The COVID-19 pandemic has been blamed for more than 235,000 deaths in the UK through the end of 2023 one of the highest death tolls in the world.
Todays report confirms what many have always believed that the UK was under-prepared for COVID-19, and that process, planning and policy across all four nations failed UK citizens, Prime Minister Keir Starmer said, referring to England, Northern Ireland, Scotland, and Wales.
The safety and security of the country should always be the first priority, and this government is committed to learning the lessons from the inquiry and putting better measures in place to protect and prepare us from the impact of any future pandemic," he said.
The first report from the inquiry, based on hearings that began in June 2023, was focused only on pandemic preparedness and didn't place blame on any individual.
A second phase looking at the governments response, including the partygate scandal in which then Prime Minister Boris Johnson and his staff broke their own rules by hosting work parties, is due later. A third phase will look into what lessons can be learned from how the nation handled the crisis. The inquiry is due to hold hearings until 2026.
Hallett found that an outdated 2011 pandemic strategy for the flu wasnt flexible enough to adapt to a crisis nearly a decade later and was abandoned almost immediately.
There were fatal strategic flaws underpinning the assessment of the risks faced by the UK, how those risks and their consequences could be managed and prevented from worsening and how the state should respond, Hallett said.
There also was a lack of focus on what was needed to deal with a rapidly transmissible disease, and not enough done to build up a system to test, trace, and isolate infected patients.
Hallett said in her 217-page report that the UK needs to be better prepared for the next pandemic one that could be even deadlier.
The UK will again face a pandemic that, unless we are better prepared, will bring with it immense suffering and huge financial cost and the most vulnerable in society will suffer the most, she said.
Hallett recommended that a new pandemic strategy be developed and tested every three years, and that government and political leaders should be accountable for having preparedness and resilience systems in place. She also said that outside experts should be used to prevent the known problem of groupthink."
Unless the lessons are learned, and fundamental change is implemented, that effort and cost will have been in vain when it comes to the next pandemic," Hallett said. "Never again can a disease be allowed to lead to so many deaths and so much suffering.
Elkan Abrahamson, who represents the nearly 7,000 members of the COVID-19 Bereaved Families for Justice, applauded Hallett for adopting most of its recommendations to prevent a repeat disaster.
However, it is extremely disappointing that the vulnerable were ignored in the recommendations and there were no proposals for dealing with racial inequality, health inequalities, or the effects of austerity, Abrahamson said.
President Joe Biden walks to his car after stepping off of Air Force One at Dover Air Force Base in Delaware, Wednesday, July 17, 2024. Biden is returning to his home in Rehoboth Beach, Del., to self-isolate after testing positive for COVID-19. (AP Photo/Susan Walsh)
By DARLENE SUPERVILLE
REHOBOTH BEACH, Del. (AP) President Joe Biden did not wear a face mask in public a couple of times after the White House announced he had tested positive for COVID-19. The White House said the Democratic incumbent was experiencing mild symptoms while the presidents physician said Biden would self-isolate in accordance with CDC guidance for symptomatic individuals.
What does the CDC guidance say? What does the White House say?
After the announcement on Wednesday, Biden emerged bare-faced from the motorcade after he arrived at the airport in Las Vegas, where he had made several appearances, and boarded Air Force One. He also was not wearing a mask, which medicals professionals have said can help slow the spread of disease, as he stepped off the plane hours later at Dover Air Force Base in Delaware. Biden was surrounded by Secret Service agents and aides on both ends of the trip.
White House press secretary Karine Jean-Pierre said in Wednesdays announcement that Biden, 81, was experiencing mild symptoms and would stick to prearranged plans to travel to his home in Rehoboth Beach, where he would isolate.
Bidens physician, Dr. Kevin OConnor, said in a separate statement that Biden had a runny nose, dry cough and a feeling of general malaise. He said Biden was being treated with the drug Paxlovid and will be self-isolating in accordance with CDC guidance for symptomatic individuals.
The Centers for Disease Control and Prevention encourages people recovering from COVID-19 or any other respiratory illness to wear masks as part of an overall strategy to reduce transmission, but masks are not mandated.
The CDC recommends that people stay home and away from others if theyre feeling sick. They say people can resume normal activities when symptoms have started to improve and the person no longer has a fever.
