Welcome to birdflustocks.com!
With fresh memories of Covid-19, most people refuse to even think about another pandemic. However, there were influenza type A pandemics of H1N1 in 1918, H2N2 in 1957, H3N2 in 1968, and H1N1 in 2009. With around one billion infections and several hundred thousand deaths, the H1N1 swine flu pandemic of 2009 was comparable to "only" an additional "flu season".
H5N1 infections are much more deadly. Every second documented patient died. Widespread human infections combined with double-digit case fatality rates would be catastrophic.
H5N1 continues to spread globally and during all seasons, both is unprecedented. As large numbers of mammals get infected by sick and dead birds, the probability of adaptation to mammals and sustained human-to-human transmission increases.
This website aims to provide all the facts needed for your own risk assessment, based on probability and impact. While the bird flu pandemic may never happen, it could also have a devastating impact, financially and otherwise.
Highly pathogenic avian influenza H5N1 was first discovered in 1996 in China and caused the first fatalities in 1997 in Hong Kong. The new variant H5N1 clade 2.3.4.4b has spread from Europe around the world since its discovery in 2020. The map shows confirmed H5N1 infections of any clade in mammals and birds in late 2022 and 2023.
Sources are EDCD, FAO, and WOAH.
Expert Opinions
Victor Dzau
President of the United States National Academy of Medicine of the United States National Academy of Sciences
"Despite all that was learned from the COVID-19 pandemic, the world is nowhere near ready for an influenza pandemic and must increase our preparations now, and with all urgency."
Source
Ian Brown
Scientific Services Director, Animal and Plant Health Agency (APHA)
"We have to consider potentially all species of birds
could have some level of susceptibility, which of course is a new dimension."
Source
Derek Smith
Director of the Centre for Pathogen Evolution, University of Cambridge
"Vaccines are our best protection - they saved the most lives in the COVID pandemic. There’s no reason why they can’t be made at least that quickly for future pandemics – and there will be another flu pandemic for sure."
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Mathilde Richard
Erasmus Medical Center
"This is the threat that’s going to keep knocking at our door until it will indeed, I assume, cause a pandemic. Because there is no way back."
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Martin Beer
Head of Institute of Diagnostic Virology, Friedrich-Loeffler-Institut
"I think we need the awareness, but it's not the right time to say we are very close to a H5 pandemic, so it's a panzootic and we have to be careful."
Source
Rebecca Poulson
University of Georgia
"We’re worried about these viruses jumping into mammals and then maybe more specifically into humans. I just always like to point out that wildlife is important for its own sake. And this has proved to be a really devastating virus to mammalian and avian species."
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Robert Redfield
Former Director of the Centers for Disease Control and Prevention (CDC)
"The great pandemic-- it's coming. It's going to be a bird flu pandemic. It's going to be rough. We're going to see some significant mortality
around the world, including the United States."
Source
Thomas Peacock
The Pirbright Instititute
"It continues to be unprecedented. By several measures, we’re at the worst it’s ever been, particularly in terms of geographical spread, how widespread it is in birds and how many mammals are getting infected."
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Andrew Pavia
University of Utah
"H5N1 has been behaving in ways that we didn't expect which means that we know we have to watch it very carefully. That doesn't mean we know what it's going to do, but it means we have to have a lot of humility and invest some real resources in studying it and watching it."
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Lawrence Gostin
Georgetown University
"For many, many decades, these avian and swine influenzas have stayed within the animal kingdom. The hope and the expectation is that it will continue to do that. But one day, that virus will mutate and go to a human, and then spread to a global pandemic very, very quickly. And we have to be ready for that day."
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Andrew Pavia
University of Utah
"It’s a really dangerous time to be a bird. But as of today, the risk to humans remains very low. Our concern is what’s going to happen as it circulates more and more."
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Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"Public health agencies but also health care workers around the world are shattered. … It’s a global phenomena and the world’s willingness to either have vaccines, mRNA, or otherwise, and have any school closures, masks, whatever interventions you may talk about, would not be the same as they were back in 2020. That makes the case that we better do what we can to avoid an event happening because I think the response would understandably be very different."
