Jayson McCauliff stood outside San Francisco’s Tesla dealership on March 29, waving a homemade sign reading, “DOGE STOLE MY JOB!” He was among thousands of people who turned out for a nationwide “Tesla Takedown” protest that day.
In recent weeks, hundreds of thousands have taken part in similar protests across the country, outraged at how Tesla CEO Elon Musk and his so-called Department of Government Efficiency — aka DOGE — have been chainsawing their way through the federal workforce in a manner that critics call reckless.
Until mid-February, McCauliff had been working as a user interface design expert for the U.S. Digital Service. He was on a 20-person team that collaborated closely with the Centers for Disease Control and Prevention, public health departments nationwide and a private software contractor to modernize the CDC’s two-decade-old national disease surveillance system, which had been overwhelmed by crushing volumes of data during the COVID-19 pandemic and was in danger of failing.
But on Feb. 14, McCauliff joined the ranks of the many thousands of federal workers laid off by DOGE as part of its self-proclaimed mission to ferret out government waste and inefficiency. What DOGE actually did through these layoffs, critics say, was to undermine a multi-year CDC effort to modernize the national disease surveillance system, just as the project was entering a critical testing phase with public health departments. It was only seven months away from its scheduled completion date.
“When our team was disbanded, we were at a crucial juncture — literally on the verge of launching our initial pilot with a partner jurisdiction,” McCauliff said. “The timing was particularly unfortunate as we were finally ready to demonstrate the real-world application of our solutions.”
McCauliff said he and his digital service colleagues were summarily terminated after two DOGE members conducted 15-minute interviews, asking five performative questions, including “What do you think of DOGE?” The termination notice came by email, stating only, “Due to the restructuring and changes to USDS’s mission, USDS no longer has a need for your services.”
McCauliff couldn’t believe it. “They didn’t understand how government works because they thought that the budget for the entire government came from the Office of Management and Budget and did not understand that agencies have their own budget,” he said.
According to the U.S. Digital Service’s 2024 impact report, the agency last year employed about 230 people. McCauliff’s team had been providing project oversight and design expertise to ensure that efforts to modernize the CDC’s National Electronic Disease Surveillance System Base System addressed the shortcomings of the predecessor system. Their job was to ensure it would flexibly meet the diverse needs of public health departments nationwide.
By laying off 19 of the 20 professionals on the digital service team working with the CDC, McCauliff said, DOGE stripped away the expertise needed to ensure the project would be successfully completed by federal software contractors — in effect promoting government waste and inefficiency instead of reducing or eliminating it.
DOGE’s derailment of the modernization project could leave the 25 U.S. states, territories and tribal nations that depend on the CDC’s disease surveillance system unable to respond effectively to looming health threats, such as recent outbreaks of measles, avian flu or the next pandemic.
Tracking public health threats
For over 20 years, public health departments across the country have been using the National Electronic Disease Surveillance System Base System, a free CDC-developed software package. The system helps officials identify, report, manage and respond to a wide range of public health threats, ranging from documenting cases of mysterious food-borne illnesses to outbreaks of measles, flu, COVID-19 and other diseases.
Written before the age of modern high-performance cloud computing, the software still required health departments to install, run and maintain it on their own computers. Prior to the adoption of the national tracking system, public health departments resorted to managing disease surveillance data through ad-hoc methods: spreadsheets, off-the-shelf software, custom software and handwritten records.
The National Electronic Disease Surveillance System Base System provided a way to replace all that, as well as a set of standards for electronic data exchange among health agencies such as diagnostic laboratories and hospitals. Early adopters of the system reported significant gains in efficiency, insight into disease case data, and cost savings.
While the software was a marked improvement over manual methods for many years, it ultimately proved woefully inadequate for crushing volumes of case data produced during the COVID-19 pandemic.
Texas and Nevada reported critical failures and slowdowns of the disease surveillance software as their health departments were deluged with COVID case data.
The Texas Tribune reported that Texas health officials said their system could not keep pace with the 60,000 or more COVID test results they were receiving on some days. The inability of the software to keep up with case reporting rates led to undercounts of COVID positivity. At one point, Texas public health officials reported a backlog of as many as 350,000 cases.
Ongoing disease surveillance problems became so severe that the Texas Health and Human Services Commission petitioned state lawmakers for $3.5 million in emergency funding to stabilize the tracking system, writing, “HHSC IT has identified NEDSS as at high risk for critical failure.”
