An article in today’s New York Times raises the alarm on the possibility of a coming pandemic that is far more deadly than Covid-19. It’s not a new pathogen, but it has been changing in ways that should concern us.
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.
That is no longer the case. 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, and a fact that establishes connections that might make it easier to spread to humans. 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.
The article issues a call for action: “The world needs to act now, before H5N1 has any chance of becoming a devastating pandemic,” the author writes.
We have many of the tools that are needed, including vaccines. What’s missing is a sense of urgency and immediate action.
The best defense against a new deadly pathogen is aggressively suppressing early outbreaks, which first requires detecting them quickly. The United States, the World Health Organization and global health officials already have influenza surveillance networks, but many avian influenza experts told me they don’t think the networks are functioning well enough given the threat level. Such surveillance would need to prioritize people in the poultry industry but also expand beyond that.
Thijs Kuiken, an expert in avian influenza at Erasmus University Medical Center in Rotterdam, the Netherlands, says farms for pigs — another species susceptible to influenza — should also be surveilled for bird flu. People interacting with wild birds and animals, as well as susceptible species of pets like ferrets, are also at higher risk. It’s not enough to detect, though: Suppression would require a major effort and global coordination.
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 and that there is already a small stockpile. However, if an epidemic should start, this would in no way be an effective measure and it would take more than 6 months to produce a greater quantity. Nor are there adequate ways of rapidly testing for the virus.
A big challenge to stockpiling flu vaccines is that they can lose potency over time and need updating as new variants arise. The U.S. government is skeptical about creating a large stockpile, fearing that stored vaccines may not be effective against whatever strain became pandemic, and worries that stockpiles will expire anyway. Officials also have faith that they can get new flu vaccines mass-produced rapidly.
Scientists are working toward a universal flu vaccine, potentially covering all variants as well as future pandemic ones — a “moonshot”, perhaps, but well worth the investment.
The writer concludes that, thanks to what we have learned in our fight against the coronavirus, “we have not just the warning, but also many of the tools we need to fend a pandemic off. We should not wait until it’s too late”.
