Most people do not want to think about bird flu, aka avian influenza A (H5N1). Americans have astonishingly short memories. We have already done our best to put COVID-19 out of our minds. That’s despite the fact that a lot of people are still coming down with it for the first, second or third time. We are as unprepared for an epidemic/pandemic of H5N1 as we were for the spread of the SARS-CoV-2 coronavirus. If bird flu becomes easily transmissible between humans, it could be far worse than COVID-19.
Flu-Shmoo…Many People Embrace Alfred E. Neuman’s Motto:
“What, Me Worry?”
In case you have forgotten MAD Magazine, Alfred E. Neuman was the “cover boy” of that humor magazine for decades. His motto was “What, Me Worry?” There is even a song you can listen to on YouTube at this link. The lyrics include this phrase:
“Happy as a clown (whoa)What, me worry?House is burning down (whoa)Don’t disturb me”
That is the aphorism that a great many Americans have adopted regarding bird flu: Don’t Disturb Me! And a great many visitors to this website have made their position very clear when it comes to infectious diseases in general:
- Not going to isolate
- Not going to wear a mask
- Not going to ever get vaccinated
- Don’t care about air quality
- Bring it/them on…the more infections people get the stronger, their immune systems will become
I share these responses because we have received so many over the last several years that I have lost count. I will not engage in a debate because it just creates more confusion.
What Do We Know About the Spread of Bird Flu?
According to the United Nations, avian influenza has killed more than 300 million birds in 108 countries across 5 continents. 500 different kinds of birds have been infected, including a LOT of chickens. At last count, about 100 million poultry have been infected.
Let me be perfectly clear about the current spread of what we are incorrectly calling bird flu. 70 different mammalian species have been infected including:
- Badgers
- Bears
- Cats
- Cows
- Coyotes
- Dogs
- Foxes
- Goats
- Harbor seals
- Leopards
- Mink
- Pigs
- Polar bears
- Skunks
At last count about 700 dairy herds in California have been infected with H5N1. That is almost ¾ of all the herds in the state. The virus has also infected many herds in Colorado, Michigan, Idaho and Texas. A total of 16 states have reported cases.
If you have not been paying attention to the price of eggs, it is skyrocketing. In California it has hit nearly $9 per dozen according to the San Francisco Chronicle. Oklahoma prices are up to nearly $5 a dozen. In the Boston area the price is even higher.
Some blame the jump in prices on extra baking around the holidays. We will wait and see if prices go back down this month.
If Bird Flu Is Widespread, Why Aren’t Humans Catching it?
As I write this, H5N1 is not a human epidemic. Most public health authorities say avian influenza poses a low risk to humans.
According to the American Veterinary Medical Association (Dec. 30, 2024), there have been 64 people infected in the U.S. with H5N1:
“Twenty-two of these cases were associated with exposure to infected poultry, 39 were associated with exposure to infected dairy cows, and two sources of infection remain unknown with potential exposure to other animals such as backyard flocks, wild birds, or other mammals.”
The H5N1 Virus HAS Infected People:
Many of the people who have contracted avian influenza A have been workers on dairy farms. They presumably caught the virus by working around cows.
The CDC maintains that there is a low risk for human-to-human transmission. But a recent severe case in Louisiana suggests that the virus can mutate inside infected individuals. If bird flu mutates enough, there is growing concern that it could start spreading in far greater numbers.
But is H5N1 really spreading to people? Let’s be clear, 60 or 70 known human cases does not seem worrisome. And perhaps this particular avian influenza virus will never really adapt to humans the way it has to chickens, cows or other mammals.
Wastewater sampling in California (San Francisco, Sacramento, San Jose and Los Angeles) have tested positive for bird flu. There have also been positive tests in Michigan, Idaho, Colorado and Texas. Are the positive wastewater results from humans or birds and cows? At the moment, that is not clear.
Are We Prepared If Bird Flu Adapts to Humans?
In my opinion, the answer to that question is no! Why am I concerned? Because humans have already had a bad experience with bird flu.
An article in The Lancet Infectious Diseases (Sept. 2024) describes mortality data of H5N1 in human infections.
“The increasing host range and ability of avian influenza viruses to spread between mammals and humans raises concerns about a potential pandemic risk. This pandemic risk is a concern as the mortality was 458 (52%) of the 876 influenza A(H5N1) cases reported in Europe since 2002.”
Please digest that mortality number for one moment: 52%. In other words, 1 out of every 2 people infected with H5N1 died.
Those numbers are from previous outbreaks many years ago, but that kind of death rate is beyond alarming. The first outbreak of an H5N1 influenza A virus in humans was in Hong Kong in 1997. Since then, cases have been reported in Cambodia, China, Egypt, Indonesia, Thailand, Turkey and Vietnam. If the “case-fatality rate” is about 50%, a bird flu pandemic in humans would be a catastrophe.
What was the “case-fatality rate” for COVID-19? Not all scientists agree. And the virus changed over time. It appeared to be more lethal in the beginning.
One mathematician concluded:
“As of April 2023, about 1% of people who contracted COVID-19 ended up dying…That 1% is what epidemiologists call the case fatality rate, calculated by dividing the number of confirmed COVID-19 deaths by the number of confirmed cases.”
What was that in total numbers?
Here is “COVID-19 Epidemiological Update – 24 December, 2024″ from the World Health Organization:
“From the start of the pandemic until November 10, 2024, over 776.8 million confirmed COVID-19 cases and over 7 million confirmed deaths were notified to WHO across 234 countries. The majority of COVID-19 associated deaths occurred in 2020, 2021, and 2022, with increased immunity leading to a significant decrease in deaths.”
According to the CDC, the number of deaths attributed to COVID-19 on death certificates through the week ending 12/28/2024 in the United States was 1,217,149.
Remember…that is with a fatality rate of roughly 1%.
Imagine if bird flu caused a 50% mortality rate in humans, as it apparently did many years ago. Well, we don’t want to imagine that scenario.
Final Words Regarding the Question: If Bird Flu Spreads to Humans, Then What?
As I described above, Americans have adopted the Alfred E. Neuman slogan, “What, Me Worry?” We have not prepared for another pandemic because we do not want to imagine such a scenario ever occurring again. But viruses mutate. Infectious disease experts state that it’s not a matter of if, but rather a matter of when.
What should we do? I for one have been preaching better testing and surveillance. Here are links to two articles from July, 2024 titled
Bird Flu Tests Are Hard To Get:
So How Will We Know When To Sound the Pandemic Alarm?
Are People Getting Sick from Bird Flu? Quite Likely!
Over a year ago I described Florence Nightingale’s efforts to improve indoor air quality in the 19th century.
Improve Indoor Air Quality to Fight COVID and Flu
As far as I can tell, my suggestions have fallen on deaf ears. Public health authorities have made little, if any, attempt to improve air quality in public buildings. And surveillance for avian influenza A (H5N1) leaves a lot to be desired.
If a different virus rears its ugly head, are we prepared? I would have to say no. And because the American public is fed up with the very idea of pandemics, we have very little in place to prevent, detect or treat another serious infectious outbreak.
Sorry to be a “nervous Nelly,” but I’d certainly be happier if our public health authorities would accelerate testing across the board. We need a lot more home tests for various infectious agents. And we need better standards for testing and maintaining air quality.
Last week I warned about influenza, RSV, colds, COVID, whooping cough, norovirus and other infectious diseases at this link. I hope that I will not have to add bird flu to that list!
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