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University of Nebraska Medical Center

America’s Infectious-Disease Barometer Is Off

Somehow, the U.S. is both over- and under-reacting to bird flu and other pressing infectious threats.

The Atlantic

he ongoing outbreak of H5N1 avian flu virus looks a lot like a public-health problem that the United States should be well prepared for.

Although this version of flu is relatively new to the world, scientists have been tracking H5N1 for almost 30 years. Researchers know the basics of how flu spreads and who tends to be most at risk. They have experience with other flus that have jumped into us from animals. The U.S. also has antivirals and vaccines that should have at least some efficacy against this pathogen. And scientists have had the advantage of watching this particular variant of the virus spread and evolve in an assortment of animals—including, most recently, dairy cattle in the United States—without it transmitting in earnest among us. “It’s almost like having the opportunity to catch COVID-19 in the fall of 2019,” Nahid Bhadelia, the founding director of Boston University Center on Emerging Infectious Diseases, told me. Yet the U.S. is struggling to mount an appropriate response. Because of the coronavirus pandemic, the nation’s alertness to infectious disease remains high. But both federal action and public attention are focusing on the wrong aspects of avian flu and other pressing infectious dangers, including outbreaks of measles within U.S. borders and epidemics of mosquito-borne pathogens abroad. To be fair, the United States (much like the rest of the world) was not terribly good at gauging such threats before COVID, but now “we have had our reactions thrown completely out of whack,” Bill Hanage, an infectious-disease epidemiologist and a co-director of the Center for Communicable Disease Dynamics at Harvard’s School of Public Health, told me. Despite all that COVID put us through—perhaps because of it—our infectious-disease barometer is broken.

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