I Reeves

Wondering if the hearts of those frustrated by small acts of petty symbolism, by the feeling that smashed windows and graffiti on bakeries are simply not enough, are cheered by the upgrade to burning ambulances this morning.

For us ID doctors, the CDC has been a rock. Data, guidelines, surveillance, travel advice -- all there, vetted by experts, referenced, reliable. Perfect? No. But watching its dismantling now breaks my heart. Some thoughts: blogs.jwatch.org/hiv-id-observa…

My resignation letter from CDC. Dear Dr. Houry, I am writing to formally resign from my position as Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), effective August 28, 2025, close of business.   I am happy to stay on for two weeks to provide transition, if requested. This decision has not come easily, as I deeply value the work that the CDC does in safeguarding public health and am proud of my contributions to that critical mission. However, after much contemplation and reflection on recent developments and perspectives brought to light by Secretary Robert F. Kennedy Jr., I find that the views he and his staff have shared challenge my ability to continue in my current role at the agency and in the service of the health of the American people. Enough is enough. While I hold immense respect for the institution and my colleagues, I believe that it is imperative to align my professional responsibilities to my system of ethics and my understanding of the science of infectious disease, immunology, and my promise to serve the American people.  This step is necessary to ensure that I can contribute effectively in a capacity that allows me to remain true to my principles. I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.  The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people.   The data analyses that supported this decision have never been shared with CDC despite my respectful requests to HHS and other leadership.  This lack of meaningful engagement was further compounded by a “frequently asked questions” document written to support the Secretary’s directive that was circulated by HHS without input from CDC subject matter experts and that cited studies that did not support the conclusions that were attributed to these authors.  Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people. It is untenable to serve in an organization that is not afforded the opportunity to discuss decisions of scientific and public health importance released under the moniker of CDC.  The lack of communication by HHS and other CDC political leadership that culminates in social media posts announcing major policy changes without prior notice demonstrate a disregard of normal communication channels and common sense.  Having to retrofit analyses and policy actions to match inadequately thought-out announcements in poorly scripted videos or page long X posts should not be how organizations responsible for the health of people should function.  Some examples include the announcement of the change in the COVID-19 recommendations for children and pregnant people, the firing of scientists from ACIP by X post and an op-ed rather than direct communication with these valuable experts, the announcement of new ACIP members by X before onboarding and vetting have completed, and the release of term of reference for an ACIP workgroup that ignored all feedback from career staff at CDC. The recent term of reference for the COVID vaccine work group created by this ACIP puts people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader.   Their desire to please a political base will result in death and disability of vulnerable children and adults.  Their base should be the people they serve not a political voting bloc. I have always been first to challenge scientific and public health dogma in my career and was excited by the opportunity to do so again.  I was optimistic that there would be an opportunity to brief the Secretary about key topics such as measles, avian influenza, and the highly coordinated approach to the respiratory virus season.  Such briefings would allow exchange of ideas and a shared path to support the vision of “Making America Healthy Again.”  We are seven months into the new administration, and no CDC subject matter expert from my Center has ever briefed the Secretary.  I am not sure who the Secretary is listening to, but it is quite certainly not to us.  Unvetted and conflicted outside organizations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources.  At a hearing, Secretary Kennedy said that Americans should not take medical advice from him.  To the contrary, an appropriately briefed and inquisitive Secretary should be a source of health information for the people he serves. As it stands now, I must agree with him, that he should not be considered a source of accurate information. The intentional eroding of trust in low-risk vaccines favoring natural infection and unproven remedies will bring us to a pre-vaccine era where only the strong will survive and many if not all will suffer.  I believe in nutrition and exercise.  I believe in making our food supply healthier, and I also believe in using vaccines to prevent death and disability.  Eugenics plays prominently in the rhetoric being generated and is derivative of a legacy that good medicine and science should continue to shun. The recent shooting at CDC is not why I am resigning.  My grandfather, who I am named after, stood up to fascist forces in Greece and lost his life doing so.  I am resigning to make him and his legacy proud.   I am resigning because of the cowardice of a leader that cannot admit that HIS and his minions’ words over decades created an environment where violence like this can occur.  I reject his and his colleagues’ thoughts and prayers, and advise they direct those to people that they have not actively harmed. For decades, I have been a trusted voice for the LGBTQ community when it comes to critical health topics.  I must also cite the recklessness of the administration in their efforts to erase transgender populations, cease critical domestic and international HIV programming, and terminate key research to support equity as part of my decision. Public health is not merely about the health of the individual, but it is about the health of the community, the nation, the world. The nation’s health security is at risk and is in the hands of people focusing on ideological self-interest. I want to express my heartfelt gratitude for the opportunities for growth, learning, and collaboration that I have been afforded during my time at the CDC. It has been a privilege to work alongside such dedicated professionals who are committed to improving the health and well-being of communities across the nation even when under attack from within both physically and psychologically. Thank you once again for the support and guidance I have received from you and previous CDC leadership throughout my tenure. I wish the CDC continued success in its vital mission and that HHS reverse its dangerous course to dismantle public health as a practice and as an institution.  If they continue the current path, they risk our personal well-being and the security of the United States. Sincerely, Demetre C. Daskalakis MD MPH (he/his/him)