The CDC describes masks as an additional strategy for preventing disease spread, but it generally leaves it up to individuals to decide whether to use them. It calls masks especially helpful when someone is sick and suggests they be used as a precaution during recovery.
The White House has not responded to an emailed request for comment about why Biden chose not to wear a mask.
OConnor said Thursday that Biden is still experiencing mild upper respiratory symptoms from COVID-19,. The president does not have a fever and his vital signs remained normal. Hes being treated with the drug Paxlovid.
Quentin Fulks, the principal deputy manager of Bidens reelection campaign, said Thursday that Biden was feeling fine and was making calls and doing work. Fulks spoke at a news conference on the sidelines of the Republican National Convention in Milwaukee.
White House national security spokesperson John Kirby told reporters during a separate Zoom briefing that Biden was being kept up to speed as appropriate by his leadership team, and certainly that includes on the national security front.
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Associated Press writers Mike Stobbe in New York and Will Weissert in Washington contributed to this report.
Victoria Pickering / Flickr cc
The proportion of COVID-19 deaths in central Europe in 2020 and 2021 would have been up to 18% to 27% higher if death certificates listing the virus as a contributing condition had coded it as the cause of death, estimates a newstudy published in PLOS One.
University of Warsaw-led researchers examined 187,300 death certificates from Austria, Bavaria (Germany), Czechia (Czech Republic), Lithuania, and Poland mentioning COVID-19 in 2020 and 2021. They performed a two-step analysis of cause-of-death association indicators (CDAIs) and contributing CDAIs to estimate the statistical strength of associations between COVID-19 and other conditions.
"Excess deaths reported to causes other than COVID-19 may have been due to unrecognised coronavirus disease, the interruptions in care in the overwhelmed health care facilities, or socioeconomic effects of the pandemic and lockdowns," the authors noted. "Death certificates provide exhaustive medical information, allowing us to assess the extent of unrecognised COVID-19 deaths."
A total of 15,700 death certificates listed COVID-19 as a contributing condition, and three of four recorded a statistically significant COVID-19 complication or pre-existing condition as the cause.
Unrecognised coronavirus deaths were equivalent to the entire surplus of excess mortality beyond registered COVID-19 deaths in Austria and the Czech Republic, and its large proportion (2531%) in Lithuania and Bavaria.
"In Austria, Bavaria, Czechia, and Lithuania the scale of COVID-19 mortality would have been up to 1827% higher had COVID-19 been coded as the underlying cause of death," the researchers wrote. "Unrecognised coronavirus deaths were equivalent to the entire surplus of excess mortality beyond registered COVID-19 deaths in Austria and the Czech Republic, and its large proportion (2531%) in Lithuania and Bavaria."
The undercount may be attributable to a lack of COVID-19 testing, atypical disease course, misclassification, or deaths from other causes such as cardiovascular disease and cancers that may have risen as strained healthcare systems prioritized COVID-19 patients or fallen owing to the reduction of risk factors such as air pollution, traffic, or other infectious diseases.
"Finally, mortality may have increased due to harmful behaviours typical of the socioeconomic instability experienced by some groups during the pandemics, lockdowns and economic slowdown, such as abuse of noxious substances, suicides and accidents," the researchers wrote.
In this Swedish retrospective cohort study, mechanically ventilated patients with COVID-19 experienced a higher incidence of ICU-acquired infections compared to those with influenza. Staphylococcus aureus was identified as the most common pathogen causing VA-LRTI among patients with influenza and COVID-19, while gram-negative bacteria as a group caused the majority of VA-LRTI in patients with COVID-19. We found an association between ICU-AI and increased risk of mortality in patients treated with corticosteroids. Our data further suggest that corticosteroid treatment in COVID-19 is a risk factor for acquiring secondary bacterial infections in the ICU.
The differing risk of ICU-AI in patients with COVID-19 as opposed to influenza accords with other studies2,11,21,22,23,24. It may be explained by factors such as increased demand on the healthcare system during the COVID-19 pandemic11,25, alterations of immune responses caused by SARS-CoV-221, a high proportion of ARDS in COVID-19, more frequent prone positioning23, and prolonged IMV and ICU stays11,26. Although we noted no difference in ICU LoS between the COVID-19 and influenza cohorts, there was a small difference in time on IMV. Consistent with findings from other studies23,26, more males were observed in critical COVID-19 cases than in influenza cases. This may account for the different incidence rates, as this and other studies suggest that male gender is a risk factor for ICU-AI15,27.
