| Sharp disagreements between Republicans and Democrats in Congress over the budget for the new fiscal year led to the US government being shut down Oct. 1. The impact was felt immediately. Federal health agencies began operating at a much smaller scale. More than 32,000 workers were furloughed at Health and Human Services. Under the Antideficiency Act, the federal government must continue to run programs that protect human life during a shutdown or funding lapse. But some programs and communications have been halted and there’s a lot that’s still unknown. Here are the details: Centers for Disease Control and PreventionThe public health agency’s emergency operations office is open, and its responses to ongoing emergency outbreaks continues. Infectious disease surveillance data is still being compiled, but analysis and reporting to the public will stop. The US is currently in a record breaking measles outbreak, and the CDC reports cases every Wednesday. As of Oct. 1, the US has recorded 1,544 infections. Since measles is a reportable disease, updates to the infection rate are likely to continue. Communications to state and local health departments around prevention of HIV and opioid overdoses has stopped. Congressionally mandated programs like the Vaccines for Children Program and the World Trade Center Health Program will continue. The weekly influenza report, usually published on Fridays, was posted on Tuesday ahead of the shutdown. The Morbidity and Mortality Weekly Report, or MMWR, that posts research reports and disease updates from public health scientists will pause. This means updates on situations like the norovirus outbreak on a Royal Caribbean cruise ship heading to Miami may not be issued during the shutdown. US health officials and insurers are also still waiting for the acting CDC director to approve new recommendations from the recent vaccine panel meeting. Once approved, the recommendations are normally posted to the MMWR. Whether there will be a special issue with the approved recommendations or no posting at all – which could hinder the implementation of new policy – also remains to be seen. Food and Drug AdministrationThe agency will continue to report food recalls and foodborne illnesses, but longer-term investigations into foodborne illness outbreaks will stop. For example, if the FDA was already looking into a listeria outbreak, that would continue because it affects human health. But routine inspections of food manufacturing facilities will pause. That’s concerning to Susan Mayne, former director of the Center for Food Safety and Applied Nutrition, because inspectors were already behind on their targets. If the shutdown drags on, she said, the lack of inspections could pile up. The agency has stopped approving any new drug, generic, medical device or animal drug applications. This has more of an impact on drugmakers, but it means it will take longer for consumers to start using any of the new products. Centers for Medicare and Medicaid ServicesThe extension of some Affordable Care Act tax credits now scheduled to end Dec. 31 are at the center of the shutdown fight. But other programs covered by federal insurance lapsed with the shutdown, including telehealth services for seniors that began during the Covid pandemic. A program that allows hospitals to provide acute care to Medicare and Medicaid beneficiaries in their homes also ended. – Jessica Nix | 
