To get the price of eggs under control, we first need to address bird flu. New York Times science and global health reporter Apoorva Mandavilli joins host Krys Boyd to discuss the H5N1 virus that has virologists concerned with its rapid evolution. And we’ll hear why poultry producers and dairy farmers are nervous about the future of their livelihoods and their ability to feed the nation.
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Transcript
Krys Boyd [00:00:00] Seasonal influenza, maybe running roughshod over your kid’s school or your office, but it’s highly likely you don’t know a single person who’s been infected with H5N1, also known as bird flu. And even if you did, as far as we know, it can’t be passed from one person to another. So why are some public health advocates sounding alarm bells that we are not doing enough to keep it under control? From KERA in Dallas, this is Think. I’m Krys Boyd. If Covid taught non-scientists one thing about virology, it is that some pathogens can rapidly evolve, gaining the ability to cross over into different species, becoming more or less dangerous to individuals infected and developing new paths of transmission, including from person to person, potentially. That doesn’t seem to have happened yet with this strain of bird flu. But if it does, it is possible we could find ourselves in the throes of another pandemic. Apoorva Mandavilli is a science and global health reporter at the New York Times, where you can read her reporting on bird flu. Apoorva, welcome to Think.
Apoorva Mandavilli [00:01:05] Thanks for having me.
Krys Boyd [00:01:06] When did scientists first become aware of this virus?
Apoorva Mandavilli [00:01:10] It was in the late 1990s. People became aware that there was this virus that seemed to be attacking poultry. It’s a bird flu virus, so that makes sense. But then there were a bunch of cases in Hong Kong, 18, in fact, and six of those people died. So that made people quite nervous, made scientists nervous. They thought this was the new bird flu virus that we really do need to pay attention to. And since then, the virus has sort of gone in and out of view. It’s made some waves here and there. But really, it’s in the last few years that we’ve become very aware of it.
Krys Boyd [00:01:45] And where has it been found? Around the world, is this outbreak in the U.S. more serious than in other places at the moment?
Apoorva Mandavilli [00:01:53] At the moment. Yes, because we’ve had a very concentrated outbreak here and we’ve had a lot of human cases. It’s been around in Asia for, you know, basically since the late 1990s. It’s especially in Southeast Asia and Cambodia and Vietnam, it’s caused a bunch of cases, but most of those have been either one offs or they’ve been, you know, maybe two people in a family. And most of them have been because of very close contact with infected birds. What we’ve been seeing here in the US is a little bit different. You know, we’ve had animal outbreaks in other parts of the world, too. But what we’ve seen here in the U.S. is is a confluence of animal and human diseases in a way that I think no other country has really fully experienced. So this the H5N1 virus came to the U.S. a couple of years ago, but then last year, they found it in dairy cattle and it’s been circulating in dairy cattle ever since. But then also it has jumped into people either from poultry or from dairy cattle. And we’ve had 67 cases. And that that scale of the number of human infections, that has not been seen anywhere else.
Krys Boyd [00:02:58] Is it possible lots of other people have had bird flu but not realized it like felt sick but assumed they had some other garden variety virus that humans get?
Apoorva Mandavilli [00:03:08] It is possible. There are a couple of things about this that seem a little bit odd. Like a lot of the dairy workers who’ve gotten infected have had conjunctivitis but not conjunctivitis like you think of like your, you know, your little child having it like really bad conjunctivitis where the eyes look like they’re hemorrhaging blood a little bit. And that may be because they had milk splash into their eyes when they were milking the cows or something like that. The truth is, we don’t know. So we don’t know if that’s a that’s a trademark sign of this virus infection in every person or just specific to those particular people. But if it’s not if it’s not a trademark symptom and it just functions like all other flu, then absolutely. It’s possible that we’ve had lots of people infected and they’ve been walking around and just not knowing they have had bird flu. We know that’s happened, at least to some extent, because even though testing has been extremely patchy, the CDC did do one test where they looked for antibodies to the virus and they found it in a bunch of farm workers who had not even reported symptoms. So we know that it is actually possible for people to be sick and either be really mildly ill or not even realize it.
Krys Boyd [00:04:16] So you mentioned this conjunctivitis. Are there other typical symptoms that look like other flus that might be available with like, do you get a cough and a fever, that sort of thing?
Apoorva Mandavilli [00:04:26] Yeah, that’s basically what you would expect to see. It’s a respiratory virus like all other flus that we normally deal with. And you’d expect to cause a headache, body ache, fever, sometimes gastrointestinal symptoms. So one of the cases that really made scientists sit up was in Missouri, where somebody with other underlying conditions had come into the hospital for those other things, but they had really strong gastrointestinal symptoms. And so there was some speculation that maybe this person and their household, their housemate, who also got very ill, may have had raw milk, for example. Maybe that is what explains the gastrointestinal symptoms. But, you know, regular flu is also often accompanied by gastrointestinal symptoms. So there’s that. So, yeah, it acts very much like your typical flu, except that it’s probably a lot more dangerous and the mortality rate is probably a lot, probably a lot higher than for seasonal flu.