In November 2020, northern and rural parts of Nevada were facing a COVID-19 case surge. The Las Vegas Review Journal reported that the state’s National Electronic Disease Surveillance System Base System software was so severely overwhelmed that it was often unusable and prone to crashing. Plagued by ongoing frustrations, Nevada ultimately abandoned the system and switched to open source software called EpiTrax, developed by the Utah Department of Health and Human Services, and used by other states, including Colorado, Missouri, Nevada, Kansas and Wyoming.
Even before the COVID-19 pandemic, public health organizations were well aware of the inadequacies in CDC disease surveillance systems. In a 2019 letter to congressional leaders, 80 health organizations, public health officials and scientists pressed Congress to appropriate $1 billion over 10 years for the CDC to modernize its disease tracking, including specific recommendations to modernize its electronic surveillance systems.
“Unfortunately, the nation’s public health data systems are antiquated, rely on obsolete surveillance methods, and are in dire need of security upgrades,” they wrote. “Sluggish, manual processes — paper records, spreadsheets, faxes, and phone calls — are still in widespread use. Lack of interoperability, reporting consistency, and data standards leads to errors in quality, timeliness, and communication. In addition, public health professionals are faced with rapid advances in data science and evolving cybersecurity threats, and many do not yet have the necessary 21st century skills to understand and securely integrate health data.”
Congress responded by appropriating $50 million in 2020 to upgrade the nation’s public health infrastructure, then $500 million to support rapid modernization from the Coronavirus Aid, Relief, and Economic Security Act. From 2021 through 2023, Congress appropriated an additional $775 million. President Joe Biden’s budget request in 2024 sought over $165 million more.
The Trump administration and congressional Republicans have embarked on downsizing the CDC and clawing back billions in pandemic-related funding, which will affect local and state health authorities that typically receive about 70% of their funding through the CDC.
Modernizing case surveillance data
In 2022, the CDC enlisted the help of the United States Digital Service to study how to modernize the flow of case surveillance data and make recommendations. The digital service conducted 65 interviews with 148 individuals representing eight state and 11 local health departments.
The digital service specifically “looked at the lifecycle of the data, starting at the point of care and ending in public health action. Its goal was to deepen understanding of the current technologies, processes, and policies around disease surveillance data. This knowledge will inform what a modernized, sustainable system could look like.”
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Among the agency’s findings was that the current data collection approach was too complicated: “Too much time and too many resources are spent on counting, cleaning, and collating case data that do not always meet the needs of users, such as jurisdictions and CDC programs. . . State and local health departments are faced with competing priorities. They also find it difficult to meet the many demands placed on them with the workforce, systems, and processes they have.”
The summary of the digital service’s recommendations focused on collecting data in a cost-effective manner, providing a single electronic pathway through which health departments could submit data to the CDC, enhancing national public health through process streamlining and situational awareness. The findings and recommendation were then embodied in a call for specific action: to rewrite the legacy National Electronic Disease Surveillance System Base System software package that had so frustrated health departments during the pandemic.
So the U.S. Digital Service worked diligently to learn what public health agencies needed and how the system should work. But the work the agency would oversee to upgrade the system was actually contracted to a private company.
Contracting and privatization
Enquizit, a Virginia-based software services company specializing in application modernization, in fall 2022 won a $48.5 million contract for modernizing the National Electronic Disease Surveillance System Base System, chosen from among three bidders. Eight months after winning the contract, Enquizit was acquired by CDW Corp., a Fortune 500 company that provides computer products and information technology services to business, government, education and healthcare customers in the United States, the United Kingdom and Canada.
The San Francisco Public Press contacted Enquizit twice for comment on this story and received no response. The Public Press also reached out to the CDC for comment regarding the National Electronic Disease Surveillance System Base System project’s administration, oversight and completion according to the CDC’s own regulations, but the agency did not respond. DOGE also did not respond to a request for comment.
To date, $46 million of the contract has been spent, according to usaspending.gov. The project is being worked on remotely by 29 engineers. Enquizit is slated to deliver the modernized software platform by this Sept. 25.
But while the contract work continues, it’s without the oversight of McCauliff and his digital service colleagues, who had painstakingly figured out what the various public health agencies and employees needed from the system.