There was no significant difference in the percentage of patients with corticosteroid treatment between the two cohorts. However, the indication for corticosteroid treatment to patients with influenza was airway obstruction and/or sepsis with lower doses and shorter duration than recommended in severe COVID-19. Furthermore, antibiotic treatment on admission has been shown to be a risk factor for ICU-AI2,28,29, and early initiation of antibiotics was high throughout the pandemic, despite the low frequency of co-infections on admission in patients with COVID-19. On the other hand, it is possible that the lower incidence of ICU-AI in the influenza cohort is partly explained by earlier diagnosis and targeted treatment of co-infection, while some co-infections in the COVID-19 cohort might been missed initially and later misinterpreted as ICU-AI.
As the pandemic developed, incidence rates of ICU-AI in patients with COVID-19 increased. A similar pattern, but with slightly lower incidence rates, was seen in a recent Swedish study on VA-LRTI29. The differing incidence rates of ICU-AI during the pandemic can be partly explained by a shift in corticosteroid treatment, for as our study and several others have suggested, corticosteroid treatment is a risk factor for ICU-AI2,15,22,29,30. Moreover, later in the pandemic patients were more critically ill and had more co-infections on admission, possibly affecting the risk of ICU-AI. Nor can we rule out other variables, such as changes in management or staffing at the ICU31, different SARS-CoV-2 strains, or vaccinations32, any of which may have affected the risk of ICU-AI throughout the pandemic.
Other studies have demonstrated the same association between ICU LoS and IMV duration, while reports on mortality are conflicting15,24,29,30,33. Our findings demonstrate an increased risk of mortality with ICU-AI in patients with corticosteroid treatment as compared to patients who have not received corticosteroids. This may in part reflect the higher mortality that occurred in later waves in contrast to the first. Although glucocorticoids have been shown to reduce mortality12,34, later studies have indicated that not all patients with severe COVID-19 may benefit from corticosteroid treatment15,35,36. We did not find any interaction between age and corticosteroid treatment on the risk of ICU-AI, but it cannot be ruled out that certain patient categories might be affected differently by corticosteroid treatment. Further riskbenefit studies of the association between corticosteroid treatment, ICU-AI, and outcome in hospitalized patients are needed.
The microbial pattern we observed in VA-LRTI is consistent with that seen elsewhere11,14,22,29,30. Although we found a larger discrepancy between the two cohorts than other studies observed11,23,24,37, this may have been due to the small number of patients with influenza and ICU-AI. A shift in the microbial pattern was observed between early and late VA-LRTI, with an increase in more difficult-to-treat microbes in later stages, consistent with findings reported in other studies11,29,30. Possible explanations for this are alterations in lung microbiota38, increase of biofilm-active bacteria39, as well as an overuse of antibiotics2. We noted a change throughout the pandemic towards more broad-spectrum antibiotic treatment on admission in patients with COVID-19. Broad-spectrum antibiotics are a risk factor for ICU-AI28 and may possibly facilitate the development of more complicated infections. Although the rate of MDRO was comparatively low23,40, there is a risk of decreasing antibiotic susceptibility with the overuse of antibiotics41,42.
The major strengths of our study are the large sample size of patients on IMV due to COVID-19 and our detailed examination of the medical charts for each case. There are however some important limitations to consider: First, the retrospective nature of the study. Second, the small comparison group, due to the relatively few patients on IMV as a result of influenza, especially during the COVID-19 pandemic. The inclusion period for the two cohorts also differed somewhat, possibly affecting the prevalence of MDRO. Third, most patients receiving corticosteroid treatment were hospitalized after the first wave, so it is possible that there were coinciding changes in management that further affected the risk of ICU-AI. Fourth, most samples from the lower respiratory tract were not taken with protected brush. This may have resulted in some colonization cultures and contaminations being included for analysis.
A Boston Children's Hospitalledstudyreveals that COVID-19 vaccine uptake lagged among US children with more social vulnerability, lower socioeconomic status (SES), and greater household composition and disability (HCD) as of July 2022.
