Employees across the massive U.S. Department of Health and Human Services began receiving notices of dismissal on Tuesday in a major overhaul expected to ultimately lay off up to 10,000 people. The notices come just days after President Donald Trump moved to strip workers of their collective bargaining rights at HHS and other agencies throughout the government.

Health Secretary Robert F. Kennedy Jr.’s announced a plan last week to remake HHS, which, through its agencies, is responsible for tracking health trends and disease outbreaks, conducting and funding medical research, monitoring the safety of food and medicine, and administering health insurance programs for nearly half of the country.

The plan would consolidate agencies that oversee billions of dollars for addiction services and community health centers across the country under a new office called the Administration for a Healthy America.

The layoffs are expected to shrink HHS to 62,000 positions, lopping off nearly a quarter of its staff — 10,000 jobs through layoffs and another 10,000 workers who took early retirement and voluntary separation offers.

Democratic Sen. Patty Murray of Washington predicted the cuts will have ramifications when natural disasters strike or infectious diseases, like the ongoing measles outbreak, spread.

“They may as well be renaming it the Department of Disease because their plan is putting lives in serious jeopardy,” Murray said Friday during a call with reporters.

Beyond layoffs at federal health agencies, cuts are beginning to happen at state and local health departments as a result of an HHS move last week to pull back more than $11 billion in COVID-19-related funds. Local and state health officials are still assessing the impact, but some health departments have already identified hundreds of jobs that stand to be eliminated because of lost funding, “some of them overnight, some of them are already gone,” said Lori Tremmel Freeman, chief executive of the National Association of County and City Health Officials.

Union representatives for HHS employees received a notice Thursday that between 8,000 to 10,000 employees will be terminated. The department’s leadership will target positions in human resources, procurement, finance and information technology. Positions in “high cost regions” or that have been deemed “redundant” will be the focus of the layoffs.

Kennedy criticized the department he oversees as an inefficient “sprawling bureaucracy” in a Thursday video announcing the restructuring, and said the department’s $1.7 trillion yearly budget, “has failed to improve the health of Americans.”

“I want to promise you now that we’re going to do more with less,” Kennedy said.

HHS on Thursday provided a breakdown of some of the cuts.

__ 3,500 jobs at the Food and Drug Administration, which inspects and sets safety standards for medications, medical devices and foods.

__ 2,400 jobs at the Centers for Disease Control and Prevention, which monitors for infectious disease outbreaks and works with public health agencies nationwide.

__ 1,200 jobs at the National Institutes of Health, the world’s leading health and medical research institution.

__ 300 jobs at the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act marketplace, Medicare and Medicaid.

At the CDC, most employees have not been unionized, but interest rose sharply this year as the Trump administration took steps to reduce the federal workforce. Roughly 2,000 CDC employees in Atlanta belonged to the American Federation of Government Employees local bargaining unit, with hundreds more who had petitioned to join this week being added.

But on Thursday night, Trump signed an executive order that would end collective bargaining for a large number of federal agencies, including the CDC and other health agencies.

The erosion of collective bargaining rights was decried by some Democratic lawmakers.

“President Trump’s brazen attempt to strip the majority of federal employees of their union rights robs these workers of their hard-fought protections. This will only give Elon Musk more power to dismantle the people’s government with as little resistance from dedicated civil servants as possible — further weakening the federal government’s ability to serve the American people,” according to a joint statement Friday by U.S. Rep. Gerald Connolly and U.S. Rep. Bobby Scott, both of Virginia.