The Atlantic Cries Wolf?
How do we navigate risk communications and management for low near-term odds, but eventual near certainty for a pandemic virus emerging?
The Missouri human H5N1 case, lacking a known animal, fomite (raw milk) or human source for infection, has again stirred pandemic speculation in the popular press. The Atlantic today published the following feature piece:
Bird Flu Is Quietly Getting Scarier: Perhaps it’s time to talk about an H5N1 pandemic
I received a LinkedIn comment from a young colleague early this week asking if speculation regarding possible undocumented human to human transmission as a possible etiology for this infection was irresponsible and should be suppressed to prevent public panic. I certainly agree that the CDC director, as an example, would be ill-advised to state publicly that she believed that this case was derived from that route, absent compelling evidence. However, we all walk that fine line between discussing multiple possibilities and risks for onward transmission while also emphasizing the “missing steps” still preventing much wider viral spread. Many people are in total denial regarding any risk of another pandemic; pointing out plausible scenarios can help with effective messaging in my opinion.
The diverse COVID pandemic lessons learned have been colored by the bitter current political environment. We lost many people, but counts can be controversial. We lost economic and educational progress; both are politically charged to measure when balanced against costs of disputed illness and mortality. The result is that we lack consensus on even basic public health measures required for surveillance and response to pandemic influenza. When people minimize or deny that SARS-CoV-2 was a real pathogen that caused illness and death, but only economic and social upheaval, it’s difficult to request that any mandatory steps be taken to measure H5 risks or infections in animals or people.
As a result, I’d predict we are much more likely to under-respond than to over-respond to the H5N1 threat as it develops. It’s a dangerous time for a One Health-centered approach towards zoonotic agents, and for public health authority in general. Individual rights to privacy and possession are ascendent over responsibilities to provide information or materials (samples) for furtherance of objectives judged by regulatory bodies to be for the public good. This is an age-old tension in governance that will self-correct when the common good suffers excessive losses from lack of reasonable cooperation by private interests. In plain terms, we’re likely to lose a lot of people we shouldn’t in the next pandemic, due to inaction or delayed responses brought on by lack of information regarding increasing dangers from the agent(s).
The old H.L. Mencken screed likely applies towards diminished public and animal health authority right now:
The current H5N1 2.3.4.4b B3.13 virus may never reach pandemic mass. Another threat may come out of left field to supplant it. However, our current regulatory environment on both the human and animal side almost guarantees that the next pandemic will be a reality before we successfully plan for it.
Party On!
John