Will Human-to-Human Bird Flu (H5N1) Be the Long-Awaited “Disease X?”

By Lambert Strether of Corrente.

Influenza A virus subtype H5N1(“Bird Flu”)[1], which is global, rapidly spreading, and “highly pathogenic,” is now infecting cattle, and (in the United States) at least one human. (Bird flu first emerged in China in 1996 in geese; from a useful potted history). The New York Times asks: “Is Bird Flu Coming to People Next? Are We Ready?” The deck, and I’m throwing a flag for a gross violation of Betteridge’s Law: “Unlike the coronavirus, the H5N1 virus has been studied for years. Vaccines and treatments are available should they ever become necessary.” Well, let’s hope so. However, I’m reluctant to attribute the miserably inadequate performance of our public health establishment on Covid to the virus not having been “studied”[2].

Influenza has been around a long time. The literature is vast, and I’m not going to try to summarize it today. (I encourage readers to expand on the science as needed, or correct me.) Rather, I will focus on bird flu institutional players, press coverage of bird flu spread and tranmission in mammals, and spillover (“zoonotic transmission”) from birds to mammals to humans (we being also mammals). I will close with a quick look at whether “Bird Flu” could be “Disease X”, which is how the major players frame the problem — and, no doubt, the opportunities — of a really bad pandemic. (In theatrical terms, will the Covid pandemic end up being a complete play? Act One? Scene One of Act One? Hard to know.) Now let’s look at the players. (I’m doing them first so when they are quoted in the press, you know the sources.)

Institutional Players

Here is the mission statement for APHIS (Animal and Plant Health Inspection Service):

The balance (contradiction) between health and economics is clearly visible, so it will be interesting to see which side APHIS comes down on in case of conflict. The “One Health” program is meant to paper this contradiction over, and maybe it does:

“One Health” is an integrated, unifying approach that sustainably balances and optimizes the health of people, plants, domestic and wild animals, and ecosystems.

The One Health approach recognizes that:

  • the health of animals, people, plants, and the environment are linked, and
  • all those involved in protecting animal, human, and environmental health must work together to achieve the best health outcomes.

Well and good, but I don’t think “One Health” has been put to the test of a national cull, either, with a dairy cow going for between $1,500 and $4,000

Here is the APHIS FAQ, “Detection of Highly Pathogenic Avian Influenza in Dairy Herds” (PDF, which I’ve gotta say at least reads better than the slop CDC so often dishes out. Some readers may wish to know the milk situation. Here are APHIS’s views:

Will there be a milk recall?

Based on the information and research available to us at this time, a milk recall is not necessary. Because products are pasteurized before entering the market, there is no concern about the safety of the commercial milk supply, or that this circumstance poses a risk to consumer health. Pasteurization has continuously proven to inactivate bacteria and viruses, like influenza, in milk.

Will there be a milk recall? Could the consumption of raw milk from these states impact human health?

FDA’s longstanding position is that unpasteurized, raw milk can harbor dangerous microorganisms that can pose serious health risks to consumers, and FDA is reminding consumers of the risks associated with raw milk consumption in light of the HPAI detections. Food safety information from FDA, including information about the sale and consumption of raw milk, can be found here.

Now let’s turn to the CDC. Here is their mission statement[3]:

CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

CDC increases the health security of our nation. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.

At least APHIS gestures in the direction of balancing health and economics; CDC does not (meaning, based on our experience with CDC, that they are doing exactly that). During Covid, CDC has operationalized its “fight” [snort] against SARS-CoV-2, after butchering testing, by fighting aerosol transmission tooth and tail, giving lethally bad guidance on masks, decreasing quarantine time at the behest of Delta (the airline, not the variant), hiding information on breakthrough infections in the vaccinated, failing to even attempt contact tracing, and minimizing the perception of tranmission at all times (the “Green Map”), and using the leadership to model unsafe behavior for the public (one imagines Mandy, maskless and smiling, swanning about a Confined Animal Feeding Operation (CAFO) fondling dead animals). In a word, CDC optimized its Covid strategy for capital at every turn, starting with restaurants and airlines, and continuing on with Big Pharma. If this is what CDC can accomplish while improvising, one hesitates to imagine what they could do with years to prepare! Meanwhile, one can hope that USDA’s APHIS is not as hopelessly corrupt at HHS’s CDC.

Here is a close reading of CDC’s guidance for workers on bird flu: “Highly Pathogenic Avian Influenza A(H5N1) Virus: Identification of Human Infection and Recommendations for Investigations and Response“:

To reduce the risk of HPAI A(H5N1) virus infection, poultry farmers and poultry workers, backyard bird flock owners, livestock farmers and workers, veterinarians and veterinary staff, and responders should wear recommended PPE (e.g., the same PPE is recommended for persons exposed to any confirmed or potentially infected animals as for exposed poultry workers; for specific recommendations see: PPE recommended for poultry workers). This includes wearing an N95[1]™ filtering facepiece respirator, eye protection, and gloves and performing thorough hand washing after contact, when in direct physical contact, or during close exposure[2] to sick or dead birds or other animals, carcasses, feces, unpasteurized (raw) milk, or litter from sick birds or other animals confirmed to be or potentially infected with HPAI A(H5N1) viruses.