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Michael Osterholm
Director of the Center for Infectious Disease Research and Policy at University of Minnesota
"I think estimates of stockpiles that currently exist and the potential to use them should this emerge into a human pathogen where it's transmitted by humans to humans, have unfortunately been overstated. I don't have a lot of faith that those vaccines will offer a great deal of protection."
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Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"I hope researchers will continue to work for better diagnostics, better drugs, and a better vaccine. It's an insurance policy against the tiny risk of a very major problem."
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Martin Beer
Head of Institute of Diagnostic Virology, Friedrich-Loeffler-Institut
"Nobody wants this dangerous virus to become entrenched in a new species that we use to produce food and that has so much close contact to humans."
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Marion Koopmans
Erasmus Medical Center
"The reason why this is not a big human health problem is because the virus is not that transmissible. It’s not because of our actions in response to this new situation."
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Michelle Wille
University of Melbourne
"I don’t think any of us could have imagined it’s been as bad as it is now, but since 2020-21, things have gotten to a whole new level. The scale of the mortalities is also something we’ve never seen before and there’s no evidence that it’s stopping any time soon."
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Peter Hotez
Baylor College of Medicine
"This has been a 20-year process. The first red flag was birds dropping from the sky. The second was harbor seals. The third is, now, cattle."
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Tom Inglesby
Director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health
"A universal flu vaccine – there are different
definitions of what that would mean – but
ideally a universal flu vaccine would create immunity
to portions of the flu virus that are common to all flu
strains, that when you do develop immunity to
your universal flu vaccine, the threat of seasonal flu
goes away, and the threat of bird flu goes away, and
the threat of pandemic flu goes away. That would be a
perfect world where one immunity or even a series of
shots, all timed in a certain way, basically took flu off
the table as a human infectious disease threat. That
would be the goal. That would be the faraway dream
and vision."
Source
Rajeev Jayadevan
Indian Medical Association
"Human infections have occurred through direct contact with poultry and cattle, but the virus hasn’t yet spread between humans. If it does, it could be highly lethal, with a 50% mortality rate. The virus’ mammalian adaptation and potential for further mutations, possibly through mixing with a human-adapted influenza virus, increase this risk."
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Yuko Sato
Iowa State University
"In a way, it's almost here to stay. I would use the word 'endemic' at this point because the virus has not left the country."
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Kelley Lee
Simon Fraser University
"We're more divided than we were before COVID. You would think that a generational event such as this would have brought us closer together … but in general, societies are more fragmented, less cohesive, and less trusting. That kind of social environment makes us far less likely to cooperate or coordinate our efforts, from the local level all the way up to the global level."
Source
Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"The virus is adapting in predictable ways that increase its risk to humans, reflecting our failure to contain it early on. The solutions to this brewing crisis — such as comprehensive testing — have been there all along, and they’re becoming only more important. If we keep ignoring the warning signs we have only ourselves to blame."
Source
Jennifer Nuzzo
Director of the Pandemic Center at Brown University School of Public Health
"Think about our judgment of China’s transparency at the start of COVID. The current situation undermines America’s standing in the world."
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Kristian Andersen
Scripps Research Institute
"A lot of criticism was leveled at China for their early response to Covid-19 — some of it reasonable, a lot of it extremely ignorant. Are we currently making some of those mistakes ourselves?"
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Michael Osterholm
Director of the Center for Infectious Disease Research and Policy at University of Minnesota
"There are going to be more pandemics, and they could absolutely be worse than anything we've seen to date, so we have to be better prepared."
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Philip Meade
Mount Sinai Health System
"We should treat potential pandemic threats like this virus with the same seriousness that we apply to our national defense."
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Chris Walzer
Executive Director of Health, Wildlife Conservation Society
"The sheer global distribution of this virus is underestimated everywhere — as well as the breadth of ecosystems that are being impacted."
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Seema Lakdawala
Emory University
"I think we are at an inflection point right now in the outbreak."
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Meghan Davis
Johns Hopkins Bloomberg School of Public Health
"The worst-case scenario would be something that would be highly transmissible and severe in humans as well as in animals."
