened, but we also haven’t heard information about what’s ongoing to make sure big developments aren’t happening.”
A spokesperson for the Massachusetts Department of Public Health said in an email that they have seen very limited outreach from the CDC since the change in administration. They added that the CDC held only one national call, which covered multiple public health topics and was too large to permit useful question and answer periods. Communications between the U.S. Department of Agriculture and state agriculture agencies have apparently been less affected, said the spokesperson.
Reports that the CDC withheld multiple issues of a key weekly report for the first time since the 1960s — and that the withheld reports were about H5N1 — is a sign that things are deeply unwell at the CDC, said Nuzzo.
“It’s really puzzling to me why we’re not releasing information that is essential to understand what risk this virus poses to people and how best to protect them,” Nuzzo said.
KFF Health News recently found that a CDC report on record-high seasonal flu levels had been delayed for release, and that the Advisory Committee to the Director of the CDC wrote to acting CDC Director Susan Monarez asking her to explain the delay.
But some state health officials said that the pause in communications either wasn’t noticeable or didn’t impact their day-to-day activities at all.
“There has been no substantial change in communication with the Federal government,” a spokesperson for the New York health commissioner, Danielle De Souza, said in an email. And a spokesperson for the Nevada Department of Health and Human Services said that “the CDC has been a responsive partner and has been in communication and collaboration with DHHS throughout the response.”
A spokesperson for the South Carolina Department of Public Health said in an email that communications about H5N1 occur between state and federal health officials at least weekly “during regularly scheduled calls, but also on an as-needed basis via calls or emails.” And Oklahoma State Epidemiologist Jolianne Stone said that while they often rely on other states or other public health partners for guidance on outbreaks like H5N1, they have had “communication with CDC technical support and with CDC if needed.”
State health departments are responsible for a broad range of disease response efforts for outbreaks like H5N1. These can range from giving personal protective equipment to farms, to outreach and education for high-risk populations or testing exposed individuals for infections and monitoring them for symptoms. States often make decisions on how best to respond to outbreaks based on the guidance and data the CDC issues.
Lindquist said that while he has still been able to get in touch with individual subject matter experts at the CDC, he’s concerned that the data consolidation and guidance that the CDC does for the states has been impacted by the communications freeze. The last update to the CDC Health Alert Network related to H5N1 was released on Jan. 16 and issued guidance for testing some influenza patients for H5N1.
A spokesperson from the Colorado Department of Public Health and Environment, Kristin Richmann, said that the department was “glad to receive CDC’s recent updates on avian flu and Ebola, and we hope that information sharing continues.”
There have been several developments since mid-January to the nature of the H5N1 virus that’s circulating in the U.S., including the detection in cattle of a variant that has previously only been found in birds. The CDC also just released a report showing that some veterinarians who treated H5N1-infected animals had asymptomatic infections of their own. The data used in that report was from September 2024.
“There’s so much virus floating around out there in North America right now,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Lindquist said the limited understanding of the outbreak, combined with the decrease in communication from the federal health agencies, has driven some state health departments to prioritize interstate communication.
CDC officials “have been told very clearly to curtail some of their communications,” Lindquist said. “But in the meantime, us states aren’t going to just sit back and be at the mercy of this. We’re going to take it into our own hands.”
The Council of State and Territorial Epidemiologists, a public health professionals organization, has “really stepped in and filled the communication void,” he added. And the state health agencies on the West Coast have always kept each other abreast of developments — which Lindquist said has been even more crucial recently.
But the uptick in interstate work creates extra work for already busy state health departments.
“I worry about states that aren’t as well resourced as Washington state, or have as much depth or experience with outbreaks,” Lindquist said. “How are they getting what they need?”
Elena Diskin, an epidemiologist at the Virginia Department of Health, said that they’ve continued to have calls coordinated by either CSTE or the CDC.
“They all have different cadences,” Diskin said.
