Up First from NPR - Limiting Musk's Powers; VA Employees On DOGE Emails; No Cure For Long COVID

Episode Date: March 8, 2025

President Trump says that his Cabinet secretaries are actually supposed to be the ones to make staffing decisions, not Elon Musk and his DOGE entity. Also, we hear from employees at the Veterans Health Administration about how they feel about DOGE emails asking them to spell out what they did last week. Plus, a look at where things stand on the treatment of Long COVID.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

President Trump now says his Cabinet Secretaries will be the ones to make staffing decisions, not Elon Musk and his Doge entity. But is that how things are really going to work? I'm Scott Simon. I'm Ayesha Roscoe and this is Up First from NPR News. I want the cabinet members to keep good people. I don't want to see a big cut where a lot of good people are cut. That's what the president said, but there have already been some big cuts.

We'll look at who's actually calling the shots. We'll also hear how federal employees at one agency feel about those efforts. Plus, five years after the start of the COVID-19 pandemic, we'll look at the efforts to treat long COVID. So please stay with us. We've got the news you need to start your weekend. President Trump said he wants his captain secretaries to work with Elon Musk on staffing decisions. It almost sounds like he might be stripping some of that power away from Musk and his Doge entity. But is he? NPR senior editor and correspondent Ron Elving joins us. Ron, thanks for being with us.

Good to be with you, Scott. Well, what are we seeing? Are they putting a leash on that Doge? It's been sold that way, like it's Trump siding with his cabinet over Musk. But if you listen to that clip we just heard, it still seems that Musk gets to come along, batting clean up, and deciding whether the cabinet secretaries and other Senate-confirmed officials have done enough. So who decides what's enough? Is it Musk or is it Trump himself?

And do we know whether that's really a difference? The New York Times reporters Maggie Haberman and Jonathan Swan have reported that there have been clashes between Musk and members of the cabinet, including Secretary of State Marco Rubio, Transportation Secretary Sean Duffy, both of whom were reported to have been scolded by Musk for not cutting enough and for having too many DEI hires still working for their departments. Is the Department of Government efficiency a potential political liability for congressional Republicans?

Because after all, federal jobs are getting cut in their states. Yes, that's right. It's not a clear liability yet, at least not for Republicans in Congress, because as we saw on Tuesday night at the State of the Union, Musk is still a hero to Trump fans, both in Congress and beyond. Musk still polls well among Trump supporters. But the Musk stock may have seen its peak, Scott. We will see how the cuts to Veterans Affairs staffing, for example, go down with the families of vets in the care of the VA.

And we'll also see how much Musk gets to do with Social Security. That's the most popular federal program in history by all measures. But Musk has compared Social Security to an illegal private investment swindle. He did that on Joe Rogan's podcast last month. Pete Slauson Everybody's got a podcast. Now, California Governor Gavin Newsom started one this week. His first guest was not another progressive Democrat, but right-wing activist Charlie Kirk, and they agreed on a few things. Danielle Pletka Yes. Newsom took a more centrist position on bans on trans athletes in school sports. Now, Scott, I remember when would-be presidents would

go on Larry King's CNN talk show to say they were thinking about the White House. Now, there may be a trend, as you suggest, towards starting your own pod. No one can be surprised that Newsom is thinking about what he may do for a living next. He's term limited as governor after 2026. So why not start a pod and start having guests who might attract an audience outside your own political base? And certainly Charlie Kirk, at at age 31 with millions of followers hoping to be influential even after the Trump era, he certainly speaks to people far from

Newsome's base. This coming Friday, March 14, is the deadline to avoid a government shutdown? How far apart are the parties? Far apart. And possibly getting farther even as we speak. A speaker, Mike Johnson, has said he wants a clean bill to extend current spending commitments through the end of the fiscal year in September. That sounds like the simple, typical kick the can solution here, but House Democratic leader Hockney Jeffries points out that the bill Johnson is backing would actually be

a set up for the new Trump-Musk budget regime, with all that implies and sets in motion. And Johnson himself says the new spending bill would get the ball rolling on the next era of Trump-Musk cuts. So there will not be any Democratic votes for that, meaning the Republican leaders in the House will have to get a majority, and in the Senate, a supermajority, with the votes of their own members alone. And it's going to be tough bringing every last Republican on board for all this controversial

stuff. That's not impossible, but the odds are not good. So right now, it seems likely that next week at this time, we'll be in a shutdown, at least for a short period of time. It'll be good to talk to you then too, MPR's Ron Ilving. Thanks so much. Thank you, Scott. Federal employees clocking in on Monday could see another email sent at the behest of Elon

