Opinion | If bird flu shows signs of pandemic spread, the U.S. is well prepared – The Washington Post

Its true that the recent spread of bird flu among dairy cows is an enormous concern, as Jeremy Farrar, the World Health Organizations chief scientist, described it last week. While only two people in the United States have contracted this H5N1 strain of the avian flu (one last year and one this month), wider spread could be catastrophic, given that, in past outbreaks, the disease has killed one of every two people who are infected.

But before anyone panics, lets take a step back and look at the facts. Health officials have a plan in the event avian flu becomes the next pandemic. In fact, as Dawn OConnell, the assistant secretary for preparedness and response at the Department of Health and Human Services, told me, the federal government is much better prepared to respond to pandemic influenza than it was for covid-19.

To start, its much easier today to access personal protective equipment such as masks, gowns and goggles through commercial markets than it was before the coronavirus hit. But even if those supply chains are pinched, OConnell said, the Strategic National Stockpile has plenty to provide for farms, health-care systems and other affected entities.

The stockpile also contains the antiviral medication Tamiflu, which works against seasonal flu and is expected to work well against H5N1. Like antivirals for covid, Tamiflu reduces the chance of an influenza infection becoming severe when taken soon after symptoms emerge. Unlike covid treatments, however, Tamiflu can also be given to close contacts of infected individuals to prevent them from falling ill.

OConnell explained there are tens of millions of courses of Tamiflu available in the national stockpile. The federal government has also funded states to build their own stockpiles, which means tens of millions more treatments are available. And this is on top of commercially available Tamiflu, which people can buy at pharmacies with a prescription from their doctors.

Another key preventive measure is vaccines. OConnell, who also oversees vaccine-preparedness efforts, explained that the federal government contracts with three manufacturers that can make avian flu vaccines. Each uses the three platforms approved by the Food and Drug Administration to develop the vaccines: egg-based, cell-based and recombinant. That means if one platform doesnt work, or if one company encounters production problems, there are other options.

Moreover, because quite a few influenza strains have already been identified, the federal government keeps a library of antigens, which are used in vaccines to trigger an immune response to flu viruses. Every year, for the seasonal flu shot, scientists try to predict which strains will be dominant that fall. They then analyze existing antigens, test them against the strains, and select the closest-matching antigens to make that years flu vaccine.

Two antigens in the library appear to match H5N1, OConnell said. The federal government also has adjuvants, the component of vaccines needed to help enhance the bodys immune response to the shot, ready for the bird-flu shot as well.

In fact, the federal government has already developed hundreds of thousands of vaccine doses that are ready to be deployed against the avian H5N1 strain. In addition, they have 10 million doses that need finishing touches, which could be completed within weeks.

If more are needed, there are two options. The first is to make more vaccines using the same technology as seasonal vaccines. OConnell estimates that manufacturers could produce 125 million doses within 130 days. Because the vaccine is a two-dose vaccine, this would only cover a fraction of the U.S. population.

The second option would be to pursue mRNA vaccines, which could be made much faster than the traditional platforms. Even if these vaccines end up not being as effective or as durable as traditional ones, they could be a useful first shot that buys time for additional vaccines to be made.

Of course, there is a third option, which is to scale up vaccine production now. OConnell has a good answer as to why this isnt happening: To make hundreds of millions of doses of avian flu vaccines, manufacturers would have to stop producing seasonal flu shots. This would also takes a lot of extra funding from Congress. Wed have to be sure that we were in a position that it warrants that, she said.

With no evidence of human-to-human transmission, the Centers for Disease Control and Prevention has assessed that the risk to humans is low. Therefore, we have not yet reached the point where ramping up vaccine production is necessary. But if we did, it is reassuring to know that the United States would be in a better place to respond compared with the start of the covid pandemic.

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Opinion | If bird flu shows signs of pandemic spread, the U.S. is well prepared - The Washington Post