The ongoing outbreak of the H5N1 avian flu virus presents a significant public health challenge that the United States should be well-prepared to address. Although this strain of flu is relatively new globally, scientists have been studying H5N1 for almost three decades. They have a solid understanding of how flu spreads and who is most at risk. Additionally, the U.S. has antivirals and vaccines that are expected to provide some level of protection against this virus. Scientists have also been closely monitoring the virus as it evolves in various animals, including recent cases in dairy cattle in the United States. Nahid Bhadelia, the founding director of the Boston University Center on Emerging Infectious Diseases, likened the current situation to having the opportunity to catch COVID-19 in the fall of 2019.
Despite this wealth of knowledge, the U.S. is struggling to mount an effective response. While the nation remains highly alert to infectious diseases due to the coronavirus pandemic, both federal action and public attention seem to be focused on the wrong aspects of avian flu and other infectious threats, such as measles outbreaks within the country and epidemics of mosquito-borne diseases abroad. Bill Hanage, an infectious disease epidemiologist and co-director of the Center for Communicable Disease Dynamics at Harvard’s School of Public Health, noted that while the U.S. and the world were not adept at gauging such threats before COVID, the pandemic has thrown our reactions off balance.
Although H5N1 is a cause for concern, experts believe the likelihood of it causing the next pandemic is low. There is currently no evidence to suggest efficient human-to-human transmission of the virus, and it would likely need further mutations to achieve this. Despite this, public fear remains high, particularly regarding the detection of viral genetic material in milk. Experts maintain that pasteurized dairy products are unlikely to pose an infectious threat. Anne Sosin, a public health researcher at Dartmouth, expressed concern that the focus on milk may be misguided, highlighting the need to understand how the virus enters the milk supply and what it indicates about the virus's environmental support.
During this outbreak, experts have called for improved testing and surveillance of wildlife and livestock. However, federal agencies have been slow to respond, with testing of dairy cows being voluntary until recently. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, emphasized the need for more extensive testing, especially in pigs, which have previously served as sources of flu viruses that jumped to humans. Increasing sampling could provide insights into the virus's spread and evolutionary changes. Osterholm also advocated for greater data transparency from federal agencies, moving away from a paternalistic approach.
Protective measures for farmworkers, who are often uninsured and undocumented, have also been lacking, potentially allowing the virus to spread undetected among them. Jennifer Nuzzo, the director of the Pandemic Center at the Brown University School of Public Health, criticized the lack of proactive testing and reporting, highlighting the importance of lessons learned from COVID.
Experts are concerned that the U.S. is not adequately preparing for the possibility of H5N1 rapidly spreading among humans. Luciana Borio, a former acting chief scientist at the FDA, expressed concern about the limited supply of vaccines against H5 flu viruses in the national stockpile. She emphasized that experience alone cannot solve the challenges posed by the virus. Anthony Fauci, NIAID’s former director, highlighted the need to address other infectious threats, such as measles and polio, which have reappeared in the U.S. due to falling vaccination rates among children.
The public's fear and perception of infectious threats have been influenced by the COVID-19 pandemic, with some overly sensitized and others indifferent. It is crucial to recalibrate our understanding of infectious danger to effectively address these threats and prevent future pandemics.