Krys Boyd [00:05:20] Are people with flu like symptoms being regularly tested for this strain of bird flu at the moment? Or are there like special circumstances required to trigger that?
Apoorva Mandavilli [00:05:30] Well, it depends. If you’re sick enough that you’ve gone to an emergency room or a hospital to get tested and you test positive for a subtype of flu and H5N1 is one of those then. Now, the CDC is actually asking everybody to automatically subtype all hospitals and labs, to automatically subtype to see if what they have is H5N1. But if you are sick and you’re testing at home with one of those rapid tests and you just get a flu positive, you know, you’re not necessarily going to go and try to find out what kind of flu it is. So in that case, it really depends where that testing is happening.
Krys Boyd [00:06:06] Do the seasonal flu shots that people may have received in the fall have any protective ability against H5n1?
Apoorva Mandavilli [00:06:15] So there’s a short answer and a long answer to that in the short answer. The short answer is no. But people should still get the flu vaccine for other reasons, which I’ll explain in a second. The long answer is it’s possible. So there have been some studies suggesting that even if the flu viruses are very different, there may be components that are similar and that we may benefit from some. You may remember from Covid times hearing about immune cells, T cells, B cells. Maybe there is some immune cell memory that has some cross-reactivity with H5N1. But the reason I said short answer no is because a lot of that long answer to speculation is just that. It’s just speculation. We don’t know for sure. So it’s best to assume we actually probably don’t get any protection from the seasonal flu vaccine. However, the CDC has been working with states where there are reported herds to infected herds to make sure that the farm workers there do get vaccinated for seasonal flu. Because you were mentioning in your intro, you know, the we know about these viruses that can mutate very quickly. Well, flu is amazing at picking up new mutations from other flu viruses. So if somebody were to be infected with both H5N1 and the seasonal flu virus, it’s very plausible that H5N1 would pick up mutations from the seasonal flu virus, which, as we know, is very good at spreading among people, that H5N1 could pick up those mutations and itself also become good at spreading among people. So that is the very big worry that you’ll get the sort of mix and match situation where this new assorted flu virus emerges, that’s H5N1 in all its pathogenic glory, dangerous, but with the same ease of spread among people as the seasonal flu has.
Krys Boyd [00:08:01] Let’s step back here for a minute. What does H5N1 do to birds exactly? Is it often lethal?
Apoorva Mandavilli [00:08:08] It is often lethal. It’s what we call a high pathogenic virus because it does actually have very high degree of of symptoms and of death. It’s often fatal to birds, or at least they get very, very sick. And that’s been the case actually, for lots of other animals. So one thing that’s been very weird about this virus in the last couple of years is that it’s infected a lot of mammalian species. And we know that it’s very dangerous to cats. For example, a lot of cats have died after being exposed to the virus, usually by drinking infected contaminated raw milk. So it is actually very dangerous for a lot of different species, including birds.
Krys Boyd [00:08:49] And how does it spread from bird to bird? Do we know?
Apoorva Mandavilli [00:08:54] Well, it can spread from all of the feces that birds spread everywhere, as we know. And feathers carry a lot of virus. Essentially, when you have birds in very close proximity, like if you think of a borough, a poultry farm where all the birds are in very close contact, they’re all exposed to each other’s material. There’s lots of virus in the air because let’s say they are flapping their wings. There’s virus dispersed that way. So it’s it can spread in a multitude of ways. And we do think that it can spread, you know, through the respiratory pathways because that’s essentially what flu is
Krys Boyd [00:09:29] So, I mean, forgive the question, do birds cough? Do they like get lung congestion the same way humans do?
Apoorva Mandavilli [00:09:36] I don’t know if it’s the same way as humans do, but they do. They do get sick in the same respiratory ways. And I don’t know that they cough necessarily, but they do exhale virus. We know from Covid, remember that you can disperse virus not just by coughing or sneezing, but even just breathing out virus. You can you can have droplets, very tiny droplets come through that way. And when they make their loud sounds, the rooster calls things like that or the clucking, all of those things are going to release virus.
Krys Boyd [00:10:09] What role do we think wild bird populations might have in spreading the virus to domesticated birds?
Apoorva Mandavilli [00:10:18] Huge. I mean, so basically, as soon as we saw this virus in wild birds, I think scientists expected that the virus was going to start spreading. Because one thing that we know wild birds do is they migrate. Right. So they’ve been carrying the virus from place to place. And then because they do tend to have, you know, there’s bird droppings, they drink from the same water, they congregate in the same places. And so there is a lot of cross-reactivity, there’s a lot of jumping off virus from wild birds to domesticated birds. We’ve now seen even backyard flocks, not just big commercial poultry, but even backyard flocks that have been infected. In fact, the one death that we’ve had in this country from bird flu has been it was in somebody in Louisiana who had backyard flock, birds that were really infected and possibly also wild birds. We think he was caring for those sick and dying birds. So there’s a lot of interaction between birds that can lead to the virus jumping around.
