COVID-19 put public health officials on the front lines against a once-in-a-lifetime threat. It's left them with less power and resources to respond to future emergencies.

Why it matters: Instead of strengthening America's public health infrastructure, the pandemic experience spawned hundreds of new laws in at least 24 states limiting public health orders or otherwise undercutting emergency responses.

• Republicans in Congress have also called for funding cuts to the CDC, and the Trump administration and HHS Secretary Robert F. Kennedy are pivoting to chronic diseases, nutrition and nontraditional cures.

What they're saying: Public health experts say it's all left the system weaker and less prepared for everyday threats — let alone the next big crisis.

• "Imagine if we just had a major fire ripping through our city, and our first instinct once we finally put the flames out is to basically get rid of all of our fire departments," said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
• "That is essentially what we're seeing happen here."

Zoom in: A federal pullback in preparedness leaves states even more on the hook to respond to crises, according to an analysis published last week in JAMA Health Forum. But legislatures in mostly conservative states have been taking aim at public health powers for the past few years.

• In February, Louisiana's surgeon general canceled the promotion of all mass vaccination campaigns in the state.
• Montana barred employers from requiring vaccinations while Ohio law bans the state health department from issuing quarantines unless a person has been diagnosed with a disease.
• "The idea that you that you would completely eliminate flexibility to use tools like that without knowing what you're up against is bananas," said author and Stanford Law School professor Michelle Mello.

The bottom line: The rapid development of the COVID vaccine demonstrated why it's critical to support public health, said Richard Besser, CEO of the Robert Wood Johnson Foundation.

• "It was done without cutting any corners on safety, and resulted in saving millions of lives," Besser said. "The chances of us doing that again are zero."

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Related: Doctors are still burned out five years after COVID exposed systemic failures (Axios)

NIH plans to centralize its peer review operations for the grants and research contracts it awards, reportedly eliminating jobs.

Why it matters: The agency said the change, announced Thursday, is aimed at removing bias from the grant awards process and making NIH more efficient. But it's fueling concerns about more layoffs and political influence over science.

State of play: NIH proposed to stop letting individual center study sections run their own first-round peer reviews and instead consolidate all initial review efforts under the agency's Center for Scientific Review.

• Institutes and centers currently coordinate first-round reviews for about 22% of grants, according to the agency.
• NIH claims the change will save more than $65 million per year. The memo does not specify where this cost savings will come from.
• As many as 300 scientific review officer jobs at NIH institutes and centers could be eliminated as a result of the change, Science reported. CSR director Noni Byrnes told the journal that many staff will be moved to her central office, but did not specify a number.

Where it stands: The change will "mitigate the potential for bias by entirely separating the peer review and funding components of NIH," Byrnes said in news release. Byrnes has held her current position since 2019.

Between the lines: Some scientists are concerned that this change — combined with the Trump administration's efforts to slash government funding for research overhead — will give politicians more power over what projects get funded.

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The Federal Trade Commission under President Trump is making its first move to challenge private equity in health care, suing to block the $627 million acquisition of a maker of specialized coatings for medical devices.

Why it matters: It's the first such FTC action around M&A in Trump's second term and could signal continued regulatory scrutiny as private equity buys more health care firms.

• The FTC under the Biden administration focused on activity including "rollups," in which PE firms can consolidate a market through a series of smaller transactions.

Driving the news: FTC commissioners voted 4-0 to seek a temporary restraining order and preliminary injunction to halt GTCR's acquisition of Surmodics, alleging the deal would combine the two largest makers of specialized coatings and is anticompetitive.

• The combined company would control more than 50% of the market for hydrophilic coatings, used on catheters, guidewires and other devices to help doctors maneuver within tight confines like blood vessels without damaging surrounding tissue.

What they're saying: The agency said the companies are locked in fierce competition and often target the same device-makers.

• Surmodics said it disagrees with the FTC and remains committed to completing the merger, announced and approved by shareholders last year.

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One in 15 Americans have been at the scene where four or more people were shot, according to a study published Friday in JAMA Network Open.

Why it matters: The findings highlight how much trauma from mass shootings can affect a community, beyond those who are directly injured or killed.

By the numbers: The University of Colorado-led study involved an online survey with a sample of 10,000 adults in January 2024. It was designed to capture a representative sample of U.S. adults.

• More than half of the mass shootings in which respondents were exposed occurred in 2015 or more recently.
• 3 out of 4 incidents took place in respondents' communities, and they were more likely to occur in neighborhoods.
• Younger people, males and Black respondents were likelier to be exposed.

Of note: 2% reported having been injured themselves, either by being shot, trampled or experiencing related injuries.

"These results suggest that mass shootings are not isolated tragedies but rather a reality that reaches a substantial portion of the population in their lifetime," the authors wrote.

💻 Millions in the U.S. live in places where doctors don't practice and telehealth doesn't reach. (KFF Health News)

🏥 Changes to Tricare, the military's health care program, have brought cascading disruptions to millions of service members. (NBC)

💰 Walgreens has gone from a $100 billion health giant to a private-equity salvage project. (WSJ)