Workers should receive training on using PPE and demonstrate an understanding of when to use PPE, what PPE is necessary, how to correctly put on, use, take off, dispose of, and maintain PPE, and PPE limitations[2].

[1] N95s, at last!

[2] “Close exposure” implies droplet dogma. If transmission is truly airborne, then workers should don N95s when they enter the facility.

[3] Somebody tell HICPAC. Don’t health care workers need training? Seriously, couldn’t one conceptualize hospitals as a sort of CAFO?

Bird Flu Spread in Mammals

Here is a handy map on Bird Flu spread in cattle from APHIS (updated weekdays by 4 pm ET):

Commentary from the estimable FluTrackers:

For mammals in general, I haven’t seen a map. Peter Hotez comments in the Houston Chronicle:

[B]irds are also transmitting H5N1 to mammals with increasing frequency. This could mean that the virus is undergoing mutations to adapt better to mammals and could ultimately spread more easily to humans, or even eventually cause human-to-human transmission. Over the last two years, avian influenza viruses have jumped to sea lions living along the Pacific Coast of South America and elephant seals. The deaths were widespread and devastating, disrupting entire ecosystems.

And nobody would have predicted that feral hogs would enter the picture:

Regarding this current episode in Texas cattle, I worry about our feral hog infestation — Texas hosts almost 40% of our nation’s feral hog population — and there’s a possibility that they could serve as animal reservoirs for “the big one.”

(“The Big One” being, I assume, “Disease X,” which we’ll get to below.)

More worrisomely:

My colleague Michael Osterholm, an influenza expert from the University of Minnesota, says he would be more worried if it were pigs infected with this H5N1, since they are vulnerable to both human and avian flu viruses. A co-infection with both kinds of viruses could allow these viruses to reassort in pigs and produce a new virus that could infect people. That sequence of events may explain how the influenza virus that caused the terrible 1918 pandemic is thought to have first arisen on a Kansas hog farm.

Bird Flu Transmission in Mammals

With Covid, I’m used to seeing serious epidemiological work on transmission (though as I said, I haven’t mastered the literature). The only material I’ve seen on bird flu transmission in mammals comes from dairy (and not beef) cattle. From Science, “Bird flu may be spreading in cows via milking and herd transport“:

The avian virus may not be spreading directly from cows breathing on cows, as some researchers have speculated, according to USDA scientists who took part in the meeting, organized jointly by the World Organisation for Animal Health and the United Nations’s Food and Agricultural Organization. “We haven’t seen any true indication that the cows are actively shedding virus and exposing it directly to other animals,” said USDA’s Mark Lyons, who directs ruminant health for the agency and presented some of its data. The finding might also point to ways to protect humans. So far one worker at a dairy farm with infected cattle was found to have the virus, but no other human cases have been confirmed.

USDA researchers tested milk, nasal swabs, and blood from cows at affected dairies and only found clear signals of the virus in the milk. “Right now, we don’t have evidence that the virus is actively replicating within the body of the cow other than the udder,” Suelee Robbe Austerman of USDA’s National Veterinary Services Laboratory told the gathering.

I’m surprised that the Science editors let “spreading directly from cows breathing on cows” go through as a description of aerosol transmission; this is simply a restatement of droplet dogma without the droplets. Aerosol transmission does not require “direct” “close contact”; like smoke, it will spread through the entire facility. From STAT, “Why a leading bird flu expert isn’t convinced that the risk H5N1 poses to people has declined“:

Of course, when we see this virus in a milking farm and you see incredibly high virus load in some milk cows and their milk, that is a new risk. Because I’m not sure how familiar you are with the milking procedures, but there’s very little that people do to prevent human contact with milk. During the milking process, there’s massive generation of aerosol formation….

There’s very little hygiene to protect the farmers that are milking.

Which, in a way, is encouraging. After all, if Bird Flu permeates the air, and a lot of humans haven’t caught it, then we aren’t on the way to a second 1918 flu. Unless and until H5N1 mutates and “spills over” to humans. [4]

All that said, it’s worth noting that on milking machines, dairy farmers vehemently disagree:

Bird Flu Spillover to Mammals

BIrd flu binds to “receptors” in the respiratory tract. From NPR:

Unlike the seasonal influenza viruses that infects humans, H5N1 doesn’t have the ability to easily attack our upper respiratory tract, so it doesn’t tend to spread among humans.

However, the virus can bind to receptors in the lower respiratory tract. This may be one reason that people who develop respiratory infections with bird flu “can get very, very sick with severe pneumonia because those receptors are located deep in the lungs,” says [Angela] Rasmussen./p>

Of course, scientists are looking out for any signs that the virus has adapted to better target our upper respiratory tract.