Musk asking them, quote, what did you do last week? Musk has been tasked by President Trump to cut the federal workforce and so he has. Over 62,000 employees across 17 agencies. And Piers, Andrea Hsu joins us now. Andrea, thanks so much for being with us. Thanks for having me. Managers ask their employees to keep them up to date all the time, tell them what they've been doing. That seems pretty ordinary but you've heard from workers at the VA who are quite mad about these emails. Why are they so upset? Yeah, well, for several reasons. First, because the original request did not come from their

managers. It came from the Office of Personnel Management at the direction of Elon Musk. And he has said this was his idea. And these emails hit inboxes over the weekend while most people were off, you know, trying to relax. Now the people I spoke with at the VA, they are mental health professionals. They help veterans with things like depression and PTSD, combat trauma, sexual trauma. And they say the government already closely tracks what they do. Supervisors can run reports on how many patients they see, how many phone calls they make, what time those interactions start and stop, what topics are discussed and so on.

So they don't know why an additional weekly email is necessary. And one psychologist I spoke with described the what did you do last week emails in pretty stark terms. She said they're like flash bang grenades meant to discombobulate federal workers. And NPR agreed not to identify her or others at the VA by name because they're scared they'll lose their jobs for speaking out. Rick Dallek, MD, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk,

MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MStalk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk,

MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS talk, MS did, but they do see it as just one more thing getting in the way of their work, which is helping veterans deal with these really tough problems. And it's coming at a time when there's been so much upheaval in the federal government. The VA this week announced deep cuts ahead, and a psychologist I talked to said patients are themselves worried. She has patients asking her, are you going to be here next week or next month? And she says she's spending a lot of time calming their nerves instead of focusing on their treatments.

So the stress that mental health workers are feeling isn't all about the emails. Yeah, well, I spoke with a Harvard Business School professor about this. Her name is Amy Edmondson and she's a social psychologist. She says you have to think about the context when you consider the impact of these emails that originated with Elon Musk. Think about it. You're in your job and suddenly you're getting an email from someone who's not your boss and not your peer, not your subordinate, not someone that you normally interact with to do your job. What's under it? And the people I talked to, Scott, say they're doing the best they can to keep it together for their patients. But one psychiatrist told me she's anxious and irritable, and she finds herself doing things like

doom-scrolling the internet, which she knows is not good. In fact, it's something she tells her own patients not to do. What does the Trump administration say? Well, we asked the White House to comment on what we've heard from these VA employees and we haven't heard back. We do know that President Trump supports Elon Musk's effort to gather these weekly responses. The president has repeatedly said there are some workers in the federal government who aren't doing a good job and shouldn't be there. Now, we don't know what the administration is doing with these responses.

Some have speculated they're using AI to analyze them, but to what end is not clear. The administration has told agencies to collect the information and decide how to deal with people who don't respond. Many of the people with whom you've spoken, mental health workers, thought about leaving. Yeah, but they tell me they really don't want to. They love their work. They know they could make more money in private practice, but one psychologist told me she felt a call to duty to serve those who have served the country.

And she said, I'm not a quitter. I won't be bullied into quitting. She plans to stay as long as she can. And Vera Zandria-Schu, thanks so much for being with us. Thanks, Scott. Tuesday will mark five years since the World Health Organization declared COVID-19 a pandemic. And for millions of Americans, the infection has had lasting consequences, leaving them with a series of, at times, debilitating symptoms referred to as long COVID. NPR health correspondent, Will Stone, joins us now.

