Concerns about H5N1 bird flu are increasing. Are COVID-19 mistakes being repeated?

There is a saying that those who do not learn from history are doomed to repeat it. Will that be the case with the H5N1 avian flu virus that has been spreading among birds for years, jumped to dairy cattle earlier this year and emerged in a pig a month ago? Isn’t hindsight 2020? Will we see the same mistakes being made with the H5N1 bird flu as during the COVID-19 pandemic? Or is this H5N1 virus situation currently so different from the severe acute respiratory syndrome coronavirus 2 pandemic that we don’t have to worry about the ‘p’ word this time?

Well, the Centers for Disease Control and Prevention currently lists public health risk of bird flu so low. But there is no guarantee that this will remain the case forever. Here’s what we currently know about H5N1:

H5N1 bird flu has been a problem among birds for years

It is called bird flu because it is a type of influenza virus that was first noticed when it spread among birds. Although I have been monitoring its progress in various bird populations around the world since 2021, the H5N1 virus has been around for much longer.

For example, a 1997 outbreak in Hong Kong consisted of 18 animal-to-human infections and six deaths. There were also two human deaths shortly after H5N1 emerged among wild birds in Asia in 2003.

The virus has gained more attention in recent years, especially as it has left the U.S. poultry industry with the bird – let alone a lot of infected birds – with at least 45 commercial poultry flocks and 30 backyard flocks, for a total of at least Since April 2024, 22.37 million birds have been infected based on reports from the US Department of Agriculture. This flying H5N1 bird was given the name highly pathogenic bird flu because it causes illness and death among birds. Such deaths, along with culling of flocks in efforts to contain the spread of the virus, have already hit people by causing shortages and driving up poultry and egg prices.

The H5N1 bird flu has been spreading among livestock since at least the spring of 2024

Earlier this year there was a holy cow moment, when dairy cattle became infected. That demonstrated the virus’s ability to mutate to the point that it could jump to another group of animals. Since it was first discovered in livestock in March 2024, the virus has spread to at least 440 dairy farms in 15 US states. according to the U.S. Department of Agriculture. The virus has recently been found in cow’s milk — including raw milk at retail in California — but at this point you don’t really have to worry about contracting the virus from drinking properly pasteurized milk or properly prepared beef like hamburgers. However, this does not necessarily mean that the spread of the virus among cows is a nothingburger.

The recent appearance of H5N1 avian flu in pigs raises concerns about reassortment

Then there was the pig event on October 30, 2024. That’s when the USDA first reported a case of H5N1 in an American pig. This was in a pig on a backyard farm in Oregon. Such an announcement raised even greater concerns. That’s not because the thought of a coughing pig is more disturbing than the thought of a coughing cow. This is because the flu viruses in pigs exchange their genetic material with each other more easily and quickly than in birds.

Such an exchange is called genetic rearrangement and can result in viruses with completely new combinations of genetic material. New combinations of genetic materials could lead to the viruses becoming more capable, which could at some point result in a virus that can spread to and among even more species such as humans. The higher redistribution rates in pigs can be a significant problem.

Pig reassignments were the cause of the 2009 H1N1 pandemic

It is important to remember that a series of reassortment events in pigs led to the 2009 influenza A(H1N1) pandemic. These pig events resulted in a version of the H1N1 influenza virus in 2009 that was able to jump to humans and spread among humans . That pandemic led to estimated 60.8 million cases, 274,304 hospitalizations and 12,469 deaths in the US and an estimated 284,400 deaths worldwide. That wasn’t nearly as bad as what COVID-19 has done, resulting in over 1.2 million deaths in the US and over 7 million deaths worldwide, along with a long, long, long list of long Covid cases and there are still being added.

However, don’t assume that a new novel flu virus would be an exact repeat of 2009 if it were to spread among humans. The world was lucky in 2009 because the H1N1 virus resembled a strain that older people had been exposed to during an earlier pandemic. That meant that many older people already had some degree of protection against the H1N1 flu virus and were therefore less susceptible to its worst effects. Compare the 2009 pandemic to the 1918 flu pandemic, which resulted in a an estimated 50 million deaths. That was roughly one-fifth of the world’s population at the time.

The key here is the word novel. When a new virus infects your body, your immune system isn’t sure how to act and can end up firing in several random directions, causing more damage to your body than it protects it. That’s why you never quite know what might happen when a virus reaches a human for the first time. So not only is there potential for the ‘p’ word at H5N1, there is also potential for a bad ‘p’.

There are 55 confirmed human cases of H5N1 bird flu in the US

So far there have been 55 confirmed H5N1 human cases in the US The vast majority have clearly had direct contact with infected animals. like the dairy worker I wrote about Forbes. There is no clear evidence that infected people transmit the virus to other people. Of course, seeing such human-to-human transmission would be a major concern. This would mean that people could pass on a new virus to each other.

Most human cases of H5N1 to date have been mild. In 2023, an 11-year-old girl died in Cambodia a teenager in British Columbia is seriously ill after becoming infected. This second case has raised additional concerns because it is not clear how the teenager became infected in the first place.

Keep in mind that mutations can turn a not-so-nasty virus into a nasty one, especially if those mutations allow the virus to attack the human lower respiratory tract more effectively. Therefore, it is important to closely monitor what happens as each person becomes infected.

With the H5N1 bird flu, the US is repeating many COVID-19 mistakes

While it is still unclear what will happen to the H5N1 virus and how much of a threat it will pose to humans in the coming years, one thing is quite clear: the US is not doing everything it can to prevent another potential pandemic. prevent and prepare for it. . In many ways, the US appears to be riding the wave of bird flu and repeating many of the same mistakes made in the years leading up to the COVID-19 pandemic.

Many of the problems that existed in 2019 still exist. The US still lacks comprehensive respiratory virus surveillance and reporting systems that allow everyone to see where different pathogens may be spreading. Good luck figuring out how many cases of COVID-19 occurred in your area over the past week. In addition, the COVID-19 pandemic exposed major long-standing deficiencies in America’s healthcare and public health systems that have not since been addressed. For example, burnout among doctors and nurses have been persistent problems Suhauna Hussain has just reported for the Los Angeles Times about how California Animal Health and Food Safety Laboratory staff complain about overwork and understaffing.

Major gaps remain in the US arsenal against H5N1. For example, the US currently has no commercially available monoclonal antibodies against the virus. Existing antiviral medications such as oseltamivir (Tamiflu) and baloxavir marboxil may have limited effectiveness against H5N1 due to mutations. Moreover, now is the time to invest in H5N1 research. Waiting until it has already caused a human epidemic or pandemic would be like waiting until your house is on fire before buying fire extinguishers and figuring out what a fire can do to your house.

Meanwhile, the misinformation and misinformation that has hampered the response to the COVID-19 pandemic continues to spread without much of an organized plan to counter anti-science messages and thinking. People have been able to successfully politicize with evidence-based countermeasures against infectious diseases, such as the use of face masks. Imagine how politicized things could become the next time a pandemic hits.

Finally, bird flu seems to receive relatively little attention from political leaders. How much talk about H5N1 preparedness have you heard from the current presidential administration, the incoming administration, or members of Congress, besides one side trying to criticize the other? The concern is that political leaders are repeating the cycle of panic during pandemics and neglect in between that has persistently plagued pandemic preparedness, as I described for Forbes back in 2020.

This is not to say that political leaders should run, wave their arms and shout, “Panic, panic.” That p-word should never be used, and it’s far too early to use the other p-word — which means pandemic — when it comes to what the H5N1 bird flu will do. However, it is certainly not too early to start using another P-word a lot more, namely preparedness.