And such “better targeting” has definitely appeared in non-human mammals (humans being, let us remember, mammals). From the Journal of Experimental Medicine, “Mammalian infections with highly pathogenic avian influenza viruses renew concerns of pandemic potential” (2023):

During 2020, a subclade of 2.3.4.4 viruses paired with an N1 NA called 2.3.4.4b emerged and started to spread to many parts of the world including Africa, Asia, Europe, and North and South America. These viruses have devastated wild bird populations and caused outbreaks in domestic poultry. Notably, they have also caused infections in various small mammals, including badgers, black bears, bobcats, coyotes, ferrets, fisher cats, foxes, leopards, opossums, pigs, raccoons, skunks, sea lions, and wild otters. Most of these have been “dead end” infections and are attributed to direct contact, from animals preying on and ingesting infected birds. However, two recent reports of H5N1 outbreaks in New England seals (Puryear et al., 2023) and on a mink farm in Spain (Agüero et al., 2023) mark the first H5N1 infections potentially involving mammal-to-mammal transmission, renewing concerns that the virus could be poised for spillover into humans. If confirmed, this is particularly concerning as the capacity to transmit between mammals has not been associated with H5N1 viruses previously, and it would suggest that clade 2.3.4.4b viruses may also have an increased capacity to cause human infection. In the absence of population immunity in humans and ongoing evolution and spread of the virus, clade 2.3.4.4b H5 viruses could cause an influenza pandemic if they acquired the ability to transmit efficiently among humans. From 2020 to date, six detections or infections in humans by clade 2.3.4.4b H5N1 viruses have been reported to the WHO. Four were asymptomatic or mild, and two cases were associated with severe disease (World Health Organization, 2022).

However, the mode of transmission has not yet been established. From the European Food Safety Authority, “The role of mammals in Avian Influenza: a review” (2024). A systematic review:

The risk of infection was identified mainly as predation (or feeding) upon infected birds or contact with avian species. Evidence of mammal-to-mammal transmission in the wild is only circumstantial and yet to be confirmed. Cases of AI from the systematic review of experimental findings were discussed concerning epidemiology, pathology and virology. Knowledge gaps and potential pandemic drivers were identified. In summary, although a greater number of infections in wild mammals have been reported, there is no hard evidence for sustained mammal-to-mammal transmission in the wild. The factors contributing to the increased number of infections found in wild carnivores are not clear yet, but the unprecedented global spread of highly pathogenic avian influenza (HPAI) viruses creates ample opportunities for intense, mostly alimentary, contact between infected wild birds and carnivores.

“Alimentary contact” is, I think, not likely in a CAFO, not even for Mandy. In terms of mutation, this layperson speculates that a mutation that allows H5NI to attack upper respiratory receptors in humans is the thing to watch for. From Nature, “Rapid evolution of A(H5N1) influenza viruses after intercontinental spread to North America” (2023):

From a public health perspective, the increased pathogenicity of the reassortant A(H5N1) viruses is of significant concern. However, this is tempered by the avian[5] virus-like characteristics of the viruses with respect to their receptor binding preference and their pH of HA activation. Modification of these characteristics are likely required to enable sustained human-to-human transmission

Paraphrasing, birds (“avian”) and mammals have different receptors in their respiratory tracts. To spread in humans, H5N1 must at least mutate to lodge itself in the receptors that mammals have. From Emerging Microbes & Infections, “HA N193D substitution in the HPAI H5N1 virus alters receptor binding affinity and enhances virulence in mammalian hosts” (2024), I can’t even with the jargon, but here is the key point:

The results revealed that the N193D substitution in the HA RBD altered the binding preference of the virus from avian-like to human-like receptors. More importantly, N193D has a profound effect on growth kinetics and virulence in chicken, mouse, and ferret models, as well as in human respiratory organoids. Our findings highlight the importance of continuous and detailed monitoring as mutations in avian influenzas viruses found in nature pose a great threat to human public health.

I’m not sure who’s doing that monitoring. It would be good to know.

Pigs, presumably including feral hogs, make good reservoirs for mutation because, if I understand this correctly, they have both avian and mamalian receptors. From the European Commissions Project FLUPIG, “Pathogenesis and transmission of influenza virus in pigs“:

Among all animals, the pig is believed to play an essential role in the influenza virus ecology, since it has been shown that (1) pigs are susceptible to all subtypes of influenza A viruses, including those of avian origin; (2) pigs have receptors for both avian and mammalian origin viruses, and thus represent an ideal vessel for viral reassortment or adaptation of an avian virus to the mammalian host.