The bottom line with all NHS staff, not just doctors, is that unless you make the NHS a decent place to work, with a decent enough salary to be able to pay off your debts and afford to buy a house near where you work, or at least know where you’re going to be working in the next six months, then people will either leave the NHS or pursue a portfolio career. I combined medicine, journalism, broadcasting, teaching and comedy for 35 years. I think I paid back the debt for my training, but I never felt obliged to work full-time in the NHS. Resident doctors have every reason to be angry, with the growth of non-doctors taking over their work, with a significant risk to patient safety, and the lack of specialty training places for them to pursue in the NHS. And there are many newly qualified GPs who can’t get work. This is all far more complicated than just restoring pay. And medical leaders are as much to blame as successive governments. The medical professional also has to sort its own shit out.

📢 The updated BHIVA guidelines on the management of HIV in pregnancy and the postpartum period 2025 are out now! Find out more here bhiva.org/clinical-guide…

We are open for recruitment! The @SPEARstudy is investigating antibiotic resistance and microbiome changes in people using and not using doxyPEP to prevent STIs. More details below doxypep.me/spear

🚨Calling all medical students and pre specialty doctors🚨 We are keen to understand where people who are interested in GUM would score points on their IMT application, so we can support you to score more points. Please fill out the survey below to help! docs.google.com/forms/d/e/1FAI…

"As I get into my 50s, my #HIV medication sits with my statins and my arthritis medication." Thank you, Kevin McKenna MP for your passionate speech about what it means to live with HIV today during the #HIVTestingWeek debate in the House of Commons.

@wesstreeting @GwynneMP @AngelaRayner Great news - thank you @GwynneMP @AngelaRayner @wesstreeting - can I ask is there a requirement to increase the SHS element by 5.4%. 🙏🏽

Out today - We looked at doxyPEP uptake among >11,000 PrEP users at Kaiser Permanente Northern California.. 1 in 5 started #doxyPEP within a year of availability, and STI incidence declined following uptake. Prescribing DoxyPEP outside of clinical trials reduces STIs.

Receipt of doxyPEP was associated with substantial declines in chlamydia and syphilis incidence and modest declines in urethral and rectal gonorrhea incidence among individuals using HIV PrEP. ja.ma/41VQmVQ

I unlocked £25 Rush tickets for A Midsummer Night's Dream on @TodayTixUK! todaytix.com/london/shows/4…

@nhs_pensions 10/ so in summary this is a mess. HMRC do not appear to be granting extensions to deadlines that many have asked for including @BMA_Pensions @AISMANewsline and others You are expected to do the impossible and estimate - even though it was slightly less impossible last year

@nhs_pensions @BMA_Pensions @AISMANewsline @NHSEmployers 13/13 it is frankly disgraceful @nhs_pensions did not anticipate this and provide TRS to all members incl those who took IA but they should have TRS reinstated by 18th December 2024 All in all, very poor service indeed from NHSBSA, adding huge amounts of stress. Do you agree?

Our chair @ProfYGilleece speaks to @cla_cor about her presentation yesterday on violence against women in Latin America and how this impacts on the HIV response #hivglasgow2024

@drlaurajwaters @HIVGlasgow In spirit.

So, this afternoon I got home to find a lovely letter from @northernassist telling me about how they wanted to prosecute me for using the below ticket to travel on the specified route at a peak time. I paid £1.90 less than the fare they say I should have paid. A thread 🧵

Funniest thing I’ve ever seen👏🏻👏🏻👏🏻 Whoever did this deserves ALL THE MEDALS! #TrumpRally

Forget riots - why not compete in the The EDL-ympics! 🎾🥋🏓 A safe space to express your misdirected hatred 😃

It’s a week since the Govt published my report on suicide in young people with gender dysphoria. What did the reaction tell us about the necessary dialogue with the public on issues of evidence? 🧵