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James Lawler
Co-Director of the Global Center for Health Security at University of Nebraska
"The messaging that has come out has been maybe a little more confident and a little more placating than it probably should be. It does not help to build back the credibility of the public health sector."
Source
Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"No, we're not ready. We could not respond with an equitable response. If we had an outbreak of avian influenza today, we would not have enough vaccines ready and available to distribute globally, especially to low- and middle-income countries, who were also last in line in the last influenza pandemic. They waited almost a year to get their vaccine. Nothing has changed since then. We wouldn't have enough diagnostics to be able to conduct the surveillance to inform countries of the risk. We wouldn't have enough therapeutics and drugs available, we wouldn't have enough masks and PPE and respiratory protection. There's a lot of work that needs to be done."
Source
Margaret Chan
Former Director General of the World Health Organization (WHO)
"Whatever resources you put in place—compared to the potential pandemic cost—it is peanuts. It is nothing."
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Tedros Adhanom Ghebreyesus
Director General of the World Health Organization (WHO)
"For the moment, WHO assesses the risk to humans as low. Since H5N1 first emerged in 1996 we have only seen rare and non-sustained transmission of H5N1 to and between humans, but we cannot assume that will remain the case and we must prepare for any change in the status quo."
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Michael Osterholm
Director of the Center for Infectious Disease Research and Policy at University of Minnesota
"At the outset, you have to say there is uncertainty, with one exception: there will be a pandemic."
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Derek Smith
Director of the Centre for Pathogen Evolution, University of Cambridge
"The strain of bird flu in Hong Kong was killing a third of the people it infected. If that could start transmitting directly between humans, it would be a disaster."
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Vijay Dhanasekaran
University of Hong Kong
"The shift of the epicenter of these highly pathogenic viruses to new regions has increased the chances of them infecting a wider range of animals, including mammals. Repeated infections in mammals, and in humans, increase the chances of the virus adapting, increasing the likelihood of a pandemic."
Source
Peter Rabinowitz
University of Washington School of Public Health
"It's really an unprecedented outbreak. The number of countries involved, the number of different types of animals involved, both birds and mammals, is something we've absolutely never seen before."
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Chris Walzer
Executive Director of Health, Wildlife Conservation Society
"As we continue to monitor the death of innumerable species and track the movement of highly pathogenic avian influenza (HPAI) into mammal populations, we must strengthen the focus on integrating the surveillance of emerging influenza clades in wild birds and mammals to support critical vaccine libraries.
H5N1 now presents an existential threat to the world’s biodiversity."
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Raina MacIntyre
Kirby Institute
"There has never been a time in the history of HPAI where the risk of a human pandemic is more concerning than it is now."
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Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"H5N1 is an influenza infection, predominantly started in poultry and ducks and has spread effectively over the course of the last one or two years to become a global zoonotic – animal – pandemic. The great concern, of course, is that in doing so and infecting ducks and chickens - but now increasingly mammals - that that virus now evolves and develops the ability to infect humans. And then critically, the ability to go from human-to-human transmission."
Source
Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"The mortality rate is extraordinarily high because humans have no natural immunity to the virus"
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Vivien Dugan
Director of the influenza division of the Centers for Disease Control and Prevention (CDC)
"It’s probably why I’m not sleeping very much right now.
I think that the threat of a pandemic is always looming in the flu space. The way that Dan Jernigan always described public health to me is that it is an art form. There’s a balance that you have to strike. There’s a difference in the pandemic risk versus the immediate risk right now. And so I think that’s what we’re trying to message to the average person who is walking about and living their lives. The risk to them is low.
But you’re right. It could absolutely change."
Source
Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"You can’t just take the virus and the biological surveillance and divorce it from the environment and the social construct that it’s happening in. That’s the reality."
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Jennifer Nuzzo
Director of the Pandemic Center at the Brown University School of Public Health
"The bigger picture is that this virus is not cooling off. We’ve been worrying about this virus for 20 years, more than 20 years. And in the last year, it has really been remarkable in how far across the globe it has been spreading and how many species it’s been affecting."
