Heeding the lessons of COVID-19 in the face of avian influenza

Yahoo

25-03-2025

Infectious disease outbreaks have a bad habit of piling on at the worst possible times.
The 1918 flu pandemic, also known as the Spanish flu, caught the world by surprise just as the First World War was coming to an end. It was responsible for killing three to five per cent of the world's population (50-100 million people, equivalent to about 400 million today).
Now, as we reflect on five years since the declaration of the COVID-19 pandemic and face economic uncertainty imposed by the United States administration — as well as lingering conflicts in places such as the Middle East and Ukraine — it's the steady march of avian influenza, or 'bird flu,' that poses an imminent threat to humanity.
Bird flu has been causing a flurry of human infections, especially in U.S. cattle workers. If the virus learns to spread effectively from human to human, it could change the course of history. Even though our weary world already feels maxed out, we have to make room to avert yet another crisis.
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The good news is that we know how to minimize risk and mobilize resources quickly, before the virus starts moving from human-to-human.
Knowing what to do and actually doing it, though, are very different, as we saw all too well five years ago when COVID-19 shut down much of the world, killing more than seven million people worldwide. And it's not through with us yet.
The question is whether we will act in time to head off a bird flu pandemic. The Spanish Flu was the first of five influenza pandemics since the end of the First World War.
A sixth is inevitable without co-ordinated global action. Otherwise, the only questions are when it will it come and how bad it will be.
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Infectious diseases constitute a permanent threat to society, especially as vaccine hesitancy and misinformation grow. Fighting pandemics needs to be a full-time, ongoing priority for governments everywhere.
After the arrival of COVID-19, there were some impressive investments in infrastructure and science to support pandemic preparedness, but many were essentially one-time projects.
Canada needs to establish permanent capacity to prevent and respond to health emergencies. Government agencies specifically dedicated to supporting the development of medical countermeasures for pathogens that pose a pandemic risk, like the recently established Health Emergencies Readiness Canada (HERC), are a step in the right direction.
However, we must also re-prioritize investments in the fundamental research that is the birthplace of new medical and non-medical solutions to pandemic preparedness — where we currently lag far behind essentially all of our G7 counterparts. This has never been more important than in the current global political context.
The cost of acting to prevent or limit a pandemic is infinitesimal compared to the price of letting one happen, whether one measures the toll in human lives, or in dollars.
The world needs to adopt a collective mentality that we are 'all in' on prevention if we want to maximize our chances of avoiding the next pandemic. We cannot sit on our hands and hope we get lucky. That strategy has failed us in the past and will doom us in the future.
Today, as we stand on the brink of an avian influenza pandemic that could be significantly worse than COVID-19, too much of the world seems unaware, unprepared or largely disengaged.
Globally, more than 900 humans are known to have been infected by H5N1 avian influenza so far. The death rate associated with these human infections is a staggering one in two, placing it on par with threats such as Ebola.
Death rates resulting from human infections of the most prevalent currently circulating H5N1 virus in the U.S. (clade 2.3.4.4b) have been much lower — though the very narrow demographic characteristics of the individuals that have been infected leaves many questions regarding the true danger that this virus poses to the population at-large. Avian influenza has become more prevalent than ever in our environment. Having adapted to spread efficiently among cattle and other mammals, the virus will follow its biological imperative to adapt and survive.
No responsible country can ignore the possibility that person-to-person spread could start anywhere and quickly wash over the planet.
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Certainly, Canada is treating the issue seriously, as I know from my work with the Public Health Agency of Canada, the National Advisory Committee on Immunization, the Ontario Immunization Advisory Committee and other bodies.
But the effort to stop or at least slow avian influenza needs to include all countries and to engage everyday people, especially those who work directly with birds, cattle and other wild and domestic animals.
The best tactics to stave off a pandemic, at least at this point, are relatively unintrusive, targeted interventions. It's critical that farm workers, veterinarians and others who work with animals follow careful protocols such as wearing masks and goggles, sanitizing equipment and continuing to cull poultry flocks where exposure is identified.
We also need to educate hunters about protective measures to lower their risk of exposure.
Most mitigation measures are entirely non-medical — though offering vaccines to those at high risk of exposure, as Finland has done, would be prudent. It's much easier to target vaccination programs to high-risk groups than to organize a global vaccine campaign after a pandemic has begun.
We need to encourage these groups to take every possible action to protect themselves — and therefore the world — and to provide financial supports that enable them to comply without cost.
If avian flu becomes established among humans, which could happen rapidly and with very little warning, COVID-19 has shown that only a swift, decisive and truly global approach can fend off disaster.
A significant lesson from COVID-19 is that we have to support pandemic prevention and response efforts for people in every corner of the world, however remote they may be, and that we must reach vulnerable populations within wealthy countries, such as elderly, frail and marginalized people, and those affected by poverty. These are the people always impacted most by infectious diseases.
A selective distribution of resources among the planet's wealthiest populations will not provide the protection the world needs and will only enlarge and extend the reach of a new pandemic.
We must remember what it was like to close down schools, workplaces and public gatherings and to have hospitals overflowing with patients as clinicians risked their lives to care for them.
We could have saved so many people and so much money by taking the threat more seriously from the outset, including providing better public education about evidence-based measures such as masking and vaccines.
It's past time we made pandemic prevention and response a permanent priority, no matter what else is happening in the world.
This article is republished from The Conversation, a nonprofit, independent news organisation bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Matthew S Miller, McMaster University
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Matthew S Miller is co-founder and Chief Scientific Officer of AeroImmune Inc. He has received compensation from Seqirus, Sanofi, GSK, Roche, Grifols, and Aramis Biotechnologies for participating on advisory boards and for supporting educational activities. He has received research funding from the Canadian Institutes of Health Research, the Canadian Foundation for Innovation, the Natural Sciences and Engineering Research Council of Canada, the Canada Research Chairs Program, the Federal Economic Development Agency for Southern Ontario, Ontario Centre of Innovation, Bay Area Health Trust, Providence Therapeutics, JN Nova Pharma, Lactiga, and Zentek. He is a member of the National Advisory Committee on Immunization COVID-19 Working Group and H5N1 Influenza Working Group. He is also a member of the Ontario Immunization Advisory Committee and the Public Health Agency of Canada Expert Panel on Avian Influenza A(H5Nx).