In the same way nobody expects me to know or care what the NFL draft is, I don’t expect anyone outside of public health circles to know or care what EIS Conference is. Still, in the same way the draft offers a useful window into American football more broadly, this conference brings into focus some of the biggest conversations driving public health today. 

As a reminder, the conference normally convenes past, present, and future members of the CDC’s Epidemic Intelligence Service program, which trains more than half of US public health leadership. These are the people who (in the absence of political interference lol) determine how outbreaks are handled, what health issues are worth the most investment, and what guidance you see. They don’t have multimillion-dollar contracts or music festivals with Wrestlemania afterparties, but they do have a real impact on your life — your drinking water, your vaccines, and whether you hear about a health threat in time.

This year’s EIS conference was very different from the ones I’ve attended in the past in that I couldn’t actually go. Normally, anyone — even random members of the public — can attend the four days of scientific presentations on everything from botulism outbreaks to alpha-gal syndrome. But this year, the conference was held on the heavily secured CDC campus, and gen pop was not allowed.

So instead, I went to what was basically a watch party held in an office building in downtown Decatur. The gathering allowed EIS alumni like me to view the virtual conference together and schmooze over elite Costco snacks (no shade, Dot’s Pretzels minis are clutch). The program also offered daily live panel discussions with assorted public health celebrities whose secrets are safe with me. (As media, I was asked to abide by the Chatham House Rule, which means I can tell you what I heard and saw, but not who.)

Folks, it was weird. The EIS Alumni Association, who put on the event, did their best to make it feel like an actual thing — integrated with the regular conference, but also educational in its own right. But the parallel tracks meant that people who’d left CDC barely interacted with those still at CDC. The cross-pollination that happens during Q&As, over coffee, and on escalators is how the field transmits its norms and culture, and pressure-tests its big ideas. Both EIS officers and alums told me they really missed it.

This has been a brutal year for the CDC, and I’m not sure what I was expecting. Over the course of the week, as I listened to speakers on panels and yapped with other attendees in the audience, I found myself mentally sorting people into two categories: the Nostalgists and the Burners. 

The Nostalgists see this moment and its solutions through the lens of CDC crises past. In their minds, the institution pre-2025 had problems, but was still trustworthy. They have great faith in the resilience of the public health institution and the people who’ve stewarded it. 

An example of the Nostalgist mindset: One panelist recalled how during the early days of the HIV epidemic, the agency was besieged and silenced by politicos under the spell of the Moral Majority. The message was, “This isn’t the first time the CDC has had to soldier on under a hail of attacks from the White House.” Eventually, they said, the pendulum would swing back, and the agency could rebuild.

(This did not sit well with some audience members, by the way. Afterward, I heard someone rage about the panel’s “toxic positivity.” HIV was one disease, and in the 1980s, the rest of the agency still worked and had leadership. There’s no comparison to the current moment, they argued: Now, the entire public health and scientific infrastructure has been both hollowed out and decapitated. And there’s no guarantee that the next swing of the pendulum will bring things back to where they were rather than take us into an entirely new hellscape.) 

The Burners see things differently. They think the CDC as we know it is cooked. In their minds, the agency’s brand is so radioactive that even if it could be reconstituted, it would have little public or political credibility. Many had serious concerns about the way the agency functioned before 2025, and even before the pandemic: They felt it was too cautious, too slow, and inadequately responsive to the grass-roots communities and the state health departments it served. In their view, the CDC and other vanguard institutions of American public health are stuck doing things the old, institutional way at a moment that demands something new and different. 

What makes this kind of thinking possible is what one panelist called “not having CDC brain.” Many of the Burners — but not all — haven’t been in the institution their entire careers. While a beginner’s mindset is good for reimagining things, it might lack institutional memory, and isn’t always realistic about what’s possible. 

The Nostalgists are often grieving a version of CDC they loved and want to recover—and nostalgia has a way of turning a flawed past into a usable myth. The Burners, meanwhile, have real pre-2025 grievances. Under pressure, grievance can harden into contempt, but I don’t see that in most of what I hear Burners say. Instead, I detect an interest in working in ways that aren’t native to public health, but maybe should be: avoiding words that give Republicans hives so they can work together; not publicly trashing or embracing the preferred politics of their colleagues. “I’ve thanked President Trump many times,” said one panelist.

Why does any of this matter? Because like the draft, EIS Conference is where the future is quietly decided. The balance between these two groups will determine what public health looks like going forward — whether it doubles down on the institutions that trained generations of leaders, or breaks from them in search of something that can actually meet this moment. That choice will shape how public health talks to the public, and whether the public talks back.

If you work in public health, I’m curious: Where do you fall? Do these camps resonate — or do I have them all wrong? Shoot me an email at [email protected], or if you want to stay anonymous, fill out this form.