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Paul Digard
Roslin Institute
"Flu is constantly evolving, and it is clear that a couple of years ago, the current strain of bird flu changed to become supercharged. Now that it seems to be fairly widespread in the cow population in the US, that’s a much more direct route where it could transmit to people and gain the adaptations it needs to go pandemic."
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Nancy Cox
Former director of the influenza division of the Centers for Disease Control and Prevention (CDC)
"One can see so many potential problems on dairy farms. There are the asymptomatic infections in cows and perhaps people. There are the cows, the dogs, and the cats, and the other farm animals including perhaps pigs, the farm workers, and the family members and so on. It is going to be very challenging to get a clear picture of what is actually happening in anything like real time."
Source
Jonathan Pekar
University of California
"The infrastructure we have in place is insufficient to prevent future pandemics."
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Rafael Medina
Emory University School of Medicine
"It’s present at such a high levels in nature, the potential of spilling over into domestic animals is something that shouldn’t surprise us anymore"
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Michael Ryan
Executive Director of the World Health Organization (WHO) Health Emergencies Programme
"You can’t just press the button and begin producing pandemic H5 vaccines. You have to stop producing your seasonal vaccine, and all of you out there know how lifesaving that vaccine is."
Source
Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"If we haven’t caught the virus before it mutates to efficiently transmit person-to-person, all bets are off in terms of being able to control it."
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Tom Inglesby
Director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health
"What we don’t know about flu is exactly when the next flu
pandemic will occur, but I think all flu virologists and
public health experts believe that it’s a matter of time."
Source
Amesh Adalja
Johns Hopkins University
"Everyone knows the cell-based vaccines are better, more immunogenic, and offer better production. But they are handicapped because of the clout of egg-based manufacturing."
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Michael Worobey
University of Arizona
"Our whole system is reactive rather than proactive and, if there is any problem in the world you need a proactive approach for, it is preventing pandemics. We need to assume this is going to start spreading in humans and building up stockpiles of vaccines that can be deployed."
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Kelley Lee
Simon Fraser University
"I would say the short answer is no, we're not anywhere near prepared. And indeed, in some ways, I think we're worse prepared than we were prior to COVID-19."
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Amesh Adalja
Johns Hopkins Center for Health Security
"There's been some mild mammalian adaptation here and there, but not enough to change the public health threat."
Source
Seema Lakdawala
Emory University
"Nobody, no one, absolutely nobody, wants another pandemic. We really need to take a moment and do everything we possibly can right now to prevent it."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"There are just so many things we don’t know, and it’s the unknowns that concern us more than what we know so far."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"While the reduction doesn’t mean the Texas virus will be fully resistant to Tamiflu, it is a clear indication that the virus has reduced susceptibility. Most likely it would take a higher treatment dose or a longer duration of treatment with Tamiflu to be able to treat someone with this H5N1 virus, but more testing is needed. At this point, we cannot rest comfortably that what we have in the stockpile will be sufficient or even adequately effective against H5N1 viruses in people."
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Brandon Brown
UC Riverside School of Medicine
"Some of the trust in public health has been broken due to inconsistent messaging from different levels of government."
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Seema Lakdawala
Emory University
"I am extremely concerned that we are on the brink of this being really already in humans—and once it's in humans, it is going to be a real problem to control. I will tell you that what has been driving me the past few months is trying to prevent H5 from becoming a pandemic…I have never felt that we were as close as we are now."
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Maria Van Kerkhove
Acting Director of Pandemic Preparedness and Prevention of the World Health Organization (WHO)
"The idea that we would have a flu pandemic anytime soon, I think the weight of that politically, economically, in terms of all of our mental health, is just too much to bear at the moment. Everyone’s tired from Covid, everyone’s tired from Mpox, everyone’s tired from climate change and war and all that. But right now, we don’t get to be tired."
SourceJennifer Nuzzo
Director of the Pandemic Center at Brown University School of Public Health
"Being worried is not a protective action."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"This virus is out of control. It is time for urgent and serious leadership and action to halt further transmission and mutation. The concept of letting it burn out through food animals, with unmonitored voluntary testing, has failed. There are pandemic playbooks that we need to dust off and begin to implement."
