Last month, an E. coli outbreak swept through McDonald’s restaurants in 13 states, killing one person and sickening 89 others, including 27 people who needed to be hospitalized. Within days, an investigation led by the U.S. Centers for Disease Control and Prevention identified the culprit—fresh, slivered onions often served on Quarter Pounders—and were able to halt the outbreak.

Under a second Trump administration, it’s not clear that public health officials would be able to act so quickly. In the wake of Trump’s victory, conservative commentators, including right-wing podcaster Matt Walsh and former Trump strategist Steve Bannon, emphasized that Project 2025, which calls for splitting up the CDC and erasing protections on health care, “is the agenda.” Meanwhile, close Trump ally Robert Kennedy Jr., who claims Trump promised him control of health and agriculture agencies, told MSNBC last week he plans to empty entire departments at agencies like the U.S. Food and Drug Administration, which regulates the food and drug supply.

Over the next two months, health officials are racing to “Trump-proof” their work, said Gregg Gonsalves, associate professor of epidemiology at Yale School of Public Health. Federal officials are scrambling to disburse funding and move up the timelines of some projects, while local and state health departments are trying to beef up any potential weaknesses in their systems.

Without quick, coordinated responses to outbreaks of deadly pathogens like E. coli, “you’ll see more of them,” Gonsalves told me. Lindsay Wiley, professor and director of the Health Law and Policy Program at UCLA Law, agreed: “Conducting investigations really requires work across state lines—we really are pretty dependent on federal agencies to perform those kinds of epidemiological investigations to track it to the source,” she said. “State and local health departments should be scanning to identify: what are the things that we would lose?” That could include funding as well as resources and leadership on epidemiological investigations and health campaigns. It’s not unusual for states to share resources and information among themselves, but multi-state efforts are usually coordinated by federal officials. Now states are rushing to fill in those gaps.

The national public health........

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