Oh, and H5N1 can reproduce, at least in some mammals asymptomatically. From Emerging Infectious Diseases, “Influenza A (H5N1) Viruses from Pigs, Indonesia“:

Pigs have long been considered potential intermediate hosts in which avian influenza viruses can adapt to humans. To determine whether this potential exists for pigs in Indonesia, we conducted surveillance during 2005–2009. We found that 52 pigs in 4 provinces were infected during 2005–2007 but not 2008–2009. Phylogenetic analysis showed that the viruses had been introduced into the pig population in Indonesia on at least 3 occasions…. No infected pig had influenza-like symptoms, indicating that influenza A (H5N1) viruses can replicate undetected for prolonged periods, facilitating avian virus adaptation to mammalian hosts.

As for H5N1 spreading asymptomatically in those workers we didn’t direct to mask up properly, would we even know?

Institutional Players and Disease X

I’m going to present a series of quotations about “Disease X” with the sources concealed by a “key” in the form of a bracketed number, thus “[0]”. I will then map the key to a value that is the name of the institution, so [0] might map to, say “National Nurses United” (to pick a non-lethal example). Here are the keyed quotes:

[1] “Disease X: A hidden but inevitable creeping danger”

An old adage says, “Prevention is better than cure.” Nothing exemplifies this idea better than “Disease X.” According to the World Health Organization (WHO), “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.”

Disease X is supposed to be caused by a “pathogen X.” Such a pathogen is expected to be a zoonosis, most likely an RNA virus, emerging from an area where the right mix of risk factors highly promotes the risk for sustained transmission.

The COVID-19 pandemic was not the first to wreak havoc on the world and it will not be the last. Thus, we need to prepare for the next outbreak as soon as possible.

[2] “What is Disease X and how will pandemic preparations help the world?”

Disease X is not a specific disease but is the name given to a potential novel infectious agent.

It represents an illness which is currently unknown but could pose a serious microbial threat to humans in the future. It is necessary to be prepared because there is a vast reservoir of viruses circulating among wildlife which could become a source of a new infectious disease to which humans do not have immunity.

At the Davos summit on Wednesday, healthcare experts emphasised that preparing for Disease X could help save lives and costs if countries begin research and preemptive measures in advance of a known outbreak.

“Of course, there are some people who say this may create panic. It’s better to anticipate something that may happen because it has happened in our history many times, and prepare for it”, said WHO Director-General Tedros Adhanom Ghebreyesus, who joined the panel.

[3] “DISEASE X – What it is, and what it is not”

Disease X is the name given by scientists and the World Health Organization to an unknown pathogen that could emerge in future and cause a serious international epidemic or pandemic.

No-one can predict where or when the next Disease X will emerge. What is certain, however, is that a future Disease X is out there and will, at some point, spill over from animals into people and begin to spread in a disease outbreak.

[4] “Disease X: The Next Pandemic”

Miles from the nearest city, deep in the dark recesses of a cave in Guangdong Province, it waits. Perhaps it silently stalks from high in the canopies of trees nestled along the Kinabatangan River. Or it lies dormant in one of the thousands of species native to the Amazon. Disease X.

This is not science fiction, it’s real.

Disease X is the mysterious name given to the very serious threat that unknown viruses pose to human health. Disease X is on a short list of pathogens deemed a top priority for research by the World Health Organization, alongside known killers like SARS and Ebola.

(It may well be, that with its horrific mortality rate, that H5N1 is, in fact, Disease X (there are other candidates). But we don’t know yet.) Now, here are the keys:

[1] National Institutes of Health (NIH)
[2] World Economic Forum (WEF)
[3] Coalition for Epidemic Preparedness Innovations (CEPI)
[4] EcoHealth Alliance

So I suppose I should welcome the great and the good being involved. Then again, have any of these institutions taken the slightest accountability for Covid? These are, after all, global elites; you’d think they’d take accountability for something (I mean, something besides making sure Davos was well-ventilated going forward). It’s good to think about and prepare for Disease X, no question. Are these the people we want doing the preparing? And if not them, who else? Man, I hate turning into “Mr. Pandemic.” It’s really stressful….

NOTES

[1] Here is CDC’s explanation of flu naming conventions. Type A viruses “are the only influenza viruses known to cause flu pandemics.” As for the H and the N: “Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N).”

[2] “Inadequate” unless you believe that CDC’s goal was, in fact, a human cull, a thesis that certainly passes Occam’s Razor.

[3] I have been ploughing through Title 42 in an attempt to determine if the CDC’s mission is defined (“The CDC shall ____”). Interestingly, the mission of the CDC Foundation (the CDC’s privatized fundraising arm) is defined. Any readers with information on this point, please contact me.

[4] It’s really noteworthy that, once again, CDC’s focus seems to be solely on vaccines. Heaven forfend that CAFOs — or, for that matter, feeding operations like brunch — should be interfered with in any way. Business as usual.

[5] Interestingly, if I have this right, the eye contains avian-like receptors. Hence the conjunctivitis in Texas?

APPENDIX The Bird Flu Vaccine

FDA Approves Seqirus’ Audenz as Vaccine Against Potential Flu Pandemic BioSpace:

Audenz is the first-ever adjuvanted, cell-based influenza vaccine designed to protect against influenza A (H5N1) in the event of a pandemic. The novel vaccine combines Seqirus’ MF59 adjuvant and cell-based antigen manufacturing. The vaccine is designed to be rapidly deployed to help protect the U.S. population and can be stockpiled for first responders in the event of pandemic.