Will, thanks for being with us. Sure thing, Scott. Long COVID can be debilitating for many people. Are scientists any closer to understanding it? They are. Researchers have coalesced around a handful of explanations. There seem to be multiple underlying drivers of the illness depending on the patient. One big focus has been the idea of viral persistence that people never fully clear the infection, but there are others related to immune

dysfunction, blood clots, the reactivation of other viruses. These could ultimately trigger symptoms like brain fog, like fatigue, shortness of breath, something called post-exertional malaise. The challenge here remains translating some of these insights into treatment. There are still no approved drugs for long COVID. The approach is often to manage symptoms and try to improve quality of life.

And what are the challenges in coming up with the treatment? It comes down to clinical trials. There just aren't enough of them. A few years ago, there were a handful looking at drugs. Dr. Michael Peluso told me by his count, there are now about 50, including some that Peluso is involved in at the University of California, San Francisco, but he says the reality is we just need

a lot more for such a complex condition. There are dozens of existing drugs that should be tested. We have drugs that can target almost every single one of the different mechanisms we think might be contributing to long COVID. But so far we've launched way too few trials to actually do that with intense effort.

And Scott, one of the major barriers here is that drug makers are still on the sidelines to some extent. Over and over again, Peluso hears the reason is there's not a reliable biological measurement of the condition, a biomarker that can be tracked across multiple trials in the same way that LDL or bad cholesterol is a biomarker for heart disease risk. Do we know how many people are affected? That's hard to pin down. Research including CDC data has found about 18 million adults in the US had long COVID. There are more conservative estimates. All of this depends on

how you're defining the condition, who you survey, and people are still getting long COVID. Here's what Hannah Davis told me. She has long COVID herself and co-founded an advocacy group called the Patient-Led Research Collaborative. It has been downplayed. We have seen so much long COVID in the last year, two years. Long COVID rates have remained high in people who are vaccinated.

It's remained high over different variants. And I hear the same message from doctors who are seeing new patients alongside those who got sick two, three, four years ago and have not recovered. What are you hearing from patients, Will? More resources, more funding? Yeah, continually. The federal government has funded long COVID research

through its Recover Initiative. Last year, an additional $660 million was appropriated. That's to be spent over the next four years, including on clinical trials. Now, obviously there's huge uncertainty about federal funding for scientific research in general under the Trump administration. I spoke to Megan Stone about this, no relation to me.

She's a patient and directs the long COVID campaign. Stone has been in DC lobbying senators and the administration to, among other things, protect those funds from any cuts. Actually, this past week, she was at the confirmation hearing for Trump's pick to lead the National Institutes of Health, Dr. J. Bhattacharya, and she managed to get a moment with him afterwards. He said to me, we're going to do the research to find a solution to this. I hope so. If the administration doesn't meet the patient community in that, then we will keep calling for action the same way that we did under President Biden. Regardless of party or political position,

long COVID patients have been failed by our leaders. To be clear, there's certainly skepticism about whether the administration will take this work seriously. And there are real disagreements between the patient community and those now leading federal health agencies around COVID policies more generally. But Stone says long COVID patients just don't have the luxury to sit this out over the next four years. And to our health correspondent Will Stone, thanks so much for being with us. Thank you. for being with us. Thank you. And that's up first for Saturday, March 8th, 2025. I'm Ayesha Roscoe. And I'm Scott Simon. Martin Patience produced today's episode with help from Michael Radcliffe and Ryan Bank.

Our editors are Dee Parvez, Ed McNulty, Melissa Gray, and Scott Hensley. Andrew Craig is our director and today's his birthday. Happy birthday! With support from technical director Andy Huther. And the engineers who helped get this on the air. David Greenberg, Zach Coleman and Arthur Halliday-Lorent. Evie Stone is our senior supervising editor and Sarah Lucy Oliver is our executive producer.

Jim Kane is our deputy managing editor. And tomorrow on the Sunday story with Ayesha, a close look at the origins of birthright citizenship, a constitutional right President Trump wants to end for children born in the U.S. to parents who enter the country illegally. And for more news, interviews, sports and music, you can tune in to Weekend Edition on your radio.

Go to stations.mpr.org to find your local NPR station. Don't just sit there, tune in now. ["Weeekend Edition"]