Krys Boyd [00:11:19] Is anybody suggesting that people stop keeping backyard flocks?
Apoorva Mandavilli [00:11:24] I don’t think they’ve gone that far yet. But the CDC has made some recommendations about what people should do if they have backyard flocks or if they keep bird feeders, for example, that they should clean the bird feeders regularly or where they should keep the bird, the backyard flocks really clean. And if they see that the flocks are sick, they should call animal services, not try to take care of it themselves, certainly not be in close contact with sick birds. One of the things we know about the virus, too, is that it has some neurological symptoms. So that’s part of the caution is if you see a bird or an animal acting oddly, like walking in a funny way or, you know, doing things that seem odd than that, that’s potentially a sign that the bird or the animal is infected. And so they’ve given those kinds of precautions, but they haven’t gone so far as to say you don’t have backyard flocks.
Krys Boyd [00:12:12] Is this virus as serious when it infects cattle as it is for poultry?
Apoorva Mandavilli [00:12:18] So that’s a good question, but we don’t actually fully know the answer to that. I think the to the best of our knowledge, no, because the rate of mortality has not been as high as it would be in poultry. But I say to the best of our knowledge, because we don’t really know the full range of symptoms in cows or how many cows have died, A lot of this infection information has been kept very quiet because there’s not a good compensation scheme for dairy farms. And so they haven’t really been willing to talk about how big the problem is on their farms or to be open about how long the infection lasted. We know some general things. We know that when cows are infected, their milk production drops. That’s one of the early ways in which we found out that this was a problem. But for example, in California, people have reported seeing dead cows on the side of the road. And because farmers didn’t want to have to deal with, you know, disposing of them and things like that. But we don’t know how widespread that is and what percent of infected cows might have died. I’ve heard again, anecdotally, because we don’t have really good studies or anything like that, that there are there’s an increased rate of miscarriages, you know, spontaneous abortions among cows that were infected and that some cows never fully returned to normal, you know, after they were infected, that they may have maybe one more milking cycle. But it didn’t seem quite as productive milk wise as they had been before. So there are a lot of unknowns. But just purely in terms of death, probably not as bad as in poultry.
Krys Boyd [00:13:50] Apoorva, you mentioned that farmers may not want to report sick cattle because they may not be compensated if they’re required to call those cattle. Is there not a legal requirement when someone’s livestock becomes ill to tell some health official about it?
Apoorva Mandavilli [00:14:08] There is. And veterinarians are also required to report. But, you know, this is like that old chestnut. If you don’t test, you don’t know. You don’t have to report.
Krys Boyd [00:14:17] Yeah.
Apoorva Mandavilli [00:14:18] And, you know, I’ve heard through the grapevine that there are farms that have wanted to know what’s going on but don’t necessarily want to be part of the government chain. And so have gone to private companies. And of course, the private companies will report. I mean, they they do follow the law. And if they find infections, they will report. But there’s just a lack of trust in this entire process where the farm owners don’t feel like their interests will be protected by the government. And, you know, in exchange for being open with their information. And so they just really don’t want to talk about it. I remember a few months ago I talked to one farm owner who has a very small dairy and he you know, he’s really a good soul. He was talking about how, you know, he really believes in public health and he’s all for being transparent with information. But then he said, but, you know, if I had an infected cow on my farm, I don’t know that I would report it. I feel like I would just quietly bury it and not tell anybody because, you know, I think he just felt, as I think a lot of these other farm owners do, that they they have nothing to gain and everything to lose by coming out with it. And maybe they would be branded forever or get on some kind of list with the government. Certainly lose commercial, you know, profits maybe be vilified in the press have people come and, you know, treat them poorly. So I think they’re just worried about a lot of different things. And the positives for them are very few.
Krys Boyd [00:15:44] Have you found farmers who aren’t taking this very seriously, who think this is just the next big thing that everyone is spun up about?
Apoorva Mandavilli [00:15:51] Yes, I have definitely heard that. I think there’s fewer of them as time has gone on. But both farm owners and even state officials who really hope that this is just going to burn itself out. Actually, I should add, federal officials to that. We’ve also heard USDA say that that they really think that, you know, it’s possible to get this under control and that it’s going to the virus is going to burn itself out. And it’s you know, it’s not going to be a permanent problem.
Krys Boyd [00:16:18] There now appear, I think, to be cattle who have been infected with H5N1 possibly more than once. And it looks like subsequent infections seem to be milder. That would sound like good news for farmers. Why does it worry evolutionary biologists?