Audenz was developed with the MF59 adjuvant. Which is believed to enhance an immune response from the body by inducing antibodies against virus strains that have mutated. The adjuvant reduces the amount of antigen required to produce an immune response, increasing the number of doses of the vaccine developed, so that a large number of people can be protected as quickly as possible, [Russel Basser, chief scientist and head of research and development at Seqirus] said.

Development of Audenz was supported by a partnership with the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services. Working with BARDA, Basser said they will be able to stockpile doses of Audenz in case of a pandemic outbreak.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

41 comments

  1. steppenwolf fetchit

    Ten thousand ” little ones” could achieve Davos Man’s much desired cull just as well as one single “Big One”. Ten thousand “disease x-es” could achieve Davos Man’s much desired cull just as well as one single ” Disease X”.

    So we of the ‘Great Unwanted’ should try and create for ourselves and eachother safety against the ten thousand “little ones” just as much as against the ” Big Disease-X One”. And we will have to accept that we will be trying to keep ourselves and eachother safe from all the diseases which Davos Man’s WHO and Davos Man’s CDC and all Davos Man’s other deliberate stealth-spreaders-of-disease will continue working their hardest to start and to spreadf ( while trying to make it look like an accident or series of accidents).

    ( Unless the ‘Great Unwanted’ could somehow achieve a successful and total revolution leading to the total and utter conquest of all relevant governments and the total physical deletion of all members of Davos Man and all of Davos Man’s agents at every level within every government from physical existence upon the earth. If we could do that with some great magical revolution, then we could turn the agents and vectors of public anti-health back into servants of public health).

  2. playon

    Miles from the nearest city, deep in the dark recesses of a cave in Guangdong Province, it waits.

    Never miss an opportunity to (preemptively) blame China for something…

    1. ambrit

      The reference to “dark recesses of a cave” subtly hints at the “Official Narrative” that the coronavirus-2019 came from a bat collected in a cave in China. In essence, it’s an attempt to reinforce the ‘wild’ ‘source’ of the original coronavirus-19 outbreak.

      1. Alex Cox

        And the source of this quote is EcoHealth Alliance, our old ‘gain of function’ friends.

  3. chris

    For those who are interested, the TWIV podcast recently interviewed Dr. Paul Offit, about his new book, and there was a long discussion about what people got wrong during the initial and intermediate stages of the SARS2 pandemic. It was interesting to hear what they thought. I’m optimistic that many of the people involved have learned from their mistakes.

    But I don’t think they’ve figured out how wrong they are about so many things involving government and our current society. They understand the public doesn’t really trust the CDC anymore and they don’t know why. Also interesting is how out of touch they are when it comes to non-science topics.

    For example, when Dr. Daniel Griffin was on the podcast recently, he lamented that most people in the US only have 20 paid vacation days a year…really? Similarly, during the Offit interview, they didn’t understand that if the lab leak theory was proven true, it wasn’t worldwide relations with China that would suffer. Because then it would have been the USA’s responsibility for unleashing the pandemic on the world. They have also expressed various elite university and PMC beliefs that blind them to the fact that the reason we don’t have universal healthcare in this country is because the Democrats don’t want it.

    But, I’m at least optimistic to hear some people in the chattering class discuss what they got wrong and what they’d do differently next time.

  4. Ben Panga

    Pondering “Disease X” has me thinking of one of my favourite books: Earth Abides by George R. Stewart. An oldy (1946) but a goody. In many ways a hopeful book, even though almost everybody dies and society collapses. It’s very much about what happens after.

    Also wondered if “Disease X” is what happens to people who spend too long on the bird site?

  5. ambrit

    I’m reinforced in my thinking to the effect that the elites are literally democidal. Thus my resolve to not co-operate in any way with top down diktats any more. My “Personal Risk Assessment” now has the governing elites and the “official” agencies that carry out their commands at the top of my “Avoid” list.
    How can one accept the explanations and recommendations of government entities such as the CDC, NIH, and likeminded organizations when, by their recent actions they have proven themselves to be, at the least, incompetent, and at the worst, actively malicious.
    Stay safe. Make your own personal decisions. (All politics really is local.)

    1. Ben Panga

      If their function is to protect a system that prioritises creditors and capital over the well-being of the 99% they may actually be very competent.

      For us little people they sure ain’t helpful. Avoid indeed!

    1. MT_Wild

      As an added note, APHIS, specifically APHIS-Wildlife Services has been conducting avian influenza surveillance in wild birds since at least 2008.

      This was in response to local mass die-offs and annually during waterfowl migration. Each state had a target sample size based on waterfowl numbers and which migratory route they represented.

      From a waterfowl perspective, northern pintails were of particular interest due to their tendency to mix more between migratory routes.

