The world is at risk for an even worse pandemic

I heard this topic discussed in a British science podcast ("Science in Action"), but hadn't seen a print version until this morning, when Kottke referred me to a New York Times op-ed piece.

Bird flu — known more formally as avian influenza — has long hovered on the horizons of scientists’ fears. This pathogen, especially the H5N1 strain, hasn’t often infected humans, but when it has, 56 percent of those known to have contracted it have died. Its inability to spread easily, if at all, from one person to another has kept it from causing a pandemic.

But things are changing. The virus, which has long caused outbreaks among poultry, is infecting more and more migratory birds, allowing it to spread more widely, even to various mammals, raising the risk that a new variant could spread to and among people.

Alarmingly, it was recently reported that a mutant H5N1 strain was not only infecting minks at a fur farm in Spain but also most likely spreading among them, unprecedented among mammals. Even worse, the mink’s upper respiratory tract is exceptionally well suited to act as a conduit to humans, Thomas Peacock, a virologist who has studied avian influenza, told me...

It’s hard to imagine a better way to incubate and spread a deadly virus than letting it evolve among tens of thousands of animals with an upper respiratory tract similar to ours crowded together. When the coronavirus infected Danish mink farms in 2020 and the minks generated new variants that then infected humans, the efforts to save the industry were futile because the outbreaks were uncontrollable.

If different strains of flu have infected the same person simultaneously, the strains can swap gene segments and give rise to new, more transmissible ones. If a mink farmworker with the flu also gets infected by H5N1, that may be all it takes to ignite a pandemic...

Perhaps the best news is that we have several H5N1 vaccines already approved by the Food and Drug Administration whose safety and immune response have been studied.

The U.S. government has a small H5N1 vaccine stockpile, but it would be nowhere near enough if a serious outbreak occurred. The current plan is to mass-produce them if and when such an outbreak occurs, based on the particular variant involved.

It's not hard to predict the divergent public response in the United States when an announcement is made that a dangerous pandemic is coming and everyone needs to get a new vaccine.  Something like this could "weed out" vaccine skeptics even more effectively than COVID did.  But the cost to the economy, not to mention the human tragedy of innocent bystanders would be catastrophic.