Source
Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"This is an unprecedented outbreak that we see now in domestic mammals. It's in dairy cattle, it’s in cats, it's in mice, and now it's spilling over from those animals, those domestic mammals, back into birds. It's affecting marine wildlife as well—and more people."
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Maurice Pitesky
University of California, Davis
"It's too complex now. Now it's in urban wastewater, it's in wild mammals. It's in dairy cows. It's in song birds. It's in waterfowl and shore birds. It's in marine mammals... We've never had anything like this before at a species level, at a geographical level, and at a food security level. Wow."
Source
Isabella Monne
Head of the viral genomics and transcriptomics laboratory at the Istituto Zooprofilattico Sperimentale delle Venezie
"Increasing genetic diversity and geographical distribution of HPAI H5N1 viruses may result in more spillover events in mammals posing great risks not only to the poultry industry but also to wildlife conservation and to human health."
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Victor Dzau
President of the United States National Academy of Medicine of the United States National Academy of Sciences
"Influenza viruses are zoonotic in origin and mutate rapidly, regularly creating novel viruses in humans, but the public tends to downplay the seriousness of influenza owing to its seasonal nature and conflation with the common cold. These factors, taken together, have led many experts to believe it is almost certain the world will experience a major influenza pandemic."
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Andy Ramey
United States Geological Survey
"What we’re dealing with now is a scenario that we haven’t dealt with in the past. And so there’s no manual."
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Paul Keim
Former Chair of the National Science Advisory Board for Biosecurity (NSABB)
"I can't think of another pathogenic organism that is as scary as this one."
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Robert Redfield
Former Director of the Centers for Disease Control and Prevention (CDC)
"People ask me what keeps me up at night. And the thing that keeps me up at night is just what you brought up, pandemic flu. So I think it's very possible. And we're at risk for another pandemic."
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Ron Fouchier
Erasmus University Medical Center
"We’ve never seen such a massive spread of virus in wild birds, and we’ve never seen such massive infections of wild mammals."
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Victor Dzau
President of the United States National Academy of Medicine of the United States National Academy of Sciences
"The devastating potential and likelihood of occurrence of a major influenza pandemic are frightening."
SourceLawrence Gostin
Georgetown University
"Pigs can get avian flu but until recently cattle did not. They were infected with their own strains of the disease. So the appearance of H5N1 in cows was a shock. It means that the risks of the virus getting into more and more farm animals, and then from farm animals into humans just gets higher and higher. The more the virus spreads, then the chances of it mutating so it can spread into humans goes up and up. Basically, we are rolling the dice with this virus."
Source
Katelyn Jetelina
University of Texas Health Science Center
"The government has confirmed that tools such as Tamiflu would work to a certain extent against H5N1. Of course, Tamiflu is not very effective even against our seasonal flu. We also have stockpiled H5N1 vaccines that are predicted to have efficacy if this does move to humans, which is great news.
But there are still a lot of unanswered questions: What about manufacturing and supply? What about the rest of the globe? What about vaccine hesitancy and declining trust and access problems?"
Source
Nathalie MacDermott
King's College London
"I know that COVID was very hard for people and we want to believe we can just go back to normal and I understand that entirely. But the next pandemic is around the corner - it might be two years, it could be 20 years, it could be longer - but we can't afford to let our guards down. We need to stay vigilant, prepared and ready to make sacrifices again"
Source
Angela Rasmussen
University of Saskatchewan
"If you have a virus that’s hopscotching back and forth between cows, humans and birds, that virus is going to have selective pressures to grow efficiently in all those species."
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Jennifer Nuzzo
Director of the Pandemic Center at Brown University School of Public Health
"We still seem to be stuck in reactive mode. We shouldn't be waiting for evidence that the virus is devastating us. We should be trying to act now to prevent the virus from devastating us."
Source
Michael Worobey
.University of Arizona
"We absolutely should be hoping for the best, but planning for the possibility that this is going to be able to transmit human to human, and has the potential of becoming a pandemic virus."
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Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"That’s my concern; that we’re in slow motion watching something which may never happen but if it were to happen, would we look back and say, ‘Why didn’t we do more?’"
