| Over the past week, many parts of the federal government have been frozen by the Trump administration. But one sector's stall seems particularly surprising: science and health work at the Department of Health and Human Services, which funds everything from cancer research to reporting on virus outbreaks. Bloomberg's Robert Langreth dives into what's happening in America's research centers. Plus: How the Indy Pass helps small ski areas. If this email was forwarded to you, click here to sign up. Morbidity and Mortality Weekly Report, the main journal of the Centers for Disease Control and Prevention, has been published virtually every week for decades. It's a go-to source for state and local public health agencies for basic information on diseases such as bird flu or occupational outbreaks. In recent months, the journal has reported on a fungus spreading among paper mill workers in Michigan that led to numerous hospitalizations, and it revealed that 7% of farmworkers exposed to bird flu had evidence of infection, including some who recalled no symptoms. Last week, it went dark. No issue was published. It appears to be first time in more than a century that the government hasn't put out the MMWR or a similar publication, says former CDC director Tom Frieden, who now heads the global nonprofit Resolve to Save Lives. The MMWR silencing was apparently part of a broad temporary freeze on some routine government health work and communication that was announced last week by the acting secretary of the Department of Health and Human Services. That communications freeze will continue until Feb. 1, according to the memo. Further generating confusion, on Jan. 27, President Donald Trump's acting budget director put out a memo that instructed all agencies to pause federal assistance, including grants and loans. Then, in a dramatic reversal, the White House budget office said today that the original memo was "rescinded." (The memo had drawn bipartisan criticism. In the aftermath, officials in some states reported being temporarily locked out of Medicaid insurance payment portals.) Viruses and bacteria, not to mention cancer cells, have no political affiliation, and will continue to spread while research plans are on hold. If reporting on outbreaks stops, "the worry is that we will lose our ability to know what is really happening," Frieden says. Among the basic scientific functions that have been caught up in the various pauses were routine grant review meetings at the National Institutes of Health, some of which were abruptly canceled last week, according to reporting by my colleagues at Bloomberg and other outlets. The National Science Foundation, which funds physics and other nonbiomedical research, has also paused grant reviews and new awards while the agency makes sure it complies with Trump's executive orders, according to an explanation on its website.  Robert F. Kennedy Jr. testifying before the Senate Finance Committee. Photographer: Tierney L. Cross/Bloomberg The halt on grant reviews and some publications has generated alarm and confusion among top scientists and health experts. Experiments and trials that were already underway can continue, the NIH said in an email. Still, outside researchers worry that the disruptions could extend well beyond Feb. 1. None of Trump's health appointees have been confirmed yet; Robert F. Kennedy Jr., Trump's nominee to head the Department of Health and Human Services, faced his first hearing in the Senate today. Grant delays have the potential to harm basic research crucial to future breakthroughs. With a roughly $48 billion budget, the NIH is the biggest public funder of biomedical research in the world, and most of that funding goes to outside academic researchers. In a system that's been honed for years, panels of expert scientists from across the country review highly technical grant proposals at one- or two-day "study sections." A minority with the highest scores are ultimately funded. "NIH funding has been absolutely essential to many of the advances we have made in public health and medical treatment over the course of the last 50 years," says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "So to suddenly see that system down is very concerning." The NIH system has flaws, according to Trump's nominee to be the agency's director, Stanford University economist and health policy researcher Jay Bhattacharya. He's best known for being the co-author of the so-called Great Barrington Declaration, an October 2020 document that advocated for easing up on Covid-19 restrictions for the majority of low-risk people. The pandemic "was just a disaster for American science and public health," Bhattacharya said in TV appearance shortly before his nomination. "We desperately need reform." Among other ideas, Bhattacharya had discussed term limits for NIH institute directors, which could help bring in new ideas and ensure no director becomes too powerful. Anthony Fauci served as director of the National Institute of Allergy and Infectious Diseases for almost 40 years, before retiring in 2022. Bhattacharya has also talked about creating a better mechanism for replicating research results to ensure spurious findings don't take hold. And House Republicans have also proposed consolidating the total number of NIH institutes, now at an unwieldly 27. None of these ideas require grinding existing processes to a halt. If the pause is short, it won't cause serious damage. But the longer it lasts, the more dangerous it becomes. The grant review system "is a well oiled machine, but it is a complicated machine" says Jeremy Berg, an associate senior vice chancellor for health sciences at the University of Pittsburgh and a former director of the National Institute of General Medical Sciences. If the works are gummed up for long, he says, "it is bad for American science, it is bad for investigators, it is bad for the NIH and it is bad for the Trump administration." | 
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