North Carolina communities still struggling to recover from Hurricane Helene feel the loss of laid-off CDC disaster team

Hurricane Helene tore through the Swannanoa River Valley of western North Carolina almost seven months ago, but many of the scars it left are still fresh. Flooding and landslides toppled trees and demolished homes and businesses. Debris still sits in piles dotting the landscape, and in some areas, people who lost their homes live in tents and RVs. In the county where it’s located, 43 people were killed. President Donald Trump traveled here in January, just four days after the start of his second term, and pledged more federal help. “We’ll be at your side through every step of the rebuilding,” he said. On April 1, a small team from the US Centers for Disease Control and Prevention’s disaster epidemiology unit was preparing to make good on Trump’s promise. The CDC epidemiologists were set to join more than 40 state and local volunteers as well as 11 other CDC public health trainees in the Asheville area. Instead, the CDC team received notifications that they were being fired. The CDC team was intended to lead an intensive door-to-door effort to survey more than 210 households in Buncombe County over two days to learn about residents’ most pressing recovery needs. It’s called a CASPER, for Community Assessment for Public Health Emergency Response, and the CDC team that led them is the only one of its kind in the federal government. “We were all packed. My car was packed. I went to Costco and bought $50 worth of candy for the team,” said a former CDC staffer who spoke on the condition of anonymity because they were afraid of retribution. CDC safety officers had already checked local routes to make sure the workers could get to the rural areas they were trying to target. The cuts torpedoed months of preparation and left the hard-hit region without a way to gauge how residents are doing nearly seven months after the storm. Instead, the CDC team had to call the health departments that had requested their help to share the difficult news. ” ‘Hi. We all just got fired,’ ” the staffer described. The county health department was at a loss. “They said, ‘Well, we can’t do this without you,’ ” the former staffer said. ‘This work is not being done right now’ The firings – part of a wave of deep cuts at federal health agencies in early April. In an op-ed published in the New York Post this month, HHS Secretary Robert F. Kennedy Jr. said he was making the cuts to streamline the sprawling agency. “Many of these offices contain duplicative and redundant functions, in many cases as the result of pet projects or crises that may have happened 20, 30 or even 40 years ago. We are not focusing on the right problems, and we are not coordinating our resources in an effective way,” Kennedy wrote. The Disaster Epidemiology Unit was part of the CDC’s Division of Environmental Health Science and Practice, which lost almost 200 experts in total, according to Dr. Erik Svendsen, who headed the division until he too was placed on administrative leave April 1. The division also lost its Vessel Sanitation Program, which investigated outbreaks of infectious diseases on cruise ships; its Childhood Lead Poisoning Prevention Program; and the staffers who monitored the National Poison Data System, real-time surveillance of calls to poison centers across the US. “All of these public health programs are gone, and there is no part of [the US Department of Health and Human Services], CDC or anywhere else in the federal government that does what our division does, and so by this action, this work is not being done right now,” Svendsen said. HHS Director of Communications Andrew Nixon told CNN that a sister agency, the Agency for Toxic Substances and Disease Registry, had not had any reductions in its workforce and that environmental health work would continue there under a new Administration for a Healthy America. But the work done by ATSDR is very different from the type of work conducted at the Division of Environmental Health Science and Practice, Svendsen said. ATSDR responds to toxic spills. Its staffers develop public health guidance to inform disaster responses, and experts who work there are toxicologists. Environmental health personnel, on the other hand, deal with threats in the environment, whether that’s E. coli in restaurant food, germs in public swimming pools or extreme heat. It’s complementary to the work done by ATSDR, he said, but it’s not the same. “If the HHS leadership thinks that environmental health is only toxic exposures, then they are misinformed,” Svendsen said. Helping residents find resources For the CASPER survey in Buncombe County, teams of two were going to knock on doors in census tracts selected to represent the broader demographics. The 30-question survey touched on housing, displacement, post-flood problems like mold and musty odors, job loss, access to health care, the condition of drinking water wells, septic systems and mental health. “Every question on a CASPER has an action associated with it, so it’s very useable data,” the former CDC staffer said. The teams planned to bring along well testing and well sanitation kits in case those were needed right away. Other responses might generate referrals or point residents to resources in the community that they may not have known about. The teams were going to administer the survey April 2 and 3. The data would have been back to Buncombe County the following Monday, April 7, the former CDC staffer said. Weeks later, the county is trying to figure out whether it can do the same kind of outreach on its own. “We are currently in the process of pivoting, working with partners to identify how we can still get the data from the community. Because we want the community to know we are invested in understanding their needs so that we can get resources out to people,” said Dr. Ellis Matheson, Buncombe County’s public health director. ‘We feel like we’ve been forgotten’ In one of the hardest-hit areas, Swannanoa, a community of about 5,000 just east of Asheville, the loss of basic services is still being felt. The only grocery store remains closed, creating a food desert. The post office hasn’t reopened. And many homes are gone or were rendered unlivable by the storm. The loss of federal resources – including the CDC’s CASPER – has been tough, said Beth Trigg, who co-founded Swannanoa Communities Together to help her neighbors who were struggling after the storm. Trigg said that like everyone in Swannanoa, she dealt with the loss of power, water and local roads after the hurricane, but her house survived the storm and her family was safe. Many of her neighbors weren’t as lucky, so she took in as many people and pets as the house could hold. “It really has just been like blow after blow of different federal agencies and entities that are being cut right now,” Trigg said. “It’s already so difficult for people to meet basic needs where we are, and to have all of these rugs getting ripped out from under us one after the other is devastating.” Hundreds of people are still inadequately housed, Trigg said. “They’re in RVs. They’re doubled up with friends and family,” she said. Others are living in damaged homes that may be unsafe because of structural damage or mold. “And then we have a lot of people who are just figuring it out day to day, living in their cars, scraping together money to pay for hotels,” she added. Across Buncombe County, more than 1,400 households are still receiving rental assistance from the Federal Emergency Management Agency, according to the county department of health. The problem for many, Trigg said, is that they don’t qualify for FEMA aid or can’t find a place to rent. The area had a shortage of affordable housing before the storm, she says, and the hurricane only deepened the crisis. Lack of transportation is also preventing many from being able to get groceries. The nonprofit Bounty and Soul, which helps people access fresh produce, says it has seen demand for its services more than double since the storm. “It has put a lot of pressure on us food organizations to fill that gap, just in the Swannanoa Valley,” founder Ali Casparian said. “There is still a lot of need. It’s real,” she said. “There are times when we feel like we’ve been forgotten.” In the meantime, Casparian said, groups like hers will continue fundraising and working to pick up the slack. “The most important thing is that this work continues somehow, somewhere, so that environmental public health programs across the country are still supported by the federal government some way,” Svendsen said. “And right now, they’re on their own, no one’s supporting them, and that needs to get fixed.”