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Thomas Peacock
The Pirbright Instititute
"There’s not a huge amount of information coming through, or it’s coming through very slowly. From a pandemic-potential perspective, to try and understand how bad this is and what’s going on, it’s frustrating."
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Bill Hanage
Harvard T.H. Chan School of Public Health
"Even though I don’t think there’s reason to believe a pandemic is imminent right now, we will have another flu pandemic at some point, and we should be ready for it. Not having a plan is just beyond stupid. Don’t panic, do prepare."
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Tom Inglesby
Director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health
"Even when we get flu vaccine in a
pandemic in the future, presuming we do successfully
create a vaccine, there would still be the problem of
mass manufacturing the vaccine, and distribution of
it."
Source
Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"Once those roosters and hens go down, you have no vaccine."
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Nicole Lurie
Former Director of the Administration for Strategic Preparedness and Response (ASPR)
"A lot of that manufacturing capacity is also already spoken for by high-income countries. Nobody is currently making an advance market commitment on behalf of low-income countries for a pandemic flu vaccine."
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Michael Worobey
University of Arizona
"This is months and months of this virus getting better at infecting mammalian cells. It is months and months of exposure of humans to millions of dairy cattle that exist across the country. Damn it, we are not getting better at these things. In many ways, we are getting worse. We have lost how many months preparing for the possibility that we will need vaccines."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"This H5N1 outbreak is a warning. The report of respiratory symptoms is not a good sign, and this is not a good way to prevent a pandemic."
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Nita Madhav
Senior Director of epidemiology and modeling at Ginkgo Biosecurity
"The more it spreads within mammals, that gives it more chances to mutate. As it mutates, as it changes, there is a greater chance it can infect humans. If it gains the ability to spread efficiently from person to person, then it would be hard to stop."
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Shayan Sharif
University of Guelph
"You have to have global endeavors to vaccinate almost everyone on the face of the planet. So we need to have plans in place for not only vaccinating Canadians, but also vaccinating the entire world."
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Michael Osterholm
Director of the Center for Infectious Disease Research and Policy at University of Minnesota
"I’ve been a student of this virus. And I surely have been amazed at how it’s changed over the course of the last 20-some years, but at the same time, you know, I’m looking for evidence that it is likely to become a virus infecting humans and then transmitted by humans to other humans. And we just haven’t seen that yet."
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Ron Fouchier
Erasmus University Medical Center
"If this virus becomes enzootic in cows, it could well cause massive damage to human and animal health in the longer term. I would find it unacceptable if authorities in the U.S.A. and/or the sector do not try to eradicate this new disease in cows a.s.a.p. If this is not deemed possible, I think the entire world would like to see the evidence and arguments."
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Tony Moody
Duke University Medical Center
"The thing CDC and others are looking for is evidence of infection passing between people -- that would be the trigger."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"I think our government officials are not doing the thorough investigation they should be doing. I think they are continually minimizing this outbreak and this virus."
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Marcela Uhart
UC Davis School of Veterinary Medicine
"High pathogenicity H5N1 is a real, tangible threat to wildlife, of a magnitude and scale never seen before."
SourceKeith Poulsen
Director of the Wisconsin Veterinary Diagnostic Laboratory
"We’ve built a system that could respond to infectious outbreaks like this but we’re not really using it. It’s baffling."
SourceJesse Goodman
Georgetown University School of Medicine
"It is highly concerning that this H5N1 strain, compared with prior ones, has had unprecedented spread among mammals. Although human cases have so far been relatively mild, the threat of a pandemic is real, given the virus’s widespread and continued presence close to humans and its potential to reassort with human influenza viruses or mutate to acquire the ability to transmit among humans."
SourceKay Russo
Veterinarian
"Influenza viruses do not follow our human rules. Instead, they follow the biology defined by a negative-sense, single-stranded, segmented RNA genome and interactions with their environment and hosts. They will not wait for us to work through our politics, our man-made rules, or even our science to exert their damage. They will merely follow their biology. This is a point we humans often fail to recognize, one that allows a virus, such as H5 influenza, to wreak havoc, leaving us in the dust. This is where we went wrong and where we need to do better."
