Many of the nation’s treatments for cancer, brain disorders and infectious disease began in a lab in Maryland.

The biggest source of funding for that work came from the National Institutes of Health — including some $2.4 billion last year. Johns Hopkins University topped the list of recipients that also included the University of Maryland and more than 140 others. NIH itself is housed in Bethesda.

So when President Donald Trump signed an executive order Jan. 21 that essentially freezes the grantmaking process in the short term, and curbs other scientific communications and publications, it sent shivers down the collective spine of the research and biotech communities.

While pauses in agency activities are common during a change in administration, this directive, which lasts until Feb. 1, has struck the scientific community as more expansive. The ripple effects could be lasting, said Gigi Gronvall, an immunologist and a senior scholar at the Johns Hopkins Center for Health Security.

“It’s easier to break something than fix it,” she said. “There may be justifiable panic.”

Gronvall noted the implications for the country as a whole, with research dollars going to every state. She said the U.S. is “without peer” in scientific research that results in new vaccines, disease treatments and other health defenses.

During the most acute part of the coronavirus pandemic, for example, she said that meant “countries that didn’t have such enterprise were not going to be anywhere close to the front of the line to get therapies and vaccines. That may be terrible, but it’s the reality.”

The executive order from Dorothy Fink, the acting head of the U.S. Department of Health and Human Services, doesn’t stop research if it has at least partial funding. Outside of the lab, there also are currently more than 2,400 clinical trials underway that are based in Baltimore or among the locations included in a wider study.

The orders say a pause will give the new administration time to “consider its plan for managing the federal policy and public communications processes.”

Andy Pekosz, a flu and COVID researcher at Hopkins who receives NIH funding, said the pause includes so-called study sections, which he said aren’t scientific meetings or a type of communication to the general public, but closed meetings designed to review documents that enable officials to “score” grant proposals. No scores, no grants.

“It’s supposed to be temporary, which won’t make a huge impact on grant reviews,” said Pekosz, professor and vice chair of Hopkins’ Department of Molecular Microbiology and Immunology. “But if grants aren’t reviewed and scored, then they can’t be funded, so a long term pause on study sections could be devastating.”

Kim Hoppe, a spokeswoman for Hopkins, said, “We are reviewing the NIH actions to understand their implications for our institution and those we serve — our students, faculty, staff, and patients.”

There are other moves by the Trump administration that could affect the scientific community, such as a review of how many scientists may continue working for NIH and efforts to end DEI, or diversity, equity and inclusion measures. Many scientists deem those efforts critical toward understanding if therapies work on everyone.

The nominee to be health secretary, Robert F. Kennedy Jr., has criticized vaccines and suggested a focus on chronic over infectious diseases, such as the currently circulating bird flu strain.

A long-term pause on research dollars could not only delay or end some scientific discoveries, but harm the economy. In Maryland, the NIH dollars produces some $5.7 billion in economic activity, according to United for Medical Research, a coalition of research institutions and advocates for NIH funding.

State records show the state, which has been working to foster the biotech industry, now includes 3,600 life science and related nonprofits and companies, including giants like AstraZeneca, with 50,000 direct jobs.

Many public and private institutions get at least some funds from NIH, including Morgan State and Towson universities; MedStar Health; and the Lieber Institute for Brain Development. Several University of Maryland campuses receive funding.

“We are closely monitoring this situation and hope this is resolved quickly,” said Michael Sandler, a spokesman for the University System of Maryland. “University researchers depend greatly on the federal grantmaking process for their work, which is critical to the health and well-being of our nation.”

The University of Maryland, Baltimore, just opened a new building in its Baltimore BioPark, where researchers from around the system will collaborate on new technologies that can be turned into therapies and devices. It joins similar work at Hopkins and other incubators in the state.

Local business leaders often tout the growing industry, which they recognize often starts with federal funding.

“We are a global leader in the field of life sciences for so many reasons,” said Mark Anthony Thomas, president and CEO of the Greater Baltimore Committee. “But the federal investment in our innovation is one of those critical drivers.”

Daniel Leaderman, spokesman for the Maryland Department of Commerce, said officials don’t yet know the impact of the executive orders.

But, he said, “there is bipartisan Congressional support for biomedical research and continuing these investments is critical to maintaining American leadership in this field.”