Apoorva Mandavilli [00:16:35] So I will caveat that and say that I know of one state where that has happened. And if you ask the USDA, they say it has happened nowhere. But I trust the state because I think they have a closer eye on their on their cows. But the reason that’s not great news, if the cows did get infected and they had milder symptoms is, as you pointed out, that’s great news for the farmers if they’re mildly infected the second time around. But what it means is that whatever immunity these cows gained from getting infected the first time is not preventing them from getting infected a second time. And it’s quite possible that they will just keep getting reinfected maybe every few months. And if they are not showing a lot of symptoms, you don’t have a great way of knowing which cows are infected. You don’t have a great way of protecting the people who work with those cows of taking preventive measures. And so the virus can circulate undetected and have lots of opportunities to jump into people undetected and keep mutating. So we’re looking at potentially that word we heard a lot about for COVID endemic, that this virus could become endemic in the dairy cattle population in the country.
Krys Boyd [00:17:42] Among farmers who keep poultry, what do they have to do to stop the spread of bird flu when they detect an outbreak within their flocks?
Apoorva Mandavilli [00:17:52] Yeah, that’s actually quite sad. When they when they detect infections, they end up having to kill all the birds. And so there’s been a lot of massive, massive killings of hundreds of thousands of birds. We’re now in the millions. Overall, you know, since H5N1 first came to the US, I believe we’re now at close to 140 million birds that have been slaughtered. Not all of them are infected. Some were infected and a whole bunch were. It just happened to be part of the same farm and had to be called because they wanted to make sure that the virus didn’t spread. And so it’s a it’s a real commercial disaster for a poultry farm. And they when they did, had an infection. And that’s why we’re seeing egg prices go up. You know, we have fewer and fewer chickens that are able to escape this virus completely.
Krys Boyd [00:18:36] This is a grisly question, but I think it’s important. How does one go about culling a poultry flock? Are they brought to the same slaughter facilities as healthy birds might have been and just killed but not sold for food?
Apoorva Mandavilli [00:18:50] You know, I think I have tried not to know all of the details, but I can tell you that it does involve mass slaughter in a way not not actually chopping off their heads or anything like that. Usually it involves something like gas or but it also does involve a lot of feathers flying in the air. So it’s not the best situation actually, for the people doing the culling. And I’ve heard some stories about very untrained, very young people working in some of these places, doing the cullings. It’s quite dangerous for them because they’re inhaling all of this. The dust, the feathers and all of that from infected birds.
Krys Boyd [00:19:30] Are these folks required to mask or encouraged to wear masks in hopes of protecting themselves?
Apoorva Mandavilli [00:19:37] So they are strongly encouraged to wear masks. They’re supposed to wear masks. There’s nobody enforcing those rules. Farm owners don’t always make them do that. And, you know, a lot of the culling, the lot of the infections in big poultry farms is happening now again, too. But some of it happened in the summer when it was just way too hot for them to wear PPE, you know, when they were in these barns trying to cull these birds, they just could not even tolerate wearing the mask. And the masks are probably going to be useless anyway because they were sweating into them. And as we know, the mice stopped being useful when they were soaked. And so they had these fans going on full blast, which also doesn’t help the feathers circulating. But yeah, they were not wearing masks a lot of the time.
Krys Boyd [00:20:19] I think it was in your reporting that I read, there are farmers who say they and their workers have just been traumatized by this culling like they actually sometimes do care about these animals. And it’s it’s hard for them beyond just the financial implications. It’s hard for them to do this.
Apoorva Mandavilli [00:20:37] I mean, it’s horrifying, right? They’re essentially you know, they’re they normally take care of these birds and then they have to go kill thousands of these birds. And it’s apart from the commercial loss that they have to to take in. It’s it’s killing of animals on a very large scale for no good purpose.
Krys Boyd [00:20:54] And then what’s required for poultry facilities to be cleaned and sterilized after a culling so that farmers can once again raise animals in that facility.
Apoorva Mandavilli [00:21:05] There are a lot of guidelines now. And actually, you know, I’ve talked to people who said poultry industry is very good at doing this now because they’ve been dealing with this kind of thing for a few years. Other farms, like dairy industries, have just not had to deal with this kind of infection. So they’re still learning how to fully decontaminate. You know, if you talk to poultry farmers, they’ll say, for example, that when there’s been an infection, they’re very careful. People who come in have to take off their clothes and wear clothes provided by the farm. And then when they leave, they take off those clothes. It’s all very sort of careful to make sure that nothing comes and nothing goes out. And swine farms are the same way, too. They also are very careful with a lot of this because, again, they’ve had to deal with viruses that really decimate the populations. But that has not always been true of dairy farms. But in this outbreak, they have really learned from poultry farms how to do some of this. You know, we think that the virus, for example, was spreading through contaminated milking machines. And so dairy farms had to learn how to decontaminate them more often. It is not something that’s routinely done after every milking session, for example, but I think they’ve tried to be more careful and every state defers on this on exactly what they require in terms of the biosecurity measures. But they’ve all sort of tried to up their game.