  6. kareninca

    Thank you for this.

    I remember reading about twenty years ago about the dire shortage of veterinarians for farm animals. There was no incentive at all to be one, other than a love of cows. New vets, coming out of vet school, laden with debt even then, had the option of living in an area with amenities, earning a good living treating Fluffy with the latest medications and surgeries, or living in the sticks and getting a phone call at three in the morning from someone who wanted them to stick their arm deep inside of a cow. And that someone didn’t want to spend more on the treatment than the cow was worth economically.

    Yes, there is “money” in big cow ag. But not compared with the money in Fluffy. Not for the vet.

    Also, Fluffy’s human wants to know if Fluffy is sick, so that Fluffy can be treated. A big ag farmer isn’t necessarily looking for problems that he might hope will go away on their own,

    I doubt the situation has gotten any better. Vet school debt is horrendous now. There’s a lot of talk about monitoring of herds going on, but I doubt much monitoring is really happening.

    1. Lena

      We have several vet clinics in my area that specialize only in the care of horses and other farm animals. Those vets love their work. They are open 24/7 to go out to the farms when needed. There are a lot of farms around here so it might be different in other parts of the country. I am in the Midwest.

      1. kareninca

        Still, it is looking really bad. This is from 2023:

        “Livestock producers all across the US are dealing with a serious shortage of large and food animal veterinarians. According to the USDA, in 2023, the shortage or rural veterinarians has reached an all-time high, with 500 counties in 46 states deemed as having a critical shortage of large animal vets. The shortfall poses risks to not only livestock and farmers, but the country’s food supply.”

        (“America’s Large Animal Veterinarian Shortage is Barreling Toward Crisis Levels”)(https://www.vantrumpreport.com/2023/11/08/americas-large-animal-veterinarian-shortage-is-barreling-toward-crisis-levels/#:~:text=According%20to%20the%20USDA%2C%20in,but%20the%20country's%20food%20supply.)

        That is consistent with the existence of devoted individuals. But per the article (which is pretty interesting), “the average student loan debt (for veterinarians) is approximately $200,000”, and that has got to make for some tough choices.

        1. Lena

          It’s true that most large animal vets here are older and they usually come from farm backgrounds themselves. When they retire, it will be hard to replace them.

  7. kareninca

    ““Right now, we don’t have evidence that the virus is actively replicating within the body of the cow other than the udder,”

    Why does this remind me of the claim that the mRNA shot remained in the arm????? So there is a good sized wall inside the cow around the udder, just as there is a little wall inside of your arm???? Does this guy have any idea how moronic his assertion is? Yes, right, the Udder Virus, which evolved within months to stay just right inside of a cow’s udder. Right. hahahahaha

  8. Raymond Sim

    I used to milk cows, albeit nearly fifty years ago. I would offer a couple observations:

    1. If it’s in the milk, then the people doing the milking are getting exposed both via aerosols and droplets.

    2. From what I read it’s causing mastitis. Competent herd managers will be highly aware of excess rates of mastitis.

    On a separate note, where does the confidence that pastuerization as commonly practiced will definitely knock out H5N1 come from? What sort of studies have been done?

    Finally, since the virus is so severe in birds, for the poultry industry it’s the virus itself that’s the threat to their profits. Mild illness in cattle will mean the beef and cattle industries are likely to view control efforts as the great enemy.

  9. kareninca

    All of those poor cows have likely had covid dozens of times each due to being around humans and mice and deer and cats, and have weakened immune systems, and are susceptible to everything now, including bird flu. They can serve as immunocompromised reservoirs for mutations. For that matter, so can the feral hogs, who have all had covid too I’m sure.

    1. SocalJimObjects

      If cows were to become a significant vector of transmission, I can’t think of a nation that would be more severely impacted than India where cows are not only viewed as sacred but also live in close proximity to humans in the big cities.

  10. The Rev Kev

    From this post and the comments, it seems that the ingredients are all there for the next pandemic. Industrialized animal farming, a constantly mutating flu virus, an unwillingness to do national herd culls, indentured vets, a migrant workforce that will be forced to come to work by their corporate masters whether sick or not, a world health system under the corrupting influence of amateur billionaires and a CDC that has proven themselves incompetent dealing with the present pandemic because how it might effect the economy. Did I miss anything? We are one rogue mutation from the entire thing catching fire and I assure you that it can be bad. Why do I say that?

    Back in 2011 I got an interest in the half-forgotten (suppressed?) 1919 flu pandemic which swept the world. I did a fair bit of research which led me to the conclusion that sooner or later there would be another and wondered if I would be around to see it. Well several years later there was a pandemic only this one was a Coronavirus and not an influenza one. It has been bad, mostly in terms of long-term damage, but not as bad as the 1919-1920 one as in the absence of mass body pits. But as a society I do not think that we will be ready for it because of the same reasons that screwed up our responses to the Coronavirus pandemic. Which means that as far as I can tell, we will be on our own in dealing with a new influenza virus as we have been the past three years plus. So saying this, we should be ready for it.

