Almost five years after Covid blew into our lives, the main thing standing between us and the next global pandemic is luck. And with the advent of flu season, that luck may well be running out.
The H5N1 avian flu, having mutated its way across species, is raging out of control among the nation’s cattle, infecting roughly a third of the dairy herds in California alone. Farmworkers have so far avoided tragedy, as the virus has not yet acquired the genetic tools to spread among humans. But seasonal flu will vastly increase the chances of that outcome. As the colder weather drives us all indoors to our poorly ventilated houses and workplaces, we will be undertaking an extraordinary gamble that the nation is in no way prepared for.
All that would be more than bad enough, but we face these threats gravely hobbled by the Biden administration’s failure — one might even say refusal — to respond adequately to this disease or to prepare us for viral outbreaks that may follow. And the United States just registered its first known case of an exceptionally severe strain of mpox.
As bad as the Biden administration has been on pandemic prevention, of course, it’s about to be replaced by something far worse. Robert F. Kennedy Jr., Donald Trump’s pick to lead the nation’s vast public health agency, has already stated he would not prioritize research or vaccine distribution were we to face another pandemic. Kennedy may even be hastening its arrival through his advocacy for raw milk, which can carry high levels of the H5N1 virus and is considered a possible vector for its transmission.
We might be fine. Viruses don’t always manage to adapt to new species, despite all the opportunities. But if there is a bird flu pandemic soon, it will be among the most foreseeable catastrophes in history.
Devastating influenza pandemics arise throughout the ages because the virus is always looking for a way in, shape shifting to jump among species in ever novel forms. Flu viruses have a special trick: If two different types infect the same host — a farmworker with regular flu who also gets H5N1 from a cow — they can swap whole segments of their RNA, potentially creating an entirely new and deadly virus that has the ability to spread among humans. It’s likely that the 1918 influenza pandemic, for example, started as a flu virus of avian origin that passed through a pig in eastern Kansas. From there it likely infected its first human victim before circling the globe on a deadly journey that killed more people than World War I.
And that’s why it’s such a tragedy that the Biden administration didn’t — or couldn’t — do everything necessary to snuff out the U.S. dairy cattle infection when the outbreak was smaller and easier to address.
Last winter, when cattle in the Texas Panhandle started getting sick, it wasn’t the established public health channels that figured it out. It took the efforts of a single veterinarian, Dr. Barb Petersen, who had the foresight and the determination to get some samples and send them to a friend at Iowa State University who could test for bird flu.
The results, and what has since come into view about the speed of the spread, should have set off every alarm imaginable.
Even now, however, there is little routine testing of farmworkers or close contact tracing for those who fall ill. We still have way too little information on how the virus spreads among cows. Its genetic sequences are being published very late, if at all, and without the kind of data necessary to understand and trace the outbreak. And the way the virus is spreading from herd to herd makes it clear that infected cows are still being moved around rather than isolated.
One recent study of 115 farmworkers found that about 7 percent of them showed signs of a recent, undetected H5N1 infection. They’d been going about their lives — visiting markets, churches, other homes — while harboring the potential seed of a new pandemic.
Last year, when a milder strain of mpox first reached the United States, we saw a glimpse of what an effective public health response looks like. The White House appointed Robert Fenton, an experienced FEMA administrator, and Demetre Daskalakis, a high-ranking official from the Centers for Disease Control and Prevention, to head the response. Daskalakis has extensive experience combating sexually transmitted diseases that disproportionately affect the gay community. While some right-wing critics obsessed over his tattoos, the pair led a smart campaign to vaccinate and educate, effectively ending the outbreak.
For the H5N1 outbreak among dairy cattle, however, the C.D.C. has limited powers. This show is run by the United States Department of Agriculture, led under Biden by Tom Vilsack, an alumnus of the Obama administration who in between those two postings took a turn in a powerful dairy industry position. The agency had already been weakened by attacks on its scientific side during the first Trump term. This time around, at a critical juncture, it has put a higher value on the short-term profits of the powerful dairy farming industry than on the health of billions of people.
Meanwhile, worrying signs keep cropping up.
Just a few weeks ago, a pig in a backyard farm in Oregon was found to have bird flu. It seems to have gotten it from sick poultry on the same farm. Pigs cause extra worry because they are considered to be ideal mixing vessels for various animal flu viruses to adapt and spread among humans. Last week, the virus was found in a flock of ducks at a pet fair in Hawaii, the one state that hadn’t previously found a case — probably transmitted by wild birds, which continue to spread the illness far and wide. Of the 34 individuals who were exposed at that pet fair, including 13 who had respiratory symptoms, all were offered voluntary testing. Five declined.
A teenager in Canada was infected, and the virus showed some key mutations that bring it closer to adapting to spread among humans. This outbreak has so far been mostly mild in humans, but historically it has been deadly, and further mutations could make it so again. That Canadian is in critical condition, unable to breathe independently.
There’s also an infected child in California who was not known to have come into contact with any sick animals at all, which raises the terrifying possibility that he got it from another human being. And the virus levels in the wastewater in several states keep spiking.
The New York Times