Krys Boyd [00:22:24] Can cattle herds be preserved once a bird flu outbreak takes hold? Does every cattle have to be called?
Apoorva Mandavilli [00:22:33] No, no. There’s not been any calling of your cattle that I know of. There’s the. They’ve just sort of tried to wait it out, wait out the buyers. So what they do is they isolate the herds and then they wait for the infection to go away. And that actually would be valuable information. I don’t know how long it took. What I have heard is that in some cases the herds have been stayed infected for, you know, a month to two months and maybe longer, like maybe 75 days and so on. But they have not been called. I think the the deaths that I described before are either when the cow was extremely ill and had to be put down or, you know, just died because of the infection. But it’s not like poultry where, you know, the second the the flock is infected, you you just called the whole thing.
Krys Boyd [00:23:21] Okay. I want to be clear that I’m not minimizing the suffering in the hazard to people who work in the livestock industry or people who keep livestock at home. But those explanation, those infections can be explained. Have we had a lot of bird flu cases that we don’t know how the person got sick?
Apoorva Mandavilli [00:23:40] Yeah, we have had quite a few. So the Missouri case that I mentioned earlier and the the house, the roommate, family member, whoever it was who shared the house, the home with that person. We don’t know how either of those people got infected. There’s one theory that they got infected at the same time. But from what we don’t know, there’s another theory that one person got infected and then gave it to their housemate. If that’s the case, that’s a person to person transmission. That is actually quite worrying. And we don’t know if that’s the case. In the case of the Louisiana person, we know, for example, backyard. But there was another a 13 year old girl in Canada who got infected with the same subtype that the Louisiana patient got infected with. And we have no idea how she got infected. And she was extremely ill and she did not have, you know, any health problems. She she was obese. But beyond that, she did not have any serious health problems. And yet she was in the hospital with organ failure. She made it. But we don’t know how she got the virus to begin with. And then there have been a couple of cases in California where kids have gotten infected. We don’t know where they got it from. There are enough of those cases that it is quite worrying to not know they didn’t come from an infected border animal, at least that those people know of. And it didn’t come from raw milk. Then where did it come from?
Krys Boyd [00:24:51] When you say raw milk, you’re talking about milk products that people consume that have not been pasteurized. Is that right?
Apoorva Mandavilli [00:24:58] That is correct. Yes, it’s quite a trend in many parts of the country. People like to drink raw milk for all sorts of reasons, including they think that it gives them some immunity from something and that it has nutritious, better nutritious value than pasteurized milk. But raw milk can be quite dangerous. And we know that even before H5N1, there are other pathogens that you can get from drinking raw milk.
Krys Boyd [00:25:20] Right. There are parts of the country where it’s not even legal to sell raw milk. Right.
Apoorva Mandavilli [00:25:24] That’s correct. But again, state by state. So some states are all for it. Some states are not at all. It’s really quite a patchwork.
Krys Boyd [00:25:32] So my understanding is that when you buy a bottle of milk at a store, it’s not like it came from one specific animal, like because it all goes into a tank somewhere. I mean, can we be confident that pasteurization will keep the milk supply entirely safe from bird flu?
Apoorva Mandavilli [00:25:51] And transition is pretty good. I mean, you know, nothing nothing in life is foolproof, right? So but in general, the the temperature at which they pasteurized milk, they’ve tested that now. Early in the outbreak, we didn’t know that for sure. We were sort of hoping that that was the case. But after that, the FDA did actually conduct tests to make sure that the temperature and the duration of time during which we pasteurize is enough to kill the H5N1 virus. And so now, actually, starting in December, which, you know, really almost a year after the outbreak began, the USDA did start to do sort of bulk milk testing of all the the states where they’ve reported herds. And they’re actually doing that even in states that haven’t yet, to make sure that if there is virus that they were detected in this bulk milk and then they can sort of backtrack and figure out where the infection came from.
Krys Boyd [00:26:41] Okay. And just to go back for a minute to this raw milk trend, I’ll confess it’s not a trend that I’m interested in, but I know people who are does. Does milk lose nutrients in the pasteurization process?
Apoorva Mandavilli [00:26:54] I don’t believe that’s true. You know, maybe there’s some magical properties in there that that you might miss out on. But I think the risk from drinking something like that that has lots of bacteria and other things that might hurt you is not worth whatever extra nutrients you might be able to get.
Krys Boyd [00:27:16] So at the moment, Apoorva, we can’t say definitively that a human who gets sick with bird flu can definitely pass the illness on to another human. What makes epidemiologists worry that that could change at any moment?