The study, published today in Pediatrics, also identified longer travel times to vaccination sites for rural, uninsured, White, and Native American families.
The researchers mined the Centers for Disease Control and Prevention's (CDC's) Vaccine Tracking System in July 2022 to estimate vaccination-site accessibility by geocoding the sites, measuring travel times to the nearest site, and weighting population demographics to arrive at nationally representative vaccination estimates for October 2021 to July 2022.
The team also compared COVID-19 county-level vaccine coverage by Social Vulnerability Index scores, SES, HCD scores, minority status and language (MSL), and housing and transportation types. HCD concerns the number of people living in a household, and disability refers to the disability of anyone in the household.
Children from marginalized and minoritized communities have also faced disparate impacts across the COVID-19 care continuum.
COVID-19 has disproportionately affected marginalized and minority communities across the country, but access to testing, clinical trials, vaccines, and treatments haven't been equitably allocated to socially and clinically vulnerable adults, the study authors noted.
"Children from marginalized and minoritized communities have also faced disparate impacts across the COVID-19 care continuum, including inequities in rates of COVID-19 infection and COVID-19-related hospitalization, ICU admission, complication (eg, multisystem inflammatory syndrome), mortality, and loss of a primary caregiver," they wrote.
More than 15.2 million COVID-19 vaccine doses (271,589 doses of the Pfizer/BioNTech vaccine for children 6 months to 4 years, 6,270 doses of the Moderna vaccine for the same age-group, and 14,956,097 doses of the Pfizer vaccine for children aged 5 to 11 years)were given at 27,526 sites.
In total, 2.0% of the US population and 2.7% of uninsured, 10.5% of rural, 13.2% of American Indian and Alaska Native (AIAN), 2.0% of White, 2.2% of Hispanic, and 1.2% of Black children lived more than 30 minutes from the nearest vaccination site for children 5 to 11 years.
In contrast, 13.7% of the population and 65.9% of rural, 15.3% of uninsured, 25.3% of AIAN, 14.5% of White, 11.8% of Hispanic, and 9.0% of Black children lived more than 30 minutes from the nearest site for children 6 months to 4 years.
Rural children had longer travel times than their urban peers in all demographic subgroups and both vaccine age-groups, with large differences in the accessibility to sites for the younger age-group. Relative to White children, who lived a median of 4.8 minutes away, AIAN children (13.5 minutes) lived farther from the nearest site for younger children, while Asian (2.2 minutes), Hispanic (2.7), and Black (3.4) children lived closer.
For children 5 to 11 years old, the median travel time was 2.3 minutes for White children, 4.1 minutes for AIAN children, 4.1 minutes for Asian American children, 1.3 minutes for Hispanic children, and 1.6 minutes for Black children.
Lower vaccine uptake was linked to higher Social Vulnerability Index scores, lower SES, and greater HCD among children aged 6 months to 4 years (overall incidence rate ratio [IRR], 0.70; SES IRR, 0.66; HCD IRR, 0.38) and 5 to 11 years (overall IRR, 0.85; SES IRR, 0.71; HCD IRR, 0.67). Social vulnerability by MSL, however, was tied to higher uptake (6 months to 4 years IRR, 5.16; 5 to 11 years IRR, 1.73).
"Pediatric COVID-19 vaccine uptake and accessibility differed by race, rurality, and social vulnerability," the authors wrote. "National supply data, spatial accessibility measurement, and place-based vulnerability indices can be applied throughout public health resource allocation, surveillance, and research."
Coordinated responses to emerging pathogens at hyperlocal, regional, and national levels must prioritize health equity.
The lower vaccine coverage among children aged 6 months to 4 years may be attributable to slow "diffusion of innovation" in the weeks after the COVID-19 vaccine became available for this age-group and higher parental hesitation to the vaccine for young children.
And the greater vaccine uptake among children with social vulnerability by MSL could reflect a troubling truth, the authors said: "Greater vaccination among privileged groups even when sites are located within marginalized communities, because of low vaccine confidence and other access barriers, disproportionately impacting marginalized populations," they said. "Moreover, early racial and spatial inequities in the pediatric vaccination rollout may grow further as pandemic-related coverage and reimbursement expansions are rescinded."
