Veterinarians, population researchers, records officers and neuroscientists were all swept up in a chaotic series of layoffs Tuesday that effectively ended the government’s health establishment as we know it.

The big picture: The sheer breadth of the cuts and reshuffling may not be apparent for weeks. But in the immediate aftermath, health care industry players and former federal workers say the workforce reductions will almost certainly affect drug approvals, low-income assistance, disease tracking and biomedical research once held up as the gold standard.

• “The rapid and substantial changes at [the Food and Drug Administration] this week raise questions about the agency’s ability to fulfill its mission to bring new innovative medicines to patients,” said Alex Schriver, senior vice president at PhRMA, the drug industry trade group.

Catch up quick: Health and Human Services Secretary Robert F. Kennedy Jr. said last week that layoffs would focus on “paring away excess administrators while increasing the number of scientists and frontline health providers.”

• Many administrators and communications professionals — including entire offices — did lose their jobs on Tuesday.
• But so did many policy experts, mid-level program directors and scientists.

State of play: Several top scientific leaders, including the director of the National Institute of Allergy and Infectious Diseases, Jeanne Marrazzo, and FDA head tobacco regulator Brian King, were offered reassignments to Indian Health Service roles in remote locations several time zones away, Stat reported.

• Key scientists at the Center for Veterinary Medicine lost their jobs, including those working on bird flu, also per Stat.
• About a dozen senior scientists working in-house at the National Institutes of Health institute focused on neuroscience were let go, Science reported.
• Nearly all staff who negotiate the FDA’s user fees with health care industry players were let go, according to Politico’s AgencyIQ.

HHS did not respond to Axios’ questions about the layoffs.

Behind the scenes: Laid-off HHS staff told Axios they received email notifications that their roles had been terminated in the early hours of the morning. One employee said he got the email before 3:30am local time.

• Some staff didn’t see or receive layoff notices before coming into the office, and they were turned away by security guards at the door.
• Employees who kept their jobs said they’re in the dark about what’s coming next.
• “Our leadership used words such as shell-shocked, cruel and chaotic while describing the situation,” one NIH employee told Axios.

What they’re saying: Scott Gottlieb, who led the FDA during the first Trump administration, wrote on X that there was once a perception the U.S. lagged behind Europe in medical advances, but investments in federal expertise and hiring helped make the U.S. into the “global center of biopharmaceutical innovation.”

• Tuesday’s workforce reduction “threatens to swiftly bring back those frustrating delays for American consumers, particularly affecting rare diseases and areas of significant unmet medical need,” he wrote.

Zoom out: HHS also made significant cuts to its human services program staff, including laying off all the federal employees who carry out the Low-Income Home Energy Assistance Program.

• “Not everyone touches those [human services] programs in their day-to- day life, but it’s part of what keeps our country’s infrastructure and people safe,” one laid-off Administration for Children and Families employee told Axios.
• The employee warned that the scale of cuts within ACF could potentially make child care less safe and accessible in the U.S.

What to watch: Former HHS employees have already started to organize. A coalition of former Centers for Disease Control and Prevention staff called Fired but Fighting on Tuesday launched a resource page for laid-off employees and started a tracker of departments that have been affected by the “reductions in force.”

• “We are speaking out not just for ourselves, but for the future of public service and the protection of public health,” the group’s website reads.

Alison Snyder contributed reporting.