Apoorva Mandavilli [00:27:32] So you’re correct. At the moment, the virus is still very much adapted to birds. Right. It’s an avian flu. So at the moment it does not have the right machinery it needs to dock itself on to a human cell and do what it needs to do. But there was a study that came out in December in the in a lab setting. I will say that to suggest that all it would take is really one mutation and that the virus could gain that ability. And there have been other studies in the past showing, you know, you need maybe two mutations for it to do this in some sort of efficient way. So that’s not a lot and it’s definitely not a lot for a virus that tends to mutate a lot. So we’re really talking about just a game of chance here. You know, the good news so far is that we haven’t seen it happen in any significant way. We did see that it happened in both the patients I mentioned earlier, the Canadian teenager and the Louisiana patient. The virus changed, mutated to get that kind of ability or it could infect another person. But in both cases, it didn’t actually do that. It did not jump to another person. So it didn’t spread beyond that initial patient, at least that we know of. And so that is good. But what it does tell you is that the virus is capable of these nifty tricks, and it’s just a matter of time, maybe before it finds it does get to that point where it can, you know, be gained those same mutations and also jump to another person and then that then we’re off to the races.
Krys Boyd [00:29:02] Yeah. And in that scenario, I guess the potential for an epidemic or even a pandemic might depend on how contagious the virus was among humans. Why is it that some pathogens, like measles, seem to spread much more easily than others among humans?
Apoorva Mandavilli [00:29:20] It’s a bunch of different factors, including how well the virus thrives in the environment. So some viruses fall apart pretty quickly in the environment and don’t survive for very long, and some can last for quite a long time. Measles, you mentioned that can linger in the air and stay infectious for two hours after somebody who was infected has left the room. That’s not true for a lot of other viruses. They would fall apart long before that. But then there are other viruses that can survive in soil for quite a long time. So, you know, including the polio virus, for example. So it just depends on the the outer shell of the virus, how hardy it is, how long it can exist in the environment, and also how good it is at latching on to human cells. So some of them have proteins that are very good at latching on to human cells and depending on what their what mutations they have, they’re either very efficient at it or not very efficient at it. If you remember all the Covid variants that came through, they became more and more contagious, partly because they got better at airborne transmission, at surviving in the air and spreading through the air. But they also got better at some of them, got better at latching on to human receptors. So it really depends on which mutations the virus gets and we know which particular versions of the virus take off. But there’s all different variations of that. And sometimes it depends on things like temperature and humidity. Some viruses do well when it’s hot. Some viruses do well at, you know, other levels of humidity. There are a lot of different factors.
Krys Boyd [00:30:48] Apoorva What is done to eggs that are sold in grocery stores to make them safe to consume? Are they pasteurized?
Apoorva Mandavilli [00:30:59] They are not pasteurized, but I believe they are safe to consume because they have a quite a good system of making sure that no eggs from infected flocks, for example, make it into the system. And to be honest with you, I would say right now, just given what we are facing in terms of bird flu, I would not eat raw eggs. I would definitely cook them and cook them well, just like we make, you know, take precautions with milk to make sure that we’re drinking pasteurized milk, to make sure that what goes into our system, raw eggs, raw meat, all of those things right now, I don’t think are the safest.
Krys Boyd [00:31:35] There is a vaccine, as I understand it, that can protect poultry from bird flu. Why is this not the first line of defense for farmers looking to keep their flocks healthy?
Apoorva Mandavilli [00:31:46] So there’s a lot of disagreement about that. There are some scientists who believe that we should be using that vaccine already and at least vaccinating farm workers who are, you know, a direct line of sight of infection. And some countries are doing that. Finland has done that, for example. But the vaccine that’s in the stockpile was developed quite a while ago before the current outbreak. And so far, it seems like it might still be effective against whatever version of virus we’re seeing. But, you know, it’s not the most effective vaccine, let’s say. First of all, it’s a two dose vaccine and its efficacy is not like it’s not like the 95% you saw with Covid. It’s more like 50, 60%. So when I’ve talked to CDC officials, what they’ve said repeatedly is we’re not there yet. But that’s the kind of, you know, really emergency measure that would be called for if they start to see human to human transmission, for example, And we are not there yet. And also because the virus is changing, you know, the version that’s in the stockpile now, we have not that many. We have a few million doses, which is a drop in the bucket if we were to really need it for the population. But even those doses, like let’s say we didn’t give it to the farmers, we needed to make sure we need to make sure that it is actually extremely effective against this particular version of the virus, whatever is current. And so before it can be given to people, before it can be scaled up in any large way, we’d have to run those tests and make sure that it’s still producing a very strong antibody response against the version of the virus that’s circulating. So that’s a step that needs to happen before the vaccine could be really rolled out. Just farmers again, lots of difference of opinion on that. I think some scientists would certainly say we should have been doing that. And others say, well, agree with the CDC. Not time yet.
Krys Boyd [00:33:39] But what about vaccinating animals themselves? I mean, I can’t imagine the work it takes to, you know, give a shot to 100,000 birds in a flock. But it’s not unheard of, is it?