They recommend taking evidence-based, "low-tech/high-touch" approaches such as behavioral nudges, reminders, employer and school vaccine requirements, parental education about vaccine importance and safety,and delivery of vaccine messages by trusted community members.
"Our methods and findings may be useful for prioritizing equity in the rollout of promising new interventions like nirsevimab for respiratory syncytial virus,targeting future outbreak response efforts,and surveilling population-level disparities in chronic pediatric conditions," the researchers wrote. Nirsevimab (Beyfortus) is a monoclonal antibody that can reduce the risk of respiratory syncytial virus (RSV) in infants.
"Coordinated responses to emerging pathogens at hyperlocal, regional, and national levels must prioritize health equity, because of distributive justice, because of the many intersections of health and social conditions, and because our health is inextricably linked to the health of those around us more than ever during a pandemic," they concluded.
Concerns have been raised in recent months after an outbreak of avian flu caused by the virus H5N1 was detected in cattle in the US. To date, 139 affected herds have been identified, and four dairy workers have contracted the virus. The UK Health Security Agency, which previously believed there to be minimal risk of the virus evolving into a form which could spread among humans, now believes there is up to a one-in-three chance of it doing so. A factory in Liverpool has been busy manufacturing stockpiles of a pre-pandemic vaccine which will be given to farm workers and others in occupations that bring them into close contact with bird flu.
We have been here before with bird flu. An outbreak among birds in East Asia in 2005 led to the World Health Organisation predicting that the disease could go on to kill between two million and 7.4 million people. Not to be outdone, Professor Neil Ferguson of Imperial College London declared that around 40 million people died in the 1918 Spanish flu outbreak, and that given subsequent population growth, you could scale [the potential death toll] up to around 200 million people probably. In the end, only 282 people died worldwide from the disease. Not for the first time, Prof. Ferguson was talking nonsense.
If H5N1 does turn out to cause a pandemic in humans, can we expect a more measured response?
The last Conservative government was in no rush to learn the lessons of Covid-19, perhaps as there were plenty of errors made by Tory ministers who were standing for re-election. The official Covid Inquiry is moving with glacial speed: the first part of its report is published only now, three years after it was first announced. And even that is looking only at preparedness. In the end, the thing we were truly unprepared for was the political panic and the devastating effect it had on this country when scientific advisers who should have known better were also swept away in the hysteria.
Sir Patrick Vallance was chief scientific adviser during the pandemic. He has now been named Keir Starmers science minister which is odd given that, under his tenure, science was not properly defended. Instead, advisers turned to faulty mathematical models provided by the likes of Professor Ferguson; and in October 2020 Vallance himself deployed a misleading graph predicting 4,000 deaths a day in the absence of a second lockdown.
Pandemics only end when herd immunity is achieved: a basic point made in April 2020 by Graham Medley, a Sage member. In an interview, he warned about the likely effects of a national lockdown. There will also be actual harms in terms of mental health, in terms of domestic violence and child abuse, and in terms of food poverty, he said. This annoyed No.10, which asked if there was a discreet way of silencing such scientists.
As the chief scientific adviser, Vallance should have been in favour of robust debate, defending the right of Sage members like Medley to speak out even (perhaps especially) if his line differed from official policy. But Vallance was a participant in the government WhatsApp chats and in those messages he agreed to deal with Prof. Medley, asking him to dial back his comments. Vallance reported back to the WhatsApp group that his intervention had been a success and Medley was mortified. Suppressing debate is not in the interests of science. All angles need to be considered and dissent should be welcomed. This, surely, is a crucial lesson we should learn from the Covid era.
Another lesson is that exaggerating a threat can be counterproductive and the resulting panic incredibly dangerous. In his 2010 autobiography, Tony Blair who was prime minister at the time of the 2005 scare said: There is a whole PhD thesis to be written about the pandemics that never arise. He went on: The old first world war flu statistics were rolled out, everyone went into general panic and any particular cases drew astonishing headlines of impending doom. In the end, he said, he tried to do the minimum in preparing for the pandemic that didnt arrive. Four years later he was vindicated when swine flu led to a similar panic. Retroviral drugs were stockpiled and the EU advised against non-essential travel to the US. The virus turned out to be no more virulent than seasonal flu.
When Covid struck a decade later, it turned out that we were embarrassingly ill-prepared, in very basic ways such as not having sufficient personal protective equipment stockpiles for NHS staff. But we were also unprepared for the danger of overreacting.
