Susan Monarez: A Look at the CDC Director’s Removal and Public Health Turmoil

In late July 2025, Susan Monarez was confirmed by the Senate as the 21st director of the Centers for Disease Control and Prevention (CDC), following her appointment as principal deputy director in January. She had briefly served as acting director before receiving confirmation on July 31. Barely a month into her tenure, on August 27, the White House and Health and Human Services officials announced Monarez had been removed from her position. The CDC director’s sudden dismissal against a backdrop of agency troubles sent shockwaves through public health circles and may have signaled repercussions on the future of healthcare guidance.

Both Sides of the Dismissal

Susan Monarez, an established authority in infectious diseases, came into her role during one of the most tumultuous periods in CDC history—amid a proposed budget cut of nearly $3.6 billion, from its $9 billion total. With the agency facing deep budget cuts and fracturing morale, she stepped in to steady the ship.

Reports suggest Monarez’s dismissal stemmed from her refusal to yield to directives that would have undermined scientific integrity. Her lawyers argued she “chose protecting the public over serving a political agenda” by resisting attempts to replace dedicated health officials and endorse questionable vaccine policies (ABC News). They also stressed that, under law, only the President, not the HHS secretary, can lawfully remove a Senate-confirmed official.

In a hearing, Secretary of Health and Human Services Robert F. Kennedy Jr. denied instructing the former CDC director to pre-approve vaccine panel recommendations. He said her dismissal resulted from her acknowledging she was “not trustworthy” when asked directly—an assertion that drew sharp rebuke from Monarez’s legal team, who labeled it “patently ridiculous.”

Resignations and Ripples Across CDC Leadership

The firing sparked widespread outrage among agency staff and the public health community, who viewed it as a threat to the CDC’s mission and independence. Within days of Monarez’s removal, four senior CDC leaders resigned in solidarity, sending a clear signal of their alarm at the changing direction. Dr. Jennifer Layden was the director of Office of Public Health Data, Science, Technology. Dr. Daniel Jernigan filled the role as director of the National Center for Emerging and Zoonotic Infectious Diseases. Dr. Debra Houry, who was the Chief Science and Medical Officer, reflected that the moment demanded a unified stand from leadership.

The former Director of the National Center for Immunization and Respiratory Diseases, Dr. Demetre Daskalakis shared his resignation letter on social media. In it, he noted his frustration that “no CDC subject matter expert from my Center has ever briefed the Secretary,” signaling disconnect between science and leadership.

Disruption to Critical Guidance Committees

Susan Monarez and the four senior CDC leaders weren’t the first dominos to fall. Back in March, the Trump administration disbanded critical advisory bodies that guide infection control and vaccine policy. The Healthcare Infection Control Practices Advisory Committee (HICPAC) was established more than 30 years ago under the Public Health Service Act. Since 1991, the committee provided the CDC with infection control guidance and advice, but no longer (NBC News). Infection prevention professionals immediately called for its reinstatement. The Association for Professionals in Infection Control and Epidemiology emphasized its “evidence-based guidance that directly informs federal healthcare standards and protects both patients and healthcare workers across hospitals, outpatient clinics, and extended care facilities.”

Likewise, the Advisory Committee on Immunization Practices (ACIP), a trusted source of science-backed advice and guidance—was dismantled. All 17 members were replaced by candidates who critics described as outspoken opponents of U.S. vaccination policies. The American Medical Association pushed back firmly, saying this action “undermines that trust” and “upends a transparent process that has saved countless lives.”

Who Is the Now-Acting CDC Director?

Secretary Robert F. Kennedy Jr. appointed Jim O’Neill as acting CDC director on August 29. While his selection filled the leadership gap quickly, many in the healthcare community have raised alarms. O’Neill does not have a medical or public health background, holding degrees in the humanities rather than in science or medicine. His career includes a stint at the Department of Health and Human Services under President George W. Bush, where he served from 2002 to 2008, eventually becoming Principal Associate Deputy Secretary. However, in 2014, he argued for the Food and Drug Administration (FDA) establishing a drug’s effectiveness once it is on the market. Remarks from 2009 also resurfaced from a Health Innovation at the Frontier event, where he stated, “there are plenty of healthy spare kidneys walking around, unused.”

Public Health Community Voices Concern

The cascading resignations prompted urgent responses from public health groups. APIC warned that the loss of expertise “jeopardizes the CDC’s ability to address critical health challenges, leaving infection prevention and control professionals without essential leadership and guidance.”

The American Nurses Association (ANA), representing the largest segment of the healthcare workforce, also voiced strong concern over the dismissal of Susan Monarez and the wave of resignations that followed. President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN stated “The removal of the CDC director and resignation of key leaders raises serious questions about our country’s ability to respond to a public health crisis if it were to happen today.” Concerning ACIP removals, the organization requested it and other liaisons be reinstated so the “advisory panels reflect balance, transparency, and expertise.” (NursingWorld)

Former CDC directors—speaking through The New York Times op-ed—said the moves from Secretary Kennedy are “unlike anything we had ever seen at the agency and unlike anything our country had ever experienced,” highlighting budget cuts that erode infrastructure safeguarding Americans from disease, environmental hazards, and more. They raised alarms about heightened risks to rural communities, low-income families, and vulnerable populations if public health systems continue to atrophy.