Apoorva Mandavilli [00:33:50] It’s not unheard of. Other countries do it. I there has always been a lot of reluctance to do that here. There you know, there is a poultry vaccine. But they I’ve heard all these arguments about whether other countries will be willing to accept, you know, chicken products or poultry products from the U.S. if our birds were vaccinated. There’s some inherent resistance to that concept. And the same has been true for cows. You know, I talked to companies in the summer who were ready to go with the dairy with a cattle vaccine. You know, cattle are already vaccinated for lots of things, lots of other diseases that they might get. So it wouldn’t be a big deal to also vaccinate them for H5N1. But the USDA was really dragging its feet, did not want to say go for quite a long time. Now, the trials have finally started. But, you know, but it takes time to test those things. And we’re not anywhere close to actually having those vaccines be ready. And if the Idaho report about, you know, cows being re-infected, for example, is true, and we you know, if we start to see that in other states, I think it’ll become really important to have the vaccine to vaccinate cows, make sure they don’t keep getting infected over and over again.
Krys Boyd [00:35:03] You mentioned that some domestic cats have contracted bird flu, possibly from drinking infected milk. Why is pet food a concern at the moment as a potential source of infection of animals other than poultry and cattle residing on farms?
Apoorva Mandavilli [00:35:18] Yeah. So a lot of the cats that died actually died either in sort of farm type situations or these small facilities where they had poultry and cats and they got it, you know, in that way. But there have been now cases where cats have died after eating raw pet food that that had virus in it. So we’ve had a recall actually already of some raw pet food. And that tells you really, though, that there is virus sort of in all of these populations, you know, in raw turkey meat, whatever the cat food has, if the cats are able to eat that and get sick, the good chance that human food supply also is similarly in. Affected, which is goes back to my point before about we really shouldn’t be eating raw meat. So that particular thing about the virus being in raw pet food and cats getting it that way and dying has actually freaked out. A couple of the scientists I talked to because they think of that as a loophole through which the virus can still get through. Even if we’re doing pasteurization and we’re doing all these other things to try and keep everybody safe, that that’s a way in which the virus can still get through to cats, potentially from cats to their owners and potentially also just raw meat getting to people through human food supply. So it’s that that whole cat angle is actually quite worrisome.
Krys Boyd [00:36:36] I don’t know what your diet is like. I’m curious Apoorva whether doing this reporting causes you to sort of change your day to day habits.
Apoorva Mandavilli [00:36:46] Well, I’m a vegetarian. But my husband and children are not. And they eat everything. And so I’ve just been making sure that they eat meat that is well cooked. I do eat eggs. And I will say I tend to like my scrambled eggs kind of runny, but lately, nope. I want to make sure they’re fully cooked all the way through.
Krys Boyd [00:37:06] Is there some way in order to ensure really scrupulous compliance on the part of farmers that that they could be better compensated for whatever revenue losses they experience when they have to call an animal?
Apoorva Mandavilli [00:37:21] Yeah, I mean, this is the number one question, right? If you if there’s nothing in it for you to do the right thing sometimes and there’s lots of harms, why would you do the right thing? And of course, you would hope that they would do the right thing anyway. But when there’s money involved in livelihoods and families involved, it’s a little bit hard and it’s a little odd to me because, you know, I report on global health also. And it’s it’s one of the first things you ask when you go to a country or when you’re reporting on an outbreak and you see that there are animals involved. You know, you ask what the government is doing to compensate people for being honest about that information and to see that not happening in the U.S. is is quite strange, really, because we are a rich country. But by all of those measures of comparison with most of the places that I’ve reported in, you know, I was in Uganda about a year plus ago and there was an anthrax outbreak where cows were dying. And it was it was a very similar situation where nobody wanted to let on that their cows were infected. And it became very obvious very quickly that what needed to happen was for those farmers to be compensated, that they needed to say, hey, if you have a cow that dies and you tell us about it, you get X amount of money. And that has not happened here. The USDA did release some amount of money to say, you know, if you test your cows, you test your people, we’ll give you X amount of money, etc.. But the amounts were quite paltry. So, you know, on the order of a couple of thousand dollars and that, I think, did not move the needle.
Krys Boyd [00:38:47] How robust is public health infrastructure at the federal level since the inauguration of President Trump for his second term?
Apoorva Mandavilli [00:38:56] I wish I could answer that for you. I don’t know. You know, everything is on lockdown at the moment. You can’t talk to the CDC. CDC is not allowed to talk to the W.H.O., the World Health Organization. They’re not allowed to talk to any of their other partners. There are many, many organizations that they work with all over the world. They’re not allowed to talk to the people that they give money to to do the work. They’re not allowed to talk to the press. So we don’t actually know what’s going on. A couple of weeks ago, the CDC was supposed to publish a couple of papers on bird flu. Those didn’t get published because they were under this giant communications embargo that was supposed to end. But now it looks like it’s going to go on for indefinitely. They didn’t really name a date. So we don’t have a lot of great sources of information coming from the federal government on what they’re doing. I did hear that there have been meetings between the Trump administration and the outgoing Biden administration on some of these things. They had some conversations about bird flu and what needed to be done. But but as far as you know, the public or the press being able to know, okay, these are the people who are now in charge of this response. These are the people who can answer your questions. Here’s what you can ask. Here’s where we can give you. None of that is going on.