So we face a vital question: if H5N1 does turn out to be on the verge of causing a pandemic in humans, can we expect the right response? The findings of the official inquiry into Covid will be no help. The disaster that was the lockdowns has hardly been examined; the main intention seems to be to prove that lockdowns were inevitable, so that the only issue at stake is why the government didnt impose them sooner.
The increasing concern over the spread of bird flu has not prompted calls for Covid-like restrictions yet, but it could all too easily lead in that direction. We need to inoculate ourselves against hysteria as much as we do against any virus.
Michigan farms help USDA in research of bird flu outbreak spreading to cattle and humans
by Jessica Harthorn
In this undated photo, lab technicians at the Michigan State University Veterinary Diagnostic Laboratory are looking at samples of the{ }Highly Pathogenic Avian Influenza.{ } (Image: MSU College of Veterinary Medicine)
LANSING, Mich.
Right now, Michigan is a hot spot for the Highly Pathogenic Avian Flu.
Otherwise known as the bird flu, its currently infecting 26 herds. The latest case was reported July 9, 2024 in Gratiot County.
The virus, which is common in wild birds, is now being discovered in dairy cattle, poultry, even people, surprising state scientists.
On May 1st, the Michigan Department of Agriculture and Rural Development issued a strict new bio-security order for dairy farms to follow trying to mitigate the spread.
News Channel 3 talked with a dairy farmer who told us this virus is the most concerning challenge he's faced in 40 years.
Its a new virus scientists across the country are scrambling to learn more about.
"What are the transmission pathways? How is it moving from farm to farm?" asked MDARD Director Tim Boring.
March 29th, the first positive detection of the avian flu in cattle was discovered on a dairy farm in Montcalm County. The cattle had just arrived from Texas.
"As a virologist, and I think that all of my virologist friends who are going to be honest, would tell you that none of us expected to see this happen," said Dr. Kimberly Dodd, the director of Michigan State University Veterinary Diagnostic Laboratory.
The sample was sent to the Michigan State University Veterinary Diagnostic Laboratory, where Director Kimberly Dodd and her team got right to work.
"A core part of our mission is to continually develop new tests to be able to detect new emerging diseases," Director Dodd said.
The lab is part of a network of 63 across the country, working with the USDA to respond to animal health disease events, and placing Michigan on the forefront of discovering what this virus is capable of.
"Is it possible it could become the next COVID, as a scientist, what are your thoughts?" asked News Channel 3 Anchor Jessica Harthorn.
"The longer that we have viruses circulating in the population, the more opportunity there is for mutation, which could potentially raise the risk for spread to other species, including humans. But that's always the case, even before we saw the situation of influenza viruses in dairy cattle," Director Dodd said.
As of July 14, the Centers for Disease Control and Prevention has reported nine human cases, two in Michigan who were in close contact with cattle.
"Well, my first reaction was I wanted to make sure my family that work with the cattle, and the farm employees were safe," Chapin said.
In May, Director Tim Boring issued mandatory bio-security rules for farms to follow.
"Of making sure that we are keeping viruses on farms, keeping it off of new farms, and really focuses a lot on people, equipment, vehicles, of addressing those transmission pathways," Director Boring said.
MDARD is also prioritizing testing. "Local health departments are out talking to farm workers in the event there is a positive herd detected, we are doing a lot of people tracking, a lot of health monitoring," Director Boring said.
Right now, a curbside sample drop-off is set up at the MSU laboratory, Director Dodd told us, hundreds of tests are being done weekly, and Michigan is leading the country using a collaborative approach, called "One Health."
"It's this idea that animal health, human health and environmental health are all interconnected, and in order to tackle a challenge in any of those areas, we need to work together. I'm really proud of the work our state has done to support the USDA and the national response," Director Dodd said.
Director Boring said numbers show the bio-security rules are working to reduce the spread of avian influenza. As for Chapin, he said right now his herd of 700 is healthy.
"Has implementing the new rules been a challenge to your farm?" asked Harthorn.
"I think yes, yes, it's been a challenge to make it all work right. As a producer, you always wish it wasn't in your backyard, so I think that's why you want to double down on your bio-security efforts, to do all that you can do to keep your cattle and your people safe," Chapin said.
