In mid-April, an unusual offer arrived in the Milwaukee health commissioner’s inbox. “I’m writing as a concerned private citizen to offer my support in Milwaukee’s ongoing response to the lead contamination in your schools,” it said. “While I regret that I’m no longer able to assist in my former government role, my commitment to this public health crisis remains steadfast.”

The commissioner, Michael Totoraitis, could have used some help. His department’s regular work hadn’t stopped. In a few days, there were two restaurants to close temporarily, one for rodent reasons, another for cleanliness violations, a tuberculosis case whose contacts needed tracing, and the countless other largely invisible tasks involved in forestalling public health messes before they occurred. But mostly there was the gargantuan job of figuring out which of the district’s 68,000 public school students were likeliest to have been exposed to lead dust and most urgently needed testing and follow-up. 

That was what the U.S. Centers for Disease Control and Prevention’s lead poisoning experts had been helping with when their office was slashed in the Trump administration’s mass federal layoffs in early April. 

Now, here was one of those scientists, coming forward as a volunteer. “It is just an American thing to do,” he said, speaking on condition of anonymity because of his family’s fear of retaliation. “As far as I know, it’s still a free country, and if you want to volunteer your time to help people in need, I don’t think that’s proscribed.”

Yet it wasn’t so simple. The same risks that made this expert’s family afraid for him to speak openly about his offer also made Totoraitis unsure if he could accept it. He hadn’t ruled it out, but there were complexities. He was scrounging for funds that would allow him to hire such laid-off federal specialists once they were officially let go from their government jobs in June. For now, though, they were in limbo, not allowed to work in those roles while on paid administrative leave. “We don’t want to jeopardize their current situation,” Totoraitis said.

Some CDC lead poisoning prevention employees share that concern. Some have kids at home and are too busy looking for paid work to join their colleague in offering to volunteer. Some are too worried that the federal government might be looking for reasons to strip them of their pay or severance, and offering to help Milwaukee might provide just such an excuse or might keep them from being rehired by the agency at a later date. 

In certain cases, they’re torn. “There’s this sense like, we can’t keep doing the work that is being cut, because then there’s no sign that the work has been cut,” another laid off employee said, also speaking on condition of anonymity. “But then all of us are public health servants, and we want to continue regardless.”

From the volunteer’s perspective, though, offering aid was worthwhile, and he’d done his due diligence, checking in with the leaders in his division, who’d also been laid off, and making clear to the city of Milwaukee that he represented only himself.  

The Department of Health and Human Services, the CDC’s parent agency, has been squishy about what’s allowed. Initially, when STAT asked the press office, an official wrote that “employees would not be barred” from volunteering under administrative leave regulations. But in response to follow-up queries about whether there was an issue with federal scientists proffering the expertise they would’ve normally provided in their government jobs had those roles not been cut, the official said they needed prior approval from an ethics office, and that “these situations are reviewed on a case by case basis.” 

HHS has been similarly hard to pin down about the fate of the lead poisoning prevention team. After it was gutted in the layoffs, health secretary Robert F. Kennedy Jr. said he believed that that program had been cut by mistake and would be reinstated — only for the agency to walk back its leader’s claim. HHS told ABC News that the team as it previously existed would not be brought back and that such “duplicate programs” were being consolidated, and told STAT that the branch’s “important work” would continue under the Administration for a Healthy America. Officials did not respond to questions about who would be doing that work and when it would be up and running.

Laid-off federal workers were skeptical. “There is no other unit like ours,” said Erik Svendsen, who directed the CDC’s Division of Environmental Health and Science Practice, which included the lead poisoning prevention team, until he was laid off on April 1. “If someone’s saying that it was duplicative, that was based on misinformation, or a misunderstanding of what we do, and I’m hoping that that mistake is fixed so that we can continue to protect public health.”

Meanwhile, Milwaukee has been left in the middle of a crisis with no backup. It began when a student showed a concerning lead level on a blood test late in 2024, and the source turned out to be the child’s school. The subsequent investigation has proved at once vast and full of fiddly details. The city has lead experts, Totoraitis explained, but the cases they usually investigate involve toddlers and generally occur in the home. Now they’re dealing with exposures in older kids, in the city’s 106 public schools that were built before 1978, when lead paint was banned. 

“If we’re investigating lead hazards in a residential duplex or something like that, it might take two of our staff a couple hours to do the assessment,” Totoraitis said. “A school, on the other hand, takes about six to eight staff around six hours. So the scale of what we’re talking about is enormous.” 

Before the CDC lead experts got laid off, his team would often turn to the feds for both strategic planning and step-by-step guidance. If they found a surface, say, that had much higher lead levels than was acceptable, what then? “We were asking questions like, ‘Should we move people out right away? Should we close the school down? What if we’re not finding lead-poisoned kids?’” Totoraitis said. “They really helped us to triage which rooms should be closed, which schools should be closed, and validate a faster process for us to do a site investigation.” 

All of this also had to happen as soon as possible. When a kid is exposed to lead — breathing in the dust that contains flakes of leaded paint, say, or getting it on their hands and swallowing it along with lunch — its molecular structure looks similar to the calcium and iron that the body’s cells need for their daily work. It latches onto the receptors that should be binding those other minerals and gums up the biochemistry. All sorts of issues can result: cognitive impairment, hearing loss, organ damage. 

“The number one ‘treatment’ — and I say that in air quotes, because it’s not really a treatment — is finding the source and removing it from the child,” said Jennifer Sample, a pediatric toxicologist in Platte City, Mo., who wrote the pediatric lead poisoning guidance for UpToDate, software that many doctors use as a clinical reference.

The CDC team wasn’t only helping with that, but also with the task of finding which children might’ve been exposed. “If we identify those kids, there are things that can be done to reduce the harm,” said the laid-off scientist who offered his expertise to Milwaukee. That could mean ensuring the child’s diet contains the calcium and iron that lead might’ve displaced in their cells, or it could mean helping a child whose hearing has been damaged access devices or other services that might improve their educational outcomes. 

Before the layoffs, he and his colleagues were also helping Totoraitis’ department to prevent any more exposures. “They found a lot of evidence of lead contamination in custodial closets,” he said. “One of the questions that came up is, ‘all right, so what are the occupational health and safety arrangements that would help to prevent the workers from getting exposed in the first place, but also prevent them from taking home that lead and then exposing members of their families?’”

That federal help is gone now, at least for the moment. While some of those who would normally be providing it have considered volunteering — or taking paid work from the city of Milwaukee once their leave ends and they’re no longer officially government workers — that couldn’t actually fill the gap left by the slashing of this office, they say. Take the national surveillance of blood lead levels, which can help identify where lead exposures are arising and why. 

“You need a place to receive the data, edit it, process it, store it, and then make it available for researchers. That relies on standardized variable names and technical assistance, when states have questions, like ‘Does this count? What do I do about this?’” said another laid-off lead expert who spoke on condition of anonymity. “There’s no way one person could just run that from their home desk, their personal computer.”