The U.S. Digital Service team and their CDC colleagues served as subject matter experts for Enquizit, representing the inputs of the project stakeholders: public health departments and the CDC. The digital service, empowered with information gleaned from its many interviews with health department workers, designed new logical and relevant interfaces or “front end” elements for the system, to make case investigative workflows more efficient and more accurate.
Under the hood, Enquizit would rebuild the disease surveillance system as a modern, secure cloud-computing application, allowing it to resiliently handle the volumes of connections and data generated by a pandemic. The digital service’s ongoing role during the implementation was to ensure the fidelity of the contractor’s work to the new specifications. Now, it’s unclear who’s in that role.
McCauliff lamented that DOGE laid off the U.S. Digital Service team as it was on the verge a critical project milestone — an initial pilot with a health department, in which the digital service could take any feedback received by testers to make critical refinements to the system.
Where to go from here
The CDC and public health departments nationwide await completion of the newly modernized system by the federal contracting team. With only five months remaining on the federal contract work, the effect of DOGE firing the U.S. Digital Service team that was providing start-to-finish oversight for the project remains unclear.
McCauliff expressed dismay over the end of his work at the digital service agency, as well as resolve to inform the public what the loss of that work means.
“The recent dismantling of our team has left me feeling a complex mix of grief for the lost potential and determination to ensure these stories are heard,” he said. “We had an opportunity to modernize a system that met the needs of these conditions in a smart way. Something I know how to do from 20 years of optimizing workflow needs in healthcare.”
As angry and frustrated as McCauliff said he was about the suddenness of his firing — and the apparent recklessness and cruelty of those behind it — he was saddened to see his whole team’s work being tossed aside and unappreciated by Musk and his DOGE minions.
“Everyone at USDS and CDC profoundly understood the national importance of our work,” he said. “I felt honored to contribute to public health initiatives and inspired daily by colleagues who consistently chose impact over income.”
When the DOGE squad laid off 19 U.S. Digital Service professionals working on the CDC project, they laid off another 25 people working digital service projects across other federal agencies. DOGE representatives publicly said their efforts were intended to save tax dollars and improve government services.
Last year, the digital service reported saving $285 million for the Social Security Administration, over 2 million work hours for Center for Medicaid and Children’s Health Insurance Program Services, and 400,000 hours for frontline COVID-19 testers. The savings by the digital service stand in stark contrast to the often fictitious savings claimed by DOGE.
The New York Times found the single largest amount that DOGE had claimed on its website was “$2.9 billion by canceling a contract for a huge shelter in West Texas to house migrant children who crossed the border alone.” Times investigators ultimately determined that the actual saving of “about $27 million — would count as savings in fiscal 2026. That was about 1 percent of the savings that Mr. Musk’s group had claimed.”
And this week, the Times reported that while Musk claims that DOGE canceling contracts and dismissing tens of thousands of government workers will save taxpayers $150 billion, the Partnership for Public Service, an independent nonprofit that studies the federal work force, estimates that DOGE actions leading to “firings, re-hirings, lost productivity and paid leave of thousands of workers will cost upward of $135 billion this fiscal year.”
The mission of the U.S. Digital Service, created in 2014 during the Obama administration, was to improve efficiency throughout the federal government by effectively using digital technology. This year, Trump and Musk coopted it to decimate the federal workforce — driven largely, as they have said on many occasions, by their anti-government grievances and ideology.
The agency was rebranded as the Department of Government Efficiency through one of President Trump’s first executive orders and then quickly commandeered by Musk. Many who oppose these actions have said DOGE and Musk have made the federal government less efficient and services worse, and wasted money through broad, careless layoffs of the federal workforce, many of which were later reversed by the courts.
But according to the Washington Post, the ultimate goal of layoffs of tens of thousands of federal workers is to privatize as many government services as possible. Musk has said repeatedly, “The government should privatize everything we possibly can.”
The United State Digital Service put considerable time and effort into understanding the shortcomings of the aging National Electronic Disease Surveillance System Base System, which proved woefully inadequate during the COVID-19 pandemic. The digital service drew upon the experience of public health departments nationwide, the knowledge of CDC experts, and the acumen of its own technology experts to design a modern replacement that would enable the country to face public health threats effectively.
The modernization project is now in the hands of a federal software contractor. It remains unclear whether it will be finished on time or correctly serve the needs of the public health mission it was designed to address.
Only a month after DOGE fired McCauliff and his digital service colleagues, it was recruiting for the same areas of expertise it had just eliminated.