Diskin, like other state health officials, said that the Virginia Health Department relies heavily on their state animal health partners in responding to zoonotic pathogens like H5N1.
“You don’t want to start a new relationship in a response effort. You want to have those relationships be strong going into those response efforts. And that’s been the case in Virginia,” Diskin said.
Outside of interstate partnerships, though, the CDC plays a critical role in issuing guidance that cuts across state lines — and Nuzzo said that there is “literally no justification” for the CDC’s sluggish response to new H5N1 developments.
“Communication is the most important public health intervention we have,” Nuzzo said. “To restrict the CDC’s ability to talk to state and local health officials — I can only guess that the purpose of that is just to dismantle that agency and is clearly not done in an interest of protecting America’s health.”
Vermont public health veterinarian Natalie Kwit said that while they rely on the CDC for “information, guidance and data,” the temporary communications freeze hasn’t caused them to slow down their state-level response.
“We still provide guidance, even in the absence of anything coming from CDC,” Kwit said.
North Carolina state epidemiologist Zack Moore said that national flu surveillance systems have still been operating normally.
Lindquist said that adding to the problem is the fact that, like many other states, Washington’s health department has embedded federal employees who have been affected by the order for federal health agencies to stop communicating. Trump has also reportedly directed the CDC and NIH to eliminate thousands of recent hires, including the most recent class of Epidemic Intelligence Service officers, who are among those federal employees working with state agencies.
Taylor said that for the Alabama Department of Health, their embedded Epidemic Intelligence officer is their only direct link to the CDC — a link that is currently broken.
“In the last week, [the EIS officer] has told us that she is no longer allowed to be in those meetings” about H5N1, said Taylor. “We can ask her a question, but she is not actively in the meetings at this point.”
Some experts warned that a communication vacuum would make it easier for misinformation to spread.
“That is the kind of thing that is only going to lead to critical gaps in our response and foment mistrust,” said Nuzzo of the CDC communications freeze.
Indeed, conspiracy theories about the virus — and the CDC’s lack of response — have already begun to circulate on certain corners of the internet. Some scientists on social media called into question the motives behind the CDC’s silence after data about cats transmitting H5N1 to humans was briefly posted to the CDC’s website, then deleted.
Adding to the maelstrom of theories is none other than newly confirmed Secretary of the Department of Health and Human Services Robert F. Kennedy Jr.
“The Usual Suspects are calling to ramp up mass testing for bird flu,” Kennedy posted on X in July 2024. “The result will be a high proportion of false positives, media hysteria, and another nightmare of authoritarian control. But we won’t let that happen!”
Osterholm said that perhaps the CDC has just been through an understandably bumpy transition period as one administration ends and another begins.
“At this point, I can’t ascribe bad motives to them, only to say I wish they would get the information to us and in a much more timely way,” Osterholm said.
Osterholm added that he is also concerned about states not receiving a steady flow of funding for the resources necessary to respond to H5N1. Many states still rely on leftover COVID-19-era funding initiatives to run their health departments and receive up to 95% of their funding from the federal government, Osterholm said. The Biden administration in its last days designated millions of dollars for H5N1 response efforts, but the Trump administration hasn’t yet reupped those funds.
“We’re not quite sure what resources are going to be available to the state agencies in the short term,” Osterholm said.
Taylor said that Alabama is in the process of applying for an additional $1.3 million of funding from the CDC to respond to H5N1.
Moore said North Carolina’s state health department is heavily reliant on federal funding. While they’ve also received H5N1-specific funding from the federal government, Moore said that’s not his primary concern.
“I’m less concerned about the future of those funds and more concerned about the core funding for surveillance and laboratory testing,” Moore said.
Regardless of what goes on in D.C., state health officials will have their noses to the bird flu grindstone for the time being.
“I keep telling our team, keep your heads down,” Lindquist said. “We’re needed now more than ever.”
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Margaret Manto is a NOTUS reporter and an Allbritton Journalism Institute fellow.