    1. Randall Flagg

      Caught it again after a reread and yea, I think that most brunch arrangements could be qualified as a CAFO operation. Though the human kind does allow one some free will to leave the premises.

      Probably exposing a lot of ignorance on my part, but to me all this virus spread and it’s mutations, spread between farms and species seems like an inevitability, one that the chickens are now coming home to roost on to use the old saying. Migratory birds moving from farm and field to another one along their route, food animals inside 24/7/365, living life on concrete floors, deprived of some of the best disinfectants Mother Nature has, sunlight, fresh air, rain and just living outside as part of a strong and healthy immune system. Just as that works for humans too.Many transfers of viruses and diseases between farm that can happen with a simple careless act.
      I am reminded of an interview years ago with a retired old timer farmer talking about a CAFO hog operation down his road and he said, paraphrasing at this point, “The whole thing is an abomination, God never intended for that many animals to be shoved together to live in one place”
      Forgetting any references to any higher authorities, this pretty much explains why disruptions in our food supply are likely to get worse.

  11. Arkady Bogdanov

    I vehemently disagree with the sterilization protocols the twitter accounts are implying. Milkers ARE NOT sterilized between cows- at least as a regular procedure. Milkers are sterilized with an acidic solution between milkings of the entire herd (most dairies milk twice a day) but not between individual cows. Before the milkers are applied to the udders, each teat is cleaned with an iodine-based solution. Sometimes a tool is used to just dip each teat, and sometimes each teat is wiped with a solution-soaked disposable towel (depends on the farm), but anyone stating that every milker is sterilized/cleaned between every cow is full of it. I cover 3 counties (and sometimes assist with 3 more) in my state and although I have not been inside every single milking parlour in those counties, I have been inside the vast majority of them and I have done so while they are milking.

    1. kareninca

      Thank you for explaining that. What I saw was a video in which a guy went down a line and wiped cow udder after cow udder withe the same wet cloth, probably wet with he iodine solution you are describing. He wasn’t using a new cloth, or even re-dipping the cloth, for each cow. So I was really skeptical that the milking machines themselves were cleaned each time. Sterilizing a machine is not a trivial task, and there were hundreds (thousands?) of cows in the barn in the video I saw.

    2. Raymond Sim

      Yeah, I’ve actually been at a loss to figure out what people were talking about in some of these instances.

      I’m guessing it’s the usual sanitation measures conveyed via whisper-down-the-lane.

  12. John Anthony La Pietra

    First, let me add my thanks to Lambert for this — study? examination? — to the thanks from others.

    Second, as a small sole-practice attorney in Michigan, let me offer a few results from some legal research I’ve done this morning — in both the Code of Federal Regulations (CFR) and the US Code (USC) of Federal statutes (laws passed by Congress, basically). Both refer to the same 50 “Titles” categorizing their contents by subject, so regulations in Title 42 of the CFR are generally related to statutes in Title 42 of the USC.

    (BTW and FWIW as another example, APHIS is discussed under Title 9 of the CFR, “Animals and Animal Products”. See Chapter I, “Animal and Plant Health Inspection Service, Department of Agriculture”.)

    Now . . . I haven’t found much of anything yet about the mission of the CDC as a whole . . . but I did find some things that the Director of the CDC “shall” do — in Section 242c of the statutes, IOW 42 USC 242c. One place to find that is here:

    https://www.law.cornell.edu/uscode/text/42/242c

    Let me quote subsections (1) and (2):

    /===============================\
    (a) In general

    The Centers for Disease Control and Prevention (referred to in this section as the “CDC”) shall be headed by the Director of the Centers for Disease Control and Prevention (referred to in this section as the “Director”), who shall be appointed by the President, by and with the advice and consent of the Senate. Such individual shall also serve as the Administrator of the Agency for Toxic Substances and Disease Registry consistent with section 9604(i) of this title. The Director shall perform functions provided for in subsection (b) and such other functions as the Secretary may prescribe.

    (b) Functions

    The Secretary, acting through the Director, shall —

    (1) implement and exercise applicable authorities and responsibilities provided for in this chapter or other applicable law related to the investigation, detection, identification, prevention, or control of diseases or conditions to preserve and improve public health domestically and globally and address injuries and occupational and environmental hazards, as appropriate;

    (2) be responsible for the overall direction of the CDC and for the establishment and implementation of policies related to the management and operation of programs and activities within the CDC;

    (3) coordinate and oversee the operation of centers, institutes, and offices within the CDC;

    (4) support, in consultation with the heads of such centers, institutes, and offices, program coordination across such centers, institutes, and offices, including through priority setting reviews and the development of strategic plans, to reduce unnecessary duplication and encourage collaboration between programs;

    (5) oversee the development, implementation, and updating of the strategic plan established pursuant to subsection (c);

    (6) ensure that appropriate strategic planning, including the use of performance metrics, is conducted by such centers, institutes, and offices to facilitate and improve CDC programs and activities;

    (7) communicate, including through convening annual meetings, with public and private entities regarding relevant public health programs and activities, and, as applicable, the strategic plan established pursuant to subsection (c).
    \===============================/

    Since the authors of Federal statutes seem to agree with Dirk Gently about the interconnectedness of all things, someone who wants to understand all of what’s going on with a statute regarding a particular topic might have to read more than just the parts that have direct references to that topic — as I expect you’ve discovered for yourself long since. But I hope this is a useful starting point.