Krys Boyd [00:40:14] I’m not asking you to speculate on the politics behind this, because that is not your beat. But can you think of a reason why any presidential administration would tell public health agencies like CDC to stop communicating with their peers around the world or with the public?
Apoorva Mandavilli [00:40:30] Well, I think it’s a reflection of the overall isolationist America first philosophy. I mean, what publicly they have said is that they want this this pause in communications and funding and everything to make sure that everybody’s aligned with President Trump’s goals and, you know, those executive orders that have been issued. And so that’s the official line. And I think they do really stand by that. On the other hand, you know, infectious diseases, they’re not something that they’re going to wait. You know, bird flu is not going to wait patiently for the 90 day pause to figure out what to do with itself. And so it’s not clear that they have taken that seriously or that they understand the urgency of the situation.
Krys Boyd [00:41:12] So what’s happening within these agencies that have been told not to communicate? Are they sort of quietly working behind the scenes, ready to release information once they’re given the all clear? Or just sitting around waiting.
Apoorva Mandavilli [00:41:26] No, you know, it’s not. You know, as much as the CDC has been maligned, the people on the inside are, for the most part, lovely and very hardworking and really care about the work they do. And they have been working away as much as they’re allowed to. They’re not communicating with their partners. In fact, I’ve talked to some of them who don’t even talk to people they would consider friends because they’re so afraid to cross the line. There’s been no communication, but they are continuing to do their work. And like the bird flu papers, for example, that I said did not come out. I know that the second they are allowed to release those papers, they will it’s you know, they they are doing everything they can to hold the line.
Krys Boyd [00:42:07] The president has announced he is pulling the United States out of the World Health Organization. What does that mean exactly?
Apoorva Mandavilli [00:42:15] So the World Health Organization is a member organization. All of the countries of the world are members. We were to when we have been since 1948. We were one of the founding members. And the way that the W.H.O. works is all of the member countries pay dues and and then some countries also volunteer to pay more on top of that. And in return, you get all the benefits of being part of this global organization that does a lot of good work around the world and keeps on top of, for example, infectious disease outbreaks. So when President Trump said we are going to withdraw from the W.H.O., what that means is he’s basically giving them a one year notice. We have a one year, basically deadline to to completely become not a member of this organization anymore. And what that means is we are no longer privy to the conversations that happen among members. We are no longer part of that global health community where we work together on things like figuring out what the flu vaccine should be this year or, you know, how to manage the Ebola outbreak in Uganda that’s brewing right now, or the Marburg outbreak in Tanzania, and how to protect not just ourselves, but the rest of the world from that flaring out. So we are not a part of that conversation even now because of the communications embargo. And certainly in a year’s time, we will be nowhere in that conversation.
Krys Boyd [00:43:32] Is it reasonable to think the U.S. can simply keep track of health threats as they exist within our own borders and then keep diseases that originate elsewhere from affecting American lives and interests?
Apoorva Mandavilli [00:43:44] We’ve tried that before, didn’t really work very well. We know that travel bans don’t work. At the very best they may delay things by a day. But if a virus is somewhere else in the world, it will find its way here. There’s just way too much travel and back and forth. And usually by the time you even think about putting a travel ban in place, things have already spread. So unless we’re planning to not go anywhere and not let anybody else in and stay locked in for, you know, however long it takes for something to stop, it’s just not a practical option as far as keeping track of it without actually being a part of the global community, I think that’s very difficult. You know, the the reason we know as much as we do is because we are in these conversations with organizations like the W.H.O. and local health ministries. And, you know, you cannot underestimate the amount of information that comes from all of those places. And if we’re not there, if we don’t even have people on the ground and we’re not talking to the people on the ground, the chances that we will actually get accurate information that is actionable is pretty low. And there’s also the goodwill issue. If we are saying we’re not going to pay for this information, we’re not going to pay to be a part of this community. What obligation do any of those countries have to share anything with us? They don’t have to do anything for us, and they don’t have to share their sequences. You know, even China, as much as, you know, much as we know that we did not behave in the best way during the pandemic. They did share the sequence early on during Covid, and that allowed us to develop the vaccine. So what happens when that doesn’t happen next time?
Krys Boyd [00:45:21] Apoorva Mandavilli is a science and global health reporter at the New York Times where you can read her reporting on bird flu and other subjects. Apoorva, thank you so much for making time to talk about this.
Apoorva Mandavilli [00:45:31] My pleasure.
Krys Boyd [00:45:32] Think is distributed by PRX, the Public Radio Exchange. You can find us on Facebook and Instagram and listen to our podcast wherever you get podcasts by searching for KERA Think or you can go to our website think.kera.org. Again, I’m Krys Boyd. Thanks for listening. Have a great day.