The MDARD map published on May 24, 2024 shows the ten counties in Michigan where positive cases were reported in dairy herds, six are in West Michigan.
For dairy farmers who want peace of mind, all testing is covered by the USDA. To find out more, click here.
As scientists continue to learn more about the Highly Pathogenic Avian Flu, MDARD said its bio-security rules will also evolve.
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The U.S. government and local health departments around the country are working to mitigate the spread of avian influenza, or bird flu.
In early 2022, the H5N1 virus was found in commercial poultry, backyard chickens and aquatic birds. Now, its also spread to cattle nationwide and to 9 people who worked closely with infected animals.
Reset sits down with a public health official to get the latest updates on the outbreak and whats being done to avoid another pandemic.
GUEST: Dr. Janna Kerins, medical director of environmental health, Chicago Department of Public Health
Where Is Bird Flu Spreading around the World?
Different versions of bird flu have been spreading around the world in recent years.
The virus, officially known as H5N1, is believed to have killed millions of wild and domestic birds worldwide. Some other animals have also been infected.
The virus infected a very small number of people as well. But, H5N1 largely has remained outside the human population. Most of the few human cases involved direct contact between people and infected birds.
Reuters news agency recently explored areas of the world where versions of H5N1 have infected humans.
United States
In the United States, the first known cases of infected dairy cows happened in Texas in March. Currently, dairy cow groups in at least 12 states have been affected.
The U.S. Agriculture Department has said tests so far suggest the virus identified in cows is the same H5N1 found to have infected wild birds and farm birds, also called poultry. Four dairy workers who tested positive for the virus this year showed only minor signs of sickness, such as conjunctivitis, an eye condition.
Officials from the European Food Safety Agency (EFSA) said in a report the H5N1 virus spreading in the U.S. is related to a version only identified in North America so far.
Mexico
The World Health Organization (WHO) said on June 5 that a resident of Mexico died with the first known cases of H5N2 bird flu in humans. Mexico's government disputed that cause of death, saying instead the person died of another sickness. Officials said the person had no known contact with animals.
Australia
On June 7, the WHO said a child reported by Australia to have H5N1 had traveled to Kolkata, India. Genetic testing showed the virus was a version of H5N1. That version was known to have been spreading in Southeast Asia and has been identified in previous human infections and in poultry.
Separately, Australia is dealing with three outbreaks of different bird flu versions on poultry farms. These include H7N3, H7N8 and H7N9. Officials said those versions likely arrived on farms through wild birds.
India
In India, the WHO reported a case of human infection with bird flu on June 11. It was caused by the H9N2 version in a four-year-old child in the eastern Indian state of West Bengal. The agency said it was the second human infection of H9N2 bird flu from India following a case in 2019.
The H9N2 virus generally only causes mild sickness. But the WHO said further human cases could happen because this version is one of the most common at poultry farms in different areas.
Vietnam
In March, Vietnam reported a 21-year-old student had died from the H5N1 virus. He had no existing medical conditions. But officials said the student had had contact with wild birds from hunting a couple of weeks before signs of sickness appeared. No contact with dead or sick poultry was reported at the time.
The EFSA said Vietnam also reported an outbreak of H9N2 in a 37-year-old man.
Cambodia
Cambodia has reported five human cases of H5N1 as of June 20.
China
This year, China has identified human cases caused by the H5N6, H9N2 and H10N3 versions. Two deaths were reported with H5N6 cases in the countrys Fujian province. The EFSA said both individuals had contact with household poultry before they showed signs of sickness.
The case of H10N3 bird flu was the third one ever reported worldwide.
Germany
Germany reported a rare outbreak of H7N5 bird flu on a farm in a western part of the country near the border with the Netherlands. The case was identified July 4 by the World Organization for Animal Health. The group said it was the first outbreak anywhere of H7N5 on the groups public records.
Im Bryan Lynn.
Reuters reported this story. Bryan Lynn adapted the report for VOA Learning English.
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domestic adj. relating to the home and family relationships
dairy n. containing or made from milk
positive adj. in a medical test, positive means the person being tested has a disease or condition
Since May, a number of poultry farms around Australia have faced outbreaks of avian influenza, or bird flu. These outbreaks have been devastating for the poultry farms affected, necessitating large-scale culls, and have caused knock-on effects for the countrys egg supplies.