SourceRick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"We have to think about access as well as production. Can we change the vaccines for mucosal delivery, oral delivery, intranasal delivery or transdermal delivery? Can we make the vaccines more room stable, so they don't require cold storage? Can we make the vaccines cross-protective? So that as the virus changes, we're not chasing the virus anymore, but we're out there in front of it with a vaccine that's going to keep it from changing. "
Source
Ian Brown
Scientific Services Director, Animal and Plant Health Agency (APHA)
"That’s the first time in the history of this virus, or group of viruses, that we’ve seen that global spread on such a scale. It’s a gamechanger."
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Keith Sumption
Chief Veterinary Officer, FAO
"The epidemiology of H5N1 continues to rapidly evolve."
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Gregorio Torres
Head of Science Department, WOAH
"There is a recent paradigm change in the ecology and epidemiology of avian influenza which has heightened global concern as the disease spread to new geographical regions and caused unusual wild bird die-offs, and alarming rise in mammalian cases."
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Caitlin Rivers
Johns Hopkins Center for Health Security
"I’m keeping a close eye on it as an expert, but as a member of the community, as a parent and someone who has been recently experiencing the COVID-19 pandemic, I’m not worried about this right now. This is an animal health issue right now that has a theoretical risk to become a human health issue."
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Anthony Fauci
Director of the National Institute of Allergy and Infectious Diseases (NIAID)
"It has the potential to be a major public health threat, but it is unpredictable. So you have to walk that balance of being prepared for something that may not come this year, may not come next year, but sooner or later knowing the history of how pandemic flus evolve over a period of time, over decades and decades, it will occur."
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Bob Gerlach
State Veterinarian, State of Alaska
"It’s not going to go away. It’s going to be here, and we have to have some way to deal with it."
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Richard Webby
St. Jude Children’s Research Hospital
"The more often the virus infects mammals, the greater the risk. It’s a numbers game."
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Jonas Waldenström
Linnaeus University
"It’s hard to contain a virus that’s now on more or less all the continents. There’s no putting the lid on that. It will run its course."
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Jeremy Farrar
Chief Scientist of the World Health Organization (WHO)
"This is a huge concern and I think we have to make sure that if H5N1 did come across to humans with human-to-human transmission, that we were in a position to immediately respond with access equitably to vaccines, therapeutics and diagnostics."
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Marcela Uhart
UC Davis School of Veterinary Medicine
"It is causing a totally unprecedented scale of global spread and mortality. We have never seen anything like this before. It’s killing hundreds of thousands of birds, and tens of thousands of mammals."
SourceAndrew Pavia
University of Utah
"We have better tools and better knowledge about influenza than we did about coronaviruses. In many ways, we would be a step ahead. But what I worry about is our political capacity to respond."
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Monique Eloit
Director of the World Organisation for Animal Health (WOAH)
"Over the last few months, we have had a whole series of diverse and varied mammals. It is worrying to see this extension to other species"
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Michael Worobey
University of Arizona
"Eventually the wrong combination of gene segments and mutations inevitably comes along."
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Jessica Leibler
Boston University
"H5N1 is with us. It’s not a virus that’s going to disappear by any means."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"I do not think we are ready with our vaccine enterprise to be able to respond fast enough. There's a lot of gaps in our preparedness response. We don't have prioritization strategy on who to vaccinate first. We don't have distribution plan in place if we need to distribute vaccines. So there's a lot of work that needs to be done."
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Gregory Poland
Director of the Mayo Clinic’s vaccine research group
"There is increasing concern at the scientific and public health levels."
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Nancy Cox
Former Director of the influenza division of the Centers for Disease Control and Prevention (CDC)
"There is an element of unexpected robustness and malleability that has surprised even seasoned influenza watchers."
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Michael Worobey
University of Arizona
"If we’re going to be serious in the U.S. and as a global community about trying to prevent pandemics that we can prevent, then this is not the way to do that."
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Mia Kim Torchetti
Director of the Diagnostic Virology Laboratory (DVL) at the National Veterinary Services Laboratories (NVSL)
"I have rapidly lost hope."
