The Government Accountability Office found that employees at four public health agencies did not report their concerns about political interference in their workplace. They said they didn't because they were unsure how to report the issues, or that agency leaders were already aware.

Two years after the emails were drafted, public opinion in the federal government is low. According to a January NBC poll, just 44 percent of Americans trust what the CDC says. The government's ability to communicate with Americans about current and future risks to their health is at risk.

GAO head Gene Dodaro is very concerned about the coordination of leadership in the Department of Health and Human Services and its handling of future public health emergencies.

There are unclear roles and responsibilities. There have been problems with clear and consistent communications. There hasn't been a lot of good data collection. There are deficiencies and transparency and accountability.

The Office of the Assistant Secretary for Preparedness and Response did not have procedures on how political inference in their work should be reported.

The office made several recommendations to the HHS, CDC, FDA, andNIH, including creating institutional procedures for reporting and addressing allegations of political interference and training staff on how to report those allegations.