The poultry farm outbreaks have been linked to bird flu strains beginning with H7 (such as H7N3 and H7N8). But the strain causing most concern at present is arguably a different strain H5N1.
This strain is spreading rapidly around the world, and can cause more serious illness and death in poultry, birds and mammals.
Experts are warning H5N1 could soon reach Australia. And while bird flu isnt currently spreading between humans, this could change in the future.
So where are we at with vaccines for bird flu?
H5N1 first emerged in southern China in 1996.
Strains like H5N1 are further broken down into variants called clades. Since emerging in 2020, clade 2.3.4.4b has spread around the world, giving experts cause for concern. Recently, it has been causing outbreaks not only in wild birds and poultry, but also in dairy cows, notably in the United States.
While H5N1 is yet to be detected in birds or other wildlife in Australia, as it continues to spread in other regions, there are concerns were likely to see it here soon. CSIRO experts have this week warned the risk of H5N1 being imported is higher this year compared with previous years.
Fortunately, cases in humans remain rare. Five human cases of H5N1 clade 2.3.4.4b have been reported in the US since 2022, all of whom had close contact with dairy cows or poultry, and around ten others elsewhere in the world.
There was a single imported human case of H5N1 in Australia in a child who returned from overseas earlier this year, but of a different clade.
One of the biggest challenges with influenza viruses is that they can change fairly easily. Theres a possibility that some of these changes may give the virus the ability to transmit more readily from person to person. This could lead to widespread transmission worldwide, or a pandemic.
Given H5N1 viruses have been around for a while, we actually already have a few vaccines designed to protect against this bird flu strain in the event of sustained transmission in humans. The US approved one from Sanofi Pasteur back in 2007, the European Union approved one from GSK in 2008, and Australia approved one from CSL Limited in the same year.
Older H5N1 vaccines were traditional egg-based vaccines, which work by growing the virus in fertilised chicken eggs and deactivating it, then injecting it into the muscle so our immune system can be trained to respond.
More recently, CSL Seqirus has created a cell-based H5N1 vaccine. This shot is based on technology already used to manufacture their seasonal flu vaccines, where the virus is grown in cultured cells of mammalian origin (rather than in eggs). Developing a vaccine that doesnt require chicken eggs to make is sensible in the context of bird flu, which can limit the availability of eggs.
While the risk in humans remains low, the World Health Organization has suggested humans dont need to be vaccinated against bird flu at this stage.
That said, Finland plans to roll the CSL Seqirus shots out imminently to those at highest risk (people routinely exposed to animals who may be infected), making them the first country to vaccinate against H5N1.
While research has suggested existing vaccines produce immune responses that will provide sufficient protection against the currently circulating strains, vaccines based on older versions of H5N1, or even those made more recently, may not be an ideal match for future strains of bird flu.
mRNA vaccine technology is now well established for COVID, while an mRNA vaccine against RSV (respiratory syncytial virus) was recently approved in the US.
mRNA (messenger RNA) vaccines essentially work by giving our immune system instructions to make proteins, usually bits found on the surface of viruses. Our immune system then recognises and responds to these proteins to protect us if we encounter the virus.
This technology also offers promise for bird flu vaccines. Moderna began clinical trials for mRNA vaccines against both H5 and H7 strains in 2023 and recently secured funding to continue late-stage development. Other companies including GSK and Pfizer are also working on mRNA vaccines against H5N1.
One of the benefits of this technology is that if the virus changes significantly from the version circulating at a given time, mRNA vaccines can be adapted to these changes quite quickly.
Other approaches are also being investigated, including universal flu vaccines that could protect from all types of flu. But these are unlikely to be available soon.
Being a virus primarily of birds, another strategy is to vaccinate the birds themselves. In some countries where bird flu is consistently found in birds such as Egypt and China, vaccinating poultry in particular has been routine for some time.
With the ever-increasing global spread of H5N1 and the growing number of species infected, there are concerns about the potential for this strain to cause a pandemic.
If we were to see a bird flu pandemic, fortunately we are perhaps in a better position than ever before to respond. Not only have we learnt a lot in recent years from responses to other infectious diseases, particularly COVID, but technology and capacity to be able to make vaccines rapidly has also come a long way.