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Jesse Goodman
Director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University
"You have to be totally conscious that, especially when you get to a global scale, it’s syringes, it’s needles, vials. It’s the capacity to fill and finish the vaccine. We don’t have that at global scale and most of it, like the antigen, or much of it is concentrated in better-off countries."
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Matthew Miller
Co-Director of the Canadian Pandemic Preparedness Hub at McMaster University
"All of our efforts need to be focused on preventing those events from happening. Once we have widespread infections of humans, we're in big trouble."
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Thomas Gillespie
Emory University
"You can find this trend around the world, almost anywhere you look. This virus has an extremely broad range of hosts that it is able to infect."
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Nicole Lurie
Former Director of the Administration for Strategic Preparedness and Response (ASPR)
"Another question is how big a dose of vaccine you would need. H5N1 isn't something human populations have really been exposed to before, and at least with tests involving traditional vaccines, it takes a lot of vaccine to get a decent immune response. mRNA vaccines are already pretty reactogenic; they are associated with a bunch of mild, but common side effects. So, we don't know how mRNA will fare if big doses are needed."
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Richard Webby
St. Jude Children’s Research Hospital
"If there's a pandemic, there's going to be a huge demand for vaccine."
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Raina MacIntyre
Kirby Institute
"We did learn that we can develop a new vaccine very quickly if we all work together … and there are a lot of scientific advances on the horizon that I think would make us more prepared. But this is a really a population health challenge. It needs society to work together. If you have everybody hoarding toilet paper or masks or just looking out for themselves, that doesn't actually help them, because the virus continues to circulate."
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Jennifer Nuzzo
Director of the Pandemic Center at Brown University School of Public Health
"When extraordinary things happen, a common psychological response is to deny it. ‘It can’t be happening.’"
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Robert Redfield
Former Director of the Centers for Disease Control and Prevention (CDC)
"Once the virus gains the ability to attach to the human receptor and then go human to human, that’s when you’re going to have the pandemic. And as I said, I think it’s just a matter of time."
Source
Jennifer Nuzzo
Director of the Pandemic Center at Brown University School of Public Health
"We’re flying blind."
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William Schaffner
Former Medical Director of the National Foundation for Infectious Diseases
"Antiviral drugs are not miracle drugs."
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Thijs Kuiken
Erasmus University Medical Centre
"My overall concern about this outbreak is that it’s being treated too much as an economic problem and too little as a public health and an animal health problem."
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Julianna Lenoch
National Coordinator of the Wildlife Disease Program of the Department of Agriculture (USDA)
"It's gigantic, the scope and scale of the presence of the disease."
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David O’Connor
University of Wisconsin–Madison
"Whatever time we have, we’re squandering that by not acting more aggressively. It seems like we’re staring at the Titanic and the iceberg, and we’re just waiting to see if the ship turns at the last minute. That’s not a great strategy."
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Maria Van Kerkhove
Acting Director of Pandemic Preparedness and Prevention of the World Health Organization (WHO)
"If we don’t address the incentives and disincentives for dealing with the drivers of spillovers, which include politics, which include financial incentives, which include trade, which include food security, then I think we’re going to continue to struggle to deal with these types of zoonotic viruses."
SourceJames Lawler
Co-Director of the Global Center for Health Security at University of Nebraska
"We should be very concerned at this point. Nobody should be hitting the panic button yet, but we should really be devoting a lot of resources into figuring out what’s going on."
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Sam Scarpino
Northeastern University
"We need to get this thing out of the dairy cow populations, because if it continues to circulate in these populations, it’s just a matter of time before we’re dealing with the big outbreak. We have more than enough evidence now to know that we really need to take decisive action."
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Rick Bright
Former Director of the Biomedical Advanced Research and Development Authority (BARDA)
"With H5N1, the risk is increasing daily."
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Robert Johnson
Director of the Medical Countermeasures Program at the Administration for Strategic Preparedness and Response (ASPR)
"It’s simply not possible, because the virus continually evolves, to have a constant stockpile—a large stockpile—of vaccines."
Source
Ali Khan
University of Nebraska Medical Center College of Public Health
"We need a moonshot project for a universal flu vaccine."
Source
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