Concerning Jim O’ Neill, the World Health Network noted that appointing a leader without direct public health expertise risks both conflict of interest and scientific competence. For many nurses and healthcare professionals who rely on consistent science-driven CDC guidance, this appointment may beg the question of what happens to that guidance.

Lessons from the Past: When Timely Guidance Makes or Breaks Public Trust

History shows that CDC leadership and guidance can be either a stabilizing force or a source of confusion when facing health threats. During the H1N1 pandemic in 2009, the CDC issued straightforward recommendations that helped schools stay open and kept public confidence intact. In one year, from April ‘09 to April ‘10, there were a total of 12,469 deaths in the United States. Overall, the agency demonstrated how decisive, science-driven leadership from health experts who are aligned with standards can shape outcomes in real time.

By contrast, the early months of the COVID-19 pandemic revealed the dangers of delayed or inconsistent guidance. Originally, the agency emphasized surface cleaning and hand hygiene as the primary defenses against SARS-CoV-2, even as evidence mounted that masks were more effective. Because of the poor research conducted on airborne transmission capabilities, it was not until April 2020 that the CDC shifted its messaging, by which point opportunities to curb transmission had already been lost.

Initially, masks were recommended in July 2020. Less than a year later, fully vaccinated people were told they could gather without masks—only for that guidance to be reversed again by late July 2021 as new variants spread. Confusion around mask guidance fueled skepticism and contributed to persistently low adherence to masking. Those who adhered to the “CDC’s initial advice – to avoid wearing a mask if you’re healthy – may have felt cheated or wronged when the CDC recommended them.” Dr. David Aronoff, director of Vanderbilt University Medical Center’s Division of Infectious Diseases and professor of medicine admitted that the guidance even confused healthcare workers (CNN).

From January 1, 2020, and February 05, 2022, there were 900,000 COVID-related deaths in the United States (National Library of Medicine). While the CDC is not the sole health agency, consistent guidance and control measures (all backed by science) are needed from its health leaders.

Impact on Nurses

Nurses are already facing high-stress challenges, but the current situation has compounded existing pressures. In some cases, they may (eventually) experience moral distress when guidelines appear disconnected from evidence-based practice. Without reliable national direction for something like vaccine eligibility for children, nurses can find themselves caught between patients’ expectations and institutional policies.

Against this backdrop, two critical strategies can help nurses continue to uphold their professional mandate (Nurse.org):

• Strengthening advocacy roles
• Supplementing public health infrastructure

1. Strengthening Advocacy Roles

Nurses have an ethical duty to advocate for evidence-based policy and safe practice conditions. In times of instability, this responsibility becomes even more important. Nurses may need to step beyond clinical care and take on stronger advocacy roles, ensuring their voices influence both policy formation and implementation (Nurse.org).

This advocacy can take several forms:

• Committees and Boards: Nurses make up the largest segment of the healthcare workforce, yet their representation on decision-making boards often lags behind. Expanding nurse participation on local, state, and national boards ensures that policies reflect real-world practice challenges.

• Policy Development: Nurses should be active in shaping the policies that affect their daily work. Engaging in policy discussions means advocating not only for safer environments but also for sustainable workplace practices.

• Systems Advocacy: Beyond internal policies, nurses can influence broader changes in laws and regulations. At a time when healthcare is under unprecedented strain, systems advocacy gives nurses the chance to shape how the profession evolves.

2. Leaning On Public Health Infrastructure

Evidence shows that nurses frequently turn to one another for guidance in clinical practice. Peer-to-peer knowledge sharing remains one of the most trusted sources of health information, alongside professional journals and reference materials. This culture of collaboration allows nursing teams to adapt quickly when centralized guidance is lacking.

By leaning on professional networks, academic resources, and continuing education, nurses can ensure that patient care remains rooted in evidence—even when national direction falters. In doing so, they not only support their colleagues but also reinforce the broader safety net of public health.

Restoring Trust and Stability Is Imperative

The abrupt dismissal of Dr. Susan Monarez—and the ensuing exodus of senior experts—has sown deep uncertainty across public health. The weakening of CDC advisory systems undermines the agency’s capacity to protect lives. To preserve our national health infrastructure, the collective voice is calling for a recommitment to evidence-based leadership, transparency, and advisory systems drawn from subject-matter experts. Regardless, nurses, no—healthcare practitioners, in general, from infection preventionists (IP) to doctors—are resourceful and will do their part to help steady the ship.

Read on to see how Seal Shield has a history of helping healthcare professionals meet CDC cleaning standards.