    1. Lambert Strether Post author

      Thank you. I was stumbling about in Cornell’s statutes as well. If you find anything for CDC as a whole, that would be great. Contrast the California Department of Public Heatlth:

      120125: “The department shall examine into the causes of communicable disease in man and domestic animals occurring or likely to occur in this state.”

      120140: “Upon being informed by a health officer of any contagious, infectious, or communicable disease the department may take measures as are necessary to ascertain the nature of the disease and prevent its spread. To that end, the department may, if it considers it proper, take possession or control of the body of any living person, or the corpse of any deceased person.”

      120195: “Each health officer shall enforce all orders, rules, and regulations concerning quarantine or isolation prescribed or directed by the department.”

      The key section in Title 42:

      The Secretary, acting through the Director, shall —

      (1) implement and exercise applicable authorities and responsibilities provided for in this chapter or other applicable law related to the investigation, detection, identification, prevention, or control of diseases or conditions to preserve and improve public health domestically and globally and address injuries and occupational and environmental hazards, as appropriate;

      I assume the Secretary is the secretary of the HHS.

      If one wished to file a writ of mandamus against CDC for balancing balancing public health against economics, instead of “preserve and improve public health”, do you think that section would work?

      (By “work” I don’t mean win, but be colorable and provide a basis for activism.)

      1. John Anthony La Pietra

        Yes, the “Secretary” is the Secretary of HHS (per 42 USC 242q).

        Looking at this section by itself for the moment, it seems to me a quite colorable argument that “preserv[ing] and improv[ing] public health” is a positive duty of the Director to have CDC as a whole perform . . . and there’s nothing similar for any duty to balance off economic factors, unless it’s implicit in “as appropriate” — or in the strategic plan mentioned here and detailed in subsection 3.

        A few more caveats: case law may lean in other directions than those in which we’re gazing hopefully — and the lawyer’s equivalent of IANAL is “I am not that kind of lawyer” (= “This is not my field).” But I’ll take a quick look for any opinions on point — and welcome any follow-up help offered.

  13. LAS

    I agree with the decision to NOT ban milk. Worried individuals can certainly choose not to drink it and that’s OK, but to make a ban or mandate at this stage seems premature. Public health policy should not be made on unproven fears.
    Bird flu risk has been a concern for a long time. The main new event is cognizance that the zoonotic reservoir is changing.

    1. Raymond Sim

      I would argue the big new event is cognizance of a new path by which the virus might adapt to humans.

      I didn’t think there’d ever even been any discussion of banning milk, did I miss something?

  14. les online

    When Mark Twain opined
    “it’s easier to fool people than to convince them they’ve been fooled”
    he must have had the smugly intellectual types in mind…
    Even Jacques Ellul, in “Propaganda”, regarded the self-regarded
    intellectual types as the easiest to con with propaganda (‘They
    consume the greatest amount.’)
    Arthur Firstenberg has been posting, about birds dropping out of the sky,
    dead; frogs, and other fauna being decimated whenever 5G antenna,
    etc, are installed, for ages…
    But that’s all “Misinformation” & “Conspiracy Theory” we’re authoritatively
    informed….The FACTS are – it’s some never ever isolated or separated,
    invisible VIRUS wot’s doing all the killings etc…
    And there’s Big Abe’s “You can fool the Clever Ones most of the time’
    – to which should be added “if you make it sound sciencey enough !”

  15. Raymond Sim

    Newsweek has an op-ed up: “The USDA isn’t inspiring confidence with its bird flu response.”

    Sorry for the lack of a link, I’m on my phone and it just doesn’t seem to let me.

    I was suprised to see questions about the efficacy of pastuerization being addressed so straightforwardly.

  16. rjs

    one of the first reports i read said that milk in Oklahoma had tested positive, but dairy cows in OK haven’t been mentioned since..

    in the only human case, the eyes were the only body part infected (ie, there was no respiratory infection), and the recovery was moderately quick…that’s not to say the next case will be the same, but it does ratchet down the threat a bit..

    1. Raymond Sim

      The concern isn’t that there will be a lot of serious illness from animal-to-human transmission, it’s that infection of humans and interaction with human-adapted viruses will produce a human-adapted “child” of H5N1.

  17. Paris

    Fear not, there’s already a developed vaccine for ***roll the drums please*** DISEASE X. Here hoping it’s not of the mRNA